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FEDERAL · 20 CFR

Part 10 — Claims for Compensation Under the Federal Employees' Compensation Act, as Amended

225 sections · Title 20: Employees' Benefits

§ 10.0What are the provisions of the FECA, in general?
§ 10.1What rules govern the administration of the FECA and this chapter?
§ 10.2What do these regulations contain?
§ 10.3Have the collection of information requirements of this part been approved by the Office of Management and Budget (OMB)?
§ 10.5What definitions apply to the regulations in this subchapter?
§ 10.6What special statutory definitions apply to dependents and survivors?
§ 10.7What forms are needed to process claims under the FECA?
§ 10.10Are all documents relating to claims filed under the FECA considered confidential?
§ 10.11Who maintains custody and control of FECA records?
§ 10.12How may a FECA claimant or beneficiary obtain copies of protected records?
§ 10.13What process is used by a person who wants to correct FECA-related documents?
§ 10.15May compensation rights be waived?
§ 10.16What criminal and civil penalties may be imposed in connection with a claim under the FECA?
§ 10.17Is a beneficiary who defrauds the Government in connection with a claim for benefits still entitled to those benefits?
§ 10.18Can a beneficiary who is incarcerated based on a felony conviction still receive benefits?
§ 10.100How and when is a notice of traumatic injury filed?
§ 10.101How and when is a notice of occupational disease filed?
§ 10.102How and when is a claim for wage loss compensation filed?
§ 10.103How and when is a claim for permanent impairment filed?
§ 10.104How and when is a claim for recurrence filed?
§ 10.105How and when is a notice of death and claim for benefits filed?
§ 10.110What should the employer do when an employee files a notice of traumatic injury or occupational disease?
§ 10.111What should the employer do when an employee files an initial claim for compensation due to disability or permanent impairment?
§ 10.112What should the employer do when an employee files a claim for continuing compensation due to disability?
§ 10.113What should the employer do when an employee dies from a work-related injury or disease?
§ 10.115What evidence is needed to establish a claim?
§ 10.116What additional evidence is needed in cases based on occupational disease?
§ 10.117What happens if, in any claim, the employer contests any of the facts as stated by the claimant?
§ 10.118Does the employer participate in the claims process in any other way?
§ 10.119What action will OWCP take with respect to information submitted by the employer?
§ 10.120May a claimant submit additional evidence?
§ 10.121What happens if OWCP needs more evidence from the claimant?
§ 10.125How does OWCP determine entitlement to benefits?
§ 10.126What does the decision contain?
§ 10.127To whom is the decision sent?
§ 10.200What is continuation of pay?
§ 10.205What conditions must be met to receive COP?
§ 10.206May an employee who uses leave after an injury later decide to use COP instead?
§ 10.207May an employee who returns to work, then stops work again due to the effects of the injury, receive COP?
§ 10.210What are the employee's responsibilities in COP cases?
§ 10.211What are the employer's responsibilities in COP cases?
§ 10.215How does OWCP compute the number of days of COP used?
§ 10.216How is the pay rate for COP calculated?
§ 10.217Is COP charged if the employee continues to work, but in a different job that pays less?
§ 10.220When is an employer not required to pay COP?
§ 10.221How is a claim for COP controverted?
§ 10.222When may an employer terminate COP which has already begun?
§ 10.223Are there other circumstances under which OWCP will not authorize payment of COP?
§ 10.224What happens if OWCP finds that the employee is not entitled to COP after it has been paid?
§ 10.300What are the basic rules for authorizing emergency medical care?
§ 10.301May the physician designated on Form CA-16 refer the employee to another medical specialist or medical facility?
§ 10.302Should the employer authorize medical care if he or she doubts that the injury occurred, or that it is work-related?
§ 10.303Should the employer use a Form CA-16 to authorize medical testing when an employee is exposed to a workplace hazard just once?
§ 10.304Are there any exceptions to these procedures for obtaining medical care?
§ 10.310What are the basic rules for obtaining medical care?
§ 10.311What are the special rules for the services of chiropractors?
§ 10.312What are the special rules for the services of clinical psychologists?
§ 10.313Will OWCP pay for preventive treatment?
§ 10.314Will OWCP pay for the services of an attendant?
§ 10.315Will OWCP pay for transportation to obtain medical treatment?
§ 10.316After selecting a treating physician, may an employee choose to be treated by another physician instead?
§ 10.320Can OWCP require an employee to be examined by another physician?
§ 10.321What happens if the opinion of the physician selected by OWCP differs from the opinion of the physician selected by the employee?
§ 10.322Who pays for second opinion and referee examinations?
§ 10.323What are the penalties for failing to report for or obstructing a second opinion or referee examination?
§ 10.324May an employer require an employee to undergo a physical examination in connection with a work-related injury?
§ 10.330What are the requirements for medical reports?
§ 10.331How and when should the medical report be submitted?
§ 10.332What additional medical information will OWCP require to support continuing payment of benefits?
§ 10.333What additional medical information will OWCP require to support a claim for a schedule award?
§ 10.335How are medical bills submitted?
§ 10.336What are the time frames for submitting bills?
§ 10.337If an employee is only partially reimbursed for a medical expense, must the provider refund the balance of the amount paid to the employee?
§ 10.400What is total disability?
§ 10.401When and how is compensation for total disability paid?
§ 10.402What is partial disability?
§ 10.403When and how is compensation for partial disability paid?
§ 10.404When and how is compensation for a schedule impairment paid?
§ 10.405Who is considered a dependent in a claim based on disability or impairment?
§ 10.406What are the maximum and minimum rates of compensation in disability cases?
§ 10.410Who is entitled to compensation in case of death, and what are the rates of compensation payable in death cases?
§ 10.411What are the maximum and minimum rates of compensation in death cases?
§ 10.412Will OWCP pay the costs of burial and transportation of the remains?
§ 10.413May a schedule award be paid after an employee's death?
§ 10.414What reports of dependents are needed in death cases?
§ 10.415What must a beneficiary do if the number of beneficiaries decreases?
§ 10.416How does a change in the number of beneficiaries affect the amount of compensation paid to the other beneficiaries?
§ 10.417What reports are needed when compensation payments continue for children over age 18?
§ 10.420How are cost-of-living adjustments applied?
§ 10.421May a beneficiary receive other kinds of payments from the Federal Government concurrently with compensation?
§ 10.422May compensation payments be issued in a lump sum?
§ 10.423May compensation payments be assigned to, or attached by, creditors?
§ 10.424May someone other than the beneficiary be designated to receive compensation payments?
§ 10.425May compensation be claimed for periods of restorable leave?
§ 10.430How does OWCP notify an individual of a payment made?
§ 10.431What does OWCP do when an overpayment is identified?
§ 10.432How can an individual present evidence to OWCP in response to a preliminary notice of an overpayment?
§ 10.433Under what circumstances can OWCP waive recovery of an overpayment?
§ 10.434If OWCP finds that the recipient of an overpayment was not at fault, what criteria are used to decide whether to waive recovery of it?
§ 10.435Is an individual responsible for an overpayment that resulted from an error made by OWCP or another Government agency?
§ 10.436Under what circumstances would recovery of an overpayment defeat the purpose of the FECA?
§ 10.437Under what circumstances would recovery of an overpayment be against equity and good conscience?
§ 10.438Can OWCP require the individual who received the overpayment to submit additional financial information?
§ 10.439What is addressed at a pre-recoupment hearing?
§ 10.440How does OWCP communicate its final decision concerning recovery of an overpayment, and what appeal right accompanies it?
§ 10.441How are overpayments collected?
§ 10.500What are the basic rules governing continuing receipt of compensation benefits and return to work?
§ 10.501What medical evidence is necessary to support continuing receipt of compensation benefits?
§ 10.502How does OWCP evaluate evidence in support of continuing receipt of compensation benefits?
§ 10.503Under what circumstances may OWCP reduce or terminate compensation benefits?
§ 10.505What actions must the employer take?
§ 10.506May the employer monitor the employee's medical care?
§ 10.507How should the employer make an offer of suitable work?
§ 10.508May relocation expenses be paid for an employee who would need to move to accept an offer of reemployment?
§ 10.509If an employee's light duty job is eliminated due to downsizing, what is the effect on compensation?
§ 10.510When may a light duty job form the basis of a loss of wage-earning capacity determination?
§ 10.511How may a loss of wage-earning capacity determination be modified?
§ 10.515What actions must the employee take with respect to returning to work?
§ 10.516How will an employee know if OWCP considers a job to be suitable?
§ 10.517What are the penalties for refusing to accept a suitable job offer?
§ 10.518Does OWCP provide services to help employees return to work?
§ 10.519What action will OWCP take if an employee refuses to undergo vocational rehabilitation?
§ 10.520How does OWCP determine compensation after an employee completes a vocational rehabilitation program?
§ 10.521If an employee elects to receive retirement benefits instead of FECA benefits, what effect may such an election have on that employee's entitlement to FECA compensation?
§ 10.525What information must the employee report?
§ 10.526Must the employee report volunteer activities?
§ 10.527Does OWCP verify reports of earnings?
§ 10.528What action will OWCP take if the employee fails to file a report of activity indicating an ability to work?
§ 10.529What action will OWCP take if the employee files an incomplete report?
§ 10.535How are dependents defined, and what information must the employee report?
§ 10.536What is the penalty for failing to submit a report of dependents?
§ 10.537What reports are needed when compensation payments continue for children over age 18?
§ 10.540When and how is compensation reduced or terminated?
§ 10.541What action will OWCP take after issuing written notice of its intention to reduce or terminate compensation?
§ 10.600How can final decisions of OWCP be reviewed?
§ 10.605What is reconsideration?
§ 10.606How does a claimant request reconsideration?
§ 10.607What is the time limit for requesting reconsideration?
§ 10.608How does OWCP decide whether to grant or deny the request for reconsideration?
§ 10.609How does OWCP decide whether new evidence requires modification of the prior decision?
§ 10.610What is a review by the Director?
§ 10.615What is a hearing?
§ 10.616How does a claimant obtain a hearing?
§ 10.617How is an oral hearing conducted?
§ 10.618How is a review of the written record conducted?
§ 10.619May subpoenas be issued for witnesses and documents?
§ 10.620Who pays the costs associated with subpoenas?
§ 10.621What is the employer's role when an oral hearing has been requested?
§ 10.622May a claimant or representative withdraw a request for or postpone a hearing?
§ 10.625What kinds of decisions may be appealed?
§ 10.626Who has jurisdiction of cases on appeal to the ECAB?
§ 10.700May a claimant designate a representative?
§ 10.701Who may serve as a representative?
§ 10.702How are fees for services paid?
§ 10.703How are fee applications approved?
§ 10.704What penalties apply to representatives who collect a fee without approval?
§ 10.705When must an employee or other FECA beneficiary take action against a third party?
§ 10.706How will a beneficiary know if OWCP or SOL has determined that action against a third party is required?
§ 10.707What must a FECA beneficiary who is required to take action against a third party do to satisfy the requirement that the claim be “prosecuted”?
§ 10.708Can a FECA beneficiary who refuses to comply with a request to assign a claim to the United States or to prosecute the claim in his or her own name be penalized?
§ 10.709What happens if a beneficiary directed by OWCP or SOL to take action against a third party does not believe that a claim can be successfully prosecuted at a reasonable cost?
§ 10.710Under what circumstances must a recovery of money or other property in connection with an injury or death for which benefits are payable under the FECA be reported to OWCP or SOL?
§ 10.711How is the amount of the recovery of the FECA beneficiary determined?
§ 10.712How much of any settlement or judgment must be paid to the United States?
§ 10.713How is a structured settlement (that is, a settlement providing for receipt of funds over a specified period of time) treated for purposes of reporting the gross recovery?
§ 10.714What amounts are included in the refundable disbursements?
§ 10.715Is a beneficiary required to pay interest on the amount of the refund due to the United States?
§ 10.716If the required refund is not paid within 30 days of the request for repayment, can it be collected from payments due under the FECA?
§ 10.717Is a settlement or judgment received as a result of allegations of medical malpractice in treating an injury covered by the FECA a gross recovery that must be reported to OWCP or SOL?
§ 10.718Are payments to a beneficiary as a result of an insurance policy which the beneficiary has purchased a gross recovery that must be reported to OWCP or SOL?
§ 10.719If a settlement or judgment is received for more than one wound or medical condition, can the refundable disbursements paid on a single FECA claim be attributed to different conditions for purposes of calculating the refund or credit owed to the United States?
§ 10.725When is a Federal grand or petit juror covered under the FECA?
§ 10.726When does a juror's entitlement to disability compensation begin?
§ 10.727What is the pay rate of jurors for compensation purposes?
§ 10.730What are the conditions of coverage for Peace Corps volunteers and volunteer leaders injured while serving outside the United States?
§ 10.731What is the pay rate of Peace Corps volunteers and volunteer leaders for compensation purposes?
§ 10.735When is a non-Federal law enforcement officer (LEO) covered under the FECA?
§ 10.736What are the time limits for filing a LEO claim?
§ 10.737How is a LEO claim filed, and who can file a LEO claim?
§ 10.738Under what circumstances are benefits payable in LEO claims?
§ 10.739What kind of objective evidence of a potential Federal crime must exist for coverage to be extended?
§ 10.740In what situations will OWCP automatically presume that a law enforcement officer is covered by the FECA?
§ 10.741How are benefits calculated in LEO claims?
§ 10.800How do providers enroll with OWCP for authorizations and billing?
§ 10.801How are medical bills to be submitted?
§ 10.802How should an employee prepare and submit requests for reimbursement for medical expenses, transportation costs, loss of wages, and incidental expenses?
§ 10.803What are the time limitations on OWCP's payment of bills?
§ 10.805What services are covered by the OWCP fee schedule?
§ 10.806How are the maximum fees defined?
§ 10.807How are payments for particular services calculated?
§ 10.808Does the fee schedule apply to every kind of procedure?
§ 10.809How are payments for medicinal drugs determined?
§ 10.810How are payments for inpatient medical services determined?
§ 10.811When and how are fees reduced?
§ 10.812If OWCP reduces a fee, may a provider request reconsideration of the reduction?
§ 10.813If OWCP reduces a fee, may a provider bill the claimant for the balance?
§ 10.815What are the grounds for excluding a provider from payment under the FECA?
§ 10.816What will cause OWCP to automatically exclude a physician or other provider of medical services and supplies?
§ 10.817How are OWCP's exclusion procedures initiated?
§ 10.818How is a provider notified of OWCP's intent to exclude him or her?
§ 10.819What requirements must the provider's answer and OWCP's decision meet?
§ 10.820How can an excluded provider request a hearing?
§ 10.821How are hearings assigned and scheduled?
§ 10.822How are subpoenas or advisory opinions obtained?
§ 10.823How will the administrative law judge conduct the hearing and issue the recommended decision?
§ 10.824How does the recommended decision become final?
§ 10.825What are the effects of exclusion?
§ 10.826How can an excluded provider be reinstated?
§ 10.900What is the death gratuity under this subpart?
§ 10.901Which employees are covered under this subpart?
§ 10.902Does every employee's death due to injuries incurred in connection with his or her service with an Armed Force in a contingency operation qualify for the death gratuity?
§ 10.903Is the death gratuity payment applicable retroactively?
§ 10.904Does a death as a result of occupational disease qualify for payment of the death gratuity?
§ 10.905If an employee incurs a covered injury in connection with his or her service with an Armed Force in a contingency operation but does not die of the injury until years later, does the death qualify for payment of the death gratuity?
§ 10.906What special statutory definitions apply to survivors under this subpart?
§ 10.907What order of precedence will OWCP use to determine which survivors are entitled to receive the death gratuity payment under this subpart?
§ 10.908Can an employee designate alternate beneficiaries to receive a portion of the death gratuity payment?
§ 10.909How does an employee designate a variation in the order or percentage of gratuity payable to survivors and how does the employee designate alternate beneficiaries?
§ 10.910What if a person entitled to a portion of the death gratuity payment dies after the death of the covered employee but before receiving his or her portion of the death gratuity?
§ 10.911How is the death gratuity payment process initiated?
§ 10.912What is required to establish a claim for the death gratuity payment?
§ 10.913In what situations will OWCP consider that an employee incurred injury in connection with his or her service with an Armed Force in a contingency operation?
§ 10.914What are the responsibilities of the employing agency in the death gratuity payment process?
§ 10.915What are the responsibilities of OWCP in the death gratuity payment process?
§ 10.916How is the amount of the death gratuity calculated?