Printing - FECA-PT2 - National Association of Letter Carriers

2-0600-4 Initial Actions
4. Initial Actions. This paragraph describes the actions required as soon as it is clear that the
employee will not return to duty within the time specified by the attending physician or the medical matrix
(see MEDGUIDE in Folioviews). PM Chapter 2-0811 addresses early management of disability claims in
detail. Except for catastrophic injury, case management should begin with receipt of the first claim for
wage loss (as opposed to a claim for leave repurchase, a schedule award, etc.) The CE should take the
following steps whether the period claimed is continuous or intermittent:
a Adjudication. The CE should adjudicate the case if necessary and possible. The evidence
needed to adjudicate a traumatic injury case which was closed short form (accepted condition code
"C") may appear in file already. If not, request it promptly.
It is recognized that adjudication and payment of occupational illness claims may need to await
additional development of the evidence (see PM Chapter 2-0806 for a development of occupational
illness claims, and PM Chapter 2-0401 concerning deferral of payments).
b. First Payment of Compensation. The CE should then set up a compensation payment for
the period supported by evidence from the attending physician or the medical matrix (see
MEDGUIDE in Folioviews). This payment may be made on the daily roll. The only cases which may
be placed on the periodic roll right away are those involving severe injury (e.g., multiple fractures
or paralysis), and where the projected return to duty date (if any) is over 90 days away. Enter the
projected return to duty date (whether light or full) in the QCM Tracking System.
c. Inquiry About Return to Work. The CE should call the claimant to advise that a payment is
being made, and find out whether he or she has returned to work. If not, ask whether he or she
has a plan to do so. Document the claimant's responses on Form CA-110. (At district office
option, the Staff RN may make this call using a list of cases where a first payment of compensation
for wage loss has just been made. The nurse should record the results on Form CA-110.)
(1) If the claimant has returned to full duty, enter the return to work date in the QCM
Tracking System. No further case management action is needed unless a claim for
recurrence is filed (see paragraph 6g below).
(2) If the claimant has returned to modified and/or part-time duty, refer the claimant to
an OWCP Staff RN as described in paragraph 5 below.
(3) If the claimant states a plan to return to duty, and the date appears to be realistic
according to the medical evidence, the medical matrix, or information contained in
MEDGUIDE, set a call-up for the date specified. Call the employing agency on that date to
find out if the claimant has in fact returned to work.
(a) If so, see subparagraphs (1) and (2) directly above.
(b) If not, refer the claimant to an OWCP Staff RN as described in paragraph 5
below.
FECA-PT2 Printed: 06/08/2010 57