Most people are aware of how the workers’ compensation program works for people in the public sector who are injured at work. The federal government does not cover its employees under this program. Instead, there is a program specifically for federal employees.
The Federal Employees Compensation Act (FECA) provides compensation benefits in the case of injury, disease, disability, or death from employment-related causes. President Woodrow Wilson signed it into law on September 7, 1916.
While the processes and regulations are complex, there hasn’t been much change over the years. The government has amended the program only four times – in 1949, 1960, 1966, and 1974.
Whom Does FECA Cover?
FECA covers both full-time and part-time federal workers, regardless of the branch of government (judicial, executive, or legislative) that employs them. The following employees are covered:
- State and local law enforcement acting in a federal capacity
- Peace Corps volunteers
- Coast Guard Auxiliary members
- Civil Air Patrol members
- Federal jurors
What is Not Covered by FECA?
FECA covers all injuries and illnesses resulting from or aggravated, precipitated, or accelerated by work activities. The only limitations are situations caused by willful misconduct of the employee, caused intentionally or by intoxication. Benefits are suspended if the employee is imprisoned due to a felony conviction, and these benefits are not restored upon release.
What Is the First Step?
The first step is to notify your supervisor. You need to have Form CA-16 (Authorization for Examination and/or Treatment) before you seek medical services, unless it is an emergency. You may choose your own physician, but you need authorization if you want to change physicians later. Your physician will need to use Form OWCP-1500 to receive compensation. Other providers, such as pharmacies and hospitals, may use their own forms.
Form CA-1 is for traumatic injuries and must be turned in within 30 days. Form CA-2 is for occupational diseases. In addition, the worker should file a Continuation of Pay (COP) request that will provide 100% of pay for the first 45 calendar days. Use Form CA-7 for this purpose.
Going Forward – Compensation for Temporary or Permanent Disability and Death
Compensation past the first 45 days is determined by various factors, including extent of injury and whether the employee has dependents. For example, with temporary total disability, compensation is 67 percent of salary with no dependents and 75 percent with dependents. If your injury requires physical therapy, it is usually authorized for the first 120 days from the date of injury. Chiropractors and other therapy may also be covered depending on the nature of the injury.
In the case of permanent effects from injury, compensation follows a schedule of benefits related to the actual loss. Death benefits are paid based on whether there is just a widow or widower, just children, or both involved.
All compensation benefits are subject to a cost-of-living raise each year based on the Consumer Price Index percentage change.
Federal employees should acquaint themselves with the DFEC publication and CRS Report to better understand the various benefits, processes, policies, elections, and appeal rights the program affords.
It is important to note that FECA compensation and medical benefits continue throughout the disability with no maximum age. Prior to the 1974 amendment, there was a reduction in benefits after age 70. The number of weeks of compensation is limited, but age is not a factor. However, there are policies for coordination with other benefits, such as Civil Service Retirement, Federal Employees’ Retirement, CSRS and FERS disability retirement, Social Security retirement, and Social Security disability.
How Does FECA Compare with State Workers’ Compensation Systems?
Each state’s workers’ compensation program has different benefit percentages and provisions, but overall, FECA disability benefits are higher. In addition, the rules in some states are even more complex. A key benefit to FECA is the 100 percent pay rate for the first 45 days. Most states range between 60 and 80 percent. Some states also go by the net wages rather than the gross, further reducing the compensation.
Some state programs are better in that they cover injuries during the commute to and from work. FECA does not, except in specific situations.
The need for FECA reform has been in and out of the spotlight for many years. With benefits topping an average of $3 billion per year, including disability, medical and death benefits, it is often under the microscope. Reforms that would put more attention on reducing injury risk, among other changes, are believed to be necessary to keep it responsive to what is happening in the workplace.
Since the last amendment occurred over 40 years ago, it is likely there is room for improvement. However, the call for reform is not to take benefits away from those dedicated to serving the public, but rather to operate more efficiently.
Other Tidbits to Know
Dealing with an injury or illness is difficult, but learning all the pertinent information will help keep you from making a mistake that could make things worse. For example, be careful to follow the various time limits for filing.
Your claim must occur within three years of the injury, although if written notice was given within 30 days, the claim period can be extended. This would be relevant in the case of an accident that did not have immediate health consequences but was responsible for injuries that appeared later.
Another useful thing to know is that you do not need to use your accumulated sick or leave time before getting compensation. You can, however, choose to do so if you wish. You cannot use sick or leave time to satisfy any waiting periods.
Regarding health insurance, deductions for health coverage will be made from compensation. You can change your health benefit plan during open season. Optional life insurance payments can also be deducted. Keep in mind that income taxes are not deducted, so you should speak with your tax preparation advisor. Other than garnishment for child support or alimony, compensation is not subject to creditor claims.
In most cases, you will not need to have an attorney or other representative to handle your case. However, if you choose to, be sure that OWCP has approved the fee before you pay them. The payments can be put into an escrow account during the approval process. The OWCP does not, however, pay legal fees.
FECA is in place to protect federal workers from the financial burden of a work-related injury or illness. Filing a false claim or entering into a conspiracy to commit fraud has serious consequences, including possible fines of up to $10,000 and spending years in prison.
Don’t wait for your employer to tell you what the benefits are. It is better to apply for the benefits you are entitled to receive. While you do not necessarily require ongoing legal representation, a consultation or two to be sure that you understand the process is not a bad idea.