2011 FECA Bulletins which have previously been issued by the DFEC but have since expired or been superseded by another Bulletin, Circular or inclusion in the FECA Procedure Manual.
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Bulletin |
Subject |
|---|---|
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Compensation Pay: Compensation Rate Changes Effective January 2011 |
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Compensation Pay - Consumer Price Index (CPI) Cost-of-Living Adjustments for March 1, 2011 |
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Skin Schedule Awards |
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 11-02
Issue Date: March 3, 2011
Expiration Date: January 1, 2012
Subject: Compensation Pay: Compensation Rate Changes Effective January 2011.
Background: On December 22, 2010, the President signed Executive Order 13561 implementing a salary freeze for the General Schedule basic pay. The rates of pay established for the 2010 GS Pay Schedule are to remain in effect through 2011. Normally, the applicability under 5 U.S.C. 8112 only includes an increase in the basic General Schedule, so no increase to the minimum or maximum rates of compensation will be afforded this year. Any additional increase for locality-based pay is excluded as always.
Reference: Memorandum for Executive Heads of Departments and Agencies dated December 22, 2010 and the attachment for the 2011 General Schedule.
Purpose: To inform the appropriate personnel of the minimum/maximum rates of compensation for affected 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, which remains $129,517 per annum. The basis for the minimum compensation rate is the salary of a GS-2, Step 1 which remains $20,017 per annum. The actual rates are outlined below.
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Type of claim |
Minimum |
Maximum |
|---|---|---|
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Disability claims: |
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Weekly |
$288.71 |
$1,868.03 |
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Death claims: |
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Monthly |
$1,668.08 |
$8,094.81 |
Action: The Integrated Federal Employees' Compensation System (iFECS) will not require updates to the periodic disability and death payrolls as the rates have not changed since the prior adjustments were made.
Applicability: Appropriate National and District Office personnel.
Disposition: This bulletin is to be retained until the indicated expiration date.
DOUGLAS C. FITZGERALD
Director for
Federal Employees' Compensation
Distribution: List No. 2 - Folioviews Groups A, B and D (Claims Examiners, All Supervisors, District Medical Advisors, Fiscal Personnel, Systems Managers, Technical Assistants, Rehabilitation Specialists and Staff Nurses)
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Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 11-03
Issue Date: March 3, 2011
Expiration Date: February 29, 2012
Subject: Compensation Pay - Consumer Price Index (CPI) Cost-of-Living Adjustments for March 1, 2011.
Reference: FECA Consumer Price Index (CPI) Amendment, dated January 6, 1981 and Bureau of Labor Statistics Consumer Price Index Publication for December 2009 (USDL-10-0011).
Purpose: To furnish information on the CPI adjustment process for March 1, 2011.
The cost of living adjustments granted to compensation recipients 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, determining the amount of the CPI increase granted to claimants. 5 U.S.C. 8146(a) establishes the base month for the FECA CPI as December.
December 2009 had a CPI-W level of 211.703 and the December 2010 level was reported by BLS as 215.262. This means that the new CPI increase, adjusted to the nearest one-tenth of one percent, is 1.7 percent. The increase is effective March 1, 2011, and is applicable where disability or death occurred before March 1, 2010. In addition, the new base month for calculating the future CPI is December 2010.
The maximum compensation rates* , which must not be exceeded, are as follows:
$ 8,094.81 per month
$ 7,472.13 each four weeks
$ 1,868.03 per week
$ 373.61 per day (for a 5 day week)
* Per Executive Order 13561 signed by President Obama on December 22, 2010, the GS pay schedules for Federal civilian employees will remain at 2010 levels for 2011 and 2012.
Action: National Office Production staff will update the Integrated Federal Employees' Compensation System (iFECS) CPI tables and have all payment records re-calculated when the iFECS system is not in use by District Office personnel. This will occur on or about March 1, 2011. The March 12, 2011 check will include the supplemental CPI payment for the period of March 1st to March 12th. The following periodic roll check will reflect the updated 28-day amount. Please note that if there are any cases with fixed gross overrides, there will be no supplemental record created. These cases must be reviewed to determine if CPI adjustments are necessary, and 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 rate for 2010. Attached to this directive is a complete list of all the CPI increases and effective dates since October 1, 1966 through March 1, 2011, for reference.
2. Forms.
a. All claimants will be provided a notice with their Benefit Statements, indicating the amount of this year's increase. The Treasury will include this notice as a "stuffer card" with every Benefit Statement issued for the March 12, 2011 rolls.
b. 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 office. 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.
Applicability: Appropriate National and District Office personnel.
Disposition: This bulletin is to be retained until the indicated expiration date.
DOUGLAS C. FITZGERALD
Director for
Federal Employees' Compensation
Distribution: List No. 2 - Folioviews Groups A, B and D (Claims Examiners, All Supervisors, District Medical Advisors, Fiscal Personnel, Systems Managers, Technical Assistants, Rehabilitation Specialists and Staff Nurses)
Attachment to FECA Bulletin 11-03 -
|
EFFECTIVE DATE |
RATE |
EFFECTIVE DATE |
RATE |
|---|---|---|---|
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10/01/66 |
12.5% |
03/01/87 |
0.7% |
Prior to September 7, 1974, 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 September 7, 1974, the new compensation after 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).
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Prior to 09/07/74 |
.08-.34 = .23 |
Eff. 11/01/74 |
.13-.37 = .25 |
Back to Top of FECA Bulletin No. 11-03
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 11–07
Issue Date: August 10, 2011
Subject: Skin Schedule Awards
Background: On August 13, 2010, the Office of Workers' Compensation Programs (OWCP) published in the Federal Register a proposal to amend the regulations governing the administration of the Federal Employees' Compensation Act (FECA). On June 28, 2011 the new Regulations were published, and they are effective as of August 29, 2011. 20 C.F.R. 10.404, which describes how compensation is paid for loss to schedule members under 5 U.S.C. 8107, now includes the skin as a schedule member, for up to 205 weeks of compensation, for injuries sustained on or after September 11, 2001.
Effective May 1, 2009, the Division of Federal Employee's Compensation (DFEC) began using the Sixth Edition of the American Medical Association's Guides to the Evaluation of Permanent Impairment for schedule award calculations, and any new schedule award skin impairment ratings will be calculated in accordance with this edition of the Guides.
Applicability: All National Office staff and District Office claims personnel.
References: 5 U.S.C. 8107 (22); 20 CFR §10.404
Purpose: To inform the appropriate personnel of the new schedule member and provide an explanation of the specific criteria used to assess a skin condition in accordance with the Guides, as well as instructions for how to obtain the necessary information.
Actions:
I. Initial Acceptance of Skin Conditions
Traumatic conditions associated with the skin usually stem from direct physical trauma or thermal injuries and may result in scars. Skin conditions claimed as a result of work-related exposures (occupational disease) should specifically note the effect on the worker's skin condition upon removal of the offending agent. As many skin conditions are temporarily aggravated by work exposure but revert to their baseline upon cessation of exposure, accurately determining work-related causation for skin conditions may require a second opinion examination if the claimant's physician cannot provide the necessary opinion on causal relationship and permanency. While acceptance of an aggravation, or temporary aggravation, should be considered, especially in occupational disease cases, a schedule award may not be paid on the basis of a temporary aggravation.
II. Types of Skin Conditions
Repeated exposure to certain chemicals can result in an immunological change that makes the worker permanently hypersensitive to the chemical and precludes future work with that, or related, chemicals. The worker may be completely asymptomatic when not exposed to the chemical, but patch testing will define the sensitivity and its severity. Strict avoidance of further contact with the sensitizing substance is essential for sensitized workers.
1. Dermatitis. Dermatitis occurring as a result of skin exposure to physical or chemical agents is common. The association between a product at work and the resultant skin disorder is confirmed through patch testing of the suspected product or products. Blood testing for antibodies to a variety of environmental allergens is available, but many types of blood testing are not scientifically valid. Such tests, alone, are not a valid basis for determining sensitivity to an agent and should be confirmed by skin-patch testing. A medical opinion stating that an agent at work caused a skin condition should be supported by patch testing results or must explain why such testing is not warranted due to the risk of repeated exposure. Specific exemptions for patch testing include arsenic and beryllium.
2. Atopic Dermatitis. Atopic dermatitis is by definition a hereditary skin disease; therefore, it cannot be caused by factors of employment. It may be referred to as eczema, but that term is too broad, applying to several different types of skin disease, and thus should not be used for the purposes of FECA. Atopic dermatitis is associated with other allergic manifestations such as hay fever and asthma. However, as with any pre-existing condition, it may be worsened by exposure to chemical or physical agents. The aggravation should be temporary, with removal of the stressing agent allowing reversion to the baseline status. Atopic dermatitis is a chronic disease often requiring lifelong therapy.
3. Contact Dermatitis. This is a very common skin disorder, second only to atopic dermatitis in frequency. It is easily diagnosed due to the fact that it typically presents as a pattern on the skin matching the surface contact with the offending chemical or physical agent. Contact dermatitis is due to an allergic reaction, differentiating it from abrasions and burns. Patch testing provides the definitive diagnosis and should be considered the only appropriate diagnostic test. Treatment is primarily though avoiding contact with the offending substance.
4. Latex Allergy. This is a type of sensitization, common in certain industries, which can have both skin and systemic symptoms, depending on the degree of sensitization. Patch testing is the primary means of confirming sensitization. Those with a history of severe systemic reactions should be tested by an allergy specialist trained to handle such systemic reactions. Antibody testing can be used as a screening test, but a negative test does not exclude latex allergy.
5. Skin Cancers. The most common risk factors for work-related skin cancers are ultraviolet exposure, arsenic, and coal tar products. The three most common skin cancers are basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. A thorough assessment of the worker's environment through industrial hygiene surveys should be used to identify potential risks for exposure to skin carcinogens.
6. Burns and Scars. Serious burns often result in scars which can cause cosmetic or functional problems. Scars should be described by their size, location, shape, color and evidence of ulceration. Impairment can occur due to loss of perspiration and sensation, especially if the scar covers a large surface area. Some scars require long-term therapy to maintain pliability to prevent impairment of the underlying body part. Scars that limit use of an extremity will need to be evaluated separately for that extremity's functional loss. Disfigurement due to scarring is addressed in section VI below.
III. Principles of Assessment in the AMA Guides, Sixth Edition
1. Chapter 8 in the AMA Guides outlines specific criteria to be considered when calculating permanent impairment of the skin.
2. In assessing skin impairment, the physician must evaluate the severity of the condition; the frequency, intensity, and complexity of the medical condition and treatment regimen; and the impact of the condition on the ability to perform Activities of Daily Living (ADLs). ADLs include bathing, dressing, eating, personal hygiene, etc.
3. Burden of Treatment Compliance (BOTC) must also be considered, as it can be significant for skin disorders. BOTC includes, but is not limited to, the following kinds of activities: soaking affected skin daily, applying topical medications on a regular basis, avoiding sun exposure, or attending phototherapy sessions on a routine basis.
IV. Developing a Claim for a Schedule Award for the Skin
1. Prior to development, confirm that the injury for which the schedule award is being claimed was sustained on or after September 11, 2001. The regulation provides for schedule awards for the skin only for injuries sustained on or after September 11, 2001. Any request for a skin schedule award for an injury prior to that date should be denied. For purposes of an occupational exposure, it must extend on or after September 11, 2001.
2. Upon receipt of a claim for a skin schedule award where the injury was sustained on or after September 11, 2001, the CE should send a development letter to the claimant outlining the information needed. The CE may instead send such a letter directly to the attending physician (AP), but the claimant should receive a copy so that he/she is aware of the required evidence and the timeframe for submission.
3. A medical evaluation for skin impairment should address all of the following specific areas, which are mentioned in the Skin Schedule Award Development Letter attached to this bulletin:
a) The diagnosis on which impairment is based and an opinion on whether the condition existed prior to the work-related exposure, and what, if any, impact the accepted work activity/exposure had on the condition. Impacts on a skin condition include a worsening of the signs or symptoms. Adverse impact includes an increased distribution of the skin condition, worsening of pre-existing lesions, or an increase in the therapy required to maintain control of the skin condition.
b) The variability in the skin condition over time. (How often the skin condition is present is noted as percentage of the time lesions are present.)
c) Documentation of the BOTC required to control the skin condition when removal from exposure has not resulted in resolution of the skin condition.
d) The impact on the worker's life activities. There are several questionnaires that are scientifically accepted as valid for measuring the impact of skin conditions on people's quality of life. These include the Dermatology Life Quality Index (DLQI), Dermatology Specific Quality of Life (DSQL), Skindex 29, Skindex 17, and the Dermatology Quality of life Scale (DQOLS).
e) A recommended percentage of impairment, with an explanation of that percentage based on the criteria/tables outlined in the AMA Guides, Sixth Edition. The impairment provided should relate to only the skin condition and not other underlying impairments associated with disfigurement or loss of function, since these should be addressed separately.
f) Whether MMI has been reached and, if so, the date of MMI.
4. After the case has been developed and the claimant has had an opportunity to submit the necessary evidence, the CE will review the file for the next appropriate action. If the AP provides a report of impairment, the case should be referred to the District Medical Advisor (DMA) for review. If the AP is unwilling or unable to provide such a report, and the medical evidence indicates that the claimant had an injury to the skin and may have a permanent impairment, the CE should refer the case for a second opinion examination.
5. If the claimant does not provide any evidence in response to the development within the response period, there is no evidence of impairment as outlined in this bulletin, and the case has only been accepted for an aggravation or temporary aggravation of a skin condition or a condition that would not typically result in a permanent impairment, the CE may deny the award. If in doubt, the CE should obtain an opinion from the DMA prior to such a denial.
6. When referring the case to the DMA, the CE should ask the DMA to verify the calculations of the AP or second opinion examiner and determine the percentage of permanent impairment based on the standards outlined in the AMA Guides. If the DMA determines that further information is necessary prior to providing a rating, he/she should specify the missing information so that it can be requested from the AP or second opinion examiner.
7. The DMA's determination of impairment must be thorough, especially when there is more than one evaluation of the impairment present. He/she must reference the physical findings, BOTC, etc.; show how he/she applied the criteria/tables in the Guides; and provide a clear explanation regarding the calculation. The DMA should also provide a reasoned opinion regarding the MMI date and explain any difference between his or her findings and the findings of the AP or second opinion examiner. This is necessary to determine whether weight can be assigned to the DMA or whether a conflict of medical opinion exists.
8. If the DMA concurs with the AP or second opinion impairment rating, the MMI date is established, and the DMA provided a rationalized opinion, the CE can proceed at that time to issue a schedule award decision based on the agreed-upon impairment rating.
9. If the DMA does not concur with the AP or second opinion impairment rating, the claimant has been provided with the opportunity to submit the necessary evidence, and the DMA provides a detailed and rationalized opinion in accordance with the AMA Guides, the CE should weigh the medical opinions and then either proceed with the DMA's rating or declare a conflict and proceed to a referee examination.
- If an opinion on the percentage of permanent impairment and a description of physical findings is on file, but the percentage estimate by the attending or second opinion physician is not based on the AMA Guides, an opinion by the DMA which gives a percentage based on reported findings and the AMA Guides may constitute the weight of the medical evidence. The CE must ensure, however, that the DMA properly considers all reported findings, gives rationale, and uses the AMA Guides, Sixth Edition.
10. If a referee opinion is obtained, once the report is received the case should be referred back to a different DMA for review. In cases where a referee specialist is involved, the role of the DMA is to verify the referee's report for correct application of the AMA Guides, thereby confirming the percentage of permanent impairment. The DMA's role, however, is not to resolve the conflict in medical opinion, and he/she should not try to clarify or expand on the referee's medical opinion.
V. Calculating an Award
1. The AMA Guides express the impairment of bodily organs, including the skin, in terms of the whole person; however, a schedule award under the FECA is based on the percentage of impairment of the particular organ. Therefore a conversion formula, as outlined in FECA Procedure Manual 3-0700-4(d), is used to calculate the organ-specific rating under the FECA.
2. According to the Guides, the maximum allowable whole-person impairment for the skin is 58%. The final impairment payable for the skin is determined by dividing the actual whole person impairment of the claimant by the maximum allowable (58%) and then converting that number to a final percentage.
3. Example: If a worker's impairment using the Guides is 30%, divide 30 by 58, which equals 0.52. Multiply by 100 to get a percentage of 52% for the organ system (skin).
VI. Disfigurement
1. Scars are a form of disfigurement, and they may or may not impair function of the affected body part. If scarring impairs movement or function of a limb, then such impairment is addressed by an assessment of the limb's function, not the skin overlying the limb. Disfigurement also includes discoloration or a change in shape or structure of the skin. Impairment due to disfigurement or scars must note impact on the worker's life style, self-image or behaviors. Facial disfigurement is based upon alterations or permanent change to the underlying facial structures, not necessarily the skin. Ensure that cosmetic-based impairments are due solely to skin changes and have not been addressed and compensated already in another impairment rating.
2. The addition of skin as a schedule member does not replace the ability of OWCP to pay compensation for disfigurement in conjunction with § 10.404(e). Based on this authority, OWCP can pay additional compensation not to exceed $3,500 for serious disfigurement of the face, head or neck which is likely to handicap a person in securing or maintaining employment.
3. Under 5 U.S.C. 8107(21), a disfigurement award may be paid concurrently with other schedule awards. Therefore, a skin schedule award may be payable based on the criteria described in this bulletin in addition to an award paid for serious disfigurement of the face, head or neck.
Disposition: This bulletin is to be retained until the FECA PM has been updated.
DOUGLAS C. FITZGERALD
Director for
Federal Employees' Compensation
Distribution: List No. 1 – FolioViews Groups A, B and D (Claims Examiners, All Supervisors, District Medical Advisors, Systems Managers, Technical Assistants, Rehabilitation Specialists, Staff Nurses and Fiscal)
Attachment to FB 11- 07, Skin Schedule Award Development Letter
Dear Doctor:
We are seeking an opinion about your patient's work-related skin condition and any resulting permanent impairment. WORKER's case has been accepted for the following condition: ACCEPTED CONDITION.
Our program requires that all impairment determinations be calculated according to the Sixth Edition of the AMA's Guides to the Evaluation of Permanent Impairment. We would greatly appreciate a report from you, based on a recent examination, which provides the following information:
1. Whether the condition has reached maximum medical improvement and, if so, the date.
2. A detailed description of any permanent impairment that includes:
a) The diagnosis on which impairment is based and an opinion on whether the condition existed prior to the work-related exposure, and what, if any, impact the work activity or exposure had on the condition.
b) The variability in the skin condition over time.
c) Documentation of the Burden of Treatment required to control the skin condition when removal from exposure has not resulted in resolution of the skin condition.
d) The impact on the worker's life activities.
3. A final rating of the worker's impairment. Please include a discussion of the rationale for the calculation based on the applicable criteria and/or tables in the Sixth Edition of the AMA Guides.
This information is needed to properly make a decision regarding WORKER'S claim; therefore, please submit this information within thirty (30) days from the date of this letter. If you have any questions, please contact our office at the above address.
If you need additional information regarding FECA's skin schedule award policies, you may use the following link to access the policy guidance Bulletin issued in August 2011:
http://www.dol.gov/owcp/dfec/procedure-manual.htm
Thank you for your assistance. Please bill us your usual fee for a report of this type using From HCFA-1500.
Sincerely,
CLAIMS EXAMINER
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