Table of Contents
INITIAL RELEASE - OWCP/DFEC FIELD NURSE HANDBOOK (FNHB)
INITIAL RELEASE - OWCP/DFEC FIELD NURSE HANDBOOK (FNHB)
FNHB TRANSMITTAL NO. 13-01
September 6, 2013
The Office of Workers' Compensation (OWCP)/Division of Federal Employees' Compensation (DFEC) Field Nurse Handbook is a new publication formulated to provide contract Field Nurses (FNs) and other DFEC stakeholders with a resource related to the policies and procedures of the OWCP/DFEC Nurse Intervention Program (NIP).
The Field Nurse Handbook (FNHB) provides specific instructions and guidelines for the FNs who are contracted by the DFEC to provide case management services as part of the Program's Disability Management protocols. The intent is to provide nationally consistent policies and procedures for DFEC's nurse program.
The FNHB is separated into specific Parts by topic, described below. Each Part has its own Table of Contents which outlines the contents of the Part by labeled paragraphs (similar to the FECA Procedure Manual).
The handbook describes specific elements that are required and expected for the various components of the NIP and includes exhibits with examples of acceptable documentation, where warranted. However, implementation of identified components and related elements may vary across District Offices due to District Office size and/or structure. For example, Part 6 of the handbook addresses various methods of documenting communications with a focus on the elements the FN should include in his/her communication. Because a preferred method of communication may not be the most functional option for some offices, alternative methods are provided and are acceptable.
Likewise, Part 6 addresses FN report formats. The focus of this Part is on the identification of each report, the elements that the FN should be including in each report and the general preferred formatting related to font type and size. The exhibits provide examples of each report type and reflect the inclusion of the required elements. While the style of reporting presented in the example may not be practical for all District Offices (and associated FNs), the intended emphasis here is on the information to be provided in the content of the reports.
As mentioned above, the intent is to bring focus and consistency to the major components of the NIP. The FNHB is meant to provide the FN with a resource and reference guide, to be used in conjunction with but not as a replacement for, formal FN orientation and training sessions conducted in accordance with NIP certification and contracting guidelines.
If any questions arise regarding interpretation or implementation of policies outlined in this handbook in general, or with regard to a specific case, the FN should always consult with the District Office Staff Nurse (SN).
Please note the FNHB references two resources that are yet to be published: the Continuation of Pay Nurse Handbook (CNHB) and the Rehabilitation Counselor Handbook (RCHB). The FNHB will be updated with the appropriate links to each of these references as they are published and made available.
Also note that matters of contractual requirements and disciplinary issues (warnings and terminations) are not addressed in this handbook because these topics are a stipulation of the signed Memorandum of Agreement (MOA). Information on these topics can be found in the FECA Procedure Manual, 3-201.12c(3) and 3-202.13. Every FN utilizing this handbook must have agreed to the contractual requirements as evidenced by his/her signature on the MOA. A FN signature on the MOA serves as the FN designation of understanding and agreement to adhere to the contractual requirements and any disciplinary actions that may result from non-compliance. Nothing in this handbook is intended to supplant, override or otherwise modify the terms of the MOA.
EXPLANATION OF MATERIAL TRANSMITTED:
Part 1, Introduction, details the purpose for (and scope of) the FNHB, including a description of the role of the Nurse Case Manager within the OWCP/DFEC program arena. The Introduction also provides a brief overview of the OWCP and DFEC programs, as well as a description of the general provisions of the FECA. The information included within the overview is intended to provide the FN with the basic tenants of the programs for which s/he will be providing services. This material serves as a valuable resource to increase the FN knowledge base regarding the OWCP/DFEC program goals and objectives, and FECA regulations, which will be of assistance when working with the injured worker and other interested parties. For more specific information pertaining to DFEC policies and procedures, the FECA Procedure Manual (available on the DFEC website) should be consulted.
Part 2, Nurse Intervention Program Overview, provides references to 20 C.F.R §10.310(a) as the authority for OWCP/DFEC's use of FNs, as well as a reference to DOL/GOVT-1 as the authority for information related to disclosure of information to/from a FN acting on behalf of the OWCP. When working as a contracted employee of the OWCP/DFEC in matters related to an injured worker's work-related medical information, the FNHB clarifies that pursuant to DOL/GOVT-1, the FN is not required to obtain a separate signed authorization from the injured worker.
This part also outlines and describes the objectives of the NIP, the key participants in the NIP, as well as the general expectations of the FN participating in the NIP.
Paragraph 3e, OWCP Certified Field Nurse (FN), specifically defines the role of the Field Nurse. Within the scope of this handbook, as well as the DFEC Procedure Manual, the term OWCP Certified Field Nurse (FN) represents all contracted nurses providing nurse case management services to injured workers, regardless of assignment category (Early Disability Management Assignment, Task-Based Assignment or Catastrophic Assignment). For consistency and clarity, the Program has phased out the use of the term "Telephonic Case Management" (TCM). While the handbook addresses the use of telephonic nurse services, specifically Part 3 paragraph 2a, the distinction between the type of FN assignment (on-site vs. telephonic only) for any given case is made during the referral process. Regardless of assignment type, the term Field Nurse is used.
Part 3, Early Disability Management Field Nurse Assignments, provides information specific to the role of the FN assigned to provide nurse case management services during the Early Disability Management phase of a case. This Part focuses on the assignments, interventions, and types of contacts common to all NIP cases in this category. It will assist the FN in knowing the Program's expectations when performing the nurse case management activities associated with these types of assignments, as well as the timeframes within which the stated goals and objectives are to be accomplished.
Paragraph 8 of this Part introduces and discusses the Dual Tracking initiative. It provides the FN with the basic information related to this Disability Management strategic approach, which will assist the FN in identifying to the Claims Examiner (CE) and SN cases that may benefit from a Dual Tracking assignment.
Part 4, Task-Based Nurse Assignments, is a relatively new category of FN assignments. The basis for a Task-Based Assignment is described in this Part and these types of assignments can assist the CE in the medical aspect of claims management and usually occur later in the life of a case, as opposed to the Early Disability Management intervention period. This Part provides the FN with the general principles related to the reason a Task-Based Assignment may be made and the expectations related to types of interventions to be performed, the types of contacts that may be required to complete the task, and time allotted to complete the goal(s) and objective(s).
Part 5, Catastrophic Case Nurse Assignments, provides for the FN the rationale for this category of assignment, the means by which the SN makes a Catastrophic Assignment (as the decision making process for assignment may differ here when compared to other assignment categories), and describes the expectations of the Program in regards to nurse interventions, contacts, and associated timeframes.
Part 6, Communications and Documentation, provides information related to FN communications with the CE and/or SN, with a focus on the importance of maintaining open lines of communications and making timely notifications of case activities and/or changes in case status, including examples of case activities that require prompt CE and/or SN notification.
This Part describes the acceptable modes of communications available to the FN and the process of documenting these communications. Included in this Part is a description of the specific elements required for the various types of communication as well as the Program's expectations regarding timeframes associated with the submission of specific documents.
The FNHB addresses formal report documentation by assignment category (Early Disability Management Assignments, Task-Based Assignments and Catastrophic Assignments) and report types within each assignment category (Initial Evaluation Report, Progress Report and Closure Report). Sample reports are included, however, it should be noted that the most important focus of this section is the content of each report and not the specific style of the report.
Part 7, Facilitating Medical Interventions, provides information related to the FN's role in identifying and communicating certain medical issues to the CE that may require prompt attention/actions. This Part also describes the Program's expectations regarding the FN's active facilitation of these issues between the CE and medical provider(s).
Part 8, Authorizations for Medical Services, provides the procedures for the FN in his/her role as a liaison for and contracted employee of the OWCP/DFEC in the medical authorization process. This Part briefly describes the Central Bill Processing (CBP) system, the requirements necessary for providers to ensure authorization of, and reimbursement for, services rendered in relation to an OWCP case, and the actions the FN may engage in to facilitate the recommended medical care/service.
Part 9, Billing Requirements and Procedures, provides a description of, and procedures for, FN billing activities and facilitating appropriate, timely reimbursement for services rendered. Specific reimbursement rates are not included.
Part 10, Security of Case Information and the Privacy Act, provides reference to 5 U.S.C. 552a and 29 C.F.R. 71. - the Privacy Act of 1974 - as the regulatory authority providing for the protection of an injured worker's personal information. The FN working as a contracted employee of the OWCP is obligated to adhere to the provisions of this regulation when rendering services in individual cases.
This Part also addresses the issue of case file security and the FN responsibilities in providing for, and maintaining, the secure status of an OWCP case file.
These components are also a condition of the signed MOA. The Program recognizes the FN signature on a MOA as designation that s/he understands and agrees to abide by the terms of the Privacy Act and Security of Case Information as set forth in the MOA.
DOUGLAS C. FITZGERALD
Federal Employees' Compensation
Transmittal of the DFEC FNHB, like the FECA Procedure Manual, is electronic in nature and material is published on DFEC's internet page.
Similar to how DFEC publishes and updates its Procedure Manual, DFEC will release and update this handbook in the same fashion. As changes and updates are made in the future, DFEC will update the material and provide a FNHB Transmittal outlining the change. Both will be visible via DFEC's internet page.
Distribution: All DFEC Staff and OWCP/DFEC Certified Field Nurses