Federal Workers Compensation Attorney – Your Guide to the Federal Employees’ Compensation Act (FECA)
As a Virginia work injury lawyer, I help many employees who were hurt while working for private employers and state and local governments obtain the workers compensation benefits and lump sum workers comp settlements they deserve. But what about federal employees? Those who are not covered by the Virginia Workers’ Compensation Act? What happens if they get hurt on the job?
Like states, the United States government has established a workers’ compensation system. This system is set forth in the Federal Employees’ Compensation Act (FECA).
This article explains the FECA program and what benefits are available to federal employees who are hurt at work. If you have any questions after reading this article, or are looking for legal representation, contact federal workers comp attorney Corey Pollard for a free consultation. We help federal employees obtain the workers compensation and disability benefits they’re entitled to under all available program.
FECA Program Overview
Congress authorized the Federal Employees’ Compensation Act beginning at 5 U.S.C. Section 8101. FECA’s implementing regulations are found at 20 C.F.R. Sections 10.00-10.826. These regulations explain how the FECA has been interpreted.
The United States Department of Labor’s (DOL’s) Office of Workers’ Compensation Programs (OWCP) administers the FECA. The Virginia Workers Compensation Commission does not have jurisdiction over FECA claims filed by federal employees in Virginia or arising out of injuries suffered by federal employees in Virginia.
The FECA program does not involve any private insurance companies or private third-party administrators (TPAs). The federal government pays all benefits. This is a key difference between federal workers comp and Virginia workers comp.
The FECA program is large. Between July 1, 2014 and June 30, 2015 it paid out more than $3 billion in benefits.Of these benefits, almost $2 billion in disability benefits were paid to injured federal employees with another $1 billion paid in medical benefits on behalf of injured federal workers. See Department of Labor (DOL), FY 2017 Congressional Budget Justification, February 2016, p. OWCP-FPWC-18.
What Employees are Covered by the Federal Employees’ Compensation Act (FECA)?
FECA covers every civilian employee of the federal government. This includes the following:
- Executive branch employees
- Federal jurors
- Judicial branch employees
- Legislative branch employees
- Members of the Coast Guard Auxiliary
- Members of the Civil Air Patrol
- Peace Corps volunteers
- Students participating in Reserve Officer Training Corps (ROTC) Programs
- U.S. Postal Service (USPS) employees, including postal workers, who make up the largest portion of the FECA program
What Injuries, Illnesses, and Conditions are Covered by the Federal Employees’ Compensation Act (FECA)?
The FECA program will pay workers compensation benefits to or on behalf of any covered federal employee who suffers disability or death caused by any work-related injury or illness. The FECA does not provide a specific list of medical conditions that are covered or are not covered. But as a general rule an injured federal employee will not receive workers’ compensation benefits under FECA if the condition was:
- Caused by the employee’s intoxication or substance use
- Caused by the employee’s intentional act (i.e. the employee tried to get hurt or harm himself or herself)
- Caused by the employee’s willful misconduct
This is similar to the willful misconduct rule found in Virginia workers compensation and many other state workers comp laws.
How Does the FECA Claims Process Work?
The OWCP processes and adjudicates all claims filed under the FECA.
A federal employee must file a claim for disability or death benefits under FECA within three years of the date of the injury or death. If the claim is based on a work-related illness that took time to manifest, then the federal employee has three years from the date he or she becomes aware of the exposure to a toxic substance, or should have become aware of the exposure to a toxic substance, to file a FECA claim.
After the FECA claim is filed and evidence is submitted, OWCP staff will make an initial decision on the federal employee’s claim. If it is having difficulty making a decision, the OWCP may order the employee to submit to a medical examination from a doctor hired and paid by the federal government. This is similar to having to undergo an independent medical examination (IME) with the insurance company’s doctor under Virginia workers comp.
If the federal employee is unhappy with the OWCP’s initial decision, then he or she may request a hearing before the OWCP or an OWCP review of the record. This is similar to attending a workers compensation hearing before a deputy commissioner with the Virginia Workers’ Compensation Commission.
If the federal employee is dissatisfied with the decision reached after the OWCP’s hearing, he or she may file an appeal with the Employees’ Compensation Appeals Board (ECAB). ECAB’s decision is final and cannot be reviewed by any court. This is a key distinction between federal workers compensation and Virginia workers compensation, where an injured worker can appeal an unfavorable Commission decision to the Court of Appeals of Virginia and the Supreme Court of Virginia.
What Benefits are Available under the Federal Employees’ Compensation Act (FECA)?
FECA Compensation Benefits
There are many types of compensation benefits available through the FECA program: (1) continuation of pay; (2) total disability; (3) partial disability; (4) scheduled benefits; and (5) death benefits.
Some federal employees are entitled to continuation of pay if they suffer a traumatic injury. A traumatic injury under the FECA is defined as “a condition of the body caused by a specific event or incident, or series of events or incidents, within a single workday or shift.” Continuation of pay is available for up to 45 days and is paid by the employing agency. Continuation of pay is considered salary, not workers compensation. As such, it is taxed.
A word of warning, however, for injured postal workers. There is a three-day waiting period before USPS employees become eligible for continuation of pay after a work pay.
If a federal employee has more than 45 days of lost time from work due to an injury or illness, then his or her disability is considered either a total or partial disability under the FECA program.
Under FECA total disability benefits are paid at: a) two-thirds of the employee’s pre-disability monthly wage or b) 75 percent of the employee’s pre-disability monthly wage if the injured employee has at least one dependent (including a spouse). This means that FECA workers compensation benefits pay more than temporary total disability benefits under the Virginia Workers’ Compensation Act.
Total disability benefits under FECA are capped at 75% of the maximum basic pay at rate GS-15. They are not taxable and are eligible for an annual cost-of-living adjustment.
Unlike Virginia workers comp, FECA total disability wage loss benefits are not capped at 500 weeks. FECA compensation benefits may continue for life, even after the federal employee retires.
FECA partial disability benefits are available if an injured federal employee is disabled but able to work either part-time or at a job in a lower pay category. These benefits are paid at either: a) two-thirds of the difference between the federal employee’s pre-disability and post-disability monthly wage or b) 75 percent of the difference between the federal employee’s pre-disability and post-disability monthly wage if the employee has at least one dependent, including a spouse.
FECA also provides scheduled benefits when an employee suffers permanent partial disability to a scheduled body part because of a work injury. These benefits are paid in addition to any total disability, partial disability, and continuation of pay benefits received by the injured federal employee.
The FECA schedule of benefits for permanent partial disability benefits is more generous than the Virginia Workers’ Compensation Act’s schedule of benefits for permanent partial disability found in Code Section 65.2-503.
First, injured federal employees can receive up to $3,500 in additional compensation for disfigurement of the face, head or neck.
Second, FECA’s scheduled benefits for partial disability compensation places more value on injured body parts than does the Virginia Workers’ Compensation Act. Below is a list of how much each injured body part is worth under FECA.
- Arm: 312 weeks
- Leg: 288 weeks
- Hand: 244 weeks
- Foot: 205 weeks
- Eye: 106 weeks
- Thumb: 75 weeks
- First finger: 46 weeks
- Great toe: 38 weeks
- Second finger: 30 weeks
- Third finger: 25 weeks
- Toe other than great toe: 16 weeks
- Fourth finger: 15 weeks
- Loss of hearing in one ear: 52 weeks
- Loss of hearing in both ears: 200 weeks
- Breast (one): 52 weeks
- Kidney (one): 156 weeks
- Larynx: 160 weeks
- Lung (one): 156 weeks
- Penis: 205 weeks
- Testicle (one): 52 weeks
- Tongue (one): 160 weeks
- Ovary: 52 weeks
- Uterus or cervix: 52 weeks
- Vulva or vagina: 52 weeks
- Skin: 205 weeks
These benefits are paid at either two-thirds of the employee’s pre-disability wage if he or she is single or 75% of the pre-disability wage if he or she has a dependent.
The FECA program also provides death benefits.
If a federal employee dies because of his or her injury or occupational illness and had no children, then his or her spouse is eligible for a monthly benefit equal to 50% of the employee’s monthly wage at the time of death.
If the federal employee had a spouse and one or more children, then the spouse is eligible for a monthly benefit equal to 45% of the employee’s monthly wage at the time of death and each child is eligible for a monthly benefit equal to 15% of the employee’s monthly wage at the time of death. Regardless of the number of children, a family cannot receive more than 75% of the employee’s monthly wage at the time of death in FECA death benefits.
If a spouse remarries before the age of 55, he or she will receive a lump sum payment equal to 24 months of benefits. If the spouse remarries after the age of 55, then benefits will continue for life under FECA.
FECA Medical Benefits
Under FECA the federal government pays for all medical costs related to the covered injury or illness. This includes therapy, medication, and medical devices. The injured federal employee does not pay any coinsurance or co-pays.
A key distinction between FECA and Virginia workers compensation is that under FECA the injured employee may choose his or her doctor and surgeon. The medical provider then asks the OWCP for authorization. This is a great benefit for injured federal employees since they are not limited to choosing from a list of doctors hand picked by the insurance company.
FECA Workers Compensation Settlements
Federal law does not allow for the compromise and settlement of workers compensation claims under FECA. This is a disadvantage of FECA compared to state workers compensation systems.
Social Security Disability Benefits for Injured Federal Employees
Many federal employees who are unable to return to work because of an industrial accident may also qualify for Social Security Disability Insurance (SSDI) benefits. Your SSDI benefits may, however, be offset partially or completely if you’re receiving FECA workers compensation benefits. As a Richmond disability lawyer, Corey Pollard can help you navigate both systems.
An Experienced Federal Workers Compensation Attorney in Virginia
Are you an injured federal employee who needs help maximizing the amount of workers comp and disability benefits you receive? Then call, text, or email us today. We’re here to help.