FEDERAL (EEOICPA) PROCEDURE MANUAL Chapter 3-0500 

 Coordinating State 

Part 3 - Fiscal Workers’ Compensation Benefits 

________________________________________________________________ 

TABLE OF CONTENTS 

Paragraph and Subject Page Date Trans. No. 

Chapter 3-0500 Coordinating State Workers’ Compensation Benefits 

Table of Contents. . . . . . . . i 08/09 09-08 

1 Purpose and Scope. . . . . . . . 1 08/09 09-08 

 2 Authority. . . . . . . . . . . . 1 08/09 09-08 

 3 State Workers’ Compensation 

 Benefits . . . . . . . . . . . 1 08/09 09-08 

 4 When Coordination is Required. . 1 08/09 09-08 

 5 Exceptions . . . . . . . . . . . 2 08/09 09-08 

 6 Signed Response Regarding SWC 

 Claim, Lawsuit and Fraud . . . 3 08/09 09-08 

7 Verifying State Workers’ 

 Compensation Claims. . . . . . 5 08/09 09-08 

 8 Pending SWC Payment. . . . . . . 6 08/09 09-08 

 9 Calculate Amount to Coordinate . 7 08/09 09-08 

 10 Actions to Absorb Surplus . . . . 9 08/09 09-08 

 11 ECMS Coding. . . . . . . . . . . 11 08/09 09-08 

 12 Contact with State Workers’ 

 Compensation Office. . . . . . 11 08/09 09-08 

Exhibits 

 

 1 Do Not Coordinate Table 08/09 09-08 

 2 EEOICPA/SWC Coordination of 08/09 09-08 

 Benefits Worksheet 

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1. Purpose and Scope. This chapter describes procedures for 

coordinating Part E benefits with state workers’ compensation 

(SWC) benefits. “Coordination of benefits” occurs when the 

compensation payable under Part E of the Act is reduced to 

reflect certain benefits previously received by the claimant 

under a SWC program for the same covered illness. 

2. Authority. 42 U.S.C. § 7385s-11 requires the Office of 

Workers’ Compensation Programs (OWCP) to coordinate the Part E 

award(s) with the amount of certain benefits received from a SWC 

program for the same covered illness, after deducting the 

reasonable costs incurred by the claimant in obtaining those 

benefits. 

3. State Workers’ Compensation Benefits. SWC programs are no 

fault systems designed to provide injured workers or survivors 

benefits for work-related injuries or illnesses without having 

to sue their employers. SWC benefits may include payments for 

medical services, vocational services, cash payments to the 

injured worker for wage loss or reduction in earning capacity, 

as well as death and funeral benefits to the worker’s 

survivor(s). 

The laws creating these systems differ by state, but the cash 

benefits (whether for temporary total disability, temporary 

partial disability, permanent total disability, permanent 

partial disability, or death of a worker) are typically a 

calculated percentage of the injured worker’s weekly earnings 

for a set number of weeks. SWC benefits can be administered 

directly by a state commission (as in Ohio). Another method is 

to have a state board supervise or adjudicate disputed claims 

and enforce the required payments made by private parties such 

as employers or insurance companies. Payments can be issued in 

a lump-sum award or settlement, on an ongoing basis (weekly or 

monthly), or a combination of both. 

4. When Coordination is Required. Coordination of Part E 

benefits (there is no coordination of Part B benefits) is 

required only if the EEOICPA beneficiary received benefits 

through a SWC program for the same covered illness for which 

that same EEOICPA beneficiary is eligible to receive benefits 

under Part E. This means the CE first determines the 

employee/survivor’s eligibility to receive Part E benefits, then 

determines who the beneficiary of the SWC benefits was before 

determining whether coordination is required. For example, if 

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4. When Coordination is Required. (Continued) 

the employee settles a SWC claim for asbestosis and the accepted 

covered illness for which the employee is entitled to Part E 

benefits is also asbestosis, coordination of the Part E award is 

required to reflect the amount of SWC benefits the employee has 

received. 

Similarly, in cases where the employee had filed a Part E claim 

but died before payment could be issued, Part E medical benefits 

through the date of employee’s death awarded to the survivor 

requires coordination if the employee had received SWC benefits 

for the same covered illness. Coordination of medical benefits 

is required in this case because the Part E medical benefits 

were based on the employee’s entitlement to Part E benefits and 

the same employee received SWC benefits for the same covered 

illness. 

However, if the employee or the deceased employee’s estate 

(considered same as the employee) receives SWC benefits for 

asbestosis and the accepted covered illness for which the 

survivor is entitled to Part E benefits is also asbestosis, the 

CE will not consider this claim for coordination (unless that 

survivor also received some form of SWC benefits for asbestosis, 

such as death benefits). 

5. Exceptions. The following are exceptions to the 

coordination requirement. Review Exhibit 1 for additional 

scenarios and determination as to whether coordination is 

required. 

 

 a. Multiple illness(s). If the claimant receives SWC 

benefits for a non-covered illness, or for both a covered 

and a non-covered illness arising out of and in the course 

of the same work-related exposure, the CE does not 

coordinate the Part E award. 

For example, if the claimant settles a SWC claim for 

asbestosis and silicosis arising out of the same exposure 

and the amounts are not apportioned between the two 

illnesses, and the accepted covered illness for which the 

claimant is entitled to Part E benefits is only asbestosis, 

coordination of the Part E benefits is not required. 

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5. Exceptions. (Continued) 

b. Covered illness. Because a “covered illness” is an 

illness resulting from exposure to a toxic substance, the 

same medical condition accepted by DEEOIC and a SWC program 

may not require coordination. For example, if the claimant 

settles a SWC claim for asbestosis in a non-DOE facility 

and is entitled to Part E benefits for asbestosis based on 

a separate and distinct exposure to asbestos at a DOE 

facility, coordination of the Part E benefits is not 

required because it is not the same covered illness (not 

resulting from the same toxic exposure). 

c. Waivers. DEEOIC may waive the requirement to 

coordinate Part E benefits with benefits paid under a SWC 

program, if it is determined that the administrative costs 

and burdens of coordinating Part E benefits in a particular 

case or class of cases justifies the waiver. A waiver is 

automatically granted if the total amount of SWC benefits 

the claimant received is under $200. 

If a waiver is to be granted, the CE prepares a memo to the 

file, approved by the District Director, explaining that 

the requirement to coordinate the benefits is waived due to 

the dollar amount of the SWC benefits the claimant 

received. 

d. Medical or Vocational Benefits Only Claims. Medical 

or vocational benefits paid by a SWC program do not require 

any coordination of benefits. 

6. Signed Response Regarding SWC Claim, Lawsuit and Fraud. 

Before a Part E claim can be accepted under the Act, the 

claimant must provide a signed response (affidavit) reporting 

whether a SWC claim had been filed for the same covered medical 

condition(s), or whether a lawsuit had been filed for the same 

toxic exposure, or if the claimant has ever pled guilty to or 

been convicted of fraud in connection with an application for or 

receipt of any federal or state workers’ compensation. This 

signed response must be obtained regardless of the information 

on the forms EE-1 or EE-2 as related to these three questions. 

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6. Signed Response Regarding SWC Claim, Lawsuit and Fraud. 

 (Continued) 

a. The CE may call the claimant to get an initial verbal 

response to the three questions. If the claimant confirms 

verbally or submits a written response that he/she has not 

filed a SWC claim, lawsuit, or pled guilty to or been 

convicted of fraud, the CE may proceed with issuance of the 

Recommended Decision (RD). 

Since a signed response from the claimant must be included 

in the case file before issuance of the Final Decision 

(FD), the CE must follow up with a development letter 

requesting the signed written response from each claimant 

before transferring the case to the FAB. The development 

letter must be claim specific and clearly note that by 

signing the written response, the claimant agrees to report 

any changes to the information provided in the response, 

immediately, to DEEOIC. The CE must also advise the 

claimant that failure to submit a signed response will 

result in administrative closure of the claim. 

b. If the CE is unable to obtain a verbal response from 

the claimant or the claimant responds affirmatively to any 

one of the questions, the CE cannot issue a RD without 

further development and clarification. The CE may consider 

administrative closure of the claim if the claimant is not 

responsive to the development request for clarification. 

This action is taken only as a last resort, and after at 

least two development letters. 

c. It is the responsibility of the FAB to obtain this 

signed response if a RD is issued without receipt of the 

signed response (i.e. the CE only received verbal 

confirmation). Every effort should be taken by the FAB to 

obtain this signed response including calling the claimant 

and sending a follow up development letter. However, if the 

FAB is unable to obtain the signed response after 30 days 

from the FAB’s follow up development letter, the FAB 

remands the case to the district office for administrative 

closure of the claim. 

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6. Signed Response Regarding SWC Claim, Lawsuit and Fraud. 

 (Continued) 

d. If the case is with the FAB, and there is evidence in 

the case file of a SWC claim, lawsuit, or fraud in 

connection with an application for or receipt of workers’ 

compensation that may impact the claimant’s EEOICPA 

benefits, further development must be undertaken. If the 

matter could be clarified by a telephone call, the FAB 

should take this action. If the matter requires extensive 

development, the case is to be remanded to the district 

office for further development. 

e. By signing the written response, the claimant agrees 

to notify DEEOIC of any changes in the information provided 

in regards to the SWC/lawsuit/fraud statement. It is not 

necessary to request this information again unless there is 

a new exposure or illness (including consequential) being 

accepted under EEOICPA. For instance, if the claimant has 

submitted a written response for lung cancer and is now 

filing a claim for a consequential condition of bone 

cancer, a new signed response regarding the bone cancer is 

required before this consequential condition is accepted 

under the Act. 

7. Verifying State Workers’ Compensation Claims. If the 

claimant reports, or the evidence indicates a SWC was filed, the 

CE verifies the illness and SWC benefits received, but only 

after the CE determines Part E eligibility. 

Once the CE determines that there is qualifying employment, 

covered illness, and a SWC claim for the same illness, the CE 

sends the claimant a development letter. The development letter 

states that a decision under the EEOICPA cannot be rendered 

until the claimant provides evidence from the state commission, 

board, payment-issuing agency, or from an attorney who settled 

his or her SWC claim verifying the total amount and type of SWC 

benefits paid to date. 

a. Benefit Categories. The evidence from the state 

commission, board, payment-issuing agency or attorney must 

specify the total amount in benefits the claimant received 

as of the date of the reply, and an itemized account of the 

total benefits paid for each benefit category, such as: 

medical benefits; disability benefits; death benefits; 

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7. Verifying State Workers’ Compensation Claims. (Continued) 

burial/funeral benefits; settlement amount; attorney fees; 

vocational rehabilitation; and the amount of any disability 

payment issued during vocational rehabilitation training. 

b. No Response or Insufficient Response. If the claimant 

does not respond to the request or the material submitted 

is not sufficient to coordinate benefits, the claim is 

administratively closed and the claimant is advised that no 

additional action will be taken until the required 

documentation is provided. 

In some limited cases, the claimant, the SWC board, 

commission, payment-issuing agency or attorney may no 

longer have the SWC records. If the CE independently 

confirms with the SWC board, commission, payment-issuing 

agency or attorney that the SWC record is no longer 

available, the CE may accept a signed affidavit from the 

claimant attesting to the amount of the SWC benefit. As a 

last resort, this affidavit can be used to determine the 

amount of coordination. 

8. Pending SWC Payment. Coordination of benefits is tied to 

the dollar value of the SWC benefits the claimant received for 

the same covered illness. Therefore, the requirement to 

coordinate benefits does not apply if the claimant has not 

received SWC benefits as of the time of the Part E payment. 

If payment of SWC benefits for the same covered illness is 

pending at the time of the Part E payment, the CE does not defer 

issuing the RD or the FD. The RD or the FD is issued without 

coordination since the claimant has not actually received SWC 

benefits yet. 

 

However, if the claimant receives payment on the pending SWC 

claim at any time after issuing the RD or FD, but before the 

issuance of the Part E payment, the Part E payment cannot be 

issued until the following actions are taken. 

a. SWC Payment Pending, Prior to RD. If the claimant 

filed a SWC claim for the same covered illness, but SWC 

payment is pending at the time of the RD, the CE issues the 

RD without any coordination. However, the CE states in the 

RD’s cover letter that if the claimant receives SWC payment 

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8. Pending SWC Payment. (Continued) 

after the issuance of the RD, but before issuance of the 

FD, the claim will be remanded by the FAB for coordination 

of benefits and a new RD. 

b. SWC Payment Pending While the Case is at the FAB. If 

the SWC payment is pending while the case is in posture for 

the FD, the FAB Hearing Representative (HR) issues the FD 

without coordination. However, the HR states in the FD’s 

cover letter that if the claimant receives SWC payment 

after the issuance of the FD, but before issuance of the 

Part E payment, the FD authorizing the payment will be 

vacated. 

c. SWC Payment Pending at the Time of EEOICPA Payment. 

Before issuing the Part E payment, the CE calls the 

claimant to verify that payment of the SWC benefits is 

still pending. If the claimant receives SWC payment after 

issuance of the FD, but before issuance of the Part E 

payment, the DO forwards the claim to the National Office 

for a reopening. 

9. Calculate Amount to Coordinate. Once the CE receives the 

documentation which verifies the amount of SWC benefits the 

claimant received for the same covered illness, the CE completes 

the “EEOICPA/SWC Coordination of Benefits Worksheet” (Exhibit 

2). This Worksheet (and its detailed instructions) is to be 

used by the CE to make the calculations necessary to determine 

how much to coordinate a claimant’s EEOICPA Part E benefits to 

reflect benefits received from a SWC program for a covered 

illness compensable under Part E. After completing the 

Worksheet, the CE staples it to the inside of the case file 

jacket. 

a. Maximum Aggregate Compensation. The amount of monetary 

compensation provided under Part E (impairment and wageloss compensation), excluding medical benefits, cannot 

exceed $250,000. In determining the aggregate compensation, 

reduction of compensation based on state workers’ 

compensation coordination or tort offset is not taken into 

consideration. For example, if the employee is awarded 

benefits for impairment in the amount of $100,000 but his 

compensation is reduced because of coordination of SWC 

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9. Calculate Amount to Coordinate. (Continued) 

benefits to $60,000, the amount of compensation used to 

determine the maximum aggregate compensation is $100,000. 

b. Periodic SWC Benefits. Some claimants receive ongoing 

periodic SWC benefits, such as a worker’s or widow’s 

annuity that can make calculation of the proper amount of 

coordination difficult. For cases with such SWC payments, 

the FAB is to use the same cut-off date for determining the 

amount of SWC received that was used by the CE at the DO. 

c. Part E Benefits Greater than SWC Benefits. If the 

amount of EEOICPA Part E benefits (which may consist of 

lump-sum payments and/or post-filing and ongoing medical 

benefits) to which the claimant is currently entitled is 

MORE than the amount of the SWC requiring coordination, the 

balance due the claimant (i.e., a positive amount) will be 

listed on Line 7 of the Worksheet. This is the amount of 

Part E benefits that must be referenced in the RD, together 

with an explanation of how this amount was calculated. 

d. Part E Benefits Less than SWC Benefits: If the amount 

of Part E benefits is LESS than the amount of the SWC 

requiring coordination, the amount of the “surplus” (i.e., 

a negative amount) is listed on Line 7 of the Worksheet. 

Because a surplus can only be absorbed from EEOICPA Part E 

benefits due an employee currently or in the future, no 

further action is required for a survivor claim. 

If there is a surplus to be absorbed in an employee’s Part 

E claim, this must be noted in the RD, along with an 

explanation that OWCP will not pay medical benefits and 

will apply the amount it would otherwise pay (directly to a 

medical provider, or to reimburse an employee for ongoing 

medical treatment) to the remaining surplus until it is 

absorbed. In addition, the CE explains in the RD that OWCP 

will not pay any further lump-sum payments for wage-loss 

and/or impairment due in the future until the surplus is 

absorbed. 

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9. Calculate Amount to Coordinate. (Continued) 

e. FAB Award Letter. In situations involving a surplus, 

the FAB issues an award letter to the claimant containing 

special language. The FAB award letter accompanies the 

final decision and advises the claimant of the exact amount 

of the surplus. 

(1) The FAB explains in the award letter that the 

surplus will be absorbed out of medical benefits 

payable and further lump-sum payments due in the 

future (i.e. wage loss and impairment) under Part E of 

the EEOICPA. 

(2) The award letter further instructs the claimant 

to submit proof of payment of medical bills to the DO 

until notice is received from the DO that the surplus 

has been absorbed. 

(3) In addition, the award letter instructs the 

claimant to advise medical providers to submit proof 

of payment of medical bills to the DO during this 

time. 

10. Actions to Absorb Surplus. Each District Director appoints 

a qualified individual to serve as the point of contact (POC) to 

monitor surplus situations for both tort settlements and SWC 

benefits. Tort settlement and SWC benefit surpluses are 

absorbed until the surplus is exhausted and EEOICPA benefit 

disbursement can commence. The POC tabulates the amounts of 

proofs of payment and further lump-sum awards for wage loss and 

impairment benefits using the DEEOIC Offset Tracking Database, 

which is accessible through the National Office Shared Drive, 

until they equal or exceed the surplus amount. 

a. While the surplus is being absorbed, the POC 

temporarily places the affected case file in a red file 

jacket denoting that a surplus exists. All case file 

contents are maintained in the red file jacket throughout 

the process of surplus depletion. 

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10. Actions to Absorb Surplus. (Continued) 

b. No further payments are made on any case contained in 

a red file jacket. Should an unpaid bill be submitted to 

the POC during the surplus period, it must be forwarded to 

the medical bill processing agent (BPA) so an explanation 

of benefits can be generated. 

c. During the time in which the surplus is being 

monitored for depletion, the POC continually tracks the 

offset using the DEEOIC Offset Tracking Database until the 

surplus has been depleted. Proofs of payment amount and 

further lump-sum awards for wage loss and impairment 

benefits will be entered into the appropriate fields in the 

DEEOIC Offset Tracking Database, until they equal or exceed 

the surplus amount. 

d. Once the surplus is completely absorbed and EEOICPA 

benefits may commence, the POC removes the temporary red 

file jacket and returns the case contents to the original 

file jacket. Removal of the red file jacket signifies that 

future benefits may be provided on the case. Cases are not 

to be deleted from the DEEOIC Offset Tracking Database 

 

 e. The POC sends a letter advising the claimant that the 

surplus is absorbed. The letter provides the claimant with 

the address of the BPA and instructs him or her to submit 

all future medical bills to that address to review for 

payment. 

 

 f. While medical benefits are not being paid because of a 

surplus that is being absorbed, the CE may find it 

necessary to obtain a medical examination, second opinion 

examination, a referee examination, or a medical file 

review. If so, DEEOIC will pay the costs for these 

directed examinations or reviews and will reimburse any 

reasonable expenses incurred by the employee, including 

medical travel expenses, without adding to the surplus. 

Therefore, the coordination of benefits will not apply to 

any prior approval medical conditions in ECMS, coded with a 

medical condition type of “PA.” In such situations, the CE 

enters a comment into ECMS case notes authorizing the BPA 

to pay all bills related to the directed medical 

examination or medical file review. 

 

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10. Actions to Absorb Surplus. (Continued) 

In a case with a surplus, BPA creates a thread for all 

medical travel refund requests to the POC requesting 

authority to deny or proceed with payment. Medical travel 

expenses related to a directed medical examination must be 

approved for payment and are not subject to coordination. 

 

11. ECMS Coding. The CE/HR must review the EEOICPA Procedure 

Manual for specific ECMS coding instructions for cases with SWC 

payment. Accurate and prompt ECMS coding is important because on 

surplus cases, the condition status field for the medical 

condition(s) must be updated to “O” (Offset) on the Employee 

Medical Condition screen to suspend medical bill payment until 

the surplus is absorbed and the “O” code is replaced by “A” 

(Accepted). During the time in which the “O” code remains in the 

medical condition status screen, the BPA denies medical bills 

related to the medical condition coded as “O” and generates 

explanations of benefits that the bills are not payable due to a 

surplus. 

12. Contact with State Workers’ Compensation Office. Due to 

privacy and disclosure regulations, the CE can not disclose any 

information regarding a claim filed by a claimant to a SWC 

office unless: 

 

a. CE Requires Information from the SWC Office. If the 

CE requires information from a SWC office to process an 

EEOICPA claim, the CE can disclose to that SWC office that 

the claimant filed for benefits under the EEOICPA. 

 

b. The SWC Office Requests Evidence. If a SWC office 

requests evidence to establish that the EEOICPA claimant 

should not receive benefits from a SWC claim, the request 

should be submitted to the National Office for review. The 

National Office will provide instructions for responding to 

the request after reviewing all information. 

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DO NOT COORDINATE TABLE 

 

DO NOT COORDINATE

Multiple illnesses arising out of same incident accepted under 

SWC, only one of those accepted as covered illness under Part E 

of EEOICPA – do not coordinate any Part E benefits

SWC paid only medical benefits, no monetary benefits – do not 

coordinate any Part E benefits

SWC paid only vocational rehabilitation benefits, no monetary 

benefits – do not coordinate any Part E benefits

Illness accepted under Part B, accepting same illness under Part 

E for causation only (no monetary) for the condition accepted 

under Part B only – do not coordinate Part E medical benefits 

(but coordinate impairment and wage-loss benefits). 

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EEOICPA/SWC COORDINATION OF BENEFITS WORKSHEET 

(For internal DEEOIC use only) 

Covered Part E Employee: 

Claimant: 

Claim Number: 

1. Gross dollar amount of SWC received for the covered 

illness or illnesses accepted by DEEOIC..........$_____________ 

 

2. Does amount listed on Line 1 include medical and/or 

vocational rehabilitation benefits?.......................YES/NO 

a. If “YES”, complete Step 3 of the Worksheet 

b. If “NO”, skip Step 3 and go directly to Step 4 

3. Deductions from amount of SWC received: 

a. SWC paid as medical benefits..............$____________ 

b. SWC paid as vocational rehabilitation.....$____________ 

c. Add Lines 3a and 3b.......................$____________ 

d. Net SWC (Subtract Line 3c from Line 1)....$____________ 

4. Deductions for costs of suit and attorney fees: 

a. Total costs of suit.......................$____________ 

b. Determine costs percentage (Line 4a/Line 1)......_____% 

 

c. Deductible costs of suit (Line 4b x either 

Line 1 or Line 3d)............................$____________ 

d. Attorney fees paid........................$____________ 

e. Determine fees percentage (Line 4d/Line 1)......._____%

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f. Deductible attorney fees (Line 1 or Line 3d x the 

LESSER of Line 4e or 40%).....................$____________ 

g. Allowable deductions (Line 4c + Line 4f)..$____________ 

5. Amount of SWC requiring coordination (Subtract 

Line 4g from either Line 1 or Line 3d)..............$___________ 

 

6. Current Part E entitlement.....................$___________ 

7. Coordinate current Part E benefits (Subtract 

Line 5 from Line 6)...............................$____________ 

8. Is the amount entered on Line 7 a positive amount?...YES/NO 

a. If “YES”, this is the amount of the Part E award. 

b. If “NO”, this is the amount of the Part E surplus 

that must be absorbed from future Part E benefits. 

* * * * * * * * * 

Instructions for Completing the Worksheet 

Determining the amount of SWC received. Enter the gross dollar 

amount of SWC the claimant received as of the date of the 

recommended decision on Line 1, less any amounts previously 

coordinated with prior Part E payments. SWC received by someone 

other than the claimant is not used to coordinate the claimant’s 

Part E benefits and must not be included in the amount entered 

on Line 1. For example, SWC received by a worker who is now 

deceased is not used to coordinate Part E benefits payable to 

that worker’s survivor(s). If the amount on Line 1 includes SWC 

that was received for a medical condition other than the covered 

illness(es) accepted by DEEOIC in the claim, DO NOT COMPLETE THE 

WORKSHEET. 

If the amount entered on Line 1 does not include medical and/or 

vocational rehabilitation benefits, the CE circles “NO” at Step 

2 and skips Step 3. However, if the amount on Line 1 does 

include medical and/or vocational rehabilitation benefits, the 

CE circles “YES” at Step 2 and performs the calculations listed 

at Step 3. On Line 3a, the CE enters the amount of medical 

benefits paid to both the employee and any providers. On Line 

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3b, the CE enters the total amount of vocational rehabilitation 

expenses paid to both the employee and any providers. These 

amounts are added at Line 3c, and this total is subtracted from 

the amount listed on Line 1, leaving the “net” SWC listed on 

Line 3d. 

Costs of suit that may be listed on Line 4a of the Worksheet are 

reasonable out-of-pocket costs and expenses involved in bringing 

a SWC lawsuit, but do not include any fees paid to co-counsel or 

normal office expenses like secretarial or paralegal services or 

in-house record copying costs. To be deductible from the amount 

of SWC received by the claimant, the costs MUST be itemized so 

each individual cost may be evaluated by the CE to ensure that 

it is allowable and authentic. Costs that are routinely 

allowable are filing fees, travel expenses, record copy 

services, witness fees, postage, court reporter costs for 

transcripts of hearings and depositions, and long distance 

telephone calls. Once the costs percentage has been calculated 

(round this figure to the nearest HIGHER one-tenth percentage 

point) and entered on Line 4b, the CE multiplies that percentage 

by the amount listed on Line 1, or the amount listed on Line 3d 

if “YES” was circled at Step 2, and enters this amount on Line 

4c. Attorney fees supported by bills or other appropriate 

documentation are entered on Line 4d of the Worksheet. In 

general, attorney fees that exceed 40% of the SWC amount entered 

on Line 1 will be considered unreasonable. If the fees 

percentage (round this figure to the nearest HIGHER one-tenth 

percentage point also) entered on Line 4e is greater than 40%, 

the CE must inform the claimant of this matter and provide him 

or her an opportunity to show (to the CE’s satisfaction) that 

the attorney fees paid were reasonable. If the claimant is 

unable to do so, the CE uses 40% to calculate the amount entered 

on Line 4f. 

To determine the amount of SWC requiring coordination, the CE 

subtracts the amount entered on Line 4g from the SWC entered on 

Line 1, or the “net” SWC entered on Line 3d if Step 3 of the 

Worksheet was used, and enters the result on Line 5. The amount 

entered on Line 5 is the amount of SWC to be used to coordinate 

the claimant’s current Part E benefits. 

EEOICPA Tr. No. 09-08 Exhibit 2 

August 2009 

Page 3 of 4 

 

SUPERSEDED
FEDERAL (EEOICPA) PROCEDURE MANUAL Chapter 3-0500 

 Coordinating 

Part 3 - Fiscal State Workers’ Compensation 

________________________________________________________________ 

Coordinating the Part E benefits. To perform the required 

coordination of Part E benefits, the CE enters the amount of 

Part E benefits that are currently payable to the claimant on 

Line 6 of the Worksheet, and subtracts the amount of SWC entered 

on Line 5 of the Worksheet from the amount entered on Line 6. 

The result of this coordination is entered on Line 7. If Line 5 

is LESS than Line 6, the amount on Line 7 is the compensation 

payable to the claimant under Part E of EEOICPA, reduced to 

reflect the benefits previously received under a SWC program. 

This is also the amount of Part E compensation that must be 

referenced in the recommended decision. If Line 5 is MORE than 

Line 6, the amount on Line 7 will be a negative number that 

represents the amount of the “surplus” of SWC that must be 

absorbed from any future Part E benefits payable to the 

claimant. 

EEOICPA Tr. No. 09-08 Exhibit 2 

August 2009 

Page 4 of 4 

 

SUPERSEDED