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

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Form CA-2 Occupational Disease Claim
Agency Processing of an OccupationalDisease Claim• The agency must ensure that the completed CA-2 is submitted to<strong>OWCP</strong> within 10 working days, in accordance with 20 C.F.R.10.110(b).• The agency should not wait for the submission of supportingevidence before sending the CA-2 to <strong>OWCP</strong>.• Narrative statements are required from both the employee andsupervisor. All statements should relate the occupational disease tothe employee’s work or otherwise.• The agency should issue to the employee two copies of theappropriate checklist, Form CA-35a-h, for the disease claimed.– CA-35a Occupational Disease in General– CA-35b Hearing Loss– CA-35c Asbestos-Related Illness– CA-35d Coronary/Vascular Condition– CA-35e Skin Disease– CA-35f Pulmonary Illness (not Asbestosis)– CA-35g Psychiatric Illness– CA-35h Carpal Tunnel Syndrome
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 and 30: Form CA-16 Instructions cont.
Page 31: Occupational Diseases (Form CA-2)OW
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
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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
Page 99 and 100:
Weight of Medical EvidenceWhen OWCP
Page 101 and 102:
Preparing the Job OfferHowever, if
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Suitable OffersTo find an offer of
Page 105 and 106:
Disqualifying FactorsVerify that no
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What to do when a job offer is vali
Page 109 and 110:
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
Page 127 and 128:
AUTHORIZATION LETTER
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Medical Bill Processing
Page 131 and 132:
Claimant Eligibilityibilit• Each
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Treatment t Suite• Services that
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Unreported Earnings or ActivitiesFo
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The Road to ForfeitureIf the employ
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Evidence Required to Establish Forf
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Administrative ActionsOnce the offi
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Other ECAB cases…..• The Office
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Office Decision Affirmed• The Boa
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Office Decision Affirmed• Appella
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Cases that do NOT lead to Forfeitur
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FECA Fraudand Criminal Prosecution
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§8148 Forfeiture of benefits by co
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18 U.S.C. 1920"§1920. False statem
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Pretrial DiversionDuring pretrial d
Page 159 and 160:
FECA Program Highlightsht‣Electro
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CA-7 and CA-3 3e-Filing‣ Effectiv
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Overview• Forms to be filed via A
Page 165 and 166:
Benefits of E-filing‣ Early recei
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How Will the ICS E-file forms?•Th
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What the ICS will seeICS willcomple
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How will the ICS know it worked?In
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Major Differences Web form vs. Pape
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Fields onCA-7aPre-Populated Populat
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RequiredFields on CA-3Pre-Populated
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CQS - Claimant Query SystemCQS will
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CQS case summary and status will di
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Description:DFEC Centralized IVRThe
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IVR Continued‣ Reduced staff work
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COP/RTW Redesign Features‣ COP As
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