Printing - FECA-PT2 - National Association of Letter Carriers

2-0601-6 Effect of RTW on QCM Status
6. Effect of RTW on QCM Status. Except as specified in subparagraph c below, QCM procedures apply
to any accepted case where the claimant returns to light-duty work, until the claimant returns to the job
held on the date of injury (DOI) or OWCP issues a formal decision regarding the claimant's entitlement.
a. No Claim Filed. Manual entry of a record into the Disability Tracking System will be
necessary if no claim for wage loss or recurrence has been filed (e.g., the return to work occurs
during the COP period). A "00" disability record should be created with the appropriate RTW code.
The date of the claimant's return to light duty should be entered as both the disability date and the
RTW date.
b. Coding. If the claimant returns to full-duty work or OWCP issues a formal decision about
the claimant's wage-earning capacity before any QCM intervention occurs, the QCM record should
be coded category 0. For cases where such interventions have occurred, QCM status codes are
used as follows:
(1) In a new QCM case, if the associated Disability Tracking record already has a RTW
code of LP or LF, the QCM record will be created with a status code of PLP or PLF and a
category code of B.
(2) In an existing QCM case where the claimant returned to work in other than the DOI
job before QCM intervention, the CE should enter a status code of PLP or PLF, with a status
date corresponding to the date of the claimant's RTW. If the claimant's work status
improves due to application of QCM procedures, the QCM code reflecting this change should
be entered.
c. Certain Recurrence Cases. If a claimant working in a light-duty job suffers a recurrence and
then returns to the same light-duty job, the following rules govern whether QCM procedures apply:
(1) If an LWEC decision had not been issued (e.g., the RTW was for less than 60 days),
the CE should apply QCM procedures and track them under the new recurrence. Status
code CRN should be used to close out an existing QCM record.
(2) If an LWEC decision had been issued, the CE need not apply QCM procedures, and
the QCM record should be changed to category 0. (However, if the claimant returns to work
in a light-duty capacity other than the LWEC job, the CE should apply QCM procedures.)
2-0601-7 Consistency in Coding
7. Consistency in Coding. Consistent coding is essential to proper measurement of QCM actions. One
aspect of consistency is ensuring that cases which do not actually undergo QCM procedures are "zeroed
out". For instance, a new QCM record is created whenever an accepted recurrence claim is entered into
the Disability Tracking System without a RTW code. If the claimant had already returned to full duty
before the claim was accepted or before QCM procedures were applied, the CE should change the QCM
record to category 0, so that case will be excluded from the QCM count.
Consistency also requires use of the same standards to define the actions which should be considered
"interventions" under QCM. To be counted, the action must meet a certain threshold in prompting or
FECA-PT2 Printed: 06/08/2010 91