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Types of Claims

Traumatic Injury

A traumatic injury is defined as a wound or other condition of the body caused by external force, including stress or strain. The injury must be identifiable by time and place of occurrence and member of the body affected; it must be caused by a specific event, or incident or series of events or incidents, within a single day or work shift.

When an employee sustains a traumatic injury in the performance of duty, he or she should complete the following steps, in order:

  1. File a written report in ECOMP by completing the OSHA-301 form.
  2. File form  CA-1Federal Employee’s Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation.

Note: To preserve entitlement to continuation of pay (COP), the claim should be filed no later than 30 days from the date of injury, and COP must be elected. However, the employee has three (3) years from the date of injury to file a claim.  

Occupational Disease

An occupational disease is defined as a condition produced in the work environment over a period longer than one workday or shift. It may result from systemic infection, repeated stress or strain, exposure to toxins, poisons, or fumes, or other continuing conditions of the work environment.

When an employee sustains an occupational disease in the performance of duty, he or she should file a written report in ECOMP by completing Form CA-2, Notice of Occupational Disease and Claim for Compensation.  The employee has 3 years after the date they first became aware that the illness was work-related, or 3 years from the date of last exposure to file the claim.  

In addition to filing the form CA-2, the employee must provide evidence supporting the claim for occupational disease.  The U.S. Department of Labor, Office of Workers’ Compensation Programs (DOL-OWCP) has developed eight checklists CA-35a-h (for various conditions) to help employees and agency personnel gather and submit material required to adjudicate occupational disease claims.  If possible, the information identified on the checklist should be submitted with form CA-2. 

The Federal Employees’ Compensation Act does not automatically cover diseases and illnesses that occur during or after Federal employment.  The claimant must provide factual and medical evidence to establish that conditions of employment caused or aggravated the disease or illness.

Notice of Recurrence Defined

A recurrence is defined as a spontaneous return or increase of disability due to a previous injury or occupational disease without intervening cause, or a return or increase of disability due to a consequential condition. A recurrence differs from a new injury in that with a recurrence, no event other than the previous injury accounts for the disability. Follow-up medical care for an injury or disease that causes time loss is considered part of the original injury rather than a recurrence unless the employee was previously released from treatment.

If a recurrence of disability develops, the employee and supervisor should complete Form CA-2a Notice of Recurrence, and submit it to the Bureau Workers’ Compensation Specialist or MCA office. Where fewer than 45 days of COP were used for the original traumatic injury, the remaining days may be authorized if less than 45 days have elapsed since the date of the first return to duty. Otherwise, the employee may elect to use sick or annual leave pending adjudication of the claim for recurrence. The employee should arrange for submission of the medical evidence described in the instructions attached to the form, paying particular attention to the need for "bridging" information which describes his or her condition and job duties between the original injury and the recurrence. Ordinarily, no medical treatment is authorized by the U.S. Department of Labor’s Office of Workers’ Compensation Program (DOL-OWCP) until the claim for recurrence is accepted.

The supervisor should complete the Agency portion of the form and send the completed CA-2a to the bureau workers’ compensation specialist or MCA office, with supporting medical documentation, no later than 3 business days after receipt of the claim form from the employee. Ensure the form contains the original signatures and the date of signature.

 

Last Update: July 2024