RIGHTS AND BENEFITS

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The USPS has the following obligations:

• To make sure the employee understands his or her rights and responsibilities.
• Provide the employee the sample letter called Rights, Responsibilities, and Initial Choice of Physicians.
• Counsel the employee regarding rights and responsibilities, using the following summary, which is more detailed than in the letter.

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Benefits available under the Federal Employees’ Compensation Act (FECA):
Compensation
Medical Care
Surgery
Return to Duty
Schedule Awards
Vocational Rehabilitation
Return to Work
Dual Benefits
Penalty

Benefits available under the Federal Employees’ Compensation Act (FECA):

1. Continuation of Pay: COP may be used in the case of job-related injury for a period not to exceed 45 calendar days.

If the employee elects COP, he or she must:

1. Annotate the appropriate block on CA-1
2. Complete Form 3971, Request for or Notification of Absence.

Advise the employee that:

1. He or she has the right to select COP, annual leave, or sick leave.
2. He or she is responsible for submitting or arranging for the submittal of prima facie medical evidence of a traumatic disabling injury within 10 working days after claiming COP. Prima facie medical evidence is medical evidence that indicates the employee is disabled as a result of a job-related injury and thus cannot perform the job held at the time of injury. Under the provisions of 20 CFR 10.204(a)(1), if such evidence is not received within that time frame, it may serve as sufficient reason for termination of COP, subject to reinstatement upon receipt of such evidence.

(Reference Section 3 of this handbook for more information on COP)

2. Sick or Annual Leave

If the employee elects sick or annual leave, he or she must:

1. Annotate the appropriate block on CA-1
2. Complete Form 3971, Request for or Notification of Absence.

Advise the employee that:

1. The use of annual or sick leave does not extend the 45-calendar-day COP period that begins with the first period of time lost after the day or shift of injury.
2. Leave is limited to the amount the employee has accrued.
3. An employee who elects to use sick or annual leave during the 45-day period in which COP is available is not entitled to buy back that leave with later compensation payments.
4. The employee may subsequently request COP instead of previously requested sick and/or annual leave. However, such a request must be made within 1 year of the date that leave is used, or within 1 year of the date OWCP approves the claim, whichever is later. If COP is granted, then the employee’s sick and annual leave used for the period of time covering the absences for the injury will be credited to the employee’s leave balance.
5. Pay attributable to the leave period (COP, sick leave, or annual leave) is subject to taxes and other usual payroll deductions.

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Compensation

If disability extends beyond the 45-day COP entitlement period, the employee is entitled to file with the OWCP for compensation payments.

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Medical Care

Injured employees are entitled to receive medical and related services made necessary by the medical condition or conditions accepted as being job-related. These services are provided by a physician or hospital of the employee’s choice. When possible, the employee’s choice of physician should be in writing and made part of the claim file. The sample letter Employee Rights, Responsibilities and Choice of Physician will serve this purpose.

For continued payment of medical expenses by OWCP, a change of the employee’s initial choice of physician is permitted only with OWCP approval. If an employee wishes to change his or her treating physician, refer the employee to either the ICCO or OWCP for assistance.

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Surgery

To ensure payment by OWCP, the injured worker must obtain approval in advance from OWCP for any surgical procedure other than emergency surgery. A second opinion medical examination may be required before surgery is authorized. If non-emergency surgery was performed because of the claimed injury before the claim was approved, he or she should ask the doctor to submit a report stating why the surgery was necessary. The injured worker should also arrange for the hospital to submit a copy of the operative report.

If surgery is planned for the future, contact the district office of OWCP to request authorization at least 30 days before the doctor plans to schedule the procedure. The injured worker should arrange for the doctor to submit a medical report stating the need for the surgery and the expected benefits. OWCP will notify the injured worker whether the surgery is authorized at OWCP expense or not.

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Return to Duty

Advise the employee of his or her obligation to return to duty (either full or limited) as soon as possible. To fulfill this obligation, the employee must:

1. Advise the attending physician that the USPS will accommodate most limitations.
2. Request that the physician specify the limitations and restrictions imposed by the injury.
3. Immediately advise the supervisor or control point of those limitations and restrictions.

If the USPS has identified specific alternative positions available, advise the employee to do the following:

1. Furnish the attending physician the description of such alternative positions.
2. Inquire whether and when he or she will be able to perform such duties.
3. Furnish the supervisor, the ICCO, or the control point with a copy of the physician’s response.

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Schedule Awards

Eligible employees may be entitled to a schedule award, defined as compensation for the permanent loss, or loss of use, of each of certain members, organs, and functions of the body as defined by 5 USC 8107. A schedule award is payable regardless of ability to work. A schedule award can not be paid for the same period as disability compensation.

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Vocational Rehabilitation

Nurses

Depending on the kind of injury and how severe it is, OWCP may ask a registered nurse to contact the injured worker concerning his or her recovery and return to work. The nurse may contact the injured worker by telephone or pay a personal visit. The nurse will discuss medical progress with the injured worker and address any problems he or she may be having in returning to work. If necessary, the nurse will coordinate with other OWCP personnel, the physician and the employing agency.

The injured worker is responsible for asking his or her doctor when they can return to work, and for notifying the agency when their doctor says they can work in some capacity. If OWCP determines that the injured worker is indefinitely disabled for their usual job, and the agency has not provided light duty, the injured worker is eligible for vocational rehabilitation services. OWCP will try to arrange work with the employing agency, another Federal agency, or a private employer.

OWCP’s policy is to assist permanently disabled employees, injured on the job, to return to gainful employment within their medically defined work restrictions. Consideration in the return-to-work effort is always given first to the previous employer.

The ICCO should advise employees that if they become eligible for participation in this program, they will be contacted by OWCP and/or the USPS ICCO. Employees may also request consideration. If disability continues the injured worker should submit through his or her employer additional Forms CA-8 (and CA-20a if needed) for each period claimed, unless OWCP informs otherwise.

Compensation may be terminated if the injured worker refuses work which is within his or her medical restrictions without good cause, and benefits may be reduced if he or she fails to cooperate with rehabilitation and placement efforts.

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Return to Work

When an injured worker returns to work, or obtains new employment, notify the district office of OWCP right away. The injured worker may not receive payments for temporary total disability while employed. If he or she receives a compensation check which includes payment for a period worked, return it to OWCP immediately to prevent an overpayment.

The employing agency should also notify OWCP as soon as the employee has returned to duty by calling the telephone number shown on the acceptance letter or filing Form CA-3, Report of Termination of Disability and/or Payment.

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Dual Benefits

An injured worker may not receive Federal retirement benefits and compensation for wage loss for the same periods of time. Compensation for wage loss includes payments for temporary total disability and for loss of wage-earning capacity. An injured worker may, however, receive compensation for schedule awards and retirement annuities for the same period.

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Penalty

Any person who knowingly makes any false statement, misrepresentation, concealment of fact, or any other act of fraud to obtain compensation as provided by the Federal Employees' Compensation Act, or who knowingly accepts compensation to which he or she is not entitled, is subject to felony criminal prosecution and may, under appropriate U.S. criminal code provisions, be punished by a fine of not more than $10,000 or imprisonment for not more than five years, or both.

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