Animal and Plant Health Inspection Service USDA – APHIS Workers’ Compensation Incident Management Team

Animal and Plant Health Inspection Service Objectives Overview of the Federal Employees’ Compensation Act (FECA) and the Office of Workers Compensation Programs Conditions of coverage Claim types Claim submission process and responsibilities Benefits Additional information and resources

Animal and Plant Health Inspection Service Federal Employees’ Compensation Act (FECA) Passed in 1916 Exclusive Remedy Non-adversarial Administered by Department of Labor (DOL), Office of Workers Compensation Programs (OWCP) Benefits paid by DOL Not a retirement system

Animal and Plant Health Inspection Service Office of Workers Compensation Programs (OWCP) DOL’s OWCP administers workers compensation program. OWCP Goals: Ensure employees can receive quality medical assistance if they sustain work related injuries or are involved in work related accidents Return employees to work as soon as medically feasible

Animal and Plant Health Inspection Service Office of Workers Compensation Programs (OWCP) OWCP provides benefits such as wage loss compensation benefits, medical treatment, vocational rehabilitation, and other benefits to employees or their dependents who experience work-related injury or occupational disease.

Animal and Plant Health Inspection Service Conditions of Coverage Acceptance of claim requires satisfaction of five basics: Timely Filing of ClaimFederal Civilian EmployeeFact of Injury Performance of Duty (POD) Causal Relationship Employees has three years to file from date of (1) injury, (2) first awareness, or (3) last exposure. Covers permanent or temporary employees excluding those from non- appropriated funds. Contract employees, volunteers, and loan employees covered in some circumstances. Verification of factual and medical evidence that the injury occurred. Injury or exposure occurred at work or because of employment versus a personal condition, non-work related, intoxication, misconduct, and/or intent to harm others or self. Medical evidence shows a causal relationship between the work-related exposure and the condition. Causal relationships include direct cause, aggravation, acceleration, or precipitation.

Animal and Plant Health Inspection Service Additional Performance of Duty Information Injury covered when: Occurred at work-site Occurred during work hours and normal breaks Performing work duties off-site In travel status Injury not covered when: Off-site lunch Normal commute to or from work Caused by intoxication, misconduct, and/or intent to harm others or self TDY Guidance: 24/7 coverage for activities incidental to the mission Coverage excluded when employee diverts from duty for a personal errand 7

Animal and Plant Health Inspection Service Types of Claims Traumatic Injury Occupational Disease Reoccurrence Death

Animal and Plant Health Inspection Service Types of Claims Traumatic Injury – Injury caused by specific event or series of events occurring during one workday or shift. Occupational Disease – Condition produced over a period longer than one work day or shift.

Animal and Plant Health Inspection Service Types of Claims Reoccurrence – Recurrence of disability caused by: Spontaneous return of the symptoms Return or increase of disability due to a consequential injury Withdrawal of a specific light duty assignment Death – Employees who die from job-related illness or injury where medical certification establishes a causal relationship between the employee’s death and his/her employment.

Animal and Plant Health Inspection Service Claim Submission Overview 11 Employee is injured and notifies supervisor Employee seek medical attention Employee complete claim form(s) Incident Supervisor complete claim form(s) Claim form(s) provided to Finance Section Chief Claim form(s) provided to WC POC

Animal and Plant Health Inspection Service Employee Responsibilities 1.See immediate medical attention if necessary 2.Report all job-related injuries or illness to Incident Supervisor as soon as possible  3 years for a claim, however  30 days for certain benefits; and  Some benefits can start the next day 3.For a traumatic injury, obtain CA-16 from the Incident Supervisor if medical treatment is required

Animal and Plant Health Inspection Service Employee Responsibilities 4.Complete forms in a timely manner  Traumatic injury: CA-1  Occupational disease: CA-2  Reoccurrence: CA-2a 5.Provide all information requested by the Agency and OWCP promptly – this includes medical reports (see CA-35 checklist) 6.Maintain continuous contact with Incident Supervisor

Animal and Plant Health Inspection Service Incident Supervisor Responsibilities 1.Ensure employee is granted time off to seek and receives immediate and appropriate medical attention 2.Fill out CA-16 within 48 hours of traumatic injury notification if medical attention is/was needed  Note that a CA-16 is not authorized for occupational disease claims 3.Provide CA-1, CA-2, and appropriate checklist from CA-35, to the employee within 1 day of request or notification of injury/illness

Animal and Plant Health Inspection Service Incident Supervisor Responsibilities 4.Fill out the “Official Supervisor’s Report” on either the CA-1 or CA-2 and provide to Finance Section Chief within 3 days of receipt from the employee  Obtain witness statements and/or responsible third party contact information 5.Complete “Side A – Supervisor” section of CA-17 if the physician indicates that the employee’s injury/illness will result in 2 or more weeks of leave or limited/light duty

Animal and Plant Health Inspection Service Incident Supervisor Responsibilities 6.Maintain communication with recuperating employee 7.Challenge a claim(s) and controvert benefits when necessary or indicated

Animal and Plant Health Inspection Service Finance Section Chief Responsibilities 1.Ensure employee and supervisor have completed all forms  Any witness statements are included with CA-1  If a third party (non-Government entity with no business relationship with the agency) caused the injury, the name and address of the party responsible is provided on the CA-1 2.Make two copies of the CA-1 or CA-2 and forward the original form to the Workers Compensation (WC) Point of Contact (POC) within 3 days of receipt from the employee  Copy 1 – Stays with the Incident  Copy 2 – Provided to employees normal front line supervisor 3.Communicate situation and maintain contact with employee’s normal first line supervisor

Animal and Plant Health Inspection Service Death Claims Incident Supervisor completes form CA-6 The deceased employee’s family member(s) should complete within 3 years  Form CA-5 – Widow/widower and/or children  Form CA-5b – Parent, Brother, Sister, Grandparents, or Grandchildren

Animal and Plant Health Inspection Service Death Claims Additional evidence must be submitted in addition to the claim form(s), to include : Death certificate Name and address(es) of next of kin Marriage certificate Birth certificate for each child Divorce decree or death certificate for prior marriages Itemized burial bills Medical certification establishing a causal relationship between the employee’s death and his/her employment

Animal and Plant Health Inspection Service Notes for Supervisors and Chiefs No one may require an employee or other claimant to waive his/her right to claim benefits. Incident Supervisors have ultimate responsibility for injury documentation and employee communication. Another Incident Supervisor or Incident Command and General Staff member may sign documents on behalf of the Incident Supervisor if verbal consent is granted.

Animal and Plant Health Inspection Service Notes for Supervisors and Chiefs Completed claims must be forwarded to the Workers Compensation (WC) Point of Contact (POC) even if: No time is lost Medical attention not sought Claim is for First Aid Depending on the injury, medical treatment/advice, and any duty limitations the incident should consider demobilizing the employee in accordance with the demobilization plan.

Animal and Plant Health Inspection Service Benefits Provided under the FECA Medical Benefits Continuation of Pay (COP) Wage Loss Compensation Schedule Awards Vocational Rehabilitation Death/Burial Expenses

Animal and Plant Health Inspection Service Benefits Medical – Authorizes treatment and payment or reimbursement of medical expenses for up to 60 days. Continuation of Pay (COP) – Provides pay compensation for medical disability and/or to seek medical treatment during the first 45 days of an employee’s disability when caused by a traumatic injury. Payable stating day after injury but medical evidence must be submitted within ten calendar days after the claim is submitted. To qualify for COP the injury must be reported on CA-1 within 30 days.

Animal and Plant Health Inspection Service Benefits Wage Loss Compensation – Provides compensation for lost wages (following any Continuation of Pay, if applicable) after 45 days while the employee is in a Leave Without Pay (LWOP) status.  Employee and Incident or assigned Supervisor complete CA-7  Initial SF -52 containing remarks of OWCP LWOP Schedule Awards – Monetary payments for a prescribed number of weeks to federal employees who suffer the permanent total or partial loss of use of anatomical members, functions, or organs.

Animal and Plant Health Inspection Service Benefits (cont’d) Vocational Rehabilitation – Assists injured or disabled employees become self-supporting and productive thus allowing employees return to suitable work, preferably with little or no loss of earnings. Death/Burial Expenses – Authorizes compensation to dependents of an employee who dies from job-related illness or injury. Also includes funeral and burial costs as well as expenses for transportation of the body.

Animal and Plant Health Inspection Service Privacy Act (DOL/GOVT-1) Covers appropriate and permissible routine uses of FECA records DOL maintains the official record The National Program Office (NPO) in connection with designated field WC POCs are the custodian(s) of the agency copy Disclosures of any FECA documents requires signed consent from employee and requests should be directed to the WC POC Contact the NPO for guidance on all requests for OWCP documents

Animal and Plant Health Inspection Service Workers’ Compensation Resources Content for this presentation taken from: OWCP Forms Medical Authorizations Unit (ACS) (Interactive Voice Response) (Customer Service ) (Fax)

Animal and Plant Health Inspection Service Workers’ Compensation Contacts APHIS Program UnitPoint of ContactContact for Submitting Claims and Questions Animal CareMarquess p: (301) f: MRP-BS & OthersMarquess p: (301) f: Plant Protection & Quarantine (PPQ) Adrienne P: (919) f: Ann Riverse: P: (919) F: (919) Jeff Yarberrye: P: (970) F: (970) Veterinary ServicesMarquess P: (301) f: Wildlife Services Mary Beth Kowalskie: Mary.B. P: (970) f: (970) Steve Greinere: P: (970) f: (970) Allen Boyere: P: (919) e: (970)

Animal and Plant Health Inspection Service USDA APHIS OWCP Help Desk Info Phone: NPO Mailing Address: USDA/APHIS/MRPBS 4700 River Road, Unit 124 Riverdale, MD 20737

Animal and Plant Health Inspection Service Questions?