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

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An interesting case…The claimant had worked using two different names and social securitynumbers. Medical evidence dated July 24, 1990 from her attending Board-certified psychiatrist indicated that the claimant suffered from a form ofmental illness in which two personalities were present, each using adifferent name. The claimant was totally divorced from one personalitywhen she was in the other, and could not remember anything about theother personality.The Board found that the Office did not establish that the claimantknowingly omitted earnings for a portion of the period that was declaredsubject to forfeiture. During one of the reporting periods covered by theCA-1032 forms, the claimant was suffering from two personalities, andtherefore, a finding that she had "knowingly" omitted earnings could not bemade for that period of time. The Board did affirm that periods of timecovered by CA-1032 forms signed prior to the July 24, 1990 medical reportwere subject to forfeiture, f since the medical evidence did not specify whenthe two separate personalities began to manifest themselves.Ruth Moreno Rios, Docket No. 94-1977, Issued July 14, 1997
Other ECAB cases…..• The Office may not base application of theforfeiture provision strictly on conclusionsdrawn in an investigation, but rather theevidence of record must establish that theclaimant had unreported earnings fromemployment which were knowingly notreported. Louis P. McKenna, Jr., 46 ECAB___ (Docket No. 93-2436, issuedDecember 8, 1994).
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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 (
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Pre-existing existing Conditions•
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Three Statutory ExclusionsWillful M
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Three Statutory ExclusionsIntoxicat
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Withdrawal of a Claim
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Continuation of Pay
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Continuation of Pay (COP)The 1974 a
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Controverting COP vs.Challenging th
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9 Reasons an Agency May Controvert
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CONTROVERTING COP (CONT’D)OTHER R
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INVESTIGATING ENTITLEMENT TO COP
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INVESTIGATIONS (CONT’D)SUBMIT OBJ
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INVESTIGATIONS (CONT’D)CREDIBLE W
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INVESTIGATIONS (CONT’D)Providing
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“NO TIME LOST” (NTL) CASES ANDC
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COUNTING COP DAYS
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Portion of DayIf the employee stops
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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 and 106: Disqualifying FactorsVerify that no
Page 107 and 108: What to do when a job offer is vali
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: Administrative ActionsOnce the offi
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
Page 157 and 158: Pretrial DiversionDuring pretrial d
Page 159 and 160: FECA Program Highlightsht‣Electro
Page 161 and 162: CA-7 and CA-3 3e-Filing‣ Effectiv
Page 163 and 164: Overview• Forms to be filed via A
Page 165 and 166: Benefits of E-filing‣ Early recei
Page 167 and 168: How Will the ICS E-file forms?•Th
Page 169 and 170: What the ICS will seeICS willcomple
Page 171 and 172: How will the ICS know it worked?In
Page 173 and 174: Major Differences Web form vs. Pape
Page 175 and 176: Fields onCA-7aPre-Populated Populat
Page 177 and 178: RequiredFields on CA-3Pre-Populated
Page 179 and 180: CQS - Claimant Query SystemCQS will
Page 181 and 182: CQS case summary and status will di
Page 183 and 184: Description:DFEC Centralized IVRThe
Page 185 and 186: IVR Continued‣ Reduced staff work
Page 187: COP/RTW Redesign Features‣ COP As
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