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

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COP/RTW Redesign, Phase 2Description:COP RTW redesign project will integrate the COPNurse operations more thoroughly hl with other iFECSapplications. COP data will propagate throughoutiFECS and more case data will be accessible toCOP Nurses. Additionally, data input by the COPNurse will be available to the Staff Nurse and ClaimsExaminer, and selected data will be made availableto the employing agencies via changes to the AQSweb application.
COP/RTW Redesign Features‣ COP Assignment Eligibility• Improved COP Assignment process using CA-3.• When Injury Comp Specialists submit a CA-3 via AQS,iFECS will alert Staff Nurse to cancel COP Nurse assignment‣ COP Nurse Input• COP Nurse should be able to update case information andclose the case.‣ Improved Access To Nurses• Secure CITRIX application through the use of tokens.‣ Agency Access to Case Information• Case information shown to Injury Comp Specialists shouldinclude the following new fields:• Date of assignment to a COP nurse• Triage Codes will be available on nurse report• COP closure date
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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
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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 and 184: Description:DFEC Centralized IVRThe
Page 185: IVR Continued‣ Reduced staff work
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