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Postal Workers Injured on Duty Information

OWCP Attorney

* Postal Workers Injured on Duty Forum

What to Do When Injured at Work Timeliness CA-Forms Listing
Right to see own physician Causal Relationship Contacting OWCP
Injury Compensation Manual (PDF) (source NALC)

USPS EL 505

Scheduled Awards


Articles by Dan Sullivan on USPS National Reassessment Program

 

New PS Form 2499, Offer of Modified Assignment (Limited Duty)

New PS Form 2499, Offer of Modified Assignment (Limited Duty), is effective October 1, 2007. The purpose of this form is to do the following:

  • Promote the timely offer of available limited duty job assignments to injured employees.
  • Facilitate service-wide standardization of the method of documenting limited duty job offers.
  • Promote and document regulatory compliance with the Federal Employees’ Compensation Act (FECA) requirement of timely issuance of limited duty job offers.
  • Clarify the precise nature of the limited duty work being offered to an injured employee, including a description of the duties to be performed, specific physical requirements, and special demands of the workload or unusual working conditions.
  • Identify the organization offering the position and the location of the job.
  • Document the date on which the job will be available.

        source: Postal Bulletin

   Memorandum: USPS’ position when light and/or limited duty employees are subject to Article 12 reassignment (pdf)

USPS Unveils Prescription Drug Card for Workplace Injuries - The USPS has announced a voluntary prescription drug card program for employees who suffer workplace injuries or illnesses. According to the Postal Service, employees who choose to participate in the program will submit their drug card and prescriptions to the pharmacy of their choice, and the prescriptions will be filled at no cost to the employee. source: APWU (5/16/06)

 U.S. Postal Service ‘Outsourcing' Program  of Injured on Duty Employees Program’ Goes Nationwide - The Postal Service aggressively monitors limited-duty and rehabilitation assignments, and in May 2005 notified the APWU that the USPS would begin a reassessment of rehabilitation jobs and limited duty assignments. The “reassessments” will be implemented nationwide, by District. San Diego has become the initial site, and is set to begin late this summer. A pilot program was initiated in April 2004 in the Long Island (NY) District. The Postal Service contends that the program is necessary because there are a declining number of jobs available for injured employees who have substantial medical limitations. If there is no medically-suitable job available for such an employee, the Postal Service will refer the employee to OWCP for placement in OWCP’s vocational rehabilitation program and eventual re-employment in the private sector.


Check out "General Summary of the Duties for a

city carrier| mail handler |manual distribution clerk| automation clerk| automated flat sorter clerk | spbs clerk. The summaries are designed to assist treating physicians in their recommendations for appropriate work restrictions. (10/21/03)


A specific group of OWCP recipients who are members of the APWU bargaining unit and received OWCP wage loss compensation during a specific time period are entitled to a review of their compensation entitlement
Leave Buy Back: Postal Service Policy Change
Limited Duty and Rehabilitation Job Reassessment Program
Any and all telephone contact initiated by the agency, regardless of the subject is entirely prohibited. Telephone or personal contact with the physician's staff is considered contact with the physician and is also prohibited
Relationship Between Retirement Annuity and Compensation for Work-Related Injuries and Diseases
ELM Revision: Return to Duty After Occupational Illness or Injury (Postal Bulletin - 6/8/06)
Return-to-work clearance may be required for absences due to an illness, injury, outpatient medical procedure (surgical), or hospitalization when management has a reasonable belief, based upon reliable and objective information, that:
  • a. The employee may not be able to perform the essential functions of his or her position, or
  • b. The employee may pose a direct threat to the health or safety of him/herself or others due to that medical condition.

In making this determination, management must consider the essential functions of the employee's job, the nature of the medical condition or procedure involved, guidance from the occupational health nurse administrator, occupational health nurse, and/or the Postal Service's physician regarding the condition or procedure involved, and any other reliable and objective information to make an individualized assessment whether there is a reason to require the return- to-work documentation.

In cases of occupational illness or injury, the employee will be returned to work upon certification from the treating physician, and the medical report will be reviewed by a medical officer or contract physician as soon as possible thereafter

 

Privacy Rules, Violations - Last year, the responsibility for investigating certain types of employee misconduct — including workers’ compensation fraud — was transferred from the Postal Inspection Service to the Office of Inspector General (OIG). OIG workers’-comp investigations routinely involve an OIG agent visiting an injured employee’s treating physician. The agent’s tactics can be intimidating — intrusive to physicians and harassing to employees. This is especially startling when you consider that less than one-half of one percent of all Office of Workers’ Compensation (OWCP) claimants have ever been found guilty of fraud. Claimants and their doctors should be well prepared when confronted with an OIG investigation. In addition to the valuable information Industrial Relations Director Greg Bell provided in a recent article.  March/April 2006 issue of The American Postal Worker magazine
OWCP Form CA-16 (source: APWU Human Relations Dept. - 7/30/05)
The OWCP “Authorization for Examination and/or Treatment ” Form (CA-16), is issued by the USPS to employees who sustain a traumatic workplace injury and report their injury within seven days of the incident.

The Code of Federal Regulations requires that the USPS issue the form within four hours of receiving notice; this is to ensure that injured workers receive immediate medical care. Postal Service officials must issue the form even when they doubt that an injury is work-related.

In emergency situations, the USPS may provide verbal authorization for medical treatment, but officials must issue the form to the employee within 48 hours. Failure to comply is a violation of Section 545.21 of the Employee and Labor Relations Manual (ELM), and should be grieved.

The CA-16 form guarantees payment to the treating physician (or any physician to whom the original treating physician referred the employee) for 60 days from the date the form is issued, unless OWCP terminates this authority at an earlier date. When a CA-16 is issued, no additional authorization is needed.

Avoiding CA-16 Pitfalls:

The following information may be helpful.

  • Section A (Items 1 to 13) is completed by the Postal Service; Section B (Items 14 to 38) is completed by the doctor.
     
  • The employee’s choice of treating physician should appear on the form, not the USPS contract physician or the medical facility.

    In emergency situations, if the form is issued naming the employee’s choice of hospital, it shouldn’t be a matter of great concern: OWCP advises that it will recognize an employee’s physician following the emergency treatment.

    Be sure that the complete mailing address of the OWCP District Office is provided in Item 12 (including the street address, city, state, and zip code). This helps ensure that your doctor sends the CA-16 to OWCP, which permits ACS to pay medical bills, without waiting for claim adjudication and medical authorization. (OWCP contracted with a single company, ACS, to handle its medical authorization and bill payment processes.)

    Employees are strongly encouraged to keep a copy of the CA-16 form. The USPS is not permitted to issue a second form to the employee to provide to other physicians they are referred to. If the CA-16 is improperly issued, most often by fax directly to the hospital or medical facility, the employee should not leave without retaining a copy for their records.

Being armed with this information and knowing your rights keeps your doctor happy, gets out-of-pocket expenses reimbursed, prevents bad credit ratings, and avoids a lot of potential frustration. Members with questions are encouraged to contact their local or state APWU representative.

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Your Injury: Your Choice -If you are injured at work, you have the right to choose the physician or facility that you want to treat your injury. You may select any qualified physician or hospital within 25 miles of your home or workplace.

In an emergency situation you also have the right to select the hospital or physician of your choice. Following emergency treatment, you retain the right to select a physician for subsequent medical care.

A supervisor is permitted to accompany you to the doctor’s office or hospital only in an emergency, and only to ensure that you receive prompt medical care. Supervisors should not interfere with medical care, breech your privacy, or be present to advise the doctor about limited-duty accommodations. Ambulances should be used to transport you in emergencies, not USPS or personal vehicles.

(APWU March/April 2005)


USPS to Implement Pilot Program  to 'Outsource' Injured On Duty Employees -The Postal Service has informed NPMHU of its intentions to implement an Outplacement Pilot Program  in conjunction with the OWCP.  The program is intended to develop work opportunities outside USPS for employees who have sustained job-related illness or injury (IOD).  The program will be initiated in the Long Island (NY)  District and later will include the other districts in the New York Metro Area and eventually nationwide.(4/4/04)

ELM 17 432.72 Medical Release Time
When an employee is released from work and directed by management to an on- or off-site health services unit due to illness or injury, all time spent waiting for and/or receiving medical attention on the service day on which the
illness or injury occurs and that would have been worked but for the medical attention, including all time that the employee otherwise would have been directed to work that day beyond his or her regularly scheduled tour, is
included and credited as work time.


LDC 68/69 Reassessment Initiative (posted 1/24/03)

The Postal Service is undertaking an internal audit to re-code job functions into productive labor codes. This internal audit affects all letter carriers working in limited duty and permanent modified positions.

According to the Postal Service, the objective of this initiative is "to provide employees injured on the job with a standardized administrative process built on eliminating ambiguous and subjective assumptions by placing employees in assignments that support the employees' recovery plan as well as meet organizational goals. Equally important, management must ensure that existing and new limited duty and rehabilitation assignments comply with all laws and postal policies while, at the same time, provide meaningful work for employees within their medical restrictions."

This initiative begins with the updating of medical information for each employee who is currently assigned to a limited duty or rehabilitation assignment. Each employee should expect to receive a letter requesting this updated medical restriction list from their treating physician. In most cases, the letter contains information concerning who will pay for this updated medical report. The Postal Service is responsible for the cost, if a claim with OWCP has been closed. If the claim is still open and active with OWCP, the doctor visit would be covered by OWCP for billing purposes because updated medical reports and restriction lists are required for the claim. During this initial stage, the supervisor will also be asked to complete a worksheet that clearly delineates the current job functions and duties that the employee is performing, including the amount of time spent performing each duty.

Once this information is gathered, the original job offer, the actual duties being performed and the listed medical restrictions are reviewed. This process will determine if the injured employee still requires alternate work assignments, and ensure that hours are being charged to the proper operation number. Some employees may require medical reassessment and some may be reassigned. The critical element of this initiative, according the Postal Service is to ensure that LDC 68/69 employees are performing work within his or her craft to the maximum extent within their medical limitations.

The team will review whether the employee's assigned duties appear to exceed medical restrictions, whether the employee is being underutilized because the medical restrictions allow for more extensive work assignments, or whether the employee is being assigned duties that are not part of the original job offer. In each of these instances, the appropriate action will be taken and will, in nearly all cases, result in a new written offer being provided. (source: NALC)


USPS Forms 2498x and 2499x

Many of you may have seen the PS 2499x and PS 2498x "Offer of Modified Assignment" forms being used in Postal Service Districts throughout the country. These forms are in draft status and are currently being reformatted by Postal Service Headquarters. Along with the final versions of the forms, the Postal Service will be issuing National Guidelines for its use.These forms are part of the LDC 68/69 Reassessment Initiative and will be useful to injured letter carriers being offered Limited Duty or Permanent Rehabilitation Assignments. The forms will provide a uniformity of job offers that we have been striving toward, for some time. The offers will now include all the required information and will stop the practice of using the phrase "other duties as assigned within medical restrictions".When the final versions of the forms are available, we will publish them in The Postal Record (source: NALC)

 

CA-14 Revised / Replaces Notification Postcard

As part of their new communication initiative, OWCP has revised the process for notifying claimants of their entitlements and claim number. The CA-14 pamphlet will replace the normal postcard notification system.

When an injured employee files a CA-1 or CA-2 for an on-the-job injury, they will no longer receive a little green postcard with OWCP's address and the claim number assigned to their claim. They will now receive a blue pamphlet that outlines all the benefits associated with the Federal Employees' Compensation Act. The claim number will be printed on the pamphlet.

Please retain this pamphlet for your records and do not simply dispose of it once read

OWCP implements a centralized mail process

OWCP is implementing a new process for handling mail for each of their District Offices. They have created one central mail room to service the entire country. The central mail room contractor has the capacity to rapidly scan large volumes of documents and create quality images. They system will route these imaged documents to the appropriate District Office and directly to the assigned responsible claims examiner for review. The paper submitted will never return to the District Office. It is anticipated that this system will actually assist the mail in reaching the responsible claims examiner quicker than through the existing methods. The possibility of misplacing mail or filing it in the wrong case file will be greatly diminished.

The new address for all mail submitted by injured employees nationwide is:

U.S. Department of Labor
Federal Employees' Compensation
PO Box 8300
London, KY 40742-8300

 

What To Do...

In Case of Injury, obtain first aid or medical treatment even if the injury is minor. While many minor injuries heal without treatment, a few result in serious prolonged disability that could have been prevented had the employee received treatment when the injury occurred.

For traumatic injuries, ask your employer to authorize medical treatment on Form CA-16 BEFORE you go to the doctor. Take Form CA-16 when you go to the doctor, along with Form OWCP-1500, which the doctor must use to submit bills to OWCP. Your employer may authorize medical treatment for occupational disease ONLY if OWCP gives prior approval.

Submit bills promptly, as bills for medical treatment may not be paid if submitted to OWCP more than one year after the calendar year in which you received the treatment or in which the condition was accepted as compensable.

Report Every Injury to your supervisor. Submit written notice of your injury on Form CA-1 if you sustained a traumatic injury, or Form CA-2 if the injury was an occupational disease or illness. (Forms CA-1 and CA-2 may be obtained from your employing agency or OWCP.)

Form CA-1 must be filed within 30 days of the date of injury to receive continuation of pay (COP) for a disabling traumatic injury. COP may be terminated if medical evidence of the injury- related disability is not submitted to your employer within 10 workdays. YOU ARE RESPONSIBLE FOR ENSURING THAT SUCH MEDICAL EVIDENCE IS SUBMITTED TO YOUR EMPLOYING AGENCY. Form CA-2 should also be filed within 30 days. Any claim which is not submitted within 3 years will be barred by statutory time limitations unless the immediate superior had actual knowledge of the injury or death within 30 days of occurrence.

Establish the Essential Elements of Your Claim. You must provide the evidence needed to show that you filed for benefits in a timely manner; that you are a civil employee; that the injury occurred as reported and in the performance of duty; and that your condition or disability is related to the injury or factors of your Federal employment. OWCP will assist you in meeting this responsibility, which is called burden of proof, by requesting evidence needed to fulfill the requirements of your claim.

File a Claim for Compensation. File Form CA-7, Claim for Compensation on Account of Traumatic Injury or Occupational Disease, if you cannot return to work because of your injury and you are losing (or expect to lose) pay for more than three days. Give the form to your supervisor seven to ten days before the end of the COP period, if you received COP. If you are not entitled to COP, submit Form CA-7 when you enter or expect to enter a leave without pay status. All wage loss claims must be supported by medical evidence of injury-related disability for the period of the claim.

If you continue to lose pay after the dates claimed on Form CA-7, submit Forms CA-8 Claim for Continuing Compensation on Account of Disability, through your employer to claim additional compensation until you return to work or until OWCP advises they are no longer needed. You are not required to use your sick or annual leave before you claim compensation.

If you choose to use your leave, you may, with your agency's concurrence, request leave buy-back by submitting Form CA-7 to OWCP through your employing agency. Any compensation payment is to be used to partially reimburse your agency for the leave pay. You must also arrange to pay your agency the difference between the leave pay based on your full salary and the compensation payment that was paid at 2/3 or 3/4 of your salary. Your agency will then recredit the leave to your leave record.

Return To Work As Soon As your Doctor Allows You To Do So. If your employing agency gives you a written description of a light duty job, you must provide a copy to your doctor and ask if and when you can perform the duties described. If your agency is willing to provide light work, you must ask your doctor to specify your work restrictions. In either case, you must advise your agency immediately of your doctor's instructions concerning return to work, and arrange for your agency to receive written verification of this information. COP or compensation may be terminated if you refuse work which is within your medical restrictions without good cause, or if you do not respond within specified time limits to a job offer from your agency.

In appropriate cases, OWCP provides assistance in arranging for reassignment to lighter duties in cooperation with the employing agency. In addition, injured employees have certain other specified rights under the jurisdiction of the Office of Personnel Management, such as reemployment rights if the disability has been overcome within one year.

Tell Your Family about the benefits they are entitled to in the event of your death. For assistance in filing a claim they may contact your employing agency's personnel office or OWCP.

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Right to see own physician

Any employee who gets injured on the job has the right to see their own physician. (ELM Section 545.4)

545.4 Implementing Medical Care

545.41 Emergency Treatment
An employee needing emergency treatment must be sent to the nearest available physician or hospital or to a physician or hospital chosen by the employee or the employee’s representative. The physician who provides emergency treatment is not considered the employee’s initial choice of physician.

545.44 Outside Treatment in a Nonemergency Situation
I
n a nonemergency situation, if an employee does not accept treatment at a Postal Service occupational health services office or contract facility, the employee may select a physician or hospital within approximately 25 miles of his or her home or worksite. The physician’s office should be contacted by telephone by the control office or control point to determine if the physician is available and will accept the employee for treatment under FECA. If not, the employee must select another qualified physician or hospital. A postal supervisor is not authorized to accompany the employee to a medical facility or physician’s office in nonemergency situations

Editor's note: Over the years I have witnessed many employees injured at work and fail to request to see their own physician. The people at medical units and  US Postal Service contract physicians (in my opinion) are not acting in the best interest of the employee but in the interest of the USPS and that is >>>to get injured employees back to work as soon as possible regardless of the well-being of the an employee.Red Line

TIMELINESS

Federal agencies are required by regulation to submit an employee's Notice of Injury (Form CA-1 or CA-2) within 10 working days (or 14 calendar days) of receiving it from an employee, if lost time from work or medical expenses are claimed or anticipated [20 CFR 10.110(a)]. Regulations require that the CA-7 should be submitted no later than 5 working days (or 7 calendar days) after its receipt from the employee [20 CFR 10.112(b)]. This prompt submission is critical if OWCP is to be able to serve injured workers' needs, and especially to ensure that medical bills can be processed timely.

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INFORMATION TO ASSIST DOCTOR IN DETERMINING CAUSAL RELATIONSHIP FOR AN OWCP CLAIM:

To a physician, "cause" may refer only to direct or principal cause, but for the law of Workers' Compensation, a variety of contributing causes must be considered. Under the Federal Employees Compensation Act (FECA), any disease or disability is compensable when it is proximately caused or materially aggravated by an employment-related injury or condition of employment. Proximate cause is that which, in a natural and continuing sequence, produces the disability. However, natural progression of a disease while a person is working does not constitute cause or aggravation. For conditions of employment to bring about aggravation of any underlying disease, the employment factors must be capable of aggravating or accelerating the disease.

There are two kinds of aggravation:
TEMPORARY AGGRAVATION:
The pre-existing condition is worsened or made more severe for a time with no residual alteration of the underlying condition and without leaving any continuing impairment beyond that time.

PERMANENT AGGRAVATION: There is a continuing and irreversible change in the underlying condition, thus adversely altering the course of the condition or disease process.

FECA DEFINITIONS:
MEDICAL RATIONALE: A logical explanation for the physician's underlying opinions, fundamental reasons and beliefs concerning causal relationship.

PROXIMATE CAUSE: That which produces the injury in a natural and continuous sequence, unbroken by an efficient and intervening cause and without which the result would not have occurred.

AGGRAVATION: A documented physiological process by which a single occupational act, or series of acts over a period of time intensified the severity of a physical or mental problem which pre-existed the occupational disease.

ACCELERATION: A documented physiological process by which a single occupational act, or series of acts, can be shown to have increased the expected speed of progression in a pre-existing condition documented to be progressive in nature.

PRECIPITATION: Hastening the occurrence of an event or causing to happen or come to crisis suddenly, unexpectedly, or too soon.

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CA-FORMS

CA-1 Federal Employee's Notice of Traumatic Injury Claim for Continuation of Pay/Compensation
CA-2 Notice of Occupational Disease and Claim for Compensation
CA-2a Notice of Employee's Recurrence of Disability and Claim for Pay/Compensation
CA-5* Claim for Compensation by Widow, Widower, and/or Children
CA-5b* Claim for Compensation by Parents, Brothers, Sisters, Grandparents, Grandchildren
CA-6 Official Superior's Report of Employee Death
CA-7 Claim for Compensation Because of Traumatic Injury or Occupational Disease
CA-7a Time Analysis Form
CA-7b Leave Buy-Back Worksheet/Certification Form
CA-10 What a Federal Employee Should Do When Injured at Work
CA-11 When Injured at Work Information
CA-12* Claim For Continuance of Compensation Under the Federal Employees' Compensation Act
CA-16 Authorization for Examination and/or Treatment
CA-17 Duty Status Report
CA-35 Evidence Required in Support of a Claim for Occupational Disease
CA-810  
OWCP-957* Medical Travel Refund Request

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Contacting  Your Federal Employees' Compensation District Office

If you are an employee or representative, and you would like detailed GENERAL information about claims under the Federal Employees' Compensation Act, please call our new toll-free information line. The number is 1-866-999-3322, or 1-877-889-5627 for TTY, and the lines are available from 8 AM to 5 PM, Monday through Friday.

In addition, OWCP now has a toll-free automated system that provides a variety of information regarding specific claims. By calling 1-866-OWCP-IVR (1-866-692-7487), injured workers and their representatives may access information regarding case status, compensation payments, reimbursement of treatment and travel expenses, and authorization of medical treatment such as physical therapy and diagnostic testing. Medical service providers may also access case status and treatment authorization through 1-866-OWCP-IVR, as well as information regarding bill payments. Injured workers should have their 9-digit case file or claim number and social security number when calling. Medical providers should have the 9-digit case file or claim number and their tax identification number.

Please note: We ask that our customers first contact a district office to resolve any issues that may arise. Problems may also be addressed to the District Directors for the Federal Employees' Compensation Program, and the Regional Directors for the Office of Workers' Compensation Programs. A list of these offices and their geographical jurisdictions is found below. The program is headed by Deborah B. Sanford, Director for Federal Employees' Compensation.

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