1. The Importance of Supervisors’ Roles and Responsibilities
Bryan J Richardson
VHA National Workers’ Compensation Program Manager
&
Kristin Coyle
VISN 1 Lead WC Specialist

2. 510, ,728

3. $510,423 per day $323,728 per day LOST PRODUCTIVITY!
VHA workers’ compensation chargeback in CBY 2013
$323,728 per day
Portion of VHA chargeback that relates to disability wage loss
LOST PRODUCTIVITY!

4. Objectives At the end of this session, you will better understand:
Impact your role has on injured employees, mission, and cost to your organization
How you as a supervisor can prevent employee injuries
Importance of thorough investigations of all incidents
How to communicate with workers’ compensation staff
Your role in return-to-work management
Timekeeping practices for injured employees
How to protect information related to on-the-job injuries

5. Impact of Workers’ Compensation

6. Impact of Workers’ Compensation
Employee
Self Actualization
Personal Growth & Fulfillment
Esteem Needs
Self Esteem, Self Respect, & Self Confidence
Belongingness & Love
Friendship, Intimacy, & Family
Abraham Maslow was a humanistic psychologist who believed that every person has these five basic needs. His theory is that a person does not feel the second need until the demands of the first have been satisfied, nor the third until the second has been satisfied, and so on.
Safety Needs
Personal, Financial, Health, & Well Being
Biological and Physiological Needs
Basic Necessity– Air, Food, Drink, Shelter, Warmth & Sleep
Maslow’s Hierarchy of Needs

7. Impact of Workers’ Compensation
Agency Mission
Staff reductions when employee is disabled from work
Over-hiring when employee is out for 365 days
Additional HR activity to ensure entitlements to injured workers
Overtime requirements for healthy employees
LOSS OF PATIENT CARE RESOURCES
INABILITY TO SERVE OUR VETERANS THE BEST WE CAN

8. Impact of Workers’ Compensation
Agency Budget
Chargeback Costs
Continuation of Pay
Indirect Cost

9. Impact of Workers’ Compensation
Chargeback Costs
Employees Compensation Fund (Congressional Appropriation)
DOL-OWCP pays medical bills and compensation on accepted claims
DOL-OWCP charges back the cost to the Agency every year, including an administrative fee
Agency has two fiscal years to pay the bill
Repayment is returned to the Employees Compensation Fund
Funds future year payments from Employees Compensation Fund
Each Administration pays its share of the cost

10. Impact of Workers’ Compensation
Continuation of Pay
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.
Entitlement to 45 days must start within 45 days from DOI
Employer paid at 100% of the employees salary which is subject to taxes and all other payroll deductions that are made from regular income.
The employer, not OWCP, pays COP.

11. Impact of Workers’ Compensation
Continuation of Pay (COP)
Employer has the right to ‘controvert’ COP entitlement
If a claim is denied by OWCP, COP is rescinded, Employee must elect AL, SL or LWOP in lieu of COP
Employees are not automatically entitled to COP
Eligibility requirements apply
Must file a CA-1 for a traumatic injury
Claim must be filed within 30 days from the date of injury
Must have lost time within 45 days from injury

12. Impact of Workers’ Compensation
Indirect Cost
Overtime – Results in 2.5 times salary for same service
Replacement receives overtime
Injured employee receives COP or disability compensation
Over-hiring – Recruitment, on-boarding, & Training
Approximately 27% of employee salary

13. WC Program Importance

14. WC Program Importance
Did you know that long-term disability recipients…
Receive up to 75% of their salary – TAX FREE when on compensation?
Receive Cost of Living Adjustment(COLA), or raises while Federal wages are frozen?
Based on CPI - inflationary indicator that measures the change in the cost of a fixed basket of products and services.
For 2013, the CPI increase was 1.7%
May be exempt from paying mortgages or car loans
If employee pays for disability insurance on their own.

15. WC Program Importance
Your roles and responsibilities to the WC Program
Pre-Injury responsibilities
Investigation of incidents
Communication with workers’ compensation staff
Timely completion and forwarding of claim forms
Proactive participation in return-to-work efforts
Appropriately document injury-related timekeeping
Protecting workers’ compensation data

16. Pre-Injury Responsibilities

17. Pre-Injury Responsibilities
Eliminating Hazards in the workplace is your BEST method of preventing injuries and illnesses
Enforce VA OSH rules, regulations, and standards within your area of responsibility.
Identify unsafe and unhealthy conditions and practices in the workplace and take prompt corrective action.
Encourage employee suggestions on how to improve Occupant Safety and Health.

18. Pre-Injury Responsibilities
Observation of employee work practices and constructive guidance is just as important
Ensure employees under your supervision are:
Trained to perform their work safely and such training is properly documented
Aware of the hazards, if any, involved in their normal work functions, and that such training is properly documented.
Initiate progressive disciplinary action, as appropriate, against employees who repeatedly violate safe work practices and procedures.

19. Pre-Injury Responsibilities
Near Miss incidents serve as a ‘dress rehearsal’ for injuries and illnesses in the workplace
“There is one Serious Injury for every 600 near miss incidents”
Frank Bird – US Safety Researcher 1
10 – Minor Injuries
30 – Property Damage
600 – Near Misses

20. Investigation of Incidents

21. Investigation of Incidents
Supervisor
Gather facts related to the incident
Obtain witness statements if necessary
Communicate findings to Safety and WCP staff
Complete VA Form 2162, Incident Report within 3 working days.
Safety Officer
Designated point of contact for secondary incident investigation
Serves as consultant in work-related accident investigations.
The WCP staff
Collaborates with employee, supervisor, and Safety
Determines relevant facts of the case
Transmits the case to DOL, if appropriate

22. Investigation of Incidents
Office of Workers’ Compensation Program (OWCP)
Exclusive authority to administer, interpret and enforce FECA
Sole adjudication authority for FECA processes
When an employee disagrees with a decision made by OWCP, they may appeal to OWCP
Liability under FECA is exclusive and instead of all other direct judicial proceedings, civil actions, or under a Federal tort liability statute.

23. Investigation of Incidents
Step 1:
Determine if emergency treatment is required!
Ensure that employees under your supervision receive prompt and appropriate medical attention in the event of an injury or illness.
Such medical services are offered—not mandatory.

24. Investigation of Incidents
Step 2: Gather facts related to the incident
Determine causal and contributing factors
Causal Factor - Any behavior, omission, or deficiency that if corrected, eliminated or avoided probably would have prevented the incident or injury.
Contributing Factor - Any behavior, omission, or deficiency that sets the stage for an incident or increases the severity of injuries or extent of property damages.
Identify necessary corrective actions

25. Investigation of Incidents
Investigating for Causal and Contributing Factors
Who – Was involved or witnessed?
What – Occurred or was seen?
Where – Did it occur, and where were witnesses?
When – Did this occur or when was it reported?
Why, Why, Why, Why, Why?
Any other factors relative to the incident?

26. Investigation of Incidents
Step 3: Document investigation on VA Form 2162
Step 4: Determine OSHA Recordability
Step 5: Collaborate with WC staff on findings
Step 6: Implement corrective actions

27. Investigation of Incidents
Implement Corrective Actions
Correcting hazards prevents future injuries and illnesses!

28. Communication with WC Staff

29. Communication with WC Staff
Your facility WC staff has no authority to accept or deny workers’ compensation claims
However, they are able to provide objective evidence of dispute for consideration by the OWCP
Findings from your incident investigation may either support or refute an employee’s statement on CA-1 or CA-2.

30. Communication with WC Staff
Disputing an employee’s claim
WC staff submits a letter of dispute to OWCP
Describe the factual allegation or argument to support disagreement
Provide evidence or argument to support the agency’s position
Include supporting documents such as witness statements, medical reports or records, or any other relevant information.
Timeliness is key! Dispute must be submitted to OWCP:
CA-1: With the notice of traumatic injury or death
CA-2: Within 30 calendar days from the date notice of occupational disease or death is received from the claimant.

31. Communication with WC Staff
Disputing an employees claim (continued)
If a letter of dispute is not submitted appropriately, OWCP may accept the claimant's report of injury as established.
A disagreement with an aspect of the claimant's report is not cause to:
Delay forwarding the claim to OWCP
Compel or induce the claimant to change or withdraw the claim.

32. Communication with WC Staff
Discussion Points with WC Staff
Has employee established burden of proof – 5 Elements?
Timely Filed (3 year statue of limitations)
Employee of the United States
Fact of Injury
Performance of Duty
Causal Relationship

33. Communication with WC Staff
Fact of Injury may be questioned if:
Employee statements and investigation findings are inconsistent
Evidence of a previous injury to the same part of the body
There is a delay in reporting the injury
You have knowledge of other employment or reserve duty
There are documented past violations of safe work practices
Notification of misconduct or pending termination was given
Leave requests during injury period have been denied

34. Communication with WC Staff
Performance of Duty may be questioned if:
The injury occurred outside of working hours
The employee was not performing assigned duties at the time of injury
The injury occurred off premises?
The injury occurred during a recreational activity
Horseplay, willful misconduct were involved
Injury was a result of a vehicular accident
Injury was the result of an assault

35. Communication with WC Staff
Employees are considered to be in the Performance of Duty on premises including steps, sidewalks and parking lots owned, controlled or managed agency:
During work hours and/or on breaks
Outside working hours
Usually considered 30 minutes before or after working hours
Not extended to employees who are visiting the premises for non-work-related reasons.
Performing representational functions entitling them to official time are covered.
Injuries to employees engaged in the internal business of a labor organization are not covered.

36. Communication with WC Staff
Causal Relationship is a medical determination usually addressed by the OWCP Claims Examiner.
Communicate with the WC staff if you have concerns that the medical condition identified by the employee is not causally related to the claimed injury.
The following Statutory Exclusion should also be addressed with the WC staff
Willful misconduct
Alcohol or drug impairment involved
Intent to injure self or others

37. Communication with WC Staff
In cases of work-related employee death
Notify the Facility Workers’ Compensation Office immediately to report a death due to a work-related traumatic or occupational disease-facility workers’ compensation office will notify OWCP immediately via telephone or fax
Complete form CA-6, Official Superior’s Report of Employee’s Death, immediately so facility workers’ compensation office can submit to OWCP within 10 workdays from notification

38. Claim Initiation Process

39. Claim Initiation Process
Supervisor
WC Staff
Provide Guidance and Counsel to Injured Employees
Communicate Employee Rights and Responsibilities
Provide Notice of Choice of Physician
Provide Release of Information Document
Investigate Incident
Dispute Questionable Claims
Emergency Treatment (if needed)
Authorize use of CA-16
Respond to Development Letters & Requests from OWCP timely
Ensure Leave Requests are Made
Authorize use of COP if applicable
Periodically Check on Employee
Track OWCP Pending Actions

40. Injury-Related Timekeeping
Supervisor
WC Staff
Ensure Entitlement to COP
Ensure Leave Requests are Made
Track COP Day Count
Ensure Appropriate Leave is Used
Authorize Requests for COP
Forward Medical to WC Staff
Controvert COP when applicable
Notify Employee of Controversion
Notify Employee when Controversion Upheld
Request Election of Other Leave
Rescind COP when Case Denied
Review COP Cost for Facility

41. Claim Initiation Process
For Traumatic Injuries:
Advise the injured employee of his or her right to file for workers’ compensation benefits using Form CA-1.
Complete the required fields of the VA 2162, the Incident Report within 5 days.
Complete the required fields of the supervisory portion of the Form CA-1 within 3 days of signing by the employee.
Do not delay injury claim completion while waiting for other documents or disputes to be completed.
Again, you need the medical documentation to know which applies. If you don’t have it, call Occupational Health and ask that they provide you with the information.

42. Claim Initiation Process
A claims is not complete until:
Employee has electronically signed
Supervisor has electronically signed
The claim form has been printed and both the employee’s and supervisor’s wet ink signature has been obtained
A claim will not be transmitted/submitted to OWCP without wet ink signature

43. Claim Initiation Process
Here’s the fine print:
No employer or other person may require an employee or other claimant to enter into any agreement, either before or after an injury or death, to waive his or her right to claim compensation under the FECA. No waiver of compensation rights shall be valid. 20 CFR 10.15
A number of statutory provisions make it a crime to file a false or fraudulent claim or statement with the government in connection with a claim under the FECA, or to wrongfully impede a FECA claim. See 20 CFR 10.16, Title 18 U.S. C. section 287, , and 1922.
Administrative proceedings may be initiated under the Program Fraud Civil Remedies Act of 1986 (PFCRA), 31 U.S.C , to impose civil penalties and assessments against persons who make, submit, or present, or cause to be made, submitted or presented, false, fictitious or fraudulent claims or written statements to OWCP in connection with a claim under FECA. 29 CFR Part 22

44. Claim Initiation Process
18 U.S.C False or withheld report concerning FECA
Whoever, being an officer or employee of the United States charged with the responsibility for making the reports of the immediate superior specified by section 8120 of title 5, willfully fails, neglects, or refuses to make any of the reports, or knowingly files a false report, or induces, compels, or directs an injured employee to forego filing of any claim for compensation or other benefits provided under subchapter I of chapter 81 of title 5 or any extension or application thereof, or willfully retains any notice, report claim, or paper which is required to be filed under that subchapter or any extension or application thereof, or regulations prescribed thereunder, shall be fined under this title or imprisoned not more than one year, or both.

45. Return to Work Management

46. Return to Work Management
Supervisor
WC Staff
Identify Transitional Job Duties
Provide Written Job Offer
Monitor Transitional Duty to Ensure Restrictions are not Exceeded
Notify WC of Updated Restrictions
Update Written Job Offer
Provide Release of Information Document
Monitor any Leave upon RTW
Monitor Medical for RTW Changes
Notify WC Staff-IOD Leave Used
Request Medical to Support Leave

47. Return to Work Management
Transitional duty must be made available to injured employees
The transitional assignment must be provided in writing to the injured employee with the option of accepting or declining the offer. (initial in verbal is okay- f/u with written.)
Transitional duties should align with medical restrictions. Transitional job offer should not exceed days without modification—This depends on severity of the injury.

48. Return to Work Management
When medical restrictions are received from the physician, you will be asked by the WC staff for the following information:
Description of duties to be performed
Physical requirements for those duties
Location where job will be performed
Salary information for transitional job
Date that the job is available
Work schedule for the job
Date response to job offer is due
If moving expenses will be paid

49. Return to Work Management
Notify your Facility Workers’ Compensation Office immediately if you believe an injured employee is off work as a result of a work injury, don’t take it for granted they are

50. Return to Work Management
If a claim is denied by OWCP
Notify employee of their right to request reasonable accommodation within 30 days of denial of claim
Engage the Reasonable Accommodation specialist at your facility for assistance

51. Return to Work Management
Supervisors SHOULD NOT:
Send an employee home because transitional duties are not available
Allow an injured employee to perform transitional duty without a written job offer
Treat injured employees differently than you treat other employees. An injury is not a “get out of jail free” card.

52. Return to Work Management
Supervisors SHOULD NOT: (continued)
Allow an employee to dictate what duties he or she feels he/she can or cannot do
Withhold taking appropriate administrative or disciplinary actions against an injured employee
Impede employee’s election to take annual, sick leave or leave without pay for time lost because of a job- related injury

53. Return to Work Management
Retention Rights – Separation from Agency Rolls
Under 5 U.S.C. 8151, an employee who recovers within 1 year of starting compensation has mandatory rights to his or her old position or its equivalent, regardless of whether he or she is still on the Agency rolls
If full recovery occurs after 1 year, or the employee is considered partially recovered, he or she is entitled to priority consideration as long as application is made within 30 days of the date compensation ceases
Employees incur no loss of benefits which they would have received but for the injury or disease.
5 CFR Section 353, 301, 302, and 303

54. Protecting Employee Data

55. Protecting Employee Data
VA Systems of Record
Created or amended as needed to meet the legislative requirements of the Privacy Act of 1974
SORNs (System of Record Notices) are in place to protect employee data.
VA Systems of Record DO NOT cover employee workers’ compensation records
DOL/GOVT-1 System of Records
Protects records relating to claims for benefits filed under the FECA, including any copies maintained by an employing agency
This system of records is maintained by and under the control of OWCP, and, as such, all records covered by DOL/GOVT-1 are official records of OWCP.

56. Protecting Employee Data
Confidentiality of WC Records
All records relating to claims for benefits, including copies of such records maintained by an employer, are considered confidential and may not be released, inspected, copied or otherwise disclosed except as provided below:
Freedom of Information Act
Privacy Act of 1974
DOL/GOVT-1 if such release is consistent with the purpose for which the record was created.

57. Protecting Employee Data
Storage and Use of WC Documents
Workers’ Compensation related documents must be stored in locked cabinets inside of a locked room
The use of the information collected must be connected in some way with the compensation claim
Agencies may not use copies of information from claim files for these purposes without written consent of the injured employee:
a) In connection with EEO complaints
b) Disciplinary actions
c) Other administrative actions

58. Protecting Employee Data
Employee Right to Representation
May appoint one individual to represent his or her interest in the claim process
Appointment must be in writing
There can be only one representative at any one time
May authorize any individual to represent him or her in regard to a claim under the FECA
A Federal employee may act as a representative only:
On behalf of immediate family members provided no fee is charged
While acting as an officially sanctioned union official provided no fee or gratuity is charged.

59. ANY QUESTIONS????