by L. Perez
In determining eligibility, OWCP must consider five basic issues:
(1) Coverage: whether the claimant is an employee within the meaning of the Federal Employees Compensation Act (F.E.C.A.).
(2) Timely filing: whether employee met all applicable time limitations.
(3) Personal Injury: whether a personal injury actually occurred. The term injury includes all diseases caused or aggravated by the employment.
(4) Performance of duty: whether the personal injury occurred in the performance of duty.
(5) Causal Relationship: whether the disability claimed is causally related to a personal injury sustained in the performance of duty, or to conditions of employment. The term “causal relationship” includes direct cause, as well as aggravation, acceleration (hastening) and/or precipitation.
(B) CHOICE OF PHYSICIAN
The employee has a right to initial FREE choice of treating physician
(C) CHOICE OF BENEFITS
The employee must elect continuation of pay (COP) or sick/annual leave in traumatic injury cases. When filing traumatic injury cases on a CA-1, COP is payable for up to forty five calendar days, with eligibility for compensation following. Compensation or sick/annual leave are payable in occupational disease cases filed on a CA-2.
(D) WAITING PERIOD
There is a three day waiting period (without pay) before compensation begins. This three day waiting period is waived, if disability extends beyond fourteen days. This does not apply for CA-1’s. There is no waiting period: COP begins immediately.
(E) MEDICAL EVIDENCE
COP and /or compensation is payable only when supported by medical evidence that definitely shows that the disability is causally related to the injury or conditions of employment. Medical evidence must also contain medical rationale (medical reasoning).
(F) TYPES OF DISABILITY
Disability can be temporary total (no work at all): temporary partial (work is possible within medical limitations); permanent total; or permanent partial ( the claimant has an earning capacity, although unemployable in the job held at time of injury).
(G) COMPENSATION FOR WAGE LOSS
Usually payable at 66 2/3% of pay on date of injury, 75% if employee has one or more dependents (remember a spouse counts as a dependent).
(H) SCHEDULE AWARD
Payable when maximum healing is reached and the medical evidence shows permanent total or partial loss of use of specified anatomical members, organs, or functions of the body. This is not payable while one is collecting compensation for wage loss. A schedule award can be collected while one is working 40 hours a week or while one is collecting retirement benefits.
The employee agency can controvert COP (and not pay in some instances) and or submit factual and medical evidence to refute an employee’s claim for compensation. The employee should ask for copies of any controversion submitted by the agency. Special provisions apply for recurrences, injuries caused by third parties, leave buy-back, limited lump-sum settlement, vocational rehabilitation, processing overpayments, attendant allowances, relocation expenses, penalties for false statements, death benefits and more.
Call Federal Workers Compensation Consultants today for a free initial consultation at 813-931-1984
Federal Workers Compensation Consultants
Workers Compensation and Disability Retirement Specialists
9639 N. Armenia Avenue
Tampa, Florida 33612
Se Habla Espanol – 813-931-1984
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