“Serving those who serve in government”

  1. Home
  2.  → 
  3. OWCP - Federal Workers' Compensation
  4.  → Federal employees can challenge federal workers’ compensation claim denials

Federal employees can challenge federal workers’ compensation claim denials

On Behalf of | Feb 13, 2023 | OWCP - Federal Workers' Compensation

When most federal employees across the country are injured or sickened on the job, their exclusive remedy is to file for federal workers’ compensation benefits. This is the only way for them to seek coverage for financial losses from work-related physical or mental harm because the worker may not sue the federal agency employing them. This is a no-fault system, meaning that federal workers’ compensation is available regardless of who caused the injury or illness.

The Office of Workers’ Compensation Programs (OWCP), part of the U.S. Department of Labor (DOL), administers the federal workers’ compensation program. Federal workers are not subject to state workers’ compensation laws.

The DOL is already sending out denial letters in 2023. An injured employee should not just give up if the government denies their claim. If their initial application is denied, avenues for review and appeal exist. For example, they have options for OWCP reconsideration of the claim (along with new evidence), a hearing before the OWCP or appeal of the OWCP’s final adverse decision to the Employees’ Compensation Appeals Board (ECAB).

Time is of the essence. Immediately upon receiving a denial, the claimant should speak with a knowledgeable attorney about their claim so as not to miss any filing deadlines. Do not delay in getting legal help, in notifying the employing agency of the injury or illness and in filing an appeal.

What benefits are due eligible claimants?

Fighting for federal workers’ compensation is important – the benefits can be significant and may include:

  • Wages
  • Medical expenses, including hospitalization, supplies and equipment, surgery, transport to and from medical services, and more
  • Vocational rehabilitation
  • Compensation for permanent loss of the use of particular body parts
  • Scheduled award
  • And others

Surviving dependents of a federal worker may be eligible for funeral expenses and survivors benefits for an employment-related fatality.

Suitability of a limited-duty job offer

If an ill or injured worker improves, the employing federal agency may identify another job with duties modified to allow the employee to work despite remaining limitations. If the claims examiner agrees, they will offer it to the employee, who must accept the position if it is reasonable.

However, the employee has 30 days to challenge the job’s suitability considering their remaining medical limitations and symptoms. It is important for the claimant to discuss the limited-duty job offer with their treating doctors and if possible, with an attorney, because declining a modified position without medical evidence to support the decision may result in job and benefit losses.

Refusing a modified-duty job offer may result in a required medical assessment by a doctor chosen by the agency or the employee may pursue further appeal.

Legal representation is a smart option

This is a broad introduction to federal workers’ compensation. The law is complex and detailed, so consulting a lawyer with specific federal-employee representation experience can be important to a claim. Legal counsel can help with the initial application or can become involved after the claimant receives a denial letter or even later. Legal counsel will understand what mistakes the agency may have made and how the denial decision may be inconsistent with the medical evidence.

While the OWCP and employing agency are not supposed to treat an injured employee as an adversary, that is not always the case. A skilled and knowledgeable lawyer can help to blunt this treatment and communicate with the government on the client’s behalf.




RSS Feed