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General Information on the FECA Program 

The following provides general information to employees, supervisors and managers on the 

AOC Worker’s Compensation Program and the FECA. 

Choice of Physician: An employee has the right to an initial choice of physician. After that, the 

employee must have pre-authorized approval from the Office of Worker’s Compensation 

Programs (OWCP). If an employee is dissatisfied with their physician, he/she must state the 

reasons in writing to the OWCP and request permission to change physicians. He/she needs to 

provide the name, address and specialty of the new physician. The employee may be held liable 

for any bills incurred without prior approval. The OWCP will honor written referrals to an 

appropriate specialist by the employee’s approved treating physician as long as they relate to the 

accepted work-related injury. 

Medical Reports/Records: Complete medical records are extremely important for an evaluation 

of a claim and bill payments. It is necessary to have all examining physicians send copies of their 

record(s) and test(s) to the Workers’ Compensation Program Unit (WCPU). This should include 

hospitalization records, radiology reports, nerve condition tests, etc. In cases involving long-term 

disability, regular medical reports are required for the WCPU and OWCP to keep current on the 

progress of the employee’s treatment program, medications for employee’s accepted condition, 

etc. 

Surgery Approval: An employee (claimant) must obtain prior approval from the OWCP for any 

surgical procedure other than emergency surgery. Emergency surgery is defined as any 

procedure which needs to be performed promptly after the onset of a condition in order to 

preserve life or function of an organ or body part. A claimant should have his/her doctor submit a 

report stating the name of the surgical procedure and estimated recovery time. If tests were 

performed, copies of the test results, radiology reports, etc. must be provided to the WCPU. 

OWCP may conduct a medical review at any time, and in some cases a second opinion will be 

necessary. 

Physical Therapy: To obtain approval, the primary treating physician should submit a request 

for authorization. 

Fitness Centers: Fitness Centers do not have qualified/certified personnel to provide therapy for 

employees who suffered a work-related injury or occupational illness/disease for which a 

physician has prescribed physical therapy. Therefore, fitness centers should not be used to 

provide therapy for employees who have suffered a work-related injury or illness/disease. 

Long-Term Disability: In cases of long-term disability, injured workers will be placed on 

OWCP’s periodic rolls, where compensation will be paid every 28 days. 

Change of Address: If a claimant’s mailing address changes, he/she should notify the OWCP 

and WCPU promptly in writing of the change; these notices must have the claimant’s signature. 
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Missing Checks: Payments are processed by the OWCP. All payments are issued by the U.S. 

Treasury Department every Friday. If a claimant does not receive a payment, the claimant should 

wait 10 days, and then request a tracer action on the missing check to the OWCP in writing. 

Health Benefits: In cases involving long-term disability, health benefits will be transferred to 

the OWCP. Open season for changes to health benefit plans normally occurs in November of 

each year. Claimants need to look for changes in deductions for health benefits the first pay 

period in January of each year. The information that will be sent to the claimants by their health 

providers will advise them of new rates and effective dates if they must make a change, Any 

questions regarding health and life insurance benefits should be directed to the Human Capital 

Management Division - Employee Benefits and Services Branch. They can be reached at 

202.226.2548. 

Cost of Living Increases: Cost of living increases may be authorized based on the Consumer 

Price Index (CPI). Normally, the increases are given each March 1st. A claimant must be disabled 

for at least one year to be eligible for any cost of living increase. 

Bills: To facilitate prompt and accurate processing of employee bills, please submit bills to the 

AQS, P.O. Box 8300, London, KY, 40742-8300, with the claimant’s OWCP case file number on 

the right hand side of the bill. 

Fee Schedule: OWCP uses a schedule of maximum allowable medical changes. The rates are 

determined based on geographic locations as a result of agreements with the Federal government. 

Employees are not responsible for charges in excess of the medical fee schedule. 

Forms: Bills for treatment of an employee’s accepted condition need to be submitted on 

Standard AMA billing form, HCFA-1500. Most doctors have this form or can obtain it through 

the Medicare carrier of the area.The medical provider must itemize services for each date 

separately, using AMA (not state) CPT codes for services performed; provide tax identification 

number, and sign and date the bill. The same holds for claimants’ paid deductible charges for 

which the claimant is seeking reimbursement. 

Hospital Bills: Should be submitted on a form UB-92, itemized fully, and submitted with 

admissions and discharge medical summaries and dates. 

Pharmacy Bills and Medical Reimbursements: Must be submitted on form OWCP 915, 

“Claim for Reimbursement Form,” and must be accompanied by original receipts. Tax 

identification numbers may be written in above the pharmacy’s name. Please do not submit bills 

on small pieces of paper. If the receipt is small, tape (not staple) it to a full size sheet of paper 

with claimant’s name and case file number indicated in the upper right hand corner. 

Chiropractic Care: Charges for chiropractic care are limited to charges for manual 

manipulation of the spine for correction of a subluxation demonstrated by X-ray. Other modes of 

treatment will not be covered and are the claimant’s responsibility. 
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True Limitations: Bills must be submitted within one year of the date of service or the 

acceptance of the claim. 

Nurse Intervention: OWCP offers nurse care managers to facilitate cases that are processed 

through the Quality Case Management Unit. 

Fees for Attorney/Representative Service: Claimants are solely responsible for paying fees 

and other charges. OWCP will not reimburse the claimant, nor is OWCP in any way liable for 

the amounts charged.