2019 FECA Bulletins which have previously been issued by the DFEC but have since expired or been superseded by another Bulletin, Circular or inclusion in the FECA Procedure Manual.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 Pay - Consumer Price Index (CPI) Cost-of-Living Adjustments. |
|
|
Compensation Pay: Compensation Rates Unchanged from 2018 Levels. |
|
|
Update Compensation Pay - Consumer Price Index (CPI) Cost-of-Living Adjustment and Minimum/Maximum Compensation Rates. |
|
|
New Opioid Prescribing Guidelines in the FECA Program Limiting Initial Fills to Seven Days and Imposing LMN at 28 Days |
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 19-01
Issue Date: January 02, 2019
Expiration Date: February 28, 2020
Subject: Compensation Pay - Consumer Price Index (CPI) Cost-of-Living Adjustments.
Purpose: To furnish information on the CPI adjustment process for March 1, 2019.
Background: The cost-of-living adjustments granted to a compensation recipient under the FECA are based on the "Consumer Price Index for Urban Wage Earners and Clerical Workers" (CPI-W) figures published by the Bureau of Labor Statistics (BLS). The annual cost of living increase is calculated by comparing the base month from the prior year to the base month of the current year, with the percentage of increase adjusted to the nearest one-tenth of 1 percent. 5 U.S.C. §8146(a) establishes the base month for the FECA CPI as December.
December 2017 had a CPI-W level of 240.526 and the December 2018 level was reported by BLS as 245.933. This means that the new CPI increase, adjusted to the nearest one-tenth of one percent, is 2.2 percent. The increase is effective March 1, 2019, and is applicable where disability or death occurred before March 1, 2018. In addition, the new base month for calculating the future CPI is December 2018.
The maximum compensation rates1, which must not be exceeded, are as follows:
$8,541.19 per month
7,884.16 each four weeks
1,971.04 per week
394.21 per day (for a 5 day week)
Applicability: Appropriate National Office and District Office personnel.
Reference: FECA Consumer Price Index (CPI) Amendment, dated January 6, 1981; Bureau of Labor Statistics Consumer Price Index Publication for December 2018 (USDL-18-1938)
Action: National Office Production staff will update the iFECS CPI tables and recalculate all payment records when the iFECS system is not in use by District Office personnel. This will occur prior to March 1, 2019. The March 1, 2019 check will be paid at the 2018 rate but include the supplemental CPI payment for March 1st.
The following periodic roll check will reflect the updated 2019 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."
- CPI Minimum and Maximum Adjustments Listings. Form CA-841, Cost-of-Living Adjustments; Form CA-842, Minimum Compensation Rates; and Form CA-843, Maximum Compensation Rates, should be updated to indicate the increase for 2019. Attached to this directive is a complete list of all the CPI increases and effective dates since October 1, 1966 through March 1, 2019, for reference.
- Verification of Compensation. If claimants write or call for verification of the amount of compensation paid (possibly for mortgage verification; insurance verification; loan application; etc.), please continue to provide this data in letter form from the district 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.
Antonio Rios
Director for
Federal Employees' Compensation
Attachment: Cost of Living Adjustments
Distribution: All DFEC Staff
1Per Executive Order signed by President Trump on December 28, 2018.
|
EFFECTIVE DATE |
RATE |
EFFECTIVE DATE |
RATE |
|---|---|---|---|
|
10/01/66 |
12.5% |
03/01/90 |
4.50% |
|
01/01/68 |
3.7% |
03/01/91 |
6.1% |
|
12/01/68 |
4.0% |
03/01/92 |
2.8% |
|
09/01/69 |
4.4% |
03/01/93 |
2.5% |
|
|
|
03/01/94 |
2.5% |
|
06/01/70 |
4.4% |
03/01/95 |
2.7% |
|
03/01/71 |
4.0% |
03/01/96 |
2.5% |
|
05/01/72 |
3.9% |
03/01/97 |
3.3% |
|
06/01/73 |
4.8% |
03/01/98 |
1.5% |
|
01/01/74 |
5.2% |
03/01/99 |
1.6% |
|
07/01/74 |
5.3% |
|
|
|
11/01/74 |
6.3% |
03/01/00 |
2.8% |
|
06/01/75 |
4.1% |
03/01/01 |
3.3% |
|
01/01/76 |
4.4% |
03/01/02 |
1.3% |
|
11/01/76 |
4.0% |
03/01/03 |
2.4% |
|
07/01/77 |
4.9% |
03/01/04 |
1.6% |
|
05/01/78 |
5.3% |
03/01/05 |
3.4% |
|
11/01/78 |
4.9% |
03/01/06 |
3.5% |
|
05/01/79 |
5.5% |
03/01/07 |
2.4% |
|
10/01/79 |
5.6% |
03/01/08 |
4.3% |
|
|
|
03/01/09 |
0.0% |
|
04/01/80 |
7.2% |
|
|
|
09/01/80 |
4.0% |
03/01/10 |
3.4% |
|
03/01/81 |
3.6% |
03/01/11 |
1.7% |
|
03/01/82 |
8.7% |
03/01/12 |
3.2% |
|
03/01/83 |
3.9% |
03/01/13 |
1.7% |
|
03/01/84 |
3.3% |
03/01/14 |
1.5% |
|
03/01/85 |
3.5% |
03/01/15 |
0.3% |
|
03/01/86 |
N/A |
03/01/16 |
0.4% |
|
03/01/87 |
0.7% |
03/01/17 |
2.0% |
|
03/01/88 |
4.5% |
03/01/18 |
2.2% |
|
03/01/89 |
4.4% |
03/01/19 |
|
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).
|
Date |
New compensation |
Date |
New compensation |
|---|---|---|---|
|
Prior to 09/07/74 |
.08-.34 = .23 |
Eff. 11/01/74 |
.13-.37 = .25 |
|
|
.35-.57 = .46 |
|
.38-.62 = .50 |
|
|
.58-.80 = .69 |
|
.63-.87 = .75 |
|
|
.81-.07 = .92 |
|
.88-.12 = 1.00 |
ATTACHMENT TO FECA BULLETIN NO. 19 - 01
Back to Top of FECA Bulletin No. 19-01
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 19-02
Issue Date: January 02, 2019
Expiration Date: January 1, 2020
Subject: Compensation Pay: Compensation Rates Unchanged from 2018 Levels.
Background: On December 28, 2018, the President signed an Executive Order freezing General Schedule basic pay rates at 2018 levels.
Reference: 5 U.S.C. 8112; Memorandum for Executive Heads of Departments and Agencies dated December 28, 2018; and the attachment for the 2019 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 $136,659 per annum. The basis for the minimum compensation rate is the salary of a GS-2, Step 1 remains $21,121 per annum. The actual rates are outlined below.
|
Type |
Minimum |
Maximum |
|---|---|---|
|
Weekly |
$304.63 |
$1,971.04 |
|
Daily (5-day week) |
$60.93 |
$394.21 |
|
Type |
Minimum |
Maximum |
|---|---|---|
|
28-Day Cycle |
$1,218.52 |
$7,884.16 |
|
Type |
Minimum |
Maximum |
|---|---|---|
|
Monthly |
$1,760.08 |
$8,541.19 |
Action: The Integrated Federal Employees' Compensation System (iFECS) will not require updates to the periodic disability and death payrolls.
Applicability: Appropriate National and District Office personnel
Antonio Rios
Director for
Federal Employees' Compensation
Distribution: All DFEC Staff
Back to Top of FECA Bulletin No. 19-02
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 19-03
Issue Date: May 22, 2019
Expiration Date: February 29, 2020
Subject: Update Compensation Pay - Consumer Price Index (CPI) Cost-of-Living Adjustment and Minimum/Maximum Compensation Rates.
Purpose: To furnish information on the CPI adjustment for 2019 and inform the appropriate personnel of the Minimum/Maximum rates of compensation for affected cases on the periodic disability and death rolls.
The cost-of-living adjustments granted to a compensation recipient under the FECA are based on the "Consumer Price Index for Urban Wage Earners and Clerical Workers" (CPI-W) figures published by the Bureau of Labor Statistics (BLS). The annual cost of living increase is calculated by comparing the base month from the prior year to the base month of the current year, with the percentage of increase adjusted to the nearest one-tenth of 1 percent. 5 U.S.C. §8146(a) establishes the base month for the FECA CPI as December.
December 2017 had a CPI-W level of 240.526 and the December 2018 level was reported by BLS as 244.786. This means the new CPI increase, adjusted to the nearest one-tenth of one percent, is 1.8 percent. The increase is effective March 1, 2019, and is applicable where disability or death occurred before March 1, 2018. In addition, the new base month for calculating the future CPI is December 2018.
The maximum compensation rate payable is based on the scheduled salary of a GS-15, Step 10, which remains $138,572 per annum. The basis for the minimum compensation rate is the salary of a GS-2, Step 1 remains $21,417 per annum. The actual rates are outlined below.
|
Type |
Minimum |
Maximum |
|---|---|---|
|
Weekly |
$308.90 |
$1,998.64 |
|
Daily (5-day week) |
$67.78 |
$399.73 |
|
Type |
Minimum |
Maximum |
|---|---|---|
|
28-Day Cycle |
$1,235.60 |
$7,994.5 |
|
Type |
Minimum |
Maximum |
|---|---|---|
|
Monthly |
$1,784.75 |
$8,660.75 |
Applicability: Appropriate National Office and District Office personnel.
Reference: FECA Consumer Price Index (CPI) Amendment, dated January 6, 1981; Bureau of Labor Statistics Consumer Price Index Publication for December 2018 (USDL-18-1938); Memorandum for Executive Heads of Departments and Agencies dated December 28, 2018; Executive Order issued on March 28, 2019 and the attachment for the 2019 General Schedule.
Action: National Office Production updated the iFECS CPI tables and recalculated all payment records when the iFECS system was not in use by District Office personnel. The March 29, 2019 check was the first check paid at the 2019 rate. The check issued on March 1, 2019 included 2 days paid at the rate of 2.2%. The Integrated Federal Employees' Compensation System (iFECS) will be updated with the new MIN/MAX rates for the periodic disability and death payrolls. Direct payments will be issued on cases on the rolls that were underpaid as a result of the pay increase. Those payments will be issued by May 31, 2019.
Disposition: This Bulletin is to be retained in Part 5, Benefit Payments, Federal (FECA) Procedure Manual, until further notice or the indicated expiration date.
ANTONIO RIOS
Director for
Federal Employees' Compensation
Attachment: Cost of Living Adjustments
Distribution: All DFEC Staff
|
EFFECTIVE DATE |
RATE |
EFFECTIVE DATE |
RATE |
|---|---|---|---|
|
10/01/66 |
12.5% |
03/01/90 |
4.5% |
|
01/01/68 |
3.7% |
03/01/91 |
6.1% |
|
12/01/68 |
4.0% |
03/01/92 |
2.8% |
|
09/01/69 |
4.4% |
03/01/93 |
2.5% |
|
|
|
03/01/94 |
2.5% |
|
06/01/70 |
4.4% |
03/01/95 |
2.7% |
|
03/01/71 |
4.0% |
03/01/96 |
2.5% |
|
05/01/72 |
3.9% |
03/01/97 |
3.3% |
|
06/01/73 |
4.8% |
03/01/98 |
1.5% |
|
01/01/74 |
5.2% |
03/01/99 |
1.6% |
|
07/01/74 |
5.3% |
|
|
|
11/01/74 |
6.3% |
03/01/00 |
2.8% |
|
06/01/75 |
4.1% |
03/01/01 |
3.3% |
|
01/01/76 |
4.4% |
03/01/02 |
1.3% |
|
11/01/76 |
4.2% |
03/01/03 |
2.4% |
|
07/01/77 |
4.9% |
03/01/04 |
1.6% |
|
05/01/78 |
5.3% |
03/01/05 |
3.4% |
|
11/01/78 |
4.9% |
03/01/06 |
3.5% |
|
05/01/79 |
5.5% |
03/01/07 |
2.4% |
|
10/01/79 |
5.6% |
03/01/08 |
4.3% |
|
|
|
03/01/09 |
0.0% |
|
04/01/80 |
7.2% |
|
|
|
09/01/80 |
4.0% |
03/01/10 |
3.4% |
|
03/01/81 |
3.6% |
03/01/11 |
1.7% |
|
03/01/82 |
8.7% |
03/01/12 |
3.2% |
|
03/01/83 |
3.9% |
03/01/13 |
1.7% |
|
03/01/84 |
3.3% |
03/01/14 |
1.5% |
|
03/01/85 |
3.5% |
03/01/15 |
0.3% |
|
03/01/86 |
N/A |
03/01/16 |
0.4% |
|
03/01/87 |
0.7% |
03/01/17 |
2.0% |
|
03/01/88 |
4.5% |
03/01/18 |
2.2% |
|
03/01/89 |
4.4% |
03/01/19 |
1.8% |
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).
|
Date |
New compensation |
Date |
New compensation |
|---|---|---|---|
|
Prior to 09/07/74 |
.08-.34 = .23 |
Eff. 11/01/74 |
.13-.37 = .25 |
|
|
.35-.57 = .46 |
|
.38-.62 = .50 |
|
|
.58-.80 = .69 |
|
.63-.87 = .75 |
|
|
.81-.07 = .92 |
|
.88-.12 = 1.00 |
ATTACHMENT TO FECA BULLETIN NO. 19 - 03
Back to Top of FECA Bulletin No. 19-03
Attention: This bulletin has been superseded and is inactive.
FECA BULLETIN NO. 19-04
Issue Date: September 9, 2019
Subject: New Opioid Prescribing Guidelines in the FECA Program Limiting Initial Fills to Seven Days and Imposing LMN at 28 Days
Background: Under the Federal Employees' Compensation Act (FECA), the Department of Labor's (DOL) Office of Workers' Compensation Programs (OWCP) shall provide to an employee injured while in the performance of duty, the services, appliances, and supplies prescribed or recommended by a qualified physician, which OWCP considers "likely to cure, give relief, reduce the degree or the period of disability, or aid in lessening the amount of the monthly compensation." See 5 U.S.C. 8103.
In accordance with the discretion granted to DOL and delegated to OWCP, OWCP's Division of Federal Employees' Compensation (DFEC) began to revise its prescription medication policies to institute new limitations including preauthorization requirements; medication limits/prohibitions and allowing certain medications only on an exception basis. As part of its opioid control policy, OWCP DFEC instituted a policy when it issued FECA Bulletin 17-07 on June 6, 2017, to monitor and manage the prescription of opioid medications for newly prescribed opioid users (i.e. where an opioid has not been prescribed within the past 180 days, if ever). This initial new entrant policy restricted opioid fills to a 30-day supply and required prior authorization for opioid prescriptions that continued after an initial 60-day period. DFEC's prior authorization requires the injured worker's treating physician to complete a Certification/Letter of Medical Necessity, Form CA-27 (LMN), which is then reviewed by a Medical Benefits Examiner (MBE) at DFEC prior to granting authorization for opioids past 60 days. While the controls outlined in FECA Bulletin 17-07 have stemmed the tide of a once-growing population of federal injured workers who continued using opioids past 30 and 60 days, additional limitations are being imposed to balance the need for necessary pain medications with the need to minimize opioid overuse and habituation.
Beginning in the fall of 2019, DFEC is instituting a new opioid policy to impose additional limitations and reduce the 60-day period for the required prior approval. DFEC is taking the following steps:
- revising the fill period for newly prescribed opioids;
- limiting the duration of certain subsequent fills; and
- requiring prior LMN authorization at 28 days.
The new policy will align more closely with recommendations from the Centers for Disease Control and Prevention (CDC)1. When this new policy becomes effective, injured workers that are newly prescribed opioid users will at the outset be limited to an initial 7-day supply for all opioids. An injured worker may receive a maximum of four sequential 7-day supply prescriptions (an initial and three subsequent prescriptions), a total of 28 days, from their provider without prior authorization. During this time, each sequential prescription could be for a different opioid but no more than one opioid may be prescribed at any given time without prior approval from DFEC. If exigent circumstances as established by well-rationalized medical evidence necessitate more than one opioid medication at any given time during the initial 28 day period, the MBE may recommend authorization through the District Director (DD) exception process. See FECA Procedure Manual 5-0202.16(a).
For any additional prescriptions exceeding the initial 28-day period, the prescribing physician will be required to complete a Certification/Letter of Medical Necessity, Form CA-27 (LMN), and obtain prior approval from DFEC. The prescriber may complete the form no sooner than 9 days prior to the end of the 28-day period. Authorization periods for opioid prescriptions following the initial 28-day period will continue to be limited to a maximum of 60 days, during which refills will continue to be limited to increments of 30 days. However, the treating physician is encouraged to prescribe the shortest duration of opioid medication that will provide appropriate pain relief2.
Purpose: To provide updated guidance to claims staff on the authorization of opioid products (including compounded medications containing an opioid), for newly prescribed opioid users for a work-related condition other than cancer. For claimants who are newly prescribed opioids, OWCP will now require an LMN to continue authorizing opioids for periods following an initial 28-day supply period and limit the duration of fills during this initial 28 days.
Action: Newly prescribed opioids for the treatment of any work-related condition, other than cancer, will be subject to the following restrictions in the fall of 20193:
- New single fill opioid medications will be limited to an initial 7-day supply fill.
- Claimants may receive up to three additional sequential, 7-day supply prescriptions without prior authorization, with a maximum supply of 28 days. Upon an initial fill of an opioid prescription, the claimant will be notified that any opioid prescriptions following the initial 28-day supply will require prior authorization and the submission of an LMN completed by his or her physician. The physician may complete the initial LMN no sooner than 9 days prior to the end of the 28-day period. For any subsequent authorizations, the physician should complete the form 10 to 15 days prior to the end of each 60-day authorization period to allow for a review of the medical documentation in the claim. During this 28-day period, no more than one opioid may be prescribed at the same time without prior approval from DFEC.
- Upon receipt of a completed LMN, the MBE will review the CA-27 along with the medical and factual evidence in the claimant's case file to determine whether approval of additional opioids is indicated or if further development of the medical evidence is necessary. In evaluating whether the request should be approved or if further development is necessary, the CE should assess factors including (1) whether the physician has demonstrated enough knowledge regarding the claimant to arrive at a sound medical opinion, (2) the medical rationale (supported by an adequate factual and medical background) provided by the physician, and (3) whether the necessity is based on objective clinical findings versus subjective complaints. See FECA Procedure Manual 2-810.6 for additional discussion on weighing and evaluating medical evidence. If the MBE determines that the totality of the medical evidence supports continued opioid use, he or she may approve the initial authorization request without further action. See items 7 and 8 below for necessary actions following receipt of subsequent authorization requests.
- Once an LMN is authorized, all fills (with maximum 30-day supply increments and not to exceed two opioid medications at any one time) will be approved until the end of the current 60-day authorization period. A new LMN will be required every 60 days and each must be reviewed and approved by the MBE prior to approval of additional opioids.
- Opioids included as a part of a compounded medication will continue to require prior authorization from OWCP. If the MBE receives a request for a compounded medication containing an opioid, he or she should follow established compounded medication procedures as outlined in FECA Bulletin 17-01.4
- A properly completed LMN will generate a request for authorization for review by the MBE. An incomplete LMN will be returned to the physician for correction. Duplicate LMNs will be returned as will those submitted when there are already two authorized opioid LMNs on record.
- Should the MBE determine additional development is needed, he or she may contact the claimant's physician for additional information. The MBE may also refer the case to the District Medical Advisor (DMA) for a medical assessment of the appropriateness of the opioid prescription and pain management plan, including the request for treatment/rehabilitation plans to treat dependence on opioids due to prescriptions for an employment-related condition. The Medical Benefits Examiner may also choose to send the claimant for a second opinion (SECOP) examination, if warranted, based on the evidence of record. If a Field Nurse (FN) has been assigned to the case, the MBE may also direct the FN to address the issue of ongoing opioid usage with the treating physician. The MBE may continue to authorize opioid medications while development is pending.
- The MBE may only authorize up to 60 days of additional opioid use with each sufficiently rationalized LMN. Following the expiration of any such authorization, a new LMN is necessary and authorization by the MBE will again be required.
- Continuing opioid use may only be authorized beyond 120 days from the initial fill where the MBE has written to the treating physician (or referred the case to a SECOP or DMA) asking for rationalized medical justification for the ongoing prescription of opioid medications. Should the MBE authorize the second consecutive letter of medical necessity in a given case file, he or she should concurrently request the treating physician to specifically address the medical necessity of continued opioid medication (or refer the file to a SECOP or DMA). The MBE may continue to authorize opioid medications while development is pending as long as there is follow up and/or additional development at reasonable intervals.
- Cases with continued opioid use should be reviewed by either a DMA or SECOP examination every six months from the first authorization.
- The requirements in items (7) and (8) may only be waived if special circumstances exist (such as in a catastrophic case involving multiple major injuries or severe burns) that are certified by a Supervisory Medical Benefits Examiner (SCE) or higher authority.
- If more than six months have passed since the last opioid medication was filled, the process begins anew with an initial 28 days of opioid medication provided without a LMN.
Applicability: Appropriate National and District Office personnel.
Disposition: This bulletin is to be retained until incorporated into the Procedure Manual.
ANTONIO RIOS
Director for
Federal Employees' Compensation
Distribution: All DFEC Staff
1 https://www.cdc.gov/opioids/
2 In accordance with longstanding FECA policy prohibiting therapeutic duplication, only one such opioid may be a Schedule II drug.
3 The issuance of this bulletin does not supersede or otherwise modify existing guidance on Fentanyl. See FECA Bulletin No. 11-05 (issued May 3, 2011). 17-07 (issued June 6, 2017).
4 Unlike other compounded medications, no screening will be performed by the Central Bill Processing Unit (CBP) on compounded medications containing an opioid.
Back to Top of FECA Bulletin No. 19-04