Number: 

DAO 202-810

SECTION 1. PURPOSE.

.01 This Department Administrative Order (DAO) outlines authorities, establishes policies, and describes responsibilities for administration and management of the centralized operation of the Workers' Compensation program under the Federal Employees' Compensation Act (FECA).

.02 This Order is a substantial rewrite that:

a. Updates new responsibilities for supervisors, claimants, and offices on filing, processing forms, delivering benefits, tracking, and submitting forms. It provides new information and electronic links to key offices, data, and background.

b. Defines responsibilities for the mandatory use of the U.S. Department of Labor, Office of Workers' Compensation Programs (DOL/OWCP) Employees' Compensation Operations and Management Portal (ECOMP) for electronically processing (e.g., filing, reviewing, adjudicating, approving, delivering benefits, controverting, and tracking) Occupational Safety and Health Administration (OSHA) injury and illness incident reports (including severe injury reports) and workers' compensation claim forms. Examples of DOL forms processed through ECOMP include (but are not limited to): OSHA Form 301, Injury and Illness Incident Report; Workers' Compensation Forms CA-1, Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation; and CA-2, Notice of Occupational Disease and Claim for Compensation.

c. Requires the use of ECOMP to electronically process and submit to DOL/OWCP employees' OSHA injury and illness incident reports. Department bureaus/operating units use ECOMP as a required first step to electronically process and submit their OSHA Form 301, Injury and Illness Incident Reports. Due to the requirements of Goal 7 of the Protecting Employees, Enabling Reemployment (PEER) Initiative, effective September 30, 2020, all DOC bureaus are required to use ECOMP to process their injuries/illnesses reports (e.g., OSHA Form 301), as well as to file workers' compensation claims (e.g., CA-1 or CA-2 forms). Note: For further information and guidance regarding the establishment and implementation of the PEER Initiative see: Office of Management and Budget Memorandum Establishing PEER (M-20-08; 01/09/2020); and Secretary of Labor's Memorandum on PEER (02/25/2020).

d. Requires the use of ECOMP to electronically process and submit to DOL/OWCP employees' workers' compensation claim forms. Use of ECOMP for processing workers' compensation claims is mandatory and applies to all Department bureaus/operating units.

e. Recommends use of Form CD-137, Report of Incident, Injury, Illness, Motor Vehicle Accident, Property Damage, or Fatality (or another bureau/operating unit-specific equivalent) as a supplemental and optional form for documenting incident investigations such as: severe injuries, serious incidents, motor vehicle accidents, property damage, and near miss incidents/events.

Note: Completing incident investigations is mandatory, while use of Form CD-137 for documenting the incident is optional.

f. Identifies DOL/OWCP as responsible for administering the Federal Government's FECA program, including the Department of Commerce (Department) workers' compensation program.

g. Clarifies the requirement to use the Department-selected contractor to provide workers' compensation claims processing support, case management, and liaison services, as well as manage the Department's Workers' Compensation Pharmacy Benefits Management (PBM) program for all Department organizations and bureaus. The PBM program includes implementation of OWCP's opioid policy (FECA Bulletin No. 18-04).

Note: See the Workers' Compensation (FECA) Tools and Resources webpage to identify the Department's current Workers' Compensation and Pharmacy Benefits Management program contractor.

h. Clarifies requirements for the implementation of the Workers' Compensation Return-to-Work (RTW) program and the application of effective case management practices for promoting increased employee return to work. An effective RTW program is critical in reducing the Department's workers compensation costs.

i. Defines responsibility for supervisors to complete "An Introduction to Workers' Compensation for Supervisors" training module available through the Commerce Learning Center (CLC). The training module must be completed under any one of the following circumstances: initially within 6 months of DAO 202-810 issue date; within 6 months of employment; when one of his/her employees suffers a work-related traumatic injury or occupational disease and prior to helping the employee use ECOMP for filing an OSHA Form 301, CA-1, CA-2 workers' compensation claim; and as refresher training once every 5 years.

Note: To gain greater clarity regarding use of ECOMP for filing injury and illness reports and workers' compensation claims, it is advisable for employees to complete "An Introduction to Workers' Compensation for Supervisors" training module when suffering a work-related traumatic injury or occupational disease and prior to using ECOMP to file an OSHA Form 301, and CA-1 or CA-2 workers' compensation claim. Further, training tutorials for employees, supervisors, Agency Maintenance Users, and Agency Reviewers are provided on the DOL/OWCP ECOMP website's User Guides under the Help menu.

j. Provides for flexibility of developing alternate and/or supplementary (equally effective Workers' Compensation and ECOMP use programs meeting FECA requirements) bureau or operating unit specific processes for administering the OWCP FECA program and use of ECOMP for filing employees' OSHA injury and illness incident reports (e.g., OSHA Form 301), as well as filing workers' compensation claims (e.g., CA-1 or CA-2 forms). Further, it provides flexibility for bureau or operating unit specific ways of meeting the information and/or training requirements (e.g., one way is for supervisors to complete "An Introduction to Workers' Compensation for Supervisors" training module available through the Commerce Learning Center (CLC) at a specified frequency of once every 5 years).

The bureau or operating unit developing an alternate and/or supplementary Workers' Compensation and ECOMP use program is responsible for obtaining OHRM approval and ensuring that the alternate and/or supplementary program meets all FISMA requirements and is in compliance with FECA. Also, see Section 4.0 Applicability and Scope.

Note: For example, the case law regarding proper forms for OWCP claims does not require a specific form but advises that filing forms in compliance with OWCP makes the process more efficient. However, an employee appears to be allowed to file their OWCP claim in any form of writing. Further, the Census Bureau administers the DOL/OWCP Workers' Compensation and ECOMP use programs differently (but equally effectively and in compliance with FECA requirements) than what is stated in this policy due to logistical limitations of the Census 2020 infrastructure.

k. Highlights the need to detect and report fraud, waste, and abuse.

l. Generally, updates the Order.

SECTION 2. AUTHORITY.

.01 The authority for providing compensation benefits to Federal employees for injuries and occupational diseases/illnesses sustained while in the performance of duty is governed by FECA, as amended, 5 United States Code (U.S.C.) 8101 et seq. This Act is administered by the Secretary of Labor (U.S. Department of Labor (DOL)) through the Office of Workers' Compensation Programs (OWCP), Division of Federal Employees', Longshore and Harbor Workers' Compensation (DFELHWC).

.02 Administrative regulations implementing FECA are set forth in Title 20, Code of Federal Regulations (CFR) Parts 1, 10, and 25.

SECTION 3. REFERENCES.

.01 The following references apply to this Order:

a. Compensation for Work Injuries, 5 U.S.C., Chapter 81.

b. 20 CFR Parts: 1, Office of Workers' Compensation Programs; 10, Claims for Compensation Under the Federal Employees' Compensation Act, As Amended; and 25, Compensation for Disability and Death of Noncitizen Federal Employees Outside the United States (Administrative regulations implementing FECA).

c. 29 CFR Part 1960, Basic Program Elements for Federal Employee Occupational Safety and Health Programs and Related Matters.

d. DAO 209-3, "Injury, Illness, Accident/Incident, Fatality and Motor Vehicle Accident Reporting and Investigation."

e. DAO 209-4, "Occupational Safety and Health Program."

f. Office of Occupational Safety and Health (OOSH) webpage: Workers' Compensation: How to File a Claim.

g. Office of Human Resources Management (OHRM), Human Resources (HR) Bulletin 189 (fiscal year (FY) 14), use of "Employees' Compensation Operations and Management Portal (ECOMP)" August 6, 2014.

h. Office of Human Resources Management, HR Bulletin 182 (FY14), "Workers' Compensation Return-to-Work Program" April 7, 2014.

i. DOL/OWCP ECOMP.

j. ECOMP Instructions for Initiating CA-1 or CA-2 Forms from an OSHA-301 Form.

k. DOL/OWCP ECOMP - "How to File a Form" (Workers' Compensation Claim Form instructions).

l. DOL/OWCP ECOMP -“ "Filing Forms as an Injured Worker," training module.

m. DOL/OWCP ECOMP -“ "Reviewing Forms as a Supervisor," training module on reviewing claim forms.

n. DOL/OWCP ECOMP -“ "Agency Reviewer," user guide training module.

o. DOL/OWCP "Division of Federal Employees' Compensation (DFEC)," Injury Compensation Specialist (ICS) training modules.

p. "Injury Compensation for Federal Employees," Publication CA-810, revised 2009, prepared by the Office of Workers' Compensation Programs, Employment Standards Administration, DOL.

q. "Questions and Answers about the Federal Employees' Compensation Act (FECA)," Publication CA-550, revised July 2002, prepared by the Office of Workers' Compensation Programs, Employment Standards Administration, DOL.

r. "When Injured at Work Information Guide for Federal Employees," Publication CA-11, prepared by the Office of Workers' Compensation Programs (OWCP); Division of Federal Employees' Compensation (DFEC).

SECTION 4. APPLICABILITY AND SCOPE.

This Order applies to all Department operating units, bureaus, agencies, offices, and other organizations or components.

Note: Operating units, bureaus, agencies, and offices may develop alternate and/or supplementary OSHA work-related injury and illness incident reporting (e.g., equally effective Workers' Compensation and ECOMP use programs meeting FECA requirements; use of an OSHA Form 301) and workers' compensation claims filing, information processing, and instructions to complement and enhance this Order. Such supplementary information may be incorporated into their training and other forms of communication. As a first step to filing a claim using ECOMP, Department bureaus/operating units decided to make full use of ECOMP's recording and case management capabilities and use the system to electronically file and submit their OSHA Form 301, Injury and/or Illness Incident Reports. Typically, when an employee (claimant) files an OSHA Form 301 (Injury and Illness Incident Report) in ECOMP, the system will allow that employee also to file a workers' compensation claim such as the CA-1 Form (for traumatic injury), or the CA-2 Form (for occupational disease). See Figure 1 for a graphic representation of how ECOMP works. Additionally, operating units, bureaus, agencies, and offices have the flexibility for developing alternate and/or supplementary means of providing the information and/or training requirements to their employees and designated supervisors.

The bureau or operating unit developing the alternate and/or supplementary Workers' Compensation and ECOMP use program is responsible for obtaining OHRM approval and ensuring that the alternate and/or supplementary program meets all FISMA requirements and is in compliance with FECA.

Note: For example, the Census Bureau administers the DOL/OWCP Workers' Compensation and ECOMP use programs differently (but equally effectively and in compliance with FECA requirements) than what is stated in this policy due to logistical limitations of the Census 2020 infrastructure.

SECTION 5. POLICY.

.01 The Department maintains a centrally managed workers' compensation program using DOL/OWCP's
ECOMP system to provide benefits to eligible employees, or their dependents or survivors. Further, the Department employs a workers' compensation contractor that provides case management activities to: assist in the effective use of ECOMP for filing and processing workers' compensation claims and related documents in a timely and efficient manner; manage claims; provide liaison functions with DOL/OWCP; and work closely with injured employees and supervisors to return them to work as soon as they are medically able (e.g., by implementation of the Workers' Compensation Return-to-Work (RTW) program).

Note: this DAO does not alter the terms of an existing collective bargaining agreement.

02. As a required first step to filing a workers' compensation claim, the Department is responsible for using ECOMP to electronically file and process OSHA Form 301 injury and illness incident reports, and subsequently using ECOMP for electronically filing and processing workers' compensation claim forms.

.03 When appropriate, the Department and its bureaus will alert OWCP/ DFELHWC of the opportunity to challenge claims that seem unrelated to workplace traumatic injuries or occupational diseases, or otherwise appear to be spurious; and will assist OWCP/ DFELHWC to challenge and offset the costs of injuries caused by a third party by seeking reimbursement.

.04 The Department will notify DOL/OWCP of errors that include inaccurate reporting, overpayments, and death of claimants.

.05 The Department will limit workers' compensation costs by working to implement the RTW program; (HR Bulletin 182 (FY14)). The RTW program is hereby incorporated by reference. Further, it is recognized that the RTW program is designed to focus on returning all disabled employees to work as soon as possible after the injury or illness and within the treating physician's restrictions.

.06 Bureau leadership will minimize workers' compensation costs to the extent possible by establishing an effective RTW program and by focusing on return-to-work opportunities and oversight of Department chargeback reports by:

a. Establishing bureau roles and responsibilities for the RTW program, including: designating the group of appropriately trained and skilled individuals who have the authority to make job offers; and producing an organizational chart showing the workers' compensation section and where their bureau, organization, or operating unit is located in the chain of command.

b. Reviewing old and/or open claims to identify those no longer eligible for benefits and can be resolved.

c. Identifying claims with return-to-work potential.

d. Identifying jobs that are suitable for claimants' medical limitations and making offers to the affected claimants to return to work.

e. Reviewing new claims and challenging those that are questionable with respect to facts of injury or work-relatedness.

f. Working with newly injured claimants to bring them back to work as soon as medically feasible in order to reduce Continuation of Pay (COP) costs.

.07 In carrying out responsibilities under this Order, all Department officers and employees and contractor personnel must comply with Department policies and practices concerning confidentiality and whistleblower protections and all applicable provisions under the Privacy Act, 5 U.S.C. 552a, the Whistleblower Protection Act, 5 U.S.C. 2302, and any other related law, regulation, or policy. Department of Labor regulations set forth provisions concerning the confidentiality of all records relating to claims for benefits under FECA and the custody and control of FECA records under 20 C.F.R. 10.10 and 10.11.

SECTION 6. DEFINITIONS.

.01 The following definitions are applicable to this Order:

a. Accident/Incident. A work-related event that resulted in an injury, amputation, loss of eye, illness, fatality, any fire (except as required for maintenance or scientific activities), property damage, or a near miss that could have resulted in an injury, fatality, or property damage. Even minor injuries such as cuts or sprains are considered accidents/incidents. The term work-related accident/incident excludes spills/releases and radiation-release-related incidents that do not involve personal injury or personal exposure. If there is any doubt, treat the situation as if it were an accident/incident.

b. Agency Reviewer (AR). The Agency Reviewer in ECOMP is responsible for reviewing FECA claim forms before submission to the contractor selected by the Department to provide processing support on workers' compensation claims. Also, the AR is frequently the bureau or operating unit's designated Workers' Compensation Specialist (WC Specialist) or Injury Compensation Specialist (ICS).

c. Benefits or Compensation. The money OWCP pays to or on behalf of a beneficiary from the Employees' Compensation Fund. The terms Benefits and Compensation include payments for lost wages, loss of wage-earning capacity, and permanent physical impairment. The terms Benefits and Compensation also include the money paid to beneficiaries for an employee's death, including both death benefits and any death gratuity benefit. These two terms also include any other amounts paid out of the Employees' Compensation Fund for such things as medical treatment, medical examinations conducted at the request of OWCP as part of the claims adjudication process, vocational rehabilitation services under 5 U.S.C. 8111, services of an attendant and funeral expenses under 5 U.S.C. 8134, but do not include continuation of pay as provided by 5 U.S.C. 8118.

d. Burden of Proof. Under FECA, the claimant is assigned the responsibility to establish through reliable, probative, and substantial evidence the five basic requirements of a claim, including: time, civil employee, fact of injury, performance of duty, and causal relationship. This responsibility is known as the "burden of proof."

e. Centralized Workers' Compensation program. Use of ECOMP to electronically file the appropriate OSHA injury and illness incident reports and workers' compensation claim forms. Further, the centralized Workers' Compensation program includes use of the contractor selected by the Department to provide workers' compensation claims processing support, including claims filing, review and approval; claims controversion; return-to-work facilitation; tracking claims' status; etc. ECOMP is operated by DOL/OWCP/DFELHWC.

f. Chargeback Report. A statement prepared by DOL that details the medical and compensation costs paid for each agency workers' compensation claim during the reporting period. The statement is submitted to the agency quarterly.

g. Claimant. A Department employee who has filed written assertion of an individual's entitlement to benefits under the FECA, submitted in a manner authorized by 20 CFR Part 10. A claim will be filed electronically through the DOL/OWCP ECOMP.

h. Collateral Duty Safety Officer (CDSO). The CDSO is defined as an appropriately trained and skilled employee designated in writing by the head of a bureau/operating unit to be responsible for supporting the organization's management in implementing the safety and health program, and who may work under the direction of the Safety Manager (29 CFR 1960.58). The CDSO is assigned by a bureau/operating unit that has mission or work in a low risk environment (e.g., office environment, etc.).

i. Continuation of Pay (COP). The process by which an eligible employee's regular pay may continue for up to 45 calendar days of wage loss due to disability and/or medical treatment after a traumatic injury. COP is not paid in cases of occupational illness.

j. Controversion. The process by which a supervisor or an agency recommends to DOL, Office of Workers' Compensation Programs (OWCP), that COP be denied.

k. ECOMP (Employees' Compensation Operations and Management Portal). The centralized online portal is used to file, submit, process, approve, and track the Department's OSHA recordable injuries or illnesses and/or its workers' compensation claims. ECOMP is operated by DOL/OWCP.

l. Injury or illness. An injury or illness is an abnormal condition or disorder. Injuries include cases such as, but not limited to, a cut, fracture, sprain, or amputation. Illnesses include both acute and chronic illnesses, such as, but not limited to, a skin disease, respiratory disorder, or poisoning. (Note: Injuries and illnesses are recordable only if they are new, work-related cases that meet one or more of the part 1904 recording criteria.)

Note: See definition of work-related occupational disease or illness at 6.01dd.

n. Leave Buy-Back. A program that allows an injured worker to repurchase leave used in association with a work-related disability. An employee may initially elect to use annual or sick leave during the period of disability. Later, the injured worker may claim compensation for the period of disability and "buy-back" the leave used as follows: the "buy-back" leave period must exceed 40 hours (no leave "buy-back" for less than 40 hours); the "buy-back" must be requested within 1 year of usage following the acceptance of the disability claim.

Note: The 1-year "buy-back" request period limit is extended if the claim was originally denied and then approved. The 1-year request period limit starts with the approval date of the claim.

o. Light Duty. Those duties and responsibilities that are outside an employee's regular position, but that meet the employee's current work capabilities as identified by a physician. They may be performed for a full work shift or for shorter time periods.

p. Limited Duty. Specific duties and responsibilities of an employee's regular position that meet the employee's current work capabilities as identified by a physician. These duties may include all or part of the employee's regular job assignment. They may be performed for a full work shift or for a shorter time.

q. Motor Vehicle Accident. Any occurrence involving a Federal Government-owned, leased, or rented
motor vehicle (GOV), or privately-owned motor vehicle (POV) operated on official business, which results in death, injury, or property damage, regardless of whom (if anyone) was injured or what property was damaged.

Note: In the event of a vehicle accident, report drivers cited with felony traffic violations while operating a GOV.

r. Near Miss. A near miss (also called a "close call" or "near hit") describes an incident where no property was damaged, and no injury or illness was sustained, but where a slight shift in time, position, or action, and damage and/or injury easily could have occurred. Near misses should be reported so conditions that led to the near miss can be corrected before injury, illness, or property damage occur.

s. Pharmacy Benefits Management (PBM) Program Administrator. The contractor selected by the Department to manage the Department's Workers' Compensation Pharmacy Benefits Management program.

t. Periodic Roll Claims. If medical reports indicate that disability will continue for at least 60 days after COP, DOL/OWCP places the employee on the periodic roll, and compensation payments are automatically paid by DOL/OWCP every 28 days with appropriate medical documentation. An injured employee will receive 75 percent (tax free) of his/her salary in compensation payments if, at the time of the injury, the employee has dependents. An injured employee will receive 66 2/3 percent (tax free) of his/her salary in compensation payments if he/she has no dependents. Employees on the periodic roll who are made suitable offers of employment must accept the offers.

u. Return to Work (RTW) program. The RTW program is defined as a Department-wide focus to identify and provide suitable opportunities for employees medically able to work to do so within their temporary or permanent medical restrictions when they cannot perform some or all of their permanent job assignments. The RTW program requires bureaus to develop annual written RTW plans and to submit their plans to the Director, Office of Human Resources Management, and to the Office of Occupational Safety and Health by August 31 each year.

v. Serious Incident. A condition that results in one or more of the following event outcomes:

w. Severe Injury Also Known as OSHA Reportable Injury. A work-related injury that employers must report to OSHA as follows: within 8 hours after the death of any employee as a result of a work-related incident; and within 24 hours after the inpatient hospitalization of one or more employees or an employee's amputation or an employee's loss of an eye, as a result of a work-related incident (29 CFR 1904.39).

x. Short Term Claims. Term for claims from the time of injury until the employee is placed on the periodic roll. Employees with Short Term Claims who are made suitable offers of employment must accept these offers.

y. Suitable Job Offer. An offer of employment determined by the OWCP to comport with an employee's work-related medical restrictions.

z. Third Party. A work-related injury caused by a private party or a "third party" and not the Department. when an injury is caused by a private party, the employee may be required by DOL to bring a claim against the party causing the injury. (For example, an employee is injured in an automobile accident that was caused by a private citizen.)

aa. Traumatic Injury. A workers' compensation-related term meaning a condition of the body caused by a specific event or series of events or incidents in a single workday or shift. Such condition must be caused by external force, including stress or strain, which is identifiable as to time and place of occurrence and member or function of the body affected. Examples of traumatic injury include: a dog bite, knee strain after a trip and fall, neck strain after an auto accident, or a broken ankle after a slip-on ice.

bb. Workers' Compensation Contractor. The contractor selected by the Department to provide workers' compensation claims processing support, case management, and liaison services for all Departmental organizations and bureaus.

cc. Workers' Compensation (WC) Specialist or Injury Compensation Specialist (ICS). An appropriately trained and skilled individual designated to assist bureau or operating unit management to effectively administer the workers' compensation program. Frequently, the WC Specialist also is designated as the bureau or operating unit's AR. Further, at a minimum, the WC Specialist must successfully complete the DOL/OWCP/DFELHWC ICS training modules and the DOL/OWCP ECOMP training modules. Note: The above referenced training modules may be completed either online or in person.

dd. Occupational disease or illness. A condition produced by the work environment over a period longer than a single workday or shift. Work-Related Occupational Disease or Work-Related Occupational Illness. A workers' compensation-related term meaning a condition produced by an exposure in the work environment over a period longer than one (1) workday or shift. It may result from systemic infection, repeated stress or strain, or conditions of the work environment. Examples of an occupational disease include: noise induced hearing loss, asbestos-related illness, or orthopedic injuries due to repetitive motion.

1. Treatment of one or more persons, including Federal employees, non-Federal employees, and employees of Federal contractors, admitted as inpatients to a hospital as a result of a single event that occurred while they were performing their assigned work duties. Note: The Department's workers' compensation program covers only Federal employees.

2. Property Damage. Property damage is damage amounting to $25,000 or more (other than vehicles). Vehicular damage is damage in excess of $5,000, or if the vehicle is totaled, or whenever there is a fatality or catastrophe related to the property damage.

3. Radiation exposure resulting in any personal exposure;

4. Biological or chemical exposure when in the judgment of competent authorities, the exposure is considered serious;

5. Non-DOC Agencies. Whenever a DOC organization alerts another governmental (Federal, state, or local) agency to the existence or suspected existence of a chemical, biological, radiological, nuclear, or explosive exposure event; and

6. Facility Evacuation. Activation of an Occupant Emergency Plan resulting from:

i. A fire beyond the incipient stage;

ii. Shelter-in-place or evacuation due to threats (e.g., suspicious package, vehicle/bomb threat, toxic material release, etc.); and

iii. Any criminal act of hostility/violence (e.g., active shooter, assault, rioting, or terrorism).

SECTION 7. RESPONSIBILITIES.

.01 Departmental Office of Human Resources Management (OHRM). OHRM will:

a. Serve as the Department's chief liaison office with DOL/OWCP through the Director, OHRM, or designated staff member.

b. Centrally administer the Department's workers' compensation program through the mandatory use of ECOMP and be responsible for development of overall program policies.

c. Manage program operations and provide oversight of the Department's currently selected workers' compensation contractor.

.02 Office of Occupational Safety and Health (OOSH). OOSH will:

a. Establish program operating policies, procedures, and guidelines that ensure effective and efficient management of the workers' compensation program in areas including: b. Provide necessary liaison with DOL/OWCP, including: c. Accommodating partially recovered injured employees by maintaining contact with them and their supervisor, and affording them light or limited duty, as warranted by their respective medical documentation.

d. Establishing an employee assignment team (at the discretion of the OOSH and Workers' Compensation Program Director) to identify potential return-to-work cases and, through contact with affected supervisors, identifying and obtaining suitable light or limited duty employment.

e. Providing or coordinating workers' compensation training to appropriate stakeholders.

f. Detecting, investigating, and reporting fraud, waste, and abuse in the workers' compensation program.

1. Designate an appropriately trained and skilled representative to coordinate routine program-related
activities, including ECOMP use-related activities with DOL/OWCP.

2. Coordinate ECOMP operation, training, and use-related matters with operating units, the workers' compensation contractor, supervisors, claimants, and the pharmacy benefit program managing contractor.

3. Provide claims and case management assistance by: conducting quarterly roll claims' reviews for compensation through monitoring medical evidence and claim status; counseling employees with their periodic roll claims; and coordinating with employees, supervisors, physicians, and the workers' compensation contractor to collect and submit (through ECOMP) complete claims-related documentation. When appropriate, challenge questionable claims and refer possible fraudulent claims to the OOSH Workers' Compensation program and the Office of Inspector General (OIG).

4. Assist operating units and their injured or ill employees in participating in the Department's optional Workers' Compensation Pharmacy Benefits Management program.

5. Assist operating units and their injured or ill employees in pursuing their options under the Department's leave buy-back program. Under the program, an employee with a work-related disability may initially elect to use annual or sick leave in association with and during the period of disability. Later, the disabled employee may claim compensation for the period of disability and repurchase or "buy-back" the leave used as follows: the buy-back leave period must exceed 40 hours (no leave buy-back for less than 40 hours); and the buy-back must be requested within 1 year of usage following the acceptance of the disability claim. Note: The 1-year, buy-back request period limit is extended if the claim was originally denied and then approved. The 1-year request period limit starts with the approval date of the claim.

6. Provide return-to-work assistance through implementation of the Workers' Compensation RTW program by pursuing job modification(s) or other means of enabling employees to work within their restrictions; requesting vocational rehabilitation assistance where indicated; and coordinating re-employment efforts with the workers' compensation contractor and DOL/OWCP, which may cross organizational lines and
reach outside the agency.

7. Provide compensation cost monitoring by reviewing and tracking compensation costs and savings; reporting to the OHRM Director, Chief Financial Officer, and operating units the cost savings of the Department; and providing chargeback reports to the Office of Financial Management for compensation benefits paid for work-related injuries and deaths.

1. Reviewing DOL/OWCP hearing transcripts and providing to DOL relevant evidence and arguments supporting the Department's position, as appropriate.

2. Reviewing and reconciling charges for compensation benefits billed to the Department by DOL/OWCP.

3. Reviewing the Social Security Administration rolls periodically (e.g., yearly) to identify claimants who

4. Notifying DOL/OWCP of the Department's position on specific third-party claims for reimbursement,
and monitoring the recovery efforts through the final reimbursement.

5. Providing an assigned Medical Review Officer to act as the Department's representative, as necessary, in obtaining information from referral physicians to reconcile DOL/OWCP cases.

.03 Office of Financial Management (OFM). OFM will:

a. Record DOL/OWCP charges in appropriate suspense account(s).

b. Issue bills based on any distributions made by OHRM to appropriate operating units, at the lowest practicable level. For example, the lowest practicable level may be the first-line supervisors.

c. Maintain appropriate records (subsidiary listing of charges and distributions for suspense accounts).

.04 The Agency or the Agency's designated workers' compensation contractor will:

a. Be responsible for all the terms and conditions described in its contract.

b. Report any detected fraud, waste, and abuse in the Workers' Compensation program to the OOSH Workers' Compensation program and to the OIG.

.05 Bureau or Operating Unit Management. Bureau or operating unit management will:

a. Allocate appropriate resources for the implementation of an effective workers' compensation program, including: designating a skilled WC Specialist and safety coordinator/manager/CDSO; ensuring that the WC Specialist and safety coordinator/manager/CDSO are appropriately trained and have the skills to effectively administer the workers' compensation program; have the skills to effectively administer the bureau/operating unit's RTW program; and work closely with affected supervisors to return injured workers to productive work as soon as they are medically able.

b. Develop and submit an annual RTW program plan in accordance with the guidelines included in the Workers' Compensation RTW program (HR Bulletin 182 (FY 14); incorporated by reference). The plan is to be submitted to the Director, OHRM, and the OOSH Director by August 31 of each calendar year.

c. Develop and submit a quarterly report of the operating unit's open workers' compensation cases in accordance with the guidelines included in the Workers' Compensation RTW program (HR Bulletin 182 (FY14)). The reports are to be submitted to the OOSH Director within 1 week after the end of the quarter.

d. Develop and implement a protocol to document all RTW program-related actions taken. A review of these actions and their associated documentation should be included in the bureau/operating unit's quarterly, open workers' compensation case reports.

.06 Bureau or operating unit WC Specialists or ICSs. WC Specialists will:

a. Will check and follow bureau specific processing and/or training procedures as appropriate in order to assist bureau or operating unit management and employees who suffered a work-related traumatic injury or occupational disease in filing workers' compensation claim forms through use of ECOMP (e.g., CA-1/CA-2 forms), as well as obtaining and submitting related medical and work status documents in a timely and efficient manner.

b. Coordinate with the injured or ill employee's supervisor to direct them in completing the appropriate ECOMP training courses.

c. Act as designated agency reviewers (ARs) and review claimants' workers' compensation forms (e.g., CA-1/CA-2/CA-7 filed in ECOMP) for completeness and accuracy and identify and request claimants or affected supervisors to provide any additional or missing claims-related information.

d. Use ECOMP to complete the necessary steps to forward the appropriately completed workers' compensation claims forms to the workers' compensation contractor for further review, case management, and submission to DOL/OWCP.

e. Assist bureaus or operating units and their injured employees in pursuing their options under the Department's leave buy-back program.

f. Provide case management assistance. Examples of case management activities include, but are not limited to: facilitating claimants' and their supervisors' contact with the workers' compensation contractor; reviewing and verifying claims; identifying and requesting claimants or affected supervisors to provide any additional or missing claims-related information; controverting COP requests, when appropriate; tracking COP requests to ensure the request is for covered time and does not extend beyond the mandated 45 days; processing leave buy-back requests; conducting periodic roll claims reviews through monitoring medical evidence and work status, etc.

g. Provide return-to-work assistance through implementation of the RTW program by developing the annual return-to-work plan and quarterly status reports.

h. Provide compensation cost monitoring by reviewing, analyzing, and tracking DOL/OWCP quarterly chargeback reports for compensation benefits paid for work-related injuries and deaths and when appropriate, compensation savings.

i. Assist bureau or operating unit management in preparing the annual RTW program plan and the quarterly open workers' compensation case reports, including a list of the actions taken to return disabled employees to work.

j. Assist in detecting, investigating, and reporting fraud, waste, and abuse in the Workers' Compensation program. Report any detected fraud, waste, and abuse in Workers' Compensation program activities to the OOSH Workers' Compensation program and to the OIG.

k. Complete "An Introduction to Workers' Compensation for Supervisors" training module available through the CLC. The training module must be completed under any one of the following circumstances: initially within 6 months of DAO 202-810 issue date; within 6 months of employment; when one of his/her bureau's employees suffers a work-related traumatic injury or occupational disease, and prior to helping the employee to use ECOMP for filing an OSHA Form 301, CA-1, CA-2 workers' compensation claim; and as refresher training once every 5 years.

l. Complete the DOL/OWCP/DFEC online or in-person training modules for the Injury Compensation
Specialist and the DOL/OWCP ECOMP online or in-person training modules.

.07 Supervisors and Managers. Supervisors and managers will:

a. Will check and follow bureau specific processing and training procedures as appropriate to assist an employee who has reported a work"‘related injury or illness to complete the following tasks: obtain appropriate medical attention, obtain authorization (Form CA-16, Authorization for Examination and/or Treatment) for medical treatment by an emergency room and/or physician of the injured employee's choice, by contacting the workers' compensation contractor before he/she goes to the doctor or as soon as practicable; report injuries to bureau WC Specialists, where these are in place; assist the employee to use ECOMP to complete the OSHA

Form 301 Injury and Illness Incident Report; and if the injured/ill employee chooses to file a workers' compensation claim, assist the employee to use ECOMP to complete the Workers' Compensation Form CA-1, Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation. In the event the employee reports that he/she suffered an occupational illness and that he/she chooses to file a workers' compensation claim, assist the employee to use ECOMP to complete the OSHA Form 301 Injury and

b. Conduct a thorough investigation of the incident and identify corrective actions to prevent a recurrence.

c. In the event of a severe accident/incident, use the optional CD-137, Report of Incident, Injury, Illness, Motor Vehicle Accident, Property Damage, or Fatality (or equivalent) to conduct and document an accident/ incident investigation. When appropriate, seek assistance from the Bureau Safety Manager/Coordinator/CDSO and/or OOSH safety and health specialist. Complete the accident/incident investigation in a timely manner.

d. Ensure injured employees are advised that workers' compensation guidance is available from the bureau WC Specialists, the workers' compensation contractor, and/or OOSH.

e. Coordinate with the workers' compensation contractor, the bureau WC Specialist, and the injured employee's timekeeper to modify the time and attendance reports for COP or compensation, as appropriate.

f. Send a copy of the injured or ill employee's current payroll history (job title, pay schedule, pay rate, etc.) and Pay Period Time & Attendance Report to get employee's work schedule information at the time of the g. Provide all relevant information to the workers' compensation contractor and bureau WC Specialist in relation to questionable claims, and, where appropriate, controvert COP in accordance with regulatory guidelines.

h. Provide any additional factual evidence to the workers' compensation contractor and the bureau
WC Specialist as required by DOL/OWCP in its adjudication of claims.

i. Provide the treating physician with information on available light or limited duty jobs (e.g., CA-17).

j. Provide light and/or limited duty work if the employee cannot return to the original position; and

maintain regular contact with and advise the employee in writing of the availability of light and/or limited duty (job offer).

k. Serve on a Workers' Compensation program-related return-to-work team when requested to do so by the
OOSH and Workers' Compensation Program Director.

l. Provide regular training and notices to employees regarding the: workers' compensation claims process; requirement to submit appropriate documentation of current medical condition and any restrictions within 10 working days of filing a claim for a work-related injury/illness, and that failure to do so may result in a challenge by the employing agency or denial of benefits by DOL/OWCP; and privacy protections that apply to information provided by employees, and the process by which these records are safeguarded.

m. Report to the OOSH Workers' Compensation program and to the OIG any fraud, waste, and abuse in the workers' compensation activities of his/her operating unit.

n. Complete "An Introduction to Workers' Compensation for Supervisors" training module available through the CLC. The training module must be completed under any one of the following circumstances: initially within 6 months of DAO 202-810 issue date; within 6 months of employment; when one of his/her employees suffer a work-related traumatic injury or occupational disease and prior to helping the employee to use ECOMP for filing an OSHA Form 301, CA-1, CA-2 workers' compensation claim; and as refresher training once every 5 years.

o. Prior to assisting an employee who has reported a work"‘related traumatic injury or occupational disease/illness, it is advisable to select and complete one or more of the DOL/OWCP ECOMP online training modules, including: Filing Forms as an Injured Worker; Reviewing Forms as a Supervisor; ECOMP - Frequently Asked Questions & Contact; ECOMP Uploading Documents to FECA Case Files; and OOSH webpage: Instructions for Initiating CA-1 or CA-2 Forms from an OSHA-301 Form. Note: To access referenced training modules, click the links provided.

.08 Human Resources Offices. The human resources office may be requested to provide:

a. Personnel information required to establish eligibility for workers' compensation benefits;

b. Copies of health benefit enrollment forms to establish entitlement to Federal employees' health benefits;

c. Retirement election forms;

d. Position descriptions or copies of personnel actions;

e. Information concerning the availability of light- and/or limited-duty jobs; and

f. Assistance in reemploying an injured employee.

g. Serve on a Workers' Compensation program-related return-to-work team when requested to do so by the OOSH and Workers' Compensation Program Director.

h. Report to the OOSH Workers' Compensation program and to the OIG any fraud, waste, and abuse in the
operating units' Workers' Compensation programs.

.09 Employees. Employees are responsible for:

a. Preventing accidents/incidents. All employees have a personal responsibility to observe safe practices, procedures, rules, and instructions relating to the efficient handling of their work tasks, work areas, maintenance areas, and other establishment areas where work operations are performed.

b. Reporting all work area hazardous conditions, near miss incidents or any circumstances that they consider unsafe to their supervisor, Bureau Safety Manager/Coordinator/CDSO, or to OOSH.

c. Notifying the supervisor promptly of any work-related injury or occupational disease/illness that has caused, aggravated, or adversely affected a medical condition; and participating collaboratively in the associated incident investigation.

d. Once the injured/ill employee files a workers' compensation claim through ECOMP, he/she is responsible for obtaining and submitting (or arranging for submittal of) appropriate medical documentation within 10 calendar days of filing the workers' compensation claim. The appropriate medical documentation should be obtained from the health care provider (e.g., the attending physician), and it should specify the employee's current medical condition and any job-related restrictions or limitations. Further, for wage loss benefits, the claimant must also submit medical evidence showing that the condition claimed is disabling and resulted in medical treatment on the dates claimed.

Note: Examples of such medical limitations include: "may lift no more than fifteen pounds (15 lbs.)"; and "may stand no more than two (2) hours in a workday." General statements such as "off work" or "light duty" without additional specific information are not acceptable to DOL/OWCP as medical evidence/documentation for workers' compensation claims.

e. Following the instructions provided in Section 8, Procedures (of this DAO), paragraph 01, Federal Employee New and Current Claims Activities for using ECOMP, to initiate and file an OSHA Form 301 injury or illness report and then filing a workers' compensation claim by completing a Form CA-1 or Form CA-2.

Note: Claims not submitted by an employee using ECOMP (alternatively a claim may be filed using any paper containing words which reasonably may be construed or accepted as a claim) will be processed by the supervisor or an Agency employee acting on the employee's behalf following the instructions provided in Section 8, Procedures (of this DAO), paragraph 01, Federal Employee New and Current Claims Activities for using ECOMP, to initiate and file an OSHA Form 301 injury or illness report and then filing a workers' compensation claim by completing a Form CA-1 or Form CA-2.

f. Advising the supervisor promptly when the treating physician makes any medical changes in his/her work status (e.g., specifying or extending injury/illness-related medical leave, adding or removing work restrictions) or has released him/her to light, limited, or full duty.

g. Maintaining regular communication with his/her supervisor on case-related matters, including reporting changes in status such as changes in marital status and number of dependents. Also, report such status changes to the bureau's WC Specialist and the workers' compensation contractor.

h. During the time on the periodic roll, accepting any offer of work from the employing agency that is consistent with medically documented restrictions.

i. If placed on the periodic roll for payment of a scheduled award, complete and submit to OWCP on an annual basis Form CA-1032, Request for Information on Earnings. The OWCP claims' examiner will send the CA-1032 to the claimant. The OWCP claims' examiner will review the claimant's responses and decide whether he/she is entitled to continue receiving compensation benefits, or whether his/her benefits should be adjusted.

j. Returning to work promptly when the treating physician has medically released him/her to light, limited, part-time, or full duty.

k. Pursuing third-party litigation as required by DOL/OWCP when a third party caused or contributed to the injury or illness. (U.S. Census Bureau employees may be exempt from this requirement in cases where the third party's identity is protected under Title 13 confidentiality restrictions.)

l. Reporting any fraud, waste, and abuse in the Workers' Compensation program to the OOSH Workers' Compensation program and to the OIG. This includes receiving overpayments of benefits, not reporting outside earnings when receiving compensation, failing to respond to DOL/OWCP requests for wage earnings, or receiving benefits when capable of returning to work.

m. To gain greater clarity regarding use of ECOMP for filing injury and illness reports and workers' compensation claims, it is advisable to complete "An Introduction to Workers' Compensation for Supervisors" training module available through the CLC, when suffering a work-related traumatic injury or occupational disease and prior to using ECOMP to file an OSHA Form 301 and CA-1/CA-2 claim.

n. Prior to using ECOMP to file an OSHA Form 301 and CA-1/CA-2 workers' compensation claim, it is advisable to select and complete the appropriate DOL/OWCP ECOMP and OOSH webpages online training modules, including: Filing Forms as an Injured Worker; ECOMP - FAQs and Contact; viewing case status, billing updates, coverage limitations, and other information via the Claimant Query System (CQS), visit OWCP Connect; ECOMP Instructions for Initiating CA-1 or CA-2 Forms from an OSHA-301 Form; and Uploading Documents to FECA Case Files.

.10 Other Claimants. Claimants for survivor benefits or for burial benefits are responsible for:

a. Contacting the Department's workers' compensation contractor or the bureau's WC Specialist for information and advice regarding the type of survivor or burial benefits available to claimants, the claim forms to be used, and any additional claim-related requirements.

b. Submitting the appropriate claim form to the employee's supervisor within required time limits.

c. Establishing that the death was causally related to factors of employment through the submission of factual and medical evidence that supports the claim filed. Further, unless the relationship between the death and the employment is obvious, the claimant must present medical evidence relating the death to the injury.

d. Submitting the official death certificate.

e. Submitting additional documentation necessary to establish claimant's survivor status.

.11 Health Units. Health units are responsible for:

a. Providing first aid for all injured employees upon request.

b. Referring injured employee for further medical treatment beyond the scope of the medical facility/health unit, at the request of the employee.

c. Issuing to an employee, or person designated to act on behalf of the employee, the appropriate instructions for notifying his/her supervisor of the incident; for obtaining and providing to the treating health care provider (e.g., physician, nurse practitioner, physician's assistant) Form CA-16, Authorization for Examination and/or Treatment; completing the DOL/OWCP ECOMP incident report (e.g., OSHA Form 301) and workers' compensation claim forms (e.g., CA-1/CA-2).

SECTION 8. PROCEDURES.

.01 Federal Employee New and Current Claims Activities.

a. When a Department employee sustains a traumatic injury or occupational disease/illness as a result of a work-related accident/incident or exposure, the employee must obtain appropriate first aid and/or medical treatment by visiting the health unit or other designated emergency medical treatment facility.

b. The injured employee (or someone acting on the employee's behalf) must check and follow bureau specific processing procedures, as appropriate.

c. The injured employee (or someone acting on the employee's behalf) must notify his/her supervisor as soon as practicable regarding the traumatic injury incident and should make reasonable efforts to do so before the end of the shift during which the incident occurred or within 24 hours.

d. The injured or ill employee (or someone acting on the employee's behalf) must follow the injury/illness reporting procedures for the Department (as stated by DAO 209-3) and his or her bureau or operating unit.

e. The injured or ill employee (or someone acting on the employee's behalf) must file an injury/illness report using ECOMP and submitting OSHA Form 301. As a required first step, Department bureaus/operating units use ECOMP to electronically process and submit their OSHA Form 301, Injury and Illness Incident Reports, before choosing to file a workers' compensation claim (Forms CA-1, CA-2, CA-7, and CA-7a). If the injured/ill employee chooses to file a workers' compensation claim, he/she must do so in a timely manner (as soon as possible, no later than 30 calendar days from the date of injury).

Note: Filing an OSHA Form 301 does not generate a workers' compensation claim. Instead, after completing the OSHA Form 301, the injured/ill employee must elect to file a workers' compensation claim. If the injured/ill employee files an OSHA Form 301 first (as required by ECOMP), and then chooses to file a claim by completing a Form CA-1 or Form CA-2 (generally completing items 1"“15 of CA-1 or CA-2), then the data entered into the OSHA Form 301 will automatically populate the claim Form CA-1 or Form CA-2.

f. When filing a workers' compensation claim, the claimant must establish the burden of proof for his/her claim including evidence establishing the five basic requirements of a claim. The five basic requirements of a claim consist of time, civil employee, fact of injury, performance of duty, and causal relationship.

Note: See chapter 3, Conditions of coverage ("Injury Compensation for Federal Employees, Publication CA-810," revised 2009) for a discussion of the requirements for filing a claim for compensation.

g. Before the injured or ill employee(or claimant) canfile forms in ECOMP, the claimant must first register for an ECOMP account by using the "Sign In/Register" function on the ECOMP home page.

Note: See theFiling Forms as an Injured Worker, training module developed and posted by theDivision of Federal Employees' Compensation(DFEC); and ECOMP Instructions for Initiating CA-1 or CA-2 Forms from an OSHA Form 301, instructions developed and posted by OOSH.

h. To establish an ECOMP account, the claimant will need to provide his/her: email address; government organization; supervisor's email address; for new injury/illness claims, details for the event (place, time, extent of injury, etc.); if available, supporting documentation, such as medical reports (have these ready in electronic format); and if filing a CA-7 form, the case number.

i. To obtain his/her agency information, the claimant should consult his/her supervisor, or Bureau Safety Manager, coordinator, representative or specialist, CDSO, or WC Specialist.

j. Once the claimant establishes his/her ECOMP account, he/she will be able to sign-in to the account and manage the entire process from the Employee Dashboard. To get to the Employee Dashboard, the claimant should click "Sign In/Register" on the ECOMP home page. To get to forms to be filed, the claimant should click on "File a Form" on the home page and enter his/her agency information.

k. Once the claimant submits his/her claim to the OWCP, through ECOMP, he/she will:

l. Once the claimant submits his/her claim to the OWCP, through ECOMP, he/she has the legal burden to prove that the claim-related medical condition is work-related. Note: The workers' compensation contractor can advise the claimant on the type of evidence needed to support a successful claim.

m. Once the claimant submits his/her claim to the OWCP, through ECOMP, he/she is responsible for:

n. Providing any additional or missing claims-related information in a timely manner, upon request from the supervisor, WC Specialist, OOSH, the workers' compensation contractor, or DOL/OWCP. o. Providing the treating physician with information on available light or limited duty jobs (e.g., a supervisor completed CA-17 form, stating the physical requirements of the job on one side of the form, and the treating physician addressing the current physical capacity of the employee on the other side of the form).

p. Initiating a prescription request, if a work-related traumatic injury or illness results in a doctor's prescription, and the claimant elects to use the Department's Workers' Compensation Pharmacy Benefits program. Following completion of a CA-1 or CA-2 claim, the claimant should obtain a temporary First Fill card from the Department's workers' compensation contractor. The workers' compensation contractor can assist claimants in completing the First Fill cards.

1. CA-1 claim forms are used when a work-related traumatic injury occurs (i.e., single incident injury, or repetitive injury, which occurs during one work shift).

2. CA-2 claim forms are used when a work-related occupational disease or illness occurs (i.e., exposure to work factors for more than one work shift that causes an injury/illness). Note: Prior to filing reports/claims in ECOMP, review and follow the guidance provided by: ECOMP Instructions for Initiating CA-1 or CA-2 Forms from an OSHA-301 Form.

1. Be assigned a case number and receive an informational letter from the OWCP with that case number.

2. Be able to use the information in the letter to view his/her case status, billing updates, coverage limitations, and other information via the Agency Query System (AQS), a secure internet site that provides access to information on OFEC injury claims; and the OWCP Connect page, which allows users to prove their identity and create an account for communication with OWCP's various self-service applications.

3. Be able to submit information pertaining to his/her case file through ECOMP's Uploading Documents to FECA Case Files (available from the ECOMP home page), and also use the upload feature for any existing case, not just those initiated through ECOMP. Note: In order to use the Document Upload feature, the claimant will need his/her last name, case number, date of birth, and date of injury.

4. Be able to file a Form CA-7 (Claim for Compensation). A CA-7 can be filed for any existing claim, not just those initiated through ECOMP, as long as the claimant has a case number and other identifying information.

5. Be able to file a CA-7a (Time Analysis Form) for intermittent periods of wage loss and/or CA-7b (Leave Buy-Back Worksheet Certification).

1. Keeping his/her supervisor and the Department's workers' compensation contractor informed of the status of his/her condition. 2. Providing his/her supervisor and the Department's workers' compensation contractor with the relevant medical reports to support his/her disability claim.

3. Requesting leave (COP, annual, sick leave, and/or LWOP) from his/her supervisor.

4. Returning to work when the physician releases him/her to return to light, limited, or full duty. The DOL/OWCP will not authorize compensation for employees who refuse suitable work.

.02 Supervisors' New Workers' and Current Compensation Claims Activities

a. When a supervisor has an employee, who has been injured or sustained a work-related occupational disease/illness who wishes to file a workers' compensation claim, the supervisor is responsible for: b. When contacted, the workers' compensation contractor will provide specific instructions for claim-related procedures to follow and if appropriate, will issue a CA-16, Authorization for Examination and/or Treatment. Note: Generally, this form should not be issued more than 7 days after a traumatic injury. This form should not be issued for occupational illness claims.

c. Using ECOMP to submit the completed report forms (e.g., CA-1, CA-2, CA-7, or CA-7a) to the workers' compensation contractor for further processing, review, and submittal to DOL/OWCP.

1. Assisting the employee in receiving first aid and/or advising the employee to seek other appropriate medical attention.

2. Assisting injured/ill employee to complete ECOMP OSHA Form 301 Injury and Illness Incident Report as thoroughly as possible. The employee must complete Form 301 report (or equivalent) within 24 hours of incident.

3. Reviewing and approving the employee's OSHA Form 301 for completeness and accuracy. ECOMP notifies the supervisor via email regarding the required OSHA Form 301 review.

4. Assisting injured/ill employee to establish an ECOMP account if the employee chooses to file a workers' compensation claim and use ECOMP to complete questions 1"“16 of the DOL/OWCP CA-1 form, the Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation, or questions 1"“18 of the DOL/OWCP CA-2 form, Notice of Occupational Disease and Claim for Compensation. Claim forms should be filed within 10 working days of receiving the employee's injury or illness notification, and in accordance with DOL/OWCP operating guidance.

5. Reviewing for completeness and accuracy the ECOMP CA-1, CA-2, CA-7, or CA-7a form completed by the employee who sustained a work-related traumatic injury or occupational illness.

6. Completing questions 17"“38 of the DOL/OWCP CA-1 or questions 19"“35 of the CA-2.

7. Contacting the workers' compensation contractor when one of his/her employees suffers a traumatic injury (single episode injury or repetitive injury that occurs during one work shift).

.03 Workers' Compensation Specialists' New and Current Claims Activities.

a. Within 5 working days of receiving a completed ECOMP workers' compensation claim form, the WC Specialist will: .04 Workers' Compensation Contractor New and Current Workers' Compensation Claims Activities. .05 OOSH New and Current OOSH Workers' Compensation Claims Activities. .06 The Department's Return-to-Work (RTW) program. SECTION 9. FORMS.

.01 The following forms, available from OOSH or ECOMP (DOL/OWCP) are likely to be required to establish a workers' compensation claim:

SECTION 10. EFFECTS ON OTHER ORDERS.

This Order supersedes Department Administrative Order 202"‘810, dated April 21, 2017, and the provisions of all bureau or operating unit directives that prescribe authorities, responsibilities, or policies related to workers' compensation.

Signed by: Director for Human Resources Management

Approved by: Acting Chief Financial Officer and Assistant Secretary for Administration

Office of Primary Interest: Office of Human Resources Management

1. Review claims for completeness and accuracy of required information and forward them to the workers' compensation contractor for further processing and review.

2. Review the claim to determine suitability for possible controversion or challenge.

b. Assist injured or ill employees in pursuing their options under the Department's leave buy-back program. Note: An employee cannot pursue leave buy-back until after his/her claim is approved and leave taken would be after the 45 days of COP.

c. Provide an employee who has initiated a CA-1 or CA-2 claim, and needs a prescription filled, with instructions and assistance on obtaining and filling out a temporary First Fill card from the Department's workers' compensation contractor.

d. Provide return-to-work assistance through implementation of the RTW program by developing and submitting to OHRM and OOSH the annual return-to-work plan and quarterly status reports.

e. Provide compensation cost monitoring by reviewing, analyzing, and tracking DOL/OWCP quarterly chargeback reports for compensation benefits paid for work-related injuries and deaths, and when appropriate, compensation savings.

f. Assist in detecting, investigating, and reporting fraud, waste, and abuse in the Workers' Compensation program.

g. Reporting any fraud, waste, and abuse in the workers' compensation activities of his/her bureau or operating unit to the OOSH Workers' Compensation program and to the OIG.

a. The workers' compensation contractor within 2 working days of receiving a completed ECOMP workers' compensation claim form, will:

1. Review claims for completeness of required information; identify and request claimant or affected supervisor provide any additional or missing claims-related information; reject claims for incomplete information; and forward adequately completed claims forms to DOL/OWCP for adjudication.

2. Coordinate with the affected bureau, operating unit, or Department WC Specialist to review the claim for accuracy and suitability for possible controversion or challenge.

3. Provide an employee who has initiated a CA-1 or CA-2 claim, and needs a prescription filled, with a temporary First Fill card (upon request) along with instructions for filling out the card. Assist the employee in completing the First Fill card.

4. Develop and submit controversions of COP when a claimant is not entitled to such, or prepare memoranda approving COP and duration of pay when claimant is entitled.

5. Notify claimants of receipt of claims and provide them information regarding their claims.

6. Work with the Department, supervisors, claimants, DOL/OWCP, and medical providers to ensure that claims are effectively managed and that claimants are receiving all benefits to which they are entitled.

a. When receiving a completed workers' compensation claim form through ECOMP, OOSH will:

1. Review all new incident reports (OSHA 301) and claims (CA-1s and CA-2s) received following the workers' compensation contractor's processing.

2. Identify any third-party involvement in the claim cases.

3. Send a letter to DOL/OWCP for all cases identified as third-party involvement, and request assistance in seeking reimbursement.

a. The Department will make all feasible efforts to return an injured employee to work as soon as he/she is medically cleared to do so.

b. In absence of medical documentation that indicates an injured worker is unable to return to the workplace in a full-time, light duty, or limited duty assignment, the OOSH Director will implement the return-to-work procedures outlined in HR Bulletin 182 (FY14; incorporated by reference), dated April 7, 2014, describing the Department's Workers' Compensation RTW program.

a. DOL/OSHA Form 301, Injury and Illness Incident Report.

b. DOL Form CA-1, Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation.

c. DOL Form CA-2, Notice of Occupational Disease and Claim for Compensation.

d. DOL Form CA-5, Claim for Compensation by Widow, Widower and/or Children.

e. DOL Form CA-5b, Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren.

f. DOL Form CA-6, Official Supervisor's Report of Employee's Death.

g. DOL Form CA-7, Claim for Compensation.

h. DOL Form CA-7a, Time Analysis Form.

i. DOL Form CA-16, Authorization for Examination and/or Treatment.

j. DOL Form CA-17, Duty Status Report.

k. DOL Form CA-20, Attending Physician's Report.

l. DOL Form CA-1032, Request for Information on Earnings.