My Employee is Injured..Now
What?
DANNA CORBELL
PROGRAM ANALYST
(VACO)
MARK BAUMANN
WC SPECIALIST
VISN 9
Course Description
3
 Provide an overview of the fundamentals
involved in the initial management of a
workers’ compensation claim. Clearly define
the roles and responsibilities of the supervisor
and the employee when an injury occurs.
 Specifically address the actions required to
ensure injured workers receive all benefits to
which they are entitled and concurrently
protect the interests of the agency.
Objectives
4
 Identify the appropriate response and action to
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be taken by a supervisor when an employee is
injured on the job
Understand the importance of timely filing of
claims
Understand how to determine the employee’s
duty status and appropriate leave status
Understand the importance of accident
investigation
Understand the involvement of other parties in
responding to the injury
Injury Reporting Flowchart
5
My Employee has been Injured…
Now What?
Injury Reporting Flowchart
6
 During Normal Working Hours
 Employee experiences an occupational
injury or illness- What is the difference
between an injury and an illness?
 Employee immediately reports injury or
illness to supervisor
 Does employee require emergency
treatment? Yes or No?
Employee Requires Emergency Treatment
7
 Employee and supervisor reports immediately to
Emergency Department for medical evaluation
and/or treatment, for an injury only.
 Supervisor creates Incident Report and
completes the Incident Report based on
supervisor’s investigation of the accident.
 If employee elects to file for Workers Compensation,
employee completes the CA-1 or CA-2 with
supervisor assistance. Then supervisor completes
the supervisor section of the CA-1 or CA-2.
Employee Does Not Require Emergency
Treatment
8
 Supervisor creates Incident Report and
completes the Incident Report based on
supervisor’s investigation of the accident.
 Employee and supervisor report to Occupational
Health Section for medical evaluation and/or
treatment if the employee requests treatment, for
an injury only.
 If employee elects to file for Workers Compensation,
employee completes the CA-1 or CA-2 with
supervisor assistance. Then supervisor completes
the supervisor section of the CA-1 or CA-2.
Injury Reporting Flowchart
9
 After Normal Working Hours,
Weekends and Holidays
 Employee experiences an occupational
injury or illness
 Employee immediately reports injury or
illness to supervisor
Injury Reporting Flowchart
10
 Employee and supervisor report to the
Emergency Department for medical
evaluation and/or treatment if the employee
requests treatment, for an injury only.
 Supervisor creates Incident Report and
completes the Incident Report based on
supervisor’s investigation of the accident.
Injury Reporting Flowchart
11
 If employee elects to file for Workers
Compensation, employee completes the CA1 or CA-2 with supervisor assistance.
 Then supervisor completes the supervisor
section of the CA-1 or CA-2.
Can the supervisor direct the employee to
file a claim?
Scenario
12
Your employee is walking into work at 6:50
am. The employee’s shift doesn’t start until
7:15 am. While walking across the grass, the
employee steps in a hole, twist their ankle
and can barely make it into work. They
report to your office and inform you of what
happened.
What are the steps that you will take in order to
assist your employee with their injury?
GROUP EXERCISE
13
Medical Care
14
Your employee reports an injury today that he
alleges occurred 3 days ago. This employee has
filed multiple claims with lost time. The employee
requests leave to seek medical care.
As the supervisor you instruct the employee to
report to Occupational Health for examination by
the OH physician prior to leaving the facility.
Is this action appropriate? Why?
Should a CA-16 be issued?
Timely Filing
15
Your employee reports an injury at the end
of tour prior to the start of your AL the next
day (of course!).
You realize that your leave will only last for
10 workdays, so you put in a call up to
complete the CA-1 or CA-2 on the morning
of your return from leave.
Will the CA form be submitted timely to
OWCP?
CA-1 or CA-2?
16
Your employee states that an injury occurred
due to lifting boxes over a few days last
week. When informed that COP is not
payable for occupational disease, the
employee states that the pain began at
10:00 on Tuesday (last week) after lifting
boxes. The employee requests a CA-1.
Should a CA-1 or a CA-2 be filed?
Continuation of Pay (COP)
17
Your employee files a CA-1 today, for an
injury that occurred 30 days ago.
Has the employee met the burden of Time?
Is the employee entitled to COP?
Continuation of Pay (COP)
18
If there is immediate time loss on the DOI
and if the employee was injured during
official work hours, time lost on DOI is
charged to ???.
If employee is injured before work hours
and there is immediate time loss, the first
day of COP is the ???.
Light Duty and Continuation of Pay (COP)
19
An employee's regular pay includes night or
shift differential and various kinds of
premium pay including Sunday pay.
True or False?
Is your employee entitled to ND if placed on
the day shift during the COP period and the
regular tour is the night shift?
Yes or No?
Continuation of Pay (COP)
20
Your employee has a medical appointment
at 10:00 AM. The employee’s tour begins at
8:00 AM. The employee calls to say that it
does not make sense to come all the way to
the VAMC for just 2 hours of work so the
employee suggests that s/he will report to
work after the appointment and requests
COP from 8:00 to 12:00.
Should the COP be approved?
Alternate Work Assignment
21
Your employee has provided you with a CA-17 that
indicates no lifting greater than 10 lbs. Initially
you cannot identify alternate work. However, after
consulting with the WC Specialist who informs you
that you must justify your inability to provide
alternate work to the Director; you realize that
there are some tasks the employee can perform.
Can you inform the employee verbally of the
availability of light duty?
Is a written job offer necessary?
CA-17 (Duty Status Report)
22
Your employee is working an alternate work
assignment due to an accepted injury. The last
medical documentation the employee provided is
30 days old. Two weeks ago, you verbally
requested that the employee provide you with
updated medical restrictions, but the employee has
not complied. You are aware that the employee
has had a medical appointment in the interim.
What should you do now?
Performance of Duty
23
Your employee reported an injury that s/he
alleges occurred at 8AM. The employee’s
tour begins at 9AM. On the CA-1 the
employee states s/he comes early to prepare
for the day, read memos that may have been
issued, get coffee and/or read the paper.
Is this injury considered to be in the POD?
Challenging Questionable Claims
24
Which of the following is not the responsibility of the
Supervisor when challenging the validity of a claim?
a. Fully investigate the circumstances of the injury
b. Conduct a fact finding
c. Provide factual evidence in support of the agency’s
position such as time cards and witness statements.
d. Promptly respond to questions posed by OWCP
e. Delay the questionable claim until the
investigation is complete or ask the employee to
withdraw it.
In Case You Missed It
25
Supervisor’s Role/Responsibilities
26
 Offer immediate medical care
 Timely completion of CA-1/CA-2 (must submit to
OWCP within 10 workdays)
 Pay COP to eligible Injured Worker
 Assist employee in returning to work/provide
light duty
 Request duty status update/CA-17
 Fully investigate injuries and
document findings
 Challenge questionable claims
 Cooperate with Workers’ Compensation
Specialist/OWCP inquires
Alternate Work Assignment/Light Duty
27
 CA-17 Duty Status Report or OWCP-5
 Identify alternate work
 Recovery
job offer
 Offer Light Duty in writing
 Include physical description of the job/physical
demands/location/salary
 Date job available and response date
 Modify assignment as restrictions change
 COP terminates on the date of refusal

Notify OWCP
FECA /Reasonable Accommodation
28
 FECA and Reasonable Accommodation (RA) are two
separate and distinct statutes. Each has their own
regulatory criteria to apply. FECA is for work-related
medical conditions and the ADA is to address nonwork-related medical conditions.
 In cases where OWCP has not yet accepted a claim as
work-related, a medical condition may still exist and
the law requires agencies to provide RA for those
who meet the established criteria.
 See 29 CFR 1614.203
Identify and Challenge Questionable Claims
29
 Differing versions of injury
 witness
statements
 medical documentation
 Previous injury
 reports to work with appearance of an injury
 Time lags
 delayed report of injury
 delay in seeking medical care
 Other employment
Employee’s Responsibilities
30
 Report all injuries immediately
 Provide prima facie medical evidence of
disability within 10 workdays
 Communicate with supervisor regarding
duty status
 Request leave in accordance with procedures
 Cooperate with Second Opinion or Agency
Medical Exam
 Inform physician of the availability of
alternate work
 Accept suitable alternate work
References
31
 5 U.S.C. 8101
 Code of Federal Regulations, 20 CFR
part 10
 FECA Procedure Manual Part 2
 Agency Handbook CA-810
 OWCP Directives
 ECAB Decisions
 http://www.dol.gov./esa/owcp.htm
Questions???