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Published byNelson Austin Modified over 8 years ago
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TIP OF THE WEEK - November 3, 2014 1 “Excessive, extravagant, or wrongful use of FECA in a manner contrary to its legal intent to acquire additional benefits for personal gain.”
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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. On the CA-1032 (annual periodic review) the claimant indicates he is working part-time and provides information on actual earnings for the 15 month period. OWCP has not taken action on the information provided on the CA-1032. Is this Abuse or Fraud? Reference: Department of Defense Instruction, DoD Civilian Personnel Management System: Injury Compensation 1400.25- V810, section http://www.dtic.mil/whs/directives/corres/pdf/1400.25-V810.pdfhttp://www.dtic.mil/whs/directives/corres/pdf/1400.25-V810.pdf Reference: ECAB http://www.dol.gov/ecab/decisions/2014/May/14-0269.htm http://www.dol.gov/ecab/decisions/2014/May/14-0269.htm FECA PM: Chapter 2-0803, Fact of Injury para, 5: http://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECA-PT2/group1.htm#208034 http://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECA-PT2/group1.htm#208034
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Answer: This does not appear to be fraud as the claimant has provided the information regarding actual wages as required. However, this does suggest abuse if the claimant is able to work and continues to collect compensation benefits for TTD. What steps could the EA take? Write OWCP and request action be taken to determine the claimant’s degree of disability given that the claimant has indicated his ability to work and earn wages. – OWCP may request addition information from the claimant regarding employment (type of work: title, salary, hours, physical requirements) in order to address the claimant’s wage-earning capacity. – Given that this claimant is only working part-time, the CE may write the TP and ask for work restrictions or determine if a SECOP is more appropriate. The EA could also write the TP and request updated restrictions; however, you may want to determine what actions OWCP will take if you have already written to the DOL for assistance. 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
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