Benefit Bits--This topic will cover the workers' compensation program. Date: Fri, 07 May 1999 10:47:18 -0400 To: "USGS Employees" From: "Cindy S. Wylie" Subject: Benefit Bits In Reply Refer To: Mail Stop 601 MEMORANDUM Supervisors, Managers, and Team Leaders: Please ensure that employees without access to email receive a copy of this message. To: All U.S. Geological Survey Employees From: Richard C. Williams Acting Personnel Officer Subject: Benefit Bits This topic will cover the workers' compensation program. This program is administered by the U.S. Department of Labor, Office of Workers' Compensation Programs (OWCP). An employee who is injured in the performance of duty is entitled to file a claim with OWCP. There are two types of claims: traumatic injury claims, in which an injury occurs in a workday, for example, a broken leg; and an occupational disease claim, in which the employee has a disease which he or she believes is work-related, for example, carpal tunnel syndrome. If your claim is accepted by OWCP, the following benefits are available: 1. Medical Benefits: An employee is entitled to medical, surgical, and hospital services and supplies needed for treatment of an injury. Medical treatment may be provided by surgeons, dentists, podiatrists, psychologists, optometrists, and chiropractors. However, payment for chiropractic services is limited. The injured employee has the initial choice of physician or hospital to provide necessary treatment. Prescriptions are also paid by OWCP for an accepted claim. 2. Compensation for Temporary Total Disability: An employee who sustains a traumatic injury may request continuation of regular pay (COP) for the period of disability not to exceed 45 calendar days. If disability continues beyond 45 days, the employee may use sick or annual leave, or enter a leave without pay status and claim compensation from OWCP. COP cannot be used for an occupational disease claim; an employee who has an occupational disease may claim compensation from OWCP. 3. Compensation for Permanent Effects of Injury: Compensation for loss of earning capacity may be paid if the employee is unable to resume regular work because of an injury-related disability. The annual compensation is paid based on 75 percent of the employee's pay if there is at least one dependent; 66 2/3 percent if there are no dependents. "Dependent" is defined as a wife or husband, an unmarried child under 18 years of age, an unmarried child who is incapable of self-support, a student until he or she reaches 23 years of age or completes 4 years of school beyond the high school level, or a wholly dependent parent. Compensation monies paid by OWCP are tax-free. OWCP also provides a schedule of benefits for permanent impairment of certain members, functions, and organs of the body (such as the eye) or for serious disfigurement. 4. Compensation for Death: If no child is eligible for benefits, the widow or widower's annual compensation is 50 percent of the employee's pay at the time of death, if death was due to the an employment-related injury or disease. If a child or children are eligible for benefits, the widow or widower is entitled to 45 percent of the pay and each child is entitled to 15 percent, but the total percentage may not exceed 75 percent. If children are the sole survivors, 40 percent is paid for the first child and 15 percent for each additional child, to be shared equally, not to exceed 75 percent. If there is no spouse or surviving children entitled to compensation, parents may be entitled to benefits. If no child, surviving spouse, parents, the brothers, sisters, grandparents or grandchildren may be eligible for compensation. Compensation to the employee's surviving spouse terminates upon his or her death or remarriage. Those benefits continue, however, if the remarriage takes places after age 55. In addition, burial expenses not to exceed $800 are payable. Transportation of the body to the employee's former residence in the United States is provided where death occurs away from the employee's home station. An additional $200 is paid to the personal representative of the decedent for reimbursement of the costs of terminating the decedent's status as an employee of the United States. 5. Cost-of-Living Increases (COLAs): In cases of disability, a beneficiary is eligible for COLAs where the injury-related disability began more than one year prior to the effective date of the COLA. In cases of death, entitlement to COLAs begin with the first such adjustment occurring more than one year after the date of death. 6. Employee and Supervisor's Responsibilities: Employee - Notify supervisor as soon as possible after the injury - Complete needed claim forms - Submit medical documentation, keeping supervisor informed of status Supervisor - Complete supervisor portion of the CA-1 or CA-2 - Authorize medical treatment for traumatic injury on CA-16 Both - Submit claim forms in a timely manner; the agency is required to submit claims to OWCP within 10 days of injury, so a quick turnaround time is essential. Failure to do so can result in delays of compensation and reimbursement of medical expenses 7. Death Gratuity: In addition to the workers' compensation benefits, a payment may be made to the personal representative of any Federal employee who dies from an injury sustained in the line of duty. This gratuity will not exceed $10,000. Other payments that are considered in determining the amount of the death gratuity payment are: - $200 payable for reimbursement of the costs of termination of the decedent's status as an employee of the United States; - up to $800 payable for funeral and burial expenses in cases of employees who died as a result of an injury sustained in the performance of duty; and - any amount paid under the Department of the Interior and Related Agencies Appropriations Act, 1995. This authority provides for payment of up to $10,000 in reimbursement for burial costs and related out-of-pocket expenses for employees killed in the line of duty in agencies that receive appropriations under this Act for fiscal year 1995 and thereafter. The amounts paid above, plus the gratuity, may not total more than $10,000. The Internal Revenue Service issued a ruling that a death gratuity payment, while not subject to Federal income tax withholding, is fully subject to Federal income tax if the death occurred on or after August 20, 1996. Any questions regarding OWCP benefits should be directed to your servicing personnel office. OWCP also has a website at www.dol.gov./dol/esa/owcp.htm. where you can obtain additional information.