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Workers’ Compensation: Federal Employees’ Compensation Act (FECA)

General Rules and Procedures

The Federal Employees’ Compensation Act is the law governing the payment of workers’ compensation benefits to civilian employees of the United States who suffer a disability due to personal injury (including occupational disease) sustained while in the performance of duty. Damage to or destruction of medical braces, artificial limbs, and other prosthetic devices incidental to a job-related personal injury is also compensable. The act also provides for the payment of benefits to dependents if a job-related injury or disease causes the employee’s death.

FECA is administered by the Office of Workers’ Compensation Programs (OWCP) in the Labor Department, through district offices located throughout the United States. Its website is www.dol.gov/esa/regs/compliance/owcp/fecacont.htm. FECA forms are found at www.dol.gov/esa/regs/compliance/owcp/forms.htm.

All injuries, including disease proximately caused by employment, sustained while in the performance of duty by civilian employees of the United States (with the exception of non-appropriated fund employees), are covered. Coverage is provided by special legislation to Peace Corps and VISTA volunteers, federal petit or grand jurors, volunteer members of the Civil Air Patrol, Reserve Officer Training Corps cadets, Job Corps, Neighborhood Youth Corps and Youth Conservation Corps enrollees, and non-federal law enforcement officers under certain circumstances (e.g., situations involving crimes against the United States). Temporary employees are covered on the same basis as permanent employees.

The employee must provide medical and factual evidence to establish the essential elements of a claim. These elements generally include proof that the claim was filed within FECA’s statutory time requirements, the injured or deceased person was an employee within the scope defined by FECA, the employee sustained an injury or disease, the employee was in the performance of duty when the injury occurred, and the employee’s compensable condition resulted from the injury.

Benefits cannot be paid if a worker’s injury or death is caused by the injured employee’s intoxication or willful misconduct or by an intent to bring about the injury or death of oneself or another.

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 will not be paid unless an injury is reported.

A traumatic injury is defined as a wound or other condition of the body caused by external force, including stress or strain. The injury must be caused by a specific event or incident or series of events or incidents within a single day or work shift.

An occupational disease is defined as a condition produced in the work environment over a period longer than one workday or shift. It may result from systemic infection, repeated stress or strain, exposure to toxins, poisons, fumes, or other continuing conditions of the work environment.

Diseases and illnesses aggravated, accelerated, or precipitated by the employment are covered. The employee must submit medical and factual evidence that establishes that the employment aggravated, accelerated, or precipitated the condition.

A recurrence of an employment-related disability is covered if an injured employee is again disabled as a result of the original injury or occupational disease.

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FECA Coverage Rules

Federal employees generally are eligible for FECA coverage regardless of the length of time they’ve been on the job or the type of position held. Compensation payments can be made after wage loss begins and medical evidence shows that the employee is unable to perform the duties of his or her regular job.

An employee who sustains a disabling traumatic injury is entitled to continuation of regular pay (COP) for a period not to exceed 45 calendar days. This is considered salary for all intents and purposes, including tax deductions, and not compensation. In order to be eligible for COP, written notice of injury must be filed within 30 days of the injury.

Schedule awards are FECA payments that are provided for specified periods of time for the permanent loss, or loss of use, of certain parts and functions of the body. Partial loss or loss of use of these parts and functions is compensated on a proportional basis. Before payment of a schedule award can be considered, the condition of the affected part of the body must reach maximum improvement. This determination involves a medical judgment that the condition has permanently stabilized.

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FECA Compensation Payments

Total disability benefits may be paid to injured workers to compensate them for lost wages after the end of a continuation-of-pay period or from the beginning of pay loss. An employee who receives disability payments will be notified by letter of the amount of compensation to be paid, including the pay rate used as a basis and the resulting compensation rate. Compensation payments for total disability may continue as long as the medical evidence substantiates total disability.

No compensation is payable for the first three days of wage loss unless the disability exceeds 14 days after the expiration of COP, where COP is payable, or the injury results in permanent impairment. Injured employees may use sick or annual leave credited to their account if so desired, in which event FECA compensation does not begin until the expiration of leave. Use of personal leave should only be necessary in extreme circumstances.

Monetary compensation is based on the monthly pay of the injured employee at the time of the injury, at the time the disability begins, or at the time a compensable disability recurs (if such recurrence begins more than six months after the injured employee resumes regular full-time employment with the United States), whichever is greater.

FECA compensation generally is calculated at two-thirds of the employee’s monthly pay rate if he or she has no dependents, or three-fourths of the pay rate if married or with one or more dependents.

For FECA benefit purposes, a dependent is: a wife or husband residing with the employee or receiving regular support payments from him or her; an unmarried child who lives with the employee or who receives regular support payments from him or her who is under age 18, or if over age 18 is incapable of self-support due to physical or mental disability; a student between 18 and 23 years of age who has not completed four years of post-high school education and who is regularly pursuing a full-time course of study; and a parent who is wholly dependent on the employee.
Locality, night differential, hazard, premium, holiday, and Sunday pay are included in determining the pay rate on which compensation is based, although overtime pay is not. The maximum payment per month cannot exceed three-fourths of the highest rate of basic pay provided for grade GS-15.

Minimum monthly compensation for total disability cannot be less than three-fourths of the lowest basic monthly pay level for GS-2, or the employee’s monthly pay, whichever is less, except for increases resulting from cost-of-living adjustments.

If, as the result of an on-the-job injury, an employee returns to work at a lower rate of pay, compensation for loss of earning capacity is paid at the rate of two-thirds (without dependents) or three-fourths (with dependents) of the loss of earning capacity. The wage earning capacity of a partially disabled employee is determined by actual earnings, or if the employee has no actual earnings, an amount determined by OWCP taking into consideration the nature of the injury and other factors that affect the capacity to earn wages.

Compensation for disability cannot be paid concurrently with an annuity (including a lump-sum payment) under the Civil Service Retirement System, or the Federal Employees’ Retirement System, or any other law providing retirement benefits in lieu of those provided under the CSRS or FERS. An employee entitled to both types of benefits (i.e., retirement and FECA) must make an election; however, a new election may be made whenever it is to the employee’s advantage to do so. (For more detail, see the section below entitled “Disability Retirement vs. FECA Benefits.”)

Health Insurance Coverage—Under provisions of the Federal Employees’ Health Benefits Act, employees, former employees, and survivors of deceased employees who meet certain requirements may continue their health benefits coverage while in receipt of disability or death compensation. The employee’s or survivor’s share of the cost of the FEHB insurance is withheld from the compensation.

Cost-of-Living Adjustments—For individuals who have been in receipt of compensation benefits for more than one year, those benefits are increased effective March 1 of each year by any percentage change in the Consumer Price Index published for December of the preceding year.

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Schedule Awards

FECA may pay a scheduled award for a permanent impairment to certain members or functions of the body (such as loss of use of an eye or arm, or loss of function or removal of a kidney due to injury). The amounts payable are specified by the Federal Employees Compensation Act.

Schedule awards can be paid during a period where the employee is receiving federal salary or retirement benefits, is working for private industry, or is self-employed. Employees may not receive wage loss compensation and schedule awards benefits concurrently for the same injury.

If an employee sustains a period of temporary total disability during the course of the award, it may be interrupted to pay the period of disability; the schedule award will resume afterwards. If an employee dies during the course of a schedule award from causes unrelated to the compensable injury, his or her dependents are entitled to two-thirds of the balance of the award.

Schedule award amounts vary from 15 weeks to 312 weeks of compensation for total loss or loss of use of designated body parts. There is an additional award for serious disfigurement of the head, face or neck.

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Medical Care Benefits

FECA covers all medical care that an employee needs to recover from the effects of a work-related injury, including hospitalization, nursing service, prosthetic appliances, and services of an attendant when required in severe injuries. The employee has the right to initially select a physician to provide medical services, appliances, and supplies. The term “physician” includes surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors (to the extent that such services are reimbursable under the Act), and osteopathic practitioners within the scope of their practice as defined by state law. Payments for chiropractic services are limited to treatment consisting of manual manipulation of the spine to correct a subluxation that has been verified by an X-ray. A physician whose license to practice medicine has been suspended or revoked by a state licensing or regulatory authority is not a physician within the meaning of this section during the period of such suspension or revocation.

Medical care coverage also extends to the necessary cost of transportation and expenses incident to securing medical services, appliances and supplies. Medical care for a compensable injury may be continued after a beneficiary accepts a retirement annuity. Bills for injury-related medical expenses should be submitted promptly. No bill will be paid for expenses incurred if the bill is submitted more than one year beyond the end of the calendar year in which the expense was incurred, or more than one year beyond the end of the calendar year in which the claim was first accepted as compensable, whichever is later.

Vocational Rehabilitation—A permanently disabled employee may be provided with vocational rehabilitation services and an additional allowance may be paid for necessary maintenance in an amount not to exceed $200 per month while the employee is undergoing an approved course of training. Also, an employee will be paid compensation at the rate for total disability while pursuing an OWCP-approved training course.

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Survivor and Death Benefits

When an employee dies as a result of a job-related injury, the individual’s surviving spouse and dependents may qualify for monthly compensation benefits. The surviving spouse must be living with or dependent for support on the injured worker at the time of death (or living apart for reasonable cause or because of the employee’s desertion).

If no children are eligible, a deceased worker’s surviving spouse would receive 50 percent of the employee’s salary. If there are children, a surviving spouse would receive 45 percent of the worker’s salary, plus an additional 15 percent for each child up to a total of 75 percent of salary. If there is no widow or widower, FECA compensation for the first child is 40 percent of the employee’s salary and each additional child is entitled to 15 percent of the employee’s salary, up to a maximum of 75 percent, payable on a share and share alike basis.

In rare instances, parents, minor brothers and sisters, and grandparents and grandchildren who were totally dependent on the deceased employee at the time of death, may be entitled to a small portion of survivor benefits. Payments are not made after a beneficiary marries or completes four years of study beyond high school.

When survivors are eligible from OPM, they may be eligible for both death compensation benefits and a survivor annuity from OPM. They must elect which of the two benefits they wish to receive.

Survivor benefits will be reduced if the employee was covered under FERS and the survivors are eligible for Social Security benefits based on the employee’s federal employment.

FECA provides for payment of reasonable burial expenses, up to a maximum of $800. Apart from any funeral or burial expenses, a separate sum of $200 is paid to the personal representative of a deceased employee for reimbursement of the costs incurred in terminating the deceased worker’s status as an employee of the United States.

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Recovery and Job Restoration

OWCP requires most individuals receiving FECA disability benefits to undergo medical examinations once a year. The evaluation usually is done by the employee’s own physician. OWCP may, however, require the employee to be examined by another physician. FECA compensation will be terminated if medical evidence is submitted that indicates that the employee no longer has residual limitations from the accepted condition and can return to the former job without limitations; or the individual’s employer makes a suitable job offer which is unreasonably refused by the employee. OWCP will determine both the suitability of the job offer and the reasonableness of a worker’s refusal.

Receipt of a schedule award—i.e., an OWCP payment for a permanent impairment of a specified body member, function, or organ—does not necessarily mean the individual has recovered for purposes of job restoration rights. It only means that part of the employee’s body is considered to have reached maximum medical improvement.

FECA benefit payments can be suspended if the employee does not cooperate with a specific directive from OWCP (such as a request to report for medical examination) or fails to respond within 30 days to a request for information on employment/earnings, dependents, or the receipt of dual benefits. Similarly, FECA compensation can be suspended if a beneficiary in a death case fails to respond to a request for information on continuing entitlement, such as verification of student status. Where an individual’s response to such requests is subsequently received, OWCP may reinstate benefits retroactive to the date of suspension, if appropriate.

Job Restoration Rights—If employees recover from their disability within one year from the date they became entitled to FECA payments, they have the right to return to their former jobs or an equivalent position. Even if their period of disability extends beyond one year, employees have priority placement rights to their former or equivalent positions.

The restoration rights of employees who sustain compensable injuries fall into four separate categories depending on the length and extent of recovery. Other factors affecting restoration rights are the timeliness of the application for restoration, the employee’s performance and conduct prior to the injury, and the availability of positions.

Full recovery is determined by a decision to terminate FECA benefits on the basis that the employee is medically able to resume regular employment. For purposes of restoration rights, a position with the same seniority, status, and pay means a position that is equivalent to the former one in terms of pay, grade, type of appointment, tenure, work schedule, and, where applicable, seniority. An employee’s standing in the organization, such as first or second supervisory level, is not a factor.

The four categories are:

  • Fully recovered within one year. Employees who fully recover within one year from the date compensation began have mandatory restoration rights to their former job or an equivalent position. This basic entitlement is to a position in the former commuting area. If a suitable vacancy does not exist, the restoration right is agency-wide. Employees must apply for restoration immediately and must be restored immediately and unconditionally by their former agency.
  • Fully recovered after one year. If full recovery takes longer than one year from the date compensation begins, injured employees are entitled to priority consideration for their former position or an equivalent one, provided they apply for restoration within 30 days of the date compensation ends. Priority consideration means the agency enters the individual on its reemployment priority list. If the agency cannot place such individuals in their former commuting area, they are entitled to priority consideration for an equivalent position elsewhere in the agency.
  • Physically disqualified. FECA compensationers who are medically unable to return to their former occupation, but who are able to do other work, are considered to be physically disqualified. Such individuals are entitled, within one year of the date compensation begins, to be placed in a position that most closely approximates the seniority, status, and pay to which they otherwise would be entitled, depending on the circumstances of the case. These restoration rights are agency-wide. After one year, such individuals are entitled to the same restoration rights as individuals who fall into the “partially recovered” category described below. Physically disqualified employees typically have a permanent medical condition, such as the loss of an arm, that disqualifies them for their old or an equivalent position and makes it unlikely that they will ever be able to return to the former position.
  • Partially recovered. In contrast to a physically disqualified worker, a partially recovered employee is expected to fully recover eventually. These individuals, who have not yet fully recovered but are able to work in some capacity, are entitled to be considered for employment in the former commuting area. The agency must make every effort to place the employee, but there is no absolute right to restoration. If the individual is restored at a lower grade or pay level, OWCP will make up the difference in pay, or the agency may elect to pay the employee at the former rate. If such employees later fully recover, they are entitled to the restoration rights of a fully recovered employee, based on the timing of the recovery. Partially recovered employees have an obligation to seek employment within their capabilities. If a partially recovered employee refuses to accept a suitable job offer, OWCP may terminate compensation. OWCP determines whether an agency job offer is suitable according to the individual’s medical restrictions, education, and vocational background.

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Claims-Filing Time Limits

Written report of a work-related injury must be given within 30 days to the employee’s immediate superior and a claim for disability or death compensation must be filed within three years. The time limitations do not apply to: (1) minors until they reach the age of 21 or have had a legal representative appointed and (2) incompetent individuals while they are incompetent and have no duly appointed legal representative. In cases of latent disability, the time limitations do not begin to run until the employee has a compensable disability and is aware, or reasonably should be aware, that the disability is causally related to employment. A claim for disability or death compensation filed after the three-year period may not be allowed, unless the immediate superior had actual knowledge of the injury or death within 30 days, or written notice of the injury or death was properly given within 30 days.

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Administration and Appeals

The Act is administered by the Office of Workers’ Compensation Programs (OWCP) of the U.S. Department of Labor. Further information regarding the law may be obtained online at www.dol.gov/esa/regs/compliance/owcp/fecacont.htm or by writing to the:
  Office of Workers’ Compensation Programs
U.S. Department of Labor
Washington, DC 20210

The adjudication and payment of claims is decentralized into the district offices of the OWCP. Inquiries concerning specific cases should be directed to the appropriate district office.

An employee or survivor who disagrees with a final determination of OWCP may, within 30 days after the date of the decision, request an oral hearing from the Branch of Hearings and Review. The hearing will be informal and will be held at a convenient location. You may be represented at the hearing by any person authorized by you in writing. As soon as possible after the hearing, a copy of the OWCP representative’s decision will be mailed to you. You will have the right to appeal this decision. The request for hearing should be addressed to the Office of Workers’ Compensation Programs, Branch of Hearings and Review, P.O. Box 37117, Washington, DC 20013-7117. Section 8124(b)(1) of the Act provides entitlement to a hearing only before reconsideration.

In lieu of an oral hearing, you may request a review of the written record by an OWCP representative at which you may submit additional written evidence in support of your claim. The request should be sent to the address above. You may not have both an oral hearing and a review of the written record on the same issue.

If you have other evidence you believe to be pertinent, you may ask the OWCP to reconsider the decision. No special form is required, but the request must be in writing and state clearly the grounds upon which reconsideration is requested. Also, the request must be accompanied by evidence not previously submitted, such as medical reports, affidavits, or statements. In order to ensure that you receive a new and independent evaluation of the evidence, your case will be reconsidered by persons other than those who made the original determination. Request for reconsideration, along with new evidence, should be addressed to the office servicing your case. Reconsideration may be requested within one year of the most recent decision on the merits of the claim, whether or not a hearing has been held. Where reconsideration is initially requested, you are not entitled to a hearing.

If you believe that all available evidence has been submitted, you have the right to appeal to the Employees’ Compensation Appeals Board for review of the decision. Review by the Appeals Board is limited to the evidence of record. No new evidence may be submitted to the Board. Request for review by the Appeals Board should be made within 90 days from the date of the decision and should be addressed to the Employees’ Compensation Appeals Board, U.S. Department of Labor, 200 Constitution Ave., N.W., Rm. N-2609, Washington, DC 20210. If you should request a hearing or reconsideration by the Office of Workers’ Compensation Programs as indicated above, the 90-day period within which you may request review by the Appeals Board will run from the date of any later decision by the OWCP. For good cause shown, the Appeals Board may waive the failure to file within 90 days if application is made within one year from the date.

Decisions of the ECAB are final and may not be appealed to federal or state courts.

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