The Federal Employees’ Compensation Act, also known as FECA, provides federal employees with workers’ compensation benefits. When a federal employee is injured while performing duties associated with their job, they will be compensated for wage loss in the case of total or partial disability, medical benefits, and vocational rehabilitation through FECA. It also provides survivor benefits to eligible dependents in the case of death.
All civilian employees of the United States government are covered under this act, as long as they are not paid from non-appropriated funds. Peace Corps and VISTA volunteers, federal petit or grand jurors, other youth and training corps, and non-federal law enforcement officers under certain circumstances involving crimes against the United States are also covered through a special legislation.
Prompt adjudication is provided through the Division of Federal Employees’ Compensation, or DFEC. If an injured worker has traumatic injuries, a decision will be reached within 45 days of receipt of filing a claim, unless it is a complex case. For simple occupational illness cases, it may take approximately 90 days to receive a decision. In the event of a more complex occupational illness case, it will require more extensive evidentiary development and a decision should be provided within six months of receipt.
Medical bills are usually processed within 28 days of receipt, whether they are submitted directly by the Federal workers compensation doctor or as a reimbursement request by an injured worker. If a bill is not payable, an explanation of benefits is issued to the submitting party. This form explains the reason the coverage is being denied.
FECA also gives the injured workers the right to reclaim their federal jobs within one year of the beginning of the loss of wage period. A registered nurse will be assigned if the employee cannot return to work soon after the injury is incurred. The nurse will assist the worker in returning to employment by providing appropriate medical care on an on-going basis.
Medical specialists are provided for a second opinion examination whenever the worker’s medical condition requires additional information or treatment. Vocational rehabilitation services are provided if the employee is unable to return to work at the original agency or job title.
The program is funded by the employing agencies. They are responsible for reimbursing the Division of Federal Employees’ Compensation for their workers’ compensation expenses once a year through a chargeback process.
The compensation in case of death is payable to both the widower and the deceased’s children. Coverage to the children or grandchildren will terminate at the age of 18 unless the dependent is incapable of self-support, continues to be a full-time student at an accredited institution, or until he or she reaches the age of 23.
If there are no children eligible for benefits, the widow or widower will receive 50 percent of the employee’s pay at the time of death. If a child or children are eligible, then the widow or widower will receive 45 percent of the pay and each child will receive 15 percent of the employee’s pay. If only children remain, then 40 percent is paid for the first child and 15 percent for each additional child. The total amount is to be shared equally among all surviving children.
In the fiscal year of 2012, 115,697 new Federal workers compensation cases were created. Over $3 billion in benefits were provided to approximately 242,000 workers and survivors. Over $1.9 billion worth of the benefits were for wage loss compensation, $929 million for medical and rehabilitation services, and $140 million for death benefit payments.