Welcome to Federal Workers Compensation Coffee break Podcast. I am your host Dr. Taylor.
I am an OWCP consultant who has been assisting and working with clients for over 29 years in the work comp arena. I have decided to start giving back to government workers and other doctors by doing a free podcast to assist with all types of government related healthcare filings.
The only thing I ask for here at the podcast is that if you find this information to be helpful PLEASE leave a review, share the podcast with others and maybe send me an email to let me know that you benefitted from this free information. Here at this podcast we discuss all sorts of topics related to federal workers compensation, Department of Labor, OWCP, FECA ACT, FERS, longshore-maritime, DOD contractors, VA benefits. I cover these relevant topics in a short coffee break style format because we like to discuss topics that are related to helping you the government employee with filing your claim, understanding your rights and responsibilities, relevant rules and provisions.
I also like to cover topics that people are always wanting information on to help you successfully navigate the convoluted waters of federal claim filing. I do this to assist you, you and your doctor or your coworkers with claim filing denials or with appropriate filing of benefit claims, disability or injured worker claims.
Today is a Q & A based on some frequently asked questions. This is part 1 of a two part series on FAQ!
Now lets get our coffee started and start on YOUR questions!
FAQs on our Medical Authorization and Bill Pay processes for Injured Workers, Medical Providers, and Employing Agencies.
Q : I was injured on the job. How do I file a claim?
A: You need to complete either form CA-1, "Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation" or form CA-2 "Notice of Occupational Disease and Claim for Compensation". A traumatic injury is one that can be pinpointed to have occurred during one particular work shift – falling down the steps for example. An occupational disease is a medical condition that has developed due to work activities performed over more than one work shift. 20 C.F.R. §§ 10.100-10.101.
Forms can be submitted electronically via the Employees' Compensation Operations and Management Portal (ECOMP). Visit the ECOMP site to register for an account and initiate a claim.
If you are submitting a CA-2, you should also review the appropriate CA-35 "Evidence Required in Support of a Claim for Occupational Disease" form/checklist. There are several of these detailing the different sorts of documentation to be submitted depending on the type of occupational disease.
Be sure to keep a copy of everything for your records. Your agency will complete their portion of the CA-1 or CA-2 and submit the entire packet to the Office of Workers' Compensation Programs (OWCP) office. OWCP will advise you of the claim number which has been established. The office will review the information submitted and will determine if there is sufficient information to adjudicate the claim. If there is insufficient information to adjudicate the claim, they will send you a letter advising of the additional information needed.
Q #2: Is there a timeline for filing a claim?
A: The Federal Employees' Compensation Act (FECA) provides that a claim for compensation must be filed within 3 years of the date of injury. For a traumatic injury, the statutory time limitation begins to run from the date of injury. For a latent condition, it begins to run when an injured employee with a compensable disability becomes aware, or reasonably should have been aware, of a possible relationship between the medical condition and the employment. Where the exposure to the identified factors of employment continues after this knowledge, the time for filing begins to run on the date of the employee's last exposure to those factors. If a claim is not filed within 3 years, compensation may still be paid if written notice of injury was given within 30 days or if the employer had actual knowledge of the injury within 30 days after it occurred. There is nothing to prohibit you from filing the claim. Timeliness is determined by the OWCP office as part of the adjudication process. 5 U.S.C. § 8122; 20 C.F.R. §§ 10.100-10.101.
Q3: How do I claim compensation for the wages lost due to my injury?
If you have a loss of wages (following any Continuation of Pay (COP) received for a traumatic injury, if applicable) and are in Leave Without Pay (LWOP) status as a result of the accepted condition(s) on your claim, you need to file a CA-7 "Claim for Compensation" with your agency. If the period claimed on the CA-7 is intermittent, you need also to complete a CA-7a "Time Analysis Form". You may file the forms on the ECOMP site. You need to provide medical documentation supporting any periods of disability claimed. Your agency will complete their portion of the CA-7 and submit it and the medical documentation to OWCP. OWCP will determine if there is sufficient information on file to pay compensation for the periods claimed or if further information/development is needed. 20 C.F.R. §§ 10.102, 10.400-10.403.
Q4: How do I buy back the leave I took for my injury?
If you used leave to cover period of disability resulting from the accepted injury, you can apply to your agency to buy back your leave. Each agency establishes its own rules for whether they allow leave buy back (LBB), timelines for submission, etc. If your agency does allow leave buy back, to request a LBB, you need to complete a complete a CA-7 and check box B in section 2. You also must sign form CA-7b "Leave Buy Back (LBB) Worksheet/Certification and Election," after it has been completed by your employing agency. If the period you claimed was intermittent (not a solid block of full days), you also need to complete a CA-7a "Time Analysis Form". Each of these forms is available through ECOMP. The agency will complete their portion and forward them to OWCP for processing. There needs to be medical documentation in the OWCP file supporting your inability to work as a result of your accepted medical condition for any period where LBB is claimed.
OWCP pays compensation at 66 2/3% of your pay rate (if you have no eligible dependents) or at 75% (if you have at least one eligible dependent), while official leave is paid at 100% of your pay rate. To buy back your leave, you have to pay your agency the difference between what you were paid and what you would have received for compensation. For example, if you have at least one eligible dependent and your pay rate was $1000 per week, OWCP would pay you $750 in compensation ($1000 x .75) if you took a week of leave. To buy back your 40 hours of leave, you need to pay your agency $250 ($1000 - $750).
Q5: How can I find out about the status of the CA-7 I filed for wage loss compensation?
Injured workers and their representatives may access information regarding case status and wage loss compensation payments by contacting the Federal Employees Program. Injured workers should have their 9-digit case file or claim number and social security number when calling.
The Claimant Query System (CQS), is no more …it now has been adopted and rolled into the ECOMP portal, also provides injured workers with 24-hour access to their case file status; accepted conditions; address of record and; compensation payments and tracking.
Q6: How do I receive my compensation payment via direct deposit?
To receive compensation payments via Electronic Funds Transfer (EFT), please complete form SF-1199a "Direct Deposit Sign-Up Form." The SF-1199a is available on our forms page.
You may upload the form to your file via ECOMP. Click the button "Access Case and Upload Document" and enter the identifying information for your case.
Q7: How do I claim a Schedule Award?
When an injured worker has permanent loss of use of certain body parts or organs, s/he may request a schedule award by submitting a CA-7 Claim for Schedule Award and an impairment rating completed by her/his treating physician. 20 C.F.R. §§ 10.103, 10.404. The impairment rating can only be completed after maximum medical improvement has been reached and must be in accordance with the 6th Edition of the American Medical Association Guides to the Evaluation of Permanent Impairment, referencing the appropriate tables, and citing the date of maximum medical improvement. Impairment ratings may be done in a narrative format. There is not a form for the physician to complete for the impairment rating unless the Claims Examiner has provided one in response to incomplete medical documentation previously submitted.
You may file the form on the ECOMP site. Your agency will complete their portion and forward the CA-7 to OWCP.
Q8: How are Schedule Awards processed?
Once the completed CA-7 and the impairment rating have been received, reviewed, and determined to appear complete by the claims examiner, s/he forwards it to the district medical advisor (DMA) for review. In some situations, the Claims Examiner must develop the claim by contacting the claimant, employer, or rating physician for additional information. In some cases, the claimant must be referred to a second opinion medical examination to obtain a complete impairment rating.
Q9: What office do I call about my claim?
A listing of the offices and their contact information is available on our contacts page. The website is https://www.dol.gov/agencies/owcp/FECA/contacts/fecacont
Q110: How do I learn my claim number?
When a case is created, a letter is mailed to the injured worker which includes the claim number and basic information about available benefits. You may also learn your claim number by calling the office with jurisdiction over your claim. Provide your name, SSN, DOB, and date of injury. The office will be able to provide you with the claim number.
If you filed your claim electronically via ECOMP, your claim number will be shown on your employee dashboard page once a case has been created.
Q11: Who can I contact for information about the status of my FECA claim?
The OWCP office that services your claim is generally the best place to contact if you have questions about the status of your claim. You may upload correspondence to your file via ECOMP. Click the button "Access Case and Upload Document" and enter the identifying information for your case. The Claimant Query System (CQS), now part of ECOMP, also provides injured workers with 24-hour access to their case file status; accepted conditions; address of record and; compensation payments and tracking.
You may also contact that office by phone or in writing. The phone number is 855-804-7310 or email at owcphelpdesk@usda.gov
When you mail a document to the Central Mailroom, the document is scanned into the case record based on the claim number written on it. The information is made available in the computer system to the claims examiner assigned to your claim. When you call the office your call will be routed to an individual who can assist you with your concerns.
Q12: Can I communicate with my claims examiner by email?
There has been a huge policy change in recent years on this email issue. Pursuant to the new policy established by the Department of Labor, Office of Workers' Compensation Programs, Division of Federal Employees' Compensation, email communication on case specific inquiries is not allowed due to security concerns. Therefore, in order to protect the identities and personal information of claimants under the Federal Employees' Compensation Act and to allow better tracking of incoming communications, we do not use email with claimants and representatives.
NOW…in order to correspond with OWCP, you need to upload all correspondence to your claims examiner or for your OWCP file via ECOMP. Click the button on the ECOMP portal at "Access Case and Upload Document" and enter the identifying information for your case.
You may also send mail to U.S. Department of Labor, OWCP/DFEC, PO Box 8311, London, KY 40742-8311. As is the case with anything you send to OWCP, please note your claim number on every page, send only single sided copies, and be sure to keep a copy for your records.
Please do not send CDs, Flash Drives, DVDs, or other electronic media. OWCP is unable to access these for security reasons. Either print and send or follow the instructions to upload the documents to ECOMP.
Q13: How do I change my address with OWCP?
To change your address with OWCP, you may upload correspondence regarding a change of address via ECOMP. Click the button "Access Case and Upload Document" and enter the identifying information for your case.
You may also send a signed letter/statement to OWCP at U.S. Department of Labor, OWCP/DFEC, PO Box 8311, London, KY 40742-8311 advising of your new address. A telephone contact is not sufficient for the OWCP to change an address. Another acceptable document for an address change is the form SF-1199a used to elect receipt of compensation payments by electronic funds transfer (EFT). You can upload into ECOMP … this SF-1199 form with a cover sheet that has your new physical address change As is the case with anything you send to OWCP, please note your claim number on every page, send only single sided copies, and be sure to keep a copy for your records. Always use a cover letter with the following information on the cover letter:
Always put your OWCP claim # in the top right hand corner of each page you upload into ECOMP.
Then the following is needed in the cover page:
Claimant name:
Claimant Date of Birth:
Claimant Date of Injury
Claimant OWCP Case #:
Dear Claims examiner,
NOTICE
The following correspondence includes the following information and /or request.
Then put the information that you are either sending or requesting in the body of the cover letter.
Lastly,
Write at the end the following:
Furthermore, per the OWCP Procedure Manual, all written correspondence is to be addressed within 30 days.
Sincerely
Your name
Well that does it for this episode of Federal Workers Comp Coffee break Podcast
I want to thank you for listening and want to remind you to share this podcast with other federal workers you think would benefit from this information. Also be kind enough to leave a review on the platform you found this podcast, like or subscribe to the podcast platform or our youtube channel so others will also find this information. Also if you need an approved medical provider for your DOL -OWCP Or Longshore case in Florida you can find me in Tampa and Pensacola. To make a consultation with me to discuss your case or if you know someone if Florida who is recently injured you can call the clinic at 813-215-4356 or 813-877-6900 or go to our website at https://fedcompconsultants.com/ & https://mrtherapycenter.com/ Also if you are in another state and you want me to assist you with claim questions or assistance for your doctor you can email me at fedcompconsultants@protonmail.com or send me a message on the website at fedcompconsultants.com
I need to warm up this coffee and get going. As usual I want to thank all of you who put on that uniform, that badge, deliver that mail, take care of our veterans and make this government run… a big thank you. I do this for free just for you…We could not do this without all of the work all of you out there do…so a big thank you. And remember if you
have an injured federal claim and you need assistance….I am here to help!.
See you next time.
Off to get my coffee!
