MANAGING THE PAPERWORK Yvette Talley and Mark Baumann

1. MANAGING THE PAPERWORKYvette TalleyandMark Baumann

2. OBJECTIVES • Identify the forms required for filing an injury or illness • Discuss the appropriate responses on the supervisor portion of the claim form • Discuss the importance of communication with the Workers’ Compensation Staff • Identify documents used to authorize medical treatment and duty status reports

3. ENTITLEMENTS • Right to file a CA-1 (injury) and CA-2 (illness), to apply for compensation • Entitlement includes the option to receive medical treatment by either the VA Occupational Health Unit or their primary care provider • Authorized to designate representation

4. DEFINITIONS • FECA- Federal Employees’ Compensation Act • OWCP-Office of Workers’ Compensation Programs • Employer or Agency - refers to officers and employees of an employer having responsibility for the supervision, direction and control of employees • Representative-An individual or law firm properly authorized by a claimant in writing to act for the claimant in connection with a claim

5. CA-1, Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation

6. CA-1 (cont) • Employee must give notice in writing using form CA-1 • Review page one of the form ensuring it includes a detailed description of the injury • Complete and sign page two of the form within 2-3 days • Complete Receipt of Notice attached to CA1 and provide to employee

7. CA-1 (cont) • Submit completed form to Workers’ Compensation Office • Medical care authorized if appropriate • Advise the employee if COP will be controverted • Advise the employee of their responsibility to submit Prima Facie medical evidence of disability within 10 calendar days

16. Additional Forms Completed With the CA-1 • Release of Information • Election of Physician • First Script Card • Employee Responsibilities • 10.330

26. CA-2, Notice of Occupational Disease and Claim for Compensation

27. CA-2 (cont) • Review page one of the form ensuring it includes a detailed description of condition and relationship to employment • Complete and sign page two of the form within 2-3 days • Complete Receipt of Notice attached to CA2 and provide to employee • Submit completed form to Workers’ Compensation Office

32. CA-35, Evidence Required in Support of a Claim for Occupational Disease

34. CA-35 Checklists • Occupational Disease (generic) • Work-Related Hearing Loss • Asbestos-Related Illness • Work-Related Coronary/Vascular Condition • Work-Related Skin Disease • Work-Related Pulmonary Illness (not asbestosis) • Work-Related Psychiatric Illness • Work-Related Carpal Tunnel Syndrome

35. CA-2a, Notice of Recurrence • Recurrence of Medical Condition • Documented need for additional medical treatment after release from treatment for the work-related injury. • Recurrence of Disability • Spontaneous return of the symptoms of a previous injury or occupational disease without an intervening cause.

36. CA-2a (cont) • Employee completes and signs page one of the form • Supervisor will review employee’s portion of the form and complete page two • Treated the same as a CA2 in that it is not considered work-related unless DOL accepts the recurrence.

42. CA-6, Official Superior’s Report ofEmployee’s Death

45. CA-5 and CA-5b, Claim for Compensation by Widow,Widower, and/or Children, Parents,Brothers, Sisters, Grandparents, orGrandchildren

46. CA-5 and CA-5b (cont) • Benefits may be paid to eligible dependents of an employee whose death results from an injury sustained in the performance of duty.