5 Strategies of Effective FECA Claims Specialists

Under the Federal Employees’ Compensation Act (FECA), the Department of Labor (DOL) provides benefits to federal employees injured on the job until they can return to work (RTW) once medically cleared. With the proper focus, RTW processes benefit employees and federal agencies aiming to restore productivity and manage their FECA chargeback. Effective FECA Claims Specialists use the following tools to facilitate the RTW transitions.

RTW is the Point

FECA primarily aims to support injured federal employees by providing essential medical and wage-loss benefits while helping them return to gainful employment.? Assuring that they RTW as soon as they are physically able to contribute, FECA medically determines what an injured employee can still accomplish for the employer. Most employees can perform certain tasks during recovery, so the challenge is identifying and maximizing these abilities as soon as possible to keep the employee engaged.

• Increase Employee Engagement and Productivity Help employees return to work, even in a limited capacity, helps them stay connected to their role and productive during recovery.
• Reduce Long-Term Workers' Compensation Costs Prolonged absence can increase compensation costs. A proactive RTW approach minimizes this by reducing employee time on workers’ compensation.
• Support Compliance and Case Resolution Engaging in RTW from the outset helps agencies remain compliant with FECA regulations, facilitating smooth case resolutions.
• Promote Consistent Documentation and Communication. Utilizing ECOMP ensures all documentation is readily accessible, fostering timely decision-making and reducing delays in the RTW process.

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Strategies of the FECA RTW Process

1.????? Use Limited Duty Job Offers (LDJO)

For employees who can’t immediately return to their original roles, agencies are encouraged to create Limited Duty Job Offers (LDJO) that align with the employee’s current abilities. A suitable LDJO must specify:

• Duties and physical requirements.
• Work schedule, location, and pay information.
• Response deadline and start date. By crafting LDJOs that meet these standards, agencies avoid having the offer deemed “not suitable” by OWCP.

2.????? Continue to Address Retirement Cases

Agencies must continue offering RTW options, as some employees later opt to return to OWCP compensation because of the taxes on retirement income that FECA benefits avoid. Even with injured employees of retirement age, being vigilant in checking an employee’s abilities is essential to ensure that FECA benefits are not used as a simple boost to retirement proceeds.? Light Duty Job Offers (LDJO) are often less appealing than retirement and are a great reminder to the employee of the intention of FECA benefits.

3.????? Embrace ECOMP ?

ECOMP (Employee Compensation Operations & Management Portal) is a case management tool that plays a vital role in the RTW process. It includes features like the Case Management Dashboard and CE-LinQ for communication with claims specialists. Key benefits include:

• Case Management Dashboard: Access all essential case details, including payment history and documents, to monitor RTW progress.
• CE-LinQ: Enables instant two-way communication with OWCP, allowing prompt responses to information requests.
• Upload Document Feature: Upload essential forms and documents directly to the case file.
• OWCP Form CA-3: This form documents any changes to the claimant’s work status, helping OWCP track RTW progress accurately.

4.????? Investigate to Resolve Discrepancies

Administrative investigations provide the tools and insights needed to navigate the complexities of RTW under FECA; they help agencies balance employee recovery and operational efficiency. By gathering comprehensive and unbiased data about the claimant's current medical, vocational, and personal circumstances, investigators inform claims specialists:

• Confirm the claimant’s medical readiness for work.
• Determine if a Limited Duty Job Offer (LDJO) aligns with the employee’s physical capabilities.
• Identify any barriers to the RTW process, such as inconsistencies in the claimant’s reported abilities and familial pressures affecting the claim.

5.????? Objectively Verify the Suitability of Job Offers

Investigators can candidly validate the alignment between an employee’s actions and medical restrictions and the duties outlined in a job offer. This ensures the offer is deemed suitable by the Office of Workers’ Compensation Programs (OWCP), reducing delays caused by rejected or inadequate offers.

Administrative investigations uncover discrepancies in claims, such as instances of exaggeration or malingering. Resolving these issues early allows claims examiners to focus on advancing legitimate RTW cases while mitigating potential fraud and reducing FECA chargeback.

Case Resolution

A successful RTW program relies on the proactive engagement of the agency and a clear resolution for each case. Agencies are required to remain actively involved throughout the life of the claim to support recovery and encourage the employees’ return to productivity. FECA aims for a resolution that results in:

• A return to full duty in the employee’s original role.
• Participation in the Vocational Rehabilitation program, where OWCP (Office of Workers’ Compensation Programs) places employees into roles matching their abilities.
• A determination that the employee has no reemployment potential, placing them on the Periodic Roll with No Employment (PN).
• A fraud conviction of an employee that perpetrated an intentional deceptive act or series of acts with the purpose of obtaining benefits or compensation under FECA that they are not entitled to receive.

Conclusion: The Successful RTW Strategy

For federal agencies, a successful RTW strategy under FECA is more than meeting compliance—it’s a tool for workforce engagement, cost management, and consistent productivity. By prioritizing case resolution, creating suitable LDJOs, leveraging ECOMP for seamless management, and utilizing administrative investigators for objective documentation in the field, agencies can return injured employees to productive work environments as soon as they are medically capable, effectively managing compensation resources.