Performance of Functions; Claims for Compensation Under the Federal Employees' Compensation Act; Compensation for Disability and Death of Noncitizen Federal Employees Outside the United States, 37898-37952 [2011-14915]

Agencies

• DEPARTMENT OF LABOR
• Office of Workers' Compensation Programs

[Federal Register Volume 76, Number 124 (Tuesday, June 28, 2011)]
[Rules and Regulations]
[Pages 37898-37952]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-14915]



[[Page 37897]]

Vol. 76

Tuesday,

No. 124

June 28, 2011

Part II





Department of Labor





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Office of Workers' Compensation Programs





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20 CFR Parts 1, 10 and 25





Performance of Functions; Claims for Compensation Under the Federal 
Employees' Compensation Act; Compensation for Disability and Death of 
Noncitizen Federal Employees Outside the United States; Final Rule

Federal Register / Vol. 76 , No. 124 / Tuesday, June 28, 2011 / Rules 
and Regulations

[[Page 37898]]


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DEPARTMENT OF LABOR

Office of Workers' Compensation Programs

20 CFR Parts 1, 10 and 25

RIN 1240-AA03


Performance of Functions; Claims for Compensation Under the 
Federal Employees' Compensation Act; Compensation for Disability and 
Death of Noncitizen Federal Employees Outside the United States

AGENCY: Office of Workers' Compensation Programs, Department of Labor.

ACTION: Final Rule.

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SUMMARY: On August 13, 2010, the Department of Labor (DOL) proposed 
revisions to the regulations governing the administration of the 
Federal Employees' Compensation Act (FECA). The FECA provides benefits 
to all civilian Federal employees and certain other groups of employees 
and individuals who are injured or killed while performing their jobs. 
At that time, DOL also proposed revisions to the regulations 
establishing the authority of the Office of Workers' Compensation 
Programs (OWCP) which administers the FECA.
    The proposed changes were summarized in that publication. The 
existing rules have been amended to acknowledge a change in the 
organization of the OWCP and amendments to the FECA which have occurred 
since the last time the regulations were amended in 1999. These changes 
also update the regulations by taking into account changes in 
technology and other changes to improve administrative efficiency. As 
many FECA claimants are not represented, the regulations are revised to 
insert FECA statutory references as a frame of reference for clarity 
and ease of use. The regulations include adding the skin as an organ 
pursuant to 5 U.S.C. 8107(c)(22). The regulations also create a new 
special schedule covering injuries to non-citizen non-resident Federal 
employees outside the United States. Finally, the regulations covering 
the processing of medical bills have been updated to provide for 
greater use of technology in that process to reduce costs and to 
clarify requirements for such submissions.

DATES: Effective Date: This final rule is effective on August 29, 2011.

FOR FURTHER INFORMATION CONTACT: Douglas Fitzgerald, Director, Division 
of Federal Employees' Compensation, Office of Workers' Compensation 
Programs, U.S. Department of Labor, Room S3229, 200 Constitution 
Avenue, NW., Washington, DC 20210, Telephone: 202-693-0040 (this is not 
a toll-free number). Individuals with hearing or speech impairments may 
access this telephone number via TTY by calling the toll-free Federal 
Information Relay Service at 1-800-877-8339.

SUPPLEMENTARY INFORMATION: Proposed regulations were published in the 
Federal Register on August 13, 2010 (75 FR 49596). They allowed a 60-
day period for comment, during which the DOL received timely comments 
from 251 parties: one comment was submitted by a Federal employing 
agency; two comments were received from labor organizations 
representing Federal employees; one comment was received from a medical 
professional association; 173 comments were received from private 
individuals; and 74 comments were received from attorneys. Also, 44 
untimely comments were received from private individuals and attorneys; 
the points made by these commenters echoed those made in comments that 
were timely submitted. Almost all of the comments addressed the 
reinsertion of the FECA's explicit bar on receipt of contingency fees. 
Furthermore, a number of the comments addressed scheduling of hearings 
before the Branch of Hearings and Review and a proposed change in how a 
request for reconsideration is determined to be timely. A smaller 
number of comments addressed changes in language regarding suitable 
employment and loss of wage earning capacity determinations. Finally, 
individual comments were received addressing a small number of issues, 
including changes to procedures involving Peace Corps volunteers, 
questions regarding verbiage, and a number of issues not raised by the 
proposed changes to the FECA regulations. All of these comments are 
addressed below.
    Two minor changes have been made to the notice of proposed 
rulemaking that did not result from any comments. The first change 
clarifies language in Sec.  10.104 to promote ease of reading. The 
second change was to Sec. Sec.  10.619, 10.818 and 10.819, which added 
``or equivalent service from a commercial carrier'' in situations where 
OWCP is to use certified mail, return receipt requested when mailing 
notices or decisions. This change will provide greater flexibility in 
such mailings while providing for proof of receipt.
    When publishing a final rule following a comment period, it is 
customary to publish only the changes that have been made to the rule; 
however, in order to be more user-friendly, OWCP is publishing the 
entire rule, including the parts that have not been changed. By doing 
so, only one document containing all of the regulations and commentary 
needs to be consulted rather than multiple documents.

I. Comments on the Notice of Proposed Rulemaking

    The section numbers used in the headings of the following analysis 
are those that were used in the notice of proposed rulemaking. Unless 
otherwise stated, the section numbers in the text of the analysis refer 
to the numbering used for the final regulations. No comments were 
received with respect to parts 1 and 25.

Section 10.16

    One attorney suggested that the addition of language to subsection 
(b) of this section which discussed actions under the False Claims Act 
indicated that OWCP was changing this section to allow other agencies 
to institute actions under the Program Fraud Civil Remedies Act. The 
addition of this language was only intended to notify employees that 
suits may be maintained under the False Claims Act. As such, the 
comment is well taken in that it indicates that placing this language 
in subsection (b) reduced the clarity of the regulation. Accordingly, 
the language has been moved to subsection (a).

Section 10.104

    Two labor organizations recommended the abbreviation ``i.e.'' be 
changed to ``e.g.'' because surgery is only one of multiple reasons 
that could support payment of wage-loss compensation for a limited 
period of disability in the presence of a loss-of-wage-earning-capacity 
determination. While OWCP does not think that such modification is 
required, the language has been changed to ``such as'' in an attempt to 
address the concerns expressed by the commenters and to add clarity 
through the use of plain language.

Section 10.310

    One medical provider noted that Round 1 of Medicare's Durable 
Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) 
Competitive Bidding process covers only a limited number of 
metropolitan areas and closed on November 4, 2009. Registration for 
Round 2 has yet to open

[[Page 37899]]

with no date even tentatively scheduled. As a result, many providers 
currently supplying durable medical equipment services for OWCP would 
be precluded from participation.
    This provision was added to afford OWCP with a measure of 
reliability in durable medical equipment suppliers while avoiding the 
use of scarce program resources to police all such providers. The 
comment is well taken as there are two processes relating to DMEPOS 
under Medicare. Relevant to this regulation is Medicare's DMEPOS 
Accreditation Process. This process was established as a result of the 
Medicare Modernization Act to implement quality standards for suppliers 
of, among other things, durable medical equipment. The accreditation 
process is currently open and providers are still being enrolled. This 
section has therefore been modified to require registration under 
Medicare's DMEPOS Accreditation Process rather than Medicare's 
Competitive Bidding Program. This should address the concerns of the 
commenter.

Section 10.321

    One attorney suggested that the language should be changed to 
require OWCP to provide notice to the claimant of the right to object 
to the referee selection at the time the referee notice is sent and 
that OWCP bears the burden of showing that it complied with the strict 
rotational system. The only proposed change to the existing rule was to 
add the ``impartial'' nomenclature that the Employees' Compensation 
Appeals Board (ECAB) uses in its appeal decisions for the third tie-
breaking (referee) physician. This section explains under what 
circumstances OWCP will appoint a third physician to make an 
examination. There is no requirement in the statute, ECAB case law or 
OWCP procedure for such notices or rotational requirements or for 
placing such strict obligations on OWCP by regulation. In addition, 
OWCP needs to retain some flexibility as to how it selects its 
impartial specialists, as some esoteric specialties may require more 
flexibility in scheduling. Consequently, the language in this section 
has not been modified.

Section 10.401

    Two labor organizations commented that the proposed language does 
not clearly establish that USPS employees who use leave during the 
first three days of temporary disability should have their leave 
reinstated if the injury causes permanent disability or if the pay loss 
continues for more than 14 calendar days. This explanation is 
specifically provided in Sec.  10.200(c). For clarity, a reference to 
Sec.  10.200(c) and to 5 U.S.C. 8117(b) has been added.

Section 10.421

    One agency commented that this section omitted a discussion of U.S. 
Department of Veterans Affairs benefits. The proposed language contains 
nothing novel and no specific reference to VA benefits appeared in 
either the 1988 or 1999 final rules. Furthermore, the program's 
procedures have long contained instructions on determining when VA 
payments constitute a prohibited dual benefit under the statute, and 
OWCP is not aware of any problems which have arisen with respect to 
these instructions. Therefore, the program does not believe that it is 
necessary to address it by regulation.

Section 10.500

    Eight attorneys noted that the additional sentence added to 
paragraph (a) of this section ignores and appears to undercut a very 
necessary procedure that has been set up to protect the employee's 
vested interest in continuation of wage-loss benefits absent being 
afforded due process rights prior to any reduction or elimination of 
benefits.
    Two labor organizations argued that the change to ``appropriate 
work'' in paragraph (b) of this section recasts the discussion into the 
context of loss of wage earning capacity determinations and that the 
term ``appropriate'' lacks a meaningful statutory or regulatory history 
and questioned the cross reference in Sec.  10.515.
    OWCP first notes that Sec.  10.500, as evidenced by the question 
proposed in the title, is meant to provide the very basic rules on 
receipt of benefits and rules regarding return to work and its effect 
on compensation. The changes made to this section were to clarify these 
situations and to provide information to claimants regarding their 
obligation to perform light duty when the evidence establishes that 
work is available within the employee's restrictions. These comments, 
however, indicate an apparent misunderstanding of the basic intent of 
Sec.  10.500. Accordingly, the section has been clarified by splitting 
up paragraphs (a) and (b) in the proposed rule to paragraphs (a)-(d) in 
this section. While these sections do not provide any new information 
or communicate a change in interpretation of current law, OWCP believes 
that the purpose and intent of the rule will be demonstrated more 
clearly. Furthermore, in any situation where benefits are reduced or 
denied under this section, OWCP will issue a decision that contains 
findings of fact and a statement of reasons. Where appropriate, such as 
in cases of ongoing continuous entitlement, OWCP will also provide the 
claimant notice of its proposed action as well as an opportunity to 
respond prior to issuing a decision based on this regulation. All such 
decisions will be accompanied by an explanation of the claimant's right 
to further administrative review including appeal to ECAB. These 
actions will address the due process concerns expressed by these 
organizations. Finally, the cross-reference that was questioned by the 
labor organizations was removed from Sec.  10.515 as that was no longer 
needed.

Section 10.509

    The proposed new Sec.  10.509 was modified by splitting this 
section into two sections, Sec.  10.509 and Sec.  10.510. Section 
10.509 now covers only situations involving the effect of downsizing of 
a light duty position on compensation. This section elicited comment 
from eight attorneys who disputed the additional phrase requiring the 
employing agency to state, in writing, that no other employment is 
available as being simply conclusory in nature. However, this 
clarifying phrase does not impact the section's basic premise that 
employees who have a wage-earning capacity determination in place do 
not sustain a compensable recurrence of disability when they lose their 
light duty positions pursuant to reductions-in-force and merely 
codifies existing procedures. As such, no change has been made to this 
section.
    Another commenter took issue with the use of ``other forms of 
downsizing'', arguing that this allows the agency to evade 
responsibilities under any collective bargaining agreement and 
established RIF law. As this is a personnel matter outside the scope of 
these FECA regulations, no change is necessary to the regulations as a 
result of this comment.

Section 10.510

    This section elicited comments from sixty-nine individuals, all of 
which were form letters, as well as comments from nine attorneys and 
two labor organizations. All comments expressed concern that the change 
in language would undercut the job suitability determination process. 
The purpose of the section, as noted in the preamble to the proposed 
rule, was to clarify when a light duty job may form the basis of a loss 
of wage-earning capacity determination, and does not involve 
determinations regarding job suitability under 5 U.S.C. 8106(c). One of 
the

[[Page 37900]]

fundamental bases for a loss of wage-earning capacity determination is 
that the position must fairly and reasonably represent an employee's 
ability to earn wages. As that basic factor was not explicitly 
expressed in this section, this language has been added.

Section 10.511

    Two labor organizations recommended the abbreviation ``i.e.'' be 
changed to ``e.g.'' because surgery is only one of multiple reasons 
that could support payment of wage-loss compensation for a limited 
period of disability in the presence of a loss-of-wage-earning-capacity 
determination. While no modification is strictly required, using the 
term ``such as'' will address the concerns expressed by the commenters 
and add clarity through the use of plain language.

Section 10.519

    Two labor organizations noted that, although the reference to OWCP 
nurses was removed from Sec.  10.518, it was not removed from this 
section. The reference to registered nurses was deleted from Sec.  
10.518 as ECAB found that nurse services were not to be considered 
vocational rehabilitation for the purposes of imposing sanctions 
pursuant to 5 U.S.C. 8113 (b). While OWCP will not apply such sanctions 
to non-cooperation with OWCP registered nurses, the reference remains 
in Sec.  10.519(a) to allow for flexibility in coordinating the 
services of both registered nurses and vocational rehabilitation 
counselors in OWCP's return to work efforts for injured workers.

Section 10.521

    The proposed rule added this section to explain the ramifications 
of electing to receive retirement benefits instead of FECA benefits. 
While not averse to referencing existing procedure in the regulatory 
language, two labor organizations objected to the addition of the 
phrase ``where OWCP is attempting to otherwise place that employee in a 
suitable job[.]'' The commenters argued that such language was 
potentially so broad as to cover any effort, including those 
inconsistent with law, regulation or procedure, and such a regulation 
would be punitive toward injured workers electing retirement benefits 
in order to receive schedule award payments. OWCP does not believe a 
change in this section is warranted, as the requirements for 
determining a loss of wage earning capacity are well established. A 
loss of wage earning capacity determination does not constitute a 
sanction; this section will have no impact on the concurrent receipt of 
OPM retirement benefits and a schedule award that is plainly 
permissible under the statute.

Section 10.607

    Ninety commenters objected to the change to Sec.  10.607, which 
modified the deadline for seeking reconsideration with OWCP on a denial 
of benefits from the requirement that the request ``be sent within one 
year'' to being ``received'' by OWCP within one year and requiring the 
request itself to be dated. Most of these comments were form letters. 
One commenter questioned whether the date would be the date received by 
OWCP or the date the letter is scanned into OWCP's electronic claim 
file system. Two commenters noted that this would create separate rules 
on deadlines for filing a request for reconsideration and a request for 
hearing with OWCP's Branch of Hearings and Review, in that the current 
rule in each instance bases the deadlines on the postmark on the 
envelope. The form letter comments suggested that this will increase 
the cost of filing reconsiderations by requiring claimants to send such 
requests by certified mail or facsimile in order to clearly know when 
the request has been received.
    OWCP notes that the prior regulation, which allowed for the date a 
request for reconsideration was sent to be documented by postmark, 
predated the current electronic file system (iFECs). Due to the large 
volume of mail that is received and scanned into this file system, it 
is not feasible or efficient to keep envelopes for all mail scanned 
prior to determining whether such mail is a request for 
reconsideration, making it impossible to determine the date such a 
request was sent to OWCP. This anomaly led to situations where dated 
requests for reconsideration were received well past the one year 
deadline, but were required to be treated as timely under the prior 
regulations. Such a problem is not inherent in requests for oral 
hearings, as hearing requests are mailed directly to the Branch of 
Hearings and Review. Therefore no change was necessary to that 
procedure. OWCP believes that this difference in procedure will be 
clearly explained in the appeal rights notice to avoid confusion.
    Furthermore, by 2012, OWCP will implement a free, Web-based system 
(E-COMP) that will allow claimants and representatives to directly 
upload documents to the electronic case file, minimizing both the cost 
and documentation questions noted by the commenters. Such electronic 
submissions should come at no cost to either the claimant or a 
representative and will provide instant acknowledgment as to when a 
document was received by OWCP.
    Finally, OWCP notes that the one year period for requesting 
reconsideration is extremely generous compared to other benefit appeals 
systems. As noted in the preamble to the notice of proposed rulemaking, 
rather than cutting back the time to file such a request (to either 180 
days, as with the ECAB, or 65 days, as with the Social Security 
Administration), OWCP simply chose to provide a solution that would 
allow OWCP to more easily document when the request was timely. The 
regulation provides more than ample time to both claimants and 
representatives to gather new evidence and submit a request for 
reconsideration. Accordingly, no change has been made to this section 
as a result of these comments.

Sections 10.616, 10.617 & 10.622

    The notice of proposed rule making drew six comments, all from 
attorneys, in regards to Sec. Sec.  10.616, 10.617 and 10.622. Although 
these sections address different issues, the comments all involved 
requests for additional flexibility in the scheduling of an oral 
hearing. One commenter specifically requested that the regulation be 
changed to require a hearing representative to consult with a claimant 
or representative prior to scheduling any hearing to arrange a mutually 
convenient time and place to hold the hearing. The remaining commenters 
simply asked that there be some coordination with the representative to 
better accommodate hearing calendars.
    Due to the volume of hearing requests and limited resources 
available to conduct those hearings, OWCP is not able to grant the 
large degree of consultation and latitude in the scheduling or 
postponements of hearings requested by the commenters. However, the 
increased use of teleconferences and other technology in hearings 
affords OWCP some flexibility in scheduling that did not exist 
previously. Accordingly, OWCP has redrafted Sec.  10.622 to provide 
greater flexibility while still maintaining OWCP's discretion in how 
and when these hearings are conducted. Specifically, OWCP added 
language allowing rescheduling within a monthly docket where a claimant 
or the representative has a prior unavoidable scheduling conflict and 
extended the previously existing language in paragraph (d) to include 
representatives as well.

[[Page 37901]]

Section 10.626

    One labor organization stated in reference to Sec.  10.626 that 
OWCP should consider adding language that states that OWCP will follow 
decisions of the Employees' Compensations Appeals Board based on the 
unions reading of a FECA circular from 1990. OWCP notes however that 
this section deals solely with the jurisdiction over a claim while that 
claim is appealed to ECAB. OWCP notes that part 0 of the Federal (FECA) 
Procedure Manual clearly states that the Employees' Compensation 
Appeals Board is an independent body that has jurisdiction to determine 
appeals from denials of FECA benefits. Federal (FECA) Procedure Manual, 
part 0-0100-3.

Section 10.700

    An attorney commented that this section should include a mandatory 
requirement that copies of all documents in the case file, including e-
mails, be automatically mailed to the claimant as well as the 
claimant's representative. OWCP notes that such a requirement is 
unnecessary, as the Privacy Act allows a claimant to request one free 
copy of all such documents and to sign a waiver allowing any 
representative to view those documents or receive a copy upon request. 
Furthermore, while representatives are frequently copied on 
correspondence to claimants, certain correspondence (such as the CA-
1032) remains the direct responsibility of the claimant to complete and 
submit. For this reason, and based on program experience, OWCP will not 
impose the regulatory requirement suggested by this commenter and the 
regulation remains unchanged.

Sections 10.702 & 10.703

    Two hundred forty-three of the comments, most of which were form 
letters, disagreed with the specific prohibition on contingency fees 
noted in these sections. One commenter strongly supported the ban on 
contingency fees as she believed that current fee application 
requirements compelled accountability on the part of the 
representative. Language specifically banning contingency fees was 
omitted during the last regulatory update, as the requirements for the 
fee application were believed to make the additional language 
redundant. Notwithstanding the regulation's explicit reference to 
hourly rates, the removal of this language left some with the 
impression that contingency fees were permissible and that the ban on 
contingency arrangements had been removed. ECAB precedent has stated 
that FECA does not allow for the payment of contingency fees, and the 
current regulations clearly contemplate the use of an hourly rate in 
determining representatives' fees. Furthermore, ECAB, in its recently 
published final rule, noted that no contract for a stipulated fee or on 
a contingent basis will be approved by ECAB. Federal Register cite. As 
5 U.S.C. 8127 applies to representative fees before both ECAB and OWCP, 
OWCP will continue to conform its position on contingency fees with 
that of ECAB's. Consequently, no change has been made to this section 
as a result of these comments.

Section 10.730

    This section was amended to restore the statutory language 
applicable to coverage of claims involving Peace Corps volunteers. The 
use of ``deemed proximately caused'' mirrors the language in 5 U.S.C. 
8142(c)(3). One attorney noted that the language of this section 
reverses the statutory burden of proof for Peace Corps Volunteers by 
adding additional requirements of proof in paragraph (b) and (c) to 
those that are required in 5 U.S.C. 8142(c)(3). The language to which 
the attorney took exception was not the amended language, but the 
general statutory requirement that a volunteer must sustain either an 
occupational disease or illness or a traumatic injury in order for FECA 
coverage to apply. As such, no change has been made to this section as 
a result of these comments.

Section 10.812

    One attorney commented that OWCP seldom sends a notice explaining 
appeal rights to the medical provider of reduced or denied fees and 
does not send notice to the claimant of a reduction or denial of a 
medical fee. This occasionally results in a claimant being sued years 
after the bill was denied or reduced.
    The existing rule was unchanged in the notice of proposed 
rulemaking. Notification of payment, denial of payment or fee reduction 
of a service is supplied in writing to the provider requesting payment. 
A claimant may review the bills submitted in his/her case and 
information regarding the amount billed, paid and the reason for any 
denial is readily available on-line. Although Sec.  10.813 of this part 
clearly states that claimants may not be billed for the difference when 
a fee is reduced, OWCP agrees that claimants may not realize that they 
are not responsible for medical charges exceeding the maximum allowed 
in the OWCP fee schedule. While no change has been made to this 
section, language regarding this concern has been added to the Web site 
and included in the acceptance letter sent to a claimant.

II. Administrative Requirements for the Proposed Rulemaking

Executive Orders 12866 and 13563

    Executive Order 12866 directs agencies to assess all costs and 
benefits of available regulatory alternatives and, if regulation is 
necessary, to select regulatory approaches that maximize net benefits 
(including potential economic, environmental, public health and safety 
effects; distributive impacts; and equity). Executive Order 13563 is 
supplemental to and reaffirms the principles, structures, and 
definitions governing regulatory review as established in Executive 
Order 12866.
    This rule constitutes a ``significant'' rule within the meaning of 
Executive Order 12866 in that any executive agency could be required to 
participate in the development of claims for benefits under this 
regulatory action. OWCP believes, however, that as this rule merely 
updates existing regulations, this rule will not have a significant 
economic impact on the economy, or any person or organization subject 
to the proposed changes. OWCP has projected that the addition of the 
skin as an organ under the schedule award provision as well as the 
revision of the part 25 compensation for non-citizen non-resident 
employees will result in additional expenditures of $10,893,434 over 
ten years.
    This projection is based on a very limited amount of data and a 
single significant event could result in substantially higher than 
projected expenditures. This has been reviewed by the Office of 
Management and Budget for consistency with the President's priorities 
and the principles set forth in Executive Order 12866.

Regulatory Flexibility Act of 1980

    This rule has been reviewed in accordance with the Regulatory 
Flexibility Act of 1980, as amended by the Small Business Regulatory 
Enforcement Fairness Act of 1996, 5 U.S.C. 601-612. OWCP has concluded 
that the rule does not involve regulatory and informational 
requirements regarding businesses, organizations, and governmental 
jurisdictions subject to regulation.

Paperwork Reduction Act (PRA)

    This rule contains information collection requirements subject to 
the Paperwork Reduction Act (PRA) of 1995, 44 U.S.C. 3501, et seq. The

[[Page 37902]]

requirements set out in this rule were both submitted to and approved 
by the OMB under the OMB Control Numbers 1240-0001, 1240-0007, 1240-
0008, 1240-0009, 1240-0012, 1240-0013, 1240-0015, 1240-0016, 1240-0017, 
1240-0018, 1240-0019, 1240-0022, 1240-0044, 1240-0045, 1240-0046, 1240-
0047, 1240-0049, 1240-0050 and 1240-0051.

The National Environmental Policy Act of 1969

    OWCP certifies that this rule has been assessed in accordance with 
the requirements of the National Environmental Policy Act of 1969, 42 
U.S.C. 4321 et seq. (NEPA). OWCP concludes that NEPA requirements do 
not apply to this rulemaking because this rule includes no provisions 
impacting the maintenance, preservation, or enhancement of a healthful 
environment.

Federal Regulations and Policies on Families

    OWCP has reviewed this rule in accordance with the requirements of 
section 654 of the Treasury and General Government Appropriations Act 
of 1999, 5 U.S.C. 601 note. This rule was not found to have a potential 
negative effect on family well-being as it is defined thereunder.

Executive Order 13045: Protection of Children From Environmental Health 
Risks and Safety Risks

    OWCP certifies that this rule has been assessed regarding 
environmental health risks and safety risks that may disproportionately 
affect children. This rule was not found to have a potential negative 
effect on the health or safety of children.

Unfunded Mandates Reform Act of 1995 and Executive Order 13132

    OWCP has reviewed this rule in accordance with the requirements of 
Executive Order 13132, 64 FR 43225 (Aug. 10, 1999), and the Unfunded 
Mandates Reform Act of 1995, 2 U.S.C. 1501 et seq., and has found no 
potential or substantial direct effects on the States, on the 
relationship between the national government and the States, or on the 
distribution of power and responsibilities among the various levels of 
government. As there is no Federal mandate contained herein that could 
result in increased expenditures by State, local, or Tribal governments 
or by the private sector, OWCP has not prepared a budgetary impact 
statement.

Executive Order 13175: Consultation and Coordination With Indian Tribal 
Governments

    OWCP has reviewed this rule in accordance with Executive Order 
13175, 65 FR 67249 (Nov. 9, 2000), and has determined that it does not 
have ``Tribal implications.'' The rule does not ``have substantial 
direct effects on one or more Indian Tribes, on the relationship 
between the Federal government and Indian Tribes, or on the 
distribution of power and responsibilities between the Federal 
government and Indian Tribes.''

Executive Order 12630: Governmental Actions and Interference With 
Constitutionally Protected Property Rights

    OWCP has reviewed this rule in accordance with Executive Order 
12630, 53 FR 8859 (Mar. 15, 1988), and has determined that it does not 
contain any ``policies that have takings implications'' in regard to 
the ``licensing, permitting, or other condition requirements or 
limitations on private property use, or that require dedications or 
exactions from owners of private property.''

Executive Order 13211: Energy Supply, Distribution, or Use

    OWCP has reviewed this rule and has determined that the provisions 
of Executive Order 13211, 66 FR 28355 (May 18, 2001), are not 
applicable as there are no direct or implied effects on energy supply, 
distribution, or use.

The Privacy Act of 1974, 5 U.S.C. 552a, as Amended

    Claims filed under these regulations are subject to the current 
Privacy Act System of Records, DOL/GOVT-1, Office of Workers' 
Compensation Programs, Federal Employees' Compensation Act File, 67 FR 
16826 (April 8, 2002).

Clarity of This Regulation

    Executive Order 12866, 58 FR 51735 (September 30, 1993), and the 
President's memorandum of June 1, 1998, require each agency to write 
all rules in plain language. OWCP invited comments on how to make the 
proposed rule easier to understand, and has incorporated plain language 
into the rule.

List of Subjects in 20 CFR Parts 1, 10, and 25

    Administrative practice and procedure, Claims, Government 
Employees, Labor, Workers' Compensation.
    For reasons set forth in the preamble, the Office of Workers' 
Compensation Programs, Department of Labor, amends 20 CFR chapter I as 
follows:

0
1. Part 1 is revised to read as follows:

PART 1--PERFORMANCE OF FUNCTIONS

Sec.
1.1 Under what authority does the Office of Workers' Compensation 
Programs operate?
1.2 What functions are assigned to OWCP?
1.3 What rules are contained in this chapter?
1.4 Where are other rules concerning OWCP functions found?
1.5 When was the former Bureau of Employees' Compensation abolished?
1.6 How were many of OWCP's current functions administered in the 
past?

    Authority: 5 U.S.C. 301, 8145 and 8149 (Reorganization Plan No. 
6 of 1950, 15 FR 3174, 3 CFR, 1949-1953 Comp., p. 1004, 64 Stat. 
1263); 42 U.S.C. 7384d and 7385s-10; E.O. 13179, 65 FR 77487, 3 CFR, 
2000 Comp., p. 321; Secretary of Labor's Order No. 13-71, 36 FR 
8155; Employment Standards Order No. 2-74, 39 FR 34722; Secretary of 
Labor's Order No. 10-2009, 74 FR 218.


Sec.  1.1  Under what authority does the Office of Workers' 
Compensation Programs operate?

    (a) The Assistant Secretary of Labor for Employment Standards, by 
authority vested in him by the Secretary of Labor in Secretary's Order 
No. 13-71 (36 FR 8755), established in the Employment Standards 
Administration (ESA) an Office of Workers' Compensation Programs (OWCP) 
by Employment Standards Order No. 2-74 (39 FR 34722). The Assistant 
Secretary subsequently designated as the head thereof a Director who, 
under the general supervision of the Assistant Secretary, administered 
the programs assigned to OWCP by the Assistant Secretary.
    (b) Effective November 8, 2009, ESA was dissolved into its four 
component parts, including OWCP. Secretary of Labor's Order 10-2009 (74 
FR 58834) cancelled or modified all prior orders and directives 
referencing ESA, devolved certain authorities and responsibilities of 
ESA to OWCP, and delegated authority to the Director, OWCP, to 
administer the programs now assigned directly to OWCP.


Sec.  1.2  What functions are assigned to OWCP?

    The Secretary of Labor has delegated authority and assigned 
responsibility to the Director of OWCP for the Department of Labor's 
programs under the following statutes:
    (a) The Federal Employees' Compensation Act, as amended and 
extended (5 U.S.C. 8101 et seq.), except

[[Page 37903]]

5 U.S.C. 8149 as it pertains to the Employees' Compensation Appeals 
Board.
    (b) The War Hazards Compensation Act, as amended (42 U.S.C. 1701 et 
seq.).
    (c) The War Claims Act of 1948, as amended (50 U.S.C. App. 2003 et 
seq.).
    (d) The Energy Employees Occupational Illness Compensation Program 
Act of 2000, as amended (42 U.S.C. 7384 et seq.), except 42 U.S.C. 
7385s-15 as it pertains to the Office of the Ombudsman, and activities, 
pursuant to Executive Order 13179 (``Providing Compensation to 
America's Nuclear Weapons Workers'') of December 7, 2000, assigned to 
the Secretary of Health and Human Services, the Secretary of Energy and 
the Attorney General.
    (e) The Longshore and Harbor Workers' Compensation Act, as amended 
and extended (33 U.S.C. 901 et seq.), except: 33 U.S.C. 919(d) with 
respect to administrative law judges in the Office of Administrative 
Law Judges; 33 U.S.C. 921(b) as it pertains to the Benefits Review 
Board; and activities, pursuant to 33 U.S.C. 941, assigned to the 
Assistant Secretary of Labor for Occupational Safety and Health.
    (f) The Black Lung Benefits Act, as amended (30 U.S.C. 901 et 
seq.)., including 26 U.S.C. 9501, except: 33 U.S.C. 919(d) as 
incorporated by 30 U.S.C. 932(a), with respect to administrative law 
judges in the Office of Administrative Law Judges; and 33 U.S.C. 921(b) 
as incorporated by 30 U.S.C. 932(a), as it applies to the Benefits 
Review Board.


Sec.  1.3  What rules are contained in this chapter?

    The rules in this chapter are those governing the OWCP functions 
under the Federal Employees' Compensation Act, the War Hazards 
Compensation Act, the War Claims Act and the Energy Employees 
Occupational Illness Compensation Program Act of 2000.


Sec.  1.4  Where are other rules concerning OWCP functions found?

    (a) The rules of OWCP governing its functions under the Longshore 
and Harbor Workers' Compensation Act and its extensions are set forth 
in subchapter A of chapter VI of this title.
    (b) The rules of OWCP governing its functions under the Black Lung 
Benefits Act program are set forth in subchapter B of chapter VI of 
this title.
    (c) The rules and regulations of the Employees' Compensation 
Appeals Board are set forth in chapter IV of this title.
    (d) The rules and regulations of the Benefits Review Board are set 
forth in Chapter VII of this title.


Sec.  1.5  When was the former Bureau of Employees' Compensation 
abolished?

    By Secretary of Labor's Order issued September 23, 1974 (39 FR 
34723), issued concurrently with Employment Standards Order 2-74 (39 FR 
34722), the Secretary revoked the prior Secretary's Order No. 18-67 (32 
FR 12979), which had delegated authority and assigned responsibility 
for the various workers' compensation programs enumerated in Sec.  1.2, 
except the Black Lung Benefits Program and the Energy Employees 
Occupational Illness Compensation Program not then in existence, to the 
Director of the former Bureau of Employees' Compensation.


Sec.  1.6  How were many of OWCP's current functions administered in 
the past?

    (a) Administration of the Federal Employees' Compensation Act and 
the Longshore and Harbor Workers' Compensation Act was initially vested 
in an independent establishment known as the U.S. Employees' 
Compensation Commission. By Reorganization Plan No. 2 of 1946 (3 CFR, 
1943-1949 Comp., p. 1064; 60 Stat. 1095, effective July 16, 1946), the 
Commission was abolished and its functions were transferred to the 
Federal Security Agency to be performed by a newly created Bureau of 
Employees' Compensation within such Agency. By Reorganization Plan No. 
19 of 1950 (15 FR 3178, 3 CFR, 1949-1954 Comp., page 1010, 64 Stat. 
1271), said Bureau was transferred to the Department of Labor (DOL), 
and the authority formerly vested in the Administrator, Federal 
Security Agency, was vested in the Secretary of Labor. By 
Reorganization Plan No. 6 of 1950 (15 FR 3174, 3 CFR, 1949-1953 Comp., 
page 1004, 64 Stat. 1263), the Secretary of Labor was authorized to 
make from time to time such provisions as he shall deem appropriate, 
authorizing the performance of any of his functions by any other 
officer, agency, or employee of the DOL.
    (b) In 1972, two separate organizational units were established 
within the Bureau: an Office of Workmen's Compensation Programs (37 FR 
20533) and an Office of Federal Employees' Compensation (37 FR 22979). 
In 1974, these two units were abolished and one organizational unit, 
the Office of Workers' Compensation Programs, was established in lieu 
of the Bureau of Employees' Compensation (39 FR 34722).

0
2. Part 10 is revised to read as follows:

PART 10--CLAIMS FOR COMPENSATION UNDER THE FEDERAL EMPLOYEES' 
COMPENSATOIN ACT, AS AMENDED

Subpart A--General Provisions
Sec.

Introduction

10.0 What are the provisions of the FECA, in general?
10.1 What rules govern the administration of the FECA and this 
chapter?
10.2 What do these regulations contain?
10.3 Have the collection of information requirements of this part 
been approved by the Office of Management and Budget (OMB)?

Definitions and Forms

10.5 What definitions apply to the regulations in this subchapter?
10.6 What special statutory definitions apply to dependents and 
survivors?
10.7 What forms are needed to process claims under the FECA?

Information in Program Records

10.10 Are all documents relating to claims filed under the FECA 
considered confidential?
10.11 Who maintains custody and control of FECA records?
10.12 How may a FECA claimant or beneficiary obtain copies of 
protected records?
10.13 What process is used by a person who wants to correct FECA-
related documents?

Rights and Penalties

10.15 May compensation rights be waived?
10.16 What criminal and civil penalties may be imposed in connection 
with a claim under the FECA?
10.17 Is a beneficiary who defrauds the Government in connection 
with a claim for benefits still entitled to those benefits?
10.18 Can a beneficiary who is incarcerated based on a felony 
conviction still receive benefits?
Subpart B--Filing Notices and Claims; Submitting Evidence

Notices and Claims for Injury, Disease, and Death--Employee or 
Survivor's Actions

10.100 How and when is a notice of traumatic injury filed?
10.101 How and when is a notice of occupational disease filed?
10.102 How and when is a claim for wage loss compensation filed?
10.103 How and when is a claim for permanent impairment filed?
10.104 How and when is a claim for recurrence filed?
10.105 How and when is a notice of death and claim for benefits 
filed?

Notices and Claims for Injury, Disease, and Death--Employer's Actions

10.110 What should the employer do when an employee files a notice 
of traumatic injury or occupational disease?

[[Page 37904]]

10.111 What should the employer do when an employee files an initial 
claim for compensation due to disability or permanent impairment?
10.112 What should the employer do when an employee files a claim 
for continuing compensation due to disability?
10.113 What should the employer do when an employee dies from a 
work-related injury or disease?

Evidence and Burden of Proof

10.115 What evidence is needed to establish a claim?
10.116 What additional evidence is needed in cases based on 
occupational disease?
10.117 What happens if, in any claim, the employer contests any of 
the facts as stated by the claimant?
10.118 Does the employer participate in the claims process in any 
other way?
10.119 What action will OWCP take with respect to information 
submitted by the employer?
10.120 May a claimant submit additional evidence?
10.121 What happens if OWCP needs more evidence from the claimant?

Decisions on Entitlement to Benefits

10.125 How does OWCP determine entitlement to benefits?
10.126 What does the decision contain?
10.127 To whom is the decision sent?
Subpart C--Continuation of Pay
10.200 What is continuation of pay?

Eligibility for COP

10.205 What conditions must be met to receive COP?
10.206 May an employee who uses leave after an injury later decide 
to use COP instead?
10.207 May an employee who returns to work, then stops work again 
due to the effects of the injury, receive COP?

Responsibilities

10.210 What are the employee's responsibilities in COP cases?
10.211 What are the employer's responsibilities in COP cases?

Calculation of COP

10.215 How does OWCP compute the number of days of COP used?
10.216 How is the pay rate for COP calculated?
10.217 Is COP charged if the employee continues to work, but in a 
different job that pays less?

Controversion and Termination of COP

10.220 When is an employer not required to pay COP?
10.221 How is a claim for COP controverted?
10.222 When may an employer terminate COP which has already begun?
10.223 Are there other circumstances under which OWCP will not 
authorize payment of COP?
10.224 What happens if OWCP finds that the employee is not entitled 
to COP after it has been paid?
Subpart D--Medical and Related Benefits

Emergency Medical Care

10.300 What are the basic rules for authorizing emergency medical 
care?
10.301 May the physician designated on Form CA-16 refer the employee 
to another medical specialist or medical facility?
10.302 Should the employer authorize medical care if he or she 
doubts that the injury occurred, or that it is work-related?
10.303 Should the employer use a Form CA-16 to authorize medical 
testing when an employee is exposed to a workplace hazard just once?
10.304 Are there any exceptions to these procedures for obtaining 
medical care?

Medical Treatment and Related Issues

10.310 What are the basic rules for obtaining medical care?
10.311 What are the special rules for the services of chiropractors?
10.312 What are the special rules for the services of clinical 
psychologists?
10.313 Will OWCP pay for preventive treatment?
10.314 Will OWCP pay for the services of an attendant?
10.315 Will OWCP pay for transportation to obtain medical treatment?
10.316 After selecting a treating physician, may an employee choose 
to be treated by another physician instead?

Directed Medical Examinations

10.320 Can OWCP require an employee to be examined by another 
physician?
10.321 What happens if the opinion of the physician selected by OWCP 
differs from the opinion of the physician selected by the employee?
10.322 Who pays for second opinion and referee examinations?
10.323 What are the penalties for failing to report for or 
obstructing a second opinion or referee examination?
10.324 May an employer require an employee to undergo a physical 
examination in connection with a work-related injury?

Medical Reports

10.330 What are the requirements for medical reports?
10.331 How and when should the medical report be submitted?
10.332 What additional medical information will OWCP require to 
support continuing payment of benefits?
10.333 What additional medical information will OWCP require to 
support a claim for a schedule award?

Medical Bills

10.335 How are medical bills submitted?
10.336 What are the time frames for submitting bills?
10.337 If an employee is only partially reimbursed for a medical 
expense, must the provider refund the balance of the amount paid to 
the employee?
Subpart E--Compensation and Related Benefits

Compensation for Disability and Impairment

10.400 What is total disability?
10.401 When and how is compensation for total disability paid?
10.402 What is partial disability?
10.403 When and how is compensation for partial disability paid?
10.404 When and how is compensation for a schedule impairment paid?
10.405 Who is considered a dependent in a claim based on disability 
or impairment?
10.406 What are the maximum and minimum rates of compensation in 
disability cases?

Compensation for Death

10.410 Who is entitled to compensation in case of death, and what 
are the rates of compensation payable in death cases?
10.411 What are the maximum and minimum rates of compensation in 
death cases?
10.412 Will OWCP pay the costs of burial and transportation of the 
remains?
10.413 May a schedule award be paid after an employee's death?
10.414 What reports of dependents are needed in death cases?
10.415 What must a beneficiary do if the number of beneficiaries 
decreases?
10.416 How does a change in the number of beneficiaries affect the 
amount of compensation paid to the other beneficiaries?
10.417 What reports are needed when compensation payments continue 
for children over age 18?

Adjustments to Compensation

10.420 How are cost-of-living adjustments applied?
10.421 May a beneficiary receive other kinds of payments from the 
Federal Government concurrently with compensation?
10.422 May compensation payments be issued in a lump sum?
10.423 May compensation payments be assigned to, or attached by, 
creditors?
10.424 May someone other than the beneficiary be designated to 
receive compensation payments?
10.425 May compensation be claimed for periods of restorable leave?

Overpayments

10.430 How does OWCP notify an individual of a payment made?
10.431 What does OWCP do when an overpayment is identified?
10.432 How can an individual present evidence to OWCP in response to 
a preliminary notice of an overpayment?
10.433 Under what circumstances can OWCP waive recovery of an 
overpayment?
10.434 If OWCP finds that the recipient of an overpayment was not at 
fault, what criteria are used to decide whether to waive recovery of 
it?
10.435 Is an individual responsible for an overpayment that resulted 
from an error made by OWCP or another Government agency?

[[Page 37905]]

10.436 Under what circumstances would recovery of an overpayment 
defeat the purpose of the FECA?
10.437 Under what circumstances would recovery of an overpayment be 
against equity and good conscience?
10.438 Can OWCP require the individual who received the overpayment 
to submit additional financial information?
10.439 What is addressed at a pre-recoupment hearing?
10.440 How does OWCP communicate its final decision concerning 
recovery of an overpayment, and what appeal right accompanies it?
10.441 How are overpayments collected?
Subpart F--Continuing Benefits

Rules and Evidence

10.500 What are the basic rules governing continuing receipt of 
compensation benefits and return to work?
10.501 What medical evidence is necessary to support continuing 
receipt of compensation benefits?
10.502 How does OWCP evaluate evidence in support of continuing 
receipt of compensation benefits?
10.503 Under what circumstances may OWCP reduce or terminate 
compensation benefits?

Return to Work--Employer's Responsibilities

10.505 What actions must the employer take?
10.506 May the employer monitor the employee's medical care?
10.507 How should the employer make an offer of suitable work?
10.508 May relocation expenses be paid for an employee who would 
need to move to accept an offer of reemployment?
10.509 If an employee's light duty job is eliminated due to 
downsizing, what is the effect on compensation?
10.510 When may a light duty job form the basis of a loss of wage-
earning capacity determination?
10.511 How may a loss of wage-earning capacity determination be 
modified?

Return to Work--Employee's Responsibilities

10.515 What actions must the employee take with respect to returning 
to work?
10.516 How will an employee know if OWCP considers a job to be 
suitable?
10.517 What are the penalties for refusing to accept a suitable job 
offer?
10.518 Does OWCP provide services to help employees return to work?
10.519 What action will OWCP take if an employee refuses to undergo 
vocational rehabilitation?
10.520 How does OWCP determine compensation after an employee 
completes a vocational rehabilitation program?
10.521 If an employee elects to receive retirement benefits instead 
of FECA benefits, what effect may such an election have on that 
employee's entitlement to FECA compensation?

Reports of Earnings From Employment and Self-Employment

10.525 What information must the employee report?
10.526 Must the employee report volunteer activities?
10.527 Does OWCP verify reports of earnings?
10.528 What action will OWCP take if the employee fails to file a 
report of activity indicating an ability to work?
10.529 What action will OWCP take if the employee files an 
incomplete report?

Reports of Dependents

10.535 How are dependents defined, and what information must the 
employee report?
10.536 What is the penalty for failing to submit a report of 
dependents?
10.537 What reports are needed when compensation payments continue 
for children over age 18?

Reduction and Termination of Compensation

10.540 When and how is compensation reduced or terminated?
10.541 What action will OWCP take after issuing written notice of 
its intention to reduce or terminate compensation?
Subpart G--Appeals Process
10.600 How can final decisions of OWCP be reviewed?

Reconsiderations and Reviews by the Director

10.605 What is reconsideration?
10.606 How does a claimant request reconsideration?
10.607 What is the time limit for requesting reconsideration?
10.608 How does OWCP decide whether to grant or deny the request for 
reconsideration?
10.609 How does OWCP decide whether new evidence requires 
modification of the prior decision?
10.610 What is a review by the Director?

Hearings

10.615 What is a hearing?
10.616 How does a claimant obtain a hearing?
10.617 How is an oral hearing conducted?
10.618 How is a review of the written record conducted?
10.619 May subpoenas be issued for witnesses and documents?
10.620 Who pays the costs associated with subpoenas?
10.621 What is the employer's role when an oral hearing has been 
requested?
10.622 May a claimant or representative withdraw a request for or 
postpone a hearing?

Review by the Employees' Compensation Appeals Board (ECAB)

10.625 What kinds of decisions may be appealed?
10.626 Who has jurisdiction of cases on appeal to the ECAB?
Subpart H--Special Provisions

Representation

10.700 May a claimant designate a representative?
10.701 Who may serve as a representative?
10.702 How are fees for services paid?
10.703 How are fee applications approved?
10.704 What penalties apply to representatives who collect a fee 
without approval?

Third Party Liability

10.705 When must an employee or other FECA beneficiary take action 
against a third party?
10.706 How will a beneficiary know if OWCP or SOL has determined 
that action against a third party is required?
10.707 What must a FECA beneficiary who is required to take action 
against a third party do to satisfy the requirement that the claim 
be ``prosecuted''?
10.708 Can a FECA beneficiary who refuses to comply with a request 
to assign a claim to the United States or to prosecute the claim in 
his or her own name be penalized?
10.709 What happens if a beneficiary directed by OWCP or SOL to take 
action against a third party does not believe that a claim can be 
successfully prosecuted at a reasonable cost?
10.710 Under what circumstances must a recovery of money or other 
property in connection with an injury or death for which benefits 
are payable under the FECA be reported to OWCP or SOL?
10.711 How is the amount of the recovery of the FECA beneficiary 
determined?
10.712 How much of any settlement or judgment must be paid to the 
United States?
10.713 How is a structured settlement (that is, a settlement 
providing for receipt of funds over a specified period of time) 
treated for purposes of reporting the gross recovery?
10.714 What amounts are included in the refundable disbursements?
10.715 Is a beneficiary required to pay interest on the amount of 
the refund due to the United States?
10.716 If the required refund is not paid within 30 days of the 
request for repayment, can it be collected from payments due under 
the FECA?
10.717 Is a settlement or judgment received as a result of 
allegations of medical malpractice in treating an injury covered by 
the FECA a gross recovery that must be reported to OWCP or SOL?
10.718 Are payments to a beneficiary as a result of an insurance 
policy which the beneficiary has purchased a gross recovery that 
must be reported to OWCP or SOL?
10.719 If a settlement or judgment is received for more than one 
wound or medical condition, can the refundable disbursements paid on 
a single FECA claim be attributed to different conditions for 
purposes of calculating the refund or credit owed to the United 
States?

[[Page 37906]]

Federal Grand and Petit Jurors

10.725 When is a Federal grand or petit juror covered under the 
FECA?
10.726 When does a juror's entitlement to disability compensation 
begin?
10.727 What is the pay rate of jurors for compensation purposes?

Peace Corps Volunteers

10.730 What are the conditions of coverage for Peace Corps 
volunteers and volunteer leaders injured while serving outside the 
United States?
10.731 What is the pay rate of Peace Corps volunteers and volunteer 
leaders for compensation purposes?

Non-Federal Law Enforcement Officers

10.735 When is a non-Federal law enforcement officer (LEO) covered 
under the FECA?
10.736 What are the time limits for filing a LEO claim?
10.737 How is a LEO claim filed, and who can file a LEO claim?
10.738 Under what circumstances are benefits payable in LEO claims?
10.739 What kind of objective evidence of a potential Federal crime 
must exist for coverage to be extended?
10.740 In what situations will OWCP automatically presume that a law 
enforcement officer is covered by the FECA?
10.741 How are benefits calculated in LEO claims?
Subpart I--Information for Medical Providers

Medical Records and Bills

10.800 How do providers enroll with OWCP for authorizations and 
billing?
10.801 How are medical bills to be submitted?
10.802 How should an employee prepare and submit requests for 
reimbursement for medical expenses, transportation costs, loss of 
wages, and incidental expenses?
10.803 What are the time limitations on OWCP's payment of bills?

Medical Fee Schedule

10.805 What services are covered by the OWCP fee schedule?
10.806 How are the maximum fees defined?
10.807 How are payments for particular services calculated?
10.808 Does the fee schedule apply to every kind of procedure?
10.809 How are payments for medicinal drugs determined?
10.810 How are payments for inpatient medical services determined?
10.811 When and how are fees reduced?
10.812 If OWCP reduces a fee, may a provider request reconsideration 
of the reduction?
10.813 If OWCP reduces a fee, may a provider bill the claimant for 
the balance?

Exclusion of Providers

10.815 What are the grounds for excluding a provider from payment 
under the FECA?
10.816 What will cause OWCP to automatically exclude a physician or 
other provider of medical services and supplies?
10.817 How are OWCP's exclusion procedures initiated?
10.818 How is a provider notified of OWCP's intent to exclude him or 
her?
10.819 What requirements must the provider's answer and OWCP's 
decision meet?
10.820 How can an excluded provider request a hearing?
10.821 How are hearings assigned and scheduled?
10.822 How are subpoenas or advisory opinions obtained?
10.823 How will the administrative law judge conduct the hearing and 
issue the recommended decision?
10.824 How does the recommended decision become final?
10.825 What are the effects of exclusion?
10.826 How can an excluded provider be reinstated?
Subpart J--Death Gratuity
10.900 What is the death gratuity under this subpart?
10.901 Which employees are covered under this subpart?
10.902 Does every employee's death due to injuries incurred in 
connection with his or her service with an Armed Force in a 
contingency operation qualify for the death gratuity?
10.903 Is the death gratuity payment applicable retroactively?
10.904 Does a death as a result of occupational disease qualify for 
payment of the death gratuity?
10.905 If an employee incurs a covered injury in connection with his 
or her service with an Armed Force in a contingency operation but 
does not die of the injury until years later, does the death qualify 
for payment of the death gratuity?
10.906 What special statutory definitions apply to survivors under 
this subpart?
10.907 What order of precedence will OWCP use to determine which 
survivors are entitled to receive the death gratuity payment under 
this subpart?
10.908 Can an employee designate alternate beneficiaries to receive 
a portion of the death gratuity payment?
10.909 How does an employee designate a variation in the order or 
percentage of gratuity payable to survivors and how does the 
employee designate alternate beneficiaries?
10.910 What if a person entitled to a portion of the death gratuity 
payment dies after the death of the covered employee but before 
receiving his or her portion of the death gratuity?
10.911 How is the death gratuity payment process initiated?
10.912 What is required to establish a claim for the death gratuity 
payment?
10.913 In what situations will OWCP consider that an employee 
incurred injury in connection with his or her service with an Armed 
Force in a contingency operation?
10.914 What are the responsibilities of the employing agency in the 
death gratuity payment process?
10.915 What are the responsibilities of OWCP in the death gratuity 
payment process?
10.916 How is the amount of the death gratuity calculated?

    Authority: 5 U.S.C. 301, 8102a, 8103, 8145 and 8149; 31 U.S.C. 
3716 and 3717; Reorganization Plan No. 6 of 1950, 15 FR 3174, 64 
Stat. 1263; Secretary of Labor's Order No. 10-2009, 74 FR 218.

Subpart A--General Provisions

Introduction


Sec.  10.0  What are the provisions of the FECA, in general?

    The Federal Employees' Compensation Act (FECA) as amended (5 U.S.C. 
8101 et seq.) provides for the payment of workers' compensation 
benefits to civilian officers and employees of all branches of the 
Government of the United States. The regulations in this part describe 
the rules for filing, processing, and paying claims for benefits under 
the FECA. Proceedings under the FECA are non-adversarial in nature.
    (a) The FECA has been amended and extended a number of times to 
provide workers' compensation benefits to volunteers in the Civil Air 
Patrol (5 U.S.C. 8141), members of the Reserve Officers' Training Corps 
(5 U.S.C. 8140), Peace Corps Volunteers (5 U.S.C. 8142), Job Corps 
enrollees and Volunteers in Service to America (5 U.S.C. 8143), members 
of the National Teachers Corps (5 U.S.C. 8143a), certain student 
employees (5 U.S.C. 5351 and 8144), certain law enforcement officers 
not employed by the United States (5 U.S.C. 8191-8193), and various 
other classes of persons who provide or have provided services to the 
Government of the United States.
    (b) The FECA provides for payment of several types of benefits, 
including compensation for wage loss, schedule awards, medical and 
related benefits, and vocational rehabilitation services for conditions 
resulting from injuries sustained in performance of duty while in 
service to the United States.
    (c) The FECA also provides for payment of monetary compensation to 
specified survivors of an employee whose death resulted from a work-
related injury and for payment of certain burial expenses subject to 
the provisions of 5 U.S.C. 8134.
    (d) All types of benefits and conditions of eligibility listed in 
this section are subject to the provisions of the FECA and of this 
part. This section shall not be construed to modify or

[[Page 37907]]

enlarge upon the provisions of the FECA.


Sec.  10.1  What rules govern the administration of the FECA and this 
chapter?

    In accordance with 5 U.S.C. 8145 and Secretary's Order 5-96, the 
responsibility for administering the FECA, except for 5 U.S.C. 8149 as 
it pertains to the Employees' Compensation Appeals Board, has been 
delegated to the Director of the Office of Workers' Compensation 
Programs (OWCP). Except as otherwise provided by law, the Director, 
OWCP and his or her designees have the exclusive authority to 
administer, interpret and enforce the provisions of the Act.


Sec.  10.2  What do these regulations contain?

    This part 10 sets forth the regulations governing administration of 
all claims filed under the FECA, except to the extent specified in 
certain particular provisions. Its provisions are intended to assist 
persons seeking compensation benefits under the FECA, as well as 
personnel in the various Federal agencies and the Department of Labor 
who process claims filed under the FECA or who perform administrative 
functions with respect to the FECA. This part 10 applies to part 25 of 
this chapter except as modified by part 25. The various subparts of 
this part contain the following:
    (a) Subpart A. The general statutory and administrative framework 
for processing claims under the FECA. It contains a statement of 
purpose and scope, together with definitions of terms, descriptions of 
basic forms, information about the disclosure of OWCP records, and a 
description of rights and penalties under the FECA, including 
convictions for fraud.
    (b) Subpar