UNITED STATES OF AMERICA

MERIT SYSTEMS PROTECTION BOARD 

ANDREW C. MURPHY,

Appellant,

v.

DEPARTMENT OF VETERANS 

AFFAIRS,

Agency.

DOCKET NUMBER

CH-0752-16-0160-I-1

DATE: February 3, 2023

THIS FINAL ORDER IS NONPRECEDENTIAL1

Ray Wilkins, St. Louis, Missouri, for the appellant.

G.M. Jeff Keys, Esquire, St. Louis, Missouri, for the agency.

Michael E. Anfang, Esquire, Kansas City, Missouri, for the agency.

BEFORE

Cathy A. Harris, Vice Chairman

Raymond A. Limon, Member

Tristan L. Leavitt, Member

FINAL ORDER

¶1 The agency has filed a petition for review of the initial decision, which

reversed the appellant’s removal. Generally, we grant petitions such as this one 

 

1 A nonprecedential order is one that the Board has determined does not add 

significantly to the body of MSPB case law. Parties may cite nonprecedential orders, 

but such orders have no precedential value; the Board and administrative judges are not 

required to follow or distinguish them in any future decisions. In contrast, a 

precedential decision issued as an Opinion and Order has been identified by the Board 

as significantly contributing to the Board’s case law. See 5 C.F.R. § 1201.117(c).
2

only in the following circumstances: the initial decision contains erroneous 

findings of material fact; the initial decision is based on an erroneous 

interpretation of statute or regulation or the erroneous application of the law to 

the facts of the case; the administrative judge’s rulings during either the course of 

the appeal or the initial decision were not consistent with required procedures or 

involved an abuse of discretion, and the resulting error affected the outcome of 

the case; or new and material evidence or legal argument is available that, despite 

the petitioner’s due diligence, was not available when the record closed. Title 5 

of the Code of Federal Regulations, section 1201.115 (5 C.F.R. § 1201.115). 

After fully considering the filings in this appeal, we conclude that the petitioner 

has not established any basis under section 1201.115 for granting the petition for 

review. Therefore, we DENY the petition for review. Except as expressly 

MODIFIED to vacate the administrative judge’s findings concerning an ex parte 

communication, we AFFIRM the initial decision.

BACKGROUND

¶2 The appellant was employed as a Rating Veterans Service Representative 

with the agency’s Veterans Benefit Administration. Initial Appeal File (IAF), 

Tab 1 at 1. On June 18, 2015, the agency proposed his removal based on a charge 

of falsifying Government records. IAF, Tab 7 at 8-11. The charge was based on 

16 specifications in which the agency alleged that on various dates the appellant

had improperly entered credit in the agency’s automated standardized 

performance elements nationwide (ASPEN) system. Id. at 8-10. By letter dated 

December 9, 2015, the agency sustained 11 of the specifications and removed the 

appellant, effective December 23, 2015. Id. at 4-7.

¶3 The appellant filed a Board appeal. IAF, Tab 1. During the proceedings 

below, the appellant raised a claim that the agency denied him due process in 

connection with the removal action and the administrative judge allowed the 

parties to submit briefs on the due process issue. IAF, Tabs 19-20. The appellant 
3

contended that the documents contained in the agency’s evidence file in support 

of its removal action were so heavily redacted that he was denied a meaningful

opportunity to respond to the charge. IAF, Tab 21 at 4. He further contended 

that the deciding official was provided with an unredacted version of the agency 

file. Id. In response, the agency did not dispute that the deciding official had

received an unredacted version of the evidence file, but maintained that the 

redacted information, which included veterans’ names and social security/claim

numbers, was not material and was not relied upon by the deciding official in 

reaching her decision to remove the appellant. IAF, Tab 22 at 4-5.

¶4 Without holding the appellant’s requested hearing, the administrative judge 

issued an initial decision reversing the agency’s removal action. IAF, Tab 25, 

Initial Decision (ID). The administrative judge found that the appellant was not 

able to meaningfully rebut the specifications because the agency failed to identify 

the cases for which it alleged that he had improperly entered credit. ID at 9, 11. 

The administrative judge further found that deciding official’s receipt of 

unredacted information in the materials relied upon that was not provided to the

appellant violated the appellant’s due process rights. ID at 11.

¶5 The agency has filed a petition for review. Petition for Review (PFR) File, 

Tab 1. The appellant has opposed the agency’s petition. PFR File, Tab 4. 

DISCUSSION OF ARGUMENTS ON REVIEW

The agency has complied with the interim relief order.

¶6 On March 7, 2017, the appellant filed a pleading in which he appears to 

argue that the agency failed to comply with the interim relief order in the 

February 27, 2017 initial decision by not issuing him appropriate notification of 

his return to duty, not responding to certain questions he had about his 

reinstatement, and failing to rescind a July 15, 2015 memorandum barring him 

from agency premises in connection with his removal. PFR File, Tab 3 at 12, 19. 

The initial decision ordered the agency to provide the appellant interim relief, 
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effective as of the date of the decision, including effecting his appointment with 

pay and benefits. ID at 13. Here, with its petition for review, the agency 

provided a Standard Form 50 showing that it had effected the appellant’s 

appointment to the position of Rating Veterans Service Representative as of 

February 27, 2017, the effective date of the initial decision. PFR File, Tab 1 

at 18. Further, the appellant’s own submission contains a letter from the agency 

dated March 3, 2017, referencing that he was reinstated on February 27, 2017, 

and that the agency had contacted him on February 28, 2017, to notify him that it 

expected him to report to work on March 1, 2017, but that he had failed to do so. 

PFR File, Tab 3 at 6. Accordingly, we reject the appellant’s contention that the 

agency failed to comply with the interim relief order. 

The administrative judge properly found that the appellant was not afforded due 

process.

¶7 Before taking an appealable action that deprives a tenured Federal employee 

of his property right in his employment, an agency must provide him with 

minimum due process of law. Cleveland Board of Education v. Loudermill, 

470 U.S. 532, 543-46 (1985). Due process entitles the employee to oral or 

written notice of the charges against him, an explanation of the employer’s 

evidence, and an opportunity to present his side of the story. Id. at 546; see

5 U.S.C. § 7513(b). In determining whether these requirements have been met,

the Board analyzes whether a notice of proposed removal, along with the 

supporting documentation attached thereto and contemporaneously provided to 

the appellant, afforded him sufficient notice of the charges against him to enable 

him to make a meaningful reply to the proposal. Alvarado v. Department of the 

Air Force, 97 M.S.P.R. 389, ¶ 8 (2004). The Board also looks to whether new 

and material information was introduced by means of an ex parte communication 

to the deciding official, which would violate the due process guarantee of notice. 

Stone v. Federal Deposit Insurance Corporation, 179 F.3d 1368, 1376-77 (Fed.

Cir. 1999). A due process violation entitles an employee to a new and 
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constitutionally correct removal proceeding. Ward v. U.S. Postal Service, 

634 F.3d 1274, 1279 (Fed. Cir. 2011).

¶8 Here, the agency’s June 18, 2015 notice of proposed removal includes 

16 unnumbered specifications which identify various dates between December 15,

2014, and February 27, 2015, on which it contends that the appellant improperly

entered in the ASPEN system certain credit for work he performed. IAF, Tab 7 

at 8-10. The specifications in the proposal, however, do not indicate to which

veteran or case the credits pertained.

2

 Id. Instead, the proposal notice informed 

the appellant that he could review the materials relied upon by the agency in 

support of its charge. Id. at 10. The agency’s evidence file is confusing and is 

not indexed, arranged in chronological order, or tabbed to correspond to the 

specifications in the proposal notice. IAF, Tabs 7-9, 11-12. It also appears to 

have been supplemented on at least two occasions after the deciding official 

notified the appellant that he had reviewed additional information. IAF, Tab 11 

at 7, Tab 12 at 118.

¶9 The appellant does not dispute that he received the documents contained in 

the agency’s evidence file. Thus, the issue is whether such documents provided

the appellant sufficient notice to allow him a meaningful opportunity to respond 

to the charge.

3

 The administrative judge found that the documents were so 

 

2

The specifications also do not clearly explain why the credits entered by the appellant 

were improper by, for example, citing to agency policies that the agency contends the 

appellant violated. IAF, Tab 7 at 8-10.

3 On review, the agency does not offer any argument concerning how the proposal

notice and evidence file afforded the appellant a meaningful opportunity to respond. 

Rather, the agency asserts that the administrative judge should have held a hearing on 

the issue of whether the deciding official’s consideration of the unredacted evidence 

file was a material ex parte communication that violated the appellant’s due process 

rights. PFR File, Tab 1 at 9. We disagree. The redacted information is relevant 

because it would have allowed the appellant, as it did the deciding official, to discern 

which cases were referenced in each specification of the proposal notice. Thus, the 

primary issue is whether, despite the redacted nature of the documents, the appellant 

was afforded a meaningful opportunity to respond.
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heavily redacted as to deprive the appellant of an opportunity to respond. ID at 9, 

11. We agree. As the administrative judge found, the underlying records, which 

redacted the veterans’ names and claim numbers, do not identify the cases for 

which the appellant allegedly took improper credit. ID at 7, IAF, Tabs 7-9, 

11-12. It is also unclear which evidence pertains to which specification. Indeed, 

the appellant noted in numerous written responses that the redacted documents 

prevented him from providing a meaningful response. IAF, Tab 10 at 7, 71; 

Tab 12 at 107, 112, 116; Tab 13 at 7. In particular, he noted that the redacted 

documents prevented him from reflecting on what actions he took on each 

veteran’s claims because he could not recall the ASPEN action numbers for each 

case. IAF, Tab 12 at 112. The appellant also indicated that, because the agency’s 

specifications were unclear, it was possible, if not likely, that he used the wrong 

documents to respond to the specifications. IAF, Tab 10 at 7.

¶10 As the administrative judge noted, the agency appears to have provided the 

appellant with a revised evidence file in which it identified each veteran by a 

letter and specified certain pieces of evidence that corresponded to each lettered 

veteran. ID at 8-9, IAF, Tab 7 at 47-48. However, this too failed to provide the 

appellant with sufficient notice because the supporting documents remained 

redacted, it is not clear which of the 14 letters assigned to the veterans pertained

to which of the 16 unnumbered specifications in the proposal notice, and the 

evidence is not otherwise clearly organized such that one can discern which

evidence pertains to which specification. For example, the supporting evidence

for Veteran D as identified in the index includes ASPEN actions dated 

February 18 and March 3, 2015. IAF, Tab 7 at 47. This appears to correspond to 

the dates in the fifth specification in the proposal notice. Id. at 8. However, one 

would presume Veteran D would correspond to the fourth specification as D is the 

fourth letter of the alphabet. Further, the index only specified certain evidence 

that corresponded to each veteran, not all of the evidence. Id. at 47-48. The 

specified evidence includes only ASPEN actions, or screen shots showing the 
7

appellant’s actions as described in the proposal notice. Id. Thus, such evidence 

provided no more information than what was provided in the proposal notice and

similarly failed to provide any information that would have informed the 

appellant of the details of the specific case to which the agency was referring in 

each specification. 

¶11 Based on the foregoing, we agree with the administrative judge that the

appellant was denied a meaningful opportunity to respond to the agency’s charge 

because the agency’s supporting documents denied him the ability to determine 

whether he had, in fact, performed any work on the pertinent case and/or whether 

he entered the appropriate credit for the work done on the case. ID at 8. In light 

of this finding, we need not reach the issue of whether the deciding official’s

consideration of the unredacted evidence file amounted to an ex parte 

communication. Accordingly, we vacate the administrative judge’s findings to 

the extent that he found a due process violation based on an ex parte 

communication.

ORDER

¶12 We ORDER the agency to cancel the appellant’s removal and to restore the 

appellant effective December 23, 2015. See Kerr v. National Endowment for the 

Arts, 726 F.2d 730 (Fed. Cir. 1984). The agency must complete this action no 

later than 20 days after the date of this decision.

¶13 We also ORDER the agency to pay the appellant the correct amount of back 

pay, interest on back pay, and other benefits under the Office of Personnel 

Management’s regulations, no later than 60 calendar days after the date of this 

decision. We ORDER the appellant to cooperate in good faith in the agency’s 

efforts to calculate the amount of back pay, interest, and benefits due, and to 

provide all necessary information the agency requests to help it carry out the 

Board’s Order. If there is a dispute about the amount of back pay, interest due, 
8

and/or other benefits, we ORDER the agency to pay the appellant the undisputed 

amount no later than 60 calendar days after the date of this decision. 

¶14 We further ORDER the agency to tell the appellant promptly in writing 

when it believes it has fully carried out the Board’s Order and of the actions it has 

taken to carry out the Board’s Order. The appellant, if not notified, should ask 

the agency about its progress. See 5 C.F.R. § 1201.181(b). 

¶15 No later than 30 days after the agency tells the appellant that it has fully 

carried out the Board’s Order, the appellant may file a petition for enforcement 

with the office that issued the initial decision on this appeal if the appellant 

believes that the agency did not fully carry out the Board’s Order. The petition 

should contain specific reasons why the appellant believes that the agency has not 

fully carried out the Board’s Order, and should include the dates and results of

any communications with the agency. 5 C.F.R. § 1201.182(a).

¶16 For agencies whose payroll is administered by either the National Finance 

Center of the Department of Agriculture (NFC) or the Defense Finance and 

Accounting Service (DFAS), two lists of the information and documentation 

necessary to process payments and adjustments resulting from a Board decision 

are attached. The agency is ORDERED to timely provide DFAS or NFC with all 

documentation necessary to process payments and adjustments resulting from the 

Board’s decision in accordance with the attached lists so that payment can be 

made within the 60-day period set forth above.

NOTICE TO THE APPELLANT REGARDING

YOUR RIGHT TO REQUEST

ATTORNEY FEES AND COSTS

You may be entitled to be paid by the agency for your reasonable attorney 

fees and costs. To be paid, you must meet the requirements set forth at Title 5 of 

the United States Code (5 U.S.C.), sections 7701(g), 1221(g), or 1214(g). The 

regulations may be found at 5 C.F.R. §§ 1201.201, 1201.202, and 1201.203. If 

you believe you meet these requirements, you must file a motion for attorney fees 
9

and costs WITHIN 60 CALENDAR DAYS OF THE DATE OF THIS DECISION. 

You must file your motion for attorney fees and costs with the office that issued 

the initial decision on your appeal.

NOTICE OF APPEAL RIGHTS4

The initial decision, as supplemented by this Final Order, constitutes the 

Board’s final decision in this matter. 5 C.F.R. § 1201.113. You may obtain 

review of this final decision. 5 U.S.C. § 7703(a)(1). By statute, the nature of 

your claims determines the time limit for seeking such review and the appropriate 

forum with which to file. 5 U.S.C. § 7703(b). Although we offer the following 

summary of available appeal rights, the Merit Systems Protection Board does not 

provide legal advice on which option is most appropriate for your situation an d 

the rights described below do not represent a statement of how courts will rule 

regarding which cases fall within their jurisdiction. If you wish to seek review of 

this final decision, you should immediately review the law applicable to your 

claims and carefully follow all filing time limits and requirements. Failure to file 

within the applicable time limit may result in the dismissal of your case by your 

chosen forum. 

Please read carefully each of the three main possible choices of review 

below to decide which one applies to your particular case. If you have questions 

about whether a particular forum is the appropriate one to review your case, you 

should contact that forum for more information. 

(1) Judicial review in general. As a general rule, an appellant seeking 

judicial review of a final Board order must file a petition for review with the U.S. 

Court of Appeals for the Federal Circuit, which must be received by the court 

 

4

Since the issuance of the initial decision in this matter, the Board may have updated 

the notice of review rights included in final decisions. As indicated in the notice, the 

Board cannot advise which option is most appropriate in any matter.
10

within 60 calendar days of the date of issuance of this decision. 5 U.S.C. 

§ 7703(b)(1)(A). 

If you submit a petition for review to the U.S. Court of Appeals for the 

Federal Circuit, you must submit your petition to the court at the 

following address: 

U.S. Court of Appeals 

for the Federal Circuit 

717 Madison Place, N.W. 

Washington, D.C. 20439 

Additional information about the U.S. Court of Appeals for the Federal 

Circuit is available at the court’s website, www.cafc.uscourts.gov. Of particular 

relevance is the court’s “Guide for Pro Se Petitioners and Appellants,” which is 

contained within the court’s Rules of Practice, and Forms 5, 6, 10, and 11. 

If you are interested in securing pro bono representation for an appeal to 

the U.S. Court of Appeals for the Federal Circuit, you may visit our website at 

http://www.mspb.gov/probono for information regarding pro bono representation 

for Merit Systems Protection Board appellants before the Federal Circuit. The 

Board neither endorses the services provided by any attorney nor warrants that 

any attorney will accept representation in a given case. 

(2) Judicial or EEOC review of cases involving a claim of 

discrimination. This option applies to you only if you have claimed that you 

were affected by an action that is appealable to the Board and that such action 

was based, in whole or in part, on unlawful discrimination. If so, you may obtain 

judicial review of this decision—including a disposition of your discrimination 

claims—by filing a civil action with an appropriate U.S. district court (not the 

U.S. Court of Appeals for the Federal Circuit), within 30 calendar days after you 

receive this decision. 5 U.S.C. § 7703(b)(2); see Perry v. Merit Systems 

Protection Board, 582 U.S. ____ , 137 S. Ct. 1975 (2017). If you have a 

representative in this case, and your representative receives this decision before 
11

you do, then you must file with the district court no later than 30 calendar days

after your representative receives this decision. If the action involves a claim of 

discrimination based on race, color, religion, sex, national origin, or a disabling 

condition, you may be entitled to representation by a court-appointed lawyer and 

to waiver of any requirement of prepayment of fees, costs, or other security. See

42 U.S.C. § 2000e-5(f) and 29 U.S.C. § 794a. 

Contact information for U.S. district courts can be found at their respective 

websites, which can be accessed through the link below: 

http://www.uscourts.gov/Court_Locator/CourtWebsites.aspx. 

Alternatively, you may request review by the Equal Employment 

Opportunity Commission (EEOC) of your discrimination claims only, excluding 

all other issues. 5 U.S.C. § 7702(b)(1). You must file any such request with the 

EEOC’s Office of Federal Operations within 30 calendar days after you receive

this decision. 5 U.S.C. § 7702(b)(1). If you have a representative in this case, 

and your representative receives this decision before you do, then you must file 

with the EEOC no later than 30 calendar days after your representative receives

this decision. 

If you submit a request for review to the EEOC by regular U.S. mail, the 

address of the EEOC is: 

Office of Federal Operations 

Equal Employment Opportunity Commission 

P.O. Box 77960 

Washington, D.C. 20013 

If you submit a request for review to the EEOC via commercial delivery or 

by a method requiring a signature, it must be addressed to: 

Office of Federal Operations 

Equal Employment Opportunity Commission 

131 M Street, N.E. 

Suite 5SW12G 

Washington, D.C. 20507 
12

(3) Judicial review pursuant to the Whistleblower Protection 

Enhancement Act of 2012. This option applies to you only if you have raised 

claims of reprisal for whistleblowing disclosures under 5 U.S.C. § 2302(b)(8) or 

other protected activities listed in 5 U.S.C. § 2302(b)(9)(A)(i), (B), (C), or (D). 

If so, and your judicial petition for review “raises no challenge to the Board’s 

disposition of allegations of a prohibited personnel practice described in section 

2302(b) other than practices described in section 2302(b)(8), or 2302(b)(9)(A)(i), 

(B), (C), or (D),” then you may file a petition for judicial review either with the 

U.S. Court of Appeals for the Federal Circuit or any court of appeals of 

competent jurisdiction.5The court of appeals must receive your petition for 

review within 60 days of the date of issuance of this decision. 5 U.S.C. 

§ 7703(b)(1)(B). 

If you submit a petition for judicial review to the U.S. Court of Appeals for 

the Federal Circuit, you must submit your petition to the court at the 

following address: 

U.S. Court of Appeals 

for the Federal Circuit 

717 Madison Place, N.W. 

Washington, D.C. 20439 

Additional information about the U.S. Court of Appeals for the Federal 

Circuit is available at the court’s website, www.cafc.uscourts.gov. Of particular 

relevance is the court’s “Guide for Pro Se Petitioners and Appellants,” which is 

contained within the court’s Rules of Practice, and Forms 5, 6, 10, and 11. 

 

5

The original statutory provision that provided for judicial review of certain 

whistleblower claims by any court of appeals of competent jurisdiction expired on 

December 27, 2017. The All Circuit Review Act, signed into law by the President on 

July 7, 2018, permanently allows appellants to file petitions for judicial review of 

MSPB decisions in certain whistleblower reprisal cases with the U.S. Court of Appeals 

for the Federal Circuit or any other circuit court of appeals of competent jurisdiction. 

The All Circuit Review Act is retroactive to November 26, 2017. Pub. L. No. 115-195, 

132 Stat. 1510. 
13

If you are interested in securing pro bono representation for an appeal to 

the U.S. Court of Appeals for the Federal Circuit, you may visit our website at 

http://www.mspb.gov/probono for information regarding pro bono representation 

for Merit Systems Protection Board appellants before the Federal Circuit. The 

Board neither endorses the services provided by any attorney nor warrants that 

any attorney will accept representation in a given case. 

Contact information for the courts of appeals can be found at their 

respective websites, which can be accessed through the link below: 

http://www.uscourts.gov/Court_Locator/CourtWebsites.aspx.

FOR THE BOARD:

Washington, D.C.

 /s/ for 

Jennifer Everling

Acting Clerk of the Board
DEFENSE FINANCE AND ACCOUNTING SERVICE

Civilian Pay Operations

DFAS BACK PAY CHECKLIST

The following documentation is required by DFAS Civilian Pay to compute and pay back pay 

pursuant to 5 CFR § 550.805. Human resources/local payroll offices should use the following 

checklist to ensure a request for payment of back pay is complete. Missing documentation may 

substantially delay the processing of a back pay award. More information may be found at: 

https://wss.apan.org/public/DFASPayroll/Back%20Pay%20Process/Forms/AllItems.aspx. 

NOTE: Attorneys’ fees or other non-wage payments (such as damages) are paid by 

vendor pay, not DFAS Civilian Pay. 

☐ 1) Submit a “SETTLEMENT INQUIRY - Submission” Remedy Ticket. Please identify the 

specific dates of the back pay period within the ticket comments. 

Attach the following documentation to the Remedy Ticket, or provide a statement in the ticket 

comments as to why the documentation is not applicable: 

☐ 2) Settlement agreement, administrative determination, arbitrator award, or order. 

☐ 3) Signed and completed “Employee Statement Relative to Back Pay”. 

☐ 4) All required SF50s (new, corrected, or canceled). ***Do not process online SF50s 

until notified to do so by DFAS Civilian Pay.*** 

☐ 5) Certified timecards/corrected timecards. ***Do not process online timecards until 

notified to do so by DFAS Civilian Pay.*** 

☐ 6) All relevant benefit election forms (e.g. TSP, FEHB, etc.). 

☐ 7) Outside earnings documentation. Include record of all amounts earned by the employee 

in a job undertaken during the back pay period to replace federal employment. 

Documentation includes W-2 or 1099 statements, payroll documents/records, etc. Also, 

include record of any unemployment earning statements, workers’ compensation, 

CSRS/FERS retirement annuity payments, refunds of CSRS/FERS employee premiums, 

or severance pay received by the employee upon separation. 

Lump Sum Leave Payment Debts: When a separation is later reversed, there is no authority 

under 5 U.S.C. § 5551 for the reinstated employee to keep the lump sum annual leave payment 

they may have received. The payroll office must collect the debt from the back pay award. The 

annual leave will be restored to the employee. Annual leave that exceeds the annual leave 

ceiling will be restored to a separate leave account pursuant to 5 CFR § 550.805(g).
NATIONAL FINANCE CENTER CHECKLIST FOR BACK PAY CASES

Below is the information/documentation required by National Finance Center to process 

payments/adjustments agreed on in Back Pay Cases (settlements, restorations) or as ordered by 

the Merit Systems Protection Board, EEOC, and courts. 

1. Initiate and submit AD-343 (Payroll/Action Request) with clear and concise information 

describing what to do in accordance with decision. 

2. The following information must be included on AD-343 for Restoration: 

a. Employee name and social security number. 

b. Detailed explanation of request. 

c. Valid agency accounting. 

d. Authorized signature (Table 63). 

e. If interest is to be included. 

f. Check mailing address. 

g. Indicate if case is prior to conversion. Computations must be attached. 

h. Indicate the amount of Severance and Lump Sum Annual Leave Payment to be 

collected (if applicable). 

Attachments to AD-343 

1. Provide pay entitlement to include Overtime, Night Differential, Shift Premium, Sunday 

Premium, etc. with number of hours and dates for each entitlement (if applicable). 

2. Copies of SF-50s (Personnel Actions) or list of salary adjustments/changes and amounts. 

3. Outside earnings documentation statement from agency. 

4. If employee received retirement annuity or unemployment, provide amount and address to 

return monies. 

5. Provide forms for FEGLI, FEHBA, or TSP deductions. (if applicable)

6. If employee was unable to work during any or part of the period involved, certification of the 

type of leave to be charged and number of hours. 

7. If employee retires at end of Restoration Period, provide hours of Lump Sum Annual Leave 

to be paid. 

NOTE: If prior to conversion, agency must attach Computation Worksheet by Pay Period and 

required data in 1-7 above. 

The following information must be included on AD-343 for Settlement Cases: (Lump Sum 

Payment, Correction to Promotion, Wage Grade Increase, FLSA, etc.) 

a. Must provide same data as in 2, a-g above. 

b. Prior to conversion computation must be provided. 

c. Lump Sum amount of Settlement, and if taxable or non-taxable. 

If you have any questions or require clarification on the above, please contact NFC’s 

Payroll/Personnel Operations at 504-255-4630.