# Presentation: 219461

## OWCP/APMC

- For Incident Business Personnel
- Nashville, Tennessee
- April 5-7, 2005

## AUTHORITIES

- The Federal Employee’s Compensation Act (FECA).
- Various Acts that authorize the immediate relief of individuals engaged in hazardous work. (APMC)
- State Workers’ Compensation Programs – Vary from State to State.

## Comp/Claims Unit Leader/Injury Compensation Specialist Responsibilities

- Authorize medical treatment through OWCP (CA-16), APMC (FS-6100-16) or State procedures.
- Obtain and review medical reports for work restrictions and inform supervisor.
- Ensure paperwork is completed in a timely manner and forwarded to the individual’s home unit.

## Advise personnel of their rights and responsibilities.
Provide the Time Unit Leader info for accurate posting of time.
Provide the Procurement Unit Leader with deductible medical treatment costs for vendor invoices.
Follow-up on the status of hospitalized or medevaced personnel.
Inform FSC and Safety Officer of incident/illness trends.

- Provide the Time Unit Leader info for accurate posting of time.
- Provide the Procurement Unit Leader with deductible medical treatment costs for vendor invoices.
- Follow-up on the status of hospitalized or medevaced personnel.
- Inform FSC and Safety Officer of incident/illness trends.

## Agency Provided Medical Care (APMC)

**Provides reasonable and initial medical care to individuals who suffer minor occupational injuries or illnesses.  Covers treatment by a clinic, hospital, physician, and prescriptions.**
- Does not cover non-occupational injuries or illnesses unless payroll or contract invoice deduction will be made.
- Involves an initial medical visit and one follow-up medical visit.
- Bills are paid by the Incident.

## APMC Coverage

**Civilian federal employees** (includes temporary employees, casual firefighters, and those covered by a written agreement).
**State employees** may or may not be eligible for medical treatment under APMC.  Coverage dependent on the contract or agreement under which dispatched.  Sending unit geographic area state or federal incident business management coordinator should be contacted as necessary.

## APMC Coverage

**Military personnel** if military medical units not available or services needed are beyond what the military medical units can provide.
**Contractors and their employees** may utilize if authorized by contractor.  All costs are deducted from the Emergency Equipment Use Invoice, OF-286.

## APMC - Immediate Relief Cases

- Medical condition is NOT related to work or injured is NOT covered by FECA.
- Treatment should be provided to relieve suffering.
- Provide treatment which allows completion of the workday and provides interim care until arrangement for private medical attention, at individual’s expense, is made.
- Charges for non-covered medical treatment will be paid directly by the individual or processed as a deduction on the appropriate pay document.

## APMC – Required Documentation

- Medical Resource Request Number (Must be included on the top of all reporting forms along with the notation “Paid by APMC”.
- FS-6100-16, APMC Medical Care Authorization and Medical Report.
- Copies of Medical Reports.
- Summary of authorized medical services on APMC treatment log.
- If Federal Employee also complete:
- CA-1 for Traumatic Injuries
- CA-2 for Occupational Illnesses

## Office of Workers’ Compensation Program (OWCP)

**Provides benefits to Federal Employees covered by the Federal Employees’ Compensation Act (FECA) when they sustain a work related injury or illness.**

## OWCP Coverage – The Five Basics

**Timely Filed** – within 3 years or longer if written notice provided or immediate supervisor was notified within 30 days.
**Civil Employee** – Regular employees, SCSEP, Volunteers, Casual Firefighters
**Fact of Injury** –
- (a) an injury did occur; and
- (b) the incident resulted in a medical condition.

## OWCP Coverage (The Five Basics)

**Performance of Duty** – On premises
- -Use of facilities for employees’ comfort, health, convenience
- -Eating meals and snacks provided on the premises
- -Reasonable time before/after shift
- -Agency controlled parking facilities
- -Reasonable use of agency housing if required or expected to occupy

## The 5 Basics (Continued)

**Performance of Duty – Off Premises**
- -If performing Duties
- -To and From Work if Agency provides transportation.
- -Travel status for all incidents related to travel.

## The Five Basics (Continued)

**Causal Relationship**
-    - Direct
-    - Aggravation
-    - Acceleration
-    - Precipitation

## Not Covered

- Exposures or fear of exposure.
- Willful misconduct.
- Intoxication.
- Intent to bring about injury or death to oneself or another.

## OWCP – Required Documentation

- CA-1 if Traumatic Injury
- CA-2 if Illness
- CA-16 (only for traumatic injuries – Do not issue for respiratory illness, colds, sore throats, etc.)
- CA-17, Duty Status Report if appropriate
- Copies of Medical Reports

## Paperwork Distribution

- All original APMC and OWCP paperwork should be sent to the individual’s home unit OWCP Coordinator as soon as possible.  OWCP claim forms are due at OWCP within 10 days of incident.
- OF-313, Incident Injury Case File Envelope

##  Forest Service Timeliness Statistics

| YEAR | GOAL | ACTUAL |
| --- | --- | --- |
| 2003 BASELINE | 24.1 |  |
| 2004 | 25.3 | 27.9 |
| 2005 | 26.5 |  |
| 2006 | 27.8 |  |

## Continuation of Pay (COP)

- Federal and casual employees who sustain a traumatic injury are **generally **entitled to up to 45 days of COP if disabled or work is lost to seek medical treatment.

## COP does not apply when:

- Disability is not caused by a traumatic injury.
- Employee is not a citizen.
- Written claim is not filed within 30 days of injury.
- Injury is reported after employment is terminated.
- Injury occurred off agency premises and not within the performance of duty.

## COP does not apply when:

- The injury was caused by the employee’s willful misconduct, intent to injure or kill himself or herself or another person, or was caused by intoxication by alcohol or illegal drugs.
- Work did not stop within 45 days following the injury.

## COP  applies when:

- Federal employee or casual firefighter sustains a traumatic injury and
- Cannot work as a result of a disability as determined by the physician and documented on the medical record.

## COP Recording Procedures for Regular Government Employees

- First day of COP is first day of disability after date of injury unless injury occurs before the beginning of the workday or shift.
- Charge COP for each day the individual is absent from work due to disability including intermittent periods or partial days.
- Record COP in a separate column on the OF-288.

## COP Recording Procedures for Casuals

- Casuals are entitled to payment of COP for 8 hours per day, 7 days per week, for periods of disability until one of the following is met:
-    Complete recovery
-    45 days are completed
-    They are released from the incident           because the incident is over and/or their crew is demobilized to the home unit.