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

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Key IVR Features‣ Ability to ‘screen-pop’ p preset forms such as the CA-110, Record of Telephone Communication‣ Extensive reporting capabilities (call volumes,performance statistics, operational analysis,workload analysis)‣ Extensive ACD functionality (business hours,holidays, emergency closures, inclement weather,self-service service claims status features)
IVR Continued‣ Reduced staff workloads‣ Reduced data collection time‣ Improved Customer Service‣ Optional features available (call-back feature,call recording, marquee monitor management,agent monitoring, workforce managementpackages, etc.)
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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
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Disqualifying FactorsVerify that no
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What to do when a job offer is vali
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If the reasons for refusal are not
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Moving ExpensesMoving Expenses and
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AUTHORIZATION LEVELS• LEVEL 1: Pr
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What requires authorization?• Whe
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Info Required for Auth Requests:Rou
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Info Required for DME Auth• Claim
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No Authorization• Certain procedu
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Authorization EOB Code• Your clai
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Authorization Approval• If a requ
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AUTHORIZATION LETTER
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Medical Bill Processing
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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
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: Description:DFEC Centralized IVRThe
Page 187: COP/RTW Redesign Features‣ COP As
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