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

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Agency Processing of Claims for Recurrence• The agency must ensure that the injured worker completes Section 1through 24 on Part A along with sections 1 though 7 on Part C. Failure toensure that the form in properly completed may delay the processing of theform.• The agency is responsible for the completion of Part B of the form andsubmission to the OWCP District Office.• The agency should not wait for the submission of supporting medicalevidence before sending the CA-2a to the OWCP District Office.• If you are unable to immediately provide narrative statements as requestedin Part B, Section 38 through 40, please do not delay the filing of the claimand submit the form indicating that comments/ statements will follow.• The complete form should be forwarded to the appropriate OWCP DistrictOffice and not the Central Mail Room in London, KY.
What if the wrong form issubmitted?• ACA-1 which describes an occupationaldisease can be created as a new CA-2and COP will be denied• A CA-2a which describes a new injury canbe created as a new case• Encourage injured worker to file thecorrect one but ultimately t l DOL will makedecision
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 and 32: Occupational Diseases (Form CA-2)OW
Page 33 and 34: Agency Processing of an Occupationa
Page 37 and 38: Recurrence of Disability Cont.It do
Page 39: Form CA-2a Notice of Recurrence
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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