1. What is the Federal Employees' Compensation Act (FECA)?
The FECA provides compensation benefits to civilian employees of the United States for disability due to personal injury or disease sustained while in the performance of duty. The FECA also provides for the payment of benefits to dependents if a work-related injury or disease causes an employee's death. Injury compensation benefits available to employees whose duties involve vessel operations are set forth in 42 U.S.C. 249 and benefits paid to United States Park Police are covered under the Policemen and Firemen's Relief Fund, District of Columbia Code, Title 4.
2. Who is responsible for FECA?
The FECA is administered by the Office of Workers' Compensation Programs (OWCP), U.S. Department of Labor, through district offices located throughout the United States. Your servicing personnel or safety offices should have the address and phone numbers of the district office which services your geographic area, along with appropriate forms.
3. Are all work injuries covered under the FECA?
All injuries, including disease proximately caused by employment, sustained while in the performance of duty by civilian employees of the Department including volunteers and emergency hires are covered as well as other types of employees such as job corps. It is the responsibility of the employee to provide medical and factual evidence to establish the essential elements of the claim, i.e., that the claim was filed within the statutory time requirements of the FECA, the injured or deceased person was an employee within the meaning of the FECA, the employee sustained an injury or disease, the employee was in the performance of duty when the injury occurred, and the condition found resulted from the injury. Benefits cannot be paid if injury or death is caused by willful misconduct of the injured employee, by intent to bring about the injury or death of oneself or another, or by intoxication of the injured employee. Benefits provided under the FECA constitute the sole remedy against the Department for work related injury or death. An employee or surviving dependent is not entitled to sue the Department or recover damages for such injury or death under any other statute.
4. How is a "Traumatic Injury" defined?
A traumatic injury is defined as a wound or other condition of the body caused by external force, including stress or strain. The injury must be identifiable as to time and place of occurrence and member or function of the body affected. It must be caused by a specific event or incident or series of events or incidents within a single day or work shift.
5. What is the definition of an "Occupational Disease or Illness?
An occupational disease is defined as a condition produced in the work environment over a period longer than one workday or shift. It may result from systemic infection, repeated stress or strain, exposure to toxins, poisons, fumes or other continuing conditions of the work environment.
6. Is there a time limit for filing notice of injury and claim for compensation?
Yes. A claim for compensation must be filed within three years of the date of injury. There is an exception to this rule and you should talk with your servicing personnel office.
7. Is there a maximum period of time during which an employee can receive compensation payments for wage loss?
No. An employee can receive compensation payments for as long as the medical evidence shows that total or partial disability is related to the accepted injury or condition. The employee may be required to undergo medical examinations.
8. Does an injured employee have to report for medical examinations when directed by OWCP?
Yes. Failure to do so without adequate reason may result in suspension of compensation or denial of the claim.
9. How are disability compensation payments computed?
Compensation is paid at two-thirds of the employee's pay rate if he or she has no dependents, or augmented to three-fourths of the pay rate if he or she is married or has one or more dependents.
10. What kind of benefits am I entitled to if my claim is approved?
Generally, hospital, physician and medication costs are covered as well as transportation costs to the doctor's office for medical treatment. Also you may be entitled disability benefits such as compensation, as well as a scheduled award. Other benefits may include an attendant's allowance, vocational rehabilitation, and death benefits if cause of death is related to the accepted job injury.
11. Is a pre-existing condition that is aggravated by factors of employment covered by the FECA?
Diseases and illnesses aggravated, accelerated or precipitated by the employment are covered. The employee must submit medical and factual evidence that establishes that the employment aggravated, accelerated, or precipitated the condition.
12. Is a recurrence of an employment-related disability covered by FECA?
Yes. If an injured employee is again disabled as a result of the original injury or occupational disease, there is coverage under FECA.
13. Can the injured employee choose the physician who will provide treatment?
An injured employee is entitled to initial selection of a physician or facility for treatment of an injury. The provider must meet the definition of "physician" under the FECA. An agency may examine the employee at its own facility in accordance with OPM regulations, but the employee's choice of physician must be honored, and treatment by the employee's physician must not be delayed.
14. Will OWCP pay the entire amount of the medical bill or is there a limit?
OWCP uses a schedule of maximum allowable medical charges. The employee is not responsible for amounts charged in excess of the maximum allowable medical charges. The schedule is not applicable to hospital, pharmacy, or nursing home charges.
15. Can an employee change physicians?
Yes. However, the employee must contact OWCP and request authorization to change to another physician.
16. What is Continuation of Pay (COP)?
COP is continuation of an employee's regular salary for up to 45 calendar days of wage loss due to disability and/or medical treatment following a traumatic injury. The intent of this provision is to eliminate interruption of the employee's income while OWCP is processing the claim. COP is subject to deductions for income tax, retirement, etc.
17. What happens if the injured employee's disability goes beyond the 45 day period?
If it appears that the disability will continue beyond 45 days, the employee and the bureau should complete Form CA-7,"Claim for Compensation on Account of Traumatic Injury or Occupational Disease," and submit it on the 40th day of COP to the appropriate OWCP district office.
18. Is the injured employee always entitled to the full 45 days?
No. If the employee's medical report indicates that the employee is capable of returning to duty, the employee must do so in order for pay to continue. If the physician's report indicates light duty, the employee is required to accept any reasonable offer of suitable light or limited duty. If the employee refuses to accept the work offered or fails to respond to the job offer within five working days, the bureau should terminate COP. OWCP will then resolve the dispute on the basis of the evidence submitted.
19. Does the Department or agency have the authority to approve or disallow a claim?
No. Only OWCP has the authority to adjudicate a claim for compensation. While the Department/bureau has a role in paying or withholding COP, this action is reviewed in every case by OWCP.
20. What is the penalty for filing a false claim?
If found guilty fined not more than $10,000 or imprisoned not more than five years or both. Conspiracy to commit fraud $10,000 and 10 years imprisonment.
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