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MANAGING THE PAPERWORK Yvette Talley and Mark Baumann. OBJECTIVES . Identify the forms required for filing an injury or illness Discuss the appropriate responses on the supervisor portion of the claim form Discuss the importance of communication with the Workers’ Compensation Staff
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OBJECTIVES • Identify the forms required for filing an injury or illness • Discuss the appropriate responses on the supervisor portion of the claim form • Discuss the importance of communication with the Workers’ Compensation Staff • Identify documents used to authorize medical treatment and duty status reports
ENTITLEMENTS • Right to file a CA-1 (injury) and CA-2 (illness), to apply for compensation • Entitlement includes the option to receive medical treatment by either the VA Occupational Health Unit or their primary care provider • Authorized to designate representation
DEFINITIONS • FECA- Federal Employees’ Compensation Act • OWCP-Office of Workers’ Compensation Programs • Employer or Agency - refers to officers and employees of an employer having responsibility for the supervision, direction and control of employees • Representative-An individual or law firm properly authorized by a claimant in writing to act for the claimant in connection with a claim
CA-1, Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation
CA-1 (cont) • Employee must give notice in writing using form CA-1 • Review page one of the form ensuring it includes a detailed description of the injury • Complete and sign page two of the form within 2-3 days • Complete Receipt of Notice attached to CA1 and provide to employee
CA-1 (cont) • Submit completed form to Workers’ Compensation Office • Medical care authorized if appropriate • Advise the employee if COP will be controverted • Advise the employee of their responsibility to submit Prima Facie medical evidence of disability within 10 calendar days
Additional Forms Completed With the CA-1 • Release of Information • Election of Physician • First Script Card • Employee Responsibilities • 10.330
CA-2, Notice of Occupational Disease and Claim for Compensation
CA-2 (cont) • Review page one of the form ensuring it includes a detailed description of condition and relationship to employment • Complete and sign page two of the form within 2-3 days • Complete Receipt of Notice attached to CA2 and provide to employee • Submit completed form to Workers’ Compensation Office
CA-35, Evidence Required in Support of a Claim for Occupational Disease
CA-35 Checklists • Occupational Disease (generic) • Work-Related Hearing Loss • Asbestos-Related Illness • Work-Related Coronary/Vascular Condition • Work-Related Skin Disease • Work-Related Pulmonary Illness (not asbestosis) • Work-Related Psychiatric Illness • Work-Related Carpal Tunnel Syndrome
CA-2a, Notice of Recurrence • Recurrence of Medical Condition • Documented need for additional medical treatment after release from treatment for the work-related injury. • Recurrence of Disability • Spontaneous return of the symptoms of a previous injury or occupational disease without an intervening cause.
CA-2a (cont) • Employee completes and signs page one of the form • Supervisor will review employee’s portion of the form and complete page two • Treated the same as a CA2 in that it is not considered work-related unless DOL accepts the recurrence.
CA-5 and CA-5b, Claim for Compensation by Widow,Widower, and/or Children, Parents,Brothers, Sisters, Grandparents, orGrandchildren
CA-5 and CA-5b (cont) • Benefits may be paid to eligible dependents of an employee whose death results from an injury sustained in the performance of duty.