FECA Bulletins (2020-2024)

FECA Bulletins (2020-2024) | U.S.
Department of Labor 10/18/21, 1:17 PM
U.S. DEPARTMENT OF LABOR
O!ice of Workers' Compensation Programs Search OWCP
FECA Bulletins (2020-2024)
Division of Federal Employees'

Compensation (DFEC)
FECA Bulletins have been divided into five-year groups to make it easier for you to search
and find the information you are looking for.
Table of Contents
2022, 2021, 2020
Fiscal Year 2022
Bulletin Subject
FECA Bulletin No. 22-01 Coverage for Injuries Resulting from the COVID-19
Vaccination Mandate for Federal Employees.
Back to FECA Bulletins (2020-2024) Table of Contents
Fiscal Year 2021
Bulletin Subject
FECA Bulletin No. 21-01 Special Case Handling in COVID-19 FECA Claims Processing
and Adjudication
FECA Bulletin No. 21-02 Telemedicine for Routine Appointments
https://www.dol.gov/agencies/owcp/FECA/regs/compliance/DFECfolio/FECABulletins/FY2020-2024#FECAB2201 Page 1 of 62
FECA Bulletins (2020-2024) | U.S. Department of Labor 10/18/21, 1:17 PM
FECA Bulletin No. 21-03 Compensation Pay - Consumer Price Index (CPI) Cost-of-
Living Adjustments.
FECA Bulletin No. 21-04 Compensation Pay: Compensation Rate Changes for 2021.
FECA Bulletin No. 21-05 Payment authorization on reimbursements exceeding

$50,000
FECA Bulletin No. 21-06 Revised Process for Converting Federal Employees'
Compensation Act (FECA) Paper Cases into Fully Imaged
O!icial Case Records
FECA Bulletin No. 21-07 New FECA Pharmacy Benefits Management System
FECA Bulletin No. 21-08 Telemedicine for Routine Appointments – Updated
FECA Bulletin No. 21-09 Processing FECA Claims for COVID-19 under the American
Rescue Plan Act of 2021
FECA Bulletin No. 21-10 Establishing FECA Claims for COVID-19 under the American
Rescue Plan Act of 2021 through Antigen Testing
FECA Bulletin No. 21-11 Retention of the American Medical Association's Guides to
the Evaluation of Permanent Impairment, 6th Edition
(2009).
FECA Bulletin No. 21-12 Release of Privileged Medical Records
Fiscal Year 2020
Bulletin Subject
Living Adjustments.
This Bulletin supersedes FECA Bulletin 20-02.
Living Adjustments.
This Bulletin supersedes FECA Bulletin 20-01.
FECA Bulletin No. 20-05 Federal Employees Contracting COVID-19 in Performance

oF Duty
FECA Bulletin No. 20-06 Change in collection procedures for debt owed to the
Division of Federal Employees' Compensation (DFEC).
FECA BULLETIN NO. 22-01

October 1, 2021
Subject: Coverage for Injuries Resulting from the COVID-19 Vaccination Mandate for
Federal Employees.
Background: On September 9, 2021, President Biden issued an executive order

mandating COVID-19 vaccination for most Federal employees. The order directed each
agency to implement a program to require COVID-19 vaccination for all of its employees,
with exceptions only as required by law.
The Federal Employees' Compensation Act (FECA) covers injuries that occur in the
performance of duty. The FECA does not generally authorize provision of preventive
measures such as vaccines and inoculations, and in general, preventive treatment is a
responsibility of the employing agency under the provisions of 5 U.S.C. 7901. However,
care can be authorized by OWCP for complications of preventive measures which are
provided or sponsored by the agency, such as adverse reaction to prophylactic
immunization. See PM 3-0400.7(a).
Further, deleterious e!ects of medical services furnished by the employing establishment

are generally considered to fall within the performance of duty. These services include
preventive programs relating to health. See PM 2-0804.19.
However, this executive order now makes COVID-19 vaccination a requirement of most
Federal employment. As such, employees impacted by this mandate who receive required
COVID-19 vaccinations on or a"er the date of the executive order may be a!orded
coverage under the FECA for any adverse reactions to the vaccine itself, and for any injuries
sustained while obtaining the vaccination.
Purpose: To provide guidance on coverage for claims for injury on or a"er September 9,
2021, resulting from receipt of the mandated COVID-19 vaccination for Federal employees.
Applicability: All FECA Program Sta! and Other Stakeholders.
Reference: Federal (FECA) Procedure Manual, Part 2 Claims, Chapter 2-0804 Performance
of Duty, and Part 3 Medical, Chapter 3-0400 Medical Services and Supplies; 20 CFR §
10.313; Executive Order on Requiring Coronavirus Disease 2019 Vaccination for Federal
Employees.
Actions::
1. Because COVID-19 vaccination is a specific event occurring during a single day or

work shi", any adverse reactions or injuries should be reported on Form CA-1, Notice of
Traumatic Injury and Claim for Continuation of Pay / Compensation. Where two
vaccinations are required several weeks apart, reactions to each are considered
separate claims.
2. When a claim is received for injury due to receipt of the COVID-19 vaccination, the
claims examiner should determine if the vaccine was received prior to September 9,
2021. If the vaccination was received prior to this date, coverage is a!orded only if the
vaccine was administered or sponsored by the employing agency. See PM 2-0804.19.
3. The claims examiner should then confirm that the employee is covered by the
September 9, 2021 executive order. The order applies to any executive agency as
defined in 5 U.S.C. 105 – agencies that fall under the executive branch of the
government (excluding the Government Accountability O!ice). The order does not
apply to employees of the United States Postal Service. If there is any question
regarding applicability of the executive order, the claims examiner should query the
employing agency. If the employee is not covered by the executive order, coverage is
a!orded only if the vaccine was administered or sponsored by the employing agency.
See PM 2-0804.19.
4. If the employee is covered by the executive order and vaccination was received on or
a"er September 9, 2021, coverage may be a!orded for (1) adverse reactions to the
COVID-19 vaccination and (2) injuries sustained as the direct result of an employee
receiving their mandated vaccination. Examples of such injuries include but are not
limited to accidents while commuting a reasonable distance to and from the
vaccination site and slip and fall injuries occurring at the vaccination site.
5. The claims examiner should, however, ensure that the employee followed any
employing agency policy with respect to obtaining their mandatory vaccination. The
executive order directs each agency to implement, to the extent consistent with
applicable law, a program to require COVID-19 vaccination for all of its Federal
employees.
a. If an employing agency requires employees to receive their mandatory vaccination

at specific times and/or at a specific location(s), coverage is only a!orded if the
employee follows the agency’s vaccination policy.
b. If any employing agency allows employees to obtain their mandatory vaccination

at any time or location, coverage is a!orded regardless of where or when the
employee receives their vaccination, with the only limitation being for that of
reasonableness.
6. The executive order requires full vaccination, which is considered to be two shots of
the Pfizer-BioNTech COVID-19 Vaccine, also known as Comirnaty, two shots of the
Moderna COVID-19 Vaccine, or one shot of the Janssen COVID-19 Vaccine. The order
does not cover or mandate booster vaccinations. Should there be any changes
regarding approved vaccination brands or mandated vaccination frequencies, the FECA
program will publish additional guidance.
Disposition: This bulletin should be retained until incorporated into Chapter 2-0804,
Performance of Duty, of the FECA Procedure Manual.
ANTONIO RIOS
Director for
Division of Federal Employees’, Longshore and Harbor Workers’ Compensation
Distribution: All FECA Program Sta!
Back to Top of FECA Bulletin No. 22-01
Issue Date: October 21, 2020
Subject: Special Case Handling in COVID-19 FECA Claims Processing and Adjudication
Background: The Federal Employees' Compensation Act (FECA) covers injury in the
performance of duty; injury includes a disease proximately caused by federal
employment. The U.S. Department of Labor's (DOL) O!ice of Workers' Compensation
Programs (OWCP) Division of Federal Employees', Longshore and Harbor Workers'
Compensation (DFELHWC) administers FECA. FECA provides to an employee injured while
in the performance of duty, the services, appliances, and supplies prescribed or
recommended by a qualified physician, which OWCP considers "likely to cure, give relief,
reduce the degree or the period of disability, or aid in lessening the amount of the monthly
compensation." See 5 U.S.C. 8103. FECA pays compensation for the disability or death of
an employee resulting from injury in the performance of duty.
While all federal employees who contract COVID-19 related to their federal employment
are entitled to FECA coverage, special case handling considerations apply. FECA Bulletin
No. 20-05 was released on March 31, 2020, to provide targeted instructions to claims sta!
on the handling of COVID-19 FECA claims, including for employment designated by the
FECA program as high-risk employment, which are expanded upon here.
Purpose: To provide additional guidance regarding special case handling of COVID-19

FECA claims.
A. High-Risk Employment Determinations by Position
As outlined in FECA Bulletin No. 20-05, OWCP recognizes that federal employees who have
direct and frequent in-person and close proximity interactions with the public may be
considered to have high-risk employment as it relates to COVID-19. This includes, but is
not limited to, members of law enforcement, first responders, and front-line medical and
public health personnel.
1. To make high-risk determinations by position, OWCP must first make a factual

determination regarding exposure to COVID-19, based primarily upon the employing
Agency's input. Questions by OWCP to the Agency will focus on the conditions of
employment, with an emphasis on exposure to individuals known to have COVID-19
and/or required exposure to the general public and/or COVID-19 a!ected populations such
as patients. Initial fact-finding will focus on the following:
1. Nature of Exposure and Contact (e.g., direct contact with one or more person(s)
confirmed to have COVID-19, direct contact with the general public and/or
COVID-19 a!ected populations such as patients, and the proximity);
2. Volume of Exposure (e.g., less than 10 people, 10-50 people, etc.);
3. Duration of Exposure (e.g., less than 2 hours per shi", 2-4 hours per shi", etc.);
and
4. Other (e.g., any pertinent information specific to the exposure or the
employee’s position).
Where the facts provided by an agency are not limited to an individual employee, but are
applicable to all employees in a specific position, at a specific location, and during a
specific time frame, OWCP will utilize this information to e!iciently make a factual high-
risk determination on the position itself. The high-risk determination pertains only to the
positions, geographic locations, and timeframes, as indicated by the employing Agency.
Additionally, the employing Agency can challenge the high-risk determination on any
individual case, since the work duties of specific individuals may be inconsistent with the
high-risk determination. For example, the employee may hold that position but be
temporarily assigned to di!erent duties.
2. An internal team, designated as the COVID-19 Task Force, and consisting of the FECA
Director (now the Director of DFELHWC) and his designees, the FECA Policy Chief, and the
OWCP Chief Medical O!icer1, will review the available evidence of likely workplace
exposure to COVID-19 for each specific position. This review includes an examination of
how COVID-19 was caused by the position’s work-related activities. The Task Force makes
the high-risk employment determination by position based upon the facts presented by
the Agency and the contemporaneous epidemiologic understanding and related science
accepted by the Centers for Disease Control and Prevention (CDC) regarding the virus and
its transmissibility. Based on that review, the Task Force finds whether there is su!icient
evidence to accept that the diagnosis of COVID-19 is proximately caused by employment.
If the COVID-19 Task Force determines that the position is high-risk, OWCP will designate
the position as high-risk. When this occurs, a position-based high-risk determination
memorandum is created and placed in the applicable FECA case files at the time of
adjudication. In each of those instances, OWCP will accept that the exposure was
proximately caused by high-risk employment and no further medical evidence explaining
the relationship between the confirmed COVID-19 diagnosis and the employment is
required.
These high-risk position level reviews occur primarily for those positions with a higher
volume of claims. Examples include a physician or nurse at the Department of Veterans
A!airs or a Correctional O!icer for the Bureau of Prisons.
B. High-Risk Employment Determinations by Case Specific Facts
In other instances, OWCP may collect information about an individual case that indicates a
possible high-risk employment determination for a specific employee, but not a high-risk
determination for all employees in this position. If a claimant/employee’s position has not
been classified as high-risk, but the individual case employment circumstances are the
same or similar to the circumstances for high-risk determination by position, and there is
indication (of likely exposure at work to COVID-19), then a memorandum will be created by
the claims examiner and submitted to the Task Force. The memorandum should include
details specific to that case regarding the job duties, nature and duration of exposure, and
all other pertinent facts obtained from the claimant/employee and the employing Agency.
The COVID-19 Task Force will review this memorandum and make a high-risk case specific
determination based on the facts submitted in the memorandum and the
contemporaneous epidemiologic understanding and other science accepted by the CDC
regarding the virus and its transmissibility. The Task Force’s review includes examining
how COVID-19 may have been caused by the employee’s work-related activities. Based on
that review, the Task Force determines whether there is su!icient evidence to accept that
the diagnosis of COVID-19 was proximately caused by employment.
If the COVID-19 Task Force determines the case specific employment is considered high-
risk, a high-risk determination memorandum is created and placed in the applicable case
file at the time of adjudication. In each of these cases, OWCP will accept the exposure was
proximately caused by high-risk employment and no further medical evidence explaining
the relationship between the confirmed COVID-19 diagnosis and the employment is
required.
C. All Other Determinations
If the claimant’s position is not considered high-risk or the claimant’s specific case is not
considered high-risk, the claimant/employee should be asked to provide medical evidence
from a physician to include the diagnosis of COVID-19 and an explanation of how COVID-19
was caused by the employee’s work-related activities.
D. Additional Development and Adjudication of Claims
All COVID-19 FECA claims will be fully developed to establish the five basic elements set
forth in 20 CFR 10.115, pursuant to the special handling procedures further addressed in
items 1-5 below.
1. Medical Development. The claimant/employee will be asked to submit the laboratory

test results that confirm the diagnosis of COVID-19. If there are any questions regarding the
laboratory test result submitted, the claims examiner should refer to OWCP’s Chief Medical
O!icer for review and clarification.
1. If the Task Force has made a high-risk determination based on position or case
specific facts, as indicated in section A and B above, and a positive COVID-19
laboratory test result is submitted, no further medical development is
necessary. However, in certain instances, and where the facts of a case warrant,
OWCP may request a medical statement of the causal relationship of how the
COVID-19 was employment-related, in addition to the COVID-19 test result.
2. If the Task Force has not made a high-risk determination, as indicated in section
C above, the claimant/employee should be asked to provide medical evidence
from a physician to include the diagnosis of COVID-19 and an explanation of
how COVID-19 was caused by the employee’s work-related activities.
3. While an antibody test may be submitted to confirm that the employee had
COVID-19, the medical evidence should also address how the diagnosis of
COVID-19 is employment-related and/or include a contemporaneous indication
that the claimant was diagnosed with/treated for COVID-19 by a physician.
4. If there is a claim that COVID-19 aggravated, accelerated, or precipitated
another ancillary medical condition, the claimant/employee should be asked to
provide additional medical evidence from a physician.
5. If the employing Agency has copies of responsive medical documentation (such
as lab results, antibody test results, or health unit entries), the Agency should
promptly provide such documents to the DFELHWC.
2. Extensions. A period of 30 days is generally allowed for the submission of any evidence
requested by OWCP. An extension of additional time can be granted in the following
circumstances:
1. If the claimant/employee requests an extension;

2. If a positive test result has been submitted, but the factual evidence is missing;
or
3. If there is a positive laboratory test result on file, but the o!icial laboratory
report is missing and OWCP’s Chief Medical O!icer (or his designee) determines
that the medical evidence is insu!icient, an o!icial laboratory test result must
be requested.
3. Adjudication/Disposition
1. All cases will be accepted for COVID-19 if the five basic elements set forth in 20
CFR 10.115 are established.
2. The case will be denied if the medical evidence does not support that the
injured worker contracted COVID-19 (where no laboratory report or medical
evidence supporting the diagnosis is submitted).
3. If the claim does not meet the five basic elements for acceptance, but the
medical evidence supports the diagnosis of COVID-19, the case will be
administratively closed and suspended for adjudication. The FECA Procedure
Manual allows for administrative closure of cases without formal adjudication
by claims sta!2 for very simple/minor traumatic injuries that are not expected
to involve large medical expenses. If the claim was filed within 30 days of the
injury and the employee provides the evidence described in 20 CFR 10.210, the
employee is entitled to Continuation of Pay (COP).3 The employer may
terminate COP when the conditions outlined in 20 CFR 10.220 are met.
Suspended adjudication does not constitute a formal denial, and the employee
will be advised of the additional documentation needed should they wish to
pursue their claim further.
4. Withdrawal of Claim. Certain COVID-19 claims may have been filed as a preventive for
exposure only, due to quarantine, or otherwise filed prematurely. In such circumstances,
an employee may decide not to pursue his or her claim. A claimant may withdraw his or
her claim in writing (but not the notice of injury) at any time before OWCP determines
eligibility for benefits. See 20 CFR 10.100 (b)(3). However, any COP granted to an employee
a"er a claim is withdrawn must be charged to sick or annual leave, or considered an
overpayment of pay consistent with 5 U.S.C. 5584, at the employee’s option.
5. Reopening Cases that were Administratively Closed and Suspended for Adjudication.
Cases suspended for adjudication under item 3(c) above should be reopened for full
development and adjudication if:
1. The employee requests a formal decision; or

2. The employee claims wage loss compensation a"er the expiration of the COP
period. In this instance, supportive medical evidence from a physician on the
relationship between the illness and the claimed disability and/or medical
expenses is needed regardless of the employment determination (high-risk or
not high-risk); or
3. The medical bills or other related expenses submitted for payment on the case
exceed $1,500.00.
6. Death benefits. Claims for COVID-19 death benefits are adjudicated in a manner similar
to other claims for death benefits.
1. The claimant has the burden of establishing the essential elements of the
claim, which includes the existence of a causal relationship between an

employee’s death and federal employment. Medical evidence addressing the
cause and e!ect relationship between death and employment is required.
2. The evidence must establish that the employee’s death was causally related to
federal employment by cause, aggravation, acceleration, or precipitation.
COVID-19 need not be the sole cause of death, and the fact that the employee
may have had other non-work related medical conditions does not preclude a
survivor’s entitlement to benefits.
3. If the employment is considered high-risk, a positive COVID-19 laboratory test
result is su!icient to find the COVID-19 was employment-related. If a COVID-19
laboratory test is not available, COVID-19 listed on the death certificate as a
primary or contributing cause of death is also highly probative and will be
considered along with the evidence discussed above.
4. It is recognized that obtaining a positive COVID-19 laboratory rest result may
not be possible in death cases and available medical records may be limited. As
such, the claims examiner may refer the available factual and supportive
medical evidence to OWCP’s Chief Medical O!icer or a District Medical Advisor
(DMA) for an opinion on the medical diagnosis and causal relationship where
appropriate.
Applicability: Appropriate National and District O!ice personnel.
Disposition: This Bulletin is to be retained until incorporated unto the FECA Procedure
Manual.
ANTONIO RIOS
Director for
Federal Employees’, Longshore and Harbor Workers’ Compensation
Distribution: All Appropriate DFELHWC Sta!
1
OWCP’s Chief Medical O!icer (CMO) is currently a physician who holds a master’s degree
in public health, and is certified as a specialist by the American Board of Preventive
Medicine. The CMO is trained in disease prevention and control, risk assessment, risk
management, and risk communication, and has extensive experience protecting military
and civilian personnel from infectious disease, occupational injury, and environmental
hazards.
2 See FECA Procedure Manual 1-0400-4. If the case is administratively closed for payment
of expenses up to $1500, a letter is sent to the employee/claimant with his/her claim

number providing information on how to access case information and how to submit
documentation and medical reports in the event that medical bills are expected to exceed
the established threshold (which would necessitate the case be reopened for formal
adjudication by claims sta!).
3
If COVID-19 is contracted during a single workday or shi", and therefore meets the
definition of a traumatic injury (see 20 CFR 10.5(ee)), COP is payable. Since the date and
time of transmission may not always be known due to the nature of the virus, OWCP
DFELHWC will use the date of last exposure prior to the medical evidence establishing the
COVID-19 diagnosis as the date of injury.
Issue Date: October 22, 2020
Subject: Telemedicine for Routine Appointments
Background: The Health Resources and Services Administration (HRSA) of the U.S.
Department of Health and Human Services (HHS) defines telehealth as “the use of
electronic information and telecommunications technologies to support and promote
long-distance clinical health care, patient and professional health-related education, and
public health and health administration.”1
Under the Federal Employees' Compensation Act (FECA), the Department of Labor's (DOL)
O!ice of Workers' Compensation Programs (OWCP) may provide to an employee injured
while in the performance of duty, the services, appliances, and supplies prescribed or
compensation." See 5 U.S.C. 8103.
While the FECA program has previously allowed telehealth services, in accordance with
the discretion granted to DOL and delegated to OWCP, the FECA program is instituting a
new policy concerning telehealth services available to employees receiving medical
benefits under the FECA.
The FECA program is fully aware that some treating physicians or providers may be
constrained in their ability to practice telemedicine by the requirements of either state law
or their licensing authorities.  The FECA program does not have the authority to
countermand or absolve physicians of their responsibility to follow those requirements,
and recognizes that such requirements must be observed by the physicians to whom they
apply. This includes the requirement that the physician must be physically located in the
same state as the claimant’s residence while providing telemedicine (or must be licensed
to practice medicine in the state where the claimant resides).
Telemedicine is optional, not required.
Purpose: To provide the FECA approved telehealth services and establish how telehealth
services must be submitted for reimbursement.
Applicability: All FECA personnel and medical providers.
Reference: Federal (FECA) Procedure Manual, Part 5 Benefit Payments and Part 3 Medical,
Chapter 3-0300 Authorizing Examination and Treatment, and Chapter 3-0400 Medical
Services and Supplies. 20 C.F.R. § 10.300; 20 C.F.R. § 10.304; 20 C.F.R. § 10.310; 20 C.F.R. §
10.335.
Action:
1. In accordance with FECA regulations, policies and procedures, authorized

providers may provide routine medical care through telemedicine (when that
care is associated directly with one or more accepted conditions), without pre-
authorization. This includes physical and occupational therapy. Some services
may still require authorization in accordance with FECA procedures, but there is
no specific pre-authorization required to provide the service via telehealth.
2. A provider may choose to conduct a routine medical appointment utilizing

telemedicine options (including phone, video conferencing or similar
technologies as permitted by state law) which the provider believes will provide
the most appropriate medical benefit to the claimant. The provider should
conduct telemedicine in private settings, such as a physician in a clinic or o!ice
connecting to a patient who is at home or at another clinic. Providers should
carefully observe privacy precautions and use private locations; claimants
should not receive telemedicine services in any other setting without the
claimant’s consent. In the exercise of their professional judgment, the provider
may determine that, to best meet the medical needs of the claimant, the
telemedicine appointment may be facilitated by a medical professional on site
with the claimant. In these circumstances, the physician may have a Registered
Nurse (RN), Advanced Practice Nurse Practitioner (APNP), or Physician Assistant
(PA) present with the claimant during the telemedicine appointment. If a field
nurse is assigned to the case, the nurse may participate telephonically in the
appointment.
3. There are a limited number of services approved by the FECA program that can
be provided through telemedicine. Covered telehealth services are analogous
with services payable by the Centers for Medicare & Medicaid Services (CMS)
but are not inclusive of all CMS approved services. The FECA program may
consider updates based on future needs of the program. See attachment.
4. Provider types eligible to be reimbursed for telehealth services in the FECA

program are limited to: 25 Physician, 32 Psychologist (with Specialty type 42 for
psychiatrists), 77 Social Worker, 28 Chiropractor, 72 Occupational Therapist,
and 71 Physical Therapist. Eligible provider types may be modified based on
future needs of the program.
5. Providers should bill utilizing appropriate modifiers, billing codes, and the
claimant’s address as the location of delivery of the medical care if applicable.
OWCP recognizes modifiers GT (via interactive audio and video

telecommunications systems), GQ (via an asynchronous telecommunications
system), and 95 (synchronous telemedicine service rendered via a real-time
interactive audio and video telecommunications system) as required billing
code modifiers for telehealth services. Providers should use the most
appropriate place of service (POS) when billing. For telemedicine or home
services the following POS should be used: 12 - Patient home (if the claimant is
located at home during the visit).
6. If other appropriate medical professionals participated in the telemedicine

appointment, then they may bill using non-telemedicine billing codes
appropriate to their visit in the home as long as they were not already in the
home for another authorized, billable service.
7. Along with the bill for services, the provider must provide the following
information when the bill is submitted for payment:
a) Appointment Notes that articulate the method of telemedicine that the
provider employed and the length of visit (prolonged services in physical
condition cases should be rare);
b) Any vitals or medical evidence collected;
c) An outline of the medical need and the benefit derived from the
appointment, as it relates to the claimant’s accepted condition(s); and
d) The additional contents of the notes should comport with the FECA
Regulations set forth at 20 C.F.R. § 10.330.
8. OWCP sta! will conduct reviews of this documentation to monitor and verify
that the requirements for payment were met. If discrepancies are identified,
they will work with the provider to overcome issues prior to initiating
recoupment of payments made or other action.
Disposition: This bulletin is e!ective 10/30/20 and is to be retained until incorporated into
the FECA Procedure Manual.
ANTONIO RIOS
Director for
Division of Federal Employees', Longshore and Harbor Workers' Compensation
1
https://www.hhs.gov/hipaa/for-professionals/faq/3015/what-is-telehealth/index.html
Attachment to Bulletin 21-02:

There are a limited number of services covered under Telehealth for FECA. This table lists
the CPT/ HCPCS codes that can be billed for telehealth.
LIST OF ALLOWABLE TELEHEALTH SERVICES

Code Description
90785 Psytx complex interactive
90791 Psych diagnostic evaluation
90792 Psych diag eval w/med srvcs
90832 Psytx w pt 30 minutes
90833 Psytx w pt w e/m 30 min
90839 Psytx crisis initial 60 min
90840 Psytx crisis ea addl 30 min
90847 Family psytx w/pt 50 min
96136 Psycl/nrpsyc tst phy/qhp 1s
97110 Therapeutic exercises
97112 Neuromusulcar reeducation
97116 Gait training therapy
97161 PT Eval low complex 20 min
97162 PT Eval mod complex 30 min
97163 PT Eval high complex 45 min
97164 PT re-eval est plan care
97165 OT eval low complex 30 min
97166 OT eval mod complen 45 min
97167 OT eval high complex 60 min
97168 OT re-eval est plan care
97530 Therapeutic activities
97535 Self care mngment training
97542 Wheelchair mngment training
97750 Physical Performance Test
97755 Assistive Technology Assess
97760 Orthotic mgmt&traing 1st en
97761 Prosthetic traing 1st enc
99201 O!ice/outpatient visit new
99211 O!ice/outpatient visit est
99232 Subsequent hospital care
99354 Prolong e&m/psyctx serv o/p
99367 Medical Team Conference
99421 Online digital e&m 5–10 min
99422 Online digital e&m 11-20 min
99423 Online digital e&m 21 or more min
99441 Phone e/m phys/qhp 5-10 min
99443 Phone e/m phys/qhp 21or more min
99080 Special Reports
G0508 Crit care telehea consult 60
Q3014 Telehealth originating site facility fee
Issue Date: February 18, 2021
Subject: Compensation Pay - Consumer Price Index (CPI) Cost-of-Living Adjustments.
Purpose: To furnish information on the CPI adjustment process for March 1, 2021.
The cost-of-living adjustments granted to a compensation recipient under the FECA are
based on the “Consumer Price Index for Urban Wage Earners and Clerical Workers” (CPI-W)
figures published by the Bureau of Labor Statistics (BLS). The annual cost of living increase
is calculated by comparing the base month from the prior year to the base month of the
current year, with the percentage of increase adjusted to the nearest one-tenth of 1
percent. 5 U.S.C. §8146(a) establishes the base month for the FECA CPI as December.
December 2019 had a CPI-W level of 250.452 and the December 2020 level was reported by
BLS as 254.081. This means that the new CPI increase, adjusted to the nearest one-tenth of
one percent, is 1.4 percent. The increase is e!ective March 1, 2021, and is applicable where
disability or death occurred before March 1, 2020. In addition, the new base month for
calculating the future CPI is December 2020.
The maximum compensation rates1 , which must not be exceeded, are as follows:
$8,974.88 per month

$8,284.52 each four weeks
$2,071.13 per week
$414.23 per day (for a 5 day week)
Applicability: Appropriate FECA Program personnel.
Reference: FECA Consumer Price Index (CPI) Amendment, dated January 6, 1981; Bureau
of Labor Statistics Consumer Price Index Publication for December 2020 (USDL-21-0024).
Action: National O!ice Production will update the iFECS CPI tables and recalculate all
payment records when the iFECS system is not in use by O!ice personnel. The March 26,
2021 will be the first check paid at the 2021 rate.
Please note that if there are any cases with fixed gross overrides, those cases must be
reviewed to determine if CPI adjustment is necessary. If so, a manual calculation will be
required. If the gross override payment is in fact eligible for annual CPI increases, the
payment plate should be adjusted in the iFECS system to pay as a “Gross Override with
CPI.”
1. CPI Minimum and Maximum Adjustments Listings. Form CA-841, Cost-of-Living

Adjustments; Form CA-842, Minimum Compensation Rates; and Form CA-843,
Maximum Compensation Rates, should be updated to indicate the increase for
2021. Attached to this directive is a complete list of all the CPI increases and
e!ective dates since October 1, 1966 through March 1, 2022, for reference.
2. Verification of Compensation. If claimants write or call for verification of the

amount of compensation paid (possibly for mortgage verification; insurance
verification; loan application; etc.), please continue to provide this data in letter
form from the district o!ice. Many times a Benefit Statement may not reach the
addressee and regeneration of the form is not possible. A letter indicating the
amount of compensation paid every four weeks will be an adequate substitute
for this purpose.
Disposition: This Bulletin is to be retained in Part 5, Benefit Payments, Federal (FECA)

Procedure Manual, until further notice or the indicated expiration date.
ANTONIO RIOS
Director for
Attachment: Cost of Living Adjustments
Distribution: All FECA Program Sta!
1 Per 2021 General Schedule (Base) 2021 General Schedule (Base).
ATTACHMENT TO FECA BULLETIN NO. 21-03
COST-OF-LIVING ADJUSTMENTS
Under 5 USC §8146(a)
EFFECTIVE DATE RATE EFFECTIVE DATE RATE
10/01/66 12.5% 03/01/90 4.50%
01/01/68 3.7% 03/01/91 6.1%
12/01/68 4.0% 03/01/92 2.8%
09/01/69 4.4% 03/01/93 2.5%
03/01/94 2.5%
06/01/70 4.4% 03/01/95 2.7%
03/01/71 4.0% 03/01/96 2.5%
05/01/72 3.9% 03/01/97 3.3%
06/01/73 4.8% 03/01/98 1.5%
01/01/74 5.2% 03/01/99 1.6%
07/01/74 5.3%
11/01/74 6.3% 03/01/00 2.8%
06/01/75 4.1% 03/01/01 3.3%
01/01/76 4.4% 03/01/02 1.3%
11/01/76 4.0% 03/01/03 2.4%
07/01/77 4.9% 03/01/04 1.6%
05/01/78 5.3% 03/01/05 3.4%
11/01/78 4.9% 03/01/06 3.5%
05/01/79 5.5% 03/01/07 2.4%
10/01/79 5.6% 03/01/08 4.3%
03/01/09 0.0%
04/01/80 7.2%
09/01/80 4.0% 03/01/10 3.4%
03/01/81 3.6% 03/01/11 1.7%
03/01/82 8.7% 03/01/12 3.2%
03/01/83 3.9% 03/01/13 1.7%
03/01/84 3.3% 03/01/14 1.5%
03/01/85 3.5% 03/01/15 0.3%
03/01/86 N/A 03/01/16 0.4%
03/01/87 0.7% 03/01/17 2.0%
03/01/88 4.5% 03/01/18 2.2%
03/01/89 4.4% 03/01/19 1.8%
03/01/20 2.3%
03/01/21 1.4%
Prior to September 7, 1974, the new compensation a"er adding the CPI is rounded to the
nearest $1.00 on a monthly basis or the nearest multiple of $.23 on a weekly basis ($.23,
$.46, $.69, or $.92). A"er September 7, 1974, the new compensation a"er adding the CPI is
rounded to the nearest $1.00 on a monthly basis or the nearest $.25 on a weekly basis
($.25, $.50, $.75, or $1.00).
New compensation rates
Prior to 09/07/74 E!. 11/1/74
.08-.34 = .23 .13-.37 = .25
.35-.57 = .46 .38-.62 = .50
.58-.80 = .69 .63-.87 = .75
.81-.07 = .92 .88-.12 = 1.00
Back to Table of Contents
Subject: Compensation Pay: Compensation Rate Changes for 2021.
Background: On December 31, 2020, the President signed an Executive Order increasing
General Schedule basic pay rates for 2021.
Reference: 2021 General Schedule (Base).
Purpose: To inform the appropriate personnel of the minimum/maximum rates of

compensation under the Federal Employees’ Compensation Act for a!ected cases on the
periodic disability and death payrolls.
The maximum compensation rate payable is based on the scheduled salary of a GS-15,
Step 10 of $143,598 per annum. The basis for the minimum compensation rate of $22,194
is the salary of a GS-2, Step 1. The actual rates are outlined below.
E!ective January 3, 2021
Type Minimum Maximum
Weekly $320.11 $2,071.13
Daily (5-day week) $64.02 $414.23
28-Day Cycle $1,280.43 $8,284.52
Monthly $1,849.50 $8,974.88
Action: The Integrated Federal Employees’ Compensation System (iFECS) was updated
with the rate changes for the periodic disability and death payrolls.
Applicability: Appropriate National and District O!ice personnel
Disposition: This bulletin is to be retained in Part 5, Benefit Payments, Federal (FECA)

Procedure Manual, until the indicated expiration date.
Antonio Rios
Director for
Distribution: All FECA Sta!
Back to FECA Bulletins Table of Contents

February 18, 2021
Subject: Payment authorization on reimbursements exceeding $50,000
Purpose: This circular is being issued to modify the authorization process for medical
reimbursements exceeding $50,000.
Authority: Under the Federal Employees’ Compensation Act (FECA), the O!ice of Workers'
Compensation Programs (OWCP) may provide to an employee injured while in the
performance of duty, the services, appliances, and supplies prescribed or recommended
by a qualified physician, which OWCP considers "likely to cure, give relief, reduce the
degree or the period of disability, or aid in lessening the amount of the monthly
compensation."
The below protocols supersede the reimbursement authorization process outlined in the
FECA Procedure Manual, 5-202(15) and 5-202(16).
Action: Reimbursements exceeding $50,000 will no longer be forwarded to a District

Director (DD) or designee for review. Authorizations will be made by the Chief or Assistant
Chief of the Branch of Fiscal Operations or the National Director of Field Operations.
Reimbursements exceeding $50,000, including cases involving special indicators such as

COVID-19 cases (COR), may also be reviewed by the Chief of the Branch of Program
Integrity and/or the Deputy Director for Program Systems and Integrity in addition to the
personnel listed above.
Antonio Rios
Director for
Distribution: All FECA Sta!

March 3, 2021
Subject: Revised Process for Converting Federal Employees’ Compensation Act (FECA)
Paper Cases into Fully Imaged O!icial Case Records
Background: In FY 2000, the then Division of Federal Employees’ Compensation (DFEC)1

which was responsible for administering the FECA program, one of the four programs
within OWCP, deployed a new imaging system, the OWCP Automated System for Imaging
Services (OASIS). All documents received by OWCP for the FECA program from that point
forward were captured and stored only electronically for FECA cases. On February 21,
2001, the OWCP issued Bulletin 01-01, OASIS - Retention Schedule for Paper Documents.
This bulletin outlined procedures for the destruction of documents that had been scanned
into the FECA electronic file. On May 5, 2010, the OWCP issued Bulletin 10-01, Converting
DFEC Paper Cases into Fully Imaged O!icial Case Records, which outlined procedures for
converting paper files that were created prior to the deployment of imaging into fully
imaged files and the resultant destruction of the paper components of the case files a"er
conversion. In February 2002, the FECA program no longer added documents to any of the
Paper Cases, instead scanning all incoming mail into the imaging system, and thus
creating a cohort of Hybrid Case Files, which is a partially imaged record with the FECA
program maintaining all paper files and documents received prior to that date.
Since that time, the district o!ices have converted many paper case file components into
imaged documents, thereby creating a fully imaged record. Cases have been fully imaged
for various reasons, including but not limited to the following: ease of management, prior
to transferring a case to the Employees' Compensation Appeals Board (ECAB) or Branch of
Hearings and Review (BHR), Improper Payment Audits and prior to referring a case for a
referee examination (see FECA Bulletin 05-01, Medical Exams/IME: Security of Case
Records During the Referral Process).
Reference: OWCP Procedure Manual Chapter 1-0300
Purpose: To notify O!ices of a change in the protocols and process for separating and
audit requirements for paper case files that are converted to electronic cases records in
order to fully image the remaining 52,000 case records currently maintained in the district
o!ices.
Applicability: Claims Examiners, All Claims Supervisors, Medical Schedulers, District

Medical Directors, Technical Assistants, System Managers, Sta! Nurses, and Vocational
Rehabilitation Specialists, OWCP Contractors
Action: New Protocol for Converting Paper Cases into Fully Imaged O!icial Case Records
1. The following new protocol will apply to any cases scanned for Backfile
Conversion, Privacy Act responses, MBE cases, and for BHR. It will not apply to
cases currently being scanned for ECAB or Improper Payment audits, or cases
subject to a Litigation Hold. The latter are to be maintained until the hold is
release.
2. The following forms in the paper case file must be imaged as distinct electronic
documents viewable in the imaged case file and properly indexed.
Forms CA1, CA2, CA-2a, CA-5, CA-6, CA-7, 7a’s, 7b’s, CA-8
3. Acceptance Letters, Forms and all Formal Decisions in the paper case file must
be imaged as distinct electronic documents viewable in the imaged case file
and properly indexed.
4. All other documents will be imaged together as one document in the same
order as they are in the Paper Case Record and indexed as Misc./Converted
Case Record.
5. The received date for all other documents not listed in Action Item Four (4) will
be 2/1/2002 (This is the date that OWCP/FECA stopped adding paper to existing
files and began the creation of hybrid case records).
6. An audit of documents within the paper case file is required to help verify that
all documents have been properly associated with the electronic case record,
that the documents have been properly categorized, and that the imaged
documents are of an acceptable quality. Two percent of all documents must be
sampled from the paper case file. In addition to the random sample all of the
following documents must also be verified as appropriately imaged and
indexed: Forms CA1, CA2, CA-2a, CA-5, CA-6, CA-7, 7a’s, 7b’s, CA-8.
7. The person(s) assigned to perform the audit must be documented in the record.
8. Once the case file has been completely imaged and audited for accuracy, the
District Director or designee must take the following steps:
a) Change the Fully Imaged indicator in iFECS to "Y"
b) Image a copy of the Fully Imaged Case Memo (See Attachment 1)
c) Index this memo as MISC/Fully Imaged Memo
9. A"er these actions have been taken, the electronic record will then be classified
as the o!icial case record for that case.
10. The paper case file must be retained for no less than seven (7) work days from
the date the case file was fully converted to electronic images and the
instructions in Section 8 completed. If no problems arise during this period, the
paper case documents may be destroyed a"er the end of the seven (7) work
day period.
Disposition: This Bulletin is to be retained until incorporated into Part 1 of the OWCP
Procedure Manual.
ANTONIO RIOS
Director for
Distribution: All FECA Program Sta! and Contractors
1 In FY 2020, the FECA program and the Longshore program were combined into a new
division called Division of Federal Employees, Longshore and Harbor Workers’

Compensation (DFELHWC)

March 9, 2021
Subject: New FECA Pharmacy Benefits Management System
Purpose: To announce the implementation of a Pharmacy Benefits Management (PBM)

System by the O!ice of Workers' Compensation's (OWCP) Division of Federal Employees',
Longshore and Harbor Workers’ Compensation for the Federal Employees’ Compensation
Act (FECA) program.
Background: Pharmacy benefit managers are third-party administrators (TPA) of

prescription drug programs for commercial health plans, self-insured employer plans,
Federal and State government employee health plans. PBMs are primarily responsible for
developing and maintaining formularies which include an approved listing of
prescriptions, contracting with pharmacies to increase enrollment, negotiating discounts
and rebates with drug manufacturers and processing and paying prescription drug claims.
In accordance with 5 U.S.C. 8103 and 20 C.F.R. 10.809, OWCP has contracted with Optum to
serve as FECA’s PBM for claimants covered under the FECA. OWCP’s FECA PBM will be
responsible for pharmaceutical transactions including implementation of FECA eligibility
determinations and pricing for pharmaceutical drugs provided to FECA claimants. All
FECA claimants will be required to use the OWCP FECA PBM for prescribed drugs;
otherwise, payment of drugs will not be authorized at the pharmacy. The PBM will pay
network pharmacies directly and then seek reimbursement for those payments from
FECA’s Employees’ Compensation Fund.
The FECA PBM will also be phasing in an optional Durable Medical Equipment (DME) and
diagnostic testing component.
Actions: PBM implementation will be accomplished in a phased approach. In order to

receive pharmacy benefits, injured workers must present their new pharmacy cards to a
participating pharmacy along with prescriptions for their accepted, work-related
condition(s). A listing of participating pharmacies can be found on the internet at
www.ecomp.dol.gov. Further assistance in locating or verifying a participating pharmacy
or transferring a prescription can be obtained by contacting Optum at 1-833-FECA-PBM.
1. Optum/FECA pharmacy cards and welcome letters will be mailed to current
FECA claimants in multiple groupings. Due to urgent safety concerns, welcome

packets will first be mailed by April 1, 2021, to claimants who have been
prescribed opioids with daily dosages exceeding the 90 MED (Morphine
Equivalent Dose). Pharmacy Cards and welcome letters for the remainder of the
FECA claimants will first be mailed by April 30, 2021. All Pharmacy cards will
include a Bank Identification Number (BIN), the date the cards become
e!ective, a PBM toll-free number for information, as well as claimant-specific
information. Once the FECA PBM is phased in, use of an employing agency
pharmacy (PBM) program is no longer permissible.
2. Additional phases are estimated to be deployed over the next several months of
Fiscal Year 2021, and will include the development and implementation of a (1)
formulary management system (2) user interface for pharmacy authorization
transmittals (3) utilization review programs (4) DME and diagnostic testing
programs along with other programs to assist FECA claimants and FECA
program sta!. Subsequent FECA Bulletins containing the details of those
phases will be issued once those phases are ready for deployment.
3. Additional information and updates will be posted on the FECA website and
provided to the subscriber list references on the FECA website.
ANTONIO RIOS
Director for
Distribution: All DFELHWC Sta!

March 26, 2021
Subject: Telemedicine for Routine Appointments – Updated
This Bulletin supersedes FECA Bulletin 21-02
On October 22, 2020, the Division of Federal Employees', Longshore and Harbor Workers'
Compensation – Federal Employees’ Compensation Act (FECA) Program published FECA
Bulletin No. 21-02 (Telemedicine for Routine Appointments) to outline FECA’s telehealth
policy. Since that date, FECA’s Program Integrity Unit (PIU) has reviewed billing data to
evaluate compliance. Based on those findings, the FECA program is making minor updates
to the existing policy.
1. The following codes are being added as payable telehealth services since the
PIU determined these codes are necessary and/or customary for treatment of
work-related injuries:
96130 PSYCL TST EVAL PHYS/QHP 1ST
96131 PSYCL TST EVAL PHYS/QHP EA
96132 NRPSYC TST EVAL PHYS/QHP 1ST
96133 NRPSYC TST EVAL PHYS/QHP EA
96137 PSYCL/NRPSYC TST EVAL PHYS/QHP EA
96138 PSYCL/NRPSYC TECH 1ST
S9999 Sales Tax (as required by law e.g. HI)
2. The following CPT codes are being removed:

99421 online digital evaluation - 5-10 minutes
99422 online digital evaluation - 11-20 minutes
99423 online digital evaluation - 21 or more minutes
The PIU determined they were incorrectly added during the initial policy
implementation, were not billed at all as telehealth services since policy
implementation in October 2020, and there are other covered codes that could
be used for services.
3. Two additional provider types are being approved for telehealth services:
Podiatrists
Insurance Company (Third Party Carriers) if the originating provider type
and procedure codes are within established policy
4. Requirements for telehealth medical reports (to include the length of visit) are
being emphasized since some reports reviewed by the PIU were determined to
be insu!icient.
For ease of use, FECA is re-publishing the contents of FECA Bulletin 21-02 in its entirety
with the above updates incorporated as part of this Bulletin
The e!ective date for the new policy is March 27, 2021.
Background (from Bulletin No. 21-02):
The Health Resources and Services Administration (HRSA) of the U.S. Department of
Health and Human Services (HHS) defines telehealth as “the use of electronic information
and telecommunications technologies to support and promote long-distance clinical
health care, patient and professional health-related education, and public health and
health administration.”1
Under the Federal Employees' Compensation Act (FECA), the Department of Labor's (DOL)
O!ice of Workers' Compensation Programs (OWCP) may provide to an employee injured
while in the performance of duty, the services, appliances, and supplies prescribed or
compensation." See 5 U.S.C. 8103.
While the FECA program has previously allowed telehealth services, in accordance with
the discretion granted to DOL and delegated to OWCP, the FECA program is instituting a
new policy concerning telehealth services available to employees receiving medical
benefits under the FECA.
The FECA program is fully aware that some treating physicians or providers may be
constrained in their ability to practice telemedicine by the requirements of either state law
or their licensing authorities.  The FECA program does not have the authority to
countermand or absolve physicians of their responsibility to follow those requirements,
and recognizes that such requirements must be observed by the physicians to whom they
apply. This includes the requirement that the physician must be physically located in the
same state as the claimant’s residence while providing telemedicine (or must be licensed
to practice medicine in the state where the claimant resides).
Telemedicine is optional, not required.
Purpose: To provide the FECA approved telehealth services and establish how telehealth
services must be submitted for reimbursement.
Applicability: All FECA personnel and medical providers.
Reference: Federal (FECA) Procedure Manual, Part 5 Benefit Payments and Part 3 Medical,
Chapter 3-0300 Authorizing Examination and Treatment, and Chapter 3-0400 Medical
Services and Supplies. 20 C.F.R. § 10.300; 20 C.F.R. § 10.304; 20 C.F.R. § 10.310; 20 C.F.R. §
10.335.
Action (Revised and Updated from Bulletin No. 21-02):
1. In accordance with FECA regulations, policies and procedures, authorized

providers may provide routine medical care through telemedicine (when that
care is associated directly with one or more accepted conditions), without pre-
authorization. This includes physical and occupational therapy. Some services
may still require authorization in accordance with FECA procedures, but there is
no specific pre-authorization required to provide the service via telehealth.
2. A provider may choose to conduct a routine medical appointment utilizing
telemedicine options (including phone, video conferencing or similar
technologies as permitted by state law) which the provider believes will provide
the most appropriate medical benefit to the claimant. The provider should
conduct telemedicine in private settings, such as a physician in a clinic or o!ice
connecting to a patient who is at home or at another clinic. Providers should
carefully observe privacy precautions and use private locations; claimants
should not receive telemedicine services in any other setting without the
claimant’s consent. In the exercise of their professional judgment, the provider

may determine that, to best meet the medical needs of the claimant, the
telemedicine appointment may be facilitated by a medical professional on site
with the claimant. In these circumstances, the physician may have a Registered
Nurse (RN), Advanced Practice Nurse Practitioner (APNP), or Physician Assistant
(PA) present with the claimant during the telemedicine appointment. If a field
nurse is assigned to the case, the nurse may participate telephonically in the
appointment.
3. There are a limited number of services approved by the FECA program that can
be provided through telemedicine. Covered telehealth services are analogous
with services payable by the Centers for Medicare & Medicaid Services (CMS)
but are not inclusive of all CMS approved services. The FECA program may
consider updates based on future needs of the program. See attached “List of
Allowable Telehealth Services”.
4. Provider types eligible to be reimbursed for telehealth services in the FECA
program are limited to: 25 Physician, 32 Psychologist (with Specialty type 42 for
psychiatrists), 77 Social Worker, 28 Chiropractor, 27 Podiatrist, 72 Occupational
Therapist, 71 Physical Therapist, and 95 Insurance Company (Third Party
Carriers), if the originating provider type and procedure codes are within
established policy. Eligible provider types may be modified based on future
needs of the program.
5. Providers should bill utilizing appropriate modifiers, billing codes, and the
claimant’s address as the location of delivery of the medical care if applicable.
OWCP recognizes modifiers GT (via interactive audio and video
telecommunications systems), GQ (via an asynchronous telecommunications
system), and 95 (synchronous telemedicine service rendered via a real-time
interactive audio and video telecommunications system) as required billing
code modifiers for telehealth services. Providers should use the most
appropriate place of service (POS) when billing. For telemedicine or home
services the following POS should be used: 12 - Patient home (if the claimant is
located at home during the visit).
6. If other appropriate medical professionals participated in the telemedicine
appointment, then they may bill using non-telemedicine billing codes
appropriate to their visit in the home as long as they were not already in the
home for another authorized, billable service.
7. Along with the bill for services, the provider must provide the following
information when the bill is submitted for payment:
a) Appointment Notes that articulate the method of telemedicine that the
provider employed and the length of visit (prolonged services in physical
condition cases should be rare)
Including the length of the visit is required as this allows the FECA
Program the ability to verify that the services provided have been
accurately reported and billed;
b) Any vitals or medical evidence collected;
c) An outline of the medical need and the benefit derived from the
appointment, as it relates to the claimant’s accepted condition(s); and
d) The additional contents of the notes should comport with the FECA
Regulations set forth at 20 C.F.R. § 10.330.
8. OWCP sta! will conduct reviews of this documentation to monitor and verify
that the requirements for payment were met. If discrepancies are identified,
they will work with the provider to overcome issues prior to initiating
recoupment of payments made or other action.
Disposition: This bulletin is e!ective March 27, 2021 and is to be retained until
incorporated into the FECA Procedure Manual.
ANTONIO RIOS
Director for
1
https://www.hhs.gov/hipaa/for-professionals/faq/3015/what-is-telehealth/index.html
Attachment to Bulletin 21-08:

There are a limited number of services covered under Telehealth for FECA. This table lists
the CPT/ HCPCS codes that can be billed for telehealth.
Code Description
90785 Psytx complex interactive
90791 Psych diagnostic evaluation
90792 Psych diag eval w/med srvcs
90839 Psytx crisis initial 60 min
90840 Psytx crisis ea addl 30 min
90847 Family psytx w/pt 50 min
96130 PSYCL TST EVAL PHYS/QHP 1ST
96131 PSYCL TST EVAL PHYS/QHP EA
96132 NRPSYC TST EVAL PHYS/QHP 1ST
96133 NRPSYC TST EVAL PHYS/QHP EA
96136 Psycl/nrpsyc tst phy/qhp 1s
96137 PSYCL/NRPSYC TST EVAL PHYS/QHP EA
96138 PSYCL/NRPSYC TECH 1ST
97110 Therapeutic exercises
97112 Neuromusulcar reeducation
97116 Gait training therapy
97161 PT Eval low complex 20 min
97162 PT Eval mod complex 30 min
97163 PT Eval high complex 45 min
97164 PT re-eval est plan care
97165 OT eval low complex 30 min
97166 OT eval mod complen 45 min
97167 OT eval high complex 60 min
97168 OT re-eval est plan care
97530 Therapeutic activities
97535 Self care mngment training
97542 Wheelchair mngment training
97750 Physical Performance Test
97755 Assistive Technology Assess
97760 Orthotic mgmt&traing 1st en
97761 Prosthetic traing 1st enc
99232 Subsequent hospital care
99367 Medical Team Conference
99443 Phone e/m phys/qhp 21or more min
99080 Special Reports
G0508 Crit care telehea consult 60
Q3014 Telehealth originating site facility fee
FECA BULLETIN NO. 21-09 April 28, 2021
Subject: Processing FECA Claims for COVID-19 under the American Rescue Plan Act of
2021
Compensation (DFELHWC) administers the FECA. The FECA provides to an employee
injured while in the performance of duty, the services, appliances, and supplies prescribed
or recommended by a qualified physician, which OWCP considers "likely to cure, give
relief, reduce the degree or the period of disability, or aid in lessening the amount of the
monthly compensation." See 5 U.S.C. 8103. The FECA pays compensation for the disability
or death of an employee resulting from injury in the performance of duty.
On March 11, 2021, the American Rescue Plan Act of 2021 (ARPA) was signed into law. This
new legislation streamlines the process for federal workers diagnosed with COVID-19 to
establish coverage under the FECA. Specifically, Section 4016 of the ARPA provides that a
“covered employee” as defined below shall, with respect to any claim made by or on
behalf of the covered employee for benefits under the FECA, be deemed to have an injury
proximately caused by exposure to COVID-19 arising out of the nature of the covered
employee’s employment.
Under Section 4016 of the ARPA, the term “covered employee” means an individual:
Who is an employee under Section 8101(1) of title 5, United States Code,

employed in the Federal service at any time during the period beginning on
January 27, 2020, and ending on January 27, 2023;
Who is diagnosed with COVID–19 during such period; and
Who, during a covered exposure period prior to such diagnosis, carries out
duties that—
require contact with patients, members of the public, or co-workers; or
include a risk of exposure to the novel coronavirus.
Previously, COVID-19 claims under the FECA were processed under the guidelines provided
by FECA Bulletin No. 20-05 (released March 31, 2020) and FECA Bulletin No. 21-01 (released
October 21, 2020). This Bulletin supersedes FECA Bulletins 20-05 and 21-01.
With respect to all COVID-19 cases processed under the ARPA, no benefits are payable a"er
September 30, 2030. This statutory limitation on benefits does not apply to COVID-19
claims accepted prior to March 12, 2021.
Purpose: To provide guidance regarding the processing of COVID-19 FECA claims as set
forth in the ARPA.
Actions:
I. Cases Processed Prior to the American Rescue Plan Act of 2021.
1. Previously Accepted Cases. Any COVID-19 claim filed under the FECA that was
accepted for COVID-19 prior to March 12, 2021 is not impacted because
coverage for benefits had already been extended. Any case accepted on or
before March 11, 2021 (the date of enactment) is not an ARPA case; such cases
are not subject to Section 4016’s limitation that no benefits may be paid a"er
September 30, 2030.
2. Previously Denied Cases. The FECA program will review all COVID-19 claims
previously denied based on a lack of federal exposure or a lack of medical
evidence establishing causal relationship to determine if the claim can now be
accepted under the ARPA. This will occur without a request from the claimant. If
the FECA program determines that the case can now be accepted under the
ARPA, the case will be reopened under the Director’s own motion under Section
8128(a) of the FECA, and the case will be accepted. If this occurs, the claimant
and Employing agency will be notified. The case will be converted to a “19”
prefix case and the C19 indicator will be added as addressed in paragraph III
below.
3. Previously Administratively Closed Cases. No action will be taken based on

the ARPA on COVID-19 cases already administratively closed. The claimant
remains eligible for Continuation of Pay (COP) pursuant to 20 CFR 10.205 - 224,
if Form CA-1 was timely filed, and medical bills for basic treatment incurred for
COVID-19, to include any testing, are still payable up to $1500. However, any
future actions, if necessary, will be taken in accordance with the ARPA since the
claim had not been formally accepted, so each of these cases has been
converted to a “19” prefix case, and the C19 indicator will be added as
addressed in paragraph III below.
II. Filing of Cases under the American Rescue Plan Act of 2021
1. Form Filing Process. The Employees’ Compensation and Management Portal

(ECOMP) should be used to file new claims as the form filing process in ECOMP
has been updated to assist claimants and employing agencies with filing claims
for COVID-19 on a CA-1.
2. Use of the CA-1. The FECA program considers COVID-19 to be a traumatic injury
since it is contracted during a single workday or shi" (see 20 CFR 10.5(ee)), and
considers the date of last exposure prior to the medical evidence establishing
the COVID-19 diagnosis as the Date of Injury since the precise time of
transmission may not always be known due to the nature of the virus.
3. Update to the CA-1 in ECOMP. To assist the FECA Program with collecting
necessary information to make determinations under the ARPA, the claimant
and agency are provided with specific instructions that are intended to
supplement the routine claim filing questions. These instructions are
documented in the attachment to this Bulletin.
III. Creation of Cases under the American Rescue Plan Act of 2021
1. Creation and Administrative Closure of Cases. Consistent with PM 1-0400.4,

cases not expected to involve large medical expenses or extended disability
may be administratively closed without formal adjudication by claims sta!.
COVID-19 cases filed under the ARPA will administratively close like other cases,
and assignment of Triage Nurses will occur using the same criteria as other
cases.
2. Nature of Injury, Cause of Injury and Location of Injury Codes. All cases filed
a"er March 11, 2021 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)
3. Case Indicator. For COVID-19 claims filed a"er March 11, 2021, a new internal
special tracking indicator (C19 – COVID-19) will be assigned. This replaces the
previous indicator (COR). Cases received on and prior to March 11, 2021 that
were pending adjudication will have their case indicator changed from COR to
C19.
4. Case Prefix. All cases filed a"er March 11, 2021 for COVID-19 will have a prefix
“19” rather than the current prefix “55” used in other new FECA claims. Cases
received on or prior to March 11, 2021, that were pending adjudication will have
their case number changed such that the prefix is “19.”
5. Case Number Conversion Notification. In all instances where a case number is

changed to a “19” prefix, regardless of the reason, a letter will be sent to the
claimant and agency notifying them of the change.
IV. Case Adjudication Procedures under the American Rescue Plan Act of 2021
1. Employee. The claims examiner should make a determination as to whether

the employee is an employee under 5 U.S.C. 8101(1) of the FECA and whether
he or she was diagnosed with COVID-19 (in accordance with paragraph 2 below)
between January 27, 2020, and January 27, 2023. If it is determined that the
employee was an employee under Section 8101(1) but diagnosed with COVID-
19 outside of the period of January 27, 2020, through January 27, 2023, routine
FECA case handling procedures apply.
Individuals otherwise covered under FECA but not covered under Section
8101(1) of title 5, United States Code are not covered under the ARPA and
routine FECA case handling procedures apply. Examples include state or local
law enforcement o!icers not employed by the United States who are covered
under 5 U.S.C. 8191-8193.
2. Diagnosis of COVID-19. In order to establish a diagnosis of COVID-19, an

employee (or survivor) should submit:
a. A positive Polymerase Chain Reaction (PCR) COVID-19 test result; or
b. A positive Antibody or Antigen COVID-19 test result, together with

contemporaneous medical evidence that the claimant had documented
symptoms of and/or was treated for COVID-19 by a physician (a notice to
quarantine is not su!icient if there was no evidence of illness); or
c. 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.
In certain rare instances, a physician may provide a rationalized opinion

with supporting factual and medical background as to why the employee
has a diagnosis of COVID-19 notwithstanding a negative or series of negative
COVID-19 test results.
Medical reports from nurses or physician assistants are acceptable if a licensed

physician cosigns the report.
3. Covered Exposure. The employee is deemed to have had exposure if, during
the covered exposure period, he or she carries out (1) duties that require a
physical interaction with at least one other person (a patient, a member of the
public, or a co-worker) in the course of employment duties, or (2) duties that
otherwise include a risk of exposure to COVID-19. The interaction does not have
to be direct physical contact. Nor is there a specified time for such interaction,
any duration qualifies. General o!ice contact and interaction is su!icient. This
includes but is not limited to interaction in shared workspaces such as

lunchrooms, break areas and common restrooms.
4. Covered Exposure Period. The evidence should establish manifestation of

COVID-19 symptoms (or positive test result) within 21 days of the covered
exposure described in paragraph 3 above.
Existing medical literature suggests that the incubation period of COVID-19 is

between two and 14 days; however, the use of 21 days acknowledges an
employee’s potential delay in seeking professional medical evaluation and
treatment.
5. Teleworking Employees. An employee that is exclusively teleworking during a

covered exposure period is not considered a “covered employee” under the
ARPA. For such cases, routine FECA case handling procedures apply.
6. Adjudication and Disposition of Claims.
a. Claim Acceptances: If, following any appropriate development, the

evidence establishes that the employee meets the definition of “covered
employee” under Section 4016 of the ARPA, the employee’s COVID-19 will be
deemed proximately caused by Federal employment and the claim will be
accepted for COVID-19.
b. Claim Denials: If, following appropriate development, the evidence fails

to establish that the employee was diagnosed with COVID-19, the claim will
generally be denied on that basis. If, following appropriate development,
the evidence fails to establish any covered exposure during a covered
exposure period as defined in paragraphs 1, 3, 4 and 5 above, the claim will
generally be denied based upon the failure to establish exposure to COVID-
19 occurred in the performance of Federal employment.
d. Withdrawal of Claim: Certain COVID-19 claims may have been filed

preventatively for exposure only, due to quarantine, or otherwise filed
prematurely. In such circumstances, an employee may decide not to pursue
his or her claim. A claimant may withdraw his or her claim in writing (but
not the notice of injury) at any time before OWCP determines eligibility for
benefits. See 20 CFR 10.100 (b)(3). However, any COP granted to an
employee a"er a claim is withdrawn must be charged to sick or annual
leave, or considered an overpayment of pay consistent with 5 U.S.C. 5584, at
the employee's option.
7. Duplicate Claims. Generally, a claim for COVID-19 will not be considered a new
injury unless the date of injury is more than 1 year from the date of injury of any
prior accepted COVID-19 claim for the same employee. Rather it will be
combined with the existing claim and developed as necessary as a

consequential or recurrence claim.
8. Claims for Disability. The ARPA outlines the criteria to determine whether
COVID-19 is deemed proximately caused by federal employment. However,
acceptance of the claim for work-related COVID-19 does not alter the claimant’s
burden of proof for establishing disability, the need for ongoing medical
treatment and any claim for a consequential condition. See PM 2-0901.5(a)(2).
9. Death Claims. The criteria to determine whether COVID-19 is deemed

proximately caused by federal employment are the same for claims involving
death. However, in death cases, the FECA program will also 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. This will typically include hospital
records showing treatment, a hospital death discharge summary detailing the
cause of death, and/or a death certificate but may also include other
documentation depending on the circumstances of the case.
V. Non-Chargeable Flag
In accordance with Section 4016(d) of the American Rescue Plan Act of 2021, all cases
flagged as an ARPA case with the “19” prefix will be flagged as non-chargeable in the FECA
database, meaning it will not be included in annual chargeback billing.
Disposition: This Bulletin is to be retained until incorporated into the FECA Procedure
Manual.
ANTONIO RIOS
Director for
Distribution: All DFELHWC – FECA Program Sta!
Attachment: CA-1 ECOMP Prompts for COVID-19 Claims under the ARPA
Attachment to FECA Bulletin 21-09

CA-1 ECOMP Prompts for COVID-19 Claims under the ARPA
A. Claimant Portion of the CA-1. Upon selecting to file a new claim in ECOMP, the
claimant is provided a new option to file a COVID specific CA-1. If they choose this option,
the following prompts will supplement the routine process:
1. Date and Time Injury Occurred. The claimant is asked about the last date he
or she was exposed to others in the work setting prior to the onset of COVID-19
symptoms or a positive COVID-19 test result.
2. Cause of Injury. The claimant is asked to explain what individuals he or she
was exposed to in the workplace and the nature and extent of the
interaction(s).
3. Nature of Injury. The claimant is asked to explain symptoms related to COVID-
19, whether he or she has received a positive test result for COVID-19 and
whether he or she has consulted with a medical professional.
4. Upload Attachments Option. The claimant is asked specifically to upload a
copy of a COVID-19 positive test result and any documentation of interactions
with a medical professional.
B. Supervisor Portion of the CA-1. In COVID-19 claims, agencies are provided with
specific questions that deviate from the routine process as outlined below:
1. Performance of Duty (POD). The employing agency is advised to only indicate

the employee is not in POD if the employee was not working or was teleworking
on the date of injury, or if the supervisor disagrees substantively with the
employee’s description of injury.
2. Third Party Liability. The answer to this question will default to no third party
liability for COVID-19 cases.
3. Anatomical Location, Nature of Injury, Cause of Injury. These responses will

be automatically filled in accordance with the codes in section III, part 2 of this
Bulletin.
4. Agreement with the Employee. The employing agency will be advised to only
indicate “no” if the employee was not working or was teleworking on the date
of injury, or if the supervisor disagrees substantively with the employee’s
description of injury.
5. Controversion of COP. The employing agency will be advised to only

controvert COP if one of the specific nine regulatory reasons applies. That
reason must be selected and explained.
6. CA-16. The employing agency is prompted to provide a CA-16 if they do not

substantively dispute the employee’s description of Cause and Nature of Injury,
and if the claim was submitted within 1 week of the Date of Injury, or the date
the employee had symptoms of COVID-19 or received a positive test result.
Issuing the CA-16 will allow the claimant to obtain the necessary test to confirm
COVID-19 and receive medical treatment, if indicated.
FECA BULLETIN NO. 21-10 August 18, 2021
Subject: Establishing FECA Claims for COVID-19 under the American Rescue Plan Act
of 2021 through Antigen Testing
Compensation (DFELHWC) administers the FECA. The FECA provides to an employee
injured while in the performance of duty, the services, appliances, and supplies prescribed
or recommended by a qualified physician, which OWCP considers "likely to cure, give
relief, reduce the degree or the period of disability, or aid in lessening the amount of the
monthly compensation." See 5 U.S.C. 8103. The FECA pays compensation for the disability
or death of an employee resulting from injury in the performance of duty.
On March 11, 2021, the American Rescue Plan Act of 2021 (ARPA) was signed into law. This
new legislation streamlined the process for federal workers diagnosed with COVID-19 to
establish coverage under the FECA.
On April 28, 2021, the FECA Program issued FECA Bulletin 21-09, which provided detailed
processing procedures for claims for COVID-19 filed under the ARPA.
FECA Bulletin 21-09 provided that, in order to establish a diagnosis of COVID-19, an

employee (or survivor) should submit:
a. A positive Polymerase Chain Reaction (PCR) COVID-19 test result; or
b. A positive Antibody or Antigen COVID-19 test result, together with contemporaneous

medical evidence that the claimant had documented symptoms of and/or was treated
for COVID-19 by a physician (a notice to quarantine is not su!icient if there was no
evidence of illness); or
c. 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.
In certain rare instances, a physician may provide a rationalized opinion with

supporting factual and medical background as to why the employee has a diagnosis of
COVID-19 notwithstanding a negative or series of negative COVID-19 test results.
Antigen tests detect specific proteins on the surface of the coronavirus. They are
sometimes referred to as rapid diagnostic tests because it can take less than an hour to get
the test results. Positive antigen test results are highly specific, meaning that if you test
positive you are very likely to be infected.1
As antigen testing has become more prevalent over the course of the COVID-19 pandemic,
the FECA Program will no longer require contemporaneous medical evidence submitted
together with an antigen test to establish the diagnosis of COVID-19. Submission of an
antigen test alone is now su!icient to establish the medical component of a COVID-19
claim.
Purpose: To provide amended guidance regarding the processing of COVID-19 FECA

claims as set forth in the ARPA.
Actions:
1. Diagnosis of COVID-19. With respect to Case Adjudication procedures under the ARPA,
the following diagnostic criteria now apply:
In order to establish a diagnosis of COVID-19, an employee (or survivor) should submit:
a. A positive Polymerase Chain Reaction (PCR) or Antigen COVID-19 test result; or
b. A positive Antibody test result, together with contemporaneous medical evidence

that the claimant had documented symptoms of and/or was treated for COVID-19 by a
physician (a notice to quarantine is not su!icient if there was no evidence of illness); or
c. 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.
In certain rare instances, a physician may provide a rationalized opinion with

supporting factual and medical background as to why the employee has a diagnosis of
COVID-19 notwithstanding a negative or series of negative COVID-19 test results.
Medical reports from nurses or physician assistants are acceptable if a licensed

physician cosigns the report.
2. Previously Denied Cases. The FECA program will review all COVID-19 claims previously
denied in accordance with the guidance provided in FECA Bulletin 21-09 based on the
submission of an antigen test without contemporaneous medical to determine if the claim
can now be accepted. This will occur without a request from the claimant. If the FECA
program determines that the case can now be accepted under the ARPA, the case will be
reopened under the Director's own motion under Section 8128(a) of the FECA, and the
case will be accepted. If this occurs, the claimant and employing agency will be notified.
Disposition: This Bulletin amends FECA Bulletin 21-09 and is to be retained until
incorporated into the FECA Procedure Manual.
--------
1
https://www.health.harvard.edu/diseases-and-conditions/if-youve-been-exposed-to-
the-coronavirus
ANTONIO RIOS
Director for
Distribution: All DFELHWC – FECA Program Sta!
Issue Date: September 1, 2021
Subject: Retention of the American Medical Association's Guides to the Evaluation of

Permanent Impairment, 6th Edition (2009).
Background: The schedule award provisions of the Federal Employees' Compensation Act
(FECA) at 5 U.S.C. 8107 and its implementing regulations at 20 C.F.R. 10.404 establish the
compensation payable to employees sustaining permanent impairment. For consistent
results, and to ensure equal justice under the law to all claimants, good administrative
practice necessitates the use of a single set of tables with uniform standards applicable to
all claimants. The American Medical Association's (AMA) Guides to the Evaluation of
Permanent Impairment has been adopted by the O!ice of Workers' Compensation
Programs (OWCP) FECA Program as the appropriate standard for evaluating schedule
losses. In January 2008, the AMA published the Sixth Edition of the Guides, noting that the
Guides are revised periodically to incorporate current scientific clinical knowledge and
judgment. This Edition implemented substantial reforms to the methodology of
calculating permanent impairment. In accordance with its established practice, the FECA
Program moved forward to this most recent version of the Guides in evaluating permanent
impairment.
In August 2008, a 54-page "Clarifications and Corrections, Sixth Edition, Guides to the
Evaluation of Permanent Impairment" was distributed. The 54-page publication specified
clarifications and corrections to the original printing of the Sixth Edition of the Guides.
Subsequently, the FECA Program adopted this most recent version of the Sixth Edition of
the Guides on March 15, 2009, with an e!ective date of May 1, 2009. See FECA Bulletin 09-
03. The most recent version of the Sixth Edition at that time was the second printing of the
Sixth Edition in 2009, which incorporated the clarifications and corrections which were
published in August 2008.
In April 2021, the AMA announced the commencement of regular updates to the Sixth
Edition of the Guides. In addition, the AMA further reported a transition to a digital
platform and subscription service for the current and all future updates to the Sixth
Edition of the Guides. These updates are to be posted on the AMA Guides Digital Website
approximately three months prior to their e!ective date.
The first update to the Sixth Edition made in accordance with the new AMA policy, AMA
Sixth Edition 2021, was made available on April 1, 2021 and became e!ective on July 1,
2021.
All substantive updates made in the AMA Sixth Edition 2021 relate to mental and
behavioral health conditions, including changes in terminology and methodology related
to the mental and behavioral health content1. As the FECA Program has no statutory or
regulatory authority to provide schedule awards for mental health impairment, the
changes in AMA Sixth Edition 2021, if adopted by the Program, would not have any
significant impact on its schedule award impairment calculations.
As noted above, the FECA Program has been using the Sixth Edition since 2009. In that
time, the Program has worked with its attending physicians, second opinion and referee
physicians, and District Medical Advisors to provide clear, consistent, and accurate
impairment ratings using this version of the Guides Adoption of the AMA Sixth Edition 2021
at this time would place an undue burden on the Program's stakeholders. It would require
the procurement, learning, and understanding of a new and digital edition of the Guides
despite such edition having no material impact on impairment ratings provided under the
FECA.
As such, it is in the best interest of the FECA Program to retain the second printing of the
Sixth Edition (2009) at this time. Future updates of the Guides will continue to be
monitored and updated versions may be adopted depending on their impact on the FECA
Program and alignment with its goal of providing fair and consistent impairment awards
to injured Federal workers.
Purpose: To provide notice that although the Sixth Edition of the AMA Guides have
recently been updated, the FECA Program will be maintaining the use of the second
printing of the Sixth Edition (2009) rather than adopting the latest updated version.
Reference: 5 U.S.C. 8107 and 20 C.F.R. 10.404. This Bulletin supplements the information
contained in the FECA Procedure Manual 3-0700 and 2-0808, as well as FECA Bulletin No.
09-03 and FECA Bulletin No. 17-06.
Action: No change or action is necessary at this time, and the FECA Program will continue
to use the second printing of the Sixth Edition (2009) to evaluate permanent impairment.
Any impairment report in which impairment is assessed using a more recent version of the
Sixth Edition should be returned to the rating physician with instructions to evaluate
impairment under the second printing of the Sixth Edition (2009).
Applicability: Claims Examiners, Quality Assurance and Mentoring Examiners,

Supervisory Claims Examiners, Hearing Representatives, District Medical Advisors, and
Claims Assistants.
Disposition: This Bulletin is to be retained until incorporated unto the FECA Procedure
Manual.
1
https://www.ama-assn.org/delivering-care/ama-guides/ama-guides-sixth-2021-current-
medicine-permanent-impairment-ratings
ANTONIO RIOS
Director for
Distribution: All Appropriate FECA Program Sta!

September 30, 2021
Subject: Release of Privileged Medical Records
Background: The Privacy Act of 1974 provides that federal agencies “establish procedures
for the disclosure to an individual upon his request of his record or information pertaining
to him, including special procedure, if deemed necessary, for the disclosure to an
individual of medical records, including psychological records, pertaining to him.” 5 U.S.C.
552a(f)(3). In accordance with the Privacy Act and the Department’s implementing
regulations, the OWCP Procedure Manual currently provides that where a claimant
requests medical records that discuss psychiatric conditions, the CE should ask the District
Medical Advisor (DMA) whether releasing such information would constitute a danger to
the claimant or others; and if so, the CE should instruct the claimant that the medical
records will instead be provided to the claimant’s treating physician. See OWCP Procedure
Manual, Chapter 1-0400-7(a)(1)(A); see also 29 C.F.R. 71.4(d).
Since establishing this procedure, federal courts have found that the Privacy Act clearly
directs agencies to devise special procedures for disclosure of medical records in cases in
which direct transmission could adversely a!ect a requesting individual, but that these
procedures eventually must lead to disclosure of the records to the requesting individual.
See Bavido v. Apfel, 215 F.3d 743, 748-50 (7th Cir. 2000). Current Department of Justice
(DOJ) guidelines further provide that while agencies have the freedom to promulgate
special procedures to limit potential harm from individual access to medical records,
many courts have held that agency rules for disclosure of medical records may not create,
in e!ect, a new substantive exemption from accessing medical records that would
otherwise be available under the Privacy Act. This bulletin provides revised procedures
consistent with the Privacy Act, case law, and current DOJ guidance.
Reference: OWCP Procedure Manual Chapter 1-0400
Purpose: To provide revised procedures in situations where the FECA Program determines
that release of medical documentation to an injured worker would represent a health or
safety risk to themselves or others.
Applicability: All DFELHWC FECA Program Sta!
Action: The claims examiner (CE) should take the following steps if he or she identifies a
case in which there is an indication that there may be a health or safety risk in allowing a
claimant direct immediate access to his or her medical records. This identification should
be made based on evidence, not accepted condition and could be made in scenarios that
include but are not limited to (1) while reviewing a copy request, (2) while reviewing a
second opinion report or other medical evidence, or (3) while taking a phone call.
Examples of cases that require further review are ones in which the medical evidence
discusses suicidal or homicidal tendencies or the claimant demonstrates threatening
behavior.
In these cases:
1. The CE should provide the case number and recommendation to the Branch of
Regulations and Procedures (R&P) through a designated e-mail address.
2. R&P will review the request and make a final determination.
3. Should R&P disagree with the CE recommendation, the CE will be advised and
no further action is needed. Any pending Privacy Act requests can be processed
in accordance with established procedure.
4. Should R&P agree with the CE determination, the claimant’s case file will be
notated accordingly, and a letter will be issued to the claimant explaining the
determination and their Privacy Act appeal rights. See action item six below.
The letter will advise the claimant that they will be restricted from viewing his
or her medical records in the Employees’ Compensation Operations and
Management Portal (ECOMP). The letter determination will be visible in ECOMP
with a specific category/subject (Outgoing/Medical Records Restricted) so that
the claimant is aware of the reason why no medical records are visible in
ECOMP.
5. If there is a pending Privacy Act or copy request, subsequent actions will
depend on whether the claimant has designated an authorized representative
in accordance with 20 C.F.R. 10.700.
a. If the claimant has a designated authorized representative, a copy of
the requested medical records should instead be provided to the
authorized representative of record. The claimant should be notified and
advised to contact the authorized representative, who will review the
medical records with the claimant and then provide the claimant a copy
of the requested medical records.
b. If the claimant has not designated an authorized representative, the

claimant should be advised that OWCP is unable to release medical
records directly to them due to concerns over the safety of the claimant
and others. Instead, the claimant should be instructed to designate an
individual (such as a physician, health professional, or other responsible
individual) who is willing to receive medical records on the claimant’s
behalf, review them, and then share them with and release them to the
claimant.
6. 6. Should the claimant disagree with the case file access restrictions indicated
in the letter issued pursuant to action item four above, they may file an
administrative appeal to the Solicitor of Labor within 90 days of the date of the
determination, by mail, fax, or email, and in accordance with the specific
requirements set forth in the provided appeal rights. See 29 C.F.R. 71.7.
Disposition: This Bulletin is to be retained until otherwise revised or incorporated into

Part 1 of the OWCP Procedure Manual.
ANTONIO RIOS
Director for
Distribution: All DFELHWC FECA Program Sta!
Issue Date: January 27, 2020
Expiration Date: February 28, 2021
Subject: Compensation Pay - Consumer Price Index (CPI) Cost-of-Living Adjustments.
based on the "Consumer Price Index for Urban Wage Earners and Clerical Workers" (CPI-W)
$8,886.25 per month

$2,050.67 per week
Applicability: Appropriate National O!ice and District O!ice personnel.
of Labor Statistics Consumer Price Index Publication for December 2019 (USDL-20-0044)
Action: National O!ice Production updated the iFECS CPI tables and recalculated all
payment records when the iFECS system was not in use by District O!ice personnel. The
March 28, 2020 will be the first check paid at the 2020 rate.
payment plate should be adjusted in the iFECS system to pay as a "Gross Override with
CPI."

for this purpose.

ANTONIO RIOS
Director for
Federal Employees' Compensation
Distribution: All DFEC Sta!
1 Per for Executive Heads of Departments and Agencies dated December 26, 2019.
10/01/66 12.5% 03/01/90 4.50%
01/01/68 3.7% 03/01/91 6.1%
12/01/68 4.0% 03/01/92 2.8%
09/01/69 4.4% 03/01/93 2.5%
03/01/94 2.5%
06/01/70 4.4% 03/01/95 2.7%
03/01/71 4.0% 03/01/96 2.5%
05/01/72 3.9% 03/01/97 3.3%
06/01/73 4.8% 03/01/98 1.5%
01/01/74 5.2% 03/01/99 1.6%
07/01/74 5.3%
11/01/74 6.3% 03/01/00 2.8%
06/01/75 4.1% 03/01/01 3.3%
01/01/76 4.4% 03/01/02 1.3%
11/01/76 4.0% 03/01/03 2.4%
07/01/77 4.9% 03/01/04 1.6%
05/01/78 5.3% 03/01/05 3.4%
11/01/78 4.9% 03/01/06 3.5%
05/01/79 5.5% 03/01/07 2.4%
10/01/79 5.6% 03/01/08 4.3%
03/01/09 0.0%
04/01/80 7.2%
09/01/80 4.0% 03/01/10 3.4%
03/01/81 3.6% 03/01/11 1.7%
03/01/82 8.7% 03/01/12 3.2%
03/01/83 3.9% 03/01/13 1.7%
03/01/84 3.3% 03/01/14 1.5%
03/01/85 3.5% 03/01/15 0.3%
03/01/86 N/A 03/01/16 0.4%
03/01/87 0.7% 03/01/17 2.0%
03/01/88 4.5% 03/01/18 2.2%
03/01/89 4.4% 03/01/19 1.8%
03/01/20 2.3%
($.25, $.50, $.75, or $1.00).
Prior to 11/1/74 E!. 11/1/74
Prior to 11/1/74 .08-.34 = .23 E!. 11/1/74 .13-.37 = .25
.35-.57 = .46 .38-.62 = .50
.58-.80 = .69 .63-.87 = .75
.81-.07 = .92 .88-.12 = 1.00
ATTACHMENT TO FECA BULLETIN NO. 20 - 01
Back to BCT Table of Contents
Issue Date: January 27, 2020
Expiration Date: January 1, 2021
Subject: Compensation Pay: Compensation Rate Changes for 2020.
Reference: Memorandum for Executive Heads of Departments and Agencies dated

December 26, 2019; and the attachment for the 2020 General Schedule.

compensation for a!ected cases on the periodic disability and death payrolls.
Weekly $316.93 $2,050.67
Daily (5-day week) $63.39 $410.13
28-Day Cycle $1,267.72 $8,202.68
Monthly $1,831.17 $8,886.25
Action: The Integrated Federal Employees' Compensation System (iFECS) will be updated

Antonio Rios
Director for
Back to BCT Table of Contents
Expiration Date: January 1, 2021
Subject: Compensation Pay: Compensation Rate Changes for 2020. This Bulletin
supersedes FECA Bulletin 20-02.
Reference: Memorandum for Executive Heads of Departments and Agencies dated

December 26, 2019; and the attachment for the 2020 General Schedule.

compensation for a!ected cases on the periodic disability and death payrolls.
Weekly $316.92 $2,050.68
Daily (5-day week) $63.38 $410.14
28-Day Cycle $1,267.68 $8,202.72

Monthly $1,831.09 $8,886.28
Action: The Integrated Federal Employees' Compensation System (iFECS) will be updated

Antonio Rios
Director for
Expiration Date: February 28, 2021
Subject: Compensation Pay - Consumer Price Index (CPI) Cost-of-Living Adjustments. This
Bulletin supersedes FECA Bulletin 20-01.
based on the "Consumer Price Index for Urban Wage Earners and Clerical Workers" (CPI-W)
$8,886.28 per month

$2,050.68 per week
of Labor Statistics Consumer Price Index Publication for December 2019 (USDL-20-0044)
Action: National O!ice Production updated the iFECS CPI tables and recalculated all
payment records when the iFECS system was not in use by District O!ice personnel. The
March 28, 2020 will be the first check paid at the 2020 rate.
payment plate should be adjusted in the iFECS system to pay as a "Gross Override with
CPI."

for this purpose.

ANTONIO RIOS
Director for
1
Per for Executive Heads of Departments and Agencies dated December 26, 2019.
10/01/66 12.5% 03/01/90 4.50%
01/01/68 3.7% 03/01/91 6.1%
12/01/68 4.0% 03/01/92 2.8%
09/01/69 4.4% 03/01/93 2.5%
03/01/94 2.5%
06/01/70 4.4% 03/01/95 2.7%
03/01/71 4.0% 03/01/96 2.5%
05/01/72 3.9% 03/01/97 3.3%
06/01/73 4.8% 03/01/98 1.5%
01/01/74 5.2% 03/01/99 1.6%
07/01/74 5.3%
11/01/74 6.3% 03/01/00 2.8%
06/01/75 4.1% 03/01/01 3.3%
01/01/76 4.4% 03/01/02 1.3%
11/01/76 4.0% 03/01/03 2.4%
07/01/77 4.9% 03/01/04 1.6%
05/01/78 5.3% 03/01/05 3.4%
11/01/78 4.9% 03/01/06 3.5%
05/01/79 5.5% 03/01/07 2.4%
10/01/79 5.6% 03/01/08 4.3%
03/01/09 0.0%
04/01/80 7.2%
09/01/80 4.0% 03/01/10 3.4%
03/01/81 3.6% 03/01/11 1.7%
03/01/82 8.7% 03/01/12 3.2%
03/01/83 3.9% 03/01/13 1.7%
03/01/84 3.3% 03/01/14 1.5%
03/01/85 3.5% 03/01/15 0.3%
03/01/86 N/A 03/01/16 0.4%
03/01/87 0.7% 03/01/17 2.0%
03/01/88 4.5% 03/01/18 2.2%
03/01/89 4.4% 03/01/19 1.8%
03/01/20 2.3%
($.25, $.50, $.75, or $1.00).
Prior to 11/1/74 E!. 11/1/74
Prior to 11/1/74 .08-.34 = .23 E!. 11/1/74 .13-.37 = .25
.35-.57 = .46 .38-.62 = .50
.58-.80 = .69 .63-.87 = .75
.81-.07 = .92 .88-.12 = 1.00
ATTACHMENT TO FECA BULLETIN NO. 20 - 04
Issue Date: March 31, 2020
Subject: Federal Employees Contracting COVID-19 in Performance oF Duty
Programs (OWCP) Division of Federal Employees' Compensation (DFEC) provides to an
employee injured while in the performance of duty, the services, appliances, and supplies
prescribed or recommended by a qualified physician, which OWCP considers "likely to
cure, give relief, reduce the degree or the period of disability, or aid in lessening the
amount of the monthly compensation." See 5 U.S.C. 8103. FECA pays compensation for
disability or death of an employee resulting from injury in the performance of duty.
While all federal employees who contract COVID-19 related to their federal employment
are entitled to FECA coverage, special case handling considerations apply to those
employees engaged in high-risk employment. In the case of COVID-19, federal employees
who are required to have in-person and close proximity interactions with the public on a
frequent basis – such as members of law enforcement, first responders, and front-line
medical and public health personnel – will be considered to be in high-risk employment
triggering the application of Chapter 2-0805-6 of the FECA Procedure Manual. In such
cases, there is an implicit recognition of a higher likelihood of infection related to such
federal employment. OWCP DFEC recognizes that certain kinds of employment routinely
present situations that may lead to infection by contact with sneezes, droplet infection,
bodily secretions, and surfaces on which the COVID-19 virus may reside. Conditions such
as COVID-19 (like the diseases covered in Chapter 2-0805-6) more commonly represent a
work hazard in health care facilities, correctional institutions, and drug treatment centers,
among others. The employment-related incidence of COVID-19 appears more likely to
occur among members of law enforcement, first responders, and front-line medical and
public health personnel, and among those whose employment causes them to come into
direct and frequent in-person and close proximity contact with the public.
DOL has created new procedures to specifically address COVID-19 claims. Employees filing
a claim for workers' compensation coverage as a result of COVID-19 should file Form CA-1,
Federal Employee's Notice of Traumatic Injury and Claim for Continuation of
Pay/Compensation. The new procedures will also call the adjudicator's attention to the
type of employment held by the employee, rather than burdening the employee with
identifying the exact day or time they contracted the novel coronavirus.
Purpose: To provide targeted instructions to claims sta! on the handling of COVID-19

FECA claims by federal employees.
Action:
1. A special indicator has been assigned to all COVID-19 claims. The indicator is
available for input in the Employees' Compensation and Management Portal
(ECOMP) or can be added by case-create clerks where the form is received on
paper or by fax. However, where the indicator is not included (such as in cases
where the agency uses its own electronic data interchange (EDI) system or
where the agency did not elect to use the indicator available in ECOMP), claims
examiners should alert their District Director that the COVID-19 indicator must
be added.
2. An OWCP DFEC COVID-19 Task Force has been created to help ensure cases are
handled expeditiously in a fair and consistent manner. The Task Force will
review all COVID-19 claims development and adjudications.
3. EXPOSURE FROM HIGH-RISK EMPLOYMENT: If a COVID-19 claim is filed by a
person in high-risk employment (by job category or otherwise confirmed by the
employer1), OWCP DFEC will accept that the exposure to COVID-19 was
proximately caused by the nature of the employment. If the employer supports
the claim and that the exposure occurred, and the CA-1 is filed within 30 days,
the employee is eligible to receive Continuation of Pay for up to 45 days.
4. EXPOSURE FROM OTHER EMPLOYMENT: If a COVID-19 claim is filed by a person
whose position is not considered high-risk, OWCP DFEC will require the
claimant to provide a factual statement and any available evidence concerning
exposure. The employing agency will also be expected to provide OWCP DFEC
with any information they have regarding the alleged exposure, and to indicate
whether they are supporting or controverting the claim. If the employer
supports the claim, including that the exposure occurred, and the CA-1 is filed
within 30 days, the employee is eligible to receive Continuation of Pay for up to
45 days.
5. TESTING: The results of any COVID-19 testing should be submitted to OWCP if
available. If the employee has encountered di!iculty in obtaining such testing,
OWCP will authorize such testing if the employee is working in high-risk
employment or otherwise has a confirmed COVID-19 employment exposure.
6. MEDICAL: Medical evidence establishing a diagnosis of COVID-19 is needed. You
will need to provide medical evidence establishing that the diagnosed COVID-
19 was aggravated, accelerated, precipitated, or directly caused by your work-
related activities. For health and safety reasons, claimants may wish to use
telehealth to obtain medical evidence from a qualified physician – OWCP
encourages this flexibility.
7. CAUSAL RELATIONSHIP: Establishing causal relationship generally requires a
qualified physician's opinion, based on a reasonable degree of medical
certainty, that the diagnosed condition is causally related to employment
conditions. This opinion must be based on a complete factual and medical
background. In the case of high-risk employment, the factual and medical
background would include the physician's recognition that the employee is
engaged in high-risk employment that included exposure to COVID-19 while in
federal employment. See D.M. (T.M.) Docket No. 19-0358 (issued March 19, 2020)
(ECAB found the employee's death due to meningococcemia was causally
related to her high-risk employment as a nurse at the employing establishment,
as her employment routinely presented situations which could lead to infection
by contact with human blood, bodily secretions, and other substances.)
8. USE OF THE DISTRICT MEDICAL ADVISOR (DMA): In the case of high-risk
employment where testing establishes a diagnosis of COVID-19 but no
physician's signature is on file following appropriate development, the CE may
use the DMA to establish the diagnosis and provide the above-referenced
recognition that the employee is engaged in high-risk employment that

included exposure to COVID-19 while in federal employment.
9. DISABILITY: FECA pays compensation for partial or total disability of an
employee resulting from injury in the performance of duty. Just as with other
conditions/claims, disability is claimed by the filing of a CA-7, Claim for
Compensation, with the employing agency and requires an incapacity because
of an employment-related injury to earn wages.
1 A real-time list of occupational codes and/or job series, including the geographic
locations where the high-risk determination has been flagged by the agency, will be
available to OWCP sta! to assist OWCP's determination that the position falls within that
category.
Applicability: Appropriate National and District O!ice personnel.
Disposition: This bulletin is to be retained until incorporated into the Procedure Manual.
ANTONIO RIOS
Director for
Issue Date: June 5, 2020
Subject: Change in collection procedures for debt owed to the Division of Federal
Employees' Compensation (DFEC).
Background: 20 CFR §10.441(b) provides that when an overpayment has been made to an
individual who is not entitled to further payments, the individual shall refund to the O!ice
of Workers' Compensation (OWCP) the amount of the overpayment as soon as the error is
discovered or his or her attention is called to the same.
The overpayment is subject to the provisions of the Federal Claims Collection Act of 1966
(as amended), 31 U.S.C. §§ 3701-3720A, and may be reported to the Internal Revenue
Service as income. If the individual fails to make such refund and the overpayment cannot
be recovered from continuing compensation, the OWCP may recover the debt through any
available means, including o!set of salary, annuity benefits, or other Federal payments,
including tax refunds as authorized by the Tax Refund O!set Program, or referral of the
debt to a collection agency or to the Department of Justice.
Previously, if DFEC could not recover an overpayment from continuing compensation or

through similar, alternative means, the debtor was required to submit a paper check by
mail.
If a payment was not received in response to the Final Overpayment Determination, DFEC
sta! issued demand letters and referred the debt to the Treasury for collection, when
appropriate.
Reference: 5 U.S. C. § 8129, 31 U.S.C. §§ 3701-3720A, 20 C.F.R. §10.441, Chapter 6-0100,

Introduction and Chapter 6-0500, Debt Liquidation, Part 6, Debt Management, Federal
(FECA) Procedure Manual.
Action:
1. Once a Final Overpayment Determination has been issued to a debtor, and

recovery cannot be made from continuing compensation payments, DFEC sta!
will refer the debt and a copy of the decision to National O!ice for submission
to Treasury's Centralized Receivable Service (CRS). CRS will collect payments on
behalf of the program and pursue collection actions including referrals for
Cross Servicing.
2. Payments received through CRS will be posted to the account via the debt
management application in the integrated Federal Employees' Compensation
System (iFECS).
Disposition: This bulletin should be retained until incorporated into Chapter 6-0500, Debt
Liquidation, of the FECA Procedure Manual.
ANTONIO RIOS
Director for
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FECA Bulletins (2020-2024) | U.S.

Department of Labor 10/18/21, 1:17 PM

U.S. DEPARTMENT OF LABOR

O!ice of Workers' Compensation Programs Search OWCP

Division of Federal Employees'

2022, 2021, 2020

Fiscal Year 2022

Back to FECA Bulletins (2020-2024) Table of Contents

Fiscal Year 2021

FECA Bulletin No. 21-02 Telemedicine for Routine Appointments

FECA Bulletin No. 21-05 Payment authorization on reimbursements exceeding

FECA Bulletin No. 21-08 Telemedicine for Routine Appointments – Updated

FECA Bulletin No. 21-12 Release of Privileged Medical Records

Back to FECA Bulletins (2020-2024) Table of Contents

Fiscal Year 2020

FECA Bulletin No. 20-05 Federal Employees Contracting COVID-19 in Performance

FECA BULLETIN NO. 22-01

Background: On September 9, 2021, President Biden issued an executive order

Further, deleterious e!ects of medical services furnished by the employing establishment

Applicability: All FECA Program Sta! and Other Stakeholders.

1. Because COVID-19 vaccination is a specific event occurring during a single day or

a. If an employing agency requires employees to receive their mandatory vaccination

b. If any employing agency allows employees to obtain their mandatory vaccination

Distribution: All FECA Program Sta!

Back to Top of FECA Bulletin No. 22-01

Back to FECA Bulletins (2020-2024) Table of Contents

FECA BULLETIN NO. 21-01

Issue Date: October 21, 2020

Purpose: To provide additional guidance regarding special case handling of COVID-19

A. High-Risk Employment Determinations by Position

1. To make high-risk determinations by position, OWCP must first make a factual

B. High-Risk Employment Determinations by Case Specific Facts

C. All Other Determinations

D. Additional Development and Adjudication of Claims

1. Medical Development. The claimant/employee will be asked to submit the laboratory

1. If the claimant/employee requests an extension;

1. The employee requests a formal decision; or

claim, which includes the existence of a causal relationship between an

Applicability: Appropriate National and District O!ice personnel.

Distribution: All Appropriate DFELHWC Sta!

of expenses up to $1500, a letter is sent to the employee/claimant with his/her claim

Back to Top of FECA Bulletin No. 21-01

Back to FECA Bulletins (2020-2024) Table of Contents

FECA BULLETIN NO. 21-02

Issue Date: October 22, 2020

Subject: Telemedicine for Routine Appointments

Telemedicine is optional, not required.

Applicability: All FECA personnel and medical providers.

1. In accordance with FECA regulations, policies and procedures, authorized

2. A provider may choose to conduct a routine medical appointment utilizing

4. Provider types eligible to be reimbursed for telehealth services in the FECA

OWCP recognizes modifiers GT (via interactive audio and video

6. If other appropriate medical professionals participated in the telemedicine

b) Any vitals or medical evidence collected;

Attachment to Bulletin 21-02:

LIST OF ALLOWABLE TELEHEALTH SERVICES

LIST OF ALLOWABLE TELEHEALTH SERVICES

90785 Psytx complex interactive

90791 Psych diagnostic evaluation

90792 Psych diag eval w/med srvcs

90832 Psytx w pt 30 minutes