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number. (If this information is not on the election form, contact the claimant by telephone to obtain it. If the claimant does not know his or her OPM claim number, be prepared to provide OPM with the claimant's date of birth and Social Security number). The CE should also furnish his or her telephone number to the OPM representative so that he or she can confirm that the annuity has been suspended. This confirmation should come within 72 hours. If it does not, follow up with OPM. (2) When OPM confirms that the annuity has been suspended, the CE will take action to commence payment of compensation on the periodic roll. The effective date should be the date OPM benefits were suspended, except when repayment of a lump-sum benefit to OPM is necessary. (In this situation, the CE will follow the procedures outlined in subparagraph (5) below.) (3) The CE will then release Form CA-1104, with copies to all parties of interest, advising OPM of the date FECA compensation began, and requesting that OPM transfer the health benefits enrollment and advise OWCP of the total amount of benefits paid by OPM from the effective date of the claimant's election until the annuity was suspended. A copy of the claimant's election form will be enclosed with the original letter to OPM. If there is no retroactive compensation from which to reimburse OPM for benefits paid on and after the effective date of election, the CE should so advise OPM on Form CA-1104 and indicate the net amount of the FECA periodic payment. OPM will then afford the claimant appropriate due process and request offset from continuing FECA payments (see paragraph 6f below). (4) Upon receipt of a reply to Form CA-1104, the CE should take action to pay the claimant retroactively to the effective date of the election, less reimbursement owed to OPM for annuity benefits, and to transfer the claimant's health benefits enrollment to OWCP. The CE will show the claimant's OPM claim number when authorizing payment to OPM on Form CA-24, CA-25 or CA-25a. Under no circumstances should any retroactive compensation be paid until OPM has been reimbursed in full for the benefits it has paid. (5) Where a lump-sum payment has been made to the claimant as part of an alternative annuity under CSRS or as part of the death benefit under FERS, FECA benefits should not be paid until OPM benefits can be fully reimbursed by the claimant or unless the retroactive benefits under the FECA fully cover the lump-sum annuity and OPM benefits. If the claimant has already been placed on the periodic roll and the retroactive compensation is insufficient to reimburse OPM, the case should be referred to National Office for further action. e. On return of Form CA-1105 electing OPM benefits, the CE should take the following actions: (1) If the claimant is not receiving compensation, close the case on Form CA-800, Nonfatal Summary, or Form 105, Fatal Summary, indicating that OPM benefits have been FECA-PT2 Printed: 06/08/2010 528
elected, refer the case to the inactive files; and enter the change of case status in the CMF. (2) If the claimant is receiving compensation, take action to terminate compensation and compute any reimbursement that may be owed by OPM. Release Form CA-1107 to OPM, with a copy of Form CA-1105. This will notify OPM of the election of OPM benefits; advise that compensation benefits have ended and that OPM benefits should begin; inform OPM of the amount of the reimbursement (if any) due OWCP; and provide OPM with the information which will allow them to transfer the claimant's health benefits enrollment (and life insurance enrollment, if applicable) to their rolls. 2-1000-6 Entitlement to Other Benefits Under the FECA 6. Entitlement to Other Benefits Under the FECA. a. Medical Treatment. Regardless of which monetary benefits the claimant elects, any medical treatment required for the effects of the compensable injury will continue to be provided under FECA. b. Schedule Awards. These awards, payable under 5 U.S.C. 8107 for the permanent loss or loss of use of specified members, organs, or functions of the body, are the only FECA monetary compensation benefits payable concurrently within an OPM annuity. These dual benefits are allowable for injuries sustained on or after September 13, 1957. For injuries which occurred prior to that date, an election between these two benefits is required. c. Vocational Rehabilitation. An employee in receipt of OPM retirement benefits is prohibited from receiving vocational rehabilitation assistance under FECA. See FECA ProM No. 27. d. Attendant's Allowance. (1) An employee entitled to total or partial disability benefits under 5 U.S.C. 8105 or 5 U.S.C 8106 who has elected to receive the benefits of the CSRS or the FERS Act may not receive an attendant's allowance under 5 U.S.C. 8111(a) during the time that benefits are being received under one of the retirement acts. (2) When an employee is entitled to a schedule award under 5 U.S.C. 8107, the attendant's allowance is considered incidental to the award and may be paid concurrently with OPM retirement benefits during the period of the award. See FECA ProM No. 72. e. Third-Party Credits. Where a claimant has made a third-party recovery resulting in a credit against the compensation entitlement, and it appears that additional compensation may be paid and medical expenses claimed, compensation payments are calculated and charged against the recovery credit to the case, as are injury-related medical expenses paid by the claimant. This procedure continues until the third-party credit is absorbed. FECA-PT2 Printed: 06/08/2010 529
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LIST OF CHAPTERS PART 2 - CLAIMS (I
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which may be useful to the CE. b. C
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d. Continuation of Pay. An employee
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o. Review of OWCP Decisions. Under
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2-0300 COMMUNICATIONS TABLE OF CONT
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2-0300-4 Regular Correspondence 4.R
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(b) Formal Decision. If a formal de
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If the information requested cannot
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eferred to the NOO for adjudication
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2-0400-6 Requesting Files 6. Reques
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the file. This process should mainl
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2-0400-10 Case Transfers and Loans
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2-0401 AUTOMATED SYSTEM SUPPORT FOR
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names and addresses is optional. By
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PW: Entitled to payment on periodic
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AM/C1: Condition accepted. Up to $1
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full appeal rights, and the adjudic
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B Both A Aggravation 2-0402 SECURIT
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a. Signatures. The CE must review c
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(a) The particular issues about whi
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c. Review by DD. Upon receipt of th
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disposition, a report, enclosing th
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2-0500 CONFERENCING TABLE OF CONTEN
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necessary to identify the official(
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2-0500-6 Senior CE Actions 6. Senio
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2-0500-9 Due Process 9. Due Process
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This chapter outlines the major ste
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(d) Been notified that OWCP will pr
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2-0600-4 Initial Actions 4. Initial
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2-0600-5 Nurse Services 5. Nurse Se
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assess the claimant's environment a
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(4) Timely responses to telephone c
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for guidance in composing such ques
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(4) Only if the CE has taken these
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(1) RS Actions. If the claimant agr
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(3) Absent such a recovery, the OWC
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(c) After any training or other pre
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under way and the CE determines tha
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2-0600 Exhibit 1: Sample Letter to
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2-0600 Exhibit 3: Example of Letter
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2-0600 Exhibit 5: Planning Chart fo
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period, and each new recurrence. a.
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a. QCM Screen. When the QCM screen
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(c) Confirmation of Data. After ent
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(1) NFN*--Referred to Field Nurse.
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2-0601-6 Effect of RTW on QCM Statu
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2-0601 Exhibit 1: Disability Tracki
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SRE Referred to SrCE for Conference
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21. FECA Death Gratuity 4/10 10-06
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. Claimant. The claimant is respons
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2-0700-6 Adjudication 6. Adjudicati
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(3) If the parties lived apart for
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(3) If the child does not begin pos
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Compensation was terminated effecti
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. Dependency Criteria. The test of
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(3) Proof of physical or mental inc
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The CE should prepare a memorandum
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. Employee Status. The $200 payment
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(b) Form CA-1617 should be released
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2-0700-20 Gratuity 20. Gratuity fro
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2-0700 Exhibit 1: Percentages of En
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2-0800-2 Definitions 2. Definitions
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. Employing Agency. The FECA requir
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claimant, the CE should send a copy
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(3) The case must be coded as withd
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entire group of cases must be adjud
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2-0800-10 Investigation 10. Investi
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2-0800-13 Affirmative Defense 13. A
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2-0801 TIME TABLE OF CONTENTS Parag
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5 U.S.C. 8122 on the ground that no
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(4) If a claim is not received by O
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(1) Disappearance During a Period o
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2-0802 CIVIL EMPLOYEE TABLE OF CONT
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2-0802-1 Purpose and Scope 1. Purpo
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(1) The precise time when the worke
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2-0802-8 Contract Job Cleaners Used
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2-0802-13 Volunteer Workers with th
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(1) Whether, prior to the transfer
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. The pay rate for compensation pur
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2-0802-24 U.S. Park Police and Secr
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a participant or crew leader servin
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2-0803 FACT OF INJURY TABLE OF CONT
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2-0803-4 Development of Factual Evi
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2-0804 PERFORMANCE OF DUTY TABLE OF
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time before or after the end of the
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(a) A diagram showing the boundarie
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d. Workers in a Travel Status. (1)
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2-0804-6 To and From Work 6. To and
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(a) The reason the employee was req
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(1) At the time of the injury, the
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(1) Martha G. List, 26 ECAB 200. Em
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duty, the CE may approve the case.
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action taken; and (4) Statements fr
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2-0804-14 Statutory Exclusions 14.
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would justify such disobedience. (c
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(2) The official superior should al
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c. Development. (1) It is the CE's
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such as soliciting new members or c
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c. Performance Ratings. The Board r
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Where an employee asserts that emot
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The Board noted that Cannon was unl
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Since both cases involve procedures
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Ashberry's disability was not compe
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no longer be considered so in light
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2-0804-18 Employing Agency Physical
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f. This matter was initially addres
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compensation would be payable for t
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limited to the period of work-relat
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(6) Certain other kinds of cases re
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(2) A nurse becomes disabled by pul
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the body originally injured is term
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2-0806 OCCUPATIONAL ILLNESS TABLE O
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the following steps, depending on w
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(4) Exposure to and Identification
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While records of past medical treat
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the medical connection between lift
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(b) The medical evidence presented
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2-080 Exhibit 2: Sample Letter to C
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TITLE _____________________________
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eason, you should call or write to
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9. [FREE FLOW IF DESIRED] We may wr
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If you do not understand any part o
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stressful situations in your person
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TITLE FECA-PT2 Printed: 06/08/2010
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I am writing in reference to your c
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We may write directly to a physicia
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2-0806 Exhibit 20: Sample Questions
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TA Amputation TB Back strain TC Con
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(D )Other Disability, Occupational
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a. Traumatic Injury. If an air traf
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2-0807-6 Period of Entitlement 6. P
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d. Return to Duty. The injured empl
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f. The injury was not reported on a
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W = Total number weeks worked P/W =
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COP is paid for the entire period o
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(c) When the physician's report ind
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(a) Assign or detail the employee t
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. Monitoring the Claim. (1) If Form
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(4) If conflicting information appe
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a. Permanent Total Disability (PTD)
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(1) Prior to December 7, 1940. No p
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(2) Impairment due to amputation is
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. Claims for Increased Schedule Awa
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compensation for temporary total di
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Medical. 2-0809-2 Introduction 2. I
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CE is ready to evaluate the evidenc
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the physician with a complete pictu
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(3) Personal habits such as smoking
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games or operating a construction b
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Jane Doe, date of birth 04/06/1965,
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elated to the employee’s duties;
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16. Physical Therapy 04/01 01-06 03
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evaluating the merits of medical re
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situation where ten days earlier th
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each opinion. The value of the evid
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manipulation of the body. They incl
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. The DMA's performance of these fu
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evidence from physicians who have n
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e. In cases involving a preexisting
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(1) The consultant should be asked
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value). Based on the results of thi
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However, if the impartial specialis
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2-0810-13 Exclusion of Medical Evid
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Leanna Garlington, 37 ECAB 849). Re
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(d) A suggested supplier, if any. (
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need for further treatment as detai
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2-0810-18 Transfer of Medical Care
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2-0810 Exhibit 1: Information from
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Dear CLAIMANT NAME: We need the fol
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2-0810 Exhibit 3: General Guideline
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2-0810 Exhibit 5: Sample Paragraph
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2-0810 Exhibit 7: Letter of Warning
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In addition, a primary goal of case
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(3) Release Form CA-1008 and Pamphl
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a. Where disability is present, the
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f. If the evidence obtained as a re
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eligible for disability benefits. A
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f. Physician's estimate of the date
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2-0812 PERIODIC REVIEW OF DISABILIT
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determine the status of dependents
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whether disability is related to th
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earnings or activity is in question
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eferred to the Office of Inspector
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. Suspension of Compensation. OWCP
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certification clauses on the CA-103
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SI Payment/Entitlement Suspension i
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with the return to work effort. CFF
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should be placed in a PN status. OP
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force. 10. If the business has had
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I am writing in follow up to the Fo
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2-0812 Exhibit 6 - Periodic Entitle
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Service. On 03/14/2003, the claiman
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Authorized Medical Care for Substan
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a. OPM's regulations on retention r
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d. To identify cases for early inte
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2-0813-7 Communication Among the CE
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d. Cooperative Agreement. The title
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ehabilitation process. 2-0813-11 Fa
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(2) To reduce compensation in this
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The specificity of the reasons offe
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in conjunction with graded conditio
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(1) Where the claimant cannot perfo
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2-0813 Exhibit 2: Non-Cooperation W
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2-0814 REEMPLOYMENT: DETERMINING WA
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Exhibits 1. Sample Letter to Claima
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. Preliminary Assessment of Positio
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(b) If the attending physician cont
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(3) The employing agency will be as
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e. Payment/Reimbursement of Relocat
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have no appeal rights attached. c.
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were not reported to OWCP or were o
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(3) If the employee can work only p
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this instance the CE will need to e
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d. Unacceptable Reasons for Abandon
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closure of an installation, cessati
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Code, and returns to duty under ret
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If you receive an increase in pay o
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2-0814 Exhibit 3: Sample Letter To
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RATE DATE FOR SCHEDULE AWARDS 01/10
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(1) Kinds of Appointments. The Post
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year, in the teaching profession, w
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(b) Census enumerators; (c) Casual
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The CE should consider these factor
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The greatest of these pay rates wil
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the Department of Veterans Affairs
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degree of expense, hardship, and in
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(2) Basic bi-weekly pay x premium p
Page 477 and 478: 2-0900-9 Computing Daily Pay Rate 9
Page 479 and 480: 2-0900-11 Computing Monthly Pay Rat
Page 481 and 482: The salary for these employees may
Page 483 and 484: 2-0901 COMPUTING COMPENSATION TABLE
Page 485 and 486: 2-0901-2 Related Topics 2. Related
Page 487 and 488: (4) A GS-12 CE or designated CE may
Page 489 and 490: 2-0901-4 Factors in Computing Compe
Page 491 and 492: (3) For schedule award payments, th
Page 493 and 494: (4) Compensation payable for less t
Page 495 and 496: 2-0901-9 Special Determinations 9.
Page 497 and 498: 2-0901-11 Maximum Compensation 11.
Page 499 and 500: payment. a. Beginning Date. Schedul
Page 501 and 502: (3) ( ) (a) is capable of earning (
Page 503 and 504: automatic pay increases. For exampl
Page 505 and 506: claimant to a higher pay rate under
Page 507 and 508: (a) the beneficiary's maintenance,
Page 509 and 510: Letter CA-1208 to the claimant, wit
Page 511 and 512: 01/01/76 4.4 10/10/76 18.96-28.44 9
Page 513 and 514: 01/02/2000 44.98-67.47 224.91-337.3
Page 515 and 516: 10/07/79 144.56 722.78 - (2,891.12)
Page 517 and 518: *Calendar Days 01/01/2001 3.3 365 1
Page 519 and 520: PERCENTAGE TABLE OF SCHEDULE AWARDS
Page 521 and 522: 2-0901 Exhibit 6: Activity Codes AC
Page 523 and 524: 12. Tennessee Valley Authority 02/9
Page 525 and 526: . Death Benefits. When compensation
Page 527: (3) Certification. The CE should ha
Page 531 and 532: (b) If there is accrued compensatio
Page 533 and 534: Centers, and DVA Hospitals. If the
Page 535 and 536: (b) The claimant may be entitled to
Page 537 and 538: d. Obtaining Elections--Educational
Page 539 and 540: (3) The CE must advise the claimant
Page 541 and 542: c. Injuries On and After September
Page 543 and 544: Based on information contained in t
Page 545 and 546: 2-1000-16 Benefits for Judicial Off
Page 547 and 548: (a) Calculate the number of weeks w
Page 549 and 550: I. Claimants must elect between Fed
Page 551 and 552: 2-1000 Exhibit 2: OPM Contact List
Page 553 and 554: When a third party is or may be leg
Page 555 and 556: (6) Ltr. CA-1109, Authorization to
Page 557 and 558: 7. Administration of Third Party Ca
Page 559 and 560: (3) If not accurate or complete, th
Page 561 and 562: the DCE, is urgent should be sent i
Page 563 and 564: (3) Provide the claimant or attorne
Page 565 and 566: for a course of action. All formal
Page 567 and 568: In any other case, where a judgment
Page 569 and 570: (b) 5 percent of the total to be al
Page 571 and 572: To determine the amount to be liste
Page 573 and 574: (6) Section 8133(a) of the FECA pro
Page 575 and 576: (2) The initial demand letter in an
Page 577 and 578: of the employee. The USPS cannot re
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not be referred to the FEEWC until
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FECA-PT2 Printed: 06/08/2010 581
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a. Under 5 U.S.C. § 8127(b) and in
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. Should an application be submitte
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and the requested fee is reduced du
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2-1200 Exhibit 1: Sample Formal Dec
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2-1300 LUMP SUM PAYMENTS TABLE OF C
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2-1300-3 Requests for Lump-Sum Paym
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2-1300-4 Calculating Lump-Sum Sched
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2-1300 Exhibit 2: Sample Appealable
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3. REVIEW BY THE EMPLOYEES' COMPENS
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SIGNATURE _________________________
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We have received your request for a
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2-1400 DISALLOWANCES TABLE OF CONTE
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2-1400-1 Purpose and Scope Purpose
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a. Initial Disallowances. Such disa
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(1) Failure to Appear for Medical A
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(1) The name and location of the em
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injury caused no disability for wor
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(3) A specific service which the cl
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2-1400-7 How to Issue Pre-Terminati
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(a) The case is being referred beca
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(a) Compensation is being terminate
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. Source of Advice. District office
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usual rate, i.e., 75 percent of the
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objective findings to support your
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2-1400 Exhibit 3: Sample Notice of
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2-1400 Exhibit 4: Sample Letter Con
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2-1400 Exhibit 6: Sample Notice of
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2-1400 Exhibit 8: Sample Letter Con
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2-1400 Exhibit 10: Sample Letter De
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2-1500 RECURRENCES TABLE OF CONTENT
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(d) Closure of a base or other faci
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(1) The medical evidence needed to
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c. Case Management. The CE should c
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emains the same regardless of wheth
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2-1600 REVIEW PROCESS TABLE OF CONT
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c. Formal Decision. Chapter 2-1400
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the request. H&R will acknowledge r
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spouse or child prevents his or her
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OWCP shall pay fees requested by wi
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2-1601-9 Cases Returned from H&R 9.
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2-1601 Exhibit 2: Sample Letters Ac
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Exhibit 3, page 1 of 3: Hearing Not
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Exhibit 3, page 3 of 3: Hearing Ins
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2-1601 Exhibit 5: Request for Comme
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2-1602 RECONSIDERATIONS TABLE OF CO
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2-1602-2 Policy 2. Policy. The foll
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d. Decision. An untimely applicatio
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percentage of the award under the S
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(2) The cover letter to the agency
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2-1602 Exhibit 1: Sample Letter Ret
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Dear CLAIMANT NAME: We have reviewe
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2-1602 Exhibit 5: Sample Compensati
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2-1603 APPEALS TABLE OF CONTENTS Pa
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d. Timeliness of Filing. A person r
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2-1603-6 Cases Returned to District
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2-1700 SPECIAL ACT CASES TABLE OF C
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2-1700-4 Peace Corps 4. Peace Corps
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(2) Staff Spouses. (a) The spouses
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Compensation for loss of wages may
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(3) Return from Service Abroad. d.
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Section 5 U.S.C. 8101(4), which pro
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(1)While at a Job Corps Center, an
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(1)Enrollees are required to report
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coverage under 5 U.S.C. 8101. b. Co
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2-1800-2 Authority 2. Authority. Ho
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determined by the type of vehicle,
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greatest current fair market value
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Such certification from an architec
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over $10,000, and that amount must
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2-1800-7 Housing Modifications for
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send an approval letter along with
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By signing this agreement, all part
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By signing this agreement, all part
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Memorandum of Agreement - Modificat
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Memorandum of Agreement - Housing M
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