Supervisor’s Guide to Technician On-The-Job Injuries Documents/ORNGTPP 810 - Supv Guide to...

ORNG TPP 810

Human Resources

Supervisor’s Guide to Technician On-The-Job Injuries

Joint Force Headquarters Oregon National Guard 01 January 2005

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ii ORNG TPP 810 01 January 2005

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i ORNG TPP 810 01 January 2005

Oregon National Guard ORNG TPP 810 Joint Force Headquarters Salem, OR 01 January 2005

Human Resources

Supervisor’s Guide to On-The-Job Injuries By Order of the Governor: RAYMOND C. BYRNE JR. Brigadier General Acting Adjutant General Official: BRUCE A. MARSHALL COL, ORANG Chief of Joint Staff History. This publication is new to the Oregon National Guard (ORNG).

Summary. This Pamphlet describes how technician on-the job injuries are reported, how compensation claims are processed and what entitlements are due for injuries or death. It also describes penalties for fraudulent claims. Applicability. This pamphlet applies to all Oregon National Guard Federal Technicians. Proponent and exception authority. The proponent for this regulation is the Director of Manpower and Personnel (J1). The Director has authority to approve exceptions to this regulation that are consistent with controlling law and regulation. The Director may

delegate this approval authority in writing, to a branch chief or specialist in the proponent office. Suggested Improvements. Users are invited to send comments and suggested improvements to: Joint Force Headquarters - Oregon, ATTN: J1/HR, PO Box 14350, 1776 Militia Way, Salem, OR 97309-5047. Distribution. This publication is available through links on several ORNG web sites or in print media, through the JFHQ-OR-J1-Human Resources Office (J1-HRO) at 503-584-3975.

Contents Section 1 – General Provisions Purpose 1-1, page 1 References 1-2, page 1 Explanation of abbreviations and terms 1-3, page 1 Responsibilities 1-4, page 1 Coverage 1-5, page 2 Basic Claim Criteria 1-6, page 2 Penalties for Fraudulent Claims 1-7, page 3 Section 2 – Required Forms Forms Required, page 3 Section 3 – Technician Injury Benefits Technician Benefits Resulting from On-The-Job Injury 3-1, page 3 Medical Benefits 3-2, page 4 Continuation of Pay (COP) 3-3, page 4 Disability Compensation 3-4, page 5 Schedule Awards 3-5, page 6 Vocational Rehabilitation 3-7, page 6 Attendant Allowance 3-8, page 6 House and Vehicle Modification 3-9, page 7

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Partial Disability Compensation 3-10, page 7 Section 4 – Technician Death Benefits General 4-1, page 7 Summary of Technician Death Benefits 4-2, page 7 Section 5 – Third Party Liability and Appeals General 5-1, page 8 Hearings & Appeals 5-2, page 8 Exclusiveness of Remedy 5-3, page 8 Penalties for Employees & Supervisors 5-4, page 8 Section 6 – Initiating Claims Traumatic Injury 6-1, page 9 Occupational Disease 6-2, page 9 Recurrence of Disability 6-3, page 10 Death Claims 6-4, page 11 Section 7 – Computing Compensation Compensation Payments 7-1, page 11 Compensation Checks 7-2, page 11 Section 8 – Buyback of Leave Leave Repurchase 8-1, page 12 Repayment of Paid Leave 8-2, page 12 Section 9 – Using Leave Instead of COP 45-Day Entitlement 9-1, page 12 Changes in Leave Election 9-2, page 12 Section 10 – Controversion Supervisor Responsibilities 10-1, page 13 Section 11 – Light Duty Program General 11-1, page 13 Procedures 11-2, page 13 Appendix A References, page 15 Appendix B Summary Procedures for Submitting OWCP Forms, page 17 Appendix C Technician Traumatic Injury Claim Quick Reference Checklist, page 20 Appendix D Technician Occupational Disease Claim Quick Reference Checklist, page 22 Figure List Figure 2-1 Department of Labor Forms, page 3 Glossary, page 24

1 ORNG TPP 810 01 January 2005

Section 1 General Provisions 1-1. Purpose a. This handbook covers Federal Technicians, both Dual Status and Non Dual Status, employed by the Oregon National Guard under provisions of 32 USC 709. Federal Technicians are authorized medical care and other entitlements, to include monetary compensation for wage loss due to a job-related injury, or disease sustained while in performance of duty. These entitlements are part of the Federal Employee’s Compensation Act (FECA). The FECA also provides benefits to dependents if a job-related injury or disease causes your death. The Act is intended to be remedial and proceedings under it are not adversarial in nature. Benefits provided constitute the sole remedy against the U.S. Government for a work related injury/death; i.e., an employee or surviving dependent is not entitled to sue the U.S. Government or recover damages for such injury or death under any other statute. b. This pamphlet is an important resource for Supervisor’s and it provides enough detail to cover most any circumstance that would result in a workman’s compensation claim. The supervisor can contact the Human Resources Office (HRO) Employee Relations Specialist for clear guidance on any supervisor actions and/or benefit associated with a workman’s compensation claim. However, the supervisor does not have time to contact the HRO when a traumatic injury occurs. c. The most common action a supervisor must do without the aid of a Human Resources Specialist is initiating an on-the-job injury claim as quickly as possible after a Technician is injured. The Supervisor’s timely initiation of a claim will help the injured Technician access care quickly and lessen any worry that there will be excessive out-of-pocket expenses. d. When the supervisor is finished reviewing this handbook, he or she should make up one or two “Traumatic Injury Response Folders” with appropriate blank forms and instructions to be used when an accident occurs. The folders should be easily accessible to the supervisor or an alternate when the supervisor is not available. The folders should contain the “Technician Traumatic Injury Claim Quick Reference Guide” and blank forms indicated on the checklist. The checklist is Appendix 2 to this pamphlet. 1-2. References Required and related publications and prescribed and referenced forms are listed in appendix A 1-3 Explanation of abbreviations and terms Abbreviations and special terms used in the regulation are referenced in the glossary 1-4 Responsibilities a. Supervisors: Supervisors will maintain an adequate supply of forms required for the proper recording and reporting of injures. Each of these forms contains a portion that the supervisor needs to complete. Forms are available through normal distribution channels or at this web address in PDF format: http://www.dol.gov/esa/regs/compliance/owcp/forms.htm b. Initiating claims

(1) Traumatic Injury Claim: The Employee, Supervisor, and HRO will accomplish the responsibilities outlined in paragraph 6-1. (2) Occupational Disease Claim: The Employee, Supervisor, and HRO will accomplish the responsibilities outlined in paragraph 6-2. (3) Recurrence of Disability Claim: The Employee, Supervisor, and HRO will accomplish the responsibilities outlined in paragraph 6-3.

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(4) Death Claim: The supervisor will accomplish the responsibilities outlined in paragraph 6-4. (5) Controversion: The supervisor will accomplish the responsibilities outlined in paragraph 10-1. 1-5. Coverage A technician is covered by FECA any time they are working in a technician status. In addition, a technician is within the scope of employment when performing authorized travel in a duty or temporary duty status in any conveyance even if the requirement to travel is not included in the technician's job description. This however, does not include travel to and from work, while off the premises for lunch, while in a military travel status or during state active duty. Nevertheless, such cases must be judged on their own merits, and the final authority for such decisions is the Office of Worker's Compensation (OWCP). 1-6. Basic Claim Criteria To qualify for benefits, technicians or their survivors must establish that the injury or technician’s death met the following requirements:

a. Timeliness: The law provides that a claim for compensation must filed within 3 years of the injury or death by the technician or their representative. Even if the claim is not filed within 3 years, compensation may still be allowed if written notice of injury was given in 30 days or the immediate supervisor had actual knowledge of the injury or death within 30 days of the occurrence.

b. Civil Employee: Coverage is for all permanent and temporary dual and non-dual status technicians within the Oregon National Guard.

c. Fact of Injury: It must be established that the technician in fact sustained an injury or disease. Two factors are involved in this determination. Did the technician actually experience the accident, event, or employment factor that is alleged to have occurred? This is resolved based on factual evidence, including statements from the employee, the supervisor, and any witnesses. An injury need not be witnessed to be compensable. Did the accident or employment factor result in an injury or disease? This is determined based on the attending physician’s statement that a medical condition is present that could be related to the incident, though the medical report need not relate the condition to the incident. Simple exposure, for instance to a contagious condition or dusty environment, does not constitute an injury.

d. Performance of Duty: If the first three criteria have been accepted, it must be determined whether the employee was engaged in the performance of duty when the injury occurred. The question of where and when the accident, event or employment factor(s) leading to filing of a claim occurred must be studied. For example, an employee who is injured on the job during working hours is covered. Coverage includes injuries, which occur while performing assigned duties. Coverage also includes such activities as the use of facilities for the employee's comfort, health, and convenience as well as eating meals and snacks provided on the premises. The premises include areas immediately outside the building, such as steps or sidewalks, if they are Federally owned or maintained. Coverage is extended to employees who are on the premises for a reasonable time (usually considered 30 minutes) before or after working hours. It is not extended, however, to employees who are visiting the premises for non-work-related reasons. The supervisor should verify the time of the injury and provide any information it has about the employee's purpose in being on the premises at the time of injury.

e. Causal Relationship: The causal relationship between the condition claimed and the injury or disease sustained is examined. This factor is based entirely on medical evidence provided by physicians who have examined and treated the employee. Sometimes the circumstances of a case raise the issues of willful misconduct, intention to bring about the injury or death of oneself or another, or intoxication. If any of these factors are established as the cause of injury or death,


benefits must be denied. This factor is based entirely on medical evidence provided by physicians who have examined and treated the employee. Opinions of the employee, supervisor or witness are not considered, nor is general medical information contained in published articles 1-7. Penalties for Fraudulent Claims Title 20, Code of Federal Regulations (CFR), Section 10.23 provides that:

a. Any person who knowingly makes, or knowingly certifies to any false statement, misrepresentation, or act of fraud with respect to a claim under the FECA may be subject to punishment by a fine of not more than $10,000 or imprisonment for any more than 5 years, or both.

b. Any person who, with respect to a claim under the FECA, enters into any agreement or conspiracy to defraud the Government, or aiding to obtain payment of any false, fictitious or fraudulent claim may be punished by a fine of not more than or imprisonment for not more than 10 years, or both.

c. Any person charged with the responsibility of making reports in connection with an injury who willfully fails, neglects, or refuses to do so; induces, compels or directs an injured technician to forego filing a claim; or willfully retains any notice or report required in connection with an injury, is subject to a fine of not more than $500 or imprisonment for not more than 1 year, or both.

Section 2 Required Forms The basic forms required for processing personal injury claims and reports are listed below. Included with each of these forms are detailed instructions for completing them. If additional assistance is needed to complete these forms, contact the Human Resource-Employee Relations Specialist HR-ERS at the Oregon Military Department:

Figure 2-1 Department of Labor Forms

DOL Form Form Name

CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation

CA-2 Notice of Occupational Disease and Claim for Compensation CA-2a Notice of Recurrence of Disability and Claim for Pay/Compensation CA-3 Report of Termination of Disability/or Payment CA-5 Claim/Compensation by Widow/Widower and Children CA-5b Claim/Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren CA-6 Official Superior's Report of Employee's Death CA-7 Claim for Compensation for a Traumatic Injury CA-16 Request for Examination and/or Treatment CA-17 Duty Status Report CA-20 Attending Physician’s Report CA-20a Attending Physician’s Supplemental Report

Section 3 Technician Injury Benefits 3-1. Technician Benefits Resulting From an On-The-Job Injury Technicians are eligible for six basic types of benefits under this program. They are: Medical benefits (including transportation expenses incurred); Continuation of Pay; Disability


compensation; Schedule awards; Vocational rehabilitation. The program applies to any disability (temporary or permanent, partial or total) incurred because of a job-related disease or condition, as well as an on-the-job traumatic injury. 3-2. Medical Benefits

a. Payment may be made for any medical services needed for treatment or to counteract or minimize the effects of any condition, disease, or injury determined to be causally related to employment with the Federal Government. There is no limit on the extent of medical treatment payable nor is there a time limit for which they are payable if the need for medical treatment can be substantiated and connected to the employment-related injury or disease. However, fee schedules do apply to many charges and balances from fee reductions cannot be collected from the employee. Payment will be made for first aid, medical treatment, hospitalization, physician's fees, drugs, appliances, or other supplies directed for use by a qualified physician. Bills must be submitted within 1 year of the date of service, one year beyond the calendar year in which the expense was incurred, or 1 year beyond the calendar year in which the claim was accepted, whichever is later, or they will not be paid.

b. Technicians may elect to be treated by a government physician (if available) or by a duly qualified physician of his or her choice who is not excluded. Although payment for preventative treatment is generally not provided, payment may be made for certain specified conditions even though such treatment is designed, in part, to prevent further injury. The specific conditions when payment may be made include: complications of preventative measures that are provided or sponsored by the Agency, such as an adverse reaction to a prophylactic immunization; actual or probable exposure to a known contaminant due to an injury, thereby requiring disease specific measures against infection such as tetanus antitoxin or booster toxoid injections for puncture wounds; conversion of tuberculin reaction from negative to positive following exposure to tuberculosis in the performance of duty; and where injury to one eye has resulted in loss of vision, periodic examination of the uninjured eye to detect possible sympathetic involvement of the uninjured eye at an early stage. Any change in treating physician after the initial choice must be authorized by OWCP; otherwise OWCP will not be liable for the expenses of treatment. 3-3. Continuation of Pay (COP)

a. The intent of Continuation of Pay (COP) is to eliminate interruption of the technician’s income while the claim is being adjudicated. A technician who sustains a disabling, job-related traumatic injury is entitled, under certain circumstances, to COP for a period not to exceed 45 calendar days pending OWCP's determination of the employee's claim for compensation under FECA. COP is paid by the agency at no charge to the technician’s leave account. COP is allowed on any traumatic injury cases resulting in loss time due to a disabling injury and/or need to seek medical care. COP is not considered compensation; therefore, it is subject to income tax and other payroll deductions. Other benefits provided during the 45 day COP entitlement period, such as medical care/transportation, etc., are considered compensation.

b. COP Eligibility: To qualify for COP, the injured technician or someone authorized to act on their behalf must complete a CA-1 within 30 calendar days of the injury and provide written medical information to support this claim within 10 calendar days of submitting the CA-1.

c. Military Drill Pay: COP for federal military technicians may also include drill pay and/or annual field training pay. For example an injured technician may miss a weekend of drill within the 45 calendar days of COP. Since drill dates and annual training periods vary, the amount of lost pay due an injured employee is calculated to include the average drill and annual training earned the year prior to the injury. This information can be obtained by contacting the military pay technician who handles the injured technicians military pay. Upon receipt of this information, the injured worker should forward a copy to the HR-ERS.


d. COP – the 45-Calendar Day Period: COP is the continuation of an injured technician’s regular pay for up to 45-calendar days with no charge to sick or annual leave. COP is charged in full days, includes weekends, and holidays.

e. COP Computation: The 45 days begin according to the appropriate one of the three rules provided below:

• If the injury occurs before the start of the technician’s duty day, the first day charged to COP is the date of the injury

EXAMPLE: A technician whose duty day begins at 8:00 A.M. is injured while entering the building at 7:50 A.M. on Tuesday. Tuesday would be the first day of COP.

• If the injury occurs during the technician’s duty day and there is an immediate time loss, the first day charged to COP is the first calendar day after the date of injury.

EXAMPLE: A technician whose duty day begins at 8:00 A.M. has a traumatic injury at 10:45 A.M. on Tuesday. The technician cannot return to duty for five days. Wednesday would be the first day of COP.

• When the time loss is not immediate, the first day charged to COP is the first day of lost time following the date of injury.

EXAMPLE: A technician is injured at 2:00 P.M. on Tuesday, is examined at a local hospital, and returns to duty after the examination. At 10:00 A.M. on Thursday, the technician returns to the local hospital for a follow-up. In this case, Thursday would be the first day of COP.

f. Recurrence of Disability and COP: If a technician returns to work following the original injury which resulted in work stoppage without using all 45 days of COP, then suffers a recurrence of disability, he/she may elect to use the remaining days of COP if the recurrence occurs within 90 days after the first return to duty date. The technician has 90 days from the first returned to work date, following the first work stoppage due to the original injury, to use any remaining COP entitlement for follow-up medical care and/or disability. Note the 90-day window following the first return to work date applies only if there is a recurrence of disability as defined above. 3-4. Disability Compensation Technicians may be eligible for one or more of several types of wage loss compensation. Disability benefits are classified based on the nature and extent of disability incurred and are categorized as temporary total, temporary partial, permanent total, or permanent partial.

a. Compensation Rates: Generally, in cases of total disability, a technician is entitled to compensation equivalent to two-thirds of the weekly salary if there are no dependents, or three-fourths of the salary if there are one or more dependents. Compensation is tax free. In establishing a person's wage rate, the law recognizes certain additional amounts that may be included in salary, such as premium pay, night and Sunday differential, holiday pay, hazard pay, dirty work pay, quarters allowances and post differential for overseas employees (Lost Drill Pay is included).

b. Duration of Compensation: Compensation payments for total disability may continue as long as the disability continues and suitable modified work is not available; in some instances, for the lifetime of the employee. As with medical care, there is no total dollar maximum or time limitation. A 3-day waiting period applies for which no compensation is payable, except in cases where disability extends more than 14 days or permanent disability results; in such cases, compensation will be paid for the 3 days.

c. Loss of Wage-Earning Capability (LWEC): When an injured technician suffers a wage loss because of disability that is less than total, compensation may be paid for this partial loss of wages or wage-earning capacity. When a claimant has completed 60 days of employment in a suitably modified, formally classified position, the Agency should complete a loss of wage-earning capacity (LWEC) worksheet and request that a formal LWEC rating be issued. If the


position carries a pay rate less than that of the date of injury, compensation will be payable for a loss of wage-earning capacity. Such a formal rating can be changed only under very limited circumstances. 3-5. Schedule Award (S/A)

a. A Scheduled Award (S/A) is compensation provided for permanent loss, or loss of use, partial or total, of certain parts and functions of the body such as arms, legs, hands, feet, fingers, toes, eyes, loss of hearing, and loss of vision. Each extremity or function has been rated for a specific number of weeks of compensation that can be paid in addition to full salary. If a serious disfigurement of the head, face, or neck results from a job related injury, an award may also be made for such disfigurements not to exceed $3,500. Multiple schedule awards may be paid concurrently for different body parts or paid concurrently with the Office of Personnel Management (OPM) retirement benefits. Technician’s can receive schedule award payments concurrently while receiving severance pay for involuntary separation from their employment. Schedule awards can be paid even if the technician returns to work. However, technicians cannot receive wage loss compensation and schedule award benefits concurrently for the same injury. It should be noted that the FECA contains no provision for payment of a schedule award for permanent impairment to the back, heart, or brain. Accordingly, each extremity or function has been rated at a specific number of weeks of payments, which can be paid even if the technician returns to work at full salary.

b. Computation of S/A: Schedule awards are computed by multiplying the specific number of weeks times 66 & 2/3% (no dependents), or 75% (with dependents) of the employee's pay rate. If a claim for wage loss has not been submitted, a CA-7 may be used to initiate a claim for a S/A, or consideration may be requested by narrative letter. However, technicians may not receive wage loss compensation and schedule awards benefits at the same time for the same injury. If a period of temporary total disability is sustained during the course of an award, the award may be interrupted to pay the period of disability. 3-6. Vocational Rehabilitation

a. If the injured technician suffers a vocational handicap due to the injury and cannot resume usual employment, OWCP-directed vocational rehabilitation may be arranged to assist in training for work that the employee can do. Rehabilitation service is supervised by OWCP, but is usually provided in cooperation with State and private rehabilitation Agencies. In addition to the cost of rehabilitation, an employee may qualify for a monthly allowance of up to $200 necessary for his or her personal maintenance.

b. Employees are also entitled to collect total disability payments during their rehabilitation period. When the rehabilitation program is completed, the claimant is expected to actively seek employment. Vocational rehabilitation is not confined to formal retraining. It includes the employment efforts of vocational rehabilitation counselors and compensation specialists. An offer of a position (employment or reemployment) for which an injured employee is medically qualified is usually the more expedient and less costly method of rehabilitation. 3-8. Attendant Allowance Severely injured workers who cannot care for their own physical needs, e.g., feeding, bathing, and dressing, may qualify for an attendant's allowance up to $1500 per month in addition to compensation for wage loss. Required assistance must be personal in nature and attendant allowance cannot be paid for housekeeping services.


3-9. House & Vehicle Modifications A technician whose injury severely restricts mobility and independence in the normal functions of living, permanently or for a prolonged period, may be entitled to house or vehicle modifications; e.g., profound bilateral deafness, blindness, or a total loss of use of limbs such that a prosthesis, wheelchair, or leg brace is required. Modifications must be recommended by attending physician and be consistent with employee's pre-injury standard of living. 3-10. Partial Disability Compensation When evidence shows the technician is no longer totally disabled, steps will be taken by OWCP to effect reemployment. If re-employed, and it is at a job paying less than the original position, or if it is determined that the technician can perform the duties of a specific job deemed suitable, payment will be made based on this loss of wage-earning capacity. This compensation is paid at a rate equal to 66 & 2/3% (without dependents), or 75% (with dependents) of the wage loss difference.

Section 4 Technician Death Benefits 4-1. General Technician death benefits that include allowable funeral benefits and survivor compensation if death was due to job related injuries. 4-2. Summary of Benefits

a. Widow or Widower & No Eligible Child: The widow or widower is eligible for 50 percent of the deceased technician’s regular pay.

b. Widow or Widower with Eligible Children: The widow or widower is eligible for 45 percent of the deceased technician’s regular pay, plus an additional 15 percent for each child -- to a maximum not to exceed 75 percent of the deceased technician’s regular pay.

c. Eligible Children & No Widow or Widower: An orphaned child is eligible for 40 percent of the deceased employee's regular pay, plus 15 percent for each additional orphan - not to exceed 75 percent of the deceased technician’s regular pay. Benefits are divided among the children, share and share alike.

d. Surviving Legal Dependents: If a deceased employee leaves no widow, widower, or child, benefits are paid to the surviving legal dependents of the employee.

e. Remarriage or Death: Widows and widowers receive benefits until death, or remarriage, if they are under age 55. If a widow or widower under age 55 remarries, a lump-sum payment equal to 24 times the monthly compensation he or she is receiving at the time of remarriage is made. If the widow or widower is age 55 or older, compensation continues as long as he or she lives, regardless of remarriage.

f. Orphaned Children: Orphaned children receive benefits until they die, marry, or reach the age of 18. If a surviving child pursues higher education on a full-time basis (generally 12 semester hours) payments will continue until he or she has completed four years of study beyond the high school level or until he or she is 23 years of age. Payment will not extend beyond the semester or enrollment period in which the surviving child reaches 23 or completes his or her fourth year of higher education, whichever occurs first.

g. Funeral Expenses: Up to $800 is paid for a deceased technician’s funeral expenses. If the technician dies away from home, the cost of transporting the body to the place of burial will be paid in full. Also, an additional sum of $200 is paid to the personal representative of the decedent for reimbursement of the expense of terminating the deceased technician’s Federal employment status.


Section 5 Third-Party Liability 5-1. General When the circumstances of the employment-related injury or illness create a legal liability upon a third party other than an employee or activity of the Federal Government, the Government has a subrogation interest (that is, the right to recover any payment it makes should the claimant collect money from another source). The injured employee or survivor is to pursue such recovery or assign the right to recover to OWCP. Failure to do so can result in a loss of all benefits. 5-2. Hearings & Appeals If an employee (or an employee's survivors) disagree with a final determination of the OWCP, either may request a reconsideration or review. The employee or survivor has the right to a hearing before the OWCP. Further, he or she has the right to appeal any decision to the Employees' Compensation Appeals Board (ECAB), a separate entity in the Department of Labor DOL. The time limits for filing such requests for hearings or appeals vary, and are strictly enforced. 5-3. Exclusiveness of Remedy Except for third party rights, FECA is the sole legal avenue by which a Federal employee (or survivors) may recover damages due to an injury or death that is causally related to Federal employment. FECA is the exclusive remedy; therefore, employees may not sue the U.S. Government for damages on their own. 5-4. Penalties for Employees and Supervisors

a. An employee who knowingly makes or knowingly certifies to any false statement, misrepresentation, concealment of fact, or any other act of fraud with respect to a claim under FECA, or who knowingly accepts compensation to which that person is not entitled, is subject to criminal prosecution and may be punished by a fine of not more than $10,000 or imprisonment of not more than 5 years, or both.

b. Any employee, beneficiary, official superior, representative, or other person who, with respect to a claim under FECA, enters into any agreement, combination, or conspiracy to defraud the United States by obtaining or aiding to obtain the payment or allowance of any false, fictitious or fraudulent claim is subject to criminal prosecution and may, under appropriate U.S. Criminal Code provisions, be punished by a fine of not more than $10,000 or imprisonment for not more than ten years, or both.

c. Any beneficiary who either pleads guilty to or is found guilty on either Federal or State criminal charges of defrauding the Federal Government in connection with a claim for benefits will have his or her benefits terminated effective the date the guilty plea is accepted or a verdict of guilty is returned after trial, for any injury occurring on or before the date of such plea or verdict.

d. Any beneficiary who is incarcerated in a State or Federal jail, prison, penal institution, or other correctional facility due to a State or Federal felony conviction forfeits all right to compensation during the period of incarceration, and said right to benefits is not restored after such incarceration ends, although payment of compensation benefits may resume. Eligible dependents will receive compensation at a reduced rate during the period of incarceration.

e. Any claimant convicted of fraud related to FECA claims on or after October 1993 will lose entitlement to FECA benefits.

f. Any claimant convicted of a felony and imprisoned as a result to claims under FECA will have benefits suspended effective date of imprisonment.


g. An officer or employee of the Federal Government responsible for making reports (such as an "official superior") who willfully fails, neglects, or refuses to make a report of injury or files a false report may be fined not more than $500, be imprisoned not more than 1 year, or receive both penalties.

h. A partially disabled employee who refuses to seek suitable work or refuses to accept work after it is offered is not entitled to any compensation except for medical benefits.

i. If an employee refuses to submit to or obstructs an examination by a Federal medical officer or by a qualified private physician as required by OWCP, the employee's right to compensation under FECA will be suspended until the refusal or obstruction ceases. The action of the employee's representative is considered to be the action of the employee for the purposes of this section. The period of refusal or obstruction will be deducted from the period for which compensation is payable to the employee.

j. An individual who, without good cause, fails to undergo vocational rehabilitation, when directed to do so by DOL, may have his or her compensation reduced.

k. An employee who fails to make an affidavit about his or her employment (including unremunerated work performed in furtherance of a business) when required, or knowingly omits or understates any part of his or her earnings, forfeits his or her right to compensation with respect to any period for which the affidavit or report was required. Compensation, if already paid, will be recovered by a deduction from additional compensation payable, if any, unless recovery is waived.

l. An employee who refuses to assign or prosecute an action in his or her own name against a third party when required is not entitled to compensation. Section 6 Initiating Claims

6-1. Traumatic Injury Claim

a. Forms To Use: (1) Notice of Traumatic Injury-Form CA-1. When a technician sustains a traumatic work-

related injury, he/she should give to the supervisor a written report on Form CA-1 as soon as possible but not later than 30 days from the date of injury. If the employee is incapacitated, someone acting on his/her behalf, including a family member, union official, representative, or agency official may give notice. The CA-1 must contain the original signature of person giving notice.

(2) Wage Loss/Permanent Impairment-Form CA-7. If disability is anticipated at the time of injury, the employee may elect to use leave or Continuation of Pay (COP) on Form CA-1; however, an employee who cannot return to work when COP terminates, or who is not entitled COP, may claim compensation for wage loss on Form CA-7. If compensation is claimed, the employee should secure a CA-7 from the Supervisor on the 3rd day of COP, complete the front and return it to the supervisor within one week. The employee should arrange to provide medical evidence to support the period of disability claimed; compensation claimed should represent the period of disability supported by the medical evidence or the interval until the employee's next medical appointment. Meantime, the employee may use leave to avoid interruption of income. 6-2. Occupational Disease Claim

a. Forms To Use: (1) Notice of Occupational Disease - Form CA-2. The injured technician, or someone acting

on his/her behalf, should give notice of an Occupational disease on a CA-2. The employee should secure from the supervisor the appropriate checklist, Form CA-35, A-H, for the disease claimed and furnish supporting medical and factual information requested on the checklist. If possible, the information should accompany the CA-2 when it is submitted.


(2) Wage Loss/Permanent Impairment - Form CA-7. Form CA-7 is used to file a claim for compensation due to pay loss from an occupational disease. The claim should be filed within 10 days after pay stops, or when the employee returns to work-, whichever occurs first. The employee may wish to use sick: or annual leave pending adjudication of the claim.

b. Employee Responsibility. An employee is responsible for: (1) Giving notice of an occupational disease on CA-2; (2) Providing detailed supporting medical and factual information requested on the checklist; (3) Establishing the essential elements of the claim as outlined above in paragraphs C(1) and

(2); (4) Returning to work once notified by physician that he/she can perform regular work or light

duty; and (5) Claiming compensation for wage loss on Form CA-7. c. Supervisor Responsibility. A supervisor is responsible for: (1) Reviewing the CA-2 for completeness and accuracy, and assisting in correcting any

deficiencies; (2) Preparing a supporting statement to include exposure data, test results, and or witness

statements, depending on the nature of the case in accordance with occupational disease checklist.

(3) Advising employee of right to elect leave pending adjudication of claim; and (4) The prompt submission of the completed CA-2 within 5 days of receipt to the HRO with

all pertinent information and documents; the CA-2 should not be held for receipt of supporting documents.

d. HRO Responsibility. The Employee Relations Sections of the HRO is responsible for: (1) The receipt and review of all supporting documents; (2) Inserting appropriate codes on the CA-2; and (3) Promptly forwarding the CA-2 to OWCP within 10 workdays of receipt; the CA-2 should

not be held for receipt of supporting documentation. (4) Providing advise and guidance to supervisors and technicians.

6-3. Recurrence of Disability Claim

a. Forms To Use: (1) Claim for Recurrence - Form CA-2a. If a recurrence develops, the employee and supervisor should promptly complete Form CA-2a. If the employee was entitled to COP and the 45 calendar days have not been exhausted, he/she may elect to use the remaining days if 90 days have not elapsed since the first return to duty date; otherwise, the employee may elect to use leave pending adjudication of the claim for a recurrence of disability. (2) Claim for Wage Loss - Form CA-7. If a claimant wishes to claim compensation because of a recurrence, Form CA-7 is required, if one was not previously submitted; if a CA-7 was submitted, the employee should complete a CA-7 and submit it to the supervisor along with supporting medical evidence. A CA-7 is to be submitted every two- (2) weeks until notified by OWCP.

b. Employee Responsibility. An employee is responsible for: (1) Submission of the factual and medical evidence requested in the instructions attached to the CA-2a; (2) Returning to work once notified by physician that he/she can perform regular work or light duty, and (3) Claiming compensation for wage loss on Form CA-7.

c. Supervisor Responsibility. A supervisor is responsible for: (1) At his/her discretion, authorizing medical care on CA-16 for a recurrence of disability if it resulted from an injury previously recognized as compensable by OWCP;


(2) Advising employee of right to use COP if there is any entitlement remaining or annual/sick leave if the injury is disabling or there is need for follow-up care. (3) Providing Form CA-17 to the employee to be completed by the treating physician; and (4) The prompt submission of all completed forms to the HRO with all pertinent information and documents.

d. HRO Responsibility. The Employee Relations Sections of the HRO is responsible for: (1) The receipt and review of all supporting documents; (2) Inserting the appropriate codes on the CA-2a; and (3) Prompt submission to OWCP all completed claim forms. (4) Providing advice and guidance to supervisors and technicians. 6-4. Death Claims

a. General: When an employee dies due to a work-related injury, survivors should be contacted by the Employee Relations Section of the HRO, provided with claim forms, and assisted in preparing the claim as much as possible. The forms should be submitted even if a disability claim had been filed and benefits paid; continuation of benefits is not automatic, as it must be shown that the death resulted from the same condition for which the disability claim was accepted.

b. Forms To Use: (1) Claims for Death Benefits – CA-5 and CA-5b. The survivors of a deceased employee

should use Form CA-5 or CA-5b in submitting claims for benefits. The survivor should complete the front of the appropriate form, and the attending physician should complete the medical report on the reverse side. The claim should include a copy of the death certificate, certified by the issuing authority; a certified marriage certificate if a spouse is making claim; a copy of any divorce or annulment decree if the decedent or spouse was formerly married; and certified copies of birth certificates of any children for whom claim is being made.

(2) Agency Notice - Form CA-6. A CA-6 is to be completed by the supervisor and is used to report the work-related death of an employee. Section 7 Computing Compensation 7-1. Compensation Payments Compensation payments for wage loss are based on a percentage of the employee's salary. Payments are computed by multiplying the applicable percentage by the wage rate and increasing the result by any cost-of-living increases to which the beneficiary is entitled.

a. Pay Rate. For both disability and death claims, the pay rate used to compute compensation payments is the pay rate in effect on the date of injury, date of recurrence, or date disability began, whichever is higher. Thus, the pay rate for compensation purposes may change over the life of a claim; however, the salary used to compute compensation is not affected by general increases in the rate paid for the employee's grade and step. In addition, the pay rate is not affected by promotion or raises the employee might have received but for the injury.

b. Other Elements of Pay. Included in the salary are night shift, Sunday differential/holiday pay, but no overtime. Drill pay is also included for employees whose membership in the National Guard is a condition of their employment.

7-2. Compensation Checks Compensation checks are issued on a weekly or 4 weekly basis, depending on the kind and lengths of time benefits are paid. Short-term payments of compensation are issued on a weekly basis, while long-term payments are made every 4 weeks.


a. Compensation Rate. This is the percentage applied to the salary to determine the amount of compensation. An employee without dependents is entitled to compensation at the rate of 66 & 2/3 percent of his/her salary. With dependents, he/she is entitled to 75% of his/her salary.

b. Cost-of-Living Increases. Each March 1 the cost of living increase for the preceding year is determined; where the claimant has been entitled to compensation for at least 1 year prior to 1 March, a cost-of-living increase is applied to his/her benefits. Section 8 Buy Back of Leave 8-1. Leave Repurchase An employee who takes sick/annual leave to avoid possible interruption of income may repurchase that leave, subject to agency concurrence; Form CA-7 may be used for this purpose. The employee should arrange for submission of medical evidence, and the supervisor should provide a detailed breakdown of leave used, showing the number of hours charged for each day claimed and whether sick or annual leave was used. 8-2. Repayment of Paid Leave Since leave is paid at 100% of the claimant's wage rate, and compensation is paid as a percentage (compensation for leave repurchase is computed in the same way as compensation for temporary total disability), the employee will generally owe the agency money for the leave repurchase. When OWCP advises the claimant and the agency of the amount of compensation payable, the claimant should consult with the civilian payroll office to determine how much money he/she will need to repay. The amount to be repaid is the gross value of the salary or wages paid to the claimant while in a leave status. Section 9 Using Leave Instead of COP 9-1. 45 Day Entitlement An employee may use annual or sick leave to cover all or part of an absence due to an injury. If leave is elected, each full or partial day for which leave is taken will be counted against the 45 days of COP entitlement; therefore, while an employee may use COP intermittently along with sick or annual leave, COP entitlement is not extended beyond 45 days of combined absences; additionally, the buy back provisions may not be used to repurchase leave taken while an employee was otherwise eligible for COP. 9-2. Changes in Leave Election An election of sick or annual leave during the 45 day period is not irrevocable and an employee may subsequently request COP in lieu of previously requested annual or sick leave; however, such a request must be made within one year of the date the leave was used or the date of OWCP's approval of the claim, whichever is later. If an employee who has elected leave for the period wishes to elect COP, the agency must make such a change on a prospective basis from the date of the employee's request. Where the employee wishes to have leave restored retroactively, the agency must honor the request, provided the agency receives clear medical evidence of an injury-related disability for the period.


Section 10 Controversion 10-1. Supervisor’s Responsibilities

a. With respect to continuation of pay, the supervisor may controvert a claim by completing the indicated portion of the CA-1 and submitting detailed information in support of the controversion.

b. While a claim is being challenged, the supervisor must continue the employee's regular pay, unless one of the following conditions is met in which case COP should not be paid:

(1) Disability is a result of an occupational disease/illness; (2) The employee is neither a citizen or a resident of the United States or Canada; (3) The injury occurred off the agency's premises and the employee was not engaged in

official off-premises duties. This also includes lunch breaks that are off the premises. (4) Injury resulted from employee's willful misconduct, or intent to kill or injure self or

another person, or intoxication by alcohol or illegal drugs, which includes any controlled substance obtained or used without proper medical prescription;

(5) Injury was not reported on a form approved by OWCP within 30 days following the injury; (6) Work stoppage first occurred 90 days or more following the injury; (7) Employee initially reported injury after employment was terminated; c. In all other cases the supervisor may controvert an employee's right to COP, but his/her

regular pay shall not be interrupted during the 45-day period unless the controversion is sustained by OWCP and the agency so notified. Section 11 Light Duty Program 11-1. General In order for the Oregon National Guard to reduce its charge-back cost for compensation claims, a limited/light duty program for technicians injured on the job is established. Light Duty is defined as duty that is reasonable for an injured Technician to perform. The Technician may be asked to perform light duty while he or she is recovering or until a final determination had been made that the Technician has suffered permanent disability. 11-2. Procedures As a minimum the following procedures will be used when a technician sustains an on the job traumatic disabling injury and elects to use COP.

a. If the treating physician determines that the employee will not be able to return to work, the supervisor will personally furnish the treating physician with a Form CA-17 (Duty Status Report) and a copy of the technician's Position Description (PD) prior to the end of the third full day of COP. These documents are used to obtain interim medical reports on the technician's medical condition and earliest date able to return to work. If immediate surgery is required, the Supervisor will personally hand carry a copy of the PD and the CA-17 to the treating physician for completion after the fifth full day of COP.

b. If the treating physician indicates that the technician is physically able to return to work, the supervisor will notify the individual that they must report for duty at the next scheduled workday. The technician should be advised that refusing to do so will result in an overpayment and may lead to a disciplinary or adverse action. Technicians refusing to return to duty, although found fit to do so by their physician, will be carried in an absent without leave (AWOL) status after receiving authorization from HRO.

c. If the treating physician determines that the technician can perform limited light duty work, the supervisor will notify the technician that he/she must return to work at the next scheduled


workday. Care must be taken to ensure that the duties being performed are in accordance with the restrictions imposed by the physician. Supervisors must contact the HRO for guidance before returning a technician to limited/light duty; additionally, supervisors must notify the HRO whenever an injured technician performs military duty (service schools, drills, annual training, etc.) while on COP or receiving OWCP compensation, as the HRO is responsible for providing OWCP written notification to this effect. OWCP may offset OWCP benefits received by the amount of military pay earned.

d. If an injured technician remains off duty or in a limited/light duty status for less than 90 days, the supervisor need not initiate any personnel action. However, should an injured technician remain in a limited/light duty status for 90 days or more, the supervisor must contact the HRO and request that the position description and performance standards be amended to indicate the limitations. For example, a WG-10 aircraft mechanic is injured and placed in a light duty status as a GS-5 clerk; the technician's position description must be altered for the period the employee is in a limited/light duty status. The HRO Classification Specialist will provide assistance in these situations.

e. When medical evidence shows that a technician's disability will continue beyond the 45 days of COP, and the technician files for compensation, the supervisor will personally deliver a CA-17 (Duty Status Report) to the treating physician in order to obtain a medical evaluation concerning whether the technician is totally disabled or medically capable of performing limited light duties.

f. If the physician determines that the technician can perform light duty, the supervisor will immediately contact the HRO to determine the availability of a position within the commuting area. The position can either be at the same or lower grade. If such a position is available, the HRO will notify the technician and OWCP in writing of the availability of the position and make a job offer to the technician. If the job offer is considered suitable by OWCP and the technician refuses the offer, the HRO will notify OWCP. OWCP will determine whether the refusal is a basis for terminating compensation benefits.

g. If a funded position is not available in the commuting area, the supervisor, in cooperation with the HRO and the servicing classification activity, will modify the existing position description to reflect the restrictions imposed by the injury if management determines that restructuring the position description will not adversely impact mission accomplishment. The supervisor, through the HRO, will notify the technician of the availability of the modified position and at the same time notify OWCP. Final determination concerning the suitability of the job offer is the responsibility of OWCP.

h. If the technician accepts the position, the HRO will notify OWCP at the earliest time possible of the date the technician returned to duty. Compensation benefits will be terminated or adjusted as of the date of return to duty. To avoid overpayment of compensation, the HRO should notify OWCP by telephone no later than close of business on the first day of return to duty. Telephone notification must be followed up with a CA-3 (Report of Termination of Disability and/or Payment).

i. In all cases regarding a job offer, OWCP must be notified. Upon receipt of the notification, OWCP will promptly evaluate the position to determine whether it is within the medical restrictions imposed by the technician's physician. If it is determined to be a suitable offer, OWCP will notify the technician and the HRO in writing that the offer is found to be within the medical restrictions imposed and that the technician is expected to accept the position. Failure to accept the position may result in termination of compensation.


Appendix A References Section I - Required Publications Title 20 CFR Section 10.23 Title 32 USC Section II - Related Publications This section contains no entries. Section III - Prescribed Forms This section contains no entries. Section IV - Referenced Forms CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation CA-2 Notice of Occupational Disease and Claim for Compensation CA-2a Notice of Recurrence of Disability and Claim for Pay/Compensation CA-3 Report of Termination of Disability/or Payment CA-5 Claim/Compensation by Widow/Widower and Children CA-5b Claim/Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren CA-6 Official Superior's Report of Employee's Death CA-7 Claim for Compensation for a Traumatic Injury CA-16 Request for Examination and/or Treatment CA-17 Duty Status Report CA-20 Attending Physician’s Report CA-20a Attending Physician’s Supplemental Report


HCFA-1500 Health Insurance Claim Form OWCP 1500 Health Insurance Claim Form


Appendix B Summary Procedures for Submitting OWCP Forms (Complete instructions are included with each form)

Form No. Form Title Purpose Prepared by When

submitted

CA-1

Federal Employee’s Notice of Traumatic Injury

& Claim for Continuation of

Pay/Compensation.

Notifies Supervisor and OWCP of traumatic

injury.

Technician or person acting

on his/her behalf & official

supervisor.

Within two working days to

supervisor& immediately

upon completion to HRO.

CA-2

Federal Employee’s Notice

of Occupational Disease & Claim for

Compensation.

Notifies Supervisor of Occupational Disease (non-traumatic injury).

Technician, supervisor, &

attending physician (use

appropriate checklist).

Immediately to HRO upon

completion of form &

appropriate statements from

technician & supervisor, along with medical

evidence.

CA-2a

Notice of Employee’s

Recurrence of Disability & Claim

for Pay/Compensation

Notifies OWCP that a technician, after

returning to work, is again disabled due to a

previously reported injury.

Technician and supervisor.

Immediately to HRO upon

receiving notice that a technician has suffered a

recurrence.

CA-3 Report of

Termination of Total or Partial

Disability

Notifies OWCP that disability has terminated.

Supervisor

Immediately to HRO after

technician has returned to

work.

CA-6 Official Superior’s

Report of Employee’s Death

Informs OWCP of technician’s death due

to personal injury incurred while in

performance of duty.

Supervisor

Promptly upon receipt of notice of technician’s death to HRO.

CA-7 Claim for Compensation

Claims compensation when disability

continues beyond 45 days of COP.

Technician and Supervisor, (Physician must complete CA-20)

Submit to HRO no later than the 35th day of COP.


Appendix B Summary Procedures for Submitting OWCP Forms Continued

Form No. Form Title Purpose Prepared by When

submitted

CA-16 Authorization for

Examination and/or Treatment

Authorizes treatment of injured technician when there is no doubt as to injury in performance of

duty & injury was by accident.

Part A- Supervisor

Part B- Attending Physician

At time of injury and treatment, original copy to hospital/physici

an. Another copy with original

supervisor signature to

HRO with CA-1.

CA-17 Duty Status Report

Provides interim medical reports

concerning duty status during periods of full or

partial disability.

Supervisor & physician (send

to physician with copy of

position description).

At intervals as often as

required by supervisor.

Send completed form to HRO.

CA-20 Attending Physician’s Report

Provides medical support of claim on

Form CA-7 and provides OWCP with medical information.

Physician

(Note that supervisor

completes items 1 through 4).

Send completed form to HRO.

HCFA Form 1500

or OWCP 1500

Health Insurance Claim Form

Claim form for reimbursement for medical expenses.

Physician, clinic or hospital.

Sent to HRO upon receipt.

Medical expenses must be submitted on

this form for payment.


THIS PAGE INTENTIONALLY BLANK


Appendix C Technician Traumatic Injury Claim Quick Reference Checklist

TECHNICIAN TRAUMATIC INJURY CLAIM

QUICK REFERENCE CHECKLIST

Complete Instructions: OTPP 810, Paragraph 6.1 Definition: A wound or other condition of the body caused by external force, including stress or strain, caused by a specific event, incident, or series of events or incidents within a single day or work shift. Forms Required: CA-1 Notice of Traumatic Injury-Form. CA-16 Request for Examination and/or Treatment CA-17 Duty Status Report

WHEN A TRAUMATIC INJURY OCCURES Supervisor will:

Furnish a CA-1 to the employee, or to someone acting in his/her behalf, with instructions to fill it out as soon as possible

Promptly authorize medical care using Form CA-16. Provide Form CA-17 to the employee for completion by the employee's treating

physician. Notify the HRO ERS of the injury at DSN 355-3975/503-584-3975

AFTER INITIAL TREATMENT Employee will: An employee is responsible for:

Complete CA-1 as soon as possible, but not later than 30 days from the date of the work-related injury.

Submit medical evidence of a disabling injury by the 10th workday of the date disability begins to supervisor who will forward to the Employee Relations Section of the HRO.

Advise physician that light duty is available and request him/her to specify any limitations imposed by the injury by completing CA-17.

Return to work when notified by physician that he/she can perform regular work or light duty.


Appendix C Technician Traumatic Injury Claim Quick Reference Checklist (page 2)

Supervisor will:

Sign and return to the employee the attached “receipt of notice of injury” portion of the CA-1.

Advise the employee of the right to use COP, annual or sick leave if the injury is disabling;

Notify employee to submit medical evidence to establish their claim within 10 work days of the date the employee claims COP or the disability begins, whichever is later;

Promptly submit to the HRO (Human Resources Office) all fully completed claim forms with all other pertinent information and documents. NOTES:


Appendix C Technician Occupational Disease Claim Quick Reference Checklist

TECHNICIAN OCCUPATIONAL DISEASE CLAIM

QUICK REFERENCE CHECKLIST Complete Instructions: OTPP 810, Paragraph 6.2 Definition: A condition produced in the work environment over a period longer than one workday or shift. It may result from a systemic infection, repeated stressor strain, exposure to toxins, poisons, or fumes, or other conditions of the work environment. Forms Required: CA-2 Notice of Occupational Disease

CA-35 Evidence Required in Support of a Claim for Occupational Disease

CA-35(A-H) 35A for Occupational Disease Claim; 35B for hearing;

etc…

WHEN A OCCUPATIONAL DISEASE IS SUSPECTED Employee will:

Request from their supervisor and then complete the front of the CA-2 as soon as possible, but no later than 30 days from the date of first becoming aware of the disease.

Complete the appropriate checklist for the disease claimed using Form CA 35A-H and include it with the CA-2. Supervisor will:

Review the employee’s portion of the CA-2 and provide comments on the employee’s statement.

Complete and sign the reverse portion of the CA-2. (Continue on Page 2)


Appendix C Technician Occupational Disease Claim Quick Reference Checklist (page 2)

Review the employee’s information provided on the CA-35 and complete the

employing agencies portion of the checklist. Forward the CA-2, CA-35 and all other documentation to the Employee Relations

Section of the HRO within 5 days. NOTES:


Glossary Section I – Abbreviations AWOL Absent Without Leave CFR Code of Federal Regulations COP Continuation of Pay DOL Department of Labor ECAB Employees' Compensation Appeals Board GS General Schedule HR-ERS Human Resource-Employee Relations Specialist HRO Human Resource Office LWEC Loss of Wage-Earning Capability ORNG Oregon National Guard OWCP Office of Workers Compensation PD Position Description S/A Scheduled Award TPP Technician Personnel Pamphlet WG Wage Grade


Section II – Terms Absent Without Leave Absent without proper authority from the properly appointed place of duty, or from unit, organization, or other place of duty at which one is required to at the prescribed time. This section contains no entries. Code of Federal Regulations: The Code of Federal Regulations (CFR) is the codification of the general and permanent rules published in the Federal Register by the executive departments and agencies of the Federal Government. Controversion: To controvert is to deny, dispute, or challenge the validity a claim on the basis of the information submitted by the employee or secured on investigation. Controvert means to deny the validity of the claim, to dispute, or challenge Occupational Disease: An occupational disease is a condition produced in the work environment over a period longer than 1 workday or shift. It may result from systemic infection, repeated stress or strain, exposure to toxins, fumes, or other conditions of the work environment. Recurrence of Disability: When the same injury causes additional time loss from the job and there is no single event, action, or apparent reason, or cause for the pain other than the previous injury; note that follow-up care is considered part of the original injury, unless claimant was previously released from treatment. Traumatic Injury: A traumatic injury is a wound or other condition of the body caused by external force, including stress or strain. The injury must be identifiable by time and place of occurrence and member or function of the body affected; it must be caused by a specific event, incident, or series of events or incidents within a single day or work shift. Only traumatic injuries entitle technicians to continuation of pay (COP). Section III – Special Abbreviations and Terms This section contains no entries.

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