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Example: Federal employee, a veteran, is disabled by or dies from pulmonary tuberculosis. DVA finds that the disease became manifest within the medical presumptive period after military service and grants benefits on the basis of military service connection. OWCP finds that the disability or death resulting from this disease is related to veteran's Federal civilian employment and grants FECA benefits. Employee or his survivors are eligible for both FEC and veterans' benefits for the same disability or death, namely, that resulting from pulmonary tuberculosis. An election is required. (2) The prohibition also extends to an increase in a veteran's service-connected disability award, where the increase is brought about by an injury sustained while in civilian employment. See Louis Teplitsky (22 ECAB 142) and France Marie Kral (24 ECAB 157). Example 1: A Federal employee is receiving benefits from the DVA for 50 percent disability due to a service-connected emotional condition, and has a civilian employment injury which causes a disabling aggravation of the pre-existing emotional condition. OWCP determines that the employee has a total loss of wage-earning capacity due to the emotional condition. Subsequent to the employment injury, DVA increases its award to 100 percent as a result of the aggravation by the civilian employment injury. An election between benefits is required in this case. The election will be between the amount of entitlement under FECA plus the amount received from the DVA for 50 percent prior to his civilian employment injury, on the one hand, and the total amount of entitlement from the DVA for 100 percent, on the other hand. In other words, no election is required between the veteran's benefit the claimant was receiving at the time of the civilian employment injury and the FECA benefits to which the claimant is entitled for the civilian employment injury because these benefits are not payable for the same injury. When the DVA increased its benefits an election was required because the increased benefits were payable because of the same employment injury which formed the basis of entitlement to FECA benefits. Example 2: A Federal employee is receiving benefits from the DVA for 20 percent disability based on a service-connected injury to the right knee. A subsequent injury to the same knee while in civilian employment results in 25 percent disability of the leg, for which FECA benefits are payable. The DVA increases its award to 30 percent because of the civilian employment injury. The election required in this case is the same as that required in Example No. 1 above--i.e., between a schedule award, for the full extent of the permanent loss of the use of the leg under the FECA plus the amount received from the DVA prior to the employment injury, on the one hand, and the total benefits provided by the DVA subsequent to its increase, on the other hand. (a) No reduction in a schedule award is required under 5 U.S.C. 8108 where the DVA has made an award for an earlier injury to the same member (see Example 2 above). It has been determined that the word "injury" as used in 5 U.S.C. 8108 means an earlier injury received while in Federal civilian employment. FECA-PT2 Printed: 06/08/2010 534
(b) The claimant may be entitled to compensation for loss of wage-earning capacity (LWEC) at the expiration of the schedule award (see Example 2 above). If so, an informed election cannot be made until the claimant's LWEC is determined. Thus, two elections are possible and permitted in such cases--the first between the schedule award under the FECA and the veteran's benefit, and the second between compensation for LWEC under the FECA and the veteran's benefit. The conditions of both elections would be as outlined in Example 2 above. (3) The prohibition does not extend to pensions, since Section 5 U.S.C. 8116(a)(2) expressly provides that there is no limitation on the right to receive FECA compensation because of the receipt of a pension for service in the Army, Navy or Air Force. The receipt of a pension from the DVA for a non-service-connected disability or death and the payment of compensation under the FECA is therefore not a prohibited dual benefit, and no election is required. (4) The DVA pays other benefits to veterans and their survivors, which are variously termed compensation, dependency and indemnity compensation, and educational assistance, etc., other than for educational awards. The payment of compensation under the FECA concurrently with such veterans' benefits would constitute a prohibited dual payment only where the veteran's award is based on the finding that the same disability or death for which FECA benefits are payable was caused by the military service. See paragraph 8b above. (5) When several kinds of disability are present, the DVA combines the percentages allowed for each disability (using a method of computation similar to the combined values chart in the AMA Guides to the Evaluation of Permanent Impairment). The resulting percentage is often less than the sum of all impairments. For instance, the veteran may have 40% disability due to one condition, 30% due to a second condition, and 10% due to a third condition, for a total award of 60%. (a) When determining percentages for election, the CE should use the amount of the percentage for the work-related condition only. (b) The amount of the percentage should not be pro-rated to account for use of the combination method. In the example given above, if the work-related condition is the one for which the DVA has granted 40% disability, the entire 40% should be used in determining the amount of the election. (c) For privacy reasons, the DVA may not provide information about percentages of disability for conditions other than the work-related one. The CE may need to contact the claimant directly to obtain a copy of the notice of benefits showing the percentages paid for each disability. c. Educational Benefits. FECA-PT2 Printed: 06/08/2010 535
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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
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2-0900-9 Computing Daily Pay Rate 9
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2-0900-11 Computing Monthly Pay Rat
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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 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: Centers, and DVA Hospitals. If the
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
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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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FECA-PT2 Printed: 06/08/2010 655
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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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FECA-PT2 Printed: 06/08/2010 713
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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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