The Federal Employees’ Compensation Act (FECA) established the workers’ compensation program for federal government employees. The U.S. Department of Labor administers the FECA program. Within the Department of Labor, the Office of Workers’ Compensation Program (OWCP) is responsible for the adjudication of claims. FECA covers all Civilian Mariners of MSC, except employees who are ill/injured while on authorized or unauthorized leave or, due to willful misconduct; intoxication, self-inflicted or intentional injury or death.
If you incur a work-related injury or occupational illness/disease while in a pay and duty status, either attached to a ship, assigned by MSC to a school or in the CSU awaiting an assignment, you may file for Workers’ Compensation. A traumatic injury is defined as a wound or other condition of the body caused by sudden external force. Work-related injuries must be filed within three years from the date of injury. However, if the claim is not filed within three years, compensation may still be paid, if written notice of injury was given within 30 days.
Filing Worker’s Compensation Claims
The claim must identify the time, place of occurrence, and member of the body affected. Occupational Illness/Disease must have occurred, over time, in the performance of your duties and be causally related to the factors of employment. You should immediately report all injury/occupational notifications to your supervisor and seek medical care from the Medical Service Officer (MSO) onboard ship. If you require further medical treatment, the front of the Form CA-16 should be completed by your supervisor within four hours of the request, unless more than a week has passed since the injury; if medical treatment was verbally authorized beforehand, the CA-16 should be completed within 48 hours of initial treatment and forwarded to the medical facility.
An employee who sustains a job-related traumatic injury may be entitled to receive Continuation of Pay (COP) for a period not to exceed 45 calendar days, which includes Saturdays, Sundays and holidays. COP is the continuation of an injured employee’s regular pay for up to 45 calendar days with no charge to sick or annual leave. Your responsible Injury Compensation Program Administrator (ICPA) authorizes COP, and it is paid by the agency payroll office without interruption.
Benefits and/or Compensation is payable to a claimant through the DOL for lost wages, a loss of wage-earning capacity, a permanent physical impairment, medical treatment, medical examinations conducted at the request of OWCP as part of the claims adjudication process, and vocational rehabilitation services, as well as, money paid to beneficiaries for an employee’s death, services of an attendant and funeral expenses but, does not include COP.
As soon as your physician declares you fit for duty, your medical status will be reviewed by the agency Fleet Medical Officer (FMO) and a determination of fit for full duty at sea will be rendered. You will then be restored back to duty. FECA authorizes medical treatment for any condition which is causally related to factors of Federal employment. A case may remain open even after the employee has returned to full duty, to allow for the payment of medical expenses related to the accepted condition as determined by OWCP.
When Filing a Claim
- Report the incident to your supervisor right away.
- Obtain first aid or medical treatment and fill out the appropriate claim forms.
- Establish the essential elements of your claim by meeting the “burden of proof” such as: timely filing of the claim; the injury occurred as reported; the injury was in the performance of duty; and your condition or disability is related to the injury or factors of your employment.
- File your claim for compensation with your ICPA listed below.
- Return to work as soon as allowed by your physician and the FMO.
- Contact the CSC at 800-793-5784 to reach your Injury Compensation Program Administrator (ICPA)
- There are many questions that pertain to this topic. Here is the FAQ resource for the most current and updated information managed by the Department of Labor.
- All forms needed for FECA and required by the Office of Workers Compensation (OWCP) can be found here.
The Claimant Query System (CQS)
The CQS is designed to provide injured workers with 24-hour access to their case file status; accepted conditions; address of record; compensation claim status; and compensation payments, dates, and periods covered. The CQS also provides specific information on medical billings, reimbursement requests, eligibility and authorization inquiries.
The CQS guide will explain how to use the CQS Portal.
Access the CQS via the ACS Portal.
The HIPAA Privacy Rule does not apply to entities that are either workers’ compensation insurers, workers’ compensation administrative agencies, or employers, except to the extent they may otherwise be covered entities. However, these entities need access to the health information of individuals who are injured on the job or who have a work-related illness to process or adjudicate claims, or to coordinate care under workers’ compensation systems. Generally, this health information is obtained from health care providers who treat these individuals and who may be covered by the Privacy Rule. The Privacy Rule recognizes the legitimate need of insurers and other entities involved in the workers’ compensation systems to have access to individuals’ health information as authorized by State or other law. Due to the significant variability among such laws, the Privacy Rule permits disclosures of health information for workers’ compensation purposes in a number of different ways. Find specific disclosures regarding HIPAA here.