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2-0600 CASE MANAGEMENT TABLE OF CONTENTS Paragraph and Subject Date Trans. No. Table of Contents 09/97 97-16 1. Purpose and Scope 11/96 97-04 2. Policy 11/96 97-04 3. Responsibilities of Claims Examiners 11/96 97-04 4. Initial Actions 11/96 97-04 09/97 97-16 5. Nurse Services 11/96 97-04 6. Medical Management 11/96 97-04 7. Referrals for Vocational Rehabilitation Services 11/96 97-04 09/97 97-16 8. Return to Work with Previous Employer 11/96 97-04 9. Ten-Month Letter 11/96 97-04 10. Plan Development 11/96 97-04 11. Return to Work with New Employer 11/96 97-04 12. Case Resolution 11/96 97-04 Exhibits 09/97 97-16 1. Sample of Letter to be Sent to Claimant at Ten Months After Disability Began 10/94 95-02 2. Sample of Letter to be Sent to Claimant when Vocational Rehabilitation Plan is Approved 10/94 95-02 3. Sample of Letter to be Sent to Claimant at Beginning of Placement New Employer Phase 10/94 95-02 4. Request for Extension of Field RN Services 11/96 97-04 5. Planning Chart for QCM Cases (Link to Image) 11/96 97-04 2-0600-1 Purpose and Scope 1. Purpose and Scope. The Office of Workers' Compensation Programs (OWCP) is responsible for ensuring that benefits are promptly paid and that they do not continue after the effects of the work-related condition have ceased. The OWCP is also obligated to help claimants return to duty as soon as possible. FECA-PT2 Printed: 06/08/2010 52
This chapter outlines the major steps in helping claimants to return to work. The procedures address only adjudicated claims. Except for catastrophic injuries, they do not apply to cases where only continuation of pay (COP) is at issue. (Procedures for COP cases are found in PM Chapter 2-0807). FECA-PT2 Printed: 06/08/2010 53
Page 1 and 2: LIST OF CHAPTERS PART 2 - CLAIMS (I
Page 3 and 4: which may be useful to the CE. b. C
Page 5 and 6: d. Continuation of Pay. An employee
Page 7 and 8: o. Review of OWCP Decisions. Under
Page 9 and 10: 2-0300 COMMUNICATIONS TABLE OF CONT
Page 11 and 12: 2-0300-4 Regular Correspondence 4.R
Page 13 and 14: (b) Formal Decision. If a formal de
Page 15 and 16: If the information requested cannot
Page 17 and 18: eferred to the NOO for adjudication
Page 19 and 20: 2-0400-6 Requesting Files 6. Reques
Page 21 and 22: the file. This process should mainl
Page 23 and 24: 2-0400-10 Case Transfers and Loans
Page 25 and 26: 2-0401 AUTOMATED SYSTEM SUPPORT FOR
Page 27 and 28: names and addresses is optional. By
Page 29 and 30: PW: Entitled to payment on periodic
Page 31 and 32: AM/C1: Condition accepted. Up to $1
Page 33 and 34: full appeal rights, and the adjudic
Page 35 and 36: B Both A Aggravation 2-0402 SECURIT
Page 37 and 38: a. Signatures. The CE must review c
Page 39 and 40: (a) The particular issues about whi
Page 41 and 42: c. Review by DD. Upon receipt of th
Page 43 and 44: disposition, a report, enclosing th
Page 45 and 46: 2-0500 CONFERENCING TABLE OF CONTEN
Page 47 and 48: necessary to identify the official(
Page 49 and 50: 2-0500-6 Senior CE Actions 6. Senio
Page 51: 2-0500-9 Due Process 9. Due Process
Page 55 and 56: (d) Been notified that OWCP will pr
Page 57 and 58: 2-0600-4 Initial Actions 4. Initial
Page 59 and 60: 2-0600-5 Nurse Services 5. Nurse Se
Page 61 and 62: assess the claimant's environment a
Page 63 and 64: (4) Timely responses to telephone c
Page 65 and 66: for guidance in composing such ques
Page 67 and 68: (4) Only if the CE has taken these
Page 69 and 70: (1) RS Actions. If the claimant agr
Page 71 and 72: (3) Absent such a recovery, the OWC
Page 73 and 74: (c) After any training or other pre
Page 75 and 76: under way and the CE determines tha
Page 77 and 78: 2-0600 Exhibit 1: Sample Letter to
Page 79 and 80: 2-0600 Exhibit 3: Example of Letter
Page 81 and 82: 2-0600 Exhibit 5: Planning Chart fo
Page 83 and 84: period, and each new recurrence. a.
Page 85 and 86: a. QCM Screen. When the QCM screen
Page 87 and 88: (c) Confirmation of Data. After ent
Page 89 and 90: (1) NFN*--Referred to Field Nurse.
Page 91 and 92: 2-0601-6 Effect of RTW on QCM Statu
Page 93 and 94: 2-0601 Exhibit 1: Disability Tracki
Page 95 and 96: SRE Referred to SrCE for Conference
Page 97 and 98: 21. FECA Death Gratuity 4/10 10-06
Page 99 and 100: . Claimant. The claimant is respons
Page 101 and 102: 2-0700-6 Adjudication 6. Adjudicati
Page 103 and 104:
(3) If the parties lived apart for
Page 105 and 106:
(3) If the child does not begin pos
Page 107 and 108:
Compensation was terminated effecti
Page 109 and 110:
. Dependency Criteria. The test of
Page 111 and 112:
(3) Proof of physical or mental inc
Page 113 and 114:
The CE should prepare a memorandum
Page 115 and 116:
. Employee Status. The $200 payment
Page 117 and 118:
(b) Form CA-1617 should be released
Page 119 and 120:
2-0700-20 Gratuity 20. Gratuity fro
Page 121 and 122:
2-0700 Exhibit 1: Percentages of En
Page 123 and 124:
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
Page 129 and 130:
(3) The case must be coded as withd
Page 131 and 132:
entire group of cases must be adjud
Page 133 and 134:
2-0800-10 Investigation 10. Investi
Page 135 and 136:
2-0800-13 Affirmative Defense 13. A
Page 137 and 138:
2-0801 TIME TABLE OF CONTENTS Parag
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5 U.S.C. 8122 on the ground that no
Page 141 and 142:
(4) If a claim is not received by O
Page 143 and 144:
(1) Disappearance During a Period o
Page 145 and 146:
2-0802 CIVIL EMPLOYEE TABLE OF CONT
Page 147 and 148:
2-0802-1 Purpose and Scope 1. Purpo
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(1) The precise time when the worke
Page 151 and 152:
2-0802-8 Contract Job Cleaners Used
Page 153 and 154:
2-0802-13 Volunteer Workers with th
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(1) Whether, prior to the transfer
Page 157 and 158:
. 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
Page 163 and 164:
2-0803 FACT OF INJURY TABLE OF CONT
Page 165 and 166:
2-0803-4 Development of Factual Evi
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2-0804 PERFORMANCE OF DUTY TABLE OF
Page 169 and 170:
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
Page 181 and 182:
(1) Martha G. List, 26 ECAB 200. Em
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duty, the CE may approve the case.
Page 185 and 186:
action taken; and (4) Statements fr
Page 187 and 188:
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
Page 201 and 202:
The Board noted that Cannon was unl
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Since both cases involve procedures
Page 205 and 206:
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
Page 225 and 226:
Page 227 and 228:
the following steps, depending on w
Page 229 and 230:
(4) Exposure to and Identification
Page 231 and 232:
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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2-0806 Exhibit 3: Sample Letter to
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TITLE _____________________________
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Page 245 and 246:
eason, you should call or write to
Page 247 and 248:
Page 249 and 250:
9. [FREE FLOW IF DESIRED] We may wr
Page 251 and 252:
Page 253 and 254:
Page 255 and 256:
If you do not understand any part o
Page 257 and 258:
Page 259 and 260:
Page 261 and 262:
stressful situations in your person
Page 263 and 264:
TITLE FECA-PT2 Printed: 06/08/2010
Page 265 and 266:
I am writing in reference to your c
Page 267 and 268:
Page 269 and 270:
We may write directly to a physicia
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2-0806 Exhibit 20: Sample Questions
Page 273 and 274:
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
Page 279 and 280:
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
Page 323 and 324:
evaluating the merits of medical re
Page 325 and 326:
situation where ten days earlier th
Page 327 and 328:
each opinion. The value of the evid
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manipulation of the body. They incl
Page 331 and 332:
. The DMA's performance of these fu
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evidence from physicians who have n
Page 335 and 336:
e. In cases involving a preexisting
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(1) The consultant should be asked
Page 339 and 340:
value). Based on the results of thi
Page 341 and 342:
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
Page 347 and 348:
(d) A suggested supplier, if any. (
Page 349 and 350:
need for further treatment as detai
Page 351 and 352:
2-0810-18 Transfer of Medical Care
Page 353 and 354:
2-0810 Exhibit 1: Information from
Page 355 and 356:
Dear CLAIMANT NAME: We need the fol
Page 357 and 358:
2-0810 Exhibit 3: General Guideline
Page 359 and 360:
2-0810 Exhibit 5: Sample Paragraph
Page 361 and 362:
2-0810 Exhibit 7: Letter of Warning
Page 363 and 364:
In addition, a primary goal of case
Page 365 and 366:
(3) Release Form CA-1008 and Pamphl
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a. Where disability is present, the
Page 369 and 370:
f. If the evidence obtained as a re
Page 371 and 372:
eligible for disability benefits. A
Page 373 and 374:
f. Physician's estimate of the date
Page 375 and 376:
2-0812 PERIODIC REVIEW OF DISABILIT
Page 377 and 378:
Page 379 and 380:
determine the status of dependents
Page 381 and 382:
whether disability is related to th
Page 383 and 384:
earnings or activity is in question
Page 385 and 386:
eferred to the Office of Inspector
Page 387 and 388:
. Suspension of Compensation. OWCP
Page 389 and 390:
certification clauses on the CA-103
Page 391 and 392:
SI Payment/Entitlement Suspension i
Page 393 and 394:
with the return to work effort. CFF
Page 395 and 396:
should be placed in a PN status. OP
Page 397 and 398:
force. 10. If the business has had
Page 399 and 400:
I am writing in follow up to the Fo
Page 401 and 402:
2-0812 Exhibit 6 - Periodic Entitle
Page 403 and 404:
Service. On 03/14/2003, the claiman
Page 405 and 406:
Authorized Medical Care for Substan
Page 407 and 408:
a. OPM's regulations on retention r
Page 409 and 410:
d. To identify cases for early inte
Page 411 and 412:
2-0813-7 Communication Among the CE
Page 413 and 414:
d. Cooperative Agreement. The title
Page 415 and 416:
ehabilitation process. 2-0813-11 Fa
Page 417 and 418:
(2) To reduce compensation in this
Page 419 and 420:
The specificity of the reasons offe
Page 421 and 422:
in conjunction with graded conditio
Page 423 and 424:
(1) Where the claimant cannot perfo
Page 425 and 426:
2-0813 Exhibit 2: Non-Cooperation W
Page 427 and 428:
Page 429 and 430:
2-0814 REEMPLOYMENT: DETERMINING WA
Page 431 and 432:
Exhibits 1. Sample Letter to Claima
Page 433 and 434:
. Preliminary Assessment of Positio
Page 435 and 436:
(b) If the attending physician cont
Page 437 and 438:
(3) The employing agency will be as
Page 439 and 440:
e. Payment/Reimbursement of Relocat
Page 441 and 442:
have no appeal rights attached. c.
Page 443 and 444:
were not reported to OWCP or were o
Page 445 and 446:
(3) If the employee can work only p
Page 447 and 448:
this instance the CE will need to e
Page 449 and 450:
d. Unacceptable Reasons for Abandon
Page 451 and 452:
closure of an installation, cessati
Page 453 and 454:
Code, and returns to duty under ret
Page 455 and 456:
If you receive an increase in pay o
Page 457 and 458:
2-0814 Exhibit 3: Sample Letter To
Page 459 and 460:
RATE DATE FOR SCHEDULE AWARDS 01/10
Page 461 and 462:
(1) Kinds of Appointments. The Post
Page 463 and 464:
year, in the teaching profession, w
Page 465 and 466:
(b) Census enumerators; (c) Casual
Page 467 and 468:
The CE should consider these factor
Page 469 and 470:
The greatest of these pay rates wil
Page 471 and 472:
the Department of Veterans Affairs
Page 473 and 474:
degree of expense, hardship, and in
Page 475 and 476:
(2) Basic bi-weekly pay x premium p
Page 477 and 478:
2-0900-9 Computing Daily Pay Rate 9
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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.
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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
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10/07/79 144.56 722.78 - (2,891.12)
Page 517 and 518:
*Calendar Days 01/01/2001 3.3 365 1
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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 and 528:
(3) Certification. The CE should ha
Page 529 and 530:
elected, refer the case to the inac
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
Page 579 and 580:
not be referred to the FEEWC until
Page 581 and 582:
FECA-PT2 Printed: 06/08/2010 581
Page 583 and 584:
a. Under 5 U.S.C. § 8127(b) and in
Page 585 and 586:
. Should an application be submitte
Page 587 and 588:
and the requested fee is reduced du
Page 589 and 590:
2-1200 Exhibit 1: Sample Formal Dec
Page 591 and 592:
2-1300 LUMP SUM PAYMENTS TABLE OF C
Page 593 and 594:
2-1300-3 Requests for Lump-Sum Paym
Page 595 and 596:
2-1300-4 Calculating Lump-Sum Sched
Page 597 and 598:
2-1300 Exhibit 2: Sample Appealable
Page 599 and 600:
3. REVIEW BY THE EMPLOYEES' COMPENS
Page 601 and 602:
SIGNATURE _________________________
Page 603 and 604:
We have received your request for a
Page 605 and 606:
2-1400 DISALLOWANCES TABLE OF CONTE
Page 607 and 608:
2-1400-1 Purpose and Scope Purpose
Page 609 and 610:
a. Initial Disallowances. Such disa
Page 611 and 612:
(1) Failure to Appear for Medical A
Page 613 and 614:
(1) The name and location of the em
Page 615 and 616:
injury caused no disability for wor
Page 617 and 618:
(3) A specific service which the cl
Page 619 and 620:
2-1400-7 How to Issue Pre-Terminati
Page 621 and 622:
(a) The case is being referred beca
Page 623 and 624:
(a) Compensation is being terminate
Page 625 and 626:
. Source of Advice. District office
Page 627 and 628:
usual rate, i.e., 75 percent of the
Page 629 and 630:
objective findings to support your
Page 631 and 632:
2-1400 Exhibit 3: Sample Notice of
Page 633 and 634:
2-1400 Exhibit 4: Sample Letter Con
Page 635 and 636:
2-1400 Exhibit 6: Sample Notice of
Page 637 and 638:
2-1400 Exhibit 8: Sample Letter Con
Page 639 and 640:
2-1400 Exhibit 10: Sample Letter De
Page 641 and 642:
2-1500 RECURRENCES TABLE OF CONTENT
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(d) Closure of a base or other faci
Page 645 and 646:
(1) The medical evidence needed to
Page 647 and 648:
c. Case Management. The CE should c
Page 649 and 650:
emains the same regardless of wheth
Page 651 and 652:
2-1600 REVIEW PROCESS TABLE OF CONT
Page 653 and 654:
c. Formal Decision. Chapter 2-1400
Page 655 and 656:
Page 657 and 658:
the request. H&R will acknowledge r
Page 659 and 660:
spouse or child prevents his or her
Page 661 and 662:
OWCP shall pay fees requested by wi
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2-1601-9 Cases Returned from H&R 9.
Page 665 and 666:
2-1601 Exhibit 2: Sample Letters Ac
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Exhibit 3, page 1 of 3: Hearing Not
Page 669 and 670:
Exhibit 3, page 3 of 3: Hearing Ins
Page 671 and 672:
2-1601 Exhibit 5: Request for Comme
Page 673 and 674:
2-1602 RECONSIDERATIONS TABLE OF CO
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2-1602-2 Policy 2. Policy. The foll
Page 677 and 678:
d. Decision. An untimely applicatio
Page 679 and 680:
percentage of the award under the S
Page 681 and 682:
(2) The cover letter to the agency
Page 683 and 684:
2-1602 Exhibit 1: Sample Letter Ret
Page 685 and 686:
Dear CLAIMANT NAME: We have reviewe
Page 687 and 688:
2-1602 Exhibit 5: Sample Compensati
Page 689 and 690:
2-1603 APPEALS TABLE OF CONTENTS Pa
Page 691 and 692:
d. Timeliness of Filing. A person r
Page 693 and 694:
2-1603-6 Cases Returned to District
Page 695 and 696:
2-1700 SPECIAL ACT CASES TABLE OF C
Page 697 and 698:
2-1700-4 Peace Corps 4. Peace Corps
Page 699 and 700:
(2) Staff Spouses. (a) The spouses
Page 701 and 702:
Compensation for loss of wages may
Page 703 and 704:
(3) Return from Service Abroad. d.
Page 705 and 706:
Section 5 U.S.C. 8101(4), which pro
Page 707 and 708:
(1)While at a Job Corps Center, an
Page 709 and 710:
(1)Enrollees are required to report
Page 711 and 712:
coverage under 5 U.S.C. 8101. b. Co
Page 713 and 714:
Page 715 and 716:
2-1800-2 Authority 2. Authority. Ho
Page 717 and 718:
determined by the type of vehicle,
Page 719 and 720:
greatest current fair market value
Page 721 and 722:
Such certification from an architec
Page 723 and 724:
over $10,000, and that amount must
Page 725 and 726:
2-1800-7 Housing Modifications for
Page 727 and 728:
send an approval letter along with
Page 729 and 730:
By signing this agreement, all part
Page 731 and 732:
By signing this agreement, all part
Page 733 and 734:
Memorandum of Agreement - Modificat
Page 735 and 736:
Memorandum of Agreement - Housing M
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