CONTROVERSION
OF COP
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):
-
The disability is caused by an occupational disease or illness,
or
-
The
injury occurred off the employing agency’s premises and the
employee was not performing official "off Premise" duties,
or
-
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
-
The
injury was not reported on Form CA-1 within 30 days following
the injury or
-
Work
stoppage first occurred more that 90 days following the injury,
or
-
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
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.)
-------------------------------------------------------------------------------------------
F.W.C.C.
9639 N. Armenia Avenue
Tampa, Florida 33612
Telephone 1-877-915-1271
(813)931-1984
Fax (813)931-4905
bill.hackney@verizon.net
http://www.federal-workers-comp.com
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