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

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Form CA-16 and Chiropractic Care• Chiropractors are only considered“physicians” under the Act if they treata subluxation (dislocation) of the spineas demonstrated on x-ray. The x-raymay be taken by the chiropractorIf thi i di d l i l ti• If this is diagnosed, only manipulationof the spine is payable
Occupational Diseases (Form CA-2)<strong>OWCP</strong> classifies occupational disease claims into two types:<strong>Basic</strong> Occupational Disease Claims:• Orthopedic strains caused by repetitive trauma• Carpal Tunnel Syndrome• Tarsal Tunnel and Plantar Fascitis• Eye Strain• Exposure to fumes, dust, smoke (over more than one shift)Extended Occupational Disease Claims:• Hearing loss• Asbestosis• Emotional stress• Sick building syndrome*Special note: almost always require a second opinion to be set up byour office and exposure data from agency is also needed.
Page 1 and 2: OWCP Basic Training
Page 3 and 4: OWCP Structure and JurisdictionThe
Page 5 and 6: Information and RecordsIndividual c
Page 7 and 8: PenaltiesThe regulations set forth
Page 9 and 10: Program BenefitsFECA provides for f
Page 11 and 12: Compensation BenefitsFederal employ
Page 13 and 14: Compensation for Loss of WagesThe A
Page 15 and 16: Schedule AwardThe Act provides for
Page 17 and 18: Other BenefitsAttendant AllowanceUn
Page 19 and 20: Federal WorkersCompensationoClaims
Page 21 and 22: Traumatic Injuries (CA-1• Back st
Page 23 and 24: Agency Processing of Traumatic Inju
Page 25 and 26: Tips for CA-1 Form Completion- Agen
Page 27 and 28: Form CA-16• Only used in Traumati
Page 29: Form CA-16 Instructions cont.
Page 33 and 34: Agency Processing of an Occupationa
Page 37 and 38: Recurrence of Disability Cont.It do
Page 39 and 40: Form CA-2a Notice of Recurrence
Page 41 and 42: What if the wrong form issubmitted?
Page 43 and 44: Form CA-7 Claim for Compensation
Page 47 and 48: Form CA-7b Leave Buy Back
Page 49 and 50: The Basic Elements of a Claim
Page 52 and 53: Statements/Comments• In cases inv
Page 54 and 55: 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 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 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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