6509.11h,30-34
Page 1 of 8
FOREST SERVICE HANDBOOK
MISSOULA, MONTANA
FSH 6509.11h - SERVICE-WIDE CLAIMS MANAGEMENT HANDBOOK
R-1 Supplement No. 6509.11h-94-3
Effective October 7, 1994
POSTING NOTICE: Supplements are numbered consecutively by Handbook number and
calendar year. Post by document name. Remove entire document and replace with this
document. Retain this transmittal as the first page of this document. The last supplement to
this Handbook was Supplement No. 6509.11h-94-2 to chapter 20 (6509.11h,26-28).
Document Name
6509.11h,30-34
Superseded
New
(Number of Pages)
-
8
Digest:
31.2 - Establishes the requirement for a claims log to be maintained by the units.
31.25 - Establishes the requirement for a formal administrative report for claims exceeding
$100,000.
31.25a - Changes the transmittal requirements to the Regional Claims Officer.
31.26 - Establishes Regional Claims Officer responsibility to inform the claimant when the
claim file is referred to the Washington Office.
31.27 - Establishes payment and notification procedures .
David F. Jolly
Regional Forester
R1 SUPPLEMENT 6509.11h-94-3
EFFECTIVE DATE 10/7/94
6509.11h,30-34
Page 2 of 8
FSH 6509.11h - SERVICE-WIDE CLAIMS MANAGEMENT HANDBOOK
R1 SUPPLEMENT 6509.11h-94-3
EFFECTIVE 10/7/94
CHAPTER 30 - ADMINISTRATIVE CLAIMS AGAINST THE GOVERNMENT
31
- Tort Claims Against the Government.
31.2 - Processing Tort Claims Against the Government. Each Unit will maintain a log of claims
received on the Forest and record the date of the incident giving rise to the claim, date of receipt
of the claim, date the claim was forwarded to the Regional Office, and any other information
needed by the Unit to ensure that the claim is processed in a timely manner.
31.25 - Administrative Report. A formal administrative report shall be prepared by the Forest
for all claims over $100,000 (See 31 - Exhibit 01).
31.25a - Transmittal to the Region or Station.
1. Claims $100,000 or Less. An original only.
2. Claims over $100,000. An original and five copies.
31.26 - Region or Station Review. For claims over $100,000, the Regional Claims Officer will
inform the claimant when the claim file is referred to the Washington Office of the Forest
Service for adjudication by the Washington Office of the General Counsel.
31.27 - Office of General Counsel Determination. If the Office of General Counsel's (OGC)
determination is for full allowance of the tort claim and is $2,500 or less, it is the responsibility
of the Forest Claims Officer to inform the claimant of the determination. This should be done
by formal letter. (See 31 - Exhibit 02.) In this case, a copy of the OGC determination will
serve as the Forest payment document.
If the tort claim is allowed in full and is over $2,500, OGC will inform the claimant of the
determination and provide an SF-1145 "Voucher For Payment Under Federal Tort Claims Act"
for the claimant to sign. (See 31 - Exhibit 03.) The claimant will be instructed to return the
signed SF-1145 to the Regional Office (Regional Claims Specialist) for processing the payment
through the General Accounting Office (GAO).
R1 SUPPLEMENT 6509.11h-94-3
EFFECTIVE DATE 10/7/94
6509.11h,30-34
Page 3 of 8
If the tort claim is allowed in part or denied in full, the OGC attorney will inform the claimant of
the determination and the claimant's right to file suit in Federal District Court if dissatisfied with
the Department's action. For claims allowed in part, OGC will provide the claimant an SF-1145
for signature as accepting the awarded amount as full settlement of the claim, and direct the
claimant to return the signed SF-1145 to the appropriate Forest for payment (if $2,500 or less) or
to the Regional Office (if over $2,500) for processing the payment through GAO.
In no case shall a tort claimant be provided a copy of the OGC determination as this document is
considered "Attorney Work Product".
The Regional Claims Specialist will inform the Forest Claims Officer of the OGC determination
by providing a copy of the OGC determination, the OGC attorney's letter to the claimant (if
applicable), and a copy of the SF-1145 (if applicable). Copies of the above documents will be
transmitted via FS-6200-28 (31 - Exhibit 04) with the appropriate blocks checked.
A copy of the Forest payment documentation shall be retained in the Forest claim case file.
35 - Exhibit 01
Tort claims of $100,000 and under - original to the Regional Claims Officer.
Tort claims over $100,000 - original and 5 copies to the Regional Claims Officer.
R1 SUPPLEMENT 6509.11h-94-3
EFFECTIVE DATE 10/7/94
6509.11h,30-34
Page 4 of 8
31 - Exhibit 01
United States
Department of
Agriculture
Reply To:
Subject:
To:
Forest
Service
6570
R-1
Date: February 1, 1994
Tort Claim - Troy Jones
Regional Forester
ADMINISTRATIVE REPORT
1. The enclosed tort claim was received by the Forest on January 1, 1994.
2. Claimant:
Troy Jones
55 Main Street
P. O. Box 21
Libby, MT 12345
3. Incident: Motor Vehicle Accident - Collision between Forest Service vehicle and privately owned
vehicle.
4. Claimant's Basis of Claim:
a. Amount of Claim: $9,376.54. This amount includes $3,210.78 for vehicle damage and
$988.76 for medical treatment, $177.00 car rental, and $5,000.00 for pain and suffering.
b. Claimant's Statement: Stopped at intersection intending to make righthand turn, operating
right turn signal. When the light turned green, I started out into the intersection to make my
righthand turn when I was struck in the left rear side of my vehicle. The impact snapped my
head backwards injuring my neck. I was transported to Holy Name Hospital emergency room
via ambulance.
5. Date/Time of Incident: November 23, 1993; approximately 10:45 a.m.
6. Location of Incident: Corner of Turner Drive and No Name Street, Eureka, Montana. (Rexford
Ranger District, Kootenai National Forest.)
7. Parties Involved:
a. Rocky North, Forest Service employee and driver of the Government vehicle. Rexford
Ranger District, Eureka, MT 12345; (406)-123-4567.
b. Troy Jones, injured party and driver of the private vehicle, 55 Main Street, Libby, MT 12345;
(406)-234-5678.
c. Wendy Smith, Forest Service employee, passenger in Government vehicle and witness.
Rexford Ranger District, Eureka, MT 12357 (406)-123-4567.
8. Vehicles Involved:
a. Forest Service - government owned 1991, 4WD Ford Ranger, License number A987654,
vehicle number 2030.
R1 SUPPLEMENT 6509.11h-94-3
EFFECTIVE DATE 10/7/94
6509.11h,30-34
Page 5 of 8
b. Private Party - 1992 Pontiac Sunbird sedan, license number 1/B 677712.
R1 SUPPLEMENT 6509.11h-94-3
EFFECTIVE DATE 10/7/94
6509.11h,30-34
Page 6 of 8
31 - Exhibit 01 cont'd
9. Background: Troy Jones' vehicle was stopped on No Name Street waiting to turn right on
Turner Drive. He was signaling to turn right and was waiting for traffic to clear.
Rocky North was driving north on Turner Drive toward No Name Street. As he approached the
intersection, the light turned red for his lane of traffic. In applying the brakes, he found the road
conditions to be slicker than he expected. He slid through the intersection and into the left rear
side of Troy Jones' car. The private vehicle received damage to the left rear door and fender.
Troy Jones complained of neck pain and an ambulance was summoned. He was taken to Holy
Night Hospital and was released at approximately 2:30 p.m. that same afternoon.
There was no damage to the Forest Service vehicle, nor were any injuries incurred by Rocky
North or Wendy Smith.
10. Investigation: An investigation was conducted by Mike Walkman of the Eureka City
Police Department. A copy of the report and photos are enclosed. Mr. North was issued a
citation for driving too fast for the conditions.
Ray Banks, Law Enforcement Officer for the Rexford Ranger District, also investigated the
accident. A copy of his report is also enclosed.
11. Position Statement: Rocky North, the driver of the government vehicle, was acting within
the scope of his official government employment when this incident occurred. The accident was
caused by the icy road conditions and the inability of Mr. North to stop the government vehicle
under the road conditions.
Mr. Jones has not submitted any proof of pain and suffering other than his attorney's statements.
The Holy Name Medical Clinic stated that
Mr. Jones has not been a patient there since his last exam on December 10, 1993. At that time
Mr. Jones expressed no discomfort from the vehicle accident.
As no further doctor bills have been presented, we strongly recommend denial of the $5,000.00
for pain and suffering.
The car rental bill of $177.00 includes $17.00 for gas. This is a cost
Mr. Jones would have incurred had he been driving his own vehicle and we, therefore,
recommend denial of the $17.00 for gas on the car rental.
12. Recommendation: Subject to the Federal Tort Claims Act, I recommend that this claim be
partially approved in the amount of $4,359.54, which includes $3,210.78 for vehicle damage,
$988.76 for medical treatment, and $160.00 car rental.
Kay D. Right
Forest Claims Officer
R1 SUPPLEMENT 6509.11h-94-3
EFFECTIVE DATE 10/7/94
Enclosures
6509.11h,30-34
Page 7 of 8
R1 SUPPLEMENT 6509.11h-94-3
EFFECTIVE DATE 10/7/94
6509.11h,30-34
Page 8 of 8
31 - Exhibit 02
United States
Department of
Agriculture
Forest
Service
Region 1
Federal Building
P.O. Box 7669
Missoula, MT 59807
Reply to:
Date:
6570
July 4, 1994
Jerry Brown
P.O. Box 123
Missoula, MT 59801
Dear Mr. Brown,
This letter is notification to you that your claim in the amount of $1,234.56 for damage to your
1993 Oldsmobile Cutlass has been approved in the full amount.
The determination was received today and will be sent to our finance center tomorrow for
processing. You should expect payment within 2 weeks.
Sincerely,
RONALD L. SMITH
Forest Claims Officer
R1 SUPPLEMENT 6509.11h-94-3
EFFECTIVE DATE 10/7/94
6509.11h,30-34
Page 9 of 8
31 - Exhibit 03
Section 31, Exhibit 03
is a separate document.
R1 SUPPLEMENT 6509.11h-94-3
EFFECTIVE DATE 10/7/94
6509.11h,30-34
Page 10 of 8
31 - Exhibit 04
United States
Department of
Agriculture
Forest
Service
Reply To: 6570
R-1
Date:
Subject:
To: Claims Contact,
The subject claim has been:
approved for (partial/full) payment for $
disallowed, under provisions of:
The Federal Tort Claims Act (28 USC 2671-2680).
The Act of January 31, 1931, as amended (16 USC 502).
The Act of May 27, 1930 (16 USC 574).
The Employee's Claims Act of 1958 (16 USC 556c).
The Military Personnel & Civilian Employees' Claims Act of 1964
(13 USC 240)
Enclosed are:
Copy of the determination.
A copy of the Attorney's letter to claimant.
A copy of the SF-1145, Voucher for Payment Under Federal Tort
Claims Act, for information only. When you receive the signed
original from claimant, you may process payment. Please send
Micki a copy of the signed SF-1145.
A copy of the SF-1145, voucher for Payment Under Federal Tort
Claims Act, for information only. RO will forward original to
GAO for payment.
Since settlement is for the full amount and is less than $2,500, and
claimant has executed an SF-95, an SF-1145 is not needed.
Please process payment in the usual manner. Close the case when
payment has been made.
Please inform claimant of determination.
If suit is not filed with 6 months, your file may be closed.
MICKI MCCORKLE
Regional Claims Specialist
Administration
Enclosure(s)
R1 SUPPLEMENT 6509.11h-94-3
EFFECTIVE DATE 10/7/94
6509.11h,30-34
Page 11 of 8
FS-6200-28(7-82)