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Home Page > Executive Branch > Code of Federal Regulations > Electronic Code of Federal Regulations
e-CFR Data is current as of November 19, 2009
TITLE 20--Employees' Benefits
CHAPTER I--OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR
SUBCHAPTER B--FEDERAL EMPLOYEES' COMPENSATION ACT
PART 10--CLAIMS FOR COMPENSATION UNDER THE FEDERAL EMPLOYEES' COMPENSATION ACT, AS AMENDED
Subpart A--GENERAL PROVISIONS
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| What are the provisions of the FECA, in general? |
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| What rules govern the administration of the FECA and this chapter? |
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| What do these regulations contain? |
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| Have the collection of information requirements of this part been approved by the Office of Management and Budget (OMB)? |
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| What definitions apply to these regulations? |
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| What special statutory definitions apply to dependents and survivors? |
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| What forms are needed to process claims under the FECA? |
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| Are all documents relating to claims filed under the FECA considered confidential? |
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| Who maintains custody and control of FECA records? |
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| How may a FECA claimant or beneficiary obtain copies of protected records? |
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| What process is used by a person who wants to correct FECA-related documents? |
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| May compensation rights be waived? |
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| What criminal penalties may be imposed in connection with a claim under the FECA? |
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| Is a beneficiary who defrauds the Government in connection with a claim for benefits still entitled to those benefits? |
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| Can a beneficiary who is incarcerated based on a felony conviction still receive benefits? |
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Subpart B--FILING NOTICES AND CLAIMS; SUBMITTING EVIDENCE
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| How and when is a notice of traumatic injury filed? |
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| How and when is a notice of occupational disease filed? |
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| How and when is a claim for wage loss compensation filed? |
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| How and when is a claim for permanent impairment filed? |
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| How and when is a claim for recurrence filed? |
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| How and when is a notice of death and claim for benefits filed? |
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| What should the employer do when an employee files a notice of traumatic injury or occupational disease? |
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| What should the employer do when an employee files an initial claim for compensation due to disability or permanent impairment? |
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| What should the employer do when an employee files a claim for continuing compensation due to disability? |
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| What should the employer do when an employee dies from a work-related injury or disease? |
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| What evidence is needed to establish a claim? |
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| What additional evidence is needed in cases based on occupational disease? |
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| What happens if, in any claim, the employer contests any of the facts as stated by the claimant? |
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| Does the employer participate in the claims process in any other way? |
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| What action will OWCP take with respect to information submitted by the employer? |
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| May a claimant submit additional evidence? |
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| What happens if OWCP needs more evidence from the claimant? |
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| How does OWCP determine entitlement to benefits? |
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| What does the decision contain? |
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| To whom is the decision sent? |
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Subpart C--CONTINUATION OF PAY
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| What is continuation of pay? |
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| What conditions must be met to receive COP? |
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| May an employee who uses leave after an injury later decide to use COP instead? |
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| May an employee who returns to work, then stops work again due to the effects of the injury, receive COP? |
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| What are the employee's responsibilities in COP cases? |
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| What are the employer's responsibilities in COP cases? |
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| How does OWCP compute the number of days of COP used? |
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| How is the pay rate for COP calculated? |
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| Is COP charged if the employee continues to work, but in a different job that pays less? |
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| When is an employer not required to pay COP? |
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| How is a claim for COP controverted? |
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| When may an employer terminate COP which has already begun? |
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| Are there other circumstances under which OWCP will not authorize payment of COP? |
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| What happens if OWCP finds that the employee is not entitled to COP after it has been paid? |
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Subpart D--MEDICAL AND RELATED BENEFITS
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| What are the basic rules for authorizing emergency medical care? |
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| May the physician designated on Form CA-16 refer the employee to another medical specialist or medical facility? |
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| Should the employer authorize medical care if he or she doubts that the injury occurred, or that it is work-related? |
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| Should the employer use a Form CA-16 to authorize medical testing when an employee is exposed to a workplace hazard just once? |
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| Are there any exceptions to these procedures for obtaining medical care? |
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| What are the basic rules for obtaining medical care? |
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| What are the special rules for the services of chiropractors? |
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| What are the special rules for the services of clinical psychologists? |
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| Will OWCP pay for preventive treatment? |
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| Will OWCP pay for the services of an attendant? |
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| Will OWCP pay for transportation to obtain medical treatment? |
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| After selecting a treating physician, may an employee choose to be treated by another physician instead? |
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| Can OWCP require an employee to be examined by another physician? |
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| What happens if the opinion of the physician selected by OWCP differs from the opinion of the physician selected by the employee? |
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| Who pays for second opinion and referee examinations? |
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| What are the penalties for failing to report for or obstructing a second opinion or referee examination? |
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| May an employer require an employee to undergo a physical examination in connection with a work-related injury? |
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| What are the requirements for medical reports? |
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| How and when should the medical report be submitted? |
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| What additional medical information will OWCP require to support continuing payment of benefits? |
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| What additional medical information will OWCP require to support a claim for a schedule award? |
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| How are medical bills submitted? |
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| What are the time frames for submitting bills? |
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| If OWCP reimburses an employee only partially for a medical expense, must the provider refund the balance of the amount paid to the employee? |
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Subpart E--COMPENSATION AND RELATED BENEFITS
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| What is total disability? |
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| When and how is compensation for total disability paid? |
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| What is partial disability? |
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| When and how is compensation for partial disability paid? |
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| When and how is compensation for a schedule impairment paid? |
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| Who is considered a dependent in a claim based on disability or impairment? |
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| What are the maximum and minimum rates of compensation in disability cases? |
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| Who is entitled to compensation in case of death, and what are the rates of compensation payable in death cases? |
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| What are the maximum and minimum rates of compensation in death cases? |
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| Will OWCP pay the costs of burial and transportation of the remains? |
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| If a person dies while receiving a schedule award, to whom is the balance of the schedule award payable? |
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| What reports of dependents are needed in death cases? |
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| What must a beneficiary do if the number of beneficiaries decreases? |
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| How does a change in the number of beneficiaries affect the amount of compensation paid to the other beneficiaries? |
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| What reports are needed when compensation payments continue for children over age 18? |
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| How are cost-of-living adjustments applied? |
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| May a beneficiary receive other kinds of payments from the Federal Government concurrently with compensation? |
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| May compensation payments be issued in a lump sum? |
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| May compensation payments be assigned to, or attached by, creditors? |
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| May someone other than the beneficiary be designated to receive compensation payments? |
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| May compensation be claimed for periods of restorable leave? |
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| How does OWCP notify an individual of a payment made? |
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| What does OWCP do when an overpayment is identified? |
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| How can an individual present evidence to OWCP in response to a preliminary notice of an overpayment? |
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| Under what circumstances can OWCP waive recovery of an overpayment? |
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| If OWCP finds that the recipient of an overpayment was not at fault, what criteria are used to decide whether to waive recovery of it? |
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| Is an individual responsible for an overpayment that resulted from an error made by OWCP or another Government agency? |
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| Under what circumstances would recovery of an overpayment defeat the purpose of the FECA? |
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| Under what circumstances would recovery of an overpayment be against equity and good conscience? |
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| Can OWCP require the individual who received the overpayment to submit additional financial information? |
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| What is addressed at a pre-recoupment hearing? |
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| How does OWCP communicate its final decision concerning recovery of an overpayment, and what appeal right accompanies it? |
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| How are overpayments collected? |
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Subpart F--CONTINUING BENEFITS
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| What are the basic rules governing continuing receipt of compensation benefits and return to work? |
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| What medical evidence is necessary to support continuing receipt of compensation benefits? |
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| How does OWCP evaluate evidence in support of continuing receipt of compensation benefits? |
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| Under what circumstances may OWCP reduce or terminate compensation benefits? |
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| What actions must the employer take? |
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| May the employer monitor the employee's medical care? |
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| How should the employer make an offer of suitable work? |
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| May relocation expenses be paid for an employee who would need to move to accept an offer of reemployment? |
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| If an employee's light-duty job is eliminated due to downsizing, what is the effect on compensation? |
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| What actions must the employee take with respect to returning to work? |
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| How will an employee know if OWCP considers a job to be suitable? |
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| What are the penalties for refusing to accept a suitable job offer? |
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| Does OWCP provide services to help employees return to work? |
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| What action will OWCP take if an employee refuses to undergo vocational rehabilitation? |
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| How does OWCP determine compensation after an employee completes a vocational rehabilitation program? |
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| What information must the employee report? |
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| Must the employee report volunteer activities? |
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| Does OWCP verify reports of earnings? |
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| What action will OWCP take if the employee fails to file a report of activity indicating an ability to work? |
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| What action will OWCP take if the employee files an incomplete report? |
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| How are dependents defined, and what information must the employee report? |
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| What is the penalty for failing to submit a report of dependents? |
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| What reports are needed when compensation payments continue for children over age 18? |
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| When and how is compensation reduced or terminated? |
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| What action will OWCP take after issuing written notice of its intention to reduce or terminate compensation? |
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Subpart G--APPEALS PROCESS
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| How can final decisions of OWCP be reviewed? |
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| How does a claimant request reconsideration? |
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| What is the time limit for requesting reconsideration? |
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| How does OWCP decide whether to grant or deny the request for reconsideration? |
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| How does OWCP decide whether new evidence requires modification of the prior decision? |
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| What is a review by the Director? |
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| How does a claimant obtain a hearing? |
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| How is an oral hearing conducted? |
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| How is a review of the written record conducted? |
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| May subpoenas be issued for witnesses and documents? |
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| Who pays the costs associated with subpoenas? |
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| What is the employer's role when an oral hearing has been requested? |
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| May a claimant withdraw a request for or postpone a hearing? |
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| What kinds of decisions may be appealed? |
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| Who has jurisdiction of cases on appeal to the ECAB? |
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Subpart H--SPECIAL PROVISIONS
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| May a claimant designate a representative? |
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| Who may serve as a representative? |
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| How are fees for services paid? |
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| How are fee applications approved? |
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| When must an employee or other FECA beneficiary take action against a third party? |
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| How will a beneficiary know if OWCP or SOL has determined that action against a third party is required? |
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| What must a FECA beneficiary who is required to take action against a third party do to satisfy the requirement that the claim be ''prosecuted''? |
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| Can 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? |
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| What 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? |
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| Under 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? |
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| How much of any settlement or judgment must be paid to the United States? |
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| What amounts are included in the gross recovery? |
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| How 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? |
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| What amounts are included in the refundable disbursements? |
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| Is a beneficiary required to pay interest on the amount of the refund due to the United States? |
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| If the required refund is not paid within 30 days of the request for repayment, can it be collected from payments due under the FECA? |
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| Is 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? |
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| Are 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? |
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| If 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? |
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| When is a Federal grand or petit juror covered under the FECA? |
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| When does a juror's entitlement to disability compensation begin? |
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| What is the pay rate of jurors for compensation purposes? |
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| What are the conditions of coverage for Peace Corps volunteers and volunteer leaders injured while serving outside the United States? |
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| What is the pay rate of Peace Corps volunteers and volunteer leaders for compensation purposes? |
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| When is a non-Federal law enforcement officer (LEO) covered under the FECA? |
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| What are the time limits for filing a LEO claim? |
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| How is a LEO claim filed, and who can file a LEO claim? |
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| Under what circumstances are benefits payable in LEO claims? |
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| What kind of objective evidence of a potential Federal crime must exist for coverage to be extended? |
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| In what situations will OWCP automatically presume that a law enforcement officer is covered by the FECA? |
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| How are benefits calculated in LEO claims? |
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Subpart I--INFORMATION FOR MEDICAL PROVIDERS
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| What kind of medical records must providers keep? |
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| How are medical bills to be submitted? |
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| How should an employee prepare and submit requests for reimbursement for medical expenses, transportation costs, loss of wages, and incidental expenses? |
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| What are the time limitations on OWCP's payment of bills? |
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| What services are covered by the OWCP fee schedule? |
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| How are the maximum fees defined? |
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| How are payments for particular services calculated? |
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| Does the fee schedule apply to every kind of procedure? |
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| How are payments for medicinal drugs determined? |
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| How are payments for inpatient medical services determined? |
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| When and how are fees reduced? |
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| If OWCP reduces a fee, may a provider request reconsideration of the reduction? |
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| If OWCP reduces a fee, may a provider bill the claimant for the balance? |
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| What are the grounds for excluding a provider from payment under the FECA? |
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| What will cause OWCP to automatically exclude a physician or other provider of medical services and supplies? |
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| When are OWCP's exclusion procedures initiated? |
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| How is a provider notified of OWCP's intent to exclude him or her? |
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| What requirements must the provider's reply and OWCP's decision meet? |
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| How can an excluded provider request a hearing? |
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| How are hearings assigned and scheduled? |
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| How are subpoenas or advisory opinions obtained? |
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| How will the administrative law judge conduct the hearing and issue the recommended decision? |
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| How can a party request review by the Director of the administrative law judge's recommended decision? |
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| What are the effects of exclusion? |
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| How can an excluded provider be reinstated? |
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Subpart J-DEATH GRATUITY
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| What is the death gratuity under this subpart? |
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| Which employees are covered under this subpart? |
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| Does 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? |
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| Is the death gratuity payment applicable retroactively? |
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| Does a death as a result of occupational disease qualify for payment of the death gratuity? |
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| If 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? |
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| What special statutory definitions apply to survivors under this subpart? |
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| What order of precedence will OWCP use to determine which survivors are entitled to receive the death gratuity payment under this subpart? |
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| Can an employee designate alternate beneficiaries to receive a portion of the death gratuity payment? |
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| How does an employee designate a variation in the order or percentage of gratuity payable to survivors and how does the employee designate alternate beneficiaries? |
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| What 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? |
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| How is the death gratuity payment process initiated? |
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| What is required to establish a claim for the death gratuity payment? |
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| In 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? |
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| What are the responsibilities of the employing agency in the death gratuity payment process? |
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| What are the responsibilities of OWCP in the death gratuity payment process? |
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| How is the amount of the death gratuity calculated? |
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