Subpart A - General Provisions

Information in Program Records

§ 10.10 - Are all documents relating to claims filed under the FECA considered confidential?

§ 10.11 - Who maintains custody and control of FECA records?

§ 10.12 - How may a FECA claimant or beneficiary obtain copies of protected records?

§ 10.13 - What process is used by a person who wants to correct FECA-related documents?

Definitions and Forms

§ 10.5 - What definitions apply to the regulations in this subchapter?

§ 10.6 - What special statutory definitions apply to dependents and survivors?

§ 10.7 - What forms are needed to process claims under the FECA?

Rights and Penalties

§ 10.15 - May compensation rights be waived?

§ 10.16 - What criminal and civil penalties may be imposed in connection with a claim under the FECA?

§ 10.17 - Is a beneficiary who defrauds the Government in connection with a claim for benefits still entitled to those benefits?

§ 10.18 - Can a beneficiary who is incarcerated based on a felony conviction still receive benefits?

Introduction

§ 10.0 - What are the provisions of the FECA, in general?

§ 10.1 - What rules govern the administration of the FECA and this chapter?

§ 10.2 - What do these regulations contain?

§ 10.3 - Have the collection of information requirements of this part been approved by the Office of Management and Budget (OMB)?

§ 10.4 - Applicability of other parts within this chapter.

Miscellaneous Provisions

§ 10.20 - Forms.

§ 10.21 - Waiver of compensation rights invalid.

§ 10.22 - Exclusiveness of remedy.

§ 10.23 - Penalties.

Subpart B - Filing Notices and Claims; Submitting Evidence

Notice of Injury or Death

Notices and Claims for Injury, Disease, and Death—Employer'sActions

Notices and Claims for Injury, Disease, and Death—Employer's Actions

Claims for Compensation

§ 10.106 - How to file a claim for disability compensation.

§ 10.107 - Application for augmented compensation.

§ 10.108 - How to file an original claim for death benefits.

§ 10.109 - Claims for balance of schedule awards unpaid at death when death is due to other causes.

Evidence and Burden of Proof

§ 10.115 - What evidence is needed to establish a claim?

§ 10.116 - What additional evidence is needed in cases based on occupational disease?

§ 10.117 - What happens if, in any claim, the employer contests any of the facts as stated by the claimant?

§ 10.118 - Does the employer participate in the claims process in any other way?

§ 10.119 - What action will OWCP take with respect to information submitted by the employer?

§ 10.120 - May a claimant submit additional evidence?

§ 10.121 - What happens if OWCP needs more evidence from the claimant?

Termination and Continuation of Eligibility

§ 10.122 - Claim for continuing compensation for disability.

§ 10.123 - Employing agency's responsibilities in returning the employee to work.

§ 10.124 - Employee's obligation to return to work or to seek work when able.

§ 10.128 - Termination of right to compensation for death; reapportionment of compensation.

Notices and Claims for Injury, Disease, and Death - Employer'S Actions

§ 10.110 - What should the employer do when an employee files a notice of traumatic injury or occupational disease?

§ 10.111 - What should the employer do when an employee files an initial claim for compensation due to disability or permanent impairment?

§ 10.112 - What should the employer do when an employee files a claim for continuing compensation due to disability?

§ 10.113 - What should the employer do when an employee dies from a work-related injury or disease?

Evidence

Notices and Claims for Injury, Disease, and Death—Employee or Survivor's Actions

Determinations of Claims, Hearing and Review Procedures

§ 10.130 - Processing of claims.

§ 10.131 - Request for a hearing.

§ 10.132 - Time and place of hearing; prehearing conference.

§ 10.133 - Conduct of hearing.

§ 10.134 - Subpoenas; witness fees.

§ 10.135 - Employing agency attendance at hearings and submission of evidence.

§ 10.136 - Termination of hearing; release of decision.

§ 10.137 - Postponement; withdrawal or abandonment of request for hearing.

§ 10.138 - Review of decision.

§ 10.139 - Review by the Employee's Compensation Appeals Board.

§ 10.140 - Participation in claims process by employing agency.

§ 10.141 - Representation of the Director.

§ 10.142 - Representation of claimants.

§ 10.143 - Qualification of representative.

§ 10.144 - Authority of representative.

§ 10.145 - Fees for services.

§ 10.150 - Statement relative to substantive rules.

§§ 10.146--10.149 - [Reserved]

Notices and Claims for Injury, Disease, and Death—Employeeor Survivor's Actions

Decisions on Entitlement to Benefits

§ 10.125 - How does OWCP determine entitlement to benefits?

§ 10.126 - What does the decision contain?

§ 10.127 - To whom is the decision sent?

Notices and Claims for Injury, Disease, and Death - Employee or Survivor'S Actions

§ 10.100 - How and when is a notice of traumatic injury filed?

§ 10.101 - How and when is a notice of occupational disease filed?

§ 10.102 - How and when is a claim for wage loss compensation filed?

§ 10.103 - How and when is a claim for permanent impairment filed?

§ 10.104 - How and when is a claim for recurrence filed?

§ 10.105 - How and when is a notice of death and claim for benefits filed?

Representative Payment

§ 10.160 - Indications for designation of a representative payee.

§ 10.161 - Selection of a payee.

§ 10.162 - Responsibilities of a representative payee.

§ 10.163 - Use of benefit payments.

§ 10.164 - Conservation and investment of benefit payments.

§ 10.165 - Termination of representation.

§ 10.166 - Accounting for benefit payments.

Subpart C - Continuation of Pay

§ 10.200 - What is continuation of pay?

Procedures

§ 10.201 - Right to continuation of pay.

§ 10.202 - Election of annual or sick leave.

§ 10.203 - Controversion by employing agency.

§ 10.204 - Termination and forfeiture of continuation of pay.

Official Superior's and Beneficiaries’ Responsibilities

§ 10.208 - Recurrence of disability.

§ 10.209 - Employee's responsibilities in continuation of pay cases.

General

Controversion and Termination of Cop

§ 10.220 - When is an employer not required to pay COP?

§ 10.221 - How is a claim for COP controverted?

§ 10.222 - When may an employer terminate COP which has already begun?

§ 10.223 - Are there other circumstances under which OWCP will not authorize payment of COP?

§ 10.224 - What happens if OWCP finds that the employee is not entitled to COP after it has been paid?

Calculation of Cop

§ 10.215 - How does OWCP compute the number of days of COP used?

§ 10.216 - How is the pay rate for COP calculated?

§ 10.217 - Is COP charged if the employee continues to work, but in a different job that pays less?

Eligibility for Cop

§ 10.205 - What conditions must be met to receive COP?

§ 10.206 - May an employee who uses leave after an injury later decide to use COP instead?

§ 10.207 - May an employee who returns to work, then stops work again due to the effects of the injury, receive COP?

Responsibilities

§ 10.210 - What are the employee's responsibilities in COP cases?

§ 10.211 - What are the employer's responsibilities in COP cases?

Subpart D - Medical and Related Benefits

Overpayments

Medical Bills

§ 10.335 - How are medical bills submitted?

§ 10.336 - What are the time frames for submitting bills?

§ 10.337 - If an employee is only partially reimbursed for a medical expense, must the provider refund the balance of the amount paid to the employee?

Medical Treatment and Related Issues

§ 10.310 - What are the basic rules for obtaining medical care?

§ 10.311 - What are the special rules for the services of chiropractors?

§ 10.312 - What are the special rules for the services of clinical psychologists?

§ 10.313 - Will OWCP pay for preventive treatment?

§ 10.314 - Will OWCP pay for the services of an attendant?

§ 10.315 - Will OWCP pay for transportation to obtain medical treatment?

§ 10.316 - After selecting a treating physician, may an employee choose to be treated by another physician instead?

Directed Medical Examinations

§ 10.320 - Can OWCP require an employee to be examined by another physician?

§ 10.321 - What happens if the opinion of the physician selected by OWCP differs from the opinion of the physician selected by the employee?

§ 10.322 - Who pays for second opinion and referee examinations?

§ 10.323 - What are the penalties for failing to report for or obstructing a second opinion or referee examination?

§ 10.324 - May an employer require an employee to undergo a physical examination in connection with a work-related injury?

Adjustments to Benefits

Emergency Medical Care

§ 10.300 - What are the basic rules for authorizing emergency medical care?

§ 10.301 - May the physician designated on Form CA-16 refer the employee to another medical specialist or medical facility?

§ 10.302 - Should the employer authorize medical care if he or she doubts that the injury occurred, or that it is work-related?

§ 10.303 - Should the employer use a Form CA-16 to authorize medical testing when an employee is exposed to a workplace hazard just once?

§ 10.304 - Are there any exceptions to these procedures for obtaining medical care?

Medical Reports

§ 10.330 - What are the requirements for medical reports?

§ 10.331 - How and when should the medical report be submitted?

§ 10.332 - What additional medical information will OWCP require to support continuing payment of benefits?

§ 10.333 - What additional medical information will OWCP require to support a claim for a schedule award?

Compensation Rates

§ 10.305 - Attendant allowance.

§ 10.306 - Eligibility for death benefits and death benefit rates.

§ 10.307 - Burial and transportation benefits.

Subpart E - Compensation and Related Benefits

§ 10.407 - Medical examinations.

§ 10.408 - Medical referee examination.

§ 10.409 - Furnishing of orthopedic and prosthetic appliances, and dental work.

Compensation for Disability and Impairment

§ 10.400 - What is total disability?

§ 10.401 - When and how is compensation for total disability paid?

§ 10.402 - What is partial disability?

§ 10.403 - When and how is compensation for partial disability paid?

§ 10.404 - When and how is compensation for a schedule impairment paid?

§ 10.405 - Who is considered a dependent in a claim based on disability or impairment?

§ 10.406 - What are the maximum and minimum rates of compensation in disability cases?

Compensation for Death

§ 10.410 - Who is entitled to compensation in case of death, and what are the rates of compensation payable in death cases?

§ 10.411 - What are the maximum and minimum rates of compensation in death cases?

§ 10.412 - Will OWCP pay the costs of burial and transportation of the remains?

§ 10.413 - May a schedule award be paid after an employee's death?

§ 10.414 - What reports of dependents are needed in death cases?

§ 10.415 - What must a beneficiary do if the number of beneficiaries decreases?

§ 10.416 - How does a change in the number of beneficiaries affect the amount of compensation paid to the other beneficiaries?

§ 10.417 - What reports are needed when compensation payments continue for children over age 18?

Overpayments

§ 10.430 - How does OWCP notify an individual of a payment made?

§ 10.431 - What does OWCP do when an overpayment is identified?

§ 10.432 - How can an individual present evidence to OWCP in response to a preliminary notice of an overpayment?

§ 10.433 - Under what circumstances can OWCP waive recovery of an overpayment?

§ 10.434 - 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?

§ 10.435 - Is an individual responsible for an overpayment that resulted from an error made by OWCP or another Government agency?

§ 10.436 - Under what circumstances would recovery of an overpayment defeat the purpose of the FECA?

§ 10.437 - Under what circumstances would recovery of an overpayment be against equity and good conscience?

§ 10.438 - Can OWCP require the individual who received the overpayment to submit additional financial information?

§ 10.439 - What is addressed at a pre-recoupment hearing?

§ 10.440 - How does OWCP communicate its final decision concerning recovery of an overpayment, and what appeal right accompanies it?

§ 10.441 - How are overpayments collected?

Adjustments to Compensation

§ 10.420 - How are cost-of-living adjustments applied?

§ 10.421 - May a beneficiary receive other kinds of payments from the Federal Government concurrently with compensation?

§ 10.422 - May compensation payments be issued in a lump sum?

§ 10.423 - May compensation payments be assigned to, or attached by, creditors?

§ 10.424 - May someone other than the beneficiary be designated to receive compensation payments?

§ 10.425 - May compensation be claimed for periods of restorable leave?

Subpart F - Continuing Benefits

§ 10.450 - Exclusion for fraud and abuse: Grounds.

§ 10.451 - Automatic exclusion.

§ 10.452 - Initiation of exclusion procedures.

§ 10.453 - Requests for a hearing.

§ 10.454 - Hearings and recommended decision.

§ 10.455 - Review by Director.

§ 10.456 - Effects of exclusion.

§ 10.457 - Reinstatement.

Reports of Dependents

§ 10.535 - How are dependents defined, and what information must the employee report?

§ 10.536 - What is the penalty for failing to submit a report of dependents?

§ 10.537 - What reports are needed when compensation payments continue for children over age 18?

Reduction and Termination of Compensation

§ 10.540 - When and how is compensation reduced or terminated?

§ 10.541 - What action will OWCP take after issuing written notice of its intention to reduce or terminate compensation?

Return to Work—Employer's Responsibilities

Return to Work - Employer'S Responsibilities

§ 10.505 - What actions must the employer take?

§ 10.506 - May the employer monitor the employee's medical care?

§ 10.507 - How should the employer make an offer of suitable work?

§ 10.508 - May relocation expenses be paid for an employee who would need to move to accept an offer of reemployment?

§ 10.509 - If an employee's light duty job is eliminated due to downsizing, what is the effect on compensation?

§ 10.510 - When may a light duty job form the basis of a loss of wage-earning capacity determination?

§ 10.511 - How may a loss of wage-earning capacity determination be modified?

Rules and Evidence

§ 10.500 - What are the basic rules governing continuing receipt of compensation benefits and return to work?

§ 10.501 - What medical evidence is necessary to support continuing receipt of compensation benefits?

§ 10.502 - How does OWCP evaluate evidence in support of continuing receipt of compensation benefits?

§ 10.503 - Under what circumstances may OWCP reduce or terminate compensation benefits?

Return to Work - Employee'S Responsibilities

§ 10.515 - What actions must the employee take with respect to returning to work?

§ 10.516 - How will an employee know if OWCP considers a job to be suitable?

§ 10.517 - What are the penalties for refusing to accept a suitable job offer?

§ 10.518 - Does OWCP provide services to help employees return to work?

§ 10.519 - What action will OWCP take if an employee refuses to undergo vocational rehabilitation?

§ 10.520 - How does OWCP determine compensation after an employee completes a vocational rehabilitation program?

§ 10.521 - If an employee elects to receive retirement benefits instead of FECA benefits, what effect may such an election have on that employee's entitlement to FECA compensation?

Reports of Earnings from Employment and Self-Employment

§ 10.525 - What information must the employee report?

§ 10.526 - Must the employee report volunteer activities?

§ 10.527 - Does OWCP verify reports of earnings?

§ 10.528 - What action will OWCP take if the employee fails to file a report of activity indicating an ability to work?

§ 10.529 - What action will OWCP take if the employee files an incomplete report?

Return to Work—Employee's Responsibilities

Subpart G - Appeals Process

§ 10.504 - Distribution of damages where cause of action is assigned.

§ 10.600 - How can final decisions of OWCP be reviewed?

Reconsiderations and Reviews by the Director

§ 10.605 - What is reconsideration?

§ 10.606 - How does a claimant request reconsideration?

§ 10.607 - What is the time limit for requesting reconsideration?

§ 10.608 - How does OWCP decide whether to grant or deny the request for reconsideration?

§ 10.609 - How does OWCP decide whether new evidence requires modification of the prior decision?

§ 10.610 - What is a review by the Director?

Review by the Employees' Compensation Appeals Board (ECAB)

§ 10.625 - What kinds of decisions may be appealed?

§ 10.626 - Who has jurisdiction of cases on appeal to the ECAB?

Hearings

§ 10.615 - What is a hearing?

§ 10.616 - How does a claimant obtain a hearing?

§ 10.617 - How is an oral hearing conducted?

§ 10.618 - How is a review of the written record conducted?

§ 10.619 - May subpoenas be issued for witnesses and documents?

§ 10.620 - Who pays the costs associated with subpoenas?

§ 10.621 - What is the employer's role when an oral hearing has been requested?

§ 10.622 - May a claimant or representative withdraw a request for or postpone a hearing?

Subpart H - Special Provisions

Non-Federal Law Enforcement Officers

§ 10.611 - Applicability.

§ 10.612 - Conditions for eligibility.

§ 10.613 - Time for filing a claim.

§ 10.614 - How to file a notice of injury or death.

§ 10.735 - When is a non-Federal law enforcement officer (LEO) covered under the FECA?

§ 10.736 - What are the time limits for filing a LEO claim?

§ 10.737 - How is a LEO claim filed, and who can file a LEO claim?

§ 10.738 - Under what circumstances are benefits payable in LEO claims?

§ 10.739 - What kind of objective evidence of a potential Federal crime must exist for coverage to be extended?

§ 10.740 - In what situations will OWCP automatically presume that a law enforcement officer is covered by the FECA?

§ 10.741 - How are benefits calculated in LEO claims?

Third Party Liability

§ 10.705 - When must an employee or other FECA beneficiary take action against a third party?

§ 10.706 - How will a beneficiary know if OWCP or SOL has determined that action against a third party is required?

§ 10.707 - 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”?

§ 10.708 - 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?

§ 10.709 - 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?

§ 10.710 - 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?

§ 10.711 - How is the amount of the recovery of the FECA beneficiary determined?

§ 10.712 - How much of any settlement or judgment must be paid to the United States?

§ 10.713 - 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?

§ 10.714 - What amounts are included in the refundable disbursements?

§ 10.715 - Is a beneficiary required to pay interest on the amount of the refund due to the United States?

§ 10.716 - 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?

§ 10.717 - 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?

§ 10.718 - 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?

§ 10.719 - 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?

Peace Corps Volunteers

§ 10.601 - Applicability of the Act.

§ 10.602 - When disability compensation commences.

§ 10.603 - Pay rate for compensation purposes.

§ 10.604 - Period of service as a volunteer.

§ 10.730 - What are the conditions of coverage for Peace Corps volunteers and volunteer leaders injured while serving outside the United States?

§ 10.731 - What is the pay rate of Peace Corps volunteers and volunteer leaders for compensation purposes?

Representation

§ 10.700 - May a claimant designate a representative?

§ 10.701 - Who may serve as a representative?

§ 10.702 - How are fees for services paid?

§ 10.703 - How are fee applications approved?

§ 10.704 - What penalties apply to representatives who collect a fee without approval?

Federal Grand and Petit Jurors

§ 10.623 - When disability compensation commences.

§ 10.624 - Pay rate for compensation purposes.

§ 10.725 - When is a Federal grand or petit juror covered under the FECA?

§ 10.726 - When does a juror's entitlement to disability compensation begin?

§ 10.727 - What is the pay rate of jurors for compensation purposes?

Subpart I - Information for Medical Providers

Exclusion of Providers

§ 10.815 - What are the grounds for excluding a provider from payment under the FECA?

§ 10.816 - What will cause OWCP to automatically exclude a physician or other provider of medical services and supplies?

§ 10.817 - How are OWCP's exclusion procedures initiated?

§ 10.818 - How is a provider notified of OWCP's intent to exclude him or her?

§ 10.819 - What requirements must the provider's answer and OWCP's decision meet?

§ 10.820 - How can an excluded provider request a hearing?

§ 10.821 - How are hearings assigned and scheduled?

§ 10.822 - How are subpoenas or advisory opinions obtained?

§ 10.823 - How will the administrative law judge conduct the hearing and issue the recommended decision?

§ 10.824 - How does the recommended decision become final?

§ 10.825 - What are the effects of exclusion?

§ 10.826 - How can an excluded provider be reinstated?

Medical Fee Schedule

§ 10.805 - What services are covered by the OWCP fee schedule?

§ 10.806 - How are the maximum fees defined?

§ 10.807 - How are payments for particular services calculated?

§ 10.808 - Does the fee schedule apply to every kind of procedure?

§ 10.809 - How are payments for medicinal drugs determined?

§ 10.810 - How are payments for inpatient medical services determined?

§ 10.811 - When and how are fees reduced?

§ 10.812 - If OWCP reduces a fee, may a provider request reconsideration of the reduction?

§ 10.813 - If OWCP reduces a fee, may a provider bill the claimant for the balance?

Medical Records and Bills

§ 10.800 - How do providers enroll with OWCP for authorizations and billing?

§ 10.801 - How are medical bills to be submitted?

§ 10.802 - How should an employee prepare and submit requests for reimbursement for medical expenses, transportation costs, loss of wages, and incidental expenses?

§ 10.803 - What are the time limitations on OWCP's payment of bills?

Subpart J - Death Gratuity

§ 10.900 - What is the death gratuity under this subpart?

§ 10.901 - Which employees are covered under this subpart?

§ 10.902 - 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?

§ 10.903 - Is the death gratuity payment applicable retroactively?

§ 10.904 - Does a death as a result of occupational disease qualify for payment of the death gratuity?

§ 10.905 - 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?

§ 10.906 - What special statutory definitions apply to survivors under this subpart?

§ 10.907 - What order of precedence will OWCP use to determine which survivors are entitled to receive the death gratuity payment under this subpart?

§ 10.908 - Can an employee designate alternate beneficiaries to receive a portion of the death gratuity payment?

§ 10.909 - 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?

§ 10.910 - 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?

§ 10.911 - How is the death gratuity payment process initiated?

§ 10.912 - What is required to establish a claim for the death gratuity payment?

§ 10.913 - 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?

§ 10.914 - What are the responsibilities of the employing agency in the death gratuity payment process?

§ 10.915 - What are the responsibilities of OWCP in the death gratuity payment process?

§ 10.916 - How is the amount of the death gratuity calculated?