Printing - FECA-PT2 - National Association of Letter Carriers

helping the claimant return to full-time work in the DOI job. The following examples are intended to
clarify when an action meets that threshold. They are based on acceptance and payment of a claim filed
on Form CA-7, and creation of a new QCM record:
a. Example 1: When the claim is approved, the CE makes an initial call to the claimant, who
states that he plans to return to work in two weeks. The CE does not intervene and, in fact, the
claimant returns to his DOI job full-time.
At the time of the initial call, the RTW code for the disability record associated with this claim
should be changed to AN and the anticipated return to work date should be entered. When the
claimant actually returns to work, the associated QCM record should be coded as category 0 and
the RTW code should be changed to FF. No QCM status code need be entered.
(While the CE did in fact call the claimant, this level of activity is not sufficient to be regarded as a
QCM intervention, and it will not be included in the QCM performance measures.)
b. Example 2: The claimant states that she doesn't know when she will return to work. The
CE prepares a Statement of Accepted Facts and refers the file to the Staff Nurse, who prepares a
Field Nurse (FN) referral package. However, the CE learns that the claimant returned to full-time
full-duty work before the referral takes place.
Again, the QCM record should be coded as category 0 and the RTW code in the Disability Tracking
System should be changed to FF.
c. Example 3: The claimant returns to work after the referral letter is sent to the FN (with a
copy to the claimant) but before the FN contacts the claimant.
Here the QCM status should be changed to NFN (Referred to Field Nurse) and then to CFF (QCM
Case Closed - Return to Work DOI Job). This case will be counted in the QCM performance
measures as successfully resolved.
(The distinction between this and the previous example is the level of intervention. Here, the
claimant's receipt of a copy of the letter to the FN prompted the return to work.)
2-0601-8 QCM Resolution
8. QCM Resolution. A case with status code NLF or RLF will be considered successfully resolved within
one year of the Track Date. After one year cases will not count as successfully resolved unless the
claimant has returned to full-time full-duty work (status CFF) or a decision has been issued (status CNL,
CCO, CAE, CSA or CLW).
Code CRN (Recurrence/New Injury Following RTW Light Duty) should be used where the claimant suffers a
recurrence after returning to light duty work. Entry of CRN will automatically change the category to C,
and the case will be counted as resolved successfully.
FECA-PT2 Printed: 06/08/2010 92