Office of Workers’ 

Compensation Programs 

Division of Federal Employees’ 

Compensation Interagency 

Meeting

February 15, 2018
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Antonio A. Rios

Director,

Division of Federal 

Employees’ Compensation
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Case Create Trends

100,000

110,000

120,000

130,000

140,000

150,000

160,000

170,000

180,000

190,000

1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016

Cases Created
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Periodic Roll Trends

40000

42000

44000

46000

48000

50000

52000

54000

56000

58000

60000

Number of

Cases Paid on

the Periodic Roll

PRM Units 

Implemented

New Policies 

• Nurse@ 2 weeks of TTD 

• 2nd Op Exams @ 12 months of TTD
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Chargeback Trends 2007 - 2017

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Billions

Medical

Compensation

Total

Drop in Comp Costs

Corresponds with Drop in PR 

Universe

2015 Rise in Compounds 2016-2017 Drop 

in Compounds 

Costs
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

We’re Listening...

New ECOMP Document Upload Categories such as:

 Job Offer Rejections or Non-Responses

 Case Copy/Document Request

 Employer’s Claim Challenge

 Compensation Question

Averages Inquiries per 

Month Increased by 85%

Average Response Time 

Decreased by 30%
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

0

1000

2000

3000

4000

5000

6000

7000

8000

FY2017

FY2018 thru Jan 31

Average Inquiries per Month
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

0

5

10

15

20

25

FY2017

FY2018 thru Jan 31

Average Days to Respond
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

• Pharmacy Benefit Manager (PBM)

 Pause any PBM contract renewals/awards 

 Consult with DOL OWCP before doing so

• End to End Case Management

• Opioid Policy Implementation 

• Expanding Program Integrity

• Collaborative Case Management 

o Disability Management Interface (DMI)

Continuing to Improve Efficiencies
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Disability Management Interface (DMI)

No RTW after Job Found Suitable 
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Disability Management Interface (DMI)
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Disability Management Interface (DMI)
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Disability Management Interface (DMI)
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Disability Management Interface (DMI)
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Disability Management Interface (DMI)

Letter shell is 

populated with text 

entered in DMI
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Disability Management Interface (DMI)
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Disability Management Interface (DMI)

To use DMI, a Federal Agency must: 

– Have a completed ECOMP MOU on file with 

DOL and demonstrate a current forms filing 

status in the system

– Contact DOL’s Branch of Technical Assistance 

to request access

– Review and agree to the DMI Rules of 

Behavior

– Complete DMI training 
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Julia A. Tritz

Deputy Director,

Division of Federal 

Employees’ Compensation
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

• Opioid Policy Development 

• CE Identity Update

• End to End District Office 

Changes
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Jennifer Valdivieso

Deputy Director,

Division of Federal 

Employees’ Compensation
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

• Four Units: Jacksonville, Seattle, 

New Orleans, Chicago

• Medical Benefit Examiner vs.

Responsible Claims Examiner 

• Cases Assigned by SSN

Prescription Management Units
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

• Identification of Risky Opioid 

Providers/Prescribers

o High Volume

o High Morphine Equivalent 

Dose (MED) 

• Predictive Analytics and Risk Metrics

Program Integrity 
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

FECA CIRCULAR 18-05, issued February 14, 2018

Payment will be denied if the items in the kit/medication:

• can typically be obtained separately and/or at a lower cost,

• there is a reasonable alternative or substitute, or 

• the primary use is for a condition not normally not caused by a 

workers’ compensation injury. 

Initial denial list has 49 different NDCs

Medication Kits and 

Combination Medications
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

FECA CIRCULAR NO. 17-03: Office of Inspector General (OIG) 

Investigations Pertaining to Federal Employees’ Compensation 

Act (FECA) Claimant and Medical Provider Fraud 

FECA BULLETIN NO. 17–04: Investigations related to Federal 

Employees’ Compensation Act (FECA) Claimant Fraud

FECA BULLETIN NO. 17-05: Investigations related to Federal 

Employees’ Compensation Act (FECA) Medical Fraud

Available at https://www.dol.gov/owcp/dfec/

Fraud Protocols
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Tara N. Jones

Chief,

Branch of Technical 

Assistance
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Where do I sign up?

Disability Management Interface 

(DMI)
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

• Contact DFEC’s Branch of Technical Assistance 

(BTA)

• Complete Training

• In person/WebEx, facilitated by BTA

• Agency must request cases through ARI in advance

• During training will work on actual claims

• Agree to Rules of Behavior

Disability Management Interface 

(DMI) – Gaining Access
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

• Non-negotiables: 

• Complete and accurate information

• No duplicates

• Upload requested information

• System abuse

Disability Management Interface 

(DMI) – Rules of Behavior
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

• Requesting suitability on temporary job offers:

• See 20 CFR §10.500, 5 U.S.C. 8106(c)(2)

• Requesting medical at unreasonable intervals:

• See 20 CFR §10.501

• Failing to provide useful data in requested 

fields of the application

Disability Management Interface 

(DMI) – Non-Compliance Examples
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

• Review and Monitor submissions

• Non Compliance will result in: 

• Suspension and/or Termination

• Individual or Departmental

Disability Management Interface 

(DMI) – Auditing
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

• WEEDS Page Limit Increased to 7 (from 6) 

• PR Schedule for 2018 Posted Online

• CQS: 

• 3,196 accounts since September 2017

• 1% reported registration issues

• Forms: CA-7/16/17/20 and OWCP5a/b/c 

General Updates
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

• Register for Listserv

• Notify Us of Staffing Changes That Affect 

User Accounts

• CHEP 2018 Announcement

General Updates
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

Julia K. Hearthway

Director,

Office of Workers’ 

Compensation Programs
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

FECA Legislative Reform

• Included in President’s FY2019 Budget

• Subject to Interagency Clearance
U.S. Department of Labor

Office of Workers’ Compensation Programs 

Division of Federal Employees’ Compensation

President’s 2019 Budget and FECA Reform

FECA Provisions

Simplifying Benefits 

Single rate of compensation*

Retirement conversion benefit*

Improving Program Integrity

Prevent retroactive election of OPM and FECA benefits

Suspend payments to indicted medical providers

Modernizing Program Administration 

Waiting period

Funeral benefit

Disfigurement

Total Proposed Cost or Savings $885M

*Applicable to new injuries post-enactment