If you suffer a work-related injury or illness, you may find yourself burdened by medical bills and unable to work. Workers in the private sector tend to address these concerns by filing for workers’ compensation. As a federal employee, you may also file for workers’ compensation. But your path to recover may look slightly different than if you were in the private sector.
The first and most important difference is that private sector employees must follow the workers’ compensation laws for the states in which they work. Those laws don’t cover federal employees. Instead, federal employees will seek their compensation through the Office of Workers’ Compensation Programs (OWCP). But the differences don’t stop there.
10 facts federal employees should know about workers’ compensation
Like the workers’ compensation laws that most states enforce, federal workers’ compensation exists to protect both employees and their employers. Workers should seek compensation for their injuries through the workers’ comp programs rather than sue their agencies. In fact, federal workers can almost never sue agencies for their injuries. This means, as the Department of Labor notes, workers’ comp is their sole option for recovery.
What else should federal employees know?
- While the OWCP handles the claims, there’s more than one law at play. Employees from different agencies may need to follow different rules.
- Workers’ compensation does cover occupational diseases. These can include diseases such as Black Lung that build up over time as well as diseases such as COVID-19 that can spread through a workplace. However, you need to satisfy the OWCP that your disease is work-related.
- When it receives your case, the OWCP will assign it a 9-digit code. You want to keep this code and use it for all communication with the OWCP. Failing to do so may cause significant disruption and delays.
- You have the right to choose your own physician. The OWCP notes that if your initial physician refers you to a specialist, the OWCP will honor the specialist’s work so long as it remains focused on your work-related injury.
- If you wish to change your physician, you must file a formal request. This must include the reason you wish to change your physician.
- You can receive physical therapy for up to 120 days. After that, you need to renew your authorization.
- As you might expect, there are forms! The OWCP’s “basic” claims information lists no fewer than 10 forms, including the CA-1, CA-2, CA-5, CA-7, CA-16, CA-17, CA-915 and HCFA-1500, which is also called OWCP-1500. Processing these forms correctly is key to resolving your claim.
- There are 12 district offices that handle forms for the OWCP. If you have questions about your claim, you can contact your district office.
- You may be able to seek reimbursement for your travel to and from medical appointments. The OWCP says it bases such reimbursement on the General Services Administration’s rate for privately owned vehicles.
- As in the private sector, it is possible to appeal a denial or early end to coverage. You can start by asking the district office to reconsider, but it’s important that you make sure to provide the appropriate evidence. If the OWCP previously made a decision you felt was wrong, your existing evidence won’t be enough. Before you ask the district office to reconsider, you want to make sure you provide all the right details.
In the end, the workers’ comp process is supposed to be “non-adversarial,” meaning the government isn’t supposed to try to prove you wrong. However, it does require proof that your injury was work-related. This requirement of causality often leads to rejected claims, just as it does in the private sector.
If at first you don’t succeed, focus on the details
The workers’ comp process can be difficult and confusing. This is especially true for occupational diseases and work injuries that owe to years and years of repetitive actions. The OWCP is not supposed to be standing in your way, blocking you from recovery. But it won’t just greenlight every claim without review.
If the OWCP denies your claim, that’s not always the final word. You just need to make sure you do a better, more thorough job with your appeal than you did with the application. The details matter.