Problems with Central ‘Case Create’
(This article appeared in the January/February 2012 issue of The American Postal Worker magazine.)
Sue Carney, Director Human Relations Dept.
On Oct. 1, 2011, the Office of Workers’ Compensation Programs (OWCP), Division of Federal Employees’ Compensation (DFEC), centralized its case creation and data entry operations. The change does not affect how workers make injury claims or file for benefits, but it does alter employer processes and create potential problems for claimants.
Employing agencies are no longer permitted to submit completed claim forms to the 12 OWCP District Offices (based on jurisdiction) as they have done in the past. All claims except those submitted through the Agency Query System (AQS) and Electronic Data Interchange (EDI) now must be sent to the new central facility in Jacksonville FL, which is located near but entirely distinct from the district office.
General mail should still be sent to the US Department of Labor — OWCP/DFEC central mail address at PO Box 8300, London, KY 40742-8300. DFEC has stated that new cases will be created within two business days of receipt; however, an agency’s failure to comply with the new submission requirement could result in a delay in case creation.
Additional Problems Anticipated
Injured workers will continue to receive a postcard notifying them of case creation, but we have been advised by DFEC that individual case numbers will be excluded from the notice. Despite case numbers being critical to many aspects of an individual’s claim, such as medical bill payment, document submission, access to personal claim information through AQS or the Claimant Query System (CQS), OWCP has opted to force employees to obtain this information from their employers. DFEC says this action is being taken to protect the privacy of identifiable information; however, contrary to this rationale, when a case is created based on the submission of a paper form, a postcard sent to the employing agency will include the new case number. Nevertheless, agencies are expected to be cooperative. Claimants also have the option of contacting OWCP to obtain their case number.
Procedures for submitting Form CA-16, A uthorization for Examination and/or Treatment,have not changed, except for the requirement that the form must be returned to the new centralized facility in order for the authorization dates to be entered into the database to enable bill payment. OWCP warns that if the form is received without a claim number, the authorization will not be recorded. When issued, the CA-16 guarantees payment for non-invasive medical treatment for up to 60 days, whether or not the claim is approved. Due to the important nature of the form, members should ensure that their physician is aware of these critical requirements. We strongly recommend physicians and claimants retain a copy of the completed form for their records.
Most disturbing is OWCP’s announcement that it will return all claims for compensation (Form CA-7) with the exception of those transitioning from continuation of pay, when the “from” date for the period claimed is a future date — saying there is no way to verify an employee’s future leave status. This policy is in direct conflict with existing regulations, which require employers to complete and submit CA-7s to OWCP not more than five business days after receipt from the employee. This policy will cause employers to hold or refuse CA-7s; will needlessly delay compensation payments, and will create undue hardship for claimants.
These changes serve as further evidence that the administration has little regard for claimants and the regulations they are obligated to uphold, and demonstrates that DFEC officials are left unchecked by the Department of Labor.
The APWU has notified the Division of Federal Employees Compensation of our concerns, and we are continuing our efforts to correct these issues.
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