Understanding the Basics of the Federal Workers' Compensation System
The Federal Employees' Compensation Act (FECA) is administered by the Office of Workers' Compensation Programs (OWCP) of the U.S. Department of Labor. It provides Workers' Compensation coverage to federal and postal workers around the world who have suffered a workplace injury or illness. Those covered under FECA include civilian government employees, such as those who work for the Transportation Security Administration, Border Patrol, Veterans Administration and countless other such entities.
FECA Benefits and Stipulations
The FECA also provides for the payment of benefits to dependents if the injury or disease causes the employee's death. However, Federal Workers' Compensation benefits cannot be paid if the injury or death is caused by the willful misconduct of the employee or by the employee's intention to bring about his or her injury or death or that of another, or if intoxication (by alcohol or drugs) is the proximate cause of the injury or death.
The Federal Workers' Compensation system differs from the widely variable state Workers' Compensation systems in many ways, including the following.
Federal Workers' Compensation Benefits
- All Federal Workers' Compensation cases are managed by the Department of Labor (DOL). No third-party administrator is involved.
- FECA will cover all necessary and proper claim-related medical treatment including rehabilitation, surgery, and prescriptions. In a case of a partial disability, where a physician says that the employee can return to work for a limited period of time per shift, the DOL will make up the reduced-work hours by paying two-thirds or three-quarters of the gross pay, based on whether or not the injured worker has a dependent.
- Compensation for lost wages is also provided though FECA if an employee is temporarily disabled and unable to work due to the industrial injury or occupational disease. The federal agency will compensate the worker directly for lost wages up to the first 45 days off work. If such a condition persists after 45 days, FECA will begin to pay those lost wages.
- If your Workers' Compensation claim stems from an occupational disease, you are eligible for compensation for lost wages from FECA after only an initial three-day waiting period.
- FECA will provide additional benefits if the work-related injury or illness leads to permanent partial disability or permanent total disability,
- The amount of the compensation is based on the severity of your permanent disability and the impact it has on your future earning capacity.
- Those with dependents will probably receive increased permanent disability compensation in order to provide for those dependents.
- Compensation for vocational retraining is also available if you need job retraining to return to the workforce.
- According to the Federal Employee Workers' Compensation law, injured federal employees cannot refuse suitable part-time or lower paying jobs.
Medical Treatment in Federal Workers' Compensation Cases
- An employee is entitled to medical, surgical and hospital services and supplies needed for treatment of an injury as well as transportation for obtaining care, according to the Department of Labor's Office of Workers' Compensation Programs (OWCP).
- The injured employee may select any qualified local physician or hospital to provide necessary treatment or may use agency medical facilities if available.
- Any change in treating physician after the initial choice must be authorized by the OWCP unless the referral was made by the attending physician. If not, the OWCP will not be liable for the expenses of treatment.
- The OWCP defines the term "physician" as surgeons, osteopathic practitioners, podiatrists, dentists, clinical psychologists, optometrists and chiropractors within the scope of their practice as defined by State law.
- Although there is no system in place mandating Utilization Review, a federal employee injured at work will often have to see a physician for a second opinion for confirmation of the injury.
- In terms of medical benefits, there are no liens allowed.
- The DOL routinely requests a second opinion even in cases where the need for medical treatment is thoroughly documented.
- There is no judicial review of the DOL findings.
- There is no distinction made between psychological/psychiatric injuries and those of a physical nature in terms of apportionment. If a work event contributed—even in a very limited way—to the medical condition that is causing the disability, it is considered a consequence of the job. There is no percentage of what is work-related and what percentage is caused by sources outside of the workplace.
Because the Federal Workers' Compensation system is a complicated one, it is wise to have an experienced, knowledgeable Federal Workers' Compensation lawyer on your side to help ensure you receive the full range of benefits to which you are entitled.