2003 FECA Bulletins which have previously been issued by the DFEC but have since expired or been superseded by another Bulletin, Circular or inclusion in the FECA Procedure Manual.
|
Bulletin |
Subject |
|---|---|
|
Compensation Orders/Letter Decisions - Signature Authority for Journey Level GS-12 and Senior Claims Examiners |
|
|
BPS - Revision in the Reimbursement Rates Payable for the Use of Privately Owned Automobiles Necessary to Secure Medical Examination and Treatment |
|
|
ADP - Automated Compensation Payment System (ACPS) Schedule for 2003 |
|
|
Compensation Pay: Compensation Rate Changes Effective January 2003 |
|
|
Comp Pay/ACPS - Consumer Price Index (CPI) Cost-of-Living Adjustments for March 1, 2003 |
|
|
ADP - Code It Fast I-9 Coding Tool |
|
|
FECA Bulletin No. 03-07 |
This was a War Hazards Compensation Act Bulletin. |
|
Medical Exams/IME: Board Certified Osteopathic Physicians in the PDS (Physicians Directory System) |
|
|
BPS - OWCP-957 – Medical Travel Refund Request Form and Instructions for Submitting OWCP-957 |
|
|
Fiscal - Change of Lockbox Depository Effective March 19, 2003 |
|
|
Forms – Foreign Payment Worksheet |
|
|
BPS - Operational Guidelines for the Central Bill Processing system |
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 03-01
Issue Date: January 16, 2003
Expiration Date: January 16, 2004
Subject: Compensation Orders/Letter Decisions - Signature Authority for Journey Level GS-12 and Senior Claims Examiners
Background: In the past, Senior Claims Examiners (SrCEs) exercised signature authority for most formal decisions. Since the office has upgraded journey level claims examiners (CEs) from a GS-11 to a GS-12, most formal decisions can now be prepared for the signature of the journey level GS-12 (general) CE.
The signature authority (approvals/denials) of GS 5-11 CEs is not affected by the contents of this bulletin or the attachment.
Reference: FECA Procedure Manual Chapter 2-807.10b, Chapter 2-808.7a, and Chapter 2-1400.2d.
Purpose: To advise claims staff of the changes in signature authority for some formal decisions.
Applicability: Claims Examiners, Senior Claims Examiners, Claims Suprevisors, Fiscal Officers, Technical Assistants, Hearing Representatives, and Hearing Examiners.
Actions:
1. Without written desisgnation from a Supervisory Claims Examiner (SCE) or higher authority, the signature authority outlined in this bulletin should not be delegated below the General GS-12 CE level.
2. The attachment should serve as a guide and/or reference with respect to signature authority and certification levels for GS-12 CEs (including seniors).
3. General CEs at the GS-12 level should exercise signature authority to deny the following: initial claims for traumatice injury and occupational disease; claims for recurrence; claims for continuation of pay (COP); requests for medical treatment, equipment, or supplies; requests for surgery; claims for schedule awards in hearing loss cases with no rateable loss; and periods of intermittent wage loss where the claimant has not met the burden of proof to establish entitlement to compensation.
4. GS-12 General CEs should adjudicate most complex disability and death cases.
5. General GS-12 CEs have signature authority to release Form CA-181, Award of Compensation when certifying a payment for a schedule award. (Note: Lump sum schedule award calculations must also be approved by a SCE.)
6. SrCEs are to have signature authority and responsibility for reconsideration decisions.
7. SrCEs are to have authority to approve and/or deny the full range of highly complex disability and death cases.
8. SrCEs are to have signature authority on preliminary notices of proposed reduction/termination of benefits, and for final decisions on reduction/termination of benefits.
9. Both the SrCEs and General GS-12 CEs are to have signature authority for no wage loss (zero LWEC) decisions based on the claimant's current employment.
10. After DD or ADD review, disallowances of disfigurement awards, should be prepared for the signature of the SrCE.
11. Disallowances, reductions and terminations not mentioned above should be prepared for the signature of the SrCE.
Disposition: Retain until incorporated in the Federal (FECA) Procedure Manual.
DEBORAH B. SANFORD
Director for
Federal Employees' Compensation
Distribution: List no. 1-Folioviews Group A and D (Claims Examiners, All Supervisors, Systems Managers, District Medical Advisors, Technical Assistants, Rehabilitation Specialists and Staff Nurses)
Attachment FB 03-01-x1
SIGNATURE AUTHORITY (APPROVALS/DENIALS/CERTIFICATION)
General GS-12 CEs
* Traumatic Injury Claims
* Occupational Disease Claims
* Most Complex Disability and Death Cases
* Medical Treatment, Equipment, Supplies
* Surgery Requests
* Recurrences
* Non-Rateable Hearing Loss
* COP
* Intermittent Wage Loss
* Payment Certification ($0-15,000; including signature on CA-181 when certifying payment whithin prescribed limit) Note: Lump sum schedule award calculations must also be approved by a SCE.
* 0% LWECs
SENIOR CLAIMS EXAMINERS
* All items listed under General GS-12 CE
* All Complex Disability and Death Claims (approval/denial)
* Proposed Terminations & Final Terminations
* Proposed Reductions & Final Reductions
* LWEC Modifications
* 8106c Decisions; Rehabilitation Sanction Decisions
* Disallowance of Disfigurement Awards
* Suspension or Forfeiture of Benefits
* Rescission of acceptance
* Housing or Vehicle Modifications
* Reconsiderations
* Certification of Placement on the PR for TTD, LWEC or survivor benefits. Certification of OPM/VA Election Letters
* Certification authority $0-$50,000
SUPERVISORY CLAIMS EXAMINER OR HIGHER LEVEL
* Payments in amounts greater than $50,000 must be verified/signed by a Supervisory Claims Examiner (SCE), GS-13 or higher level. This authority may be delegated to a SrCE in writing for a specific period of time, for example while serving as acting SCE. The SrCE should relect such authorization in the case file by signing the payment as 'Acting SCE'
* SCE - Attorney Fees ($0-$50,000)
* DD or Add Attorney Fees > $50,000
Back to Top of FECA Bulletin No. 03-01
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 03-02
Issue Date: January 27, 2003
Expiration Date: January 27, 2004
Subject: BPS - Revision in the Reimbursement Rates Payable for the Use of Privately Owned Automobiles Necessary to Secure Medical Examination and Treatment.
Background: Effective January 1, 2003, the mileage rate for reimbursement to Federal employees traveling by privately-owned automobile was reduced to 36.0 cents per mile by GSA. No restriction is made as to the number of miles that can be traveled. As in the past, this rate will also apply to individuals covered by the FECA who travel by POV in order to obtain necessary medical examination and treatment.
Applicability: Appropriate National Office and District Office personnel.
Reference: Chapter 5-0204, Principles of Bill Adjudication, Part5, Benefit Payments, Federal (FECA) Procedure Manual; Instruction CA-77, Instructions for Submitting Travel Vouchers; and 5 USC 8103.
Action: Instruction CA-77, Instructions for Submitting Travel Vouchers, has been revised to reflect the indicated rate change. A copy of the revised instructions is attached to this bulletin and may be reproduced at local levels. Vouchers being processed for travel periods after January 1, 2003 may be adjusted to reflect this decrease.
Disposition: This Bulletin should be retained in Chapter 5-0204, Principles of Bill Adjudication, Federal (FECA) Procedure Manual.
DEBORAH B. SANFORD
Director for
Federal Employees' Compensation
Distribution: List No. 2 -- Folioviews Groups A and D (Claims Examiners, All Supervisors, Systems Managers, District Medical Advisors, Technical Assistants, Rehabilitation Specialists, and Fiscal/Bill Pay Personnel)
Attachment 1
Instructions for Submitting Travel Vouchers
Instructions for Submitting Travel VouchersU.S. Department of Labor (For reimbursement of travel and related expenses Employment Standards Administration under the Federal Employees' Compensation Act) Office of Workers' Compensation Programs
------------------------------------------------------------------------------------------------------------------------------------------
Note: Any item not in conformity with the following instructions and not legible will be deducted from the voucher. Both forms SF-1012 and SF-1012a MUST be submitted with a valid case file number.
1. Claim for necessary and reasonable expense incident to travel authorized in accordance with provisions of the Federal Employees Compensation Act may be submitted for consideration on Voucher Forms SF-1012 and SF-1012a. Travel must be by shortest route and, if practicable, by public conveyance (streetcar, bus, boat, or train).
2. The Office will promptly reimburse all bills received on the approved form and submitted in a timely manner. However, no bill will be paid for expenses incurred if the bill is submitted more than one year beyond the calendar year in which the expense was incurred or the service/supply was provided, or more than one year beyond the calendar year in which the claim was first accepted by the Office, whichever is later (CFR §10.803)
3. Payment will be made for taxicab fare or the hire of special conveyance where streetcars, buses, or other public and regular means of transportation are not available, except where these cannot be used because of the injured employee's disability. If claim is made for payment of expenses for taxicabs or hire of special conveyances, a full explanation must be made showing the necessity thereof.
4. Reimbursement for transportation by automobile owned by an employee or a member of his/her immediate family or another Government employee, may be claimed when no public conveyance is available or where the physical condition of the injured employee requires the use of special conveyance.
Mileage expenses will be reimbursed at the following rates for travel during the following periods:
| Dates | Rates |
|---|---|
|
January 1, 1995 to June 6, 1996 |
30.0 cents per mile |
If mileage expense is claimed prior to January 1, 1995, contact your OWCP district office for rates.
5. Claim may be made for parking fees. If travel must be over a toll route, toll charges may be claimed. The voucher must show the locations where travel began and ended, mode of travel, and name of the transportation company (if by public conveyance). List each item of expense separately, showing the date incurred, place, and cost of the travel.
6. There will be no reimbursement for meals or lodging when travel is for less than 12 hours in total. If the authorized travel was for longer than 12 hours, and a claim for meals or lodging is made, the dates and hours must be shown on the voucher. The necessity for lodging must be explained in detail. All charges must be reasonable, and will be reimbursed at the per diem rate for the locality of travel.
7. Any stopover or delay en route should be carefully explained. If several trips are covered by the same voucher, list each separately, indicate the purpose of each trip, and secure the approval of the attending physician, certifying that the dates are correct according to his/her records.
8. Original itemized receipts made out in factor of the person making payment, signed in ink or indelible pencil by the person receiving payment must be furnished for all items in excess of $75.00.
9. After a voucher SF-1012 has been completed, it must be signed in ink or indelible pencil in the space provided for the payee.
10. The travel voucher should not be submitted if there is no expense claimed.
INSTRUCTION CA-77
Revised January 2003
Back to Top of FECA Bulletin No. 03-02
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 03-03
Issue Date: January 27, 2003
Expiration Date: January 27, 2004
Subject: ADP - Automated Compensation Payment System (ACPS) Schedule for 2003.
Purpose: To provide the 2003 schedule for processing the periodic disability and death payrolls under the ACPS for calendar year 2003.
Applicability: Appropriate National Office and District Office personnel that need to be aware of both the periods and "cut-off" dates for the ACPS periodic disability, death, and weekly payrolls.
Disposition: This Bulletin should be retained in front of Part 5, Benefit Payments, Federal (FECA) Procedure Manual, until the indicated expiration date.
DEBORAH B. SANFORD
Director for
Federal Employees' Compensation
Attachment
Distribution: List No. 2 -- Folioviews Groups A and D (Claims Examiners, All Supervisors, Systems Managers, District Medical Advisors, Technical Assistants, Rehabilitation Specialists, and Fiscal/Bill Pay Personnel)
Attachment
AUTOMATED COMPENSATION SYSTEM (ACPS) - 2003
Table to be inserted here!
Back to Top of FECA Bulletin No. 03-03
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 03-04
Issue Date: March 7, 2003
Expiration Date: January 1, 2004
Subject: Compensation Pay: Compensation Rate Changes Effective January 2003.
Background: In December 2002, the President signed an Executive Order implementing a salary increase of 3.10 percent in the basic pay for the General Schedule. The applicability under 5 U.S.C. 8112 only includes the 3.10 percent increase in the basic General Schedule. Any additional increase for locality-based pay is excluded. The adjustment was effective the first pay period after January 1, 2003.
Purpose: To inform the appropriate personnel of the increased minimum/maximum compensation rates, and the adjustment procedures for affected cases on the periodic disability and death payrolls.
The new rates were effective with the first compensation payroll period beginning on or after January 1, 2003. The new maximum compensation rate payable is based on the scheduled salary of a GS-15, Step 10, which is now $110,682 per annum. The basis for the minimum compensation rate is the salary of $17,106 per annum (GS-2, Step 1).
The minimum increase specified in this Bulletin is applicable to Postal employees.
The effect on 5 U.S.C. 8112 is to increase the payment of compensation for disability claims to:
|
Effective January 2, 2003 |
Minimum |
Maximum |
|---|---|---|
|
Monthly |
$1,069.13 |
$6,917.63 |
The effect on 5 U.S.C. 8133(e) is to increase the monthly pay on which compensation for death is computed to:
|
Effective January 2, 2003 |
Minimum |
Maximum |
|---|---|---|
|
Monthly |
$1,425.50 |
$6,917.63 |
Applicability: Appropriate National and District Office personnel
Reference: Memorandum for Directors of Personnel dated December 2002; and the attachment for the 2003 General Schedule.
Action: ACPS will update the periodic disability and death payrolls. Any cases with gross overrides will not have a supplemental record created. Thus, the cases with gross overrides must be reviewed to determine if adjustments are necessary. If adjustment is necessary, a manual calculation will be required.
1. Adjustments Dates.
a. As the effective date of the adjustment was January26, 2003, no supplemental payroll was necessary for the periodic disability and death payrolls.
b. The new minimum/maximum compensation rates are available in ACPS.
2. Adjustment of Daily Roll Payments. Since the salary adjustments are not retroactive, it is assumed that all Federal agencies have ample time to receive and report the new pay rates on claims for compensation filed on or after January 1, 2003. Therefore, it is not necessary to review any daily roll payments unless an inquiry is received. If an inquiry is received, verification of the pay rate must be secured from the employing establishment.
3. Minimum and Maximum Adjustment Listings. Form CA-842, Minimum Compensation Pay Rates, and Form CA-843, Maximum Compensation Rates, should be annotated with the new rate information as follows:
|
CA-842 – 01/02/03 |
||||
|
49.34-74.01 |
246.72-370.05 |
49.34 |
246.72(986.88) |
1,069.13 |
|
CA-843 – 01/02/03 |
||||
|
319.28 |
1,596.38(6,385.52) |
|
6,917.63 |
|
4. Forms. CP-150, Minimum/Maximum Compensation, were generated for each case adjusted. It should be noted that this adjustment process re-calculates EVERY ACPS record from very beginning to current date, thus, it may be that minor changes in the gross compensation are noted; this is not necessarily incorrect. Notices to all payees receiving periodic compensation payments were generated, informing them of potential changes to their compensation benefits.
The notices were sent as an attachment to the Benefit Statement generated after each periodic cycle. Manual adjustments necessary because of gross overrides should be made on Forms CA-24 or CA-25 with a notice sent to the payee by the District Office.
Disposition: This bulletin is to be retained in Part 5, Benefit Payments, Federal (FECA) Procedure Manual, until the indicated expiration date.
DEBORAH B. SANFORD
Director for
Federal Employees' Compensation
Distribution: List No. 2--Folioviews Groups A and D (Claims Examiners, All Supervisors, Systems Managers, District Medical Advisors, Technical Assistants, Rehabilitation Specialists, and Fiscal and Bill Pay Personnel)
Back to Top of FECA Bulletin No. 03-04
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 03-05
Issue Date: March 7, 2003
Expiration Date: February 29, 2004
Subject: Comp Pay/ACPS - Consumer Price Index (CPI) Cost-of-Living Adjustments for March 1, 2003.
Purpose: To furnish instructions on CPI adjustment implementation of March 1, 2003.
1. The new CPI increase, adjusted to the nearest one-tenth of one percent, is 2.4 percent.
2. The increase is effective March 1, 2003, and is applicable where disability or death occurred before March 1, 2002.
3. The new base month is December 2002.
4. The maximum compensation rates, which must not be exceeded, are the following:
| Rate | Time |
|---|---|
|
$ 6,917.63 |
per month |
Applicability: Appropriate National Office and District Office personnel.
Reference: FECA Consumer Price Index (CPI) Amendment, dated January 6, 1981.
Action: On or about March 14, 2003, both the periodic disability and death payrolls will be updated in ACPS. If there are any cases with gross overrides, there will be no supplemental record created. Thus, the cases with gross overrides must be reviewed to determine if CPI adjustments are necessary. If adjustment is necessary, a manual calculation will be required.
1. Adjustment Dates.
a. As the effective date of the CPI is March 1, 2003 and the start date of the periodic and death payroll cycles is February 23, 2003, there will be a supplemental record created for the period March 1 through March 22, 2003. Effective March 23, 2003, the periodic and death payrolls will reflect the increased amount.
b. The CA-816, LWEC, program will be updated with the new CPI percentage. This update will be performed for all district offices by the National Office.
2. Adjustments of Daily Roll Payments. Since the CPI will not be in ACPS until March 16, 2003, daily roll payment cases requiring the new CPI should be held for data entry until that date. ACPS RECORDS THAT REQUIRE ADJUSTMENT SHOULD NOT BE ENTERED BETWEEN MARCH 13, 2003 AND MARCH 17, 2003. ACPS data entry may resume on March 18, 2003.
3. 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 with the new information. Attached to this directive is a complete list of all the CPI increases and effective dates since October 1, 1966 through March 1, 2003.
4. Forms.
a. Beginning with the compensation payment cycle that covers March 23, 2003 to April 19, 2003, the Office will issue an updated monthly Benefit Statement to each individual receiving benefits on the 28-day periodic roll cycle. This Benefit Statement will state the gross amount of compensation, the period of compensation covered by the statement, and the pertinent deductions made from the gross compensation. For compensation payments made via paper checks, the Benefit Statement will accompany the check. For compensation payments made through Electronic Fund Transfer (EFT), the Benefit Statement will be mailed separately.
b. Any manual adjustments necessary because of gross overrides in cases should be made on Form CA-24 or CA-25. A notice to the payee should be sent from the district office.
c. A CP-140 report will be printed for each case adjusted, upon specific request by a District Office.
d. If claimants write or call for verification of the amount of compensation paid (possibly for mortgage verification; insurance verification; loan application; etc.), please provide this data in letter form from the district office. Many times a benefit statement may not reach the addressee, and regeneration of the form is not possible. Thus, a simple 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.
DEBORAH B. SANFORD
Director, Federal Employees' Compensation
Distribution: List No. 2 --Folioviews Groups A and D (Claims Examiners, All Supervisors, District Medical Advisors, Fiscal Personnel, Systems Managers, Technical Assistants, and Rehabilitation Specialists)
Attachment
|
EFFECTIVE DATE |
RATE |
EFFECTIVE DATE |
RATE |
|---|---|---|---|
|
10/01/66 |
12.5% |
03/01/81 |
3.6% |
Prior to 09/07/74, the new compensation after 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). After 09/07/74, the new compensation after adding the CPI is rounded to the nearest $1.00 on a "periodic" basis or the nearest $.25 on a weekly basis ($.25, $.50, $.75, or $1.00).
| Date | Rate | ||
|---|---|---|---|
|
Prior to 11/1/74 |
.08-.34 = .23 |
Eff. 11/01/74 |
.13-.37 = .25 |
1 There was an error made by the Bureau of Labor Statistics (BLS) in calculating the CPI figure for 2000 and 2001 (see OMB Bulletin 01-04 for reference). The 2000 increase was erroneously reported as 2.7% instead of 2.8%, and the 2001 increase was reported as 3.4% instead of 3.3%. The OWCP issued a supplemental payment equivalent to 0.1% for all claimants entitled to CPI increases for the period of 03/01/00 to 02/28/01 to correct the shortfall. The initial CPI figures (2.7% and 3.4%) were originally kept in the system for consistency, rather than adjusting to the corrected BLS figures. However, in order to remain statistically correct, the figures have been adjusted this year to reflect the corrected BLS figures.
2 There was an error made by the Bureau of Labor Statistics (BLS) in calculating the CPI figure for 2000 and 2001 (see OMB Bulletin 01-04 for reference). The 2000 increase was erroneously reported as 2.7% instead of 2.8%, and the 2001 increase was reported as 3.4% instead of 3.3%. The OWCP issued a supplemental payment equivalent to 0.1% for all claimants entitled to CPI increases for the period of 03/01/00 to 02/28/01 to correct the shortfall. The initial CPI figures (2.7% and 3.4%) were originally kept in the system for consistency, rather than adjusting to the corrected BLS figures. However, in order to remain statistically correct, the figures have been adjusted this year to reflect the corrected BLS figures.
Back to Top of FECA Bulletin No. 03-05
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 03-06
ISSUE DATE: May 9, 2003
EXPIRATION DATE: May 9, 2004
Subject: ADP - Code It Fast I-9 Coding Tool
Background: The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) is used in the Division of Federal Employees' Compensation (DFEC) to identify the condition(s) accepted by the program as compensable. The ICD-9-CM code(s) and the accompanying narrative description(s) are present in the case file itself, the Case Management File (CMF), and in documents to the claimant and provider(s). The accepted diagnoses are of importance in case management issues such as the appearance of additional conditions, consequential injuries, and length of disability. They are also necessary for the accurate processing of medical bills.
The ICD-9-CM classification is a hierarchical system of coding, with three digit category codes, followed in many instances by more specific four and five digit diagnosis codes that pinpoint the anatomical location and the particular nature of the disease or injury. This higher level of specificity is of benefit for case management purposes and is of particular importance in the Central Bill Processing System that will be implemented shortly.
To help facilitate the use of more specific codes, the Office of Workers' Compensation Programs (OWCP) has purchased an electronic medical coding tool known as Code It Fast I-9 (Code It Fast).
Code It Fast is a desktop application that enables the user to search and reference ICD-9-CM Volumes 1 and 3 from his or her desktop. It also provides the user with a tool that can be used to search for ICD-9 codes using narrative diagnoses or numeric code references. The program comes complete with Sticky Note and Bookmark features, and provides the same annotations and icons contained in the ICD-9 Coding books. The user's manual is available at http://www.ingenixonline.com/content/cifi9/. Online customer service is available at http://www.ingenixonline.com/content/techsupport/default.asp
Reference: FECA Bulletin 88-19 and 93-12.
Purpose: This bulletin will briefly describe some of the software features of the Code It Fast I-9 software, including logins and passwords.
Applicability: Claims staff, and medical staff in the district offices and the National Office, including the Branch of Hearings and Review.
Actions:
1. Code It Fast I-9 will be deployed to each user's desktop from the National Office. Users will receive notice of the availability of the program and the desktop icon will appear on their PC when available. The desktop icon should be used to access the program.
2. User Logins: Each time the user accesses Code It Fast, the User Login dialog box appears. A user name and password are required. Your user name must be at least 4 characters, but not more than 10 characters. Your user name and password can be saved for future logins by selecting save user name and password during login. Once logged in each user is uniquely identified and will have access to personal sticky notes and bookmarks. You can change your user password by selecting change user password from the file menu's administration option.
3. Performing a Code Search: The search box is used to enter search terms and narrow search results. The user can also type in a valid ICD-9 code in order to bypass the search and go directly to the tabular listing. Up to four key words or code numbers can be entered. Code It Fast searches all selected code set databases for a specific match based on the key words entered and the type of search option specified. Code It Fast also has an automatic spell check feature that ensures that the term entered is valid. If the search term is not valid, the search term alternative dialog box appears and alternative search terms are provided. The user's manual section entitled tips for entering search terms should be consulted for additional help in this area.
4. Viewing Search Results: After the user executes a search, the tabular results box displays matches found in all applicable code sets. The number of code matches found is referenced on the screen. Codes are displayed so that the most likely codes are listed first (by rank). Fourth and fifth digit ICD-9-CM codes are grouped under the primary code. CPT and HCPCS codes are grouped under the corresponding section or subsection. Matches to the search term results can be viewed in either the tabular listing or in the indexes for ICD-9-CM, CPT, and HCPCS codes.
Select the code from the tabular results box in order to view the full description. All neighboring codes in the adjacent tabular listing will also be displayed. The tabular listing also shows "excludes" and "includes" notes, as well as "code first" and "code also" references for ICD-9 Codes. CPT and HCPS codes in the tabular listing are grouped by section/subsection. This process is similar to looking up the code and the description in the ICD-9-CM, CPT, or HCPCS code book.
5. Code Specific Dialog Boxes for ICD-9-CM: This box can be used to view notes from the code book that specifically pertain to the selected code, and which provide further defining terms, clarifying information, and fifth digit information and includes and excludes notes. This box is accessed by selecting an ICD-9 code that has associated notes/references from the tabular listing. The user then clicks the notes button from the toolbar, or goes to the ICD-9 menu and selects ICD-9 section notes.
6. ICD-9 Annotations: From this dialog box one can view annotations that pertain to the code selected. Annotations provide explanations of medical terminology and descriptions for specific diseases or conditions. This box accessed by selecting an ICD-9-CM code that has an annotation from the Tabular Listing. Click either the Annotations button from the toolbar, or go the ICD-9 menu and select Annotations.
7. Additional Features:
a. The History Menu lists a trail of up to 15 previously viewed codes. This makes it easy to go back to a previous code selection during the current session.
b. The Bookmark Dialog Box is used to store, amend, and catalog lists of frequently used codes. To open the bookmark dialog box, click the bookmarks button, or select bookmarks from the view menu. The bookmark dialog box will not contain any codes when you first access the application. Once codes are added the bookmark dialog box will contain code number links which direct you to the appropriate code in the tabular listing. This feature also provides you with a description of the code and the category assigned when it was created. See the user's manual for more details on adding, editing and deleting bookmarks.
c. The user can copy codes, descriptions and modifiers into the Windows clipboard and paste them into other Windows applications. Code It Fast, provides two ways for copying information to the clipboard: Ctrl+C or the copy option under the edit menu. Either a code line or block of text must be selected before executing the copy command.
d. The user may add/edit comments to codes by using the sticky notes feature. Each code with a sticky note attached is flagged for user references. The Sticky Note dialog box is opened by either clicking the sticky note button on the main toolbar or selecting sticky notes from the view menu. As with bookmarking, sticky notes must be added to the dialog box. See the user's manual for details on adding, deleting or editing sticky notes.
e. To print the code information that appears in any dialog box, simply click the Print button or select Print from the File menu. The Print Report dialog box will appear. The user must select the items to be print, click the Setup button to display the Print Setup dialog box, and click the Print button. See the User's Manual for Print Report Options.
8. Code It Fast should be introduced to office staff prior to its deployment. Training on this bulletin may be conducted at the district office's discretion.
9. Updates to the Code It Fast software will be through National Office deployment when such become available.
10. The National Office will continue to assess the accuracy of ICD-9 coding.
Disposition: Retain until incorporated in the FECA procedural manual.
DEBORAH B. SANFORD
Director for
Federal Employees' Compensation
Distribution: List No. 2(Claims Examiners, All Supervisors, District Medical Director, Fiscal Personnel, Systems Managers, Technical Assistants and Rehabilitation Specialists)
Back to Top of FECA Bulletin No. 03-06
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 03-08
Issue Date: May 23, 2003
Expiration Date: May 23, 2004
Subject: Medical Exams/IME: Board Certified Osteopathic Physicians in the PDS (Physicians Directory System)
Background: The OWCP policy of according special weight to the medical opinions of Board-certified specialists includes physicians certified by the American Osteopathic Association (AOA) as well as those certified by the American Board of Medical Specialties (ABMS). For some time there has been a question as to whether the special weight afforded by Board certification is equal among physicians who are certified by the ABMS and the AOA.
The original database for the Physician's Directory System (PDS), which OWCP uses for selecting referee physicians, was derived from the Directory of Medical Specialists published by Marquis Who's Who. This directory was compiled by the American Board of Medical Specialties (ABMS) which includes the medical boards of the American Medical Association that certify candidates in their respective fields of specialization.
In addition to the medical doctors (MDs) as described above, OWCP recognizes osteopathic doctors (DOs) as physicians within the meaning of the Act. OWCP also accords special weight to their opinions, provided they are Board-certified and it can be established that such certification has been verified with the American Osteopathic Association (AOA).
Reference: Federal (FECA) Procedure Manual, Chapters 2-810 and 3-0500.
Purpose: To further clarify OWCP's longstanding position that special weight is to be given to the opinion of a physician within the meaning of 5 U.S.C. 8101 who is Board-certified in an area of medical specialization; and to provide guidance to district office personnel with respect to adding osteopathic physicians to the PDS and selecting osteopaths for referee examinations.
Applicability: Claims Examiners, Senior Claims Examiners, All Claims Supervisors, Medical Schedulers, District Medical Directors, Technical Assistants, System Managers, Staff Nurses, and Vocational Rehabilitation Specialists
Action:
1. Adding Physicians to the PDS by the District Office Manager (PDS) administrator). since the original PDS database from Marquis Who's Who contained only MDs certified by the ABMS, there is currently no means of identifying DOs that have been added to the system. In order to remedy this situation, the following guidelines must be observed:
a. The PDS administrator must verify board-certification of all physicians entered into the PDS database (i.e, both DOs and MDs).
(1) In the case of DOs this must be done via the American Osteopathic Association (AOA), and not the State medicla board (which can only verify that a physician is licensed and in good standing to practice medicine in the particular state).
(2) To document board certification of all physicians added to the PDS, the PDS administrator will maintain a file for each physician which contaians copies of the curriculum vitae and the information verifying the board certification from either the ABMS or the AOA, which ever is apppropriate.
b. When a doctor who is a DO is added to the system, the PDS administrator must enter a note in the physician's note field indicating that this doctor is an osteopathic physician.
c. The DO's area of board-certification will be entered in the field where the area of specialization is normally entered.
d. If the DO has a sub-specialty it must be entered into the subspecialty field.
2. Modifying the PDS to include DOs as distinguished from MDs. If it is recognized that a DO has been added to the PDS without a means of distinguishing him or her from the larger body of MDs in the system, the PDS administrator must enter a note designating the physician as an osteopath and indicate the specialty and subspecialty just as in the guidelines at 1a., 1b. and 1c above. This will be the only means of identifying osteopathic physicians in the database until such time as upgrades to the system and modifications to the database are loaded.
The above described procedures will be effective within thirty (30) days of the release of this bulletin. Please ensure that proper notification/training is provided to district office personnel that are affected.
DEBORAH B. SANFORD
Director for
Federal Employees' Compensation
Distribution: List No. 1, Folioviews Groups A and D (Claims Examinres, All Supervisors, District Medical Advisors, Technical Assistants, Rehabilitation Specialists, and Staff Nurses)
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Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 03-09
Issue Date: July 7, 2003
Expiration Date: July 7, 2004
Subject: BPS - OWCP-957 – Medical Travel Refund Request Form and Instructions for Submitting OWCP-957
Background: Effective August 12, 2003, new Form OWCP-957 should be submitted by all FECA claimants to claim travel reimbursement.
Reference: Federal (FECA) Procedure Manual Chapter 5-0200
Purpose: To notify all FEC staff of the new form to be used by FECA claimants for all reimbursements of travel.
Applicability: Appropriate National Office and District Office personnel.
Action:
1. Effective August 1, 2003, in all cases where a request for the form used to make a claim for medical travel reimbursement is received; the requestor should be provided with Form OWCP-957. Form OWCP-957 is needed for processing requests for medical travel reimbursement through the automated bill processing system. A copy of Form OWCP-957 is attached to this bulletin and may be reproduced at local levels. When a request for medical travel reimbursement is made on a standard travel form (SF-1012), the requestor should be advised that Form OWCP-957 is needed for all future medical travel reimbursement requests. Form OWCP-957 should be provided to the requestor when practical.
2. Instructions for Submitting Form OWCP-957, Medical Travel Refund Request, provide guidance for completion of Form OWCP-957 by FECA recipients. A copy of the instructions is also attached to this bulletin.
3. The National Office will arrange for an initial supply of Form OWCP-957 to be provided to each District Office. The form and instructions are available on the DFEC website at http://www.dol.gov/esa/regs/compliance/owcp/forms.htm.
Disposition: This bulletin should be retained until incorporated in the Federal (FECA) Procedure Manual.
DEBORAH B. SANFORD
Director for
Federal Employees' Compensation
Distribution: List No. 3 - Folioviews Groups A, B, C and D (All FECA Employees)
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Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 03-10
Issue Date: June 13, 2003
Expiration Date: June 12, 2004
Subject: Fiscal - Change of Lockbox Depository Effective March 19, 2003
Background: In March 2003, the U.S. Treasury/Financial Management System (FMS) severed its ties with PNC Bank of Pittsburgh, PA. As a result, the current DFEC lockbox accounts were cancelled, requiring a new depository. FMS has since negotiated new agreements for the affected lockbox depository accounts with Bank of America in Atlanta, Georgia.
Purpose: To inform the appropriate personnel of the change in lockbox depository addresses, ensuring the proper processing of all incoming cash receipts.
Applicability: Appropriate National and District Office personnel. This includes each district office that previously had a lockbox account with PNC Bank. All DFEC lockboxes with an account apart from PNC Bank are not affected by this change, and their depository accounts remain the same. The current list of all DFEC lockboxes is attached to this publication.
Action:
1. All letters requesting payment to be mailed directly to the lockbox depository should be changed immediately. All letters pertaining to overpayment decisions (CA-2223, CA-2225, and the CA-9000 series) should be changed at each district office to reflect the new address as detailed in the attached listing.
2. DFEC System Managers have already been notified of the needed address change via e-mail, and should have modified the district office's "v44_lb_addr table." This update will also automatically update the Letter Generator System (LGS), since the LGS retrieves the lockbox addresses from this part of the v44 table through the "letters.cgi" when the "Generate Letter" button is clicked.
3. All other appropriate district office personnel must be made aware of the local lockbox address change.
4. As deposits sent to the old lockbox at PNC Bank will only be forwarded to Bank of America for approximately six months, the district offices affected must make every effort to inform any individual or organization that is sending cash deposits to the lockbox. This includes notifying entities such as medical providers and claimants with overpayments of the applicable address change.
5. All deposits mailed from the district office to the lockbox after March 19, 2003 should be mailed to the new lockbox address at the Bank of America.
6. It will also be necessary for each district office to identify all Office of Personnel Management (OPM) and salary offsets that are currently being mailed directly to its lockbox. The Cash Receipts Register will serve as a source for quick identification of such deposits. Notices must be sent to OPM and/or the employing agency immediately.
7. Deposit transactions will be made in the same manner as those previously made with PNC Bank. Transactions data will be sent from Bank of America to the district offices via FedEx. "Zero Activity" reports from Bank of America will not be forwarded, only daily reporting with actual deposit activity. The date of deposit will continue to be the Treasury confirmation date.
The contact person at Bank of America is Linda Thomas. Ms. Thomas can be reached by telephone at (770) 774-6430, and by e-mail at linda.j.thomas@bankofamerica.com.
Disposition: This bulletin is to be retained in Part 5, Benefit Payments, Federal (FECA) Procedure Manual, until the indicated expiration date.
DEBORAH B. SANFORD
Director for
Federal Employees' Compensation
Distribution: List No. 2--Folioviews Groups A and D (Claims Examiners, All Supervisors, Systems Managers, District Medical Advisors, Technical Assistants, Rehabilitation Specialists, and Fiscal and Bill Pay Personnel)
LOCKBOX DEPOSITY ADDRESSES
The following is a listing of the current mailing addresses for all DFEC lockboxes. This listing has been revised to include the new addresses for all lockboxes that have been switched from PNC Bank to Bank of America. All other district office lockbox addresses remain unchanged.
Boston District Office:
U.S. Dept. of Labor – DFEC Boston
P.O. Box 403498
Atlanta, GA 30384-3498
New York District Office:
U.S. Dept. of Labor – DFEC New York
P.O. Box 403484
Atlanta, GA 30384-3484
Philadelphia District Office:
U.S. Dept. of Labor – DFEC Philadelphia
P.O. Box 403471
Atlanta, GA 30384-3471
Jacksonville District Office:
U.S. Dept. of Labor – DFEC Jacksonville
P.O. Box 403376
Atlanta, GA 30384-3376
Cleveland District Office:
U.S. Dept. of Labor – DFEC Cleveland
P.O. Box 403459
Atlanta, GA 30384-3459
Chicago District Office:
U.S. Dept. of Labor – DFEC Chicago
P.O. Box 403449
Atlanta, GA 30384-3449
Kansas City District Office:
U.S. Dept. of Labor
Kansas City FECA Office
P.O. Box 845038
Dallas, TX 75284-5038
Denver District Office:
U.S. Dept. of Labor
Denver FECA Office
P.O. Box 60000
San Francisco, CA 94160-1251
San Francisco District Office:
U.S. Dept. of Labor
San Francisco FECA Office
P.O. Box 60000
San Francisco, CA 94160-1251
Seattle District Office:
U.S. Dept. of Labor
Seattle FECA Office
P.O. Box 60000
San Francisco, CA 94160-1252
Dallas District Office:
U.S. Dept. of Labor
Dallas FECA Office
P.O. Box 843537
Dallas, TX 75284-3537
Washington D.C. District Office:
U.S. Dept. of Labor – DFEC Washington D.C.
P.O. Box 403431
Atlanta, GA 30384-3431
National Office:
U.S. Dept. of Labor – DFEC National Office
P.O. Box 403356
Atlanta, GA 30384-3356
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Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 03-11
Issue Date: August 29, 2003
Expiration Date: August 29, 2004
Subject: Forms – Foreign Payment Worksheet
Background: Foreign nationals are entitled to full medical benefits, including a choice of qualified physicians. Often, because of remote or undeveloped locations, employees will be treated at a Federal medical facility or may be transported to another country for treatment. Bills which have been approved for payment and in which payment is to be made to a foreign address must be forwarded to the National Office (District 50) for manual processing. All foreign bills, even those requesting reimbursement in U.S. dollars, will be sent to the National Office for payment, and should not be processed through the automated system.
Reference: FECA Procedure Manual, Chapter 4-0801-8(b)(2)
Purpose: To notify all employees of the existence of the new Foreign Payments Worksheet, and provide revised procedures for the handling of foreign bills.
Applicability: All staff.
Actions:
1. Processing Payments: All foreign payments that are received at the district office must be reviewed prior to submission to the National Office for payment. When it has been determined that the submission contains all appropriate information, the responsible claims staff at the district office must then compete Items 1–11 of the Foreign Payments Worksheet (Attachment 1). Particular attention should be paid to detailing the specifics of the payment request in Box 9 of the form. It is noted that all bills submitted for claimants residing in Germany will be paid as reimbursements directly to the claimant, due to strict German bill pay laws.
Once complete, the individual completing the form should initial the Worksheet in Box 10 of the form, and attach the Worksheet to the original source documents that generated the payment request. The entire packet should then be forwarded to the responsible Claims Examiner (CE) assigned to the claim for certification. The CE has the responsibility to ensure that the submitted bills are in fact payable for that claim, and that the information listed on the Worksheet is accurate. Once certified by the CE, the entire packet should be forwarded to the appropriate staff for local imaging. The packet should be categorized as "Incoming Correspondence and Calls" in OASIS, with the attached Worksheet acting as the first page of the document. This will allow the image(s) to serve as a record of any foreign bills pending processing at the National Office.
The Worksheet should then be forwarded to National Office for payment processing. In order to confirm the accuracy of the data on the completed Worksheet, the National Office should review the submitted bills in the OASIS case record. The National Office will complete the SF-1166, and submit it to the Kansas City Financial Management Center (KC/FMS) for payment.
When the payment has been confirmed by KC/FMS, National Office staff will complete Items 12-17 of the Worksheet, detailing the payment specifics. A Foreign Payment Notification will then be sent to the claimant, indicating that payment is forthcoming and specifying the payment details (Attachment 3). A completed copy of the Worksheet, Foreign Payment Notification letter, and associated payment voucher from the KC/FMS will be sent to the ACS Central Bill Pay staff to update the bill history and then image as a paid bill.
2. Incomplete Payment Requests: If the district office staff cannot determine all the necessary specifics of a foreign payment request, they will immediately return the bills to the claimant. Attached to the bills will be the Foreign Bill Return letter (Attachment 2), explaining that the submitted bills cannot be paid due to the fact that key elements of the payment request cannot be identified. The letter will ask the claimant to provide the information necessary to pay the medical provider. In addition, a Form CA-915 (Claimant Medical Reimbursement Form) will be included in the return packet, to allow the claimant to provide the necessary information to allow reimbursement of expenses paid.
Disposition: Retain until incorporated in the Federal (FECA) Procedure Manual.
DEBORAH B. SANFORD
Director for
Federal Employees' Compensation
Distribution: List No. 2 - FolioViews Groups A and D (Claims Examiners, All Supervisors, Systems Managers, District Medical Advisors, Technical Assistants, Rehabilitation Specialists, and Fiscal and Bill Pay Personnel)
Attachment 1
Foreign Payment Worksheet
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Attachment 2
Letter With Enclosed Bills recently Submitted
Claimant:
File Number
DATE
CLAIMANT NAME
STREET ADDRESS
CITY
COUNTRY
Dear Claimant:
The enclosed bills were recently submitted to our office in connection with your workers' compensation claim. However, additional information is required before the bills can be paid. Please provide the information needed on the lines provided below.
PLEASE NOTE: If you are seeking reimbursement of medical expenses already paid by you, please complete the enclosed Form CA-915.
If there are any questions concerning your claim or this form, please contact the Office at (XXX) XXX-XXXX.
Sincerely,
Claims Examiner
Claimant:
File Number:
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Attachment 3
Letter - Total Payment
DATE
CLAIMANT NAME
STREET ADDRESS
CITY
COUNTRY
TOTAL PAYMENT:
Within the next several weeks, the U.S. Treasury will send a check to you at the address noted above. When received, the check will represent payment of the medical expenses that were recently submitted to our office for payment. The check will be issued in the foreign currency indicated on the bill(s).
If the bill(s) have been paid by you, please accept the check as your reimbursement; if the bill(s) have not been paid, please ensure that the appropriate medical provider(s) are paid upon receipt of the check.
If you have incurred additional medical expenses as a result of your employment-related injury, you may submit the bills to our Central Mail facility at the following address: DFEC Central Mailroom, P.O. Box 8300, London, KY 40742. Please be sure to include your claim file number (as shown on the top of this letter) on each item submitted, along with your current mailing address.
Sincerely,
Special Examiner
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Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 03-12
Issue Date: September 26, 2003
Expiration Date: September 26, 2004
Subject: BPS - Operational Guidelines for the Central Bill Processing system
Background: Effective September 2, 2003, OWCP began providing centralized bill processing (including most bill resolution/adjustment) for all of its DFEC district offices through Affiliated Computer Services (ACS). On August 13, 2003 ACS began to receive point-of-sale pharmacy bills. ACS is also providing medical authorization services. Bills should be mailed to: U.S. Department of Labor, DFEC Central Mail Room, P.O. Box 8300, London, KY 40742-8300. All bills should be sent directly to London, KY except foreign currency bills, bills for field nurse or rehabilitation counselor services, bills for OWCP directed medical examinations and bills for DMA review. Bills from contract nurses and rehabilitation counselors should be submitted electronically through the ACS web-portal.
Reference: Current version of the District Office Operational Rules and Processing Information document.
Purpose: To provide operating procedures for centralized bill processing.
Applicability: Claims Examiners, Senior Claims Examiners, All Claims Supervisors, Medical Schedulers, District Medical Advisors, Technical Assistants, System Managers, Staff Nurses, Vocational Rehabilitation Specialists, Communications Specialists, Fiscal Operations Specialists, Medical Coding Specialists, and Customer Service Representatives
Action:
1. Prior medical authorizations will be provided via telephone call and written correspondence to ACS. Written medical authorizations will be mailed or transmitted to London, KY and scanned into both OASIS and SIR (Storage Information Retrieval) (SIR is the image system used by ACS).
a. ACS will continue to categorize all incoming mail; however, when a piece of mail is determined to be an authorization request, ACS will add a subject index in the OASIS file. This additional indexing will notify the claims examiner (CE) that ACS has processed that document as a medical authorization request, and the document has been imaged into SIR and reviewed by the prior authorization department in Tallassee.
b. If ACS needs to contact the district office regarding a written authorization request or a phone request, the responsible CE will receive an Omni-track thread from ACS concerning the requested medical service. The training material from ACS includes instructions on the use of Omni-track and the Prior Authorization process.
2. The toll free contact number for providers and claimants regarding medical billing is (866) 335-8319. This number should also be used to obtain a medical authorization. For faster service regarding medical bill inquiries, providers, claimants, and employing agencies may obtain information on-line at the OWCP web bill portal. Medical authorizations should be faxed to ACS for processing at (800) 215-4901.
3. Appropriate FEC personnel are to refer all pharmacy calls to ACS or to the web-site. If the pharmacy calls the district office regarding a medication that is not payable under the new system (and the pharmacy has already talked to ACS), the district office should state that the pharmacy cannot pursue the issue for the claimant any further. The pharmacy should be told that the issue is now a matter to be resolved between the treating physician and the CE. If the medication has been rejected by the treatment suite the CE should refer the request to the DMA for review of the medication and its use for treatment of the accepted condition(s). If the DMA opines that the medication is needed for treatment of the accepted condition the issue should be directed to the National Office, through the District Director, to determine if modification of the treatment suite is needed.
4. All staff nurses (SN) and vocational rehabilitation specialists (RS) should receive training on web-bill processing. The SN and RS will be responsible for reviewing and approving bills and reports submitted via the web-portal. The bills will be submitted to ACS for processing through the web-portal by the SN and RS. All field nurses and vocational rehabilitation counselors will need to enroll as providers with ACS. They will also need to sign a web-billing agreement form in order to log onto the web-portal and submit bills.
5. The toll free number for ACS will direct the caller to an IVRS that will be maintained by ACS. The caller, with the proper identifying information, will be able to access information about bill submission, prior authorization, and bill payment. The caller will be led through a series of menu options, designed to handle routine calls and inquiries, prior to being provided an option to speak with a customer service representative. Access to information will be limited in volume and time. The caller will be informed that the web-site is a better tool for gathering information several times throughout the call.
6. Effective immediately all GTRs submitted for payment should be forwarded to the National Office fiscal officer for processing.
7. All payments for 100% wage loss due to the claimant's attendance at an OWCP directed medical examination should be processed through ACPS as a direct payment. If the case is under development or is in a denied status, a certification memorandum should be faxed to the National Office fiscal officer at (202) 693-1498.
8. Each district office should conduct training for its employees within 30 days of the issuance of this bulletin. It is recommended that employees receive training only on the systems they will specifically use to perform their duties.
Disposition: Retain until incorporated into the FECA Procedure Manual.
DEBORAH B. SANFORD
Director for
Federal Employees' Compensation
Distribution: List No. 3 Folioviews Groups A, B, C, and D (All FECA Employees)
Back to Top of FECA Bulletin No. 03-12