Reconsiderations

Through authority delegated by OPM, agencies will establish and process enrollments for Federal Employees Group Life Insurance and Federal Employees Health Benefits coverage. When the employing office receives the appropriate forms for enrollment from the employee and determines the employee is not eligible for coverage the employing office must provide a written explanation referred to as the initial decision for denial of coverage to the employee. The letter must contain the reconsideration process, time limit, and final reconsideration decision.

The final reconsideration requires the DoD Insurance Officer or designee to review the initial decision from the employing office, the letter from the employee requesting reconsideration and determine if the law and regulations for denial of coverage are correctly applied. Upon review of the case by the Insurance Officer or their designee, the employee and the employing office receive the final written reconsideration decision. The determination will either concur with the initial decision or overrule the employing office based on the cited law and regulation. The employee and the employing office will also receive the procedure guidance to resubmit the enrollment form and if necessary retroactively establish coverage.

Deferred Retirement Estimates

deferred annuity estimate may be requested by former DoD employees who have met eligibility requirements for a deferred annuity and have been separated from federal service for more than 120 days. Estimates will be based on the documentation provided by the former DoD employee and will be completed within 30 calendar days of receipt. Any estimate provided is an approximation and in no way replaces or substitutes the deferred annuity and or estimate calculated by OPM.

Former DoD Employees are responsible for requesting the deferred annuity estimate, providing service history required to complete the estimate and proving eligibility for a deferred annuity.

For more information call (703) 882-5197 or email dodhra.mc-alex.dcpas.mbx.benefits-contacts@mail.mil

Injury Compensation and Unemployment Compensation (ICUC) Overview

Workplace injuries can happen anywhere, anytime - placing an immediate administrative burden on supervisors and affecting short-term and possibly long-term productivity.

The Injury Compensation and Unemployment Compensation (ICUC) team is the centralized source for civilian injury compensation support within the DOD. Our expert advisors help supervisors, Injury Compensation Program Administrators, and Commanders reduce the impact of workplace injuries by demystifying the compensation process. We work with your installation to ensure the timely filing of new injury claim forms and claims for wage loss compensation. Our Management Advisors coordinate in person with the Department of Labor Office of Workers’ Compensation Programs (OWCP) to bring employees back to work as quickly and safely as possible.

With 9 offices nationwide and specialists at headquarters to assist with civilian injuries that occur overseas and in the war zones, ICUC Management Advisors can help you meet the challenges of ensuring your employees are professionally cared for when a workplace injury occurs.

What to Do If You are Injured

If injured at work, you may be entitled to injury compensation benefits provided under the Federal Employees' Compensation Act (FECA). Federal employees have certain rights and responsibilities in filing for these benefits:

1. Immediately report any work-related injury to your supervisor.
2. You have a right to choose your treating physician.
3. File Form CA-1, Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation, or CA-2 Federal Employee's Notice of Occupational Disease and Claim for Compensation using the process required by your employing agency.
4. Provide additional information if needed.
5. Keep your supervisor informed

What To Do If You Are Injured is a complete description of how to proceed if you are injured at work.
What to Do If You Are a DoD Deployed or Overseas Civilian
What to Do If You Are a ROTC Cadet Injured While in the Performance of Duties

Useful links:

Department of Labor, Division of Federal Employees’ Compensation (DFEC)
Office of Workers’ Compensation Programs Connect (OWCP Connect) allows injured employees to prove their identity and create an account for communication with OWCP’s various self-service applications.
Department of Labor, Bill Processing Portal
Laws and Related Materials

Supervisor Responsibilities

Work-Related Injuries/How to File a Claim When a civilian employee is injured at the workplace, supervisors have certain basic responsibilities:

• If the employee requires emergency medical treatment, ensure that he or she receives immediate care.
• If the employee's injury results from a specific event or series of events during one day or shift, the supervisor and employee complete a Form CA-1, Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation using the Employees' Compensation Operations & Management Portal (ECOMP). If the employee develops a condition due to prolonged exposure lasting more than one day or shift, complete a Form CA-2, Federal Employee's Notice of Occupational Disease, and Claim for Compensation using ECOMP. For more information on ECOMP, contact your local Injury Compensation Program Administrator (ICPA).
• If the employee has a traumatic injury (a specific event or series of events during one day or shift), provide him or her with a Form CA-16, Authorization for Examination and/or Treatment. This form should be issued within four hours of the injury, whether or not the claim appears valid. For questionable claims, box 6b should be checked to indicate its doubtful nature. Only one Form CA-16 may be issued per traumatic injury. A Form CA-16 may not be issued for past medical care, except within 48 hours after emergency treatment if treatment was verbally authorized beforehand.
• When reviewing Form CA-1 or CA-2, check to see that the facts are consistent. You need not have witnessed the injury to agree with the stated history. Review the form and submit immediately, whether or not you feel that the claim should be approved. ECOMP will transmit it to your designated Injury Compensation Program Administrator (ICPA) who will review and authenticate. If you have specific information which casts doubt on the claim's validity, you may challenge it and supply supporting information, but you must still submit the claim promptly. Failure to submit a claim promptly can result in a fine, imprisonment, or both, under 20 CFR 10.16(a).
• If the employee has a traumatic injury, explain that he or she is entitled to Continuation of Pay (COP) for absences due to disability or obtaining medical treatment, for not more than 45 calendar days following the injury. Any such absence must be supported by medical documentation. The specific COP periods should be clearly indicated on the time and attendance sheets, whether the employee loses entire days or only a few hours of a day. If you are unfamiliar with the COP provisions, contact your local ICPA for further information.

DoD has an obligation under the Federal Employees' Compensation Act (FECA) to accommodate employees' medical limitations if the treating physician indicates that the employee is capable of performing light duty. Keeping a partially disabled employee in the work place tends to speed his or her recovery, which benefits the employee and reduces agency costs. If the employee is totally disabled, or if you are unable to accommodate the restrictions, maintain contact with the employee during his or her absence from work. You should advise your local ICPA promptly of any injuries occurring in your section.

You should also refer the injured employee to the ICPA for further assistance after taking the steps described above. The ICPA will provide specific information throughout the course of the injury compensation claim, to both you and the injured employee. The ICPA is also available to provide basic training which can help you become more familiar with what to do when one of your employees is injured at work.

The Pipeline Program Overview

The Pipeline Program (a transitional return to work strategy) is a collaborative initiative designed to assist agencies in recognizing and capturing the contributions of skilled employees recovering from on the job injuries. Additionally, it promotes a work environment that motivates and drives commitment, resulting in a contribution of value to the organization's stakeholders.

The Pipeline Program initiative mitigates the impact that large contingencies of injured workers' have on an agency's fiscal budget. The Program also denotes a revolutionary commitment and investment in human capital (injured workers) by DoD agencies and installations to retain valuable education and skills that are often lost to an injured workforce.

The Pipeline Program provides funding for salaries and benefits for the first year of reemployment. This provides an installation with the ability to integrate injured workers back to full employment while effectively reducing lost production days during the recovery period. The program also has a positive effect on mission readiness and preparedness, while allowing injured workers to contribute to that mission and improve their quality of life.

The DCPAS budget programs funds specifically for the Pipeline Program. The Deputy Under Secretary for Civilian Personnel Policy (CPP) monitors and oversees the program to ensure compliance and results. The DCPAS ICUC team manages the program to ensure performance of appropriate return-to-work processes. Since December 2004, more than 130 DOD installations have tapped into Pipeline funding offering more than 1,300 injured workers the opportunity to return to work, realizing a potential lifetime cost avoidance (LCA) in excess of $1 billion.

Things You Should Know About Pipeline

Pipeline is a reemployment initiative designed to return recovering employees to productive duty as soon as they are medically able by providing over-hire authority DoD installations and agencies, and funding for salary and benefits for the first year. Pipeline removes the budget constraints that have historically presented barriers to installations seeking to reintegrate recovering employees back into the workforce.

Pipeline Employs a Three-Tiered Approach:

1. The reemployment process requires cooperation amongst several levels within the organization:
   • DoD Component Headquarters Injury Compensation Program Administrators;
   • Field Commanders;
   • Injury Compensation Program Administrator (ICPA);
   • Installation Supervisors and HR Staff; and
   • Funding and oversight.
2. Funding - DoD installations receive funding when an injured employee returns to work under the Pipeline Program. Funding is effective on the return-to-work date and continues for the remainder of the Fiscal Year. Disbursement of funds may also occur at the beginning of the next Fiscal Year until an employee who is in a productive position receives a full year of return to work funds.
3. Oversight of this Program occurs at the Civilian Personnel Policy (CPP) level, utilizing the resources of the Defense Civilian Personnel Advisory Service Injury & Unemployment Compensation (ICUC) team to implement policy, provide guidance, and develop and monitor performance metrics. To ensure proper processing of funds to and from DOD installations by appropriate accounting methods DHRA Financial Management works closely with the ICUC team.

How Can Pipeline Bring Down Costs?

Pipeline helps in a couple of ways:

Pipeline mitigates the impact recovering workers have on an agency’s budget. This cost can be substantial over time.

In addition to direct cost savings, Pipeline helps achieve indirect cost savings by minimizing the replacement and training costs for employees on worker compensation rolls. These costs equate to approximately 6.5% of salary and benefit costs.

Of course, realize the biggest cost reductions by avoiding the costs in the first place. Work disability incidence, duration, and costs are lower in workplaces that have a people-oriented culture, a strong safety climate, that pay attention to ergonomic issues, and have a proactive return-to-work program!

The Pipeline Program provides the Injury Compensation Program Administrator (ICPA) with two indispensable tools to manage their Injury Compensation Program: positions and funding for those positions!

Job Offers

ICPAs must comply with FECA regulations when making Pipeline Program job offers. Job offers must be in writing ( verbal offer is appropriate but must always be followed by a written offer within 2 business days) and must be offered as a permanent position unless the former position was temporary.

Job offers must state that the agency looked for suitable employment in or around the area in which the claimant currently lives. 20 CFR 10.508 - EA "should" offer suitable employment where the injured worker currently resides, if possible. Therefore, the employing agency must offer positive evidence showing that such an offer is not possible or practical. - Robin Cox, Docket No 05-1153, issued October 18, 2005.

How Leadership Can Contribute

In most organizations, the belief is that little, if anything, can be done to change the processes in the workers' compensation system because of laws, regulations, rules and union contracts. However, workers' comp need not be an adversarial system. While the legal and other restrictions may seem like walls, agencies should instead look at their workers' compensation programs from the outside to see what they can do for injured workers so everyone benefits.

The biggest obstacles to returning injured workers to gainful employment have been: 1) available positions; 2) funding for those positions; and 3) resistance from managers and other employees. The Pipeline Program removes the first two obstacles, but what about resistance from managers and other employees. Some supervisors, for example, fear that if an injured worker returns before full recovery, he might be re-injured, but allowing injured workers to stay at home may do them more harm than good. The Pipeline Reemployment Program provides an additional platform for the agency to use to counter this concern by requiring a physician’s written release allowing the employee to return to work with specific limitations based on the physician’s full knowledge of the employee’s job duties.

Additionally, co-workers may resent temporarily assuming more of the physically difficult duties. The leadership in the agency can counter this concern by pointing out that the return to work program is available for all injured employees, and that if that employee is injured, he will appreciate the assistance of co-workers during recovery. Be sure that all transitional assignments make meaningful contributions to the workplace.

Management can also “raise the bar” by ensuring that all key players in the process are doing things correctly. This will cut down on unnecessary time and expense in the workers' comp system.

Recommendations:

• Train managers, employees, and physicians involved in the process.
• Instead of asking doctors what the injured worker can't do, find out what they can do.
• Work to change perceptions about the perceived lack of power to improve the workers' comp system.
• Define what workers' compensation is for.
• Explore attitudes among managers and employees.
• Raise the bar for all key players involved.
• Evaluate Program performance.

Augment Your Return to Work Program:

• Ensure there is a written position description for your compensation program manager defining specific duties and responsibilities that align with the program’s performance objectives.
• Provide on-going workers’ compensation training. Additional training is necessary to ensure the manager has the knowledge and skill necessary to fulfill the day-to-day responsibilities.
• Consider designating a “back-up” to handle the program’s day-to-day responsibilities while the manager is on leave or otherwise absent. To meet OWCP deadlines it is important to maintain the program’s continuity and that open cases receive ongoing attention.
• Ensure that written guidance is available to employees, supervisors, and managers outlining the steps to take when an employee is injured.
• Establish an internal control procedure of systematic review for fraud indicators and, when appropriate, refer cases with fraud indicators for further investigation.

What is My Role in the Process?

• Identify partially recovered employees through review of medical documentation.
• Request positions from supervisors and managers.
• Coordinate with OWCP Nurse Intervention (when assigned) to assist in position design.
• Coordinate with Safety & Occupational Health as necessary to assist in position design. based on treating physician restrictions (unless OWCP Nurse Intervention is assigned).
• Coordinate with OWCP Rehabilitation Counselors (when assigned) to assist in position design.
• Prepare a valid job offer to employee once position details are received.
• Maintain a thorough knowledge of worker's compensation laws.

HQ Injury Compensation Program Administrator (ICPA)

HQ ICPAs may use the Pipeline Initiative to offset their efforts to reduce the cost of compensation for their respective agencies. Regularly identify potential candidates for the Pipeline Program through thorough analysis of the agencies chargeback listing.

What is My Role in the Process?

• Obtain commitment from senior leadership to support the Pipeline Program.
• Communicate and train installation leadership in the Pipeline Program’s processes.
• Review Chargeback listings to identify potential Pipeline candidates.
• Keep DCPAS informed of changing dynamics within the agency that may affect use of the Pipeline Program.

Tools You Can Use

Sample Job Offer Letter
Pipeline Brochure
Re-Employment Frequently Asked Questions
Injury Compensation Pipeline Frequently Asked Questions

Supervisors

The supervisor is the key to any successful return to work initiative. The supervisor, working in conjunction with the injury compensation program administrator, the Department of Labor, and in being open to exploring return to work alternatives, creates the formula for success. The Pipeline Program assists supervisors by providing a valuable underutilized resource, skilled and experienced recovering employees, whose cost for training is paid!

What is My Role in the Process?

As a supervisor/manager, you play a critical role in the reemployment process. The goal is to create a work environment where employees are motivated to return to work as soon as medically possible because they feel supported and they know their work is valued. Employees must see there is a corporate culture that values them and their abilities. This attitude often requires more effort on the part of the employer and/or supervisor, because it is very common for an employee to feel depressed during a lengthy absence from work.

Supervisors can and should act in tandem with the employee and the ICPA to explore return to work alternatives. To facilitate safe and timely return of employees that are injured on the job, supervisors/managers can:

• Maintain a safe and healthy work environment for all employees.
• Ensure injured employees are working within medical restrictions.
• Coordinate with ICPAs to identify productive duty.
• Coordinate with ICPAs to increase duties and productivity as deemed appropriate through medical documentation.
• Notify ICPA of any change in duties made on behalf of any injured worker.
• Notify ICPA if a reemployed injured worker does not appear for work without notice.
• Notify ICPA if a reemployed injured worker complains of symptoms or indicates that they cannot perform the duties of the position offered.
• Treat all employees with dignity and respect.

Field Commanders/HR Directors

Pipeline is a tool which improves DOD regulatory compliance and FECA cost containment which allows more resources to be used to support the war fighter.

Field Commanders/HR Directors Pipeline FAQs

Online Tools

THE EMPLOYEES' COMPENSATION OPERATIONS & MANAGEMENT PORTAL (ECOMP)

ECOMP is the technical solution that allows Defense Activities to complete CA-1 (Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation) and CA-2 (Federal Employee's Notice of Occupational Disease) forms on-line and submit them via the Internet to the Office of Workers' Compensation Programs.

Defense Injury and Unemployment Compensation System
The Defense Injury and Unemployment Compensation System (DIUCS) is an enterprise-wide case management application that allows Injury Compensation Specialists in the Department to manage, research and report on FECA claims within their area of responsibility. The application will also provide Component/Agency level data in order to help Program Managers effectively manage programs at the Component/Agency level.

Laws and Related Materials, United States Department of Labor, Division of Federal Employees’ Compensation

Unemployment Compensation Overview

Do you need assistance delivering unemployment benefits on time?

The ICUC team is your source for information about civilian unemployment compensation (UC) within the DoD. Because we serve as a liaison between DoD and State Employment Security Agencies (SESAs), let ICUC assist with training and technical assistance on claims administration and auditing support. Our services can help improve the process of UC management—so that you can deliver benefits on time and save money.

PROVEN RESULTS: TIME AND MONEY
We have helped DoD achieve tangible cost savings of over $11.8 million in credits for erroneous UC charges. These charges come directly back to each Component.>

Useful Links
Unemployment Brochure
Find Your State Workforce Development/Unemployment Office

Wage and Salary

DoD conducts Federal Wage Surveys (FWS) and establishes pay rates for all regular FWS wage schedules and most special FWS wage schedules. One of the key statutory principles underlying the FWS is that employee pay rates are to be maintained in line with prevailing levels of pay for comparable levels of work in the private sector within a local wage area. To carry out this statutory principle, Wage and Salary conducts annual wage surveys to collect wage data from private sector establishments. Wage and Salary works with both management and labor conducting local prevailing rate wage surveys to develop and adjust pay schedules under the FWS. Separate wage schedules are developed for appropriated fund hourly employees and non-appropriated craft, trade, labor, administrative, and patron services occupations. Wage and Salary also conducts occupational/industry surveys to establish pay for DoD educators, civilian mariners, power generation employees, and health care professionals.

Wage – History and Information

Latest Appropriated Fund Schedules
Latest NonAppropriated Fund Schedules
Appropriated Fund Wage Schedules
Appropriated Fund Special Schedules
Nonappropriated Fund Wage Schedules
Nonappropriated Fund Overseas Schedules
General Schedules (GS)

NAF Health Benefits Program

The FY95 National Defense Authorization Act requires the DoD to provide a uniform Health Benefits Program (HBP) for DoD NAF employees. The DoD NAF HBP, implemented on January 1, 2000, provides medical and dental insurance to more than 87,000 eligible NAF employees, retirees, and dependents.

NAF Policy works in close cooperation with DoD Component representatives of the NAF Health Benefits Committee, to oversee, review, and revise the program to provide comprehensive health benefits coverage to NAF employees. The NAF HBP consists of Preferred Provider Organizations (PPOs), Indemnity, Dental, and Health Maintenance Organizations (HMOs). DoD Components manage contracts with HMOs. PPOs, Indemnity, and Dental plan linked to the NAF medical plans are self-funded by the NAF employers; claims and administrative costs are funded by employee premiums and employer nonappropriated funds. Aetna is the third party-administrator for the PPO, indemnity plans, and the dental plan linked to the medical plans. Aetna insures and administers the stand-alone dental plan.

For a complete listing of medical and dental benefits go to NAF Health Plans where you will find information on summary plan descriptions, benefit changes, premiums, stand-alone dental plan, pharmacy, and health and wellness resources programs to help manage wellness and lower out-of-pocket costs.

Aetna’s customer service number: 1-800-367-6276

DoD NAF HBP Privacy Notice

NAF Retirement Plans

To help attract and retain qualified and productive employees, each NAF employer provides eligible employees an opportunity to participate in a retirement program consisting of a defined benefit (pension) plan and a defined contribution (401(K)) plan. These plans are in addition to and in consideration of Social Security benefits. Generally, NAF employees do not receive coverage under the Government’s Civil Service or Federal Employees Retirement Systems and Thrift Savings Plan.

Within the parameters of DoD-wide NAF policy, Components have flexibility to establish Component-specific personnel programs in line with their business models. With the exception of uniform health benefits, NAF employer-sponsored benefits programs (such as retirement plans) are separate and distinct, offering different benefit levels and features.

NAF Component Contacts

NAF Demographics