Episode 20 Federal Workers Compensation Coffee Break Podcast - Scheduled Awards & Disability

Federal Workers Compensation Coffee Break Podcast is about all things related to Federal Workers Compensation, FECA, OWCP, DOL & Longshore claim filing as an injured federal worker.  The podcast is an educational and informative training on how to navigate the DOL -OWCP claims filing process for all types of injured US government and federal workers. The podcaster has 27 years in assisting with federal workers compensation as a consultant and trainer. The podcast is free and is educational. If you need help with anything related to a federal workers compensation claim...help is just a cup of coffee away.
The FECA provides that loss of both hands, arms, feet, or legs, or the loss of sight of both eyes is prima facie evidence of permanent total disability. See 5 U.S.C. 8105(b). It does not mean, however, that a claimant in this medical condition should be automatically declared permanently and totally disabled. 
Compensation is provided for specified periods of time for the permanent loss or loss of use of certain members, organs and functions of the body. Such loss or loss of use is known as permanent impairment. Compensation for proportionate periods of time is payable for partial loss or loss of use of each member, organ or function. 5 U.S.C. 8107(b)(19). 

 Employees covered under the Federal Employees’ Retirement System (FERS) are required to apply for Social Security disability benefits in order to obtain FERS disability retirement. Social Security regulations provide for dollar-for-dollar offset of Social Security disability benefits if an employee receives workers’ compensation disability benefits.

Social Security Disability: Social Security considers OWCP Schedule Awards as disability benefits, and will deduct the full amount from any Social Security disability benefits due. Moreover, Social Security will report the full amount of the deduction to the IRS as taxable income, even though it never was paid to the injured worker.

VA Disability: Under FECA, an injured federal worker whose claim is accepted is entitled to medical benefits and wage loss compensation. For federal worker with DVA disability ratings, applying for some FECA benefits may require an election between the DVA benefits and FECA benefits. An injured worker with a DVA disability rating for the same injury will often receive more from an increase of their DVA disability rating than from a schedule award. Injured workers with DVA disability ratings should contact their National Business Agent’s office for guidance.

 To receive a Schedule Award, the person must be rated by a physician, using the AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, g, the person has to have reached Maximum Medical Improvement, which is referred to as MMI.

Schedule Award is paid using the formula:

(OWCP Compensation Rate) x (Number of weeks allowed on the Schedule for the injured body part) x (% of Impairment) = $Schedule Award

Dr. Taylor's educational podcast utilizes his experience and history as a DOL - OWCP provider and his years of consulting and teaching all things federal workers compensation related. This is an educational short form format for learning how to successfully file federal workers compensation claims. So grab a cup of coffee and lets begin.

Dr. Taylor's contact information for more information or assistance is:
https://fedcompconsultants@protonmail.com

If you need a provider or assistance with a DOL claim in Tampa, Jacksonville or other areas of Florida you can make an appointment to see him and the other providers at his clinic at 813-877-6900.

Transcript

                                                                         Scheduled Awards

To Qualify for a work-related injury settlement also called a scheduled award …Your Federal Worker work-related injury must have resulted in the loss, or loss of use, of the parts of the body,  listed in the table above. Loss of a body part simply means that a specific part of your body was cut off, or was amputated because of your work related injury.

Ok…let’s start with reading the official FECA § 10.404 When and how is compensation for a schedule impairment paid?

Compensation is provided for specified periods of time for the permanent loss or loss of use of certain members, organs and functions of the body. Such loss or loss of use is known as permanent impairment. Compensation for proportionate periods of time is payable for partial loss or loss of use of each member, organ or function. 5 U.S.C. 8107(b)(19). OWCP evaluates the degree of impairment to schedule members, organs and functions as defined in 5 U.S.C. 8107 according to the standards set forth in the specified (by OWCP) edition of the American Medical Association’s Guides to the Evaluation of Permanent Impairment.

In order to receive a Schedule Award, the person must be rated by a physician, using the AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, otherwise known as the AMA GUIDE 6th Edition. Prior to receiving the rating, the person has to have reached Maximum Medical Improvement, which is referred to as MMI.

Submitting the Schedule Award Request

When you receive the medical report, send it to OWCP with a cover letter requesting a schedule award. Active federal worker must complete the employee portion of the CA-7, check "schedule award," and submit it to the Employing agency. Request a completed copy of the CA-7 from the Employing agency. The Employing agency has 5 working days to submit the CA-7 to OWCP. If you are retired and applying for a schedule award, federal regulations allow an application to be submitted with a cover letter requesting the schedule award as long as there was a previous CA-7 filed.

 Schedule awards are payable concurrent with wages or retirement benefits.

 Schedule awards are generally not payable concurrent with OWCP wage-loss compensation benefits. However, if an employee has a job-related injury that causes impairment in one body part (that entitles him or her to a schedule award) and at the same time has a different job related injury to a different body-part that is disabling, both wage-loss compensation and a schedule award may be paid concurrently.

Schedule awards paid by OWCP do not constitute a settlement or final payout.

 Receiving a schedule award does not end the right to continue receiving other OWCP benefits, such as payment for medical bills, reimbursement of transportation expenses for travel to medical appointments, wage-loss compensation benefits, etc.

 Schedule Awards and Social Security Disability

A limitation arises when employees apply for and are entitled to Social Security disability benefits. Employees covered under the Federal Employees’ Retirement System (FERS) are required to apply for Social Security disability benefits in order to obtain FERS disability retirement. Social Security regulations provide for dollar-for-dollar offset of Social Security disability benefits if an employee receives workers’ compensation disability benefits.

 Social Security considers OWCP Schedule Awards as disability benefits, and will deduct the full amount from any Social Security disability benefits due. Moreover, Social Security will report the full amount of the deduction to the IRS as taxable income, even if there never was payment to the injured worker.

 Federal Workers covered by FERS who may be entitled to a schedule award and concurrently entitled to disability retirement should seek advice from their branch OWCP specialist or National Business Agent’s office or reach out to me for assistance at my email.

 Schedule awards and VA disability ratings

Under FECA, an injured federal worker whose claim is accepted is entitled to medical benefits and wage loss compensation. For federal worker with DVA disability ratings, applying for some FECA benefits may require an election between the DVA benefits and FECA benefits.

 An injured worker with a DVA disability rating for the same injury will often receive more from an increase of their DVA disability rating than from a schedule award. Injured workers with DVA disability ratings should contact their National Business Agent’s office for guidance.

 Method of Payment

 Schedule awards are paid for a certain number of weeks, calculated by multiplying the percentage of impairment of a body part (determined by the rating physician) times the number of weeks set out in the schedule in the FECA for that body part. Each week of the schedule award is paid at the employee’s compensation rate, which is weekly salary times 2/3 or 3/4, depending on whether the employee is single with no dependents (2/3) or married or otherwise has one or more dependents (3/4).

 So let me break this down a little bit more.  Schedule awards are given only to employees with accepted FECA, LongShoreman or OWCP federal workers compensation claims claims. They are dispersed for regional permanent partial impairment to a body part that is listed on the schedule. If the injured part of your body is not a scheduled member, than you are not entitled to a scheduled award.

 If your body part is listed on the FECA/ OWCP schedule, look at the corresponding number of weeks of compensation that the body part is eligible in its entirety. There are some body parts that are not ratable. We discussed in previous podcast for example that the spine is not a covered body part on the OWCP table.  Fortunately, you can receive a scheduled award due to the effects a back or neck injury has on a body part that does appear in the tables above. For example, a back injury may permanently affect a nerve in your arm or leg, causing permanent weakness, loss of sensation, loss of range of motion, and the like. This nerve damage may entitle you to a scheduled for the affected arm or leg – but not the any part of the spine. 

At this point, a special medical report is required called and Permanent Partial Impairment Rating (PPI). All federal impairment ratings should be done using the AMA Guides 6th Edition. Any rating using a different edition of the AMA Guides will not be considered.

Once a rating is given by the physician, the report is reviewed by the OWCP’s District Medical Advisor. The DMA will judge whether or not the PPI report is accurate. Once the impairment percentage is reviewed and determined, the Schedule Award is paid using the formula:

(OWCP Compensation Rate) x (Number of weeks allowed on the Schedule for the injured body part) x (% of Impairment) = Schedule Award

 5 USC 8107 provides for compensation to the following list of scheduled members:

  | Member | Weeks
| Arm | 312
| Leg | 288
| Hand | 244
| Foot | 205
| Eye | 160
| Thumb | 75
| First Finger Lost | 46
| Great Toe | 38
| Second Finger | 30
| Third finger | 25
| Toe other than great toe | 16
| Fourth Finger | 15
| Hearing, one ear | 52
| Hearing, both ears | 200
Pursuant to the authority provided by 5 U.S.C. 8107(c)(22), the Secretary of Labor added the following organs to the compensation schedule for injuries that were sustained on or after September 7, 1974, except that a schedule award for the skin may be paid for injuries on or after September 11, 2001:

  | Member | Weeks
| Breast (one) | 52
| Kidney (one) | 156
| Larynx | 160
| Lung (one) | 156
| Penis | 205
| Testicle (one) | 52
| Tongue | 160
| Ovary (one) | 52
| Uterus/cervix and vulva/vagina | 205
| Skin |