THE FEDERAL EMPLOYEES’ COMPENSATION ACT (FECA) AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

The Federal Government has its own Workers’ Compensation System.  Thus, a Federal Government Employee, living in California, pursue FECA claims rather than filing California workers’ compensation claim.

This article briefly details the Federal Employee’s Compensation Act (FECA) system and how it differs from the California State system.  This article is cursory and not meant to be relied upon for the purposes of pursuing a claim.   It is merely informational.

Who Is covered By FECA?

“The FECA program covers all civilians employed by the federal government, including employees in the executive, legislative, and judicial branches of the government. Both full-time and part-time workers are covered, as are most volunteers and all persons serving on federal juries. Coverage is also extended to certain groups, including state and local law enforcement officers acting in a federal capacity, federal jurors, Peace Corps volunteers, students participating in Reserve Officer Training Corps programs, and members of the Coast Guard Auxiliary and Civil Air Patrol.” The Federal Employees’ Compensation Act (FECA): Workers’ Compensation for Federal Employees Updated April 13, 2020, Congressional Research Service https://crsreports.congress.gov R42107

Note: There are Injured Workers who are employed by businesses with Federal Government contracts.   These employees may be as a private employee and may not be eligible for a FECA claim. Instead, they are eligible to pursue a state-based workers’ compensation claim.

What Conditions are Covered Under FECA?

Under FECA, “workers’ compensation benefits are paid to any covered employee for any disability or death caused by any injury or illness sustained during the employee’s work for the federal government.  There is no list of covered conditions nor is there a list of conditions that are not covered.” Supra.

Defenses available for certain injuries.   The defenses include willful misconduct and intoxication as causes of the injury.

Note: These defenses are similar to that of state-based systems.  In addition, state-based systems place limitations on claiming benefits on certain body parts. In California,  compensation is limited with respect to the following body parts: psyche, sleep, and sexual dysfunction.

What Is the FECA Claims Process?

“All FECA claims are processed and adjudicated by OWCP (Office of Workers’ Compensation Programs.) Initial decisions on claims are made by OWCP staff based on evidence submitted by the claimant and his or her treating physician. The law also permits OWCP to order a claimant or beneficiary to submit to a medical examination from a doctor contracted to the federal government. An employee dissatisfied with a claims’ decision may request a hearing before OWCP or an OWCP review of the record of its decision. A final appeal can be made to the Employees’ Compensation Appeals Board (ECAB). The decision of the ECAB is final, cannot be appealed, and is not subject to judicial review”. Supra.

Note: in the California state-based system, there is the Workers’ Compensation Appeals Board which provides for adjudication of claims.   Employers are required to maintain insurance, be self-insured, or be legally uninsured.  Also, the California state-based system also allows for an employer opt-out in the form of Alternative Dispute Resolution (ADR.)  In the California system, Injured Workers are capable of appealing cases up to the California Supreme Court. In very limited circumstances, there may be even access to Federal Courts.

Are There Time Limits to Filing FECA Claims?

 “FECA Claims In general, a claim for disability or death benefits under FECA must be made within three years of the date of the injury or death. In the case of a latent disability, such as a condition caused by exposure to a toxic substance over time, the three-year time limit does not begin until the employee is disabled and is aware, or reasonably should be aware, that the disability was caused by his or her employment.” Supra.

Note: In California Workers’ Compensation, there are multiple time limits for filing claims.  Generally, there is a one-year statute to file an Application at the Workers’ Compensation Board.

What Are the FECA Disability Payments?

 The FECA system has various forms of disability payments. They include continuation of pay, partial disability payments, scheduled benefits (which are permanent partial disability payments), and total disability payments.

For the scheduled permanent partial disability payments, there is a schedule which determines the disability payments.

For total disability, there is a monthly benefit paid.

Note: The California system has salary continuation benefits for some public employees.  Otherwise, there is a temporary disability rate which is essentially two-thirds of the workers’ average weekly wage. Similar to FECA, California has a permanent disability schedule which addresses the amount of payments of permanent partial disability.   The California based system also has a form of total disability payment as well.

Are There FECA Death Benefits Available?

 Yes.  If an employee dies in the course of employment or from a latent condition caused by his or her employment, the employee’s survivors may be eligible to receive compensation benefits.

Note: The California system also has a death benefit component  for dependents.

What Are Medical Benefits Under FECA?

“Under FECA, all medical costs—including medical devices, therapies, and medications— associated with the treatment of a covered injury or illness are paid for, in full, by the federal government.”  Supra. “Generally, a beneficiary may select his or her own medical provider and is reimbursed for the costs associated with transportation to receive medical services.”  Supra.

Note: This is different from the California system.  In that system, there are medical provider networks that may impact which providers a worker can choose as their treater.   California industrial medical treatment is also entirely the responsibility of the carrier and not the worker.

Does FECA Provide Vocational Rehabilitation Benefits?

“The Secretary of Labor may direct any FECA beneficiary to participate in vocational rehabilitation, the costs of which are paid by the federal government. While participating in vocational rehabilitation, the beneficiary may receive an additional benefit of up to $200 per month. However, any beneficiary who is directed to participate in vocational rehabilitation and fails to do so may have his or her benefit reduced to a level consistent with the increased wage earning capacity that likely would have resulted from participation in vocational rehabilitation.”

Note: The California system is different.  Currently, for 2013 dates of injury and beyond, there is an educational voucher along with a separate job displacement benefit payment.  It is  markedly different from FECA.

What If I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

 

 

 

 

 

THE QUEBEC BACK PAIN DISABILITY SCALE AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

For both workers’ compensation treatment and evaluation, Injured Workers are frequently asked to fill out surveys concerning their medical conditions. The Quebec Back Pain Disability Scale (QBPDS) is one of those surveys.

This article will discuss how and why such scales are used within the workers’ compensation system, what is the Quebec Back Pain disability Scale, what questions are asked within the scale, how the scale is scored? and what it can mean to a workers’ compensation claim.

What is the QBPDS?

This questionnaire is one that addresses back pain.  It inquires as to the daily activities that impacted by Back Pain.

Why are Surveys and Scales Used?

Surveys and Scales which ask the Injured Worker to self-report on their conditions are helpful to both treating doctors and evaluators.  First, they are a cheap quick method of getting some insight into the Injured Worker’s complaints.  Second, they can give the doctor or evaluator a sense of how serious the worker perceives their injury.  Third, they can give some insight as to whether someone is exaggerating with respect to the complaints. Fourth, if the same scale is administered over time, it can reveal some insight as to the course of the injured Worker’s condition.  Repeated testing may show whether the Injured Worker sees their pain improving, staying the same, or getting worse.

What are the QBPDS Questions Asked?

There are twenty questions asked within the inventory. The questions are about getting out of bed, sleeping through the night, turning over in bed, riding in a car, standing up for 20-30 minutes, sitting in a chair for several hours, climbing one slight of stairs, walking a few blocks, walking several kilometers, reaching up to high shelves, throwing a ball, running one block, taking food out of the refrigerator, making your bed, putting socks or pantyhose on, bending over to clean the bathtub, moving a chair, pulling or pushing heavy doors, carrying two bags or groceries, and lifting and carrying a heavy suit case.

Note: The questions are interesting in that they include activities that an individual may rarely or never participate in.  For example, there are some people who do not throw balls or handle suit cases.

How Are the Responses Scored?

There are five responses that can be made. They are not difficult at all, minimally difficult, somewhat difficult, fairly difficult, very difficult, and unable to do.  They are scored from 0-5.

Note: The responses address ability to perform activities as opposed to the individual’s pain experience.

What Do the Scores Mean?

A higher score represents a greater level of perceived functional disability.  A lower score represents a lower level of perceived functional disability.

Is The QBPDS Helpful for Treating Evaluators and Physicians With Respect to Permanent Disability Assignment?

In California Workers’ Compensation Law, Activities of Daily Living are a basis for making impairment assessments.  Impairment assessments render a Whole Person Impairment which then translates into a Permanent Disability Percentage. The QBPDS can be helpful to an evaluator on their assessment.  The Activities of Daily Living based upon the AMA Guides 5th Edition are Self-care: urinating, defecating, brushing teeth, personal hygiene combing hair, bathing, dressing oneself, and eating,  Communication:  writing, typing, seeing, hearing, and speaking, Physical activity:  standing, sitting, reclining, walking, and climbing stairs, Sensory Function: hearing, seeing, tactile feeling, tasting, smelling, Nonspecialized Hand Activities: grasping, lifting, tactile discrimination,  Travel: riding, driving, flying, Sexual Function: orgasm, ejaculation, lubrication, erection, and Sleep: restful and nocturnal sleep pattern.

The QBPDS does not explore self-care and sexual function. Therefore, it is not fully comprehensive to render an ADL assessment.

As an Injured Worker, What Should I Do When I Fill Out These Scales?

When fill out these scales, try to be accurate as possible. Sometimes, I personally roll my eyes when I see scales in which every answer is the highest.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

 

 

 

 

AGE, PHYSICAL DEMANDING JOBS AND MUSCULOSKELETAL DISORDERS: OLDER WORKERS AT RISK FOR WORK INJURIES AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

The Labor Market in the United States is aging. As a result, Older Workers are performing a large variety of task within the Open Labor Market. Older Workers performing more tasks that make them at risk for work injuries. This is the case with respect to musculoskeletal injuries. Musculoskeletal injuries are commonly known as orthopedics injuries which include medical conditions with respect to the spine, the upper and the lower extremities. A study was done with respect and there were some findings made.

This article will discuss Older Workers, injury rates for Older Workers, and laws which impact Older Workers’ Workers’ Compensation Claims.

Does Age Matter When Looking at the Risk of Work Injuries?

Age alone is not the issue. The type of labor is what is of import. In the labor market, there are jobs with minimal physical demands. There are other jobs which involve greater physical demands. Thus, some Older Workers perform light duty jobs such as receptionists or greeters. Other Older Workers perform more arduous jobs such as warehouse worker or construction worker.

The study, of interest, focused on jobs with physical demands.

Old Age combined with greater physical demands were relevant with respect to work injuries. See P. M. Smith, J. Berecki-Gisolf, Age, occupational demands and the risk of serious work injury, Occupational Medicine, Volume 64, Issue 8, December 2014, Pages 571–576, https://doi.org/10.1093/occmed/kqu125

It was found when the occupational [physical] demands were greater there was an increase of risk of injury. Further, “[t]he relationship between age and claim-risk was strongest when occupational demands were highest.” P. M. Smith, J. Berecki-Gisolf, Age, occupational demands and the risk of serious work injury, Occupational Medicine, Volume 64, Issue 8, December 2014, Pages 571–576, https://doi.org/10.1093/occmed/kqu125

Is the Increase Risk Associated only with Musculoskeletal Injuries?

It was found that “Older age was associated with a higher risk of work injury claims for both musculoskeletal and non-musculoskeletal conditions,” P. M. Smith, J. Berecki-Gisolf, Age, occupational demands and the risk of serious work injury, Occupational Medicine, Volume 64, Issue 8, December 2014, Pages 571–576, https://doi.org/10.1093/occmed/kqu125

Is there a Difference Between Musculoskeletal vs. Non-Musculoskeletal Disorders?

Yes. “with a slightly stronger relationship observed for occupational physical demands and risk of musculoskeletal, compared with non-musculoskeletal, conditions.” P. M. Smith, J. Berecki-Gisolf, Age, occupational demands and the risk of serious work injury, Occupational Medicine, Volume 64, Issue 8, December 2014, Pages 571–576, https://doi.org/10.1093/occmed/kqu125

Are There any Laws or Rules in Workers’ Compensation that Assist Older Workers?

Yes. Age is factored as part of the Permanent Disability Rating Formula.
Per the Schedule for Rating Permanent Disabilities, California Workers’ Compensation Law provides for an age adjustment which provides for an increase in permanent disability for ages 42 and older. It also scales up with age and tops out at age 62. The age used in this assessment is the age on the date of injury. There is a table upon which you obtain the figures. It is on Pages 6-1-6-5. See SCHEDULE FOR RATING PERMANENT DISABILITIES UNDER THE PROVISIONS OF THE LABOR CODE OF THE STATE OF CALIFORNIA (2005)

Are There Any Rules that Do Not Assist Injured Workers?

Yes. There is a legal issue of apportionment. Apportionment is a tool allowed to reduce an Injured Workers’ Award.

Labor Code Section 4663, provides that “[a] physician shall make an apportionment determination by finding what approximate percentage of the permanent disability was caused by the direct result of injury arising out of and occurring in the course of employment and what approximate percentage of the permanent disability was caused by other factors both before and subsequent to the industrial injury, including prior industrial injuries. See Escobedo v. Marshalls, CNA Ins. Co., 70 Cal. Comp. Cases 604, 2005 Cal. Wrk. Comp. LEXIS 71 (W.C.A.B. April 19, 2005). In Escobedo, the board indicated that apportionment of permanent disability can be made based on the preexisting arthritis in applicant’s knees was found acceptable. Note: Older Employees are more likely to have pre-existing arthritic processes which could allow for apportionment to be found.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

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