Worker's Compensation (Federal Employees' Compensation Act) provides monetary compensation, medical care and assistance (attendant allowances), vocational rehabilitation, and reemployment rights to federal employees who sustain disabling injuries as a result of their federal employment. FECA also provides for a fixed payment for the deceased employee's funeral expenses and for compensation benefits to qualified survivors of the decedent in cases of employment-related death.
FECA Benefits. Employees may be eligible for six basic types of benefits under FECA: Medical benefits (including transportation expenses incurred); Continuation of pay; Disability compensation; Schedule awards; Vocational rehabilitation; and, Death benefits that include allowable funeral benefits and survivor compensation. The program applies to any disability (temporary or permanent, partial or total) incurred as a result of a job-related disease or condition, as well as an on-the-job traumatic injury.
Medical Benefits. Payment may be made for any medical services needed for treatment or to counteract or minimize the effects of any condition, disease, or injury determined to be causally related to employment with the Federal Government. There is no limit on the extent of medical treatment payable nor is there a time limit for which they are payable if the need for medical treatment can be substantiated and connected to the employment-related injury or disease. Payment will be made for first aid, medical treatment, hospitalization, physician's fees, drugs, appliances, or other supplies directed for use by a qualified physician. Bills must be submitted within 1 year of the date of service, one year beyond the calendar year in which the expense was incurred, or 1 year beyond the calendar year in which the claim was accepted, whichever is later, or they will not be paid. The employee may elect to be treated by a government physician (if available) or by a duly qualified physician of his or her choice who is not excluded. Although payment for preventative treatment is generally not provided, payment may be made for certain specified conditions even though such treatment is designed, in part, to prevent further injury. The specific conditions when payment may be made include: complications of preventative measures which are provided or sponsored by the agency, such as an adverse reaction to a prophylactic immunization; actual or probable exposure to a known contaminant due to an injury, thereby requiring disease specific measures against infection such as tetanus antitoxin injections for puncture wounds; conversion of tuberculin reaction from negative to positive following exposure to tuberculosis in the performance of duty; and where injury to one eye has resulted in loss of vision, periodic examination of the uninjured eye to detect possible sympathetic involvement of the uninjured eye at an early stage.
There shall be no charge for occupational health or Office of Workers' Compensation Programs (OWCP) care for DoD employees treated at Federal government medical facilities. However, DoD Components shall continue to bill, at the interagency rate, for OWCP care provided to non-DoD employees by a DoD medical treatment facility. The interagency rate charge shall be processed through the OWCP Revolving Fund.
Continuation of Pay (COP). An employee who sustains a disabling, job-related traumatic injury is entitled, under certain circumstances, to COP for a period not to exceed 45 calendar days pending OWCP's determination of the employee's claim for compensation under FECA. To qualify for COP, the traumatically injured employee or someone authorized to act on his or her behalf must file written notice of injury on a Form CA-1, "Federal Employees' Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation," within 30 calendar days after the date of injury. COP is not compensation for FECA purposes and is subject to all applicable taxes and payroll deductions. The injured employee or someone authorized to act on his or her behalf must provide written medical evidence to support the disability within 10 calendar days of submitting the CA-1. COP is not applicable for occupational illnesses and diseases claims. The employee must make a separate claim for monetary compensation on a Form CA-7, "Claim for Compensation on Account of Traumatic Injury or Occupational Disease," with Form CA-20, "Attending Physician's Report," if the disability exceeds 45 calendar days or results in any permanent disability.
Disability Compensation. Employees may be eligible for one or more of several types of wage loss compensation. Disability benefits are classified based on the nature and extent of disability incurred and are categorized as temporary total, temporary partial, permanent total, or permanent partial.
Compensation Rates. Generally, in cases of total disability, an employee is entitled to compensation equivalent to two-thirds of the weekly salary if there are no dependents, or three-fourths of the salary if there are one or more dependents (see glossary for definition of dependents). Compensation is tax free. In establishing a person's wage rate, the law recognizes certain additional amounts that may be included in salary, such as premium pay, night and Sunday differential, holiday pay, hazard pay, dirty work pay, quarters allowances and post differential for overseas employees. Overtime pay is not included except for administratively uncontrollable work covered under 5 U.S.C. 5545(c) (2) (reference (e)). Under 5 U.S.C. 5112 (reference (e)) the maximum compensation rate may not exceed more than 75 percent of the monthly pay of the maximum rate of basic pay for GS-15 (excluding locality pay).
Duration of Compensation. Compensation payments for total disability may continue as long as the disability continues and suitable modified work is not available; in some instances, for the lifetime of the employee. As with medical care, there is no total dollar maximum or time limitation.
Loss of Wage-Earning Capability (LWEC). When an injured person suffers a wage loss because of disability that is less than total, compensation may be paid for this partial loss of wages or wage-earning capacity. Provisions of 5 U.S.C. 8115 (reference (a)) govern the determination of wage-earning capacity. When a claimant has completed 60 days of employment in a suitably modified, formally classified position, the agency should complete a loss of wage-earning capacity (LWEC) worksheet and request that a formal LWEC rating be issued. If the position carries a pay rate less than that of the date of injury, compensation will be payable for a loss of wage earning capacity. Such a formal rating can be changed only under very limited circumstances.
Schedule Awards. 5 U.S.C. 8107 also provides for payment of compensation for permanent loss or loss of use (either partial or total) of certain internal and external organs; members or functions of the body such as arms, legs, hands, feet, fingers, toes, eyes; or loss of hearing or loss of vision. Each extremity or function has been rated for a specific number of weeks of compensation that can be paid in addition to full salary. If a serious disfigurement of the head, face, or neck results from a job-related injury, an award may also be made for such disfigurement, not to exceed $3,500. Multiple schedule awards may be paid concurrently for different body parts or paid concurrently with the Office of Personnel Management (OPM) retirement benefits. Employees can receive schedule award payments concurrently while receiving severance pay for involuntary separation from their employment. Schedule awards can be paid even if the employee returns to work. However, employees cannot receive wage loss compensation and schedule award benefits concurrently for the same injury.
Vocational Rehabilitation.. If the injured employee suffers a vocational disability due to the injury and cannot resume usual employment, OWCP-directed vocational rehabilitation may be arranged to assist in training for work that the employee can do. The cost for rehabilitation is paid from the Employees' Compensation Fund and charged back to the DoD Component. Rehabilitation service is supervised by OWCP, but is usually provided in cooperation with state and private rehabilitation agencies. In addition to the cost of rehabilitation, an employee may qualify for a monthly allowance of up to $200 necessary for his or her personal maintenance. Employees are also entitled to collect total disability payments during their rehabilitation period. When the rehabilitation program is completed, the claimant is expected to actively seek employment. Vocational rehabilitation is not confined to formal retraining. It includes the employment efforts of vocational rehabilitation counselors and compensation specialists. An offer of a position (employment or reemployment) for which an injured employee is medically qualified is usually the more expedient and less costly method of rehabilitation.
Survivor Compensation Benefits.. If the employee's death was due to the job-related injury, dependents are entitled to the following benefits:
Widow or Widower and No Eligible Child. The widow or widower is eligible for 50 percent of the deceased employee's regular pay. Widow or Widower with Eligible Children. The widow or widower is eligible for 45 percent of the deceased employee's regular pay, plus an additional 15 percent for each child -- to a maximum not to exceed 75 percent of the deceased employee's regular pay.
Eligible Children and No Widow or Widower. An orphaned child is eligible for 40 percent of the deceased employee's regular pay, plus 15 percent for each additional orphan - not to exceed 75 percent of the deceased employee's regular pay. Benefits are divided among the children, share and share alike.
Surviving Legal Dependents. If a deceased employee leaves no widow, widower, or child, benefits are paid to the surviving legal dependents of this employee as specified in FECA (5 U.S.C. 8133, 8134 (reference (a)).
Remarriage or Death. Widows and widowers receive benefits until death, or remarriage, if they are under age 55. If a widow or widower under age 55 remarries, a lump-sum payment equal to 24 times the monthly compensation he or she is receiving at the time of remarriage is made. If the widow or widower is age 55 or older, compensation continues as long as he or she lives, regardless of remarriage.
Orphaned Children. Orphaned children receive benefits until they die, marry, or reach the age of 18. If a surviving child pursues higher education on a full-time basis (generally 12 semester hours) payments will continue until he or she has completed four years of study beyond the high school level or until he or she is 23 years of age. Payment will not extend beyond the semester or enrollment period in which the surviving child reaches 23 or completes his or her fourth year of higher education, whichever occurs first. Funeral Expenses. Up to $800 is paid for a deceased employee's funeral expenses. If the employee dies away from home, the cost of transporting the body to the place of burial will be paid in full. Also, an additional sum of $200 is paid to the personal representative of the decedent for reimbursement of the expense of terminating the deceased employee's Federal employment status. Additional benefits may apply; please consult the servicing Civilian Personnel Advisory Center (CPAC).