# Presentation: 219467

## Union's Role in Helping the Injured Employee Return to Work

- Al Schmidt - AFGE National Safety Representative -
- Elaine Gerace, RN - SEIU 200 United, VA National Partnership Council  Representative

## Objectives:

- Identify proper forms for work related injury or illness.
- Provide information on how employees provide proper medical information to support their claim.
- Provide appropriate means for tracking OWCP claims and insure that physical restrictions are followed.
- Identify ways to facilitate the employee’s return to work
- Develop strategies to help reduce future injuries from occurring.

## Proper Forms for Work-Related Injury/Illnesses  

- CA-1:  for traumatic injuries (incident occurs during one work shift and is identifiable by time & place)
- CA-2: for occupational illnesses/diseases (a condition that results over a period of time and can be related to factors of employment)

## Proper Forms for Work-Related Injury/Illnesses  con’t.

- CA-2a:  for recurrence of injury or disability (a spontaneous return or increase of disability due to a previous injury or occupational disease without intervening cause)
- CA-7:  claim for compensation
- Other forms may be found at: http://www.dol.gov/dol/topic/workcomp/index.htm

## Definition of Work Injury Terms

- Traumatic Injury - A wound or other condition of the body caused by external force, including stress or strain.  The injury must be identifiable by time and place of occurrence and member or function of the body affected, it must be caused by a specific event or incident or series of events or incidents within a single day or work shift

## Definitions con’t

- Occupational Diseases or Illnesses
-  A condition produced in the work environment over a period longer than one workday or shift.  It may result from systemic infection, repeated stress or strain, exposure to toxins, poisons, or fumes, or other continuing conditions of the work environment.

## Definitions con’t

- Recurrence
- A spontaneous return or increase of disability due to a previous injury or occupational disease without intervening cause, or a return or increase of disability due to a consequential injury.  A recurrence is distinguished from a new injury by criterion that in a recurrence no event other than the previous injury accounts for the disability.

- Form CA-1 must be filed within 30 days of the date of injury to receive continuation of pay.
- COP may be terminated if medical evidence of the injury-related disability is not submitted within 10 workdays.
- The employee is responsible for ensuring that such medical evidence is submitted to the agency

- Form CA-2 should also be filed within 30 days
- Note:  Any claim that is not submitted within 3 years will be barred by statutory time limitations unless the immediate superior had actual knowledge of the injury or death within 30 days of occurrence

## Establish the Elements of the Claim

- Provide evidence:
-  that the employee filed for benefits in a timely manner
- that the employee is a federal employee
- that the injury occurred in the performance of duty

- that the condition or disability is related to the injury or factors of their Federal employment
- OWCP will help the employee meet this responsibility by requesting evidence needed to fulfill the requirements of their claim

##  An employee should file a claim when

- The employee believes the injury occurred while in the performance of duty
- The employee believes that occupational exposure to disease or hazardous agents has caused an illness

## TO FILE A CLAIM

- Notify supervisor of the injury or illness ASAP
- Agency must provide forms and information
- Complete employee portion
- Submit forms to supervisor to complete their portion
- Agency must submit forms to the DOL office of workers Compensation if there is lost time and/or medical expenses

## OWCP BENEFITS

- Medical Care - Physician of Choice (agency cannot interfere with right of choice)
- Continuation of Pay
- Total Disability - Wage is paid when capacity to earn wages is lost

## CHOICE OF PHYSICIAN

- The agency may not interfere with choice of physician.
- The agency may help the employee set up an appointment with a private physician
- Agency can only contact the physician in writing for information regarding duty status and medical progress - CA-17

## CONTINUATION OF PAY

- Employee’s pay may continue for up to 45 calendar days
- Avoids interruption of the employee’ income while the case is being adjudicated

- Employee is entitled to receive COP when absent from work due to disability or medical treatment or when reassigned by formal personnel action to a position with a lower rate of pay.

## Continuation of Pay - con’t

- The agency may dispute COP if:
- Work stoppage first occurred more than 45 days after the injury
- Injury occurred off the employing agency premise -not involved in “off premises”duties
- Injury first reported after termination
- condition claimed is not the result of a work related injury

- Injury was not reported on a form approved by OWCP (CA-1) within 30 days of the injury
- The employee was not performing assigned duties when the injury occurred
- Objections should be supported by factual evidence such as photos, witness statements, time sheets and accident investigation reports

##  Disability

- Employees disabled by a work related illness or injury are compensated at a rate equal to 66 2/3% (without dependents) or 75% (with dependents) of the wage lost as a result of the disability

## Tracking OWCP Claims

- All limited duty assignments should be documented and signed by the employee and supervisor.
- Employees are instructed to provide updated medical documentation after each appointment.
- Develop a good working relationship with the OWCP Program Specialist

## Tracking Claims - con’t

- In order to insure that restrictions are followed, the employee should receive the job description and the duties it entails in writing.

## Union Roles In OWCP

- Educator
- Mediator
- Representative
- Advocate
- Liaison
- Support

## The Union Rep can:

- Help the member understand the filing process
- Help fill out forms and write the narrative
- Help respond to the agency and OWCP request for information
- This would include helping the employee obtain the appropriate medical reports from their physician

## Union Rep - con’t

- Help monitor progress on the claim
- Help/arrange negotiate accommodations
- Help employee with appeals process
- Represent employee in a hearing
- Help employee through EEO process to request reasonable accommodation
- Advise employee on retirement options

## Common Interests

- Help the injured employee obtain prompt medical treatment and workers’ compensation benefits
- Help keep the employee in a pay status
- Help the employee return to work when medically appropriate
- Help keep the employee from being re-injured

## Facilitate Employees Return to Work

- Work with OWCP specialist and the facility to identify jobs that will meet the restrictions of the employee.
- Assist the employee in gathering information needed to return to work.

## Develop Strategies to Reduce Future Injuries

- Case Management Teams - Union Involvement
- Review all employee accidents
- Determine if correct procedure was followed

- If correct procedure - review accident site/ recommend changes
- If incorrect procedure- employee should be instructed in proper technique.
- Consider ergonomic solutions when applicable.

## QUESTIONS?

- Points for discussion - Let’s learn from each other!
- How does your facility promote injured employees returning to work?
- What role do you as Union representatives play in this process?
- Do you have suggestions that you feel might promote return to work programs?