CONTROVERSION OF COP

by L. Perez

 

The agencies, their supervisors and or managers are improperly withholding, delaying, controverting, and terminating continuation of pay (COP). This is a violation of the regulations of the Office of Worker’s Compensation programs (OWCP).

Background: COP is a substitute for compensation benefits during the first (45) forty five days of an employee’s disability, caused by a traumatic on the job injuries. Remember COP only applies for traumatic injuries when filing a CA-1 it does not apply when one files CA-2 for Occupational illnesses or diseases. COP must be requested by the injured employee when the employee completes OWCP’s form CA-1. Notice of injury and claim for continuation of pay within (30) thirty days of the injury.

Granting or Controverting COP: OWCP’s regulations specify that an employing agency Must grant an injured employee’s request for COP except in the following six circumstances ( There are others, but we will only cover six):

  1. The disability is caused by an occupational disease or illness, or
  2. The injury occurred off the employing agency’s premises and the employee was not performing official "off Premise" duties, or
  3. The injury was caused by the employee’s willful misconduct, the employee’s intent to kill or injure himself or herself or another person, or the employee’s intoxication by alcohol or illegal drugs was the proximate cause of the injury, or
  4. The injury was not reported on Form CA-1 within 30 days following the injury or
  5. Work stoppage first occurred more that 90 days following the injury, or
  6. The employee initially reports the injury after his or her employment has terminated.

Although the employing agency may controvert an employee’s right to COP for reasons other that the six circumstances listed above, the employee’s COP must be initiated and must be continued unless the controversion is sustained by OWCP---or another reason intervenes justifying termination (see below).

Termination of COP: Once COP has been initiated, the employing agency is authorized to terminate COP only if:

  • The employee does not provide prima facie medical evidence that a disabling traumatic injury occurred within 10 work days after the employee stops work (except that COP shall be continued without interruption in the absence of such medical evidence if the employing agency is satisfied that the employee sustained a disabling traumatic injury).
  • The employing agency receives evidence that the attending physician has found the employee no longer disabled (i.e., the employee can perform the duties of the position held at the time of injury).
  • The employing agency receives evidence that the attending physician has found the employee to be partially disabled and the employee refuses suitable work which has been offered by the agency or fails to respond to such offer within five work days of receipt of the offer.
  • The employee’s scheduled period of employment expires or employment is otherwise terminated, provided the date of termination of employment is established prior to the date of injury.
  • The 45-day COP period expires.

The employing agency will also terminate COP if OWCP notifies the employing agency that COP is to be terminated because either:

  • OWCP has sustained a controversion of COP by the employing agency or
  • OWCP has independently determined that the employee has failed to meet the FECA’s eligibility criteria for disability benefits or

OWCP will also require the employing agency to suspend COP when it determines that an employee has refused to submit to, or obstructs, a medical examination required by OWCP. The suspension will continue until OWCP determines that the refusal or obstruction stops.

Finally, an employing agency must grant COP unless one of the six circumstances noted above applies. COP cannot be withheld or delayed pending receipt of medical evidence or because the medical evidence is not immediately available. (As noted above, an injured employee has up to 10 work days to furnish medical evidence.)

-------------------------------------------------------------------------------------------

Federal Workers Compensation Consultants

Workers Compensation and Disability Retirement Specialists

9639 N. Armenia Avenue
Tampa, Florida 33612

Telephone 1-877-915-1271
813-931-1984
Fax 813-931-4905

bill.hackney@verizon.net

lenny.perez@verizon.net

vivi.perez@verizon.net

http://www.federal-workers-comp.com

Permission is granted to publish this article in print or online as long as the article is published in it's entirety without changes and with the author's contact information and URL hyperlinks included.