Periodic wage-loss payments are WC. These payments are normally two-thirds of the previous wages, but if the number holder (NH) has one or more dependents, the payment rises to three-quarters of the previous wage. Offset DIB using the entire gross FECA payment, whether paid at the two-thirds amount or the three-quarters amount. DOL pays short-term FECA benefits weekly and long-term FECA benefits every 28 days. To determine the monthly equivalent, follow Determining the Workers’ Compensation/Public Disability Benefit (WC/PDB) Amount Used to Compute Offset instructions in DI 52150.035C.

Since it is not always possible to determine how long the injury or illness will prevent the NH from working, many FECA cases begin with weekly payments and progress to 28-day long-term disability payments.

FECA schedule awards are offsettable WC payments that compensate NHs for the work-related loss of, or loss of use of, one or more body parts. Schedule awards are not paid simultaneously with regular wage-loss payments for the same injury. These awards begin once maximum medical improvement has occurred for the body part involved. FECA schedule awards pay WC for a statutory number of weeks depending on the body part(s) affected. For example, may allot 46 weeks for a pointer finger or 312 weeks for an arm.

Schedule awards not paid simultaneously with regular wage-loss payments can continue while the NH receives a disability retirement pension under the Civil Service Retirement System (CSRS) or the Federal Employee Retirement System (FERS). We consider both the CSRS and FERS payments as federal public disability benefits (PDBs). Therefore, it is possible for PDB offset and WC offset to apply if the claimant receives both FECA (WC) and a CSRS or FERS disability retirement pension (PDBs).

DOL pays schedule awards without regard to loss of earning capacity. The NH can actually receive a schedule award after going back to work even if the work is in the previous employment.

Disfigurement payments compensate NHs whose injury causes permanent damage to the head, face, or neck. FECA disfigurement is a separate, offsettable award of up to $3,500.00.

VR may pay up to $200.00 monthly but usually paid in addition to WC. Therefore, it is rarely subject to offset. For VR payment offset rules, see DI 52110.005 Vocational Rehabilitation (VR) Payments.

FECA payments may decrease in the following situations:

• •

  The only dependent child, spouse, or parent no longer qualifies as a dependent;

• •

  The NH reenters the workforce or is able to reenter the workforce at a lower salary than prior to becoming disabled; or

• •

  The NH refuses to work after progressing through VR to the point that suitable work is identified. (DOL then reduces FECA payments by the amount the NH would have earned.)

FECA payments may increase in the following situations:

• •

  FECA cost-of-living adjustments (for additional information, see DI 52115.010D in this section);

• •

  A qualifying dependent child, spouse, or parent becomes entitled on the NH’s record;

• •

  Payments previously reduced due to a work attempt are no longer reduced when the NH becomes unable to work.

FECA payments may require suspension in the following situations:

• •

  NH fails to comply with a specific request from OWCP (failure to attend a medical exam, for example) or fails to respond to requests for information; or

• •

  NH confined due to the conviction of a felony.

See NOTE regarding suspension and termination of FECA in DI 52115.010C.4. in this section below.

FECA payments may terminate when the NH:

• •

  dies;

• •

  returns to work with no loss of wages;

• •

  is no longer medically disabled;

• •

  refuses to work when medically able to;

• •

  quits a job for other than medical reasons;

• •

  never suffered any work-related injury (i.e., if there is a disability, investigation reveals it is not work-related);

• •

  refuses to file a third-party lawsuit related to the work injury when compelled by the government to do so; or

• •

  is guilty of fraud in connection with the WC claim.

NOTE: If DOL suspends or terminates FECA, take into consideration the reason for suspension or termination; and whether it affects title II (DIB). For example, if the NH’s FECA terminates for work activity, it may be substantial gainful activity (SGA) for DIB purposes.

All PCs have a limited number of employees with access to DOL’s Agency Query System (AQS). AQS is an online tool containing payment records for NHs receiving WC FECA benefits. AQS displays the gross payment amounts needed to apply offset. However, AQS access is not available for every case.

Information from online access is a third-party report. Third-party reports that result in adverse actions require advance due process notification prior to DIB benefit reduction. For due process notice information, see NOTE in DI 52115.010D in this section.

Consult your PC’s local procedures to route requests for FECA verification to the PC personnel with designated AQS access.

NOTE: Field offices (FOs) do not have access to AQS.

If you cannot obtain proof from the NH:

1. a. 

   Follow the guidelines for DOL mail contact shown in DI 52115.010F in this section.

2. b. 

   Establish a tickle date for 35 days.

3. c. 

   If no response is received in 35 days, contact the DFEC district office by telephone following instructions in DI 52115.010F in this section.

4. d. 

   When you receive the requested proof, review the master beneficiary record (MBR) and the electronic record for any necessary adjustments.

   NOTE: Proof from DOL is a third-party report. Third-party reports that result in adverse actions require advance due process notification prior to DIB benefit reduction. For due process notice information, see the NOTE in DI 52115.010D in this section.

5. e. 

   Retain the FECA proof following Retention of Workers’ Compensation/Public Disability Benefit (WC/PDB) Proofs procedure in DI 52145.015.

If the NH is unable to provide proof and information is not available from the online access described in DI 52115.010E.1. in this section; follow DOL mail contact guidelines in DI 52115.010F.2.f. in this section, and take the following actions:

1. a. 

   Set a diary for 35 days for receipt of proof from DOL.

2. b. 

   When the diary matures, check for any paper and paperless responses from DOL. Check all pending and closed actions to be sure the proof is not attached to another ACR or set up under an incorrect type of event level (TOEL) code.

3. c. 

   If you receive a response that contains only net amounts or is otherwise inadequate, follow telephone contact instructions with DFEC district office per DI 52115.010F.3. in this section.

4. d. 

   If you do not receive a response, send another written request for information to DOL as described in DI 52115.010F.2. in this section. Indicate the mailing date of the first request. Write “Second Request” in red at the top of the form and mail the form to the same address.

5. e. 

   Set a diary for another 35 days.

6. f. 

   When the diary matures, check for any paper and paperless responses from DOL. Check all pending and closed actions to be sure the proof is not with another ACR or set up under an incorrect TOEL.

7. g. 

   If you do not receive a response, the response contains only net amounts or is otherwise inadequate, contact the DFEC district office by following the instructions for telephone contact in DI 52115.010F.3. in this section.

8. h. 

   Once you receive documentation proof, review the MBR and the electronic record for possible necessary adjustments. The proof from DOL is a third-party report. Third-party reports that result in adverse actions require advance due process notification prior to DIB benefit reduction. For notice information, see Notices Required Before and After Taking a Title II Adverse Action in GN 03001.015, and Due Process Notice to Disabled Number Holder (NH) in NL 00703.511.

9. i. 

   Provide due process, if necessary, then process any needed adjustment action. Retain all FECA proof per Retention of Workers’ Compensation/Public Disability Benefit (WC/PDB) Proofs instructions in DI 52145.015.

10. j. 

    Set a stand-alone diary for the following March to develop changes and adjust benefits for the FECA COLA.

The DOL claim number for FECA payments is a nine-digit number that begins with a two-digit code separated from the other seven digits by a hyphen (e.g., 01-2345678). The first two digits identify the DOL district office that handled the claim. If the worker relocates, the originating office retains jurisdiction. Include the DOL claim number and the Social Security Number (SSN) on any correspondence sent to DOL. If the DOL claim number on our records is incorrect, they may be able to use the SSN to access the information.

Take the following actions to request proof from DOL:

1. a. 

   Submit all initial requests for information in writing. Generally, DOL does not respond to faxed requests. Do not send a fax unless DOL requests that you do so.

2. b. 

   Use Form SSA-1709 (Request for Workers’ Compensation/Public Disability Benefit Information) or local version of the DOL Information Request Form.

3. c. 

   Complete and date the form.

4. d. 

   If you need extensive information, request a complete history for the period(s) involved.

5. e. 

   In the PC, scan the completed form into the paperless system and add to the ACR. If working with a paper folder, scan the document with the TOEL code of “FILE WC” and prong-file a copy in the folder.

6. f. 

   Mail requests to:

   U.S. Department of Labor
   DFEC Central Mailroom
   P.O. Box 8300
   London, KY 40742-8300

DOL scans the requests into a database and then forwards electronically to the appropriate DFEC district office for their action.

If you do not receive a timely response, contact the appropriate DFEC office at the phone numbers listed on the United States Department of Labor, Office of Workers’ Compensation Programs (OWCP), DFEC website.

Contact the office servicing the state where the NH resides or, if different, the state where the injury took place. Use the public contact number, not the Director’s office number. DFEC needs the DOL claim number and the claimant’s name. Identify yourself as a representative from the Social Security Administration (SSA). Explain that we need proof of the gross FECA payment before any deductions, and that we previously requested this information in writing. DFEC should advise when to expect the proof.

Sometimes a DOL representative will ask for written permission from the NH before releasing any information to SSA. This authorization is unnecessary. If the DOL representative insists on the authorization, notify the appropriate regional office (RO) or PC WC analyst, using proper channels. The RO or PC analyst notifies the Office of Income Security Programs, Office of Applications and Electronic Services Support Policy (OISP/OAESP) WC analyst, who then contacts DOL to resolve the issue.