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Workers' Compensation: How to File a Claim

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Civilian federal workers are covered under the Federal Employees’ Compensation Act (FECA), which provides benefits for Federal workers who are injured on the job, or who have sustained a work-related illness.

Although the Department of Labor administers the FECA program, all Department of Commerce (DOC) claims and claims-related material should be sent to the DOC centralized processing office, which is the OWCP contractor, Contract Claims Services, Incorporated (CCSI, L.P.). This contractor has extensive experience processing Federal government workers' compensation claims, and has an excellent customer service. CCSI works closely with the Department of Labor to ensure all claims are processed timely.

All claims and claims-related information should be forwarded to CCSI, as follows:

In order to ensure timely claims submission, please have your supervisor send all initial claims (CA-1's and CA-2's) and claims for disability compensation (CA-7's) by FAX or Federal Express to the following address:

CCSI, L.P.
300 E. Royal Lane
Suite 200
Irving, TX 75039

All other claims-related documents should be sent to this address:

CCSI, L.P.
P.O. Box 542528
Dallas, TX 75354-2528

The contact numbers at CCSI, L.P. are (800) 743-2231 (extension 3005 for Decennial employees, or extension 2965 for all other employees within DOC, FAX (877) 516-4283).

If you have any questions or concerns, or if you have suggestions which may help us to serve you better, you may contact Doug Shjeflo, Workers’ Compensation Office, at (202) 482-2968 (dshjeflo@doc.gov ) or Sandra Williams at (202) 482-0799 (sWilliams@doc.gov ).

INJURED EMPLOYEES

If you are injured while at work, you should:

  • Notify your supervisor as soon as possible.
  • Visit your health unit, or seek appropriate medical attention, if necessary.
  • File an injury/illness report using the DOC form CD 137, “Report of Incident, Injury, Illness, Motor Vehicle Accident, Property Damage, or Fatality: (http://ocio.os.doc.gov/s/groups/public/@doc/@os/@ocio/@oitpp/documents/content/dev01_002416.pdf ) This accident form must be completed and submitted within seven calendar days to the Bureau Safety Manager/Coordinator.
  • File the appropriate WC forms (CA 1, CA 2, etc.):

CA-1 claim forms are used when a work-related traumatic injury occurs. (i.e., Single incident injury, or repetitive injury, which occurs during one work shift).

CA-2 claim forms are used when a work-related occupational illness occurs. (i.e., Exposure to work factors for more than one work shift which causes an injury/illness).

To print a copy of the appropriate form, go to http://www.dol.gov/owcp/dfec/regs/compliance/forms.htm

Provide Form CA-1/CA-2, with the employee’s section completed to your supervisor.

Injured workers have a legal burden to prove that their medical condition was work-related. (The workers’ compensation contractor, CCSI, L.P. can advise you of the type of evidence you need to support your claim.)

Keep your supervisor and the Workers’ Compensation Center, CCSI, L.P., informed of the status of your condition.

You must also provide your supervisor and the workers’ compensation contractor, CCSI, L.P. with medical reports to support your disability.

You are still required to request leave (COP, Annual Leave, Sick Leave and/or LWOP) from your supervisor.

If your physician releases you to return to light duty or to full duty, you should return to work. The Department of Labor will not authorize compensation for employees who refuse suitable work.

SUPERVISORS

If you have an employee who has been injured, or an employee who wishes to file a claim for traumatic injury, you should:

  • Assist the employee in receiving first-aid and/or advise the employee to seek other medical attention.
  • If an employee suffers a traumatic injury (single episode injury or repetitive injury which occurs during one work shift), contact the workers’ compensation contractor, CCSI, L.P., at 1-800-743-2231 (extension 3005 for Decennial employees, or extension 2965 for all other employees within DOC). They will issue a CA-16, Authorization for Examination and/or Treatment. This form generally should not be issued more than 7 days after a traumatic injury. This form should not be issued for occupational illness claims.

  • Ensure that all items on the CA-1, Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation, are completed. (Note: Witness statements are not mandatory.) Unsigned claim forms will not be forwarded to the Department of Labor.

  • Complete supervisor's part of the CA-1/CA-2 form and forward to CCSI, L.P.

If you have an employee who wishes to file a claim for an occupational illness, please contact the workers’ compensation contractor, CCSI, L.P., at 1-800-743-2231 (extension 3005 for Decennial employees, or extension 2965 for all other employees within DOC) for specific instructions .




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