Your Guide to Federal Workers Compensation Benefits

fihguide

5 years ago

State law determines how most people who get injured or sick at work apply and qualify for workers comp benefits. But the federal workers compensation program, however, is quite different. The Federal Employees’ Compensation Act (FECA) governs how benefits work at the federal level. Learn all about the federal workers compensation program below — including forms, benefit amounts and claim deadlines.

How to Apply for Federal Workers Compensation Benefits

Government and postal employees can apply for federal workers compensation benefits. When that happens, follow these steps:

Report your job-related injury to your supervisor immediately. Always seek emergency treatment first if needed! Otherwise, get Form CA-16 to authorize your treatment.
Choose a doctor to treat your injury or illness. Take forms CA-16 and OWCP-1500 to your doctor so you won’t owe any money.
You must submit written notice to your employer within 30 days. For a workplace injury, use Form CA-1. For an occupational illness, complete Form CA-2. Failure to submit written notice within 30 days may disqualify you from claiming any benefits.
If you miss three work shifts due to injury, apply for lost wages. You may get up to 45 days off with full-time pay to recover.
File Form CA-7 within 10 days after that initial period ends to apply for reduced lost wages. With no dependents, lost-wage benefits are two-thirds your normal paycheck. With dependents, they’re three-quarters your normal paycheck.

What Gets Most Federal Workers Compensation Claims Denied?

The Office of Workers’ Compensation Programs (OWCP) automatically approves some claims. (For example: If your medical bills are less than $1,500 with no request for lost wage benefits.) But there are plenty of reasons why they also may deny claims, such as:

Injuries from willful misconduct. If you break posted safety rules and get hurt, you won’t qualify for federal workers compensation.
Intentional self-harm or injury to others. Suicide attempts or an angry coworker striking you are typical injuries not covered by federal workers compensation.
Accidents involving alcohol or drug use. If you’re drunk or high, the OWCP won’t approve your federal workers compensation claim.
Injuries that occur outside the workplace or while not performing job duties. For example: If you’re hurt while driving to work, it’s not covered. Slip and fall while visiting a coworker on your day off? Then that likely won’t qualify, either.

If Your Claim’s Denied, You Can Always File an Appeal

If the OWCP denies your claim, then you can appeal their decision. Here are three different ways to do that:

Contact the Branch of Hearings and Review for an oral hearing or written record review.
Submit a written reconsideration request to the same OWCP district office that denied your claim.
Request a second claim review from the Employees’ Compensation Appeals Board (ECAB).

You can submit new evidence if you appeal using options 1-2. For option 3, however, the ECAB will review your claim without any additional evidence.

When Do You Need an Attorney?

Some people struggle to qualify for federal workers compensation benefits. If any bullet point below describes you, contact an attorney immediately:

You have either preexisting health conditions or an older, similar injury. Have a herniated disc in the same place you threw your back out two years ago while moving? Then you probably need a lawyer.
Conflicting accounts about your injury accident. If you tell your supervisor a coworker witnessed your accident but that person disagrees, it’s a problem. The OWCP is unlikely to approve your workers comp claim.
You’re working more than one job when the injury or illness occurs. Maybe you’re a postal worker on weekdays and cleaning houses part-time on weekends. Multiple jobs makes it much harder to prove you qualify for federal workers compensation benefits.

Want free legal advice about your workers comp case, but not a federal employee? Talk to a workers compensation attorney free of charge about filing a claim in your state.