In Case of Injury, obtain first aid or medical treatment even if the injury is minor. While many minor injuries heal without treatment, a few result in serious prolonged disability that could have been prevented had the employee received treatment when the injury occurred.
For traumatic injuries, ask your employer to authorize medical treatment on Form CA-16 BEFORE you go to the doctor. Take Form CA-16 when you go to the doctor, along with Form OWCP-1500, which the doctor must use to submit bills to OWCP. Your employer may authorize medical treatment for occupational disease ONLY if OWCP gives prior approval. Submit bills promptly, as bills for medical treatment may not be paid if submitted to OWCP more than one year after the calendar year in which you received the treatment or in which the condition was accepted as compensable. Report Every Injury to your supervisor. Submit written notice of your injury on Form CA-1 if you sustained a traumatic injury, or Form CA-2 if the injury was an occupational disease or illness. (Forms CA-1 and CA-2 may be obtained from your employing agency or OWCP.) Form CA-1 must be filed within 30 days of the date of injury to receive continuation of pay (COP) for a disabling traumatic injury. COP may be terminated if medical evidence of the injury-related disability is not submitted to your employer within 10 workdays. YOU ARE RESPONSIBLE FOR ENSURING THAT SUCH MEDICAL EVIDENCE IS SUBMITTED TO YOUR EMPLOYING AGENCY. Form CA-2 should also be filed within 30 days. Any claim which is not submitted within 3 years will be barred by statutory time limitations unless the immediate superior had actual knowledge of the injury or death within 30 days of occurrence. Both the CA-1 and the CA-2 are available on the DOL website at: https://www.dol.gov/agencies/owcp/FECA/regs/compliance/forms Establish the Essential Elements of Your Claim. You must provide the evidence needed to show that you filed for benefits in a timely manner; that you are a civil employee; that the injury occurred as reported and in the performance of duty; and that your condition or disability is related to the injury or factors of your Federal employment. OWCP will assist you in meeting this responsibility, which is called burden of proof, by requesting evidence needed to fulfill the requirements of your claim. File a Claim for Compensation. File Form CA-7, Claim for Compensation on Account of Traumatic Injury or Occupational Disease, if you cannot return to work because of your injury and you are losing (or expect to lose) pay for more than three days. Give the form to your supervisor seven to ten days before the end of the COP period, if you received COP. If you are not entitled to COP, submit Form CA-7 when you enter or expect to enter a leave without pay status. All wage loss claims must be supported by medical evidence of injury-related disability for the period of the claim. If you continue to lose pay after the dates claimed on Form CA-7, submit Forms CA-8 Claim for Continuing Compensation on Account of Disability, through your employer to claim additional compensation until you return to work or until OWCP advises they are no longer needed. You are not required to use your sick or annual leave before you claim compensation. If you choose to use your leave, you may, with your agency's concurrence, request leave buy-back by submitting Form CA-7 to OWCP through your employing agency. Any compensation payment is to be used to partially reimburse your agency for the leave pay. You must also arrange to pay your agency the difference between the leave pay based on your full salary and the compensation payment that was paid at 2/3 or 3/4 of your salary. Your agency will then recredit the leave to your leave record. Return To Work As Soon As your Doctor Allows You To Do So. If your employing agency gives you a written description of a light duty job, you must provide a copy to your doctor and ask if and when you can perform the duties described. If your agency is willing to provide light work, you must ask your doctor to specify your work restrictions. In either case, you must advise your agency immediately of your doctor's instructions concerning return to work, and arrange for your agency to receive written verification of this information. COP or compensation may be terminated if you refuse work which is within your medical restrictions without good cause, or if you do not respond within specified time limits to a job offer from your agency. In appropriate cases, OWCP provides assistance in arranging for reassignment to lighter duties in cooperation with the employing agency. In addition, injured employees have certain other specified rights under the jurisdiction of the Office of Personnel Management, such as reemployment rights if the disability has been overcome within one year. ------------------------------------------------------------------------------ Right to see own physician Any employee who gets injured on the job has the right to see their own physician. (ELM Section 545.4) 545.4 Implementing Medical Care 545.41 Emergency Treatment An employee needing emergency treatment must be sent to the nearest available physician or hospital or to a physician or hospital chosen by the employee or the employee’s representative. The physician who provides emergency treatment is not considered the employee’s initial choice of physician. 545.44 Outside Treatment in a Nonemergency Situation In a nonemergency situation, if an employee does not accept treatment at a Postal Service occupational health services office or contract facility, the employee may select a physician or hospital within approximately 25 miles of his or her home or worksite. The physician’s office should be contacted by telephone by the control office or control point to determine if the physician is available and will accept the employee for treatment under FECA. If not, the employee must select another qualified physician or hospital. A postal supervisor is not authorized to accompany the employee to a medical facility or physician’s office in nonemergency situations ELM 17 432.72 Medical Release Time When an employee is released from work and directed by management to an on- or off-site health services unit due to illness or injury, all time spent waiting for and/or receiving medical attention on the service day on which the illness or injury occurs and that would have been worked but for the medical attention, including all time that the employee otherwise would have been directed to work that day beyond his or her regularly scheduled tour, is included and credited as work time. Steward's note: Over the years I have witnessed many employees injured at work and fail to request to see their own physician. The people at medical units and US Postal Service contract physicians (in my opinion) are not acting in the best interest of the employee but in the interest of the USPS and that is to get injured employees back to work as soon as possible regardless of the well-being of the an employee. ------------------------------------------------------------------------------ TIMELINESS Federal agencies are required by regulation to submit an employee's Notice of Injury (Form CA-1 or CA-2) within 10 working days (or 14 calendar days) of receiving it from an employee, if lost time from work or medical expenses are claimed or anticipated [20 CFR 10.110(a)]. Regulations require that the CA-7 should be submitted no later than 5 working days (or 7 calendar days) after its receipt from the employee [20 CFR 10.112(b)]. This prompt submission is critical if OWCP is to be able to serve injured workers' needs, and especially to ensure that medical bills can be processed timely. ------------------------------------------------------------------------------ INFORMATION TO ASSIST DOCTOR IN DETERMINING CAUSAL RELATIONSHIP FOR AN OWCP CLAIM: To a physician, "cause" may refer only to direct or principal cause, but for the law of Workers' Compensation, a variety of contributing causes must be considered. Under the Federal Employees Compensation Act (FECA), any disease or disability is compensable when it is proximately caused or materially aggravated by an employment-related injury or condition of employment. Proximate cause is that which, in a natural and continuing sequence, produces the disability. However, natural progression of a disease while a person is working does not constitute cause or aggravation. For conditions of employment to bring about aggravation of any underlying disease, the employment factors must be capable of aggravating or accelerating the disease. A supervisor is permitted to accompany you to the doctor’s office or hospital only in an emergency, and only to ensure that you receive prompt medical care. Supervisors should not interfere with medical care, breech your privacy, or be present to advise the doctor about limited-duty accommodations. Ambulances should be used to transport you in emergencies, not USPS or personal vehicles. See 543.223 of the Postal Service’s Employee and Labor Relations Manual. There are two kinds of aggravation: TEMPORARY AGGRAVATION: The pre-existing condition is worsened or made more severe for a time with no residual alteration of the underlying condition and without leaving any continuing impairment beyond that time. PERMANENT AGGRAVATION: There is a continuing and irreversible change in the underlying condition, thus adversely altering the course of the condition or disease process. FECA DEFINITIONS: MEDICAL RATIONALE: A logical explanation for the physician's underlying opinions, fundamental reasons and beliefs concerning causal relationship. PROXIMATE CAUSE: That which produces the injury in a natural and continuous sequence, unbroken by an efficient and intervening cause and without which the result would not have occurred. AGGRAVATION: A documented physiological process by which a single occupational act, or series of acts over a period of time intensified the severity of a physical or mental problem which pre-existed the occupational disease. ACCELERATION: A documented physiological process by which a single occupational act, or series of acts, can be shown to have increased the expected speed of progression in a pre-existing condition documented to be progressive in nature. PRECIPITATION: Hastening the occurrence of an event or causing to happen or come to crisis suddenly, unexpectedly, or too soon. ------------------------------------------------------------------------------ New Online ECOMP Claim System The Postal Service has enrolled for electronic submission of forms via the Employees' Compensation Operations and Management Portal (ECOMP). Most federal employee OWCP claims can be filed online with little intervention needed with a Postal supervisor. Register for an account and access the Dept of Labor ECOMP website at: https://www.ecomp.dol.gov You can upload many of your medical documents directly to the website without submitting them through your supervisor. How do I claim compensation for the wages lost due to my injury? If you have a loss of wages 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". Both of these forms are available on the DOL website at: https://www.dol.gov/agencies/owcp/FECA/regs/compliance/forms You can also contact the Office of Workers' Compensation Programs (OWCP) Federal Employees Program Offices: General Telephone Inquiries: (202) 513-6860 (Monday-Friday, 9:30am to 6:30pm, ET) ------------------------------------------------------------------------------ There is also a Medical Bill Processing Portal for OWCP Claims. https://owcpmed.dol.gov/portal/ There is also a Medical Provider Search tool to locate OWCP medical providers in your area. You will select the DFEC (Division of Federal Employees' Compensation) Program Name when searching for providers as a Postal Service Employee. https://owcpmed.dol.gov/portal/provider/search If you need to speak with a representative at the Medical Bill Processing Portal, they are available between the hours of 8:00 a.m. – 8:00 p.m. (Eastern Time): Division of Federal Employees’ Compensation (DFEC): 1-844-493-1966 ------------------------------------------------------------------------------ OWCP CLAIMS ARE OUTSIDE THE UNION’S EXCLUSIVE REPRESENTATIVE OBLIGATIONS What the Union can get involved with are contractual issues involving handbook responsibilities that supervisors are required to follow through on. In The USPS, The Injury Compensation Specialist (ICS) is responsible for sending claims to OWCP. The USPS Injury Compensation Office and their representatives are not an extension of OWCP. They are the control point and have no authority to adjudicate claims. All claims should be electronically submitted. The electronic system is called ECOMP (Employee Compensation and Management Portal). The USPS Supervisor forwards claim forms to the ICS. RESPONSIBILITIES OF THE IMMEDIATE SUPERVISOR: Provide Employee with Form CA-1 (Traumatic), or Form CA-2 (Occupational) Provide Form To Employee (Complete Receipt And Give To Employee). On The Same Day As Received: Complete And Forward Form CA-1 Or Form CA-2 To The ICS Failure to do so is a violation of Article 19 (Handbook ELM 544.11). If Traumatic Injury Prevents Employee From Working Must Advise Employee Of Right To Choose Continuation Of Pay (COP). Failure to do so is a violation of Article 19 (Handbook ELM 544.112). RESPONSIBILITIES OF THE USPS INJURY COMPENSATION SPECIALIST: (The Union Steward can request the name and contact information for this USPS employee) Completes Employer Portions of Forms CA-16 and CA-17. Advises Employee Whether Continuation of Pay (COP) Will Be Controverted (disputed). Advises Employee If COP Will Not Be Paid. Provides Copy Of Completed CA-1, CA-2 or CA-2a To Employee And Copy of All Correspondence Between USPS and Employee's Physician. Failure to do so is a violation of Article 19 (Handbook ELM 544.12). Submits Form CA-1, CA-2, Or CA-2a To OWCP Within 10 Working Days. Failure to do so is a violation of Article 19 (Handbook ELM 544.212). If Traumatic Injury (CA-1) Must Promptly Authorize Medical Care By Issuing Employee Form CA-16 Within 4 Hours Of Receiving Notice Of Claimed Injury. Failure to do so is a violation of Article 19 (Handbook ELM 545.21). The recomended remedy? That Grievant be made whole with compensation at the Grievant's regular pay rate for administrative leave for all hours Grievant is in a non-pay status (LWOP) for the same number of hours the Grievant would otherwise be compensated through the OWCP program if Management had not failed to perform the required responsibilities in processing the Grievant's claim for workers' compensation. Comments are closed.
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