By Frank Ferreri, May 19, 2021
With the American Rescue Plan Act (ARPA) looking to make it easier for Federal employees diagnosed with COVID-19 to file workers’ compensation claims, the Office of Workers’ Compensation Programs has put together updated guidance for processing coronavirus-related claims.
In FECA Bulletin No. 21-09, which supersedes Bulletins No. 20-05 and No. 21-01, OWCP addressed the processing of pre- and post-ARPA claims as well as what counts as “exposure,” why a CA-1 is required, and how employees must establish a COVID-19 diagnosis. The following chart highlights OWCP’s latest guidance:
| Workers’ Compensation Considerations | OWCP Guidance |
| Previously accepted cases | COVID-19 FECA claims that were accepted prior to March 12 are not impacted because coverage for benefits had already been accepted. Because these aren’t ARPA cases, they are not subject to that law’s limitation that no benefits may be paid after Sept. 30, 2030. |
| Previously denied cases | OWCP’s FECA program will review all COVID-19 claims previously denied to determine if claims can now be accepted under ARPA. If so, the employee and agency will be notified that the case will be reopened. |
| Previously closed cases | No action will be taken on cases that are already administratively closed. Any future actions will be taken in accordance with ARPA since the claim had not been formally accepted. |
| Form-filing process | The Employees’ Compensation and Management Portal should be used to file new claims, and ECOMP has been updated. |
| Use of the CA-1 | OWCP considers COVID-19 to be a traumatic injury per 20 CFR 10.5(ee) because it is contracted during a single workday or shift. The agency also considers the date of last exposure prior to the medical evidence establishing the COVID-19 diagnosis as the date of injury. |
| Codes | All cases filed after March 11 for COVID-19 will use the following codes:
· Nature of Injury – COVID-19 (T9). · Cause of Injury – Exposure to COVID-19 (9C). · Location of Injury – COVID-19 (ZZ). |
| Employees covered | The claims examiner should determine whether the employee is an employee under 5 USC 8101(1) and whether she was diagnosed with COVID-19 between Jan. 27, 2020, and Jan. 27, 2023. If the employee’s diagnosis does not fall within that date range, routine FECA case-handling procedures apply. |
| COVID-19 diagnosis | To establish a COVID-19 diagnosis, an employee or survivor should submit one of the following:
· A positive polymerase chain reaction COVID-19 test result. · A positive antibody or antigen COVID-19 test result together with contemporaneous medical evidence that the employee had documented symptoms of or was treated for COVID-19 by a physician. · If no positive laboratory test is available, a COVID-19 diagnosis from a physician together with rationalized medical opinion supporting the diagnosis and an explanation as to why a positive test result is not available. |
| Covered exposure | An employee is deemed to have had exposure if, during the covered exposure period, she carries out one of the following:
· Duties that require a physical interaction with at least one other person in the course of employment duties. · Duties that otherwise include a risk of exposure to COVID-19. |
| Covered exposure period | The evidence should establish manifestation of COVID-19 symptoms or a positive test result within 21 days of the covered exposure. |
| Teleworking employees | An employee who is exclusively teleworking during a covered exposure period is not considered a “covered employee.” In that case, routine FECA case-handling procedures apply. |
| Death claims | In death cases, the FECA program will ask for evidence and records to support that the death was the result of COVID-19 or that COVID-19 was a contributing cause of death. |
| CA-16 | When an employee uses ECOMP, the agency will be prompted to provide a CA-16 if they do not substantively dispute the employee’s description of cause and nature of injury. Issuing the CA-16 will allow the employee to obtain the necessary test to confirm COVID-19 and receive medical treatment. |
