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540 Injury Compensation Program

541 Overview

541.1 Background

541.11 Law

Under the provisions of the Postal Reorganization Act, 39 U.S.C. 1005 (c), all employees of the United States Postal Service are covered by the Federal Employees' Compensation Act (FECA), 5 U.S.C. 81.

541.12 Administration

FECA is administered by the Office of Workers' Compensation Programs (OWCP), United States Department of Labor. OWCP determines whether the employee, or a survivor of the employee, is entitled to benefits under FECA. The director of OWCP and his or her designees have the exclusive authority to administer, interpret, and enforce the provisions of the Act.

541.13 Coverage

541.131 Disability

FECA provides that employees who suffer job-related disabilities are entitled to:

a. Continuation of pay (COP) for the period of the disability, up to a maximum of 45 calendar days, for a traumatic job-related injury (see 541.2d).

b. Compensation for wages lost as a result of job-related injury or disease or illness.

c. Medical care for disability due to:

(1) Personal injuries sustained while in the performance of duty.

(2) Diseases proximately caused, aggravated, or accelerated by postal employment.

d. Vocational rehabilitation.

541.132 Death

FECA provides for payment of monetary compensation to specified survivors of an employee whose death results from a work-related injury or occupational disease or illness and payment of certain burial expenses subject to the provisions of 5 U.S.C. 8134.

541.133 Schedule Awards

Compensation is provided for the permanent loss, or loss of use, of each of certain members, organs, and functions of the body.

541.14 Privacy Act

Injury compensation records are maintained by the Postal Service within the privacy system of records identified as USPS 120.098 (OWCP Record Copies). (See 314 for a full explanation of injury compensation case files.)

541.2 Definitions

Except where the content clearly indicates otherwise, the following definitions apply:

a. Benefits or compensation - any of the following:

(1) Money paid to claimants by OWCP because of loss of wages or earning ability.

(2) Money paid in the form of schedule awards (e.g., loss of finger).

(3) Money paid as reimbursement for medical diagnostic and treatment services supplied under FECA.

(4) Money paid as reimbursement for the replacement or repair of medical braces, artificial limbs, and other prosthetic devices, and for time lost while such devices or appliances are being replaced or repaired. However, a claim is not appropriate for the replacement or repair of eyeglasses and hearing aids except as provided in 541.2h.

(5) Money paid to specified survivors of employees whose death is job-related.

(6) Certain payments to individuals who are participating in an approved vocational rehabilitation program.

b. Claim - an assertion, in writing, of an individual's entitlement to benefits under FECA. This claim must be submitted on a form as required by 542. A claim may be filed for a traumatic injury, an occupational disease or illness, or death.

c. Claimant - an individual whose claim for benefits and/or compensation has been filed in accordance with FECA and the provisions of 542.

d. Continuation of pay (COP) - continuation of the employee's regular pay for a period of 45 calendar days. The first COP day is the first day disability begins following the date of injury (except where the injury occurs before the beginning of the work day or shift, in which case the date of injury is charged to COP). COP can be received only if the disability begins within 45 days of the date of the injury or within 45 days from the date the employee first returns to work following the initial period of disability. Examples are as follows:

(1) If an employee is called in ahead of the employee's scheduled tour, is injured during the call-in period, and is unable to continue to work due to the injury, the 45-calendar-day period begins at the start of the scheduled tour.

(2) If an employee is injured during the scheduled tour and is unable to work due to the injury, the 45-calendar-day period begins on the next calendar day.

(3) If an employee works only a portion of a day or tour (other than the day or tour when the injury occurred), that day or tour is counted as 1 calendar day toward the 45-day period.

e. Control office - a unit staffed with an Injury Compensation manager and human resources specialists responsible for injury compensation program administration.

f. Control officer - the Injury Compensation manager who heads the control office and manages the administration of the injury compensation program within a performance cluster.

g. Control point - an individual who is designated by the district manager and/or installation head to coordinate claim management activity with the control office and is one of the following:

(1) A human resources specialist if an injury compensation unit is available and staffed.

(2) The postal physician or occupational health nurse administrator if an occupational health services office is available and staffed.

(3) An appropriate designated supervisor (full-time or collateral duty).

h. Injury - a traumatic injury (see 541.2r) or an occupational disease or illness (see 541.2j), including damage to or destruction of medical braces, artificial limbs, and other prosthetic devices. The term does not include the damage or destruction of eyeglasses and hearing aids, unless the damage or destruction is a direct result of a personal job-related injury requiring medical services.

i. Monthly pay - the greatest of the following:

(1) Monthly pay at the time of injury.

(2) Monthly pay at the time disability begins.

(3) Monthly pay at the time compensable disability recurs if the recurrence begins more than 6 months after the injured employee resumes full-time employment with the Postal Service or other government agency.

j. Occupational disease or illness - an illness or disease produced by one of the following:

(1) Systemic infections.

(2) Continued or repeated stress or strain.

(3) Exposure to toxins, poisons, fumes, etc.

(4) Other continued and repeated exposure to conditions of the work environment over a longer period of time than a single day or work shift.

k. Occupational health nurse administrator - a career postal or contract occupational health nurse who, at the district level, is responsible for the oversight and management of the medical and occupational health services.

l. Official supervisor - an individual who is responsible for the supervision, direction, or management of employees.

m. Physician - any surgeon, podiatrist, dentist, clinical psychologist, optometrist, chiropractor, or osteopathic practitioner used within the scope of his or her practice as defined by state law. Exceptions are as follows:

(1) Chiropractors are included only to the extent that their reimbursable services are limited to treatment to correct a spinal subluxation as demonstrated by X ray to exist.

Note: "Subluxation as demonstrated by X ray to exist" must appear in the chiropractor's report for OWCP to consider payment of a chiropractor's bill. Also, a chiropractor may provide physical therapy under the direction of a physician.

(2) Clinical psychologists serve as physicians within the scope of practice as defined by state law. Unless the state law allows clinical psychologists to treat physical conditions, a clinical psychologist may not serve as a physician when a condition includes a physical component.

(3) Naturopaths, faith healers, and other practitioners of the healing arts are not recognized as physicians within the meaning of FECA.

n. OWCP - the Office of Workers' Compensation Programs, Employment Standards Administration, of the Department of Labor.

o. Postal physician - a Postal Service physician, medical designee, or contract physician.

p. Recurrence of disability - an employee's inability to work, after return to work, that is caused by a spontaneous change in the employee's medical condition and is related to a previous injury or illness without intervening injury or new exposure.

q. Recurrence of medical condition - a documented need for further medical treatment after release from treatment for the accepted condition or injury when there is no work stoppage.

r. Traumatic injury - a condition of the body caused by external force, including stress or strain. The injury:

(1) Must be identifiable as to time and place of occurrence and member or function of the body affected.

(2) Must be caused by a specific event or incident, or series of events or incidents, within a single day or work shift.

541.3 Forms

Each installation head must maintain an adequate supply of the following basic forms, which are needed for recording and reporting injuries: