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Filing a Federal Workers’ Compensation Claim: What You Need to Know

At Injured Worker Centers, we are dedicated to guiding injured federal workers through every step of the workers’ compensation claim process. Our mission is to ensure that you receive the benefits and support you are entitled to under the Federal Employees’ Compensation Act (FECA). Here’s a comprehensive overview of how the process works, what you’re entitled to, and important information to help you along the way.

Understanding Federal Workers’ Compensation

Federal workers’ compensation provides medical care, wage replacement, and rehabilitation services to federal employees who are injured or become ill due to work-related causes. It also provides survivor benefits to family members if a work-related injury or illness results in death.
The program is administered by the Office of Workers’ Compensation Programs (OWCP) under the U.S. Department of Labor and governed by the Federal Employees’ Compensation Act (FECA). It covers all civilian federal employees, including postal workers, federal law enforcement officers, and agency staff. FECA ensures coverage without requiring employees to prove fault, simplifying the claims process and minimizing litigation.

Step-by-Step Guide to Filing a Claim

1. Report the Injury or Illness Immediately
Notify Your Supervisor: As soon as you’re injured or recognize a work-related illness, inform your supervisor. Prompt reporting is crucial.
Form CA-1 (Traumatic Injury): For injuries that occur during a single work shift.
Form CA-2 (Occupational Disease): For conditions developed over time due to workplace exposure.

2. Seek Medical Treatment
Emergency Care: Go to the nearest medical facility.
Non-Emergency Care: Choose an in-network doctor familiar with federal workers’ compensation claims. We can refer you to experienced providers.
Ensure that your doctor provides a detailed medical report linking your condition to your federal job duties.

3. Complete the Necessary Forms
Complete your portion of Form CA-1 or CA-2 and submit it to your employing agency.
Your agency will complete their section and forward it to the Office of Workers’ Compensation Programs (OWCP).

4. OWCP Review Process
OWCP reviews all documentation, including medical records.
They may request additional information or an independent medical examination.
Form CA-20 (Attending Physician’s Report): Your treating physician should complete this form to provide a detailed medical opinion on the relationship between your injury and your job duties. The CA-20 is essential for OWCP to determine medical coverage and compensation eligibility.
You will receive a written decision regarding your claim.

5. Initiate Treatment and Obtain Coverage
Authorization for Treatment: Once OWCP accepts your claim or upon preliminary approval, you will receive authorization for medical treatment related to your injury.
Form CA-16 (Authorization for Examination and/or Treatment): Typically provided by your agency for traumatic injuries within seven days of injury notification. It guarantees payment for authorized medical care.
Continue following up with your physician and ensure that all treatments and prescriptions are documented and linked to your work-related injury.

Our Process at Injured Worker Centers

We follow a structured approach to ensure that every injured federal worker receives the right care and services:

Referral for Physical Health Needs:
If you are solely in need of physical medical assistance, we will promptly refer you to one of our trusted partner clinics. These clinics specialize in treating work-related physical injuries and are experienced in federal workers’ compensation cases.

Comprehensive Psychological Care:
If psychological care is required, Injured Worker Centers will manage your casework directly. Our process includes:
Coverage Check: We will verify whether psychological services are covered under your accepted conditions.
Preauthorization Requests: If psychological care is not initially covered, we will request preauthorization from OWCP.
Claim Expansion: In cases where preauthorization is denied, we will assist in expanding your claim to include psychological conditions.
Evaluation and Treatment Plan: Once coverage is secured, you will undergo a comprehensive psychological evaluation to assess your needs.
Therapy Scheduling: We will schedule as much therapy as possible based on your approved coverage to support your recovery journey.

What You Are Entitled To

1. Wage Replacement Benefits

Continuation of Pay (COP): Up to 45 days of full pay if your traumatic injury claim is accepted.
Compensation for Lost Wages: After COP expires, you may receive compensation at 66 2/3% of your salary (or 75% if you have dependents).

2. Medical Benefits

Coverage of all necessary medical treatment related to your injury or illness, including:

Doctor visits
Hospital care
Prescription medications
Physical therapy

3. Vocational Rehabilitation

Services to help you return to work if your injury prevents you from resuming your previous job.

4. Schedule Awards

Compensation for permanent impairment to certain body parts, even if you return to work.

5. Death Benefits

Financial support for eligible dependents in the event of a work-related death.

Key Things to Know

Timely Filing Is Essential

For traumatic injuries, file Form CA-1 within 30 days for COP eligibility.

For occupational diseases, file Form CA-2 as soon as you realize the condition is work-related.

Choosing Your Physician

You have the right to select your initial treating physician. We can connect you with in-network doctors experienced in federal claims.

Medical Documentation

Detailed medical reports linking your condition to your job are critical for claim approval. The CA-20 form plays a key role in providing OWCP with essential medical information.

Appeals Process

If your claim is denied, you can:

Request a reconsideration.

Appeal to the Employees’ Compensation Appeals Board (ECAB).

Request a hearing before an OWCP hearing representative.

How Injured Worker Centers Can Help

We provide comprehensive support to make the federal workers’ compensation claim process easier:

• Expert Case Management: We track your case and ensure all forms and deadlines are met.
• In-Network Provider Referrals: Access doctors who understand federal workers’ compensation requirements.
• Mental Health Support: We offer mental health services to help you cope with the impact of your injury.
• Claims Guidance: From initial filing to appeals, we assist you at every stage.

Contact Us

Injured Worker Centers is here to ensure that you receive the benefits you deserve. Contact us today to schedule a consultation or to learn more about how we can support you.