Workers' Compensation Newsletter
The Benefits of FECA
Most states require private employers to provide Workers’ Compensation insurance for employees who suffer an injury or disease on the job. Similarly, the U.S. Department of Labor (DOL) implemented the Federal Employees’ Compensation Act (FECA) to provide benefits to federal government employees for their work-related injuries and illness.
Workers Covered by FECA
Generally, FECA is a self-insurance system for some three million federal employees, providing wage replacement, medical, and rehabilitation benefits for occupational injuries and diseases. The FECA program covers executive, legislative and judicial branch employees of the U.S. government, including:
- Civilian Defense workers
- Medical workers in Veterans’ hospitals
- Postal Service workers
Such federal employees are covered whether they work full-time, volunteer, are “emergency hires” or are job corps. All types of injury and disease are covered under FECA provided that they were proximately caused by and sustained during employment with the federal government.
FECA Requirements
Administered by the DOL’s Office of Workers’ Compensation Programs (OWCP), FECA is the only entity that can adjudicate a claim for compensation for federal workers. In order to qualify for FECA benefits, injured or ill federal employees must show all of the following:
- The claim was filed within the statutory time requirements;
- The injured or deceased person was an “employee” under FECA definitions;
- The employee actually suffered an injury or developed an occupational disease;
- The injury or disease occurred during the course of employment; and
- The condition complained of was the result of the injury or disease.
Federal employees are not entitled to FECA benefits for injury or death caused by:
- Their own willful misconduct
- The employee’s intent to cause injury or death to self or another
- Intoxication of the injured employee
Type of Benefits
In general, if a federal employee follows the above process and their FECA claim is approved, they may be entitled to receive the following where applicable:
- Hospital, physician, and medication costs
- Transportation costs to a doctor’s office for medical treatment
- Disability such as compensation or scheduled awards (wage replacement)
- Monthly allowance for a personal attendant
- Vocational rehabilitation
- Death/survivor benefits if the cause of death is related to the accepted job injury, including compensation to spouse/dependants, and burial costs
Processing a FECA Claim
The FECA benefit system is “non-adversarial” and is thus administered strictly through a defined administrative system. FECA remedies are the sole remedies available to covered workers. Stated differently, federal employees who suffer on-the-job injuries generally have no right to sue the government, the department, or other government “employers” in connection with such injuries.
With few exceptions, a claim must generally be filed within three years of the date of injury. The OWCP will make a final determination of a FECA claim and decide whether to issue benefits to the federal worker. If successful, the employee can receive compensation for as long as the medical evidence shows total or partial disability related to the injury or condition. If unsuccessful, the employee may appeal the final determination of the OWCP and request an oral hearing or review of the written record.
Filing a False Claim
The penalties for filing a false claim include a fine of not more than $10,000 or imprisonment for not more than five years, or both. Conspiracy to commit fraud may incur up to a $10,000 fine and 10 years imprisonment.
© 2024 NextClient.com, Inc. All rights reserved.
