540 Injury Compensation Program

541 Overview

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.

542.11 Traumatic Injury

542.111 Notice

The notice of traumatic injury is given on Form CA-1.

542.112 Time Limit

FECA requires that written notice of a traumatic injury be given by the

employee, or person acting on behalf of the employee, within 3 years of the

injury. However, failure to give notice on Form CA-1 within 30 calendar days

from the date the injury occurred will result in a loss of entitlement to COP

and may also result in a loss of compensation rights if the claim for

compensation is not filed within 3 years. In order to protect their own

interests and to ensure an uninterrupted income, employees should give

notice or have someone give notice on their behalf, immediately after the

traumatic injury occurs.

542.12 Occupational Disease or Illness

542.121 Notice

The notice of occupational disease or illness is given on Form CA-2.

542.122 Time Limit

FECA specifies that notice be given by the employee, or person acting on

behalf of the employee, within 3 years of the onset of the condition. In cases

of latent disability, the time for filing the claim does not begin to run until the

employee has a compensable disability and is aware, or reasonably should

be aware of the causal relationship between the disability and the

employment. Failure to give notice within this time period may result in a loss

of compensation rights. If the claim is not filed within 3 years, compensation

may still be allowed if notice of injury was given within 30 days or the

employer had actual knowledge of the injury or death within 30 days after

occurrence. This knowledge may be evidenced by written records or verbal

notification.

Note: Continuation of regular pay is not applicable in instances of

occupational disease or illness.

542.13 Recurrence

542.131 Notice

The notice of recurrence is given on Form CA-2a.

542.132 Time Limit

A specific time limit for giving the notice of recurrence is not specified by

FECA. The recurrence should be reported by the employee if it causes the

employee to lose time from work and incur a wage loss or if the employee

experiences a renewed need for treatment after previously being released

from care.

542.2 Evidence Required

542.21 General

Forms CA-1, CA-2, CA-2a, CA-5, and CA-5b describe the evidence required.

The evidence submitted must be reliable, probative, and substantial. The

employee is responsible for establishing that five requirements have been

met for a claim to be accepted. The five requirements are:

a. The claim was filed within the time limits specified by FECA.

b. The injured person was, at the time of injury, an employee of the United

States as defined in 5 U.S.C. 8101.

c. The fact that an injury, disease, or death occurred.

d. The injury, disease, or death occurred while the employee was in the

performance of duty.

e. The medical condition for which benefits are claimed is causally related

to the claimed injury, disease, or death.

542.22 Medical Reports

The employee is responsible for submitting a medical report from the

attending physician. (See 545.5 and 545.51 for requirements of medical

reports and rules governing submission to OWCP.)

542.23 Disability

The employee must submit medical evidence to substantiate any claimed

disability.

In COP cases, the employee must ensure the following:

a. That medical evidence supporting disability resulting from the claimed

traumatic injury, including a statement as to when the employee can

return to his or her date-of-injury job, is provided to the control office or

control point within 10 calendar days after the claim for COP is filed.

b. That the treating physician specifies work limitations and provides

them to the control office or control point and representatives of

OWCP.

543.3 Medical Care

FECA guarantees the employee the right to an initial choice of physician. The

employee is entitled to receive all medical services, appliances, or supplies

that a qualified physician prescribes and OWCP determines necessary to

treat the injury. For continued payment of medical expenses by OWCP, a

change of the employee’s initial choice of physician is permitted only with

OWCP approval. Referrals for further examination, testing, or medical

care by the physician designated on the Form CA-16 are covered. (See 545.4 for

implementing medical care.)

543.4 Continuation of Regular Pay or Leave for Disabling Injuries

If the injury is disabling, an eligible employee may elect to have regular pay

continued for up to 45 calendar days or to use annual leave or sick leave.

(See 545.72 for explanation of eligibility for COP.)

543.41 Continuation of Regular Pay

For most employees who sustain a traumatic injury, FECA provides that the

employer must continue the employee’s regular pay during any periods of

resulting disability up to a maximum of 45 calendar days (see 545.72 for

explanation of eligibility for COP). Such pay is subject to taxes and all other

usual payroll deductions. If an employee elects COP and the claim is

subsequently denied, any COP granted to the employee must be charged to

sick or annual leave or considered an overpayment of pay at the employee’s

option (see 437).

543.42 Sick or Annual Leave

The following provisions apply:

a. The use of annual or sick leave does not extend the 45-calendar-day

COP period, which begins with the first period of time lost after the day

or shift of injury.

b. Leave is limited to the amount that the employee has accrued.

c. An employee may subsequently request COP in lieu of previously

requested sick and/or annual leave, subject to leave carryover

provisions. However, such a request must be made within 1 year of the

date that leave is used, or within 1 year of the date OWCP approves the

claim, whichever is later.

d. An employee who elects to use sick or annual leave during the 45-day

period in which COP is available is not entitled to buy back that leave

with later compensation payments.

e. Pay that is attributable to the leave period is subject to taxes and other

usual payroll deductions.

f. An employee may use sick or annual leave after the COP period

expires or during a period of disability due to an occupational disease

or illness. In such cases, the employee may be entitled to buy back the

leave with compensation payments (see 512.923 and 545.84). The

buy-back must be initiated within 1 year of the return, or within 1 year

of the date OWCP approves the claim, whichever is later. Only

employees who are on the rolls of the Postal Service may buy back

leave.

545.51 Medical Report Requirements

The medical report should include:

a. Dates of examination and treatment.

b. History given by the employee.

c. Physical findings.

d. Results of diagnostic tests (MRI, CAT scans, etc.).

e. Diagnosis.

f. Course of treatment.

g. A description of any other conditions found but not due to the claimed

injury.

h. The treatment given or recommended for the claimed injury.

i. The physician’s opinion, with medical reasons, as to causal

relationship between the diagnosed conditions and the factors or

conditions of the employment.

j. The extent of disability affecting the employee’s ability to work due to

the injury.

k. The prognosis for recovery.

l. All other material findings.

545.7 Continuation of Pay by the Postal Service

545.71 General

FECA provides that the employer must continue regular pay during periods

of disability up to a maximum of 45 calendar days for eligible employees who

sustain traumatic injuries. Employees are not required to use their own sick

or annual leave, unless the provisions of 545.73 or 545.74 apply.

545.72 Eligibility

545.721 Initial Disability for a Traumatic Injury

To be eligible for COP, an employee must:

a. Have a traumatic injury.

b. File Form CA-1 within 30 days of the date of the injury and elect COP.

c. Begin losing time from work within 45 days of the injury.

545.722 Recurrence of Disability

In recurrence of disability cases, an employee is eligible for any balance of

the 45 days of entitlement to COP not used during prior periods of disability

provided that:

a. The employee completes Form CA-2a and elects to receive COP.

b. OWCP did not deny the original claim for disability.

c. The disability recurs and the employee stops work within 45 days of

the time he or she first returned to work following the initial period of

disability.

d. Pay has not been continued for the entire 45 days.

545.723 Exclusions

FECA excludes authorization of COP to members of the following groups:

a. Persons rendering personal service to the United States similar to the

service of a civil officer or employee of the United States, without pay

or for nominal pay.

b. Volunteers.

c. Individuals in work-study programs.

d. Grand or petit jurors (unless otherwise federal employees).

545.724 Employee Responsibility

To ensure continuing eligibility for COP, an employee must:

a. Complete and submit Form CA-1 to the employing agency as soon as

possible, but no later than 30 days from the date the traumatic injury

occurs.

b. Ensure that medical evidence supporting disability resulting from the

claimed traumatic injury is provided to the employer upon receipt from

the attending physician, but no later than 10 calendar days after filing

the claim for COP. The report from the physician must include a

statement as to when the employee can return to the date-of-injury job.

c. Ensure that relevant medical evidence is submitted to OWCP and

cooperate with OWCP in developing the claim.

d. Ensure that the treating physician specifies work limitations and

provides them to the employer.

e. Provide the treating physician with a description of any specific

alternative positions offered by the Postal Service to the employee and

ensure that the treating physician responds promptly to the control

office or control point with an opinion as to whether and how soon the

employee can perform that or any other specific duties.

545.8 Compensation by OWCP for Disability

545.81 Initial Period of Compensation

545.811 Traumatic Injury

If medical evidence shows that disability resulting from a traumatic injury is

expected to continue beyond 45 days of COP and compensation from

OWCP is desired after the expiration of the 45-day period, the employee and

the control office or control point personnel give the employee a Form CA-7

by day 30 of the COP period. The employee completes the front side of the

Form CA-7 and the control office or control point completes the reverse side.

The completed form and any accompanying medical documentation is then

filed with the OWCP district office by day 40 of the COP period.

Note: An employee may file Form CA-7 to claim compensation

for initial periods of disability for which there is no entitlement to COP.

545.812 Occupational Disease or Illness

If the disability is a result of an occupational disease or illness, a Form CA-7

is completed and submitted to OWCP not more than 5 working days after

receipt from the employee.

545.82 Subsequent Periods of Compensation

In instances of either traumatic injury or occupational disease or illness,

subsequent claims of compensation for periods of disability beyond the

initial period of compensation are also made on Form CA-7. Employees are

responsible for submitting the CA-7. Without receipt of such a claim, OWCP

has no knowledge of a continuing wage loss. Therefore, while disability

continues:

a. The employee submits a claim using Form CA-7 every 2 weeks until

the employee is otherwise instructed by OWCP.

b. The employee completes and signs the face of the form and the control

office or control point completes the reverse side.

c. The employee is responsible for submitting or arranging for the

submission of medical evidence in support of the claim (see 545.33

and 545.51).

d. The control office or control point forwards the completed Form CA-7

and any other accompanying medical reports to OWCP within

5 working days upon receipt from the employee.

545.83 Waiting Period

The employee is advised that there is a waiting period of 3 calendar days

before OWCP compensation begins, unless the disability extends beyond

14 calendar days. The 3-day waiting period may not be satisfied by using

sick or annual leave; the employee must be in a nonpay status.

The waiting period applies as follows:

a. In the case of an occupational disease or illness, compensation is not

payable for the first 3 days of disability, unless the disability extends

beyond 14 calendar days.

b. In the case of traumatic injury, the 3-day waiting period begins

immediately after the end of the 45-day COP period, unless the

disability continues for more than 14 calendar days after the expiration

of the 45-day COP period.

545.84 Leave Buy-Back

An employee may use sick or annual leave after the COP period expires, or

during a period of disability due to an occupational injury. In such cases, the

employee may be entitled to buy back the leave with compensation

payments (see 512.923). The control office is responsible for informing

employee, in writing, that:

a. The buy-back must be initiated within 1 year of the return to duty, or

within 1 year of the date OWCP approved the claim, whichever is later.

b. Employees who are being separated because of disability or other

reasons cannot buy back leave after they are off the rolls of the Postal

Service.