I got hurt at work — what do I do?
If you have a traumatic injury while on duty (e.g., break your ankle, hit your head, cut your arm, etc.), you are entitled to medical treatment at government expense via the Department of Labor’s (DOL) Officer of Workers’ Compensation Programs (OWCP).
After you get injured, the first thing you should do is notify your supervisor and submit a Form CA-1. You can fill out the form online at DOL’s ECOMP Portal. If you don’t have an account, register using your personal email address and begin a new claim. Your supervisor is supposed to help you fill out the form, but if you aren’t getting that help, ask them or a union rep.
How long do I have to submit a Form CA-1?
You have three years to submit a Form CA-1, but you must submit it within 30 days of the injury to qualify for continuation of pay (COP), of which you get a maximum of 45 days. Some supervisors don’t know this (PDF), so as always, take care of it sooner, rather than later.
You can even submit it after three years, but only if you can show that you notified a supervisor of the injury when it happened. Basically, don’t wait — submit the Form CA-1 right away.
What kind of paperwork do I need to get medical treatment?
If you’re going to go to the doctor or hospital right away, ask your supervisor for a Form CA-16 — they should do this automatically. This document authorizes your medical treatment and tells the doctor or hospital that your bills will be paid by OWCP. Ask for this form right away, because if you wait more than a week, it is practically guaranteed that Del Rio Sector is going to give you a hassle. So ask for the CA-16 sooner, rather than later, to avoid problems.
You have the right to choose your own doctor, but that doctor should be part of the OWCP system. Hospital emergency departments are already part of it, but if you go to a primary care physician, ask them if they take OWCP claims.
Can someone from the agency tell me which doctor to see?
No, you get to choose your own doctor. In fact, your supervisor is supposed to tell you that you have the right to your initial choice of doctor. Your supervisor, manager, injury compensation specialist (ICS), injury compensation coordinator (ICC), CBP nurse, or anyone else cannot require you to go to a certain doctor. They can certainly give you the names of doctors they know will take OWCP claims, but you are under no obligation to go to them.
Generally, you are supposed to see a doctor who is within 50 miles of your home. However, since we have a limited number of doctors in this region, DOL allows us to go to San Antonio or elsewhere to seek treatment. Even if a manager or someone else with the agency suggests you go to someone local, you are under no obligation to do so. You are encouraged to explore your options in San Antonio and elsewhere to make sure you find a doctor you are comfortable with.
Note: You may be contacted by someone who refers to herself as a CBP nurse, but actually is a contractor working for Managed Care Advisors (MCA). You are not required to speak with this person, so always confirm who you are talking to if you get calls about your medical claim. Once you choose a doctor, MCA may try to communicate with your doctor, so if you learn of that, confirm that it was in writing, because they are barred from making phone calls to your doctor.
Do I need to have a primary care physician and a specialist?
No, DOL lets you go straight to a specialist if you like. Some specialists may have a policy that their patients need to be referred to them by a primary care physician, so explain to them that this is an OWCP case and you have not been referred.
After I see the doctor, what paperwork do I need to give my supervisor?
After you get a CA-17 (signed by a doctor), you must provide a copy of it to your supervisor; your supervisor is only entitled to a copy of the Form CA-17. You may provide the other forms, like medical reports and other OWCP forms, but you do not have to. However, if you choose not to, you still need to make sure that your doctor submits these forms straight to DOL, or you can submit them via DOL ECOMP. Either way, you have to make sure these additional reports get submitted.
Once you are seen by a doctor, it is critical that any doctor’s notes, Forms CA-17, or any other medical documents are signed by a doctor. OWCP will reject documents signed by a nurse practitioner (NP) or physician’s assistant (PA), so do not leave the doctor’s office or hospital without a doctor’s signature.
Doctors don’t always fill out the forms properly, so you may have to ask the doctor to clarify or fix something — this is why it’s important to make sure the document is not missing any information.
What do I do if my doctor says I need to stay away from work?
Your doctor should give you a fully-completed Form CA-17 that indicates you are not to return to work until a certain date — this date will usually be the date of your next appointment. Give the CA-17 to your supervisor and make sure they understand you are not supposed to return to work for now. You should then be placed on COP, with the first day (you get up to 45 days) being your first full day away from work due to the injury.
My doctor said I can return to work with no restrictions — what process do I follow?
You should get a CA-17 indicating you are free to return to work. Give that to your supervisor and return to work on your next work day. Confirm what day this is with your supervisor so you don’t accidentally fail to show up to work.
If you have multiple doctors, you will need to be cleared by all of them before you can return to work. If one doctor releases you, but the other does not release you, make sure you get documentation from your other doctors explaining why you must remain off duty.
My doctor says I can return to work, but I need to be on light duty — how do I request light duty?
Some supervisors will say you need to submit a memorandum requesting light duty. However, no memo is required because the agency is obligated to try to find you light duty if you give them a CA-17 that shows what your restrictions are. By suggesting that you are requesting light duty, they are implying that they get to decide if you can work light duty. It’s not up to the agency to determine if you are allowed to work light duty, but they can determine if they have an open position that can support your restrictions.
Tell your supervisor you are being told to return to work, make sure they understand your medical restrictions, and ask them to look for something that fits. If they don’t have anything, you will have to use leave or leave without pay (LWOP) and request compensation via a Form CA-7.
What is continuation of pay (COP)?
Continuation of pay is the continuance of your regular salary for up to 45 calendar days of disability, including night differential, Sunday differential, holiday pay, BPAPRA, etc. You should not see an interruption in any pay during these 45 days. The first day of COP must begin within 45 days of the date of injury.
Day One of the 45 days is the first full day away from work due to an injury. For example, let’s say you get hurt on Friday, and you are scheduled to be off duty Saturday and Sunday, returning to work on Monday. If you cannot return to work on Monday, that is Day One of COP because it’s your first full day away from work because of the injury.
You should have already provided medical documentation of your disability, but if you have not, you will need to provide it within 10 days.
DOL put together a thorough training document which is available here (PDF).
You can also find more information about COP in DOL’s procedure manual.
What happens if I use up all 45 days of continuation of pay (COP)?
At this point you have to decide if you want to go on LWOP or use your leave. If you use your own leave, your paychecks will continue as normal. If you opt for LWOP, you will need to fill out a Form CA-7 to request compensation from OWCP.