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| Subpart
E--Compensation and Related Benefits--CONTENTS |
| Click on section numbers at left |
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Compensation for Disability and
Impairment
10.400 What is total disability?
10.401 When and how is compensation for total disability paid?
10.402 What is partial disability?
10.403 When and how is compensation for partial disability
paid?
10.404 When and how is compensation for a schedule impairment
paid?
10.405 Who is considered a dependent in a claim based on
disability or impairment?
10.406 What are
the maximum and minimum rates of compensation in disability cases?
Compensation for Death
10.410 Who is entitled to compensation in case of death, and
what are the rates of compensation payable in death cases?
10.411 What are the maximum and minimum rates of compensation
in death cases?
10.412 Will OWCP
pay the costs of burial and transportation of the remains?
10.413 If a person dies while receiving a schedule award, to
whom is the balance of the schedule award payable?
10.414 What reports of dependents are needed in death cases?
10.415 What must a beneficiary do if the number of
beneficiaries decreases?
10.416 How does a change in the number of beneficiaries affect
the amount of compensation paid to the other beneficiaries?
10.417 What reports are needed when compensation payments
continue for children over age 18?
Adjustments to Compensation
10.420 How are cost-of-living adjustments applied?
10.421 May a beneficiary receive other kinds of payments from
the Federal Government concurrently with compensation?
10.422 May compensation payments be issued in a lump sum?
10.423 May compensation payments be assigned to, or attached
by, creditors?
10.424 May someone other than the beneficiary be designated to
receive compensation payments?
10.425 May compensation be claimed for periods of restorable
leave?
Overpayments
10.430 How does OWCP notify an individual of a payment made?
10.431 What does OWCP do when an overpayment is identified?
10.432 How can an individual present evidence to OWCP in
response to a preliminary notice of an overpayment?
10.433 Under what circumstances can OWCP waive recovery of an
overpayment?
10.434 If OWCP
finds that the recipient of an overpayment was not at fault, what criteria are used to
decide whether to waive recovery of it?
10.435 Is an individual responsible for an overpayment that
resulted from an error made by OWCP or another Government
agency?
10.436 Under what circumstances would recovery of an
overpayment defeat the purpose of the FECA?
10.437 Under what circumstances would recovery of an
overpayment be against equity and good conscience?
10.438 Can OWCP require the individual who received the
overpayment to submit additional financial information?
10.439 What is addressed at a pre-recoupment hearing?
10.440 How does OWCP communicate its final decision concerning
recovery of an overpayment, and what appeal right
accompanies it?
10.441 How are overpayments collected? |
Subpart E--Compensation and Related
Benefits
Compensation for Disability and
Impairment
Sec. 10.400 What is total
disability?
(a) Permanent total disability is presumed to result from the loss of use of both hands,
both arms, both feet, or both legs, or the
loss of sight of both eyes. However, the presumption of permanent total disability as a
result of such loss may be rebutted by
evidence to the contrary, such as evidence of continued ability to work and to earn wages
despite the loss.
(b) Temporary total disability is defined as the inability to return to the position held
at the time of injury or earn equivalent
wages, or to perform other gainful employment, due to the work-related injury. Except as
presumed under paragraph (a) of this
section, an employee's disability status is always considered temporary pending return to
work.
Sec. 10.401 When and how is compensation for total
disability paid?
(a) Compensation is payable when the employee starts to lose pay if the injury causes
permanent disability or if pay loss
continues for more than 14 calendar days. Otherwise, compensation is payable on the fourth
day after pay stops.
Compensation may not be paid while an injured employee is in a continuation of pay status
or receives pay for leave.
(b) Compensation for total disability is payable at the rate of 66\2/3\ percent of the pay
rate if the employee has no dependents,
or 75 percent of the pay rate if the employee has at least one dependent. (``Dependents''
are defined at 5 U.S.C. 8110(a).)
Sec. 10.402 What is partial
disability?
An injured employee who cannot return to the position held at the time of injury (or earn
equivalent wages) due to the
work-related injury, but who is not totally disabled for all gainful employment, is
considered to be partially disabled.
Sec. 10.403 When and how is compensation for partial
disability paid?
(a) 5 U.S.C. 8115 outlines how compensation for partial disability is determined. If the
employee has actual earnings which
fairly and reasonably represent his or her wage-earning
capacity, those earnings may form the basis for payment of
compensation for partial disability. (See Secs. 10.500 through 10.520 concerning return to
work.) If the employee's actual
earnings do not fairly and reasonably represent his or her wage-earning capacity, or if
the employee has no actual earnings,
OWCP uses the factors stated in 5 U.S.C. 8115 to select a position which represents his or
her wage-earning capacity.
However, OWCP will not secure employment for the employee in the position selected for
establishing a wage-earning
capacity.
(b) Compensation for partial disability is payable as a percentage of the difference
between the employee's pay rate for
compensation purposes and the employee's wage-earning capacity. The percentage is 66\2/3\
percent of this difference if the
employee has no dependents, or 75 percent of this difference if the employee has at least
one dependent.
(c) The formula which OWCP uses to compute the compensation payable for partial disability
employs the following terms: Pay
rate for compensation purposes, which is defined in Sec. 10.5(s) of this part; current pay
rate, which means the salary or wages
for the job held at the time of injury at the time of the determination; and earnings,
which means the employee's actual earnings,
or the salary or pay rate of the position selected by OWCP as representing the employee's
wage- earning capacity.
(d) The employee's wage-earning capacity in terms of percentage is computed by dividing
the employee's earnings by the
current pay rate. The comparison of earnings and ``current'' pay rate for the job held at
the time of injury need not be made as
of the beginning of partial disability. OWCP may use any convenient date for making the
comparison as long as both wage
rates are in effect on the date used for comparison.
(e) The employee's wage-earning capacity in terms of dollars is computed by first
multiplying the pay rate for compensation
purposes by the percentage of wage-earning capacity. The resulting dollar amount is then
subtracted from the pay rate for
compensation purposes to obtain the employee's loss of wage-earning capacity.
Sec. 10.404 When and how is compensation for a schedule impairment paid?
Compensation is provided for specified periods of time for the permanent loss or loss of
use of certain members, organs and
functions of the body. Such loss or loss of use is known as permanent impairment.
Compensation for proportionate periods of
time is payable for partial loss or loss of use of each member, organ or function. OWCP
evaluates the degree of impairment to
schedule members, organs and functions as defined in 5 U.S.C. 8107 according to the
standards set forth in the specified (by
OWCP) edition of the American Medical
Association's Guides to the Evaluation of Permanent Impairment.
(a) 5 U.S.C. 8107(c) provides a list of schedule members. Pursuant to the authority
provided by 5 U.S.C. 8107(c)(22), the
Secretary has added the following organs to the compensation schedule for injuries that
were sustained on or after September
7, 1974:
Member
Weeks
Breast (one)
52
Kidney (one)
156
Larynx
160
Lung (one)
156
Penis
205
Testicle (one)
52
Tongue
160
Ovary (one)
52
Uterus/cervix and vulva/vagina
205
(b) Compensation for schedule awards is payable at 66\2/3\ percent of the employee's pay,
or 75 percent of the pay when the
employee has at least one dependent.
(c) The period of compensation payable under 5 U.S.C. 8107(c) shall be reduced by the
period of compensation paid or
payable under the schedule for an earlier injury if:
(1) Compensation in both cases is for impairment of the same member or function or
different parts of the same member or
function, or for disfigurement; and
(2) OWCP finds that compensation payable for the later impairment in whole or in part
would duplicate the compensation
payable for the pre-existing impairment.
(d) Compensation not to exceed $3,500 may be paid for serious disfigurement of the face,
head or neck which is likely to
handicap a person in securing or maintaining employment.
Sec. 10.405 Who is considered a dependent
in a claim based on disability or impairment?
(a) Dependents include a wife or husband; an unmarried child under 18 years of age; an
unmarried child over 18 who is
incapable of self- support; a student, until he or she reaches 23 years of age or
completes four years of school beyond the high
school level; or a wholly dependent parent.
(b) Augmented compensation payable for an unmarried child, which would otherwise terminate
when the child reached the age
of 18, may be continued while the child is a student as defined in 5 U.S.C. 8101(17).
Sec. 10.406 What are the maximum and minimum rates of
compensation in disability cases?
(a) Compensation for total or partial disability may not exceed 75 percent of the basic
monthly pay of the highest step of grade
15 of the General Schedule. (Basic monthly pay does not include locality adjustments.)
However, this limit does not apply to
disability sustained in the performance of duty which was due to an assault which occurred
during an attempted assassination of
a Federal official described under 10 U.S.C. 351(a) or 1751(a).
(b) Compensation for total disability may not be less than 75 percent of the basic monthly
pay of the first step of grade 2 of the
General Schedule or actual pay, whichever is less. (Basic monthly pay does not include
locality adjustments.)
Compensation for Death
Sec. 10.410 Who is entitled to compensation in case of
death, and what are the rates of compensation payable in death cases?
(a) If there is no child entitled to compensation, the employee's surviving spouse will
receive compensation equal to 50 percent
of the employee's monthly pay until death or remarriage before reaching age 55. Upon
remarriage, the surviving spouse will be
paid a lump sum equal to 24 times the monthly compensation payment (excluding compensation
payable on account of another
individual) to which the surviving spouse was entitled immediately before the remarriage.
If remarriage occurs at age 55 or
older, the lump-sum payment will not be paid and compensation will continue until death.
(b) If there is a child entitled to compensation, the compensation for the surviving
spouse will equal 45 percent of the
employee's monthly pay plus 15 percent for each child, but the total percentage may not
exceed 75 percent.
(c) If there is a child entitled to compensation and no surviving spouse, compensation for
one child will equal 40 percent of the
employee's monthly pay. Fifteen percent will be awarded for each additional child, not to
exceed 75 percent, the total amount
to be shared equally among all children.
(d) If there is no child or surviving spouse entitled to compensation, the parents will
receive compensation equal to 25 percent
of the employee's monthly pay if one parent was wholly dependent on the employee at the
time of death and the other was not
dependent to any extent, or 20 percent each if both were wholly dependent on the employee,
or a proportionate amount in the
discretion of the Director if one or both were partially dependent on the employee. If
there is a child or surviving spouse entitled
to compensation, the parents will receive so much of the compensation described in the
preceding sentence as, when added to
the total percentages payable to the surviving spouse and children, will not exceed a
total of 75 percent of the employee's
monthly pay.
(e) If there is no child, surviving spouse or dependent parent entitled to compensation,
the brothers, sisters, grandparents and
grandchildren will receive compensation equal to 20 percent of the employee's monthly pay
to such dependent if one was
wholly dependent on the employee at the time of death; or 30 percent if more than one was
wholly dependent, divided among
such dependents equally; or 10 percent if no one was wholly dependent but one or more was
partly dependent, divided among
such dependents equally. If there is a child, surviving spouse or dependent parent
entitled to compensation, the brothers, sisters,
grandparents and grandchildren will receive so much of the compensation described in the
preceding sentence as, when added
to the total percentages payable to the children, surviving spouse and dependent parents,
will not exceed a total of 75 percent
of the employee's monthly pay.
(f) A child, brother, sister or grandchild may be entitled to receive death benefits until
death, marriage, or reaching age 18.
Regarding entitlement after reaching age 18, refer to Sec. 10.417 of these regulations.
Sec. 10.411 What are the maximum and minimum rates of
compensation in death cases?
(a) Compensation for death may not exceed the employee's pay or 75 percent of the basic
monthly pay of the highest step of
grade 15 of the General Schedule, except that compensation may exceed the employee's basic
monthly pay if such excess is
created by authorized cost-of-living increases. (Basic monthly pay does not include
locality adjustments.) However, the
maximum limit does not apply when the death occurred during an assassination
of a Federal official described under 18 U.S.C.
351(a) or 18 U.S.C. 1751(a).
(b) Compensation for death is computed on a minimum pay rate equal to the basic monthly
pay of an employee at the first step
of grade 2 of the General Schedule. (Basic monthly pay does not include locality
adjustments.)
Sec. 10.412 Will OWCP pay the costs of burial and
transportation of the remains?
In a case accepted for death benefits, OWCP will pay up to $800 for funeral and burial
expenses. When an employee's home
is within the United States and the employee dies outside the United States, or away from
home or the official duty station, an
additional amount may be paid for transporting the remains to the employee's home. An
additional amount of $200 is paid to
the personal representative of the decedent for reimbursement of the costs of terminating
the decedent's status as an employee
of the United States.
Sec. 10.413 If a person dies while receiving a schedule
award, to whom is the balance of the schedule award payable?
The circumstances under which the balance of a schedule award may be paid to an employee's
survivors are described in 5
U.S.C. 8109. Therefore, if there is no surviving spouse or child, OWCP will pay benefits
as follows:
(a) To the parent, or parents, wholly dependent for support on the decedent in equal
shares with any wholly dependent brother,
sister, grandparent or grandchild;
(b) To the parent, or parents, partially dependent for support on the decedent in equal
shares when there are no wholly
dependent brothers, sisters, grandparents or grandchildren (or other wholly dependent
parent); and
(c) To the parent, or parents, partially dependent upon the decedent, 25 percent of the
amount payable, shared equally, and the
remaining 75 percent to any wholly dependent brother, sister, grandparent or grandchild
(or wholly dependent parent), shared
equally.
Sec. 10.414 What reports of dependents are needed in
death cases?
If a beneficiary is receiving compensation benefits on account of an employee's death,
OWCP will ask him or her to complete a
report once each year on Form CA-12. The report requires the beneficiary to note changes
in marital status and dependents. If
the beneficiary fails to submit the form (or an equivalent written statement) within 30
days of the date of request, OWCP shall
suspend compensation until the requested form or equivalent written statement is received.
The suspension will include
compensation payable for or on behalf of another person (for example, compensation payable
to a widow on behalf of a child).
When the form or statement is received, compensation will be reinstated at the appropriate
rate retroactive to the date of
suspension, provided the beneficiary is entitled to such compensation.
Sec. 10.415 What must a beneficiary do if the number of
beneficiaries decreases?
The circumstances under which compensation on account of death shall be terminated are
described in 5 U.S.C. 8133(b). A
beneficiary in a claim for death benefits should promptly notify OWCP of any event which
would affect his or her entitlement to
continued compensation. The terms ``marriage'' and ``remarriage'' include common-law
marriage as recognized and defined by
State law in the State where the beneficiary resides. If a beneficiary, or someone acting
on his or her behalf, receives a check
which includes payment of compensation for any period after the date when entitlement
ended, he or she must promptly return
the check to OWCP.
Sec. 10.416 How does a change in the number of
beneficiaries affect the amount of compensation paid to the other
beneficiaries?
If compensation to a beneficiary is terminated, the amount of compensation payable to one
or more of the remaining
beneficiaries may be reapportioned. Similarly, the birth of a posthumous child may result
in a reapportionment of the amount of
compensation payable to other beneficiaries. The parent, or someone acting on the child's
behalf, shall promptly notify OWCP
of the birth and submit a copy of the birth certificate.
Sec. 10.417 What reports are needed when compensation payments
continue for children over age 18?
(a) Compensation payable on behalf of a child, brother, sister, or grandchild, which would
otherwise end when the person
reaches 18 years of age, shall be continued if and for so long as he or she is not married
and is either a student as defined in 5
U.S.C. 8101(17), or physically or mentally incapable of self-support.
(b) At least twice each year, OWCP will ask a beneficiary receiving compensation based on
the student status of a dependent
to provide proof of continuing entitlement to such compensation, including certification
of school enrollment.
(c) Likewise, at least twice each year, OWCP will ask a beneficiary or legal guardian
receiving compensation based on a
dependent's physical or mental inability to support himself or herself to submit a medical
report verifying that the dependent's
medical condition persists and that it continues to preclude self-support.
Adjustments
to Compensation
Sec. 10.420 How are cost-of-living
adjustments applied?
(a) In cases of disability, a beneficiary is eligible for cost-of- living adjustments
under 5 U.S.C. 8146a where injury-related
disability began more than one year prior to the date the cost-of-living adjustment took
effect. The employee's use of
continuation of pay as provided by 5 U.S.C. 8118, or of sick or annual leave, during any
part of the period of disability does
not affect the computation of the one- year period.
(b) Where an injury does not result in disability but compensation is payable for
permanent impairment of a covered member,
organ or function of the body, a beneficiary is eligible for cost-of-living adjustments
under 5 U.S.C. 8146a where the award for
such impairment began more than one year prior to the date the cost-of-living adjustment
took effect.
(c) In cases of recurrence of disability, where the pay rate for compensation purposes is
the pay rate at the time disability
recurs, a beneficiary is eligible for cost-of-living adjustments under 5 U.S.C. 8146a
where the effective date of that pay rate
began more than one year prior to the date the cost-of living adjustment took effect.
(d) In cases of death, entitlement to cost-of-living adjustments under 5 U.S.C. 8146a
begins with the first such adjustment
occurring more than one year after the date of death. However, if the death was preceded
by a period of injury-related
disability, compensation payable to the survivors will be increased by the same
percentages as the cost- of-living adjustments
paid or payable to the deceased employee for the period of disability, as well as by
subsequent cost-of-living adjustments to
which the survivors would otherwise be entitled.
Sec. 10.421 May a beneficiary receive other kinds of
payments from the Federal Government concurrently with
compensation?
(a) 5 U.S.C. 8116(a) provides that a beneficiary may not receive wage-loss compensation
concurrently with a Federal
retirement or survivor annuity. The beneficiary must elect the benefit that he or she
wishes to receive, and the election, once
made, is revocable.
(b) An employee may receive compensation concurrently with military
retired pay, retirement pay, retainer pay or equivalent
pay for service in the Armed Forces or other uniformed services, subject to the reduction
of such pay in accordance with 5
U.S.C. 5532(b).
(c) An employee may not receive compensation for total disability concurrently with severance pay or separation pay.
However, an employee may concurrently receive compensation for partial disability or
permanent impairment to a schedule
member, organ or function with severance pay or separation pay.
(d) Pursuant to 5 U.S.C. 8116(d), a beneficiary may receive compensation under the FECA
for either the death or disability of
an employee concurrently with benefits under title II of the Social Security Act on
account of the age or death of such
employee. However, this provision of the FECA also requires OWCP to reduce the amount of
any such compensation by the
amount of any Social Security Act benefits that are attributable to the Federal service of
the employee.
(e) To determine the employee's entitlement to compensation, OWCP may require an employee
to submit an affidavit or
statement as to the receipt of any Federally funded or Federally assisted benefits. If an
employee fails to submit such affidavit or
statement within 30 days of the date of the request, his or her right to compensation
shall be suspended until such time as the
requested affidavit or statement is received. At that time compensation will be reinstated
retroactive to the date of suspension
provided the employee is entitled to such compensation.
Sec. 10.422 May compensation payments be issued in a lump sum?
(a) In exercise of the discretion afforded under 5 U.S.C. 8135(a), OWCP has determined
that lump-sum payments will not be
made to persons entitled to wage-loss benefits (that is, those payable under 5 U.S.C. 8105
and 8106). Therefore, when
OWCP receives requests for lump-sum payments for wage-loss benefits, OWCP will not
exercise further discretion in the
matter. This determination is based on several factors, including:
(1) The purpose of the FECA, which is to replace lost wages;
(2) The prudence of providing wage-loss benefits on a regular, recurring basis; and
(3) The high cost of the long-term borrowing that is needed to pay out large lump sums.
(b) However, a lump-sum payment may be made to an employee entitled to a schedule award
under 5 U.S.C. 8107 where
OWCP determines that such a payment is in the employee's best interest. Lump-sum payments
of schedule awards generally
will be considered in the employee's best interest only where the employee does not rely
upon compensation payments as a
substitute for lost wages (that is, the employee is working or is receiving annuity
payments). An employee possesses no
absolute right to a lump-sum payment of benefits payable under 5 U.S.C. 8107.
(c) Lump-sum payments to surviving
spouses are addressed in 5 U.S.C. 8135(b).
Sec. 10.423 May compensation payments be assigned to, or
attached by, creditors?
(a) As a general rule, compensation and claims for compensation are exempt from the claims
of private creditors. This rule does
not apply to claims submitted by Federal agencies. Further, any attempt by a FECA
beneficiary to assign his or her claim is null
and void. However, pursuant to provisions of the Social Security Act, 42 U.S.C. 659, and
regulations issued by the Office of
Personnel Management (OPM) at 5 CFR part 581, FECA benefits, including survivor's
benefits, may be garnished to collect
overdue alimony and child support payments.
(b) Garnishment for child support and alimony may
be requested by providing a copy of the State agency or court order to the
district office handling the FECA claim.
Sec. 10.424 May someone other than the beneficiary be
designated to receive compensation payments?
A beneficiary may be incapable of managing or directing the management of his or her
benefits because of a mental or physical
disability, or because of legal incompetence, or because he or she is under 18 years of
age. In this situation, absent the
appointment of a guardian or other party to manage the financial affairs of the claimant
by a court or administrative body
authorized to do so, OWCP in its sole discretion may approve a person to serve as the
representative payee for funds due the
beneficiary.
Sec. 10.425 May compensation be claimed for periods of
restorable leave?
The employee may claim compensation for periods of annual and sick leave which are
restorable in accordance with the rules
of the employing agency. Forms CA-7a and CA-7b are used for this purpose.
Overpayments
Sec. 10.430 How does OWCP notify an individual of a
payment made?
(a) In addition to providing narrative descriptions to recipients of benefits paid or
payable, OWCP includes on each periodic
check a clear indication of the period for which payment is being made. A form is sent to
the recipient with each supplemental
check which states the date and amount of the payment and the period for which payment is
being made. For payments sent by
electronic funds transfer (EFT), a notification of the date and amount of payment appears
on the statement from the recipient's
financial institution.
(b) By these means, OWCP puts the recipient on notice that a payment was made and the
amount of the payment. If the
amount received differs from the amount indicated on the written notice or bank statement,
the recipient is responsible for
notifying OWCP of the difference. Absent affirmative evidence to the contrary, the
beneficiary will be presumed to have
received the notice of payment, whether mailed or transmitted electronically.
Sec. 10.431 What does OWCP do when an overpayment is
identified?
Before seeking to recover an overpayment or adjust benefits, OWCP will advise the
beneficiary in writing that:
(a) The overpayment exists, and the amount of overpayment;
(b) A preliminary finding shows either that the individual was or was not at fault in the
creation of the overpayment;
(c) He or she has the right to inspect and copy Government records relating to the
overpayment; and
(d) He or she has the right to present evidence which challenges the fact or amount of the
overpayment, and/or challenges the
preliminary finding that he or she was at fault in the creation of the overpayment. He or
she may also request that recovery of
the overpayment be waived.
Sec. 10.432 How can an individual present evidence to
OWCP in response to a preliminary notice of an overpayment?
The individual may present this evidence to OWCP in writing or at a pre-recoupment
hearing. The evidence must be presented
or the hearing requested within 30 days of the date of the written notice of overpayment.
Failure to request the hearing within
this 30-day time period shall constitute a waiver of that right.
Sec. 10.433 Under what circumstances can OWCP waive recovery of an overpayment?
(a) OWCP may consider waiving an overpayment only if the individual to whom it was made
was not at fault in accepting or
creating the overpayment. Each recipient of compensation benefits is responsible for
taking all reasonable measures to ensure
that payments he or she receives from OWCP are proper. The recipient must show good faith
and exercise a high degree of
care in reporting events which may affect entitlement to or the amount of benefits. A
recipient who has done any of the
following will be found to be at fault with respect to creating an overpayment:
(1) Made an incorrect statement as to a material fact which he or she knew or should have
known to be incorrect; or
(2) Failed to provide information which he or she knew or should have known to be
material; or
(3) Accepted a payment which he or she knew or should have known to be incorrect. (This
provision applies only to the
overpaid individual.)
(b) Whether or not OWCP determines that an individual was at fault with respect to the
creation of an overpayment depends
on the circumstances surrounding the overpayment. The degree of care expected may vary
with the complexity of those
circumstances and the individual's capacity to realize that he or she is being overpaid.
Sec. 10.434 If OWCP finds that the recipient of an
overpayment was not at fault, what criteria are used to decide whether to waive recovery
of it?
If OWCP finds that the recipient of an overpayment was not at fault, repayment will still
be required unless:
(a) Adjustment or recovery of the overpayment would defeat the purpose of the FECA (see
Sec. 10.436), or
(b) Adjustment or recovery of the overpayment would be against equity and good conscience
(see Sec. 10.437).
Sec. 10.435 Is an individual responsible for an
overpayment that resulted from an error made by OWCP or another
Government agency?
(a) The fact that OWCP may have erred in making the overpayment, or that the overpayment
may have resulted from an error
by another Government agency, does not by itself relieve the individual who received the
overpayment from liability for
repayment if the individual also was at fault in accepting the overpayment.
(b) However, OWCP may find that the individual was not at fault if failure to report an
event affecting compensation benefits,
or acceptance of an incorrect payment, occurred because:
(1) The individual relied on misinformation given in writing by OWCP (or by another
Government agency which he or she had
reason to believe was connected with the administration of benefits) as to the
interpretation of a pertinent provision of the
FECA or its regulations; or
(2) OWCP erred in calculating cost-of-living increases, schedule award length and/or
percentage of impairment, or loss of
wage-earning capacity.
Sec. 10.436 Under what circumstances would recovery of
an overpayment defeat the purpose of the FECA?
Recovery of an overpayment will defeat the purpose of the FECA if such recovery would
cause hardship to a currently or
formerly entitled beneficiary because:
(a) The beneficiary from whom OWCP seeks recovery needs substantially all of his or her
current income (including
compensation benefits) to meet current ordinary and necessary living expenses; and
(b) The beneficiary's assets do not exceed a specified amount as determined by OWCP from
data furnished by the Bureau of
Labor Statistics. A higher amount is specified for a beneficiary with one or more
dependents.
Sec. 10.437 Under what circumstances would recovery of
an overpayment be against equity and good conscience?
(a) Recovery of an overpayment is considered to be against equity and good conscience when
any individual who received an
overpayment would experience severe financial hardship in attempting to repay the debt.
(b) Recovery of an overpayment is also considered to be against equity and good conscience
when any individual, in reliance
on such payments or on notice that such payments would be made, gives up a valuable right
or changes his or her position for
the worse. In making such a decision, OWCP does not consider the individual's current
ability to repay the overpayment.
(1) To establish that a valuable right has been relinquished, it must be shown that the
right was in fact valuable, that it cannot be
regained, and that the action was based chiefly or solely in reliance on the payments or
on the notice of payment. Donations to
charitable causes or gratuitous transfers of funds to other individuals are not considered
relinquishments of valuable rights.
(2) To establish that an individual's position has changed for the worse, it must be shown
that the decision made would not
otherwise have been made but for the receipt of benefits, and that this decision resulted
in a loss.
Sec. 10.438 Can OWCP require the individual who received
the overpayment to submit additional financial information?
(a) The individual who received the overpayment is responsible for providing information
about income, expenses and assets as
specified by OWCP. This information is needed to determine whether or not recovery of an
overpayment would defeat the
purpose of the FECA, or be against equity and good conscience. This information will also
be used to determine the repayment
schedule, if necessary.
(b) Failure to submit the requested information within 30 days of the request shall result
in denial of waiver, and no further
request for waiver shall be considered until the requested information is furnished.
Sec. 10.439 What is addressed at a pre-recoupment
hearing?
At a pre-recoupment hearing, the OWCP representative will consider all issues in the claim
on which a formal decision has
been issued. Such a hearing will thus fulfill OWCP's obligation to provide pre- recoupment
rights and a hearing under 5 U.S.C.
8124(b). Pre-recoupment hearings shall be conducted in exactly the same manner as provided
in Sec. 10.615 through Sec.
10.622.
Sec. 10.440 How does OWCP communicate its final decision
concerning recovery of an overpayment, and what appeal right accompanies it?
(a) OWCP will send a copy of the final decision to the individual from whom recovery is
sought; his or her representative, if
any; and the employing agency.
(b) The only review of a final decision concerning an overpayment is to the Employees'
Compensation Appeals Board. The
provisions of 5 U.S.C. 8124(b) (concerning hearings) and 5 U.S.C. 8128(a) (concerning
reconsiderations) do not apply to
such a decision.
Sec. 10.441 How are overpayments collected?
(a) When an overpayment has been made to an individual who is entitled to further
payments, the individual shall refund to
OWCP the amount of the overpayment as soon as the error is discovered or his or her
attention is called to same. If no refund
is made, OWCP shall decrease later payments of compensation, taking into account the
probable extent of future payments,
the rate of compensation, the financial circumstances of the individual, and any other
relevant factors, so as to minimize any
hardship. Should the individual die before collection has been completed, collection shall
be made by decreasing later
payments, if any, payable under the FECA with respect to the individual's death.
(b) When an overpayment has been made to an individual who is not entitled to further
payments, the individual shall refund to
OWCP the amount of the overpayment as soon as the error is discovered or his or her
attention is called to same. The
overpayment is subject to the provisions of the Federal Claims Collection Act of 1966 (as
amended) and may be reported to
the Internal Revenue Service as income. If the individual fails to make such refund, OWCP
may recover the same through any
available means, including offset of salary, annuity benefits, or other Federal payments,
including tax refunds as authorized by
the Tax Refund Offset Program, or referral of the debt to a collection agency or to the
Department of Justice.