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

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Fraud ConvictionUnder §8148, the claimant’s entitlement to benefits isterminated the date the plea is accepted in open court orthe date of conviction.The investigative body will need to forward to our officeany accepted plea agreements or documentation ofconviction. The court documents should include whatform of restitution or settlement was ordered. It isimportant for our office to know if there was a global ornon-global settlement ordered.
Pretrial DiversionDuring pretrial diversion the case is put onhold for a period of 6 months to one year,and if the defendant abides by the termsof the pretrial diversion agreement, thecase is dismissed and there is noconviction. In such a circumstance,there’s noactual“conviction conviction, ” andtermination under 5 U.S.C. § 8148(a) isnot appropriate.
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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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End of PeriodThe claimant's entitle
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Counting COP Entitlement - Example
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RETURNING INJURED EMPLOYEES TO MODI
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Requesting Medical ReportsA. The fi
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Weight of Medical EvidenceWhen OWCP
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Preparing the Job OfferHowever, if
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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 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: 18 U.S.C. 1920"§1920. False statem
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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