ELM Revision: Injury Compensation Program – Effective June 26, 2014

oig_injury_compensation

Effective June 26, 2014, the Postal Service™ is revising the Employee and Labor Relations Manual (ELM) subchap­ter 5, due to the following:

  • In January 2013, the Department of Labor/Office of Workers’ Compensation Programs (DOL/OWCP) updated its website that included injury compensa­tion basic forms which are required to record and report a work-related injury.
  • ELM section 541.3, Forms needs to be revised to reduce the risk of inaccurate information or employee actions that could potentially result in negative legal, contractual, or other business consequences to the Postal Service.

* * * * *

Employee and Labor Relations Manual (ELM)

* * * * *

5 Employee Benefits

* * * * *

540 Injury Compensation Program

* * * * *

541 Overview

* * * * *

541.3 Forms

[Revise the text and table of 541.3 to read as follows:]

Each installation head/Health & Resource Management office must maintain an adequate supply of the following basic forms, which are needed for recording and reporting injuries.

Form

Title

CA-1

Federal Employee’s Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation

CA-2

Notice of Occupational Disease and Claim for Compensation

CA-2a

Notice of Recurrence

CA-5

Claim for Compensation by Widow, Widower, and/or Children

CA-5b

Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren

CA-6

Official Superior’s Report of Employee’s Death

CA-7

Claim for Compensation

CA-7a

Time Analysis Form

CA-7b

Leave Buy-Back (LBB) Worksheet/Certification and Election

CA-10

What a Federal Employee Should Do When Injured at Work

CA-16

Authorization for Examination and/or Treatment

CA-17

Duty Status Report

CA-20

Attending Physician’s Report

CA-35A

Evidence Required in Support of a Claim for Occupational Disease

CA-35B

Evidence Required in Support of a Claim for Work-Related Hearing Loss

CA-35C

Evidence Required in Support of a Claim for Asbestos-Related Illness

CA-35D

Evidence Required in Support of a Claim for Work-Related Coronary/Vascular Condition

CA-35E

Evidence Required in Support of a Claim for Work-Related Skin Disease

CA-35F

Evidence Required in Support of a Claim for Work-Related Pulmonary Illness (not asbestosis)

CA-35G

Evidence Required in Support of a Claim for Work-Related Psychiatric Illness

CA-35H

Evidence Required in Support of a Claim for Carpal Tunnel Syndrome

HCFA-1500

Health Insurance Claim Form

OWCP-915

Claim For Medical Reimbursement

PUB WHD 1420

Employee Rights and Responsibilities Under the Family and Medical Leave Act

PS Form 2488

Authorization for Medical Report

PS Form 2573

Request — OWCP Claim Status

Injury Compensation and Medical Services, Employee Resource Management, 6-26-14

via ELM Revision: Injury Compensation Program.

Leave a Reply

Required fields are marked *