OWCP Refresher

(This article appeared in the May/June 2009 issue of The American Postal Worker magazine.)

Sue Carney, Director Human Relations Dept.

Postal employees who sustain a workplace injury have the right to seek prompt medical treatment from the physician of their choice. Examination by a USPS contract-physician should not interfere with this treatment. In fact, injured workers have the right to decline treatment from the USPS provider.

A medical condition that is caused or aggravated by the work environment within a single work shift is a traumatic injury, and is claimed on Office of Workers’ Compensation Programs (OWCP) Form CA-1. Form CA-2 is used to give notice of an occupational disease; a medical condition which is caused or aggravated by the work environment over a period longer than one work shift. Claims must be filed within three years of the injury date, or within three years from when the employee became aware that the medical condition is attributable to work.

Employees reporting a traumatic injury should receive a “First Script” card from the USPS. (Occupational disease claimants will receive the card from OWCP when their claim has been accepted.) Form CA-16, which guarantees payment for most medical treatments for up to 60 days, must be issued by the USPS to individuals who report a traumatic injury within seven days of occurrence.

Before a claim can be approved, the following requirements must be met: The claim must be filed within OWCP’s specified time limits; the worker must be a civilian federal employee; a fact of injury must be established; the injury must have occurred in the performance of duty; and a causal relationship must exist between the injury and the workplace.

Wage Loss

Employees are generally entitled to continuation of pay (COP) or wage-loss compensation (WLC) for absences resulting from disability or medical treatment. In order to be eligible for COP, Form CA-1 must be filed within 30 days of the traumatic injury date, and the first day of work stoppage must have occurred within 45 days of the injury. Unless the injury occurs before the beginning of the work shift, time lost on the date of injury is charged to administrative leave.

Employees are eligible for up to 45 calendar days of COP. COP is charged for non-scheduled days and holidays when medical evidence indicates that disability exists during these time periods.

Employees must begin to use any remaining COP balance within 45 days from their first return-to-work (resulting from disability). COP is not considered compensation, but it is subject to the usual payroll deductions and withholdings, and recipients are considered to be in a “pay status.” The employer must allow injured workers 10 days to submit medical documentation supporting their absence before they can interrupt COP.

Form CA-7 is submitted to claim WLC. Upon receipt, the employer has five working days to complete its portion of the form and submit it to OWCP. The pay rate used to compute compensation payments is the one in effect on either the date of injury, the date of recurrence, or the date of disability, whichever is greater. Subsequent salary adjustments such as contract and step increases do not alter the compensation rate.

Claimants with dependents are entitled to 75 percent of the applicable pay rate and those without dependents are entitled to 66 percent. Compensation recipients are in a LWOP status. Compensation is not taxable or reportable to the IRS. Although health-benefit and life-insurance premiums are withheld, the law does not permit “compensationers” to contribute to the Thrift Savings Plan or for the employer to make matching contributions.

A three-day waiting period, which begins on the first day of disability, must be satisfied before an employee can receive COP or WLC. Non-scheduled days and LWOP can be used to satisfy the waiting periods (for COP, annual leave may also be used). In both instances, the waiting periods are waived when there are 14 days of cumulative work stoppage.

COP and WLC payments include night differential, Sunday premium and holiday pay, but exclude overtime. OWCP claim approval is not required for COP to begin, but subsequently denied claims will be subject to repayment. OWCP claim approval is required before WLC will be paid.

Knowing your rights can lessen the pain of an on-the-job Injury.