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| Subpart
C--Continuation of Pay--CONTENTS |
| Click on section numbers at left |
|
10.200 What is
continuation of pay?
Eligibility for COP
10.205 What conditions must be met to receive COP?
10.206 May an employee who uses leave after an injury later
decide to use COP instead?
10.207 May an
employee who returns to work, then stops work again due to the effects of the injury,
receive COP?
Responsibilities
10.210 What are the employee's responsibilities in COP cases?
10.211 What are the employer's responsibilities in COP cases?
Calculation of COP
10.215 How does OWCP compute the number of days of COP used?
10.216 How is the pay rate for COP calculated?
10.217 Is COP charged if the employee continues to work, but in
a different job that pays less?
Controversion and Termination
of COP
10.220 When is an employer not required to pay COP?
10.221 How is a claim for COP controverted?
10.222 When may an employer terminate COP which has already
begun?
10.223 Are there other circumstances under which OWCP will not
authorize payment of COP?
10.224 What happens if OWCP finds that the employee is not
entitled to COP after it has been paid? |
Subpart C--Continuation of Pay
Sec. 10.200 What is continuation of pay?
(a) For most employees who sustain a traumatic injury, the FECA provides that the employer
must continue the employee's
regular pay during any periods of resulting disability, up to a maximum of 45 calendar
days. This is called continuation of pay,
or COP. The employer, not OWCP, pays COP. Unlike wage loss benefits, COP is subject to
taxes and all other payroll
deductions that are made from regular income.
(b) The employer must continue the pay of an employee who is eligible for COP, and may not
require the employee to use his
or her own sick or annual leave, unless the provisions of Secs. 10.200(c), 10.220, or Sec.
10.222 apply. However, while
continuing the employee's pay, the employer may controvert the employee's COP entitlement
pending a final determination by
OWCP. OWCP has the exclusive authority to determine questions of entitlement and all other
issues relating to COP.
(c) The FECA excludes certain persons from eligibility for COP. COP cannot be authorized
for members of these excluded
groups, which include but are not limited to: persons rendering personal service to the
United States similar to the service of a
civil officer or employee of the United States, without pay or for nominal pay; volunteers
(for instance, in the Civil Air Patrol
and Peace Corps); Job Corps and Youth Conservation Corps enrollees; individuals in
work-study programs, and grand or
petit jurors (unless otherwise Federal employees).
Eligibility
for COP
Sec. 10.205 What conditions must be met to receive COP?
(a) To be eligible for COP, a person must:
(1) Have a ``traumatic injury'' as defined at Sec. 10.5(ee) which is job-related and the
cause of the disability, and/or the cause
of lost time due to the need for medical examination and treatment;
(2) File Form CA-1 within 30 days of the date of the injury (but if that form is not
available, using another form would not alone
preclude receipt); and
(3) Begin losing time from work due to the traumatic injury within 45 days of the injury.
(b) OWCP may find that the employee is not entitled to COP for other reasons consistent
with the statute (see Sec. 10.220).
Sec. 10.206 May an employee who uses leave after an
injury later decide to use COP instead?
On Form CA-1, an employee may elect to use accumulated sick or annual leave, or leave
advanced by the agency, instead of
electing COP. The employee can change the election between leave and COP for prospective
periods at any point while
eligibility for COP remains. The employee may also change the election for past periods
and request COP in lieu of leave
already taken for the same period. In either situation, the following provisions apply:
(a) The request must be made to the employer within one year of the date the leave was
used or the date of the written
approval of the claim by OWCP (if written approval is issued), whichever is later.
(b) Where the employee is otherwise eligible, the agency shall restore leave taken in lieu
of any of the 45 COP days. Where
any of the 45 COP days remain unused, the agency shall continue pay prospectively.
(c) The use of leave may not be used to delay or extend the 45-day COP period or to
otherwise affect the time limitation as
provided by 5 U.S.C. 8117. Therefore, any leave used during the period of eligibility
counts towards the 45-day maximum
entitlement to COP.
Sec. 10.207 May an employee who returns to work, then stops work again due to
the effects of the injury, receive COP?
If the employee recovers from disability and returns to work, then becomes disabled again
and stops work, the employer shall
pay any of the 45 days of entitlement to COP not used during the initial period of
disability where:
(a) The employee completes Form CA-2a and elects to receive regular pay;
(b) OWCP did not deny the original claim for disability;
(c) The disability recurs and the employee stops work within 45 days of the time the
employee first returned to work following
the initial period of disability; and
(d) Pay has not been continued for the entire 45 days.
Responsibilities
Sec. 10.210 What are the employee's responsibilities in
COP cases?
An employee who sustains a traumatic injury which he or she considers disabling, or
someone authorized to act on his or her
behalf, must take the following actions to ensure continuing eligibility for COP. The
employee must:
(a) Complete and submit Form CA-1 to the employing agency as soon as possible, but no
later than 30 days from the date the
traumatic injury occurred.
(b) Ensure that medical evidence supporting disability resulting from the claimed
traumatic injury, including a statement as to
when the employee can return to his or her date of injury job, is provided to the employer
within 10 calendar days after filing
the claim for COP.
(c) Ensure that relevant medical evidence is submitted to OWCP, and cooperate with OWCP in
developing the claim.
(d) Ensure that the treating physician specifies work limitations and provides them to the
employer and/or representatives of
OWCP.
(e) Provide to the treating physician a description of any specific alternative positions
offered the employee, and ensure that the
treating physician responds promptly to the employer and/or OWCP, with an opinion as to
whether and how soon the
employee could perform that or any other specific position.
Sec. 10.211 What are the employer's responsibilities in
COP cases?
Once the employer learns of a traumatic injury sustained by an employee, it shall:
(a) Provide a Form CA-1 and Form CA-16 to authorize medical care in accordance with Sec.
10.300. Failure to do so may
mean that OWCP will not uphold any termination of COP by the employer.
(b) Advise the employee of the right to receive COP, and the need to elect among COP,
annual or sick leave or leave without
pay, for any period of disability.
(c) Inform the employee of any decision to controvert COP and/or terminate pay, and the
basis for doing so.
(d) Complete Form CA-1 and transmit it, along with all other available pertinent
information, (including the basis for any
controversion), to OWCP within 10 working days after receiving the completed form from the
employee.
Calculation
of COP
Sec. 10.215 How does OWCP compute the number of days of COP
used?
(CORRECTION, to
the Final Rule issued 12/23/99
Sec. 10.215 [Corrected]
4. On page 65316, in the second column, paragraph (b) is corrected by replacing ``30''
with ``45''.)
COP is payable for a maximum of 45 calendar days, and every day used is counted toward
this maximum. The following rules
apply:
(a) Time lost on the day or shift of the injury does not count toward COP. (Instead, the
agency must keep the employee in a
pay status for that period);
(b) The first COP day is the first day disability begins following the date of injury
(providing it is within the 45 days following the
date of injury), except where the injury occurs before the beginning of the work day or
shift, in which case the date of injury is
charged to COP;
(c) Any part of a day or shift (except for the day of the injury) counts as a full day
toward the 45 calendar day total;
(d) Regular days off are included if COP has been used on the regular work days
immediately preceding or following the
regular day(s) off, and medical evidence supports disability; and
(e) Leave used during a period when COP is otherwise payable is counted toward the 45-day
COP maximum as if the
employee had been in a COP status.
(f) For employees with part-time or intermittent schedules, all calendar days on which
medical evidence indicates disability are
counted as COP days, regardless of whether the employee was or would have been scheduled
to work on those days. The
rate at which COP is paid for these employees is calculated according to Sec. 10.216(b).
Sec. 10.216 How is the pay rate for COP calculated?
(CORRECTION, to
the Final Rule issued 12/23/99
Sec. 10.216 [Corrected]
5. On page 65316, in the third column, paragraph (b)(3) is corrected by replacing the
phrase ``For intermittent, seasonal and on-call workers,'' with, ``For intermittent and
seasonal workers,'')
The employer shall calculate COP using the period of time and the weekly pay rate.
(a) The pay rate for COP purposes is equal to the employee's regular ``weekly'' pay (the
average of the weekly pay over the
preceding 52 weeks).
(1) The pay rate excludes overtime pay, but includes other applicable extra pay except to
the extent prohibited by law.
(2) Changes in pay or salary (for example, promotion, demotion, within-grade increases,
termination of a temporary detail, etc.)
which would have otherwise occurred during the 45-day period are to be reflected in the
weekly pay determination.
(b) The weekly pay for COP purposes is determined according to the following formulas:
(1) For full or part-time workers (permanent or temporary) who work the same number of
hours each week of the year (or of
the appointment), the weekly pay rate is the hourly pay rate (A) in effect on the date of
injury multiplied by ( x ) the number of
hours worked each week (B): A x B = Weekly Pay Rate.
(2) For part-time workers (permanent or temporary) who do not work the same number of
hours each week, but who do
work each week of the year (or period of appointment), the weekly pay rate is an average
of the weekly earnings, established
by dividing (<divide>) the total earnings (excluding overtime) from the year
immediately preceding the injury (A) by the number
of weeks (or partial weeks) worked in that year (B): A <divide> B = Weekly Pay Rate.
(3) For intermittent and seasonal
workers, whether permanent or
temporary, who do not work either the same number
of hours or every week of the year (or period of appointment), the weekly pay rate is the
average weekly earnings established
by dividing (<divide>) the total earnings during the full 12-month period
immediately preceding the date of injury (excluding
overtime) (A), by the number of weeks (or partial weeks) worked during that year (B) (that
is, A <divide> B); or 150 times the
average daily wage earned in the employment during the days employed within the full year
immediately preceding the date of
injury divided by 52 weeks, whichever is greater.
Sec. 10.217 Is COP charged if the employee continues to
work, but in a different job that pays less?
If the employee cannot perform the duties of his or her regular position, but instead
works in another job with different duties
with no loss in pay, then COP is not chargeable. COP must be paid and the days counted
against the 45 days authorized by
law whenever an actual reduction of pay results from the injury, including a reduction of
pay for the employee's normal
administrative workweek that results from a change or diminution in his or her duties
following an injury. However, this does not
include a reduction of pay that is due solely to an employer being prohibited by law from
paying extra pay to an employee for
work he or she does not actually perform.
Controversion and Termination of COP
Sec. 10.220 When is an employer not required to pay COP?
(CORRECTION to
the Final Rule issued 03/12/99.
Sec. 10.220 [Corrected]
On page 65317, in the first column, paragraph (g) is corrected by replacing ``30'' with
``45''.)
An employer shall continue the regular pay of an eligible employee without a break in time
for up to 45 calendar days, except
when, and only when:
(a) The disability was not caused by a traumatic injury;
(b) The employee is not a citizen of the United States or Canada;
(c) No written claim was filed within 30 days from the date of injury;
(d) The injury was not reported until after employment has been terminated;
(e) The injury occurred off the employing agency's premises and was otherwise not within
the performance of official duties;
(f) The injury was caused by the employee's willful misconduct, intent to injure or kill
himself or herself or another person, or
was proximately caused by intoxication by alcohol or illegal drugs; or
(g) Work did not stop until more than 45 days following the injury.
Sec. 10.221 How is a claim for COP controverted?
When the employer stops an employee's pay for one of the reasons cited in Sec. 10.220, the
employer must controvert the
claim for COP on Form CA-1, explaining in detail the basis for the refusal. The final
determination on entitlement to COP
always rests with OWCP.
Sec. 10.222 When may an employer terminate COP which has
already begun?
(a) Where the employer has continued the pay of the employee, it may be stopped only when
at least one of the following
circumstances is present:
(1) Medical evidence which on its face supports disability due to a work-related injury is
not received within 10 calendar days
after the claim is submitted (unless the employer's own investigation shows disability to
exist). Where the medical evidence is
later provided, however, COP shall be reinstated retroactive to the date of termination;
(2) The medical evidence from the treating physician shows that the employee is not
disabled from his or her regular position;
(3) Medical evidence from the treating physician shows that the employee is not totally
disabled, and the employee refuses a
written offer of a suitable alternative position which is approved by the attending
physician. If OWCP later determines that the
position was not suitable, OWCP will direct the employer to grant the employee COP
retroactive to the termination date.
(4) The employee returns to work with no loss of pay;
(5) The employee's period of employment expires or employment is otherwise terminated (as
established prior to the date of
injury);
(6) OWCP directs the employer to stop COP; and/or
(7) COP has been paid for 45 calendar days.
(b) An employer may not interrupt or stop COP to which the employee is otherwise entitled
because of a disciplinary action,
unless a preliminary notice was issued to the employee before the date of injury and the
action becomes final or otherwise takes
effect during the COP period.
(c) An employer cannot otherwise stop COP unless it does so for one of the reasons found
in this section or Sec. 10.220.
Where an employer stops COP, it must file a controversion with OWCP, setting forth the
basis on which it terminated COP,
no later than the effective date of the termination.
Sec. 10.223 Are there other circumstances under which OWCP will not authorize
payment of COP?
When OWCP finds that an employee or his or her representative refuses or obstructs a
medical examination required by
OWCP, the right to COP is suspended until the refusal or obstruction ceases. COP already
paid or payable for the period of
suspension is forfeited. If already paid, the COP may be charged to annual or sick leave
or considered an overpayment of pay
consistent with 5 U.S.C. 5584.
Sec. 10.224 What happens if OWCP finds that the employee
is not entitled to COP after it has been paid?
Where OWCP finds that the employee is not entitled to COP after it has been paid, the
employee may chose to have the time
charged to annual or sick leave, or considered an overpayment of pay under 5 U.S.C. 5584.
The employer must correct any
deficiencies in COP as directed by OWCP.