 denotes
special page for related topic
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| Filing and documenting claims from Code of Federal Regulations CFR
and FECA |
See 20
CFR ... Subpart B -- Filing Notices and Claims; Submitting Evidence.
In the FECA see 8120
Report of injury, 8121
Claim, 8122
Time for making claim |
| Forms and Types of claims: traumatic vs. occupational |
A claim is in order whenever the work causes a period of disability or need
for medical treatment. Besides the sudden accident called traumatic injury, there are
conditions that develop over time on the job, and exposures,
called occupational illness or disease.
Traumatic and occupational claims are handled differently, in the forms you file, the way
you get paid while off work, and the way you get medical
treatment .
See Traumatic vs Occupational
Illness/disease in CA-550 # 5,
# 6, and CA-810
2-3 & 2-4. Download forms . See CFR changes
on CA-7. See use of CA-17 Duty Status Report
in CFR changes .
If your agency fails to process forms, see CA-550 #Q129.
See use of official forms and getting copies from management in CFR changes . |
| Preexisting conditions, aggravation, stress, consequential or
intervening injuries, recurrences |
Underlying conditions don't
rule out a claim when the work accelerates
or precipitates a disability or need for treatment, including stress. Work may aggravate a condition,
temporarily or permanently. A secondary injury (consequential) on or off
the job may result from an on the job injury or condition. SEE ALSO Consequential and intervening
injuries , Recurrences , Temporary vs. permanent
aggravation ,
Acceleration & Precipitation
. See
relevant ECAB rulings on recurrences in ECABS . On Recurrences
and situations where CA-2a does NOT need to be filed, see CFR
changes .
See Recurrences from Bert Doyle,
NALC. Filing on
temporary aggravation is not recommended. Intermittent periods of disability, or
wage loss due to the claim condition, should be filed with form CA-7, filed every two
weeks of continuous disability. This also applies if COP is not applicable or has
run out. If the job requirements change so the work is no longer within current
restrictions on file, CA-7 may be used to file for the wage loss while off work again. |
| burden of proof, causal relationship |
Where the
work-injury connection is not obvious to all concerned, getting the medical documentation
to show causal relationship becomes absolutely critical. These
points are documented in the links to official sources online. The burden of proof is always on you, to get the right forms , to make sure they're handled right, to make sure your doctor
properly documents his findings for OWCP. See Burden of Proof in CFR changes . See relevant ECAB rulings on medical reports and causal
relationship in ECABS . Of course, FedupFeds argues that the law,
the FECA, should be rewritten to set up a fair, non-adversarial system where you don't
have to act as your own lawyer under stress. Consider the advice from FedupFeds
director in "Don't Give Up!" . |
| Occupational illness issues |
On occupational illness see Multiple
chemical sensitivity (MCS) in Health Topics , and the Bonnye Matthews campaign, and Toxic Kitsap and Polluted Puget
from Robert Farmer, both FedupFeds members. See Occupational disease or illness claims,
and Carpal
tunnel syndrome from Bert Doyle, NALC,.
Current official study from NIOSH
covers several physical conditions and current medical opinion on work-relatedness. This
is IMPORTANT. From NIOSH see "A Guide to the Work-relatedness of Disease"
- chemicals, NIOSH (downloadable - .pdf files- long), "Occupational Diseases A Guide to Their
Recognition" - NIOSH (downloadable .pdf files- long). SEE Stress , and evidence in stress
claims in Medical Reports . See also Evidence
required for specific diseases - .pdf file. |
| General guides |
General
guides to filing claims are found in "How to File a
Claim and Related Topics" from OWCP Region IV, Pub. CA-11
"When Injured at Work -- Information Guide for Federal Employees", Reporting
injury, initial steps - CA-550 # 33, NRLCA Injury Compensation
Handbook -- rural letter carriers publication, "Injury compensation made
simple" - Bert Doyle, NALC, "Avoid errors/omissions following
on the job injuries" - Bert Doyle, NALC, & Steve Burt (Michigan NALC Director
of Education) FECA page, with a 2 part course in basic compensation esp of value to
Postal Workers with applicable regulations.
See who is covered in CA-550 # 3, and
in CFR 20 Part 10 Subpart A - 10.5 - Definitions
and use of terms, including covered agencies. Conditions
for coverage in CA-810 3 1-5
includes: 3-1 Time, 3-2 Civil Employee, 3-3 Fact of Injury,
3-4 Performance of Duty, 3-5 Causal Relationship,
3-6 Statutory Exclusions. |
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Weigh the
consequences if you DON'T file when the time is right. It can get worse. You can
lose pay and protections the law intended you to have. LET YOUR DOCTOR DECIDE
WHETHER IT IS WORK RELATED. Once you've got treatment on your own without filing for
it, and failed to tell the doctor you want to know if it is work related, you may have
lost a lot more than your health.
from CA-550 # 4
4.Is it necessary to report all injuries that occur
at work, even minor injuries such as a scratched finger or bumped knee?
All injuries should be reported, since a seemingly minor injury may develop into a more
serious condition. For protection, the employee should file a report of the injury with
the immediate supervisor when it occurs. Benefits cannot be paid unless an injury is
reported. from
CA-810 2-2.
Traumatic Injury
......
b. Medical Treatment--Form CA-16
(1) Delayed Report of Injury. If an employee has
reported an injury several days after the fact, or did not request medical treatment
within 24 hours of the injury, the supervisor may still authorize medical care using Form
CA-16. Agency personnel are encouraged to use discretion in issuing authorizations for
medical care under such circumstances, but employees should not be penalized for short
delays in reporting injuries. The supervisor may, however, refuse to issue a CA-16 if more
than a week has passed since the injury on the basis that the need for immediate treatment
would normally have become apparent in that period of time. An employee may not use Form
CA-16 to authorize his or her own medical treatment.
from CA-810 5-3.
Controversion (situations where COP is NOT paid, and you need to apply for compensation
instead SEE Compensation)
......
f. The injury was not reported on a form approved by OWCP (usually Form CA-1) within
30 days following the injury; |
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| TRAP
# 2. filing the wrong kind of claim, traumatic or occupational |
from CA-550
# 7
7.Is there a specific form to be used for reporting an injury?
Form CA-1, "Federal Employee's Notice of Traumatic Injury and Claim for Continuation
of Pay/Compensation" is the form to use when reporting a traumatic injury. Form
CA-2, "Federal Employee's Notice of Occupational Disease and Claim for
Compensation," is the form for reporting an occupational disease. In addition, the
employee should be given two copies of the appropriate checklist, Form CA-35A through H, for the disease claimed (specific
checklists have been devised for various conditions in order to facilitate submission of
evidence).
Instructions attached to Forms CA-1 and CA-2 should be followed carefully. Form CA-1
should be filed within 30 days following the injury, and Form CA-2 should be filed within
30 days from the date the employee realized the disease or illness was caused or
aggravated by the employment. The forms may be obtained from the employing agency or from
OWCP.
SEE Traumatic vs Occupational
Illness |
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You need proof you filed the claim,
CA-1 or CA-2. Maybe they don't have a clue what to do with the paperwork, or worse.
If you don't get a claim number from OWCP soon, you may have to show them your
receipt as proof of filing.
from CA-810 2-2.
Traumatic Injury
a. Notice of Injury--Form CA-1
......
(3) Sign and return to the employee the receipt attached to Form CA-1 and give a copy of
the form to the employee if requested; |
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