OWCP Basic Training - 15th Annual Federal Workers ...

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What to do when a job offer is neither valid nor suitableIf the offer does not meet the necessary requirements WE WILL WRITEOR CALL THE EMPLOYING AGENCY and advise them of the problems.If they can modify and/or make corrections to the offer so it can be ruledvalid and suitable, ask the agency to do so and submit a corrected copy toour office.
What to do when a job offer is valid and suitableWhen the claims examiner determines that the offer is valid and suitable and theemployee has neither accepted the job nor returned to work, we will take thesesteps.(1) Phone the agency and confirm that the job is still available. Document ourconversation in the file.(2) Write to the employee. The letter will contain the following information:a. The job has been determined to be suitable.b. The job remains open for the employee.c. The employee will be paid compensation for the difference (if any) between the pay of theoffered job and the pay of the date of injury job.d. The employee has 30 days from the date of the claims examiner’s letter to either accept thejob or provide an explanation of the reason(s) for refusal. Otherwise the employee willpenalized with loss of compensation. To satisfy the requirement of due process, our officemust quote 5 USC 8106 c (2) in our letter to the employee.e. The employee can accept the job without penalty within the 30 day period.
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OWCP Basic Training
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OWCP Structure and JurisdictionThe
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Information and RecordsIndividual c
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PenaltiesThe regulations set forth
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Program BenefitsFECA provides for f
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Compensation BenefitsFederal employ
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Compensation for Loss of WagesThe A
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Schedule AwardThe Act provides for
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Other BenefitsAttendant AllowanceUn
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Federal WorkersCompensationoClaims
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Traumatic Injuries (CA-1• Back st
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Agency Processing of Traumatic Inju
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Tips for CA-1 Form Completion- Agen
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Form CA-16• Only used in Traumati
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Form CA-16 Instructions cont.
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Occupational Diseases (Form CA-2)OW
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Agency Processing of an Occupationa
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Recurrence of Disability Cont.It do
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Form CA-2a Notice of Recurrence
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What if the wrong form issubmitted?
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Form CA-7 Claim for Compensation
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Form CA-7b Leave Buy Back
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The Basic Elements of a Claim
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Statements/Comments• In cases inv
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A note about property vs.premises (
Page 56 and 57: Pre-existing existing Conditions•
Page 58 and 59: Three Statutory ExclusionsWillful M
Page 60 and 61: Three Statutory ExclusionsIntoxicat
Page 62 and 63: Withdrawal of a Claim
Page 64 and 65: Continuation of Pay
Page 66 and 67: Continuation of Pay (COP)The 1974 a
Page 69 and 70: Controverting COP vs.Challenging th
Page 71 and 72: 9 Reasons an Agency May Controvert
Page 73 and 74: CONTROVERTING COP (CONT’D)OTHER R
Page 75 and 76: INVESTIGATING ENTITLEMENT TO COP
Page 77 and 78: INVESTIGATIONS (CONT’D)SUBMIT OBJ
Page 79 and 80: INVESTIGATIONS (CONT’D)CREDIBLE W
Page 81 and 82: INVESTIGATIONS (CONT’D)Providing
Page 84: “NO TIME LOST” (NTL) CASES ANDC
Page 87 and 88: COUNTING COP DAYS
Page 89 and 90: Portion of DayIf the employee stops
Page 91 and 92: End of PeriodThe claimant's entitle
Page 93 and 94: Counting COP Entitlement - Example
Page 95 and 96: RETURNING INJURED EMPLOYEES TO MODI
Page 97 and 98: Requesting Medical ReportsA. The fi
Page 99 and 100: Weight of Medical EvidenceWhen OWCP
Page 101 and 102: Preparing the Job OfferHowever, if
Page 103 and 104: Suitable OffersTo find an offer of
Page 105: Disqualifying FactorsVerify that no
Page 109 and 110: If the reasons for refusal are not
Page 111 and 112: Moving ExpensesMoving Expenses and
Page 113 and 114: AUTHORIZATION LEVELS• LEVEL 1: Pr
Page 115 and 116: What requires authorization?• Whe
Page 117 and 118: Info Required for Auth Requests:Rou
Page 119 and 120: Info Required for DME Auth• Claim
Page 121 and 122: No Authorization• Certain procedu
Page 123 and 124: Authorization EOB Code• Your clai
Page 125 and 126: Authorization Approval• If a requ
Page 127 and 128: AUTHORIZATION LETTER
Page 129 and 130: Medical Bill Processing
Page 131 and 132: Claimant Eligibilityibilit• Each
Page 133 and 134: Treatment t Suite• Services that
Page 135 and 136: Unreported Earnings or ActivitiesFo
Page 137 and 138: The Road to ForfeitureIf the employ
Page 139 and 140: Evidence Required to Establish Forf
Page 141 and 142: Administrative ActionsOnce the offi
Page 143 and 144: Other ECAB cases…..• The Office
Page 145 and 146: Office Decision Affirmed• The Boa
Page 147 and 148: Office Decision Affirmed• Appella
Page 149 and 150: Cases that do NOT lead to Forfeitur
Page 151 and 152: FECA Fraudand Criminal Prosecution
Page 153 and 154: §8148 Forfeiture of benefits by co
Page 155 and 156: 18 U.S.C. 1920"§1920. False statem
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Pretrial DiversionDuring pretrial d
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FECA Program Highlightsht‣Electro
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CA-7 and CA-3 3e-Filing‣ Effectiv
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Overview• Forms to be filed via A
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Benefits of E-filing‣ Early recei
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How Will the ICS E-file forms?•Th
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What the ICS will seeICS willcomple
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How will the ICS know it worked?In
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Major Differences Web form vs. Pape
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Fields onCA-7aPre-Populated Populat
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RequiredFields on CA-3Pre-Populated
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CQS - Claimant Query SystemCQS will
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CQS case summary and status will di
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Description:DFEC Centralized IVRThe
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IVR Continued‣ Reduced staff work
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COP/RTW Redesign Features‣ COP As
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