TIP OF THE WEEK - November 17, “Excessive, extravagant, or wrongful use of FECA in a manner contrary to its legal intent to acquire additional benefits for personal gain.”

Scenario: 2 If you have a question or topic for Tip of the Week, contact your District 6 Liaison, Jacksonville, FL  Claimant currently has an accepted claim with OWCP and is currently on the Periodic Roll (PR).  Current medical indicates the claimant has “NO” work capacity and is disabled due to the accepted work-related conditions.  The employee agency has been advised that the claimant is working full time at his second job even though he is receiving compensation benefits for temporary total disability.  The investigative unit has documented that the claimant is working a full time job while collecting wage loss compensation benefits. Is this Abuse or Fraud? Reference: Department of Defense Instruction, DoD Civilian Personnel Management System: Injury Compensation V810, section Reference: ECAB FECA PM: Chapter , Fact of Injury para, 5:

Answer: This very well could be Fraud. What steps could the EA take?  Contact your DOD Liaison and request a case file review, to determine whether the claimant has reported his employment-earnings to the OWCP on his annual CA-1032s.  If no employment earnings have been reported, see if the investigative unit can present this case to an Assistant U. S. Attorney (AUSA) for consideration of preparing an indictment for fraud, for violating 5 USC 8106 (b). The AUSA will need copies of all of the CA-1032s pertinent to the period of time during which the claimant worked and earned wages.  The EA could also write to the Treating Physician (TP) and request updated medical work restrictions.  Contact your liaison for assistance to help determine the next appropriate action(s). If you have questions or a topic for the Tip of the Week contact your District 6 Liaison, Jacksonville FL 3