6.800.1. Workers’ Compensation Program

(1) The Federal Employees’ Compensation Act (FECA), Title 5, United States Code (USC), Chapter 81, is administered by the Department of Labor (DOL) Office of Workers’ Compensation Program (OWCP). The FECA provides workers' compensation coverage for employment-related injuries and occupational diseases. The FECA benefits include wage replacement, payment for medical care, medical and vocational rehabilitation, assistance in returning employees to work and survivor benefits.

(2) The DOL OWCP has the exclusive authority to administer, interpret, and enforce the provisions of the FECA and final decision on all matters.

(3) The WCC establishes guidance and oversight of the IRS workers' compensation program.

(1) Laws: United States Code at: https://www.govregs.com/uscode

1. Title 5, Government Organization and Employees
   • 8101-8152, Compensation for Work Injuries
   • 552a, Records Maintained on Individuals

2. Title 18, Crimes and Criminal Procedures
   • 1920, False Statement or Fraud to Obtain Federal Employees’ Compensation
   • 1922, False or Withheld Report Concerning Federal Employees’ Compensation

(2) Regulations: Code of Federal Regulations at: https://www.ecfr.gov/

1. Title 5, Administrative Personnel
   • Part 353, Restoration to Duty from Uniformed Service or Compensable Injury

2. Title 20, Employee Benefits
   • Part 10, Claims for Compensation under the Federal Employees’ Compensation Act (FECA)

(1) The IRS is committed to their responsibility of implementing the Workers’ Compensation Program, as outlined by FECA.

(2) The IRS Human Capital Officer is the executive responsible for this IRM and overall Servicewide policy for the Workers’ Compensation Program.

(3) The HCO, Office of HR Strategy (OHRS), Policy and Audits (P&A) is responsible for developing and publishing content in this IRM.

(4) The HCO, LERN, WCC is responsible for providing ongoing support to management.

(5) The WCC serves as the official liaison between IRS and the DOL OWCP.

(6) Supervisors are responsible for ensuring employees receive prompt medical care upon notification that an on the job injury or illness has occurred and the appropriate workers’ compensation forms are filed.

(7) Employees are responsible for reporting all work-related injuries and illnesses to their supervisor as soon as possible and seek medical attention immediately, when necessary.

(1) The HCO, OHRO, LERN, WCC, monitors the effectiveness of this program based on feedback from customers and stakeholders and considers any statutory or regulatory changes. The IRM sections are revised, added, or deleted annually during review and publishing, in partnership with HCO’s P&A division.

(1) The WCC is responsible for implementing, monitoring, and improving internal controls including:

1. Establishing program goals to measure performance to assess efficient and effective objectives.

2. Ensuring the program and resources are protected against waste, fraud, abuse, mismanagement, and misappropriation.

3. Ensuring program operations are reviewed in conformance with workers’ compensation laws and regulations.

4. Ensuring financial reporting is complete, current, and accurate.

5. Ensuring current workers’ compensation data is used in decision making and quality assurance.

(1) The following table is a list of terms and definitions discussed in this IRM, as defined by the DOL Office of Workers’ Compensation.

(1) Information on the Federal Employees’ Compensation Program can be found at: https://www.dol.gov/agencies/owcp/FECA.

(2) Information on the DOL, Division of Federal Employee’s Compensation (DFEC) Procedure Manual, for the administration of the FECA, can be found at: https://www.dol.gov/agencies/owcp/FECA/procedure-manual.

(3) Information on ECOMP can be found at: https://www.ecomp.dol.gov/#/.

(1) A traumatic injury is a condition to the body caused by a specific event or incident, or a series of events or incidents, within a single workday or shift. The condition must be caused by external force, including stress or strain, which is identifiable as to time and place of occurrence and member or function of the body affected.

(2) The injured employee must report all injuries to their supervisor immediately and complete the following forms electronically using ECOMP :

1. Federal Employee’s Notice of Traumatic Injury and Claim for Continuation of Pay Form, Form CA -1. The employee may contact the WCC for assistance in completing the paper version if the employee does not have access to a computer, at: hco.workers.compensation.center@irs.gov.

2. Injuries and Illnesses Incident Report, OSHA Form 301.

(3) The supervisor must complete the OSHA Form 301 and Supervisor’s Report of Form CA - 1 within the timeframe required by the DOL and submit to the WCC.

(4) The supervisor must advise the employee to select a qualified physician within a 100-mile round trip radius from the employee’s Post of Duty (POD) or home for medical care. If appropriate care is not available within a 100-mile round trip radius, the DOL OWCP may approve appropriate additional mileage. A change in physician must be requested in writing and can only be authorized by the DOL OWCP.

(5) The supervisor must authorize treatment by giving the employee a properly executed Authorization for Examination and Treatment Form, Form CA-16, within seven days of the injury. This form is only available by request through the WCC. Supervisors must use discretion in issuing Form CA-16. This form obligates the IRS to pay for medical treatment for a period of up to 60-calendar days or up to $1500.00 of medical treatment. Form CA-16 may be used to authorize treatment in cases of a doubtful nature, and in emergencies or unusual circumstances by completing block 6B of Form CA-16. If the employee has already been seen by a physician, Form CA -16 cannot be issued retroactively. An authorization for future treatment or as the need arises, is not to be issued. When such authorization is requested, the employee should be advised to contact their supervisor or the WCC as the need for treatment arises.

(6) It is the employee’s responsibility to provide medical evidence to support their work-related injury, work status and ability to return-to-work as soon as possible. The supervisor must issue Duty Status Report, Form CA -17, to the employee for each doctor's visit:

1. The employee must return the completed Form CA -17 and all other medical evidence to their supervisor immediately after the examination or at the start of their next scheduled work day or shift.

2. If the employee is totally disabled, Form CA -17 must be mailed or faxed to the supervisor without delay. Upon receipt, the supervisor must forward the medical documentation to WCC.

3. Supervisors must track COP during the 45-calendar day entitlement period for traumatic injuries.

(7) Supervisors must inform the employee of their obligation to advise the physician of available modified duty assignments. The supervisor should monitor the employee's medical progress and duty status regularly by completing Form CA -17, Duty Status Reports, until the employee is released to full duty or from medical care.

(8) If the employee returns to work with restrictions:

1. The supervisor must furnish the employee with a written light duty job offer letter that includes a description of the specific duties, the physical requirements, the date the job is available and the duration of the duty assignment. See Exhibit 6.800.1-6, Sample Job Offer Letter.

2. The employee must sign and date the Acceptance or Declination Statement.

3. A copy of the signed job offer letter and signed Acceptance or Declination Statement must be sent to the WCC.

(1) An occupational disease or illness is a medical condition produced by the work environment over a period longer than a single workday or shift.

(2) The injured employee must report their occupational illness to their supervisor immediately and file a workers’ compensation claim in ECOMP completing the following forms:

1. Notice of Occupational Disease and Claim for Compensation, Form CA -2, If the employee does not have access to a computer, they may contact the WCC for assistance with a paper version at: hco.workers.compensation.center@irs.gov.

2. Notice of Recurrence, Form CA -2a, is used when an employee returns to work from an injury and the same injury recurs.

3. Injuries and Illnesses Incident Report, OSHA Form 301.

(3) The supervisor is responsible for completing the Supervisor’s Report of the OSHA Form 301 and Form CA -2 within the designated time period and submitted to the WCC. Form CA -2 must be completed and transmitted from the WCC to the DOL OWCP within 10-calendar days from the date the supervisor receives the claim from the employee.

(4) The employee and supervisor must complete the Evidence Required in Support of a Claim for Occupational Disease Form, Form CA -35, and email it to the WCC immediately.

(5) The supervisor must advise the employee to select a qualified physician within a 100-mile round trip radius from the employee’s POD or home for medical care. If appropriate care is not available within that radius, the DOL OWCP may approve appropriate additional mileage. A change in physician can only be authorized by the DOL OWCP.

(6) The DOL OWCP can take up to six months or longer to approve or deny benefits for an occupational disease or illness claim.

(7) The supervisor must advise the employee of their responsibility to return-to-work as soon possible and provide medical evidence to substantiate lost time and their duty status. The employee is obligated to advise their physician that modified job duties are available.

1. The supervisor must issue Form CA -17 to the employee for each doctor's visit to monitor the employee’s medical progress and duty status until the employee is released to full duty.

2. The employee must return their completed Form CA -17 and any medical evidence to their supervisor after the examination or at the start of the employee's next scheduled work day or shift. If the employee is totally disabled, the form must be sent to the supervisor immediately.

3. The supervisor must forward the medical documentation to the WCC immediately.

(8) If the employee returns to work with restrictions:

1. The supervisor must furnish the employee with a written light duty job offer letter, a description of the specific duties, physical requirements, and date of availability of the modified duty assignment.

2. The employee must sign and date the Acceptance or Declination Statement indicating their acceptance or declination of the modified duty offer and return to their supervisor. A copy of the signed job offer letter and signed Acceptance Declination Statement must be submitted to the WCC.

(1) If an employee sustained a traumatic injury and cannot return-to-work at the end of the 45-calendar day period of Continuation of Pay (COP), the employee may choose to be placed in OWCP-LWOP leave status and file a claim requesting wage loss compensation from the DOL OWCP.

(2) The employee may opt to use personal leave and file a LBB claim within one calendar year from the date of the DOL acceptance. See IRM 6.800.1.2.5, Leave Buy Back.

(3) At the end of the 45-calendar day period of COP, the employee must complete and submit page 1 of Form CA -7 in ECOMP and any supporting medical documentation to their supervisor.

(4) For intermittent absences, the employee is required to submit the Time Analysis Form, Form CA 7a. If the employee does not have access to a computer, the supervisor or the WCC will assist the employee with a paper Form CA -7 and Form CA 7a to file for compensation benefits:

1. The supervisor must complete Form CA -7 and forward to the WCC, along with all relevant medical evidence within the required DOL timeframe.

2. If the employee’s disability is expected to continue beyond the period claimed on the initial Form CA -7, the employee must complete subsequent Form CA -7 every two weeks until the employee returns to work on limited or regular duty, or until otherwise directed by the WCC or the servicing DOL OWCP office. If the employee accumulates 80 hours or more of OWCP-LWOP leave, the supervisor must prepare a PAR to document the employees compensable leave status by placing the injured employee on extended OWCP-LWOP.

3. The supervisor must contact the employee’s workers' compensation human resources specialist immediately after the employee returns to work to ensure action is taken to prevent overpayment by DOL OWCP.

4. If the employee returns to work with restrictions, the supervisor will prepare a written job offer using Exhibit 6.800.1-6 Sample Job Offer Letter.

5. Questions for the WCC should be sent to: hco.workers.compensation.center@irs.gov.

(1) The COP is the continuation of an employee’s regular pay for a period of time, not to exceed 45-calendar days, due to a work-related injury. COP applies to traumatic injuries only and is not authorized for occupational illnesses. The intent of COP is to avoid interruption of pay while the claim is adjudicated. To qualify for COP, an employee must file Form CA -1 within 30-calendar days from the date of injury.

(2) The COP is counted in one day increments even if the employee worked a portion of the day, including holidays and weekends. Any absence from work on the date of injury for medical attention will be charged to administrative leave. The supervisor should contact the WCC with questions on reporting leave while an employee is out on workers’ compensation.

(3) A WCC human resources specialist will assist supervisors in monitoring the duration of the COP. Dates of eligibility for COP should be compared with the medical reports and the employee’s inability to work. Employees electing to take sick leave or annual leave will be placed in leave status. Medical documentation is required for all work-related injuries and illness, regardless of the type of leave requested.

(1) The LBB is a leave restoration program to reinstate sick or annual leave used during a period for which OWCP compensation benefits are payable that can be repurchased by the employee. The leave is restored to the employee’s personal leave account. Credit or compensatory hours may not be purchased under the LBB Program. The LBB process may take up to eighteen months to complete.

(2) Following a work-related injury or disease, employees may choose to use sick leave or annual leave to avoid interrupting their income. This frequently occurs when an employee has exhausted COP or has filed an occupational disease or illness claim.

(3) An employee with an approved DOL OWCP workers’ compensation claim who used their sick leave or annual leave to cover their disability from work, may be eligible to have their leave restored through the LBB program. The claim must be supported with medical evidence showing the employee was unable to work during the period claimed. The used leave may be repurchased if the IRS agrees that all requirements have been met.

(4) The employee must pay the IRS the difference between the leave pay which is based on 100% of the employee’s salary and the workers’ compensation entitlement which is payable at 66 2/3% or 75% of the employee’s salary. Once the difference is paid back in its entirety, the IRS will restore the leave to the employee’s annual leave or sick leave balance.

(5) Annual leave purchased under the LBB program is credited to the year in which the leave was actually used. If the employee buys back annual leave that results in an end of leave year balance in excess of the maximum permissible carryover balance, the excess annual leave will be forfeited and may not be restored.

(1) Controvert refers to a dispute in order to discontinue the COP entitlement. The IRS shall continue the regular pay of an eligible employee without a break in time for up to 45-calendar days, except when:

1. The disability was not caused by a traumatic injury.

2. The employee is not a citizen of the United States or Canada.

3. A written claim was not filed within 30-calendar days from the date of injury.

4. The injury was not reported until after employment was terminated.

5. The injury occurred off the IRS premises and was not within the performance of official duties.

6. The injury was caused by the employee's willful misconduct, intent to injury or kill themselves or another person or was proximately caused by intoxication by alcohol or illegal drugs.

7. Work did not stop for more than 45-calendar days following the injury.

(2) The IRS may challenge the entire claim or any portion of it, if the preliminary review of Form CA -1, Form CA -2, Form CA -2a, witness statement, and medical report suggests the claim is unjustified. It is the responsibility of all supervisors to dispute any claim or any element of the claim, for which there is credible evidence of:

1. Fraud or abuse.

2. Honest misjudgment by the employee.

3. Any circumstances which question the employee's entitlement to workers' compensation.

(3) It is essential for the WCC and management to provide all pertinent facts to the DOL OWCP as soon as the information is available. Absent a full reply from the IRS, DOL OWCP will accept the employee’s statements and allegations as factual and will assume the IRS fully concurs with them. The IRS has no appeal rights in the claim's adjudication process; therefore, it is critical all factual evidence be provided without delay to the WCC for submission to the DOL OWCP.

(1) When an employee has suffered a work-related traumatic injury resulting in an extended period of disability, the WCC will take the following steps to facilitate the injured employee’s return-to-work process:

1. Providing and authorizing medical care on the Authorization for Examination and Treatment Form, Form CA-16, for the employee to present to medical providers. If the supervisor is not certain that the injury occurred in the performance of duty, item 6B on Form CA-16 should be checked.

2. Providing Form CA-1, Traumatic Injury Claim Form, to the employee for completion of the employee's portion of the form.

3. Notifying the employee of the right to elect COP or to use annual leave, sick leave or OWCP-LWOP if the injury is disabling. The employee should be advised that annual leave or sick leave used will count against the 45-calendar day COP period.

4. Notifying the employee of the need to submit medical evidence of a disabling traumatic injury within 10-calendar days of the date the disability begins or pay may be terminated. The WCC will provide the employee with a Duty Status Report, Form CA-17, for completion by their physician providing medical care.

5. Informing the employee whether COP will be controverted and, if so, whether pay will be terminated, and the basis for such action. The basis for controversion will be included on the Traumatic Injury Claim Form, Form CA-1, or by separate narrative report.

6. Submitting Form CA-1, Traumatic Injury Claim Form, fully completed by both the employee and the supervisor, all pertinent documents, to the DOL OWCP within 10-calendar days following receipt by the IRS.

7. Advising the employee of their obligation to return-to-work as soon as possible in accordance with the medical evidence.

8. Terminating COP when disability ends, the 45-calendar day period expires, or the employee returns to work.

(1) The FECA requires a permanent employee to be restored to their former position or an equivalent position who recovers within one year after beginning compensation.

(2) The WCC provides guidance and assistance to facilitate the return-to-work effort, per the FECA requirements. This provision does not apply to temporary or term employees.

(3) The return-to-work process for injured employees requires collaboration and cooperation of the IRS Leadership at all levels, including IRS business units, WCC, LERN, various support functions and the injured employee to timely and safely return the employee to work.

(4) The following steps must be taken to identify suitable work across all organizations to meet IRS compliance with applicable FECA regulations:

1. The IRS Leadership will work with WCC, LERN and EDI to identify light, limited, or modified duty assignments for injured employees who are able to return to restricted work with the intent to return the injured employees to gainful employment as soon as medically feasible.

2. The WCC will work with servicing employment offices to ensure employees who are fully or partially recovered from compensable work-related injuries and illnesses, return-to-work in their local commuting area in accordance with applicable laws and regulations.

   Note: The definition of “local commuting area” is set forth in IRM 6.335.1, Promotion and Internal Placement.

3. If suitable work cannot be identified after considering available placement options within the commuting area, the injured employee’s first-level executive will certify suitable work is not available. This certification will include documentation to support such findings.

   Note: These procedures supplement IRM 6.335.1, Promotion and Internal Placement, Merit Promotion Plan and Internal Placement concerning employees with statutory placement rights.

(5) These restoration rights generally depend on the injured employee’s length of disability and the extent of recovery as outlined below:

(1) The employee is entitled to an oral hearing before an OWCP representative after a final decision has been made and before reconsideration,
under Section 5 USC. 8128.

(2) In place of an oral hearing, the employee is entitled to a review of the written record by an OWCP representative. Such a review will not involve oral testimony or attendance by the employee, but the employee may submit any written evidence or argument deemed relevant.

(3) The hearing or review is usually limited to those issues which were addressed by the OWCP claims office in the contested decision. Other issues may be addressed at the discretion of the OWCP representative.

(1) An employee may apply for reconsideration of a final decision regardless of the date of injury, illness or death.

(2) While no special form is required, the request must be in writing, signed and dated by the employee or the authorized representative and accompanied by relevant new evidence or argument not considered previously.

(3) The request should also identify the decision and the specific issue(s) for which reconsideration is being requested.

(4) The request must be received within one year of the date of the contested decision.

(1) The ECAB was created as an entity separate from OWCP to give federal employees the same administrative due process of law and right of appellate review.

(2) The ECAB consists of three members, one of whom is designated as the Chairman. The ECAB may consider and decide appeals from the final decisions of the OWCP in any case arising under the FECA.

(3) The ECAB may review all relevant questions of law, fact, and exercise of discretion in such cases, except decisions concerning the amounts payable for medical services and decisions concerning exclusion and reinstatement of medical providers.

(4) Only the evidence in the case record at the time of OWCP's final decision will be reviewed. The ECAB will not consider new evidence.

(5) An employee residing within the United States or Canada must file application for review by the ECAB within 90-calendar days from the date of the OWCP's decision. An employee residing elsewhere must file within 180-calendar days.