Transcript Slide 1

FEDERAL INJURY COMPENSATION
OVERVIEW
How Does the Process Work?
How Does It All Fit Together?
FECA
DOL
20 CFR
OWCP
APWU
ELM 540
INJURED
EMPLOYEE
USPS
EL 505
1
Created by APWU Human Relations Department Director, Sue Carney
TABLE OF CONTENTS
Message from APWU President Burrus and
Human Relations Director Susan M. Carney
TOPIC
2
SLIDE No.
OWCP Statistics
9
What It’s All About
10
Who’s Involved In The Claim Process
11
Responsibilities
Immediate Supervisor
USPS Injury Compensation Specialist
Assistance By APWU
12
13
14
Five Basic Requirements For Successful Claim
Time Limits
Civilian Employee
Fact of Injury
Performance of Duty
Causal Relationship
Cite Reference Chart: Five Basic Requirements
15
16
16
17
19
20
21
Created by APWU Human Relations Department Director, Sue Carney
TABLE OF CONTENTS
(continued)
TOPIC
3
SLIDE No.
Types of Claims
Traumatic Injury Definition (Form CA-1)
Occupational Disease Definition (Form CA-2)
Recurrence Definition (Form CA-2A)
Cite Reference Chart: Three Types of Claims
22
24
26
29
Traumatic Injury
Form CA-16 Authorization for Examination/Treatment
Cite Reference Chart: Traumatic Injury (Form CA-16)
Continuation Of Pay (COP)
Cite Reference Chart: Traumatic Injury: COP
Controversion with COP Withheld
Cite Reference Chart: Traumatic Injury: COP Withheld
Stopping COP Which Has Already Begun
Cite Reference Chart: Traumatic Injury: COP Stopped
30
32
33
36
38
40
41
43
Claim for Compensation (Forms CA-7, CA-20)
Cite Reference Chart: Claim for Compensation
44
48
Leave Buy Back (Form CA-7b)
Cite Reference Chart: Leave Buy Back (CA-7b)
50
53
Created by APWU Human Relations Department Director, Sue Carney
TABLE OF CONTENTS
(continued)
TOPIC
4
SLIDE No.
Return To Work Capability
Medical Restrictions
Cite Reference Chart: Return to Work Capability (Medical Restrictions)
Job Offers (Limited Duty/Rehab)
Cite Reference Chart: Job Offers
Rights and Benefits
55
57
58
62
63
Selection of Physician
Postal Physician or Contract Equivalent
USPS May Require Medical Examination
Physician Changes & Referrals
Cite Reference Chart: Selection of Physician
66
68
70
72
73
Providing Supporting Evidence
Employee’s Statement
Medical Reports
Sample Medical Report Traumatic Injury
Sample Medical Report Occupational Disease
OWCP Criteria For Evaluating Medical Reports
74
75
79
83
84
85
OWCP Directed Medical Exams
Second Opinions
Referee Specialist
86
88
Created by APWU Human Relations Department Director, Sue Carney
TABLE OF CONTENTS
(continued)
TOPIC
5
SLIDE No.
Postal Service: Fitness for Duty
90
Medical Privacy
92
Schedule Award
Cite Reference: Schedule Award
95
99
Challenging Formal OWCP Decisions
Oral Hearing
Review of the Written Record
Reconsideration
Review by ECAB
100
101
103
105
107
Definitions
Work Limitation Due To Pain
Separation Disability
Disability Retirement
Medical Bill Payment and Medical Authorization Process
108
112
113
114
116
Created by APWU Human Relations Department Director, Sue Carney
TABLE OF CONTENTS
(continued)
TOPIC
SLIDE No.
OWCP Information
Federal Employees Compensation Act (FECA), Title 5, Chapter 81
Code of Federal Regulations, Claims for Compensation under FECA, Parts 10 and 25
Questions and Answers About FECA, CA 550
Injury Compensation for Federal Employees, CA 810
When Injured at Work, Guide for Federal Employees, CA 11
118
OWCP Forms
119
OWCP- Information (Handbooks and Manuals)
U.S. Dep’t of Labor, Self-Instructional Injury Compensation Specialist Training Video
ELM 540, Injury Compensation Program
EL 505, Injury Compensation
120
Letters, MOUS, and Step 4 Decisions
121
Letters:
Letter from USPS Labor Relations At Headquarters—Services Policy for Employees
that Sustained On-the-job injuries.
USPS Sample Letter—Limited Duty Assignments and MOU from Headquarters.
Letter from USPS Labor Relations—Local Management . . .Limited Duty
Letter from USPS Labor Relations—Use of Medical Reports
Letter from USPS. Management’s Discrimination of . . . limited duty vs.
light duty assignments .
Letter from USPS Labor Relations Discipline for Safety Rule Violation
6
A1
A2
A6
A9
A14
A27
Created by APWU Human Relations Department Director, Sue Carney
TABLE OF CONTENTS
(continued)
TOPIC
7
SLIDE No.
National Pre-Arb Settlement:
Limited Duty Assignments
Limited Duty FTRE . . . with varying report times.
Job Related First Aid Injuries
A3
A5
A8
Step 4 Decisions:
Separation from Postal Service for reasons of disability
Reporting an accident
Fitness for duty . . . on-the-job injury or illness
Availability of CA-8 Forms
Limited Duty—Violation of ELM Provisions
Locally developed form supplementing data on Form 3996
Use of Locally generated forms
Outside party paying medical expenses . . . compensation forms
Employee can’t be compelled . . . during non-working hours
Light duty/limited duty signing Overtime Desired List
Completing form 2488 is voluntary (employee)
CA17 usually adequate for medical information
Completing PS Form 3971, Continuation of Pay (COP)
Limited Duty Employee Coverage by CBR
A4
A7
A10
A11
A12
A15
A16
A17
A18
A19
A20
A21
A22
A23
Created by APWU Human Relations Department Director, Sue Carney
TABLE OF CONTENTS
(continued)
TOPIC
8
SLIDE No.
Step 4 Decisions (continued):
Agreement Violation of Permanently Reassigned Work in another craft
Removal from bid while on Limited Duty
Limited Duty Withdrawal with subsequent Notice of Proposed Removal.
A24
A25
A26
MOUs:
(NALC) Limited Duty Grievance Representation
A13
Created by APWU Human Relations Department Director, Sue Carney
OFFICE OF WORKERS’
COMPENSATION (OWCP)
STATISTICS

Approximately 175,000 Workers’ Compensation Claims
Are Filed Annually.
 Of These, 85,000 Are Filed By USPS Employees,
Representing More than 10% Of The USPS Workforce.
 Generally, 90% Of Simple Traumatic Claims And
60% Of Simple Occupational Claims Are Accepted.
 In 2003, These Claims Cost The USPS Over $1.5 Billion.
 The Future Liability For These Employee Injuries Is
Almost $7 Billion.
9
Created by APWU Human Relations Department Director, Sue Carney
WHAT IT’S ALL ABOUT?
FECA
5 U.S.C
81
•
Federal Employee
Compensation Act (FECA)
•
20 Code of Federal
Regulations (CFR)
•
Employee Labor Relations
Manual (ELM)
•
EL 505, Injury
Compensation
10
§ 8149
20 CFR
ELM
EL 505
CA 550
Q&A
10.0
541.1
Ch. 1
A-1
Ch. 1
Ch.1
Ch. 1
Created by APWU Human Relations Department Director, Sue Carney
WHO’S INVOLVED IN THE CLAIM
PROCESS?
 Under The Department Of Labor, The Employment Standards
Administration Oversees OWCP.
 Within OWCP, The Division Of Federal Employees’ Compensation
(FEC) Decides Injury Claims. They Are The Determining Office.
 In The USPS, The Injury Compensation Specialist (ICS) Is
Responsible For Sending Claims To OWCP. The USPS Injury
Compensation Office And Their Representatives Are Not An
Extension Of OWCP. They Are The Control Point And Have No
Authority To Adjudicate Claims.
 The USPS Supervisor Forwards Claim Forms To The ICS.
11
Created by APWU Human Relations Department Director, Sue Carney
RESPONSIBILITIES OF THE
IMMEDIATE SUPERVISOR

Immediately Ensuring That Appropriate Medical Care Is Provided.

Form CA-1 (Traumatic), Or Form CA-2 (Occupational)

Provide Form To Employee (Complete Receipt And Give To Employee).

On The Same Day As Received, Complete And Forward Form CA-1 Or
Form CA-2 To The ICS [ELM 544.11].

Permit Employee To Select A Physician/Hospital Of Choice [ELM 545.21].

If Traumatic Injury Prevents Employee From Working Must Advise Employee
Of Right To Choose Continuation Of Pay (COP) [ELM 544.112].

Cannot Cause An Employee To Forgo Filing A Claim, Or Refuse To Process It
[ELM 544.11] .
12
Created by APWU Human Relations Department Director, Sue Carney
RESPONSIBILITIES OF THE
USPS INJURY
COMPENSATION SPECIALIST

Completes Employer Portions Of Forms CA-16 And CA-17.

Advises Employee Whether Continuation Of Pay (COP) Will Be Controverted.

Advises Employee If COP Will Not Be Paid.

Provides Copy Of Completed CA-1, CA-2 Or CA-2a To Employee And Copy
Of All Correspondence Between USPS And Employee’s Physician.
[ELM 544.12].

Submits Form CA-1, CA-2, Or CA-2a To OWCP Within 10 Working Days.
[ELM 544.212].

If Traumatic Injury (CA-1) Must Promptly Authorize Medical Care By Issuing
Employee Form CA-16 Within 4 Hours Of Receiving Notice Of Claimed Injury.
[ELM 545.21].
13
Created by APWU Human Relations Department Director, Sue Carney
ASSISTANCE BY APWU
●
Member And Non-Member:
If Language Of Collective Bargaining Agreement (CBA) Or A
Handbook Or Manual (e.g., ELM 540, EL 505) Has Been Violated
By The USPS Make Grievance Decision. Grievances Cannot Be
Filed Against OWCP.
●
Member Only:
Provide Information About OWCP Procedures And Appeals.
You Do Not Have To Be Employee’s “Authorized OWCP
Representative” To Assist Them With Their Claim.
14
Created by APWU Human Relations Department Director, Sue Carney
FIVE BASIC
REQUIREMENTS FOR
SUCCESSFUL CLAIM
In The Order They Are Considered:
● Time Limits
● Civilian Employee
● Fact Of Injury
● Performance Of Duty
● Causal Relationship
(continued)
15
Created by APWU Human Relations Department Director, Sue Carney
FIVE BASIC REQUIREMENTS
(continued)
Time Limits
 Written Notice Must Be Given Within 3 Years Of Injury Or Onset Of
Medical Condition.
 Latent (Not Evident) Disability—Must Be Given Within 3 Years Of
Reasonably Knowing Condition Caused By Work Activity.
Civilian Employee
 All USPS Employees Including Casuals And TEs Are Civilian
Federal Employees.
(continued)
16
Created by APWU Human Relations Department Director, Sue Carney
FIVE BASIC REQUIREMENTS
(continued)
Fact Of Injury
Two Elements Must Be Met:
Occurrence Of Event
 The Employee Must Have Actually Experienced The Accident,
Event Or Employment Factor.
 Determined On The Basis Of Factual Evidence, Including
Statements From The Employee, The Supervisor, And Any
Witnesses.
 An Injury Does Not Have To Be Witnessed To Be Compensable.
(continued)
17
Created by APWU Human Relations Department Director, Sue Carney
FIVE BASIC REQUIREMENTS:
(continued)
Fact Of Injury
Existence Of Medical Condition
 The Accident Or Employment Factor Resulted In An Injury
Or Disease. However, Employment Is Not Required To Be
The Sole Factor To Have Caused An Injury Or Disease,
Only A Contributing Factor.
 Determined On The Basis Of The Attending Physician’s
Statement That A Medical Condition Is Present That
Could Be Related To The Incident Though The Medical
Report Does Not Have To Relate The Condition To The
Incident.
 Simple Exposure Does Not Constitute An Injury.
(continued)
18
Created by APWU Human Relations Department Director, Sue Carney
FIVE BASIC REQUIREMENTS
(continued)
Performance Of Duty
 Usually Injury/Illness Must Occur While At Work.
 Must Be Performing Expected Job Duties.
 Breaks And “Lunches” Covered If On Premises.
 For Most APWU Crafts Driving To And From Work
Ordinarily Not Covered.
(continued)
19
Created by APWU Human Relations Department Director, Sue Carney
FIVE BASIC REQUIREMENTS
(continued)
Causal Relationship
● Physician Must State To A “Reasonable Medical
Certainty” That Work Activity Caused Or Contributed
To The Diagnosed Condition.
● Physician Must Provide Medical Reasoning (Rationale)
To Support Opinion Of Causal Relationship (How
Physician Came To The Conclusion That There Is
A Causal Relationship Between The Injury And The
Workplace).
(continued)
20
Created by APWU Human Relations Department Director, Sue Carney
FIVE BASIC REQUIREMENTS
FECA
5 USC
20 CFR
ELM
EL 505
CA 550
Q&A
§8122
10.100
10.101
542.112
542.122
542.132
Exh. 4-6
C-2
● Civilian Employee
§8101.(1)
10.5(h)
542.21.b.
Exh. 4-6
A-3
C-3
● Fact Of Injury
§8101.(5)
10.115(c)
542.21.c.
Exh. 4-6
C-4
● Time Limits
● Performance Of Duty
● Causal Relationship
21
§8102.(a)
10.115(d)
542.21.d
Exh. 4-6
C-5
to
C-9
§8101.(5)
10.115(e)
542.21.e
Exh. 4-6
C-10
Created by APWU Human Relations Department Director, Sue Carney
THREE TYPES OF CLAIMS:
TRAUMATIC, OCCUPATIONAL,
AND RECURRENCE
Traumatic Injuries (Form CA-1)
 A Medical Condition Caused By A Specific Incident
Or Series Of Incidents In A Single Work Day/Shift.
 Specific As To When And Where It Happened.
 Specific As To Part Of The Body Injured.
 Filed As Traumatic Not By Type Of Medical Condition,
But Because Injury Happened On A Single Work
Day/Shift.
 May Choose COP If Injury Reported On Form CA-1
Within 30 Days Of The Injury.
(continued)
22
Created by APWU Human Relations Department Director, Sue Carney
THREE TYPES OF CLAIMS
USPS
Traumatic Injury
(continued)
 Complete CA-1 To Give Notification.
 USPS Has Ten (10) Working Days To Submit CA-1
To OWCP.
 COP – If Eligibility Requirements Are Met.
 CA-1 States Employer Statement And Physician’s
Medical Report Are Required.
 Follow Instructions On CA-1 To Satisfy Requirements.
(continued)
23
Created by APWU Human Relations Department Director, Sue Carney
THREE TYPES OF CLAIMS
(continued)
Occupational Disease Or Illness
(Form CA-2)
● A Medical Condition Caused By Work Activity
Occurring Over More Than A Single Work
Day/Shift.
● No Entitlement To COP Or Form CA-16.
● Filed As An Occupational Not By Type Of
Medical Condition But Because It Happened
Over More Than One Work Day/Shift.
(continued)
24
Created by APWU Human Relations Department Director, Sue Carney
THREE TYPES OF CLAIMS
(continued)
Occupational Disease/Illness
(Form CA-2)
● Complete CA-2 To Give Notification.
 USPS Has 10 Working Days To Submit CA-2 To OWCP
● No COP Entitlement.
 File CA-7 For Wage Loss Compensation
● CA-16 (Issuance Very Rare. USPS May Issue Only
After Obtaining Approval From OWCP).
(continued)
25
Created by APWU Human Relations Department Director, Sue Carney
THREE TYPES OF CLAIMS
(continued)
Recurrence
(Form CA-2A)
Recurrence Of Disability
● Spontaneous Worsening Of An Accepted Condition Without
An Intervening Event.
 Worsening: Unable To Continue Working The Same Amount
Of Hours After Returning To Work, e.g., 40 Hours To 30 Hours,
Call-Out Due To Work-Related Injury.
 If Accepted Condition Is Worsened By Work Activity, File A
New Traumatic Or Occupational Claim. May Be Entitled To
COP If Traumatic.
(continued)
26
Created by APWU Human Relations Department Director, Sue Carney
THREE TYPES OF CLAIMS
Recurrence
Recurrence Of Disability
(continued)

USPS Withdrawal Of Limited Duty/Rehab Job.

Any Reduction In Job Hours.

Recurrence Of A Need For Medical Treatment
With No Work Stoppage (Also Reopening A
“Closed Claim”).
 If No Longer Seeing Physician But Need Additional
Medical Care
 Continuous Treatment Is Not “Additional” Treatment
 Simple Examination By Physician Is Not “Treatment”
(continued)
27
Created by APWU Human Relations Department Director, Sue Carney
THREE TYPES OF CLAIMS
Recurrence
(continued)
●
May Be Entitled To Any COP Balance If Original
Injury Traumatic.
 Must Provide A Detailed Factual Statement (Comply
Fully With Instructions On Form CA-2a).
 Medical Evidence Must Establish That The Recurrence
Of Inability To Work Is Causally Related To The Original
Accepted Injury.
 After Returning To Work From Original Disability, Only
OWCP Can Declare A Subsequent Absence Compensable,
i.e., An “IOD”.
(continued)
28
Created by APWU Human Relations Department Director, Sue Carney
THREE TYPES OF CLAIMS
FECA
5 USC

Traumatic Injury
(Form CA-1)

Occupational Disease
(Form CA-2)
 Recurrence
(Form CA-2a)
29
20 CFR
ELM
EL 505
CA 550
Q&A
§8101 (5)
10.5 (ee)
10.100
541.2.r
542.11
544.112
544.2
545.21
Exh. 5.1
Ch. 3-6
Ch. 4-1
B-3
§8101 (5)
10. 5 (q)
10.101
541.2.j
542.12
Ch. 3.7
Exh. 5.1
Ch. 4-8
B-3
B-4
10.5 (x)
10.5 (y)
10.104
541.2.p
541.2.q
542.13
544.22
Ch. 3.8
Ch. 5
B-8
B-9
Created by APWU Human Relations Department Director, Sue Carney
USPS
TRAUMATIC INJURY
OWCP Form CA-16
“Authorization For Examination/Treatment”
 Issued For Traumatic Injuries Requiring Medical Care.
 Authorizes Medical For 60 Days Unless OWCP Stops
Authorization.
 Employee Chooses Physician.
 Must Be Issued To Employee Within 4 Hours Of Receiving
Notice Of Claimed Injury (Within 48 Hours If Initial
Authorization Is Verbal).
 Not Issued If More Than One Week From Injury Date.
(continued)
30
Created by APWU Human Relations Department Director, Sue Carney
USPS
TRAUMATIC INJURY
OWCP Form CA-16
“Authorization For Examination/Treatment”
(continued)
 Authorization Includes Subsequent Physicians When
Original Physician Refers.
 Issuance Required Even If USPS Doubts Injury.
 Not Required For First Aid When Employee Voluntarily
Accepts Postal/Contract Physician (Maximum 2 Visits).
 Not Required For Simple Hazard Exposure Without
Medical Condition.
(continued)
31
Created by APWU Human Relations Department Director, Sue Carney
USPS
TRAUMATIC INJURY
OWCP FORM CA16
“Authorization For Examination/Treatment”
FECA
5 USC
20 CFR
ELM
EL 505
CA 550
Q&A
§8103(b)
10.300(a)
545.21
Ch. 3.3
B-1.(c.)

Authorizes Medical Care

60 Day Maximum

Employee Selects Physician

Within 4 Hours
10.300(b)
545.21

Within One Week Of Injury
10.300(b)
545.21
E-1

Referral To Different Physician
10.301
543.3
E-2

USPS Doubts Injury
10.302

First Aid By Postal/Contract

Hazard Exposure
32
10.300(c)
§8103(a)
E-2
10.300(d)
545.21
10.303(a)
Ch. 3.10
E-3
Ch. 3.10
E-1
Ch. 3.10
545.23
Created by APWU Human Relations Department Director, Sue Carney
TRAUMATIC INJURY
USPS
Continuation Of Pay
● COP Is The Continuation Of Employee’s Regular Salary For
Wage Loss Due To Disability And/Or Medical Treatment.
● It’s Intended To Eliminate Interruption Of The Employee’s
Income While OWCP Processes The Claim.
● It Includes N/D, S/P And Holiday Pay.
● COP Is Not Considered Compensation.
● Is Employer Paid.
● Is Subject To Deductions For Income Tax, Retirement, Etc.
● Employee Is In Pay Status.
(continued)
33
Created by APWU Human Relations Department Director, Sue Carney
TRAUMATIC INJURY
USPS
Continuation Of Pay
(continued)
 Not Available For Occupational Injuries (Form CA-2).
 Must File CA-1 Within 30 Days Of Injury.
 Must Begin Losing Time From Work Within 45 Days Of Injury.
 Employee’s Choice To Use COP—Should Not Be Required To Use
S/L Or A/L. If Unaware COP Was An Entitlement/ Choice, Employee
Has One Year (From Date Of Use) To Request Adjustment.
 Must Provide Prima Fascia Medical Evidence Of Disability (Inability
To Work) Within 10 Days Of When COP Begins In Order For COP
To Continue.
 45 Calendar Day Entitlement.
 Day Of Injury Not Counted As COP (Paid As Administrative Leave).
(continued)
34
Created by APWU Human Relations Department Director, Sue Carney
TRAUMATIC INJURY
USPS
Continuation Of Pay
(continued)
 Must Begin Using Any Balance Of COP Within 45 Days Of First
Return To Work (RTW)—RTW From Disability Not Date Of Injury.
 COP May Be Used Beyond 45 Day RTW Time Limit Provided
Employee Begins Using COP Balance No Later Than The 45th Day
From Their RTW And Disability Continues Without Interruption.
 If Disability Extends Beyond COP Period, File For Compensation.
 May Use COP For Medical Treatment/Examination Time. Employee
Required To RTW To Complete Work Shift Unless Disabled.
 COP Is Counted By Days Not Hours. Partial Days Of COP Count
As A Full Day Of COP.
 May Later Request COP After Using SL/AL Once Claim Is Approved.
 If OWCP Denies Claims COP Must Be Repaid (May Use SL/AL).
35
Created by APWU Human Relations Department Director, Sue Carney
TRAUMATIC INJURY
Continuation Of Pay
FECA
5 USC
 Not For
“Occupationals”
20 CFR
ELM
CA 550
Q&A
EL 505
10.205(a)(1)
542.122
545.721.a
 File Within 30 Days
10.205 (a)(2)
545.721.b
Exh. 4.16
D-4(f)
 Lose Time Within 45
Days
10.205(a)(3)
545.721.c
541.2.d
Exh. 4.16
D-4(g)
10.210(b)
545.724.b
545.74.a
541.2.d
Ch. 13.1
D-5a
10.200(a)
10.200(b)
541.2.d
545.71
Ch. 1
Ch. 13.1
D-1
 Day Of Injury Not
Counted
10.215(a)
541.2.d (2)
Ch. 13.4
 Repayment
10.224
543.41
Ch. 13.11
§8118(a)
 Medical Within 10
Days
 45 Day Entitlement
§8118(b)
D-1
(continued)
36
Created by APWU Human Relations Department Director, Sue Carney
TRAUMATIC INJURY
Continuation Of Pay
USPS
(continued)
FECA
5 USC
 Begin Within 45 Days
Of RTW
20 CFR
10.205(a)(3)
EL 505
CA 550
Q&A
541.2.d
545.721.c
Exh. 4-16
D-4 (g.)
ELM
 Using Balance
(Uninterrupted)
10.207
545.722
Ch. 13.1
 Disability Goes
Beyond COP
10.401(a)
545.81
545.83
Exh. 3-5.a
 Physician Visits
 Remaining COP
 May Request COP
Later
37
Ch. 13.4
§8118(d)
10.224
543.41
10.206
543.42.c
Exh. 3.5.a
Created by APWU Human Relations Department Director, Sue Carney
D-7
TRAUMATIC INJURY
Controversion With COP Withheld
 The USPS Can Controvert (Challenge, Dispute) An
OWCP Claim. However, OWCP Makes The Final
Decision As To Whether A Claim Is Accepted Or Denied.
 The USPS Can Controvert And Deny Payment Of
COP Only For The Following Reasons:
 The Disability Was Not Caused By A Traumatic Injury;
 The Employee Is Not A Citizen Of The U.S. Or Canada;
 No Written Claim Was Filed Within 30 Days From The
Date Of Injury;
(continued)
38
Created by APWU Human Relations Department Director, Sue Carney
TRAUMATIC INJURY:
CONTROVERSION WITH
COP WITHHELD
(continued)
 The Injury Was Not Reported Until After Employment Has Been
Terminated;
 The Injury Occurred Off The Employing Agency’s Premises And
Was Not Otherwise Within The Performance Of Official Duties;
 The Injury Was Caused By The Employee’s Willful Misconduct,
Intent To Injure Or Kill Himself/Herself Or Another Person, Or
Was Proximately Caused By Intoxication By Alcohol Or Illegal
Drugs;
 First Absence Caused By The Injury Was More Than 45 Days
After The Date Of Injury.
(continued)
39
Created by APWU Human Relations Department Director, Sue Carney
TRAUMATIC INJURY
COP Withheld

Not A Traumatic Injury

Not A Citizen Of U.S.

No Claim Within 30 Days

FECA
5 USC
20 CFR
ELM
EL 505
CA 550
Q&A
§8118(b)
10.220(a)
545.732(a)
Exh. 4.16
D-4 (a)
10.220(b)
D-4 (c)
10.220(c)
545.732(b)
D-4 (f)
Injury Not Reported Prior
To Termination Notice
10.220(d)
545.732(c)
D-4 (h)

Injury Off Premises And
Not In Performance Of
Duty
10.220(e)
545.732(d)
D-4 (d)

Willful Misconduct, Intent
To Injure, Intoxication
10.220(f)
545.732(e)
D-4 (e)

First Absence More Than
45 Days After Injury
10.220(g)
545.732(f)
40
§8118(b)
Exh. 4.16
Created by APWU Human Relations Department Director, Sue Carney
D-4 (g)
TRAUMATIC INJURY
USPS
Stopping COP Which Has Already Begun
After COP Has Been Started It May Be Stopped Only In The
Following Circumstances:
 Medical Evidence Which On Its Face Supports Inability To
Work Due To The Workplace Injury Is Not Received Within
10 Calendar Days After Claim Is Submitted;
 Medical Evidence From Employee’s Physician Shows
Employee Not Disabled;
 Medical Evidence From Employee’s Physician Shows
Employee Not Totally Disabled And Employee Refuses
Written Job Offer That Is Approved By Employee’s Physician;
(continued)
41
Created by APWU Human Relations Department Director, Sue Carney
TRAUMATIC INJURY
USPS
Stopping COP Which Has Already
Begun
(continued)
 Employee Returns To Work With No Loss Of Pay;
 Specific Term Of Employment Ends;
 Termination Of Employment Established Prior To Injury;
 OWCP Directs Employer To Stop COP;
 And/Or COP Paid For 45 Calendar Days.
42
Created by APWU Human Relations Department Director, Sue Carney
TRAUMATIC INJURY
COP Stopped
FECA
5 USC
20 CFR
ELM
EL 505
Exh. 4-16
CA 550
Q&A

No Medical Evidence Within
10 Days
10.222(a)(1)
545.741.a

Medical Evidence Shows No
Disability
10.222(a)(2)
545.741.b

Medical Evidence Shows
Partial Disability And Job
Offer Refused
10.222(a)(3)
545.741.c

Employee Returns To Work
With No Pay Loss
10.222(a)(4)
545.741.d

Term Of Employment Ends
10.222(a)(5)
545.741.e
D-5(c)

Termination Of Employment
10.222(b)
545.741.f
D-6

OWCP Directs
10.222(a)(6)
545.741.g
Exh. 4.16

45 Days Paid
10.222(a)(7)
545.741.h
Exh. 4.16
43
D-5 (a)
D-5 (b)
D-9
Created by APWU Human Relations Department Director, Sue Carney
CLAIM FOR COMPENSATION
(Form CA-7)
(Form CA-20)
● Submit Form CA-7 To Supervisor Every Two Weeks
And Send Form CA-20, “Attending Physician’s Report”
To OWCP.
● Wage Loss Compensation Is Paid At Two-Thirds Of
Pay Rate If No Dependents And Three-Fourths If One
Or More Dependents.
● Compensation Is Based On Pay Rate On Day Of Injury
Or First Disability, Whichever Is Greater.
(continued)
44
Created by APWU Human Relations Department Director, Sue Carney
CLAIM FOR COMPENSATION
(continued)
● Night Differential, Sunday Premium And Holiday Pay
Are Included In Pay Rate, But Overtime Is Excluded.
● Compensation Is Tax Free. The Only Deductions Are
Premiums For Health Insurance And Optional Life
Insurance.
● Payable After Three Day Wait (Non-Work Day, Non-Pay
Status), But Waiting Period Waived If Total Disability
Exceeds 14 Days.
(continued)
45
Created by APWU Human Relations Department Director, Sue Carney
CLAIM FOR COMPENSATION
(continued)
● Postal Service Must Submit CA-7 To OWCP Not
More Than 5 Working Days After Receipt From
Employee.
● An Employee Is In A Leave Without Pay (LWOP)
Status When Receiving Wage Loss Compensation
From OWCP.
● Employees In A LWOP Status For Any Reason Do
Not Accrue Sick Or Annual Leave Nor Can They
Participate In The Thrift Savings Plan.
(continued)
46
Created by APWU Human Relations Department Director, Sue Carney
CLAIM FOR COMPENSATION
(continued)
● Time Spent In A LWOP Status For Purpose Of
Receiving OWCP Compensation Is Computed As
Creditable Service For Retirement.
● Once Pay Rate For Compensation Is Established
It Does Not Change (No Negotiated COLAs Or
Raises), Unless Employee Returns To Work
For More Than 6 Months Of Regular Full Time
Employment .
(continued)
47
Created by APWU Human Relations Department Director, Sue Carney
CLAIM FOR COMPENSATION
FECA
5 USC
● Submit Form CA-7
20 CFR
ELM
10.102(b)(1)
545.82
● ⅔ Or ¾ Pay Rate
§8105
§8110
10.401(b)
● Pay Rate At Time
Of Injury
§8114
10.5(s)
● Sunday Premium,
Night Differential,
Holiday Pay, Not OT
541.2.i
§8114(e)
EL 505
CA 550
Q&A
Ch.1
F-9
Ch.1
Ch.1
F-28
G-1
● Tax Free
● Three Day Wait
10.401(a)
545.83
(continued)
48
F-14
Created by APWU Human Relations Department Director, Sue Carney
F-4
CLAIM FOR COMPENSATION
(continued)
FECA
5 USC
● Five Working Days,
USPS To OWCP
● LWOP For
Compensation
20 CFR
ELM
EL 505
10.111(c)
545.812
545.82
Ch. 4.10
Exh. 514.4.4.e
● No Leave Accrual In
LWOP
512.311.e
● Creditable Service
For Retirement
546.143.d
● No Contractual
Increase In
Compensation Pay
Rate
49
Exh.11.9e
§8101(4)
Created by APWU Human Relations Department Director, Sue Carney
CA 550
Q&A
LEAVE BUY BACK
(Form CA-7b)
● A Leave Buy Back (LBB) Program Is At The Discretion
Of The Employer. It Is Not An OWCP Requirement.
● If Employees Use Sick Or Annual Leave While Waiting
For Their Claim To Be Approved By OWCP They May
Apply To Buy It Back.
● The USPS Will Not Process A LBB Request For Leave
Used After A Claim Has Been Approved.
 File Local Grievance, Hold Pending Adjudication Of
National Grievance (Q98C-4Q-C01208677).
(continued)
50
Created by APWU Human Relations Department Director, Sue Carney
LEAVE BUY BACK
(continued)
● When Paid Leave Is Bought Back, The Original Period
Of Leave Use Is Retroactively Changed To LWOP
Which Will Result In A Downward Adjustment Of
Leave For Every 80 Hours Of LWOP.
● LBB May Have Income Tax Implications, Consult
IRS Or Tax Advisor [Form CA-7b Worksheet].
(continued)
51
Created by APWU Human Relations Department Director, Sue Carney
LEAVE BUY BACK
(continued)
● LBB Must Be Initiated Within 1 Year Of RTW Or Within 1
Year Of OWCP Approval Of Claim, Whichever Is Later.
● Cannot Buy Back Leave If No Longer A USPS Employee.
● If LBB For Previous Year Exceeds Allowable Carryover
The Excess Will Be Forfeited.
● The Employee Must Pay The USPS The Difference
Between Paid Leave (100% Of Wage) And The
Compensation Amount (66 ⅔% Or 75% Of The Wage) [Form
CA-7b Worksheet].
(continued)
52
Created by APWU Human Relations Department Director, Sue Carney
LEAVE BUY BACK
FECA
5 USC
20 CFR
ELM
EL 505
CA550
Q&A
• Discretionary
Program
F-7
F-8
• For Leave Used
While Waiting For
Claim Adjudication
By OWCP
543.42.f
545.84
• No LBB Of Leave
Used After Claim
Approved
512.923(a)
Ex.514.4.e(6)
• Initiate Within 1 year
543.42.f
545.84.a
Ch.13.19
Exh. 13.19a
Exh. 13.19a
(continued)
53
Created by APWU Human Relations Department Director, Sue Carney
Leave Buy Back
(continued)
FECA
5 USC
 No LBB If No
Longer USPS
Employee
 Cannot Exceed
Maximum Leave
Carry-Over
 Retroactive
Conversion To
LWOP Will
Change Leave
Balance
54
20 CFR
ELM
EL 505
543.42.f
545.84b
Exh. 13.19a
512.923.b
Exh. 514.4.e.(6)
Ch.13.19
Exh. 13.19a
512.923.c.
Exh. 514.4.e(6)
Exh. 13.19a
CA 550
Q&A
Created by APWU Human Relations Department Director, Sue Carney
RETURN TO WORK
CAPABILITY
Medical Restrictions
● Form CA-17, “Duty Status Report,” Is Normally Used.
 Treating Physician Completes “Side B” In Detail.
 Physician Should Provide Specific Details If Using
General Language Such As “No Repetitive Activity.”
● Employees Must Advise Their Physicians That The
USPS Will Accommodate Work Limitations And Must
Also Advise The USPS Of These Limitations.
(continued)
55
Created by APWU Human Relations Department Director, Sue Carney
RETURN TO WORK
CAPABILITY
Medical Restrictions
(continued)
● Medical Restrictions Also Apply To Your Activities
Outside The Workplace.
● The USPS May Contact Your Physician (In Writing
Only, Must Send Copy To You) Concerning Your Work
Limitations And Possible Job Assignments.
(continued)
56
Created by APWU Human Relations Department Director, Sue Carney
RETURN TO WORK
CAPABILITY
Medical Restrictions
FECA
5 USC 20 CFR
57
ELM
EL 505
● Form CA-17
10.506
545.52
Ch. 4-16
Ch. 4-17
● Advise Physician
And USPS
10.515
545.33
● Contact With Your
Physician
10.506
545.52
CA 550
Q&A
Created by APWU Human Relations Department Director, Sue Carney
D-9
H-1
JOB OFFERS
Limited Duty/Rehab
●
Limited Duty Job Offer = Temporary Medical Restrictions
●
Rehab Job Offer = Long Term/Permanent Medical Restrictions
 Maximum Medical Improvement (MMI) Achieved
 MMI Declared By Physician
●
An Employee Who Is Capable Of Performing Core Duties
Of Their Bid (With Or Without Modification) Is Not Considered
A Limited Duty/Rehab.
(continued)
58
Created by APWU Human Relations Department Director, Sue Carney
JOB OFFERS
Limited Duty/Rehab
(continued)
●
The Job Offer May Be Made Verbally As Long As Written
Job Offer Is Provided Within 2 Business Days.
●
To Be Considered Suitable By OWCP The Job Offer Must
Include:






Description Of The Duties;
Description Of The Specific Physical Requirements;
Location Of The Job;
Effective Date;
Pay Rate;
The Date By Which The Job Offer Must Be
Accepted/Refused.
(continued)
59
Created by APWU Human Relations Department Director, Sue Carney
JOB OFFERS
Limited Duty/Rehab
(continued)
● If The Job Offer Is Not Accepted, OWCP Will Then
Review The Offered Work To Determine Suitability
 Compensation Will Be Continued Until Final OWCP
Decision.
 If Considered Suitable, Employee Will Have 30 Days
To Accept Job Or Present Evidence Of Unsuitability.
 If OWCP Determines The Reasons Are Unacceptable,
The Employee Has 15 Days To Accept The Job.
 No Further Evidence Will Be Considered By OWCP.
(continued)
60
Created by APWU Human Relations Department Director, Sue Carney
JOB OFFERS
Limited Duty/Rehab
(continued)
● USPS Should Minimize Any Adverse Or Disruptive
Impact On The Employee.
● If There Is Adequate Work Available Within Employee’s
Craft, Facility, And Regular Hours, Then The Employee
Must Be Assigned To That Work.
● All Concurrent Medical Conditions Whether Or Not
Caused By Or Related To The Accepted Condition
Must Also Be Included In Medical Suitability
Determinations.
(continued)
61
Created by APWU Human Relations Department Director, Sue Carney
JOB OFFERS
Limited Duty/Rehab
FECA
5 USC
20 CFR
ELM
EL 505
● Job Offer
10.507(c)
545.32
Ch. 7.4
Exh. 7.1
● Suitability
10.507(d)
545.32
Ch. 7.4
Ch. 11.8
10.516
546.64
Ch. 7.5
Ch. 11.12
● Adverse Or
Disruptive Impact
546.142
Exh. 7.1
● All Concurrent
Conditions
546.622
Ch. 11.4
● OWCP Review
62
CA 550
Q&A
Created by APWU Human Relations Department Director, Sue Carney
H-4
RIGHTS AND BENEFITS
● LWOP For Compensation Is Credited For Computing
Retirement Credit (Years Of Service) (ELM 546.143).
 However, If Working Partial Days (e.g., Working 6
Hours With Compensation For 2 Hours) Current
OPM Policy Is That The Full-Time Annuity (Salary)
Rate Will Be Prorated (Reduced) According To
Percentage Of LWOP Hours (EL505, Exhibit 11.9e).
(continued)
63
Created by APWU Human Relations Department Director, Sue Carney
RIGHTS AND BENEFITS
(continued)
● No Leave Accrual When In A LWOP Status. However,
Leave Accrual Rate (4, 6, 8, Hours/Pay Period) Is Not
Affected By LWOP For Compensation (ELM 514.24).
● No Deferral Of Step Increase For LWOP For Compensation
(ELM 422.33).
● No Thrift Savings Plan When In LWOP (ELM 592.91).
(continued)
64
Created by APWU Human Relations Department Director, Sue Carney
RIGHTS AND BENEFITS
(continued)
● An Employee In A Limited Duty/Rehab Job Can:
 Work Overtime If Within Restrictions
(EL 505, Exhibit 7.1, Q&A);
 Bid If Meet Physical Requirements Of Bid Position
(EL 505, Exhibit 11.9b);
 Convert To Full-Time If Capable Of Performing Core
Duties (With Or Without Modification) Of Vacant Position
(Step 4, 9-10-97, I90C-4I-C 93046587).
65
Created by APWU Human Relations Department Director, Sue Carney
SELECTION OF PHYSICIAN
● Injured Employees Always Have The Right To Choose
Their Treating Physician Or Medical Facility.
● Non-Emergency: The Employee May Select A Physician
Or Hospital Within Approximately 25 miles. A Supervisor
Is Not Authorized To Accompany The Employee.
(A Chiropractor Is A Physician Under FECA Only For
Manual Manipulation Of A Subluxation Of The Spine
Demonstrated By X-Ray To Exist.)
(continued)
66
Created by APWU Human Relations Department Director, Sue Carney
SELECTION OF PHYSICIAN
(continued)
● Emergency: Sent To Nearest Available Physician Or
Hospital, Or To Physician Or Hospital Chosen By The
Employee. A Supervisor May Accompany The Employee
To Ensure Prompt Medical Treatment.
● Animal Bites And Eye Injuries Are Always Considered
Emergencies. If There Is Doubt As To The Emergent
Nature Of An Injury, It Is Treated As An Emergency.
● Physician Providing Emergency Care Is Not Considered
The Employee’s Treating Physician.
(continued)
67
Created by APWU Human Relations Department Director, Sue Carney
SELECTION OF PHYSICIAN
(continued)
Postal Physician Or Contract
Equivalent
● May Provide Medical Treatment Not To Exceed Two Visits
If:
 Employee Accepts Treatment;
 Treatment Complies With EL-806 And With OWCP Regulations
And Directives.
● If Treatment Exceeds Two Visits:
 That Provider Becomes Employee’s Treating Physician.
(continued)
68
Created by APWU Human Relations Department Director, Sue Carney
SELECTION OF PHYSICIAN
Postal Physician Or Contract
Equivalent
(continued)
● Choosing A Contract Doctor As Your Treating Physician Is
Probably Not In Your Best Interest.
 More Obliged To Their Employer (The USPS) Than
To The Employee.
 Employee Sacrifices Doctor-Patient Confidentiality.
 Doctor Legally Can Share Any Information With The
USPS.
(continued)
69
Created by APWU Human Relations Department Director, Sue Carney
SELECTION OF PHYSICIAN
(continued)
USPS May Require Employee To Be
Examined By Their “Contract Doctor”
● Employee Does Not Have To Accept Their Recommended
Course Of Treatment.
● Employee Does Not Have To Accept The “Contract
Doctor” As Their Treating Physician.
● Such Examination May Not Delay Employee’s Initial
Medical Treatment With Their Own Doctor.
(continued)
70
Created by APWU Human Relations Department Director, Sue Carney
SELECTION OF PHYSICIAN
USPS May Require Employee To Be
Examined By Their “Contract Doctor”
(continued)
● If Exam Goes Beyond Employee’s Regular Work Hours,
Employee May Request Through Their Supervisor To Leave.
If Denied, Employee Should Request Overtime
Pay.
● Employee Should Not Be Required To Sign Any Guarantor
Or Medical Release Forms.
(continued)
71
Created by APWU Human Relations Department Director, Sue Carney
SELECTION OF PHYSICIAN
Physician Changes & Referrals
(continued)
● To Ensure Payment Of A Medical Bill, An Employee
Changing Physicians Should Write To OWCP Providing
The Reason For The Change And The Name And Address
Of Both The New Physician And The Previous One.
● Referral By A Physician To A Specialist Is Not A Change Of
Physician. Get The Referral In Writing And Send A Copy To
OWCP.
(continued)
72
Created by APWU Human Relations Department Director, Sue Carney
SELECTION OF PHYSICIAN
• Emergency
FECA
5 USC
20 CFR
ELM
EL 505
CA
550
Q&A
§8103
10.300(d)
545.41
Ch. 3.2
E-3
Ch. 3.2
E-4
545.44
Ch. 3.9
E-3
541.2 m (1)
Ch. 3.9
E-4
E-5
• Definition
• Non-Emergency
§8103
• Chiropractor
10.311
• Change Of
Physician
10.316(a)
10.316(b)
•Contract Doctor
73
10.324
E-11
545.43
545.45
Created by APWU Human Relations Department Director, Sue Carney
E-3
PROVIDING SUPPORTING
EVIDENCE
● The Greater The Complexity Of The Medical Condition Being Claimed,
The Greater Is The Need For Thorough And Detailed Evidence.
● Claims For Occupational Disease/Illness Normally Require More
Complete Evidence.
● One Of The Most Common Reasons For Claims Being Denied Is The
Lack Of A Clear And Persuasive Medical Opinion Regarding Causal
Relationship Between Specific Work Activity And The Diagnosed
Condition.
(continued)
74
Created by APWU Human Relations Department Director, Sue Carney
PROVIDING SUPPORTING
EVIDENCE
(continued)
Employee’s Statement
● Traumatic Injury
 Describe In Detail How And Why The Injury Occurred.
 Give Appropriate And Specific Details.
 Give A Complete Description Of The Condition(s) Resulting
From Your Injury.
● Occupational Disease/Illness
 Provide A Detailed History Of The Medical Condition From
Date It Started.
 Give Specific Details About The Employment Activity Which
You Believe Caused The Condition.
(continued)
75
Created by APWU Human Relations Department Director, Sue Carney
The
PROVIDING SUPPORTING
EVIDENCE
Employee’s Statement
● Occupational Disease/Illness (continued)
 Describe Specific Exposures To Substances Or Stress
Causing The Disease/Illness.
 Identify The Part Of The Body Affected.
 Provide A Statement As To Whether Ever Suffered A Similar
If So, Provide Full Details.
Condition.
 Give A Complete And Detailed Description Of The Current
Disease/Illness
(continued)
76
Created by APWU Human Relations Department Director, Sue Carney
PROVIDING SUPPORTING
EVIDENCE
Employee’s Statement
(continued)
● Recurrence
 Describe In Detail Your Medical Condition Since Returning
To Work.
 Provide A Listing Of The Nature And Frequency Of All
Medical Treatment Received.
 Describe Specifically How And When The Recurrence
Happened.
 Identify ALL Injuries/Illnesses Which Have Been Experienced
Between Date Of Return To Work After The Original Injury
And The Recurrence.
(continued)
77
Created by APWU Human Relations Department Director, Sue Carney
PROVIDING SUPPORTING
EVIDENCE
(continued)
Medical Reports
● Traumatic/Occupational/Recurrence
 Dates Of Examination Or Treatment.
 History Of Work Activity And The Claimed Condition As
Provided By Employee.
 Results Of X-rays, Laboratory Tests, MRIs, EMGs, Etc.
 Specific Medical Diagnosis.
 Opinion With Medical Reasoning Explaining The Basis Of
Such Opinion Regarding Whether The Condition Was Caused
Or Aggravated By Employment (Statement Of Causality).
(For Recurrence, Such Opinion Should Address The Causal
Relationship Between The Current Condition And The Original
Injury).
78
Created by APWU Human Relations Department Director, Sue Carney
USPS
MEDICAL REPORTS
(20 CFR 10.330, ELM 545.51)
●
All Claims Reported To OWCP Require A Medical Report
●
Detailed And Thorough Medical Evidence Is One Of The
Most Important Aspects Of A Claim
●
A Good Medical Report Should Include (See Sample Reports
Traumatic, Occupational):
 A History Of The Specific Work Activity Surrounding The
Medical Condition;
 Dates Of Examination And Treatment;
(continued)
79
Created by APWU Human Relations Department Director, Sue Carney
MEDICAL REPORTS
USPS








(continued)
Physical Findings Including Results Of Diagnostic Testing;
Specific Diagnosis;
Course Of Treatment;
A Description Of All Medical Conditions Whether Work-Related
Or Not;
Treatment Provided Or Recommended For The Claimed Condition;
The Physician’s Opinion With Medical Reasons Regarding
Causal Relationship Between The Diagnosed Condition And
Specific Work Activities And/Or Work Incidents;
Whether The Employee Can Perform Any Type Of Work;
Prognosis For Recovery (Full Or Partial).
(continued)
80
Created by APWU Human Relations Department Director, Sue Carney
USPS
MEDICAL REPORTS
(continued)
● Form CA-16 May Be Used For Initial Medical Report,
Form CA-20 May Also Be Used For Initial Report And
Subsequent Reports (Use Of These Forms Is Not
Mandatory).
● A Medical Report May Be Made In Narrative Form On
The Physician’s Letterhead Stationery.
● Medical Reports Should Bear The Physician’s Signature
Or Signature Stamp.
(continued)
81
Created by APWU Human Relations Department Director, Sue Carney
USPS
MEDICAL REPORTS
(continued)
● The Medical Report Is Submitted Directly To OWCP
(Keep A Copy For Yourself).
● The Postal Service May Request A Copy From OWCP.
● Form CA-17 Is Normally Used To Obtain Periodic Reports
Regarding The Employee’s Medical Restrictions
And Degree Of Disability.
82
Created by APWU Human Relations Department Director, Sue Carney
USPS
EXAMPLE OF A
THOROUGH MEDICAL REPORT:
TRAUMATIC INJURY
(PHYSICIAN’S LETTERHEAD STATIONERY)
To Whom It May Concern:
On January 25, 2004 I examined Mr. Ricardo Velasquez. Mr. Velasquez, who is a Postal Service employee,
works 3:30 PM to 11:00 PM at the Northland Processing and Distribution Center. He stated that at approximately
6:10 PM he was pushing a loaded mail container which weighed approximately 310 pounds up a small incline
when it started to tip to the right. Mr. Velasquez quickly moved to the right side of the container raising his right
arm and placing his right hand at the top of the container. He pushed against the container, preventing it from
tipping over and held it upright for a few seconds until two co-workers came to his assistance and helped right
the container. Mr. Velasquez felt no immediate pain and finished his work shift without incident. However, after
sleeping several hours Mr. Velasquez woke up with a moderate to severe pain in his right shoulder area. An
MRI was performed (see attached report) and it demonstrated a partial tear of the supraspinatus of
approximately 1.7centimeters proximal to the humerus.
The patient will be treated conservatively with physical therapy and ultrasound. He has no other complaints
or symptoms. He can return to work but should not use his right arm to lift more than 5 pounds, nor should he
reach above shoulder height with his right arm.
In my medical opinion the above described traumatic work place incident caused the rotator cuff tear which
was demonstrated by the referenced MRI report. Mr. Velasquez’ use of his right arm to keep the container
upright caused a sudden loading of the right shoulder rotator cuff, especially the external rotators which
were attempting to keep the humeral head centered in the glenoid causing macrotrauma to the supraspinatus
as described above.
Mr. Velasquez has a good prognosis for recovery. I will examine his progress at the end of four weeks of
physical therapy.
83
(Signed ByCreated
Physician)
by APWU Human Relations Department Director, Sue Carney
USPS
EXAMPLE OF A THOROUGH
MEDICAL REPORT:
OCCUPATIONAL DISEASE
(PHYSICIAN’S LETTERHEAD STATIONERY)
To Whom It May Concern:
On January 25, 2004 I examined Ms. Brenda Starr. Ms. Starr, who is a Postal Service Employee, works 3:30 PM to
11:00 PM at the Northland Processing and Distribution Center. Ms. Starr, who is 5’4” tall, holds the position
of automation clerk. She describes the physical activity of a normal work day as follows: for approximately two
hours at a time, two times a day, she repeatedly lifts trays of mail, which she estimates as weighing 20-30 lbs.,
over shoulder height to place them in a storage container. She has been performing this work for approximately
three years.
Ms. Starr complains that for the past two weeks she is awakened at night with moderate to severe pain in her right
shoulder area. An MRI was performed (see attached report) and it demonstrated a partial tear of the supraspinatus
of approximately 1.7 centimeters proximal to the humerus.
The patient will be treated conservatively with physical therapy and ultrasound. She has no other complaints or
symptoms. She can return to work, but should not use her right arm to lift more than 5 pounds, nor should she
reach above shoulder height with her right arm.
In my medical opinion the above described repetitive work performed at the Postal Service caused the rotator cuff
tear which was demonstrated by the MRI report. Ms. Starr’s repetitive lifting overhead caused constant fatiguing
of the rotator cuff muscles (especially the external rotators) as they attempted to keep the humeral head centered
in the glenoid, resulting in chronic inflammation and microtrauma resulting in the injury to the supraspinatus as
described above. Ms. Starr has a good prognosis for recovery. I will evaluate her progress at the end of 4 weeks
of physical therapy.
(Signed by Physician)
84
Created by APWU Human Relations Department Director, Sue Carney
OWCP CRITERIA FOR
EVALUATING
MEDICAL REPORTS
● When A Claims Examiner (CE) Must Determine The
Relative Value Of Medical Evidence They Ask The
Following Questions:
 Is The Physician A Specialist In The Appropriate Field?
 Is The Physician’s Opinion Based On A Complete And Accurate
Medical History?
 What Are The Nature And Extent Of Medical Findings?
 Is The Physician’s Opinion Well-Reasoned (Rationalized)?
 Is The Opinion Speculative Or Equivocal (Uncertain)?
85
Created by APWU Human Relations Department Director, Sue Carney
OWCP DIRECTED MEDICAL
EXAMS
Second Opinions
● The Attending Physician Is Ordinarily The Primary Source
Of Medical Information And The First Line For Medical
Questions From The CE.
● If The Physician Does Not Respond Or The Response
Is Equivocal, A Second Opinion May Be Requested By
The CE (An OWCP Second Opinion Exam Cannot Be
Initiated By The Claimant).
● The Claimant Must Submit To An OWCP Mandated
Examination As Often And At Such Times As OWCP
Considers Necessary [20 CFR 10.320].
(continued)
86
Created by APWU Human Relations Department Director, Sue Carney
OWCP DIRECTED MEDICAL
EXAMS
Second Opinions
(continued)
● The Medical Opinion Determined By The CE To Hold
More Probative Value (Using The Criteria Described
Previously) Will Be Used To Determine Entitlement
[20 CFR 10.321].
● If Two Medical Reports Of Virtually Equal Weight And
Rationale Reach Opposing Conclusions A Medical
Conflict Exists [20 CFR 10.321, 20 CFR 10.502].
● An Employee Scheduled For A Second Opinion Exam
Should Write To OWCP And Request A Copy Of: The
Medical Report, The Statement Of Accepted Facts, The
Questions The Physician Is Asked To Answer (And The
Answers).
(continued)
87
Created by APWU Human Relations Department Director, Sue Carney
OWCP DIRECTED MEDICAL
EXAMS
(continued)
Referee Specialist Exam
(Impartial Medical Exam)
● When Equally Well-Reasoned Medical Reports Support
Inconsistent Conclusions About An Issue Under
Consideration, OWCP Will Schedule A Referee Exam
CFR 10.502].
● A Physician Who Has Had No Prior Connection With
The Case Who Is Qualified In The Appropriate Specialty
Will Be Selected By OWCP [20 CFR 10.321].
● Results Of The Referee Examination Will Be Given
“Special Weight” By OWCP [20 CFR 10.502].
(continued)
88
Created by APWU Human Relations Department Director, Sue Carney
[20
OWCP DIRECTED MEDICAL
EXAMS
Referee Specialist Exam
(Impartial Medical Exam)
(continued)
● An Employee Scheduled For A Referee Exam Should
Write To OWCP And Request Copies Of: The Medical
Report, The Statement Of Accepted Facts, The Questions
The Physician Is Asked To Answer (And The Answers).
89
Created by APWU Human Relations Department Director, Sue Carney
POSTAL SERVICE
FITNESS-FOR-DUTY
● The Postal Service Has Authority Independent Of FECA
To Require A Fitness For Duty (FFD) Examination, And
Nothing In The Law Changes That Right. Such Exam
Shall Not Interfere With The Employee’s Initial Choice
Of Physician, Treatment Or Issuance Of Form CA-16
[20 CFR 10.324].
● Such A FFD Report If Submitted To OWCP Must Receive
Due Consideration, And If Its Findings Or Conclusions
Differ Materially From The Treating Physician’s The CE
Should Schedule A Second Opinion.
(continued)
90
Created by APWU Human Relations Department Director, Sue Carney
POSTAL SERVICE
FITNESS-FOR-DUTY
(continued)
● A Postal Service Installation Head, Human Resources
Manager, Or Designee Is Authorized To Approve A FFD
Exam. [ELM 545.61].
● If The FFD Conflicts With Findings Of The Treating
Physician No Administrative Action May Be Taken
To Change The Employee’s Employment Status
Until Resolution By OWCP [ELM 545.64].
● Employees And/Or Their Physicians Should Request
A Copy Of The FFD Examination.
91
Created by APWU Human Relations Department Director, Sue Carney
MEDICAL PRIVACY
● Medical Reports Should Be Sent Directly To OWCP,
The Postal Service May Request Copies From OWCP
[20 CFR 10.331].
● The Postal Service May Submit Relevant Medical
Evidence In Its Possession, Or Which It May Acquire
Through Investigation. However, The Privacy Act Applies
To Any Such Effort [20 CFR 10.118].
● The Postal Service May Contact The Treating Physician
In Writing, But Not By Telephone Or Personal Visit (For Limited
Reasons) [20 CFR 10.506, ELM 545.52].
(continued)
92
Created by APWU Human Relations Department Director, Sue Carney
MEDICAL PRIVACY
(continued)
● When Such Communication Takes Place The Postal
Service Must Send A Copy To OWCP And The
Employee, As Well As A Copy Of The Physician’s
Response Upon Receipt [20 CFR 10.506, ELM 545.52 ].
● The Postal Inspection Service May Receive Restricted
Medical Information Upon Written Request.
● The Signing Of A Medical Release For Postal Service
Use Is Voluntary. (Step 4 Decision, PS Form 2488)
(continued)
93
Created by APWU Human Relations Department Director, Sue Carney
MEDICAL PRIVACY
(continued)
● Form CA-17, “Duty Status Report,” May Be Used To
Obtain Interim Medical Reports Regarding Return To
Work Capability [20 CFR 10.331, ELM 545.52].
● OWCP Related Medical Records May Be Made Available
To Supervisors Who Have A Legitimate Need To Know.
● These Records Are Confidential, Must Be Kept Under
Strict Control And Stored In Locked File Cabinets.
94
Created by APWU Human Relations Department Director, Sue Carney
SCHEDULE AWARD
● Compensation For The Permanent Loss Or Loss Of Use
(Permanent Impairment) Of Specified Members, Functions
And Organs Of The Body.
● An Employee Who Has Reached Maximum Medical
Improvement And Has A Permanent Impairment To A
Part Of The Body May File For A Schedule Award.
● A Physician Must Determine The Percent Of Impairment
Using The American Medical Association’s Guides To The
Evaluation Of Permanent Impairment, Fifth Edition.
(continued)
95
Created by APWU Human Relations Department Director, Sue Carney
SCHEDULE AWARD
(continued)
●
A Schedule Award And Wage Loss Compensation
Cannot Be Paid At The Same Time, For The Same
Part Of The Body. Therefore, Application For The
Schedule Award Ordinarily Occurs After Return To
Full Time Employment Or After Retirement.
●
By Law A Schedule Award Cannot Be Paid For Brain,
Heart, Or Back (Spine) Impairments. Other Members,
Functions And Organs That Are Permanently Impaired
As A Result Of These Exclusions Are Still Payable.
(continued)
96
Created by APWU Human Relations Department Director, Sue Carney
SCHEDULE AWARD
(continued)
● A Form CA-7, “Claim For Compensation,” Must
Be Completed Unless One Has Previously Been
Submitted.
● The Award Is Tax-Free And Paid At Your Wage
Loss Compensation Rate For The Specified Number
Of Weeks Equivalent To Your Percentage Of
Permanent Impairment.
(continued)
97
Created by APWU Human Relations Department Director, Sue Carney
SCHEDULE AWARD
(continued)
● Formula Is:
Your Specified Number Of Weeks (Maximum Number
Of Compensation Weeks Assigned To An Anatomical
Member) X (Your Percentage Of Impairment) X (Your
Amount Of Wage Loss Compensation) = Schedule Award.
Example:
100% Loss Of Use For The Arm = 312 Weeks Of Compensation
Determined Your Loss Of Use Is 20% = 62.4 Weeks
Your Weekly Rate Of Pay Is $1000 Per Week
You Have Dependents So You Are Compensated At 75% Or $750
$750 X 62.4 Weeks = Schedule Award
(continued)
98
Created by APWU Human Relations Department Director, Sue Carney
SCHEDULE AWARD
•
Schedule Award For
Permanent Impairment
•
Use AMA, Guides
•
Cannot Get Compensation
And Award Simultaneously
•
Not For Brain, Heart, Or
FECA
5 USC
20 CFR
ELM
EL 505
CA 550
Q&A
§8107
10.404
541.133
p. 11
F-23
p. 11
F-26
10.404
10.404(c)
F-25
Back (Spine)
•
Specific Number Of Weeks
At Compensation Rate
•
Compensation Schedule
For Anatomical Member
99
§8107
10.404(a)
10.404 (b)
p. 11
F-23
F-24
F-24
Created by APWU Human Relations Department Director, Sue Carney
CHALLENGING FORMAL
OWCP DECISIONS
● OWCP Will Enclose A Description Of Appeal Rights With
Every Formal Decision. The Choices Are:
 Hearing (Oral And Written)
 Reconsideration
 Employees’ Compensation Appeals Board (ECAB)
● You May Not Request Two Forms Of Appeal At The
Same Time.
● Be Sure To Send Your Appeal To The Right Address.
● Time Limits For Appeal Begin To Run On The Date Of
The Decision Letter.
● The Date Of Your Appeal Is Determined By The Postmark
Of Your Appeal Letter.
(continued)
100
Created by APWU Human Relations Department Director, Sue Carney
CHALLENGING FORMAL
OWCP DECISIONS
(continued)
Branch Of Hearings And Review
Oral Hearing
● Request Must Be Made Within 30 Days Of
Decision. [20 CFR 10.616].
● Conducted By An OWCP Hearing Representative
Within Commuting Area Where The Claimant Lives.
● Probably More Than 3-4 Months Before Hearing Is
Scheduled.
● Claimant Notified At Least 30 Days In Advance Of
The Time And Place. [20 CFR 10.617].
(continued)
101
Created by APWU Human Relations Department Director, Sue Carney
CHALLENGING FORMAL
OWCP DECISIONS
Branch Of Hearings And Review
Oral Hearing (continued)
 Claimant States Argument And Provides Any New
Evidence [20 CFR 10.617].
 Postal Service May Attend, But Not Give Argument.
[20 CFR 10.621].
 Probably More Than 3 Months Or More After Hearing
Is Held Before A Decision Is Issued.
 May Request A Reconsideration Of An Oral Hearing
Decision.
(continued)
102
Created by APWU Human Relations Department Director, Sue Carney
CHALLENGING FORMAL
OWCP DECISIONS
Branch Of Hearings And Review
(continued)
Review Of The Written Record
 Request Must Be Made Within 30 Days Of
Decision [20 CFR 10.616].
 Conducted By An OWCP Hearing Representative
In Washington, DC, After Claim File Is Sent To
Them [20 CFR 10.618].
 New Evidence And/Or Argument May Be Submitted
(No Oral Testimony) [20 CFR 10.618].
(continued)
103
Created by APWU Human Relations Department Director, Sue Carney
CHALLENGING FORMAL
OWCP DECISIONS
Branch Of Hearings And Review
Review Of The Written Record (continued)
 Branch Policy Is To Issue A Decision Within 120
Days Of Receipt Of Claim File.
 May Request A Reconsideration Of A Review Of
The Written Record Decision.
104
Created by APWU Human Relations Department Director, Sue Carney
CHALLENGING FORMAL OWCP
DECISIONS
Reconsideration
Reconsideration
 Request Must Be Made Within One Year Of The
Date Of The Decision [20 CFR 10.607].
 Must Be In Writing, Contain Argument And/Or
Evidence Showing An Erroneous Application
Of Law Or Advancing A New Legal Argument,
And Must Constitute Relevant New Evidence
Not Previously Submitted [20 CFR 10.605].
(continued)
105
Created by APWU Human Relations Department Director, Sue Carney
CHALLENGING FORMAL
OWCP DECISIONS
Reconsideration
(continued)
● Sent To The OWCP District Office Where The Original Decision
Was Made [20 CFR 10.605].
● A Claims Examiner Different From The One Who Made The
Original Decision Will Conduct The Review [20 CFR 10.609].
● OWCP’s Policy (Not A Requirement Of Law) Is To Issue A
Decision Within 90 Days.
● An Employee Who Has Previously Requested A Reconsideration
Cannot Appeal That New Merit Decision To The Branch Of
Hearings And Review [20 CFR 10.616]. However, A New
Reconsideration May Be Requested.
● A Decision Refusing To Conduct A Reconsideration May Only
Be Appealed To ECAB.
(continued)
106
Created by APWU Human Relations Department Director, Sue Carney
CHALLENGING FORMAL
OWCP DECISIONS
(continued)
Employees’ Compensation
Appeals Board (ECAB) [20 CFR 10.625]
● Final Decisions Of OWCP May Be Appealed To ECAB
Within 90 Days Of The Decision Being Appealed.
● For Good Cause Shown ECAB May Waive The
90-day Time Limit And Accept An Appeal Up To
One Year From The Date Of Decision Being
Appealed.
● No New Evidence Will Be Considered By ECAB.
● The Board Consists Of Three Members Appointed
By The Secretary Of Labor.
● It Takes Approximately 12-18 Months To Receive A
Decision From ECAB.
107
Created by APWU Human Relations Department Director, Sue Carney
DEFINITIONS
ACCELERATION—A Medical Process By Which Workplace Activity
Has Increased The Speed Of An Expected Worsening Of A Progressive
Pre-Existing Condition.
AGGRAVATION—A Medical Process By Which Workplace Activity
Has Worsened The Severity Of A Pre-Existing Medical Condition.
● TEMPORARY—A Worsening For A Specific Period Of Time
Ultimately Returning To Previous Medical Status.
● PERMANENT—An Irreversible Worsening With No Return To
Previous Medical Status.
(continued)
108
Created by APWU Human Relations Department Director, Sue Carney
DEFINITIONS
(continued)
CONSEQUENTIAL INJURY—A New Medical Condition Caused By
A Weakness Or Impairment Resulting From An Accepted Workplace
Injury Or Illness. Can Be To The Same Or To A Different Part Of
The Body. No Special Claim Form Needed, Submit To OWCP A
Full Narrative Medical Report Detailing The New Condition And Its
Connection To The Original Accepted Condition.
(continued)
109
Created by APWU Human Relations Department Director, Sue Carney
DEFINITIONS
(continued)
IDIOPATHIC FALL—A Fall Caused By A Non-Work Related Medical
Condition (e.g., Epilepsy, Diabetes) And The Subsequent Injury Was
Caused By Contact With The Floor. However, If The Injury Was
Caused By Workplace Equipment Or Furnishing, Then That Injury
Is Compensable, But The Medical Condition Causing The Fall Is Not.
An Injury Caused By A Fall Which Is Unexplained, But Not Idiopathic,
And Occurs In Performance Of Duty Is Compensable Even If The
Injury Is Caused By The Floor.
(continued)
110
Created by APWU Human Relations Department Director, Sue Carney
DEFINITIONS
(continued)
INTERVENING INJURY— A Non-Work Injury To The Same Part Of
The Body Previously Accepted As A Compensable Workplace Injury.
The Original Injury Must Still Contribute To The Disability Caused By
The New Non-Work Condition. No Special Claim Form Needed,
Submit A Full Narrative Medical Report To OWCP Detailing The New
Condition And Its Connection To The Original Accepted Condition.
PRECIPITATION—A Medical Process By Which Workplace Activity
Hastens The Occurrence Of A Medical Condition Or Causes It To
Happen Unexpectedly Or Sooner Than Normal.
111
Created by APWU Human Relations Department Director, Sue Carney
WORK LIMITATION DUE
TO PAIN
● Ordinarily, OWCP Does Not Accept Pain As Justification For Not
Working.
● Pain Is Considered To Be A Symptom Of An Underlying Medical
Problem. Therefore, OWCP Wants A Medical Diagnosis Of The
Underlying Condition Which Is Causing The Pain.
● However, If There Is No Physical Basis For The Pain And It Is Not
Exaggerated, Or Produced Voluntarily Or Falsely, Then The Condition
Could Be Designated As “Psychogenic Pain Disorder.”
● This Diagnosis Would Have To Result From An Accepted Medical
Condition And Would Be Filed As A Consequential Injury.
112
Created by APWU Human Relations Department Director, Sue Carney
SEPARATION—DISABILITY
[ELM 545.9]
● This Is Not A Disability Retirement.
● An Employee May Be Issued A Disability Separation If That
Employee:
 Has Been In Continuous LWOP For A Year, And
Is Not Likely To Return In The Next 6 Months, And
The Separation Is Approved By USPS Headquarters.
 An Employee Who Partially Or Fully Recovers After
Separation Has Certain Restoration Rights Enforceable
Through The Merit System Protection Board (MSPB)
[ELM 546.3 And 546.4].
113
Created by APWU Human Relations Department Director, Sue Carney
DISABILITY RETIREMENT
● OPM Makes Decisions Regarding Disability Retirement Based On
Whether An Employee Has A Medical Condition, Work Related Or Not,
Which Prevents That Employee From Performing Useful And Efficient
Service In The Job The Employee Was Hired To Perform.
● OWCP Makes Decisions Regarding Wage Loss Compensation Based On
Whether An Employee Has An Accepted Workplace Medical Condition
Which Prevents That Employee From Performing Any Type Of Medically
Suitable Work.
● Each Agency Makes Independent Decisions.
● A Claimant Who Is Receiving OWCP Wage Loss Compensation From
OWCP Can Retire, Waive The OPM Retirement Annuity, And Continue To
Receive Compensation For As Long As OWCP Determines The Claimant
Continues To Be Disabled.
(continued)
114
Created by APWU Human Relations Department Director, Sue Carney
DISABILITY RETIREMENT
(continued)
● Application For Disability Retirement Must Be Received By OPM
Within One Year Of Separation.
● A FERS Employee Applying For Disability Retirement Must Also
Apply For Social Security Disability Benefits.
● Under OPM Regulations An Employee Receiving A Disability Annuity
Can Work In A Non-Government Job And Earn Up To 80% Of The
Current Salary Of The Previous USPS Job.
● A Claimant Receiving Compensation Who Is Separated From The
USPS, Or Who Has Dependents And Is In Poor Health And/Or Of
Advanced Age, Should Seriously Consider Filing For Retirement.
● Do Not Make A Decision Before Receiving Pre-Retirement Counseling
From The USPS, And, If Applicable, The Social Security
Administration.
115
Created by APWU Human Relations Department Director, Sue Carney
OWCP MEDICAL BILL
PAYMENT AND
AUTHORIZATION FOR
MEDICAL PROCEDURES
● OWCP Has Contracted With ACS, A Private Sector Firm,
To Administer Bill Payments And Medical Authorizations.
● The Web Site Is www.owcp.dol.acs-inc.com. The
Interactive Voice Response (IVR) Phone Number
Is 1-866-335-8319. The Customer Service Number
Is (850) 558-1818 (Mon-Fri, 8 AM-8PM, ET). This
Number Is Not Toll Free.
● Medical Providers Must Enroll. They May Do So Through
The Above Web Site. Providers And Claimants May
Review Bill Pay And Authorization Status At The Above
Web Site.
(continued)
116
Created by APWU Human Relations Department Director, Sue Carney
OWCP MEDICAL BILL PAYMENT
AND AUTHORIZATION
FOR MEDICAL PROCEDURES
(continued)
● Medical Bills Are First Mailed To First Health/USPS,
P.O. Box 23808, Tucson, AZ 85734-3808 Where
They Are Reviewed And Forwarded To ACS (OWCP).
● OWCP Still Is The Final Decision-Making Authority
Regarding Entitlement To All Medical Benefits.
117
Created by APWU Human Relations Department Director, Sue Carney
OWCP INFORMATION
● Federal Employees’ Compensation Act (FECA),
Title 5, Chapter 81
● Code Of Federal Regulation, Claims For Compensation
Under FECA, Part 10 and 25
● Questions And Answers About FECA, CA 550
● Injury Compensation For Federal Employees, CA-810
● When Injured At Work, Guide For Federal Employee, CA11
118
Created by APWU Human Relations Department Director, Sue Carney
OWCP FORMS
● CA-1
Federal Employee's Notice Of Traumatic Injury And Claim For
Continuation Of Pay
● CA-2
Notice Of Occupational Disease And Claim For Compensation
● CA-2a
Notice Of Recurrence
● CA-5
Claim For Compensation By Widow, Widower, And/Or Children
● CA-6
Official Superior’s Report Of Employee’s Death
● CA-7/20
Claim For Compensation/Attending Physician’s Report
● CA-7a
Time Analysis Form
● CA-7b
Leave Buy Back (LBB) Worksheet Certification And Election
● CA-16
Authorization (Employer Issued) For Examination And/Or
Treatment
● CA-17
Duty Status Report
● CA-915
Claimant Medical Reimbursement Form
119
Created by APWU Human Relations Department Director, Sue Carney
OWCP INFORMATION
(continued)
● U.S. Department of Labor, Office of Workers’
Compensation Programs, Self-Instructional Video:
Injury Compensation Specialist Training.” This
Video Presentation Was Created For Use By
The Federal Employing Agencies. Please Be
Very Aware When Reviewing This Training
Tool, The Presentor Is Speaking To The Agency
Representative, Not The Injured Worker.
● ELM 540, Injury Compensation Program
● EL 505,
120
Injury Compensation
Created by APWU Human Relations Department Director, Sue Carney
LETTERS, MOUs AND STEP
4 DECISIONS
● A1
Letter From USPS Labor Relation At Headquarters. On the
Services Policy for Employees that Sustained On-The-Job
Injuries
● A2
USPS Sample Letter. Limited Duty Assignments and MOU
from Headquarters
● A3
National Pre-Arb Settlement. When an employee has partially
overcome a compensable disability, the USPS must make every
effort toward assigning the employee to limited duty consistent
with the employee’s medically defined work limitation tolerances
(see 546.32). In assigning such limited duty the USPS should
minimize any adverse or disruptive impact on the employee.
The following considerations must be made in effecting such
limited duty assignments.
(continued)
121
Created by APWU Human Relations Department Director, Sue Carney
LETTERS, MOUs AND STEP
4 DECISIONS
(continued)
● A4
Step 4 Decision. Grievant has been determined medically
unable to perform the duties of a letter carrier. As he has
declined the opportunity to be permanently reassigned to
duties which he can perform in another Craft the employer
has no alternative, at this time, other than to consider his
separation from the Postal Service for reasons of disability.
However, he is not precluded from filling an application for
disability retirement if he should choose to do so.
● A5
National Pre-Arb Settlement. Full-time regular employees
on limited duty will not be scheduled day-to-day with varying
reporting times.
(continued)
122
Created by APWU Human Relations Department Director, Sue Carney
LETTERS, MOUs AND STEP
4 DECISIONS
(continued)
● A6
Letter from USPS Labor Relation at Headquarters. States
that local management will Instruct employees on light or
limited duty to perform only duties which are permitted by
the instructions of the physician
●
Step 4 Decision. An employee may be required to report
an accident on the day it occurs however completion of the
appropriate forms will be in accordance with applicable rules
and regulation and need not be on the day of the accident
A7
(continued)
123
Created by APWU Human Relations Department Director, Sue Carney
LETTERS, MOUs AND STEP
4 DECISIONS
(continued)
● A8
Management Instruction EL5409. Job-Related First Aid Injures
● A9
Letter from USPS Labor Relations at Headquarters. OWCP Use
of Medical Reports Submitted by employing Agencies
● A10
Step 4. The following procedures apply only to fitness-for-duty
determinations incident to an on-the-job injury or illness.
Fitness-for-duty determinations for other purposes are not
covered by this instruction.
● A11
Step 4. Management's instructions requiring employees on
limited duty to pick up CA-8 forms during daytime hours at the
Injury Compensation Office violates the National Agreement.
The said Forms will be made available to employees in limited
duty status on all tours.
(continued)
124
Created by APWU Human Relations Department Director, Sue Carney
LETTERS, MOUs AND STEP
4 DECISIONS
(continued)
● A12 Step 4. Whether management’s assignment of limited duty
In this case violated the provisions of ELM, Section 546.14
● A13
MOU between APWU, USPS and NALC. For example, if a
letter carrier craft employee is given a limited duty assignment
in the clerk craft, and grieves that assignment, the employee
will be represented by the NALC. If a clerk craft employee is
given a limited duty assignment in the letter carrier craft, and
grieves that assignment, the employee will be represented by
the APWU.
(continued)
125
Created by APWU Human Relations Department Director, Sue Carney
LETTERS, MOUs AND STEP
4 DECISIONS
(continued)
● A14
Step 4. Letter from USPS. The union alleges that
management discriminates against employees injured off duty
in violation of Article 13 of the collective bargaining agreement,
when limited-duty assignments are granted preference over
light-duty assignments
● A15
Step 4. The issue in this grievance is whether management
violated the National Agreement when it used a locally developed
form to supplement the data provided on Form 3996
● A16
Step 4. Use of locally generated forms
● A17
Step 4. Even if you are injured and an outside party wants to
pay for the medical expenses you must still fill out compensation
forms
(continued)
126
Created by APWU Human Relations Department Director, Sue Carney
LETTERS, MOUs AND STEP
4 DECISIONS
(continued)
● A18 Step 4. It is agreed that an employee cannot be required
or compelled by the Postal Service to undergo a scheduled
medical examination and/or treatment, during nonworking hours.
● A19 Step 4. Whether employees on light duty or limited duty
may sign the Overtime Desired list.
● A20 Step 4. Completion of PS Form 2488 by the employee is
voluntary
● A21 Step 4. CA-17 is usually adequate for medical information
on an injured employee Completion of PS Form 2488 by
the employee is voluntary
(continued)
127
Created by APWU Human Relations Department Director, Sue Carney
LETTERS, MOUs AND STEP
4 DECISIONS
(continued)
● A22 Step 4. Whether management may require an employee to
complete PS Form 3971 to receive Continuation of Pay (COP)
● A23 Step 4. Are limited duty employees covered by the collective
bargaining agreement
● A24 Step 4. Whether management violated the Agreement when,
the grievant was permanently reassigned work in another craft.
(continued)
128
Created by APWU Human Relations Department Director, Sue Carney
LETTERS, MOUs AND STEP 4
DECISIONS
(continued)
●
A25 Step 4. Management removing employees permanently
from their bid while on Limited duty
●
A26 Step 4. Whether management violated the National
Agreement when it withdrew the grievant from limited duty
and issued a Notice of Proposed removal
● A27
129
Letter from USPS Labor Relation at Headquarters.
Discipline for safety rules violations
Created by APWU Human Relations Department Director, Sue Carney