Procedure Manual
Get this from a library! Federal (FECA) procedure manual. Part 6, Correspondence. [United States. Employment Standards Administration.
FECA Part 7
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1. OWCP Objectives. The Office of Workers' Compensation Programs (OWCP) is committed to seeing that benefits for compensation and medical services are appropriately and timely provided. OWCP is also committed to assisting injured workers in obtaining a successful medical recovery and minimizing the period of disability from work. Management of disability claims begins as soon as a new claim is received indicating that the employee has lost time from work as a result of the injury or is disabled from his or her date of injury position.
2. Scope. This chapter defines the objectives and purpose of nurse intervention and the types of nurses involved in the OWCP nurse intervention program. Federal Employees' Compensation Act (FECA) Procedure Manual (PM) 2-0600 discusses disability management from a CE's perspective, and FECA PM 2-0811 discusses the role of nurse case management.
Services of field nurses are authorized by 5 U.S.C. 8103; 20 C.F.R. §10.310(a) specifically references that 'OWCP may also utilize the services of a field nurse to facilitate and coordinate medical care for the employee.'
Disclosure of information to contract nurses is authorized by routine use 'e' of DOL/GOVT-1, which permits disclosure: To physicians, pharmacies, and other health care providers for their use in treating the claimant, in conducting an examination or preparing an evaluation on behalf of OWCP, and for other purposes relating to the medical management of the claim, including evaluation of and payment for charges for medical and related services and supplies.
3. Purpose. To further the objectives noted above, OWCP created the Nurse Intervention Program and incorporated it into the Quality Case Management (QCM) portion of the Disability Management process. QCM is a case management approach which has as its primary goal the medical recovery and reemployment of injured workers who are in the beginning stages of disability. The objectives of QCM are to take a series of purposeful actions to obtain medical care in a timely manner, to obtain timely work tolerance limitations, and to prevent cases from reaching the long-term disability roll. QCM is an initiative to intervene with injured workers, employing agencies (EA) and medical providers as early as possible in the recovery process to assist in the facilitation of medical treatment plans and arrange for appropriate reemployment.
Incorporating nurse intervention services into the QCM disability management process, and involving nurses in the early stages of disability cases, facilitates expedited medical care and recovery and can result in shortening the length of disability from work. Although the Claims Examiner (CE) ultimately remains responsible for the case management activities and overall direction of the case, QCM consists of more than just CE intervention. The best outcomes stem from an active team approach where the CE, the nurse, the EA, the claimant, and the medical providers use all available tools to facilitate medical recovery and a successful return to work. As a result, nurse intervention is an integral part of the overall disability management of a claim.
4. National Office Nurse Consultant. The National Office Nurse Consultant (NONC) serves as the National Coordinator for the OWCP nurse intervention program. The NONC is responsible for overseeing the appropriate application of medical standards to the OWCP nurse program; planning and developing methods for the assessment of the OWCP nurse programs; serving as a resource for the District Office Staff Nurses; and, as needed, implementing improvements based upon the analysis of internal OWCP data and examination of outside trends in the workers' compensation field.
5. District Office Staff Nurses. Each district office retains the services of a Staff Nurse (SN) to administer the policies and procedures of the OWCP nurse intervention program. The SN coordinates the assignment of contract nurses for specific cases; monitors contract nurses' performance in correlation to both the contract specifications and the quality of services provided; reviews nurse reports for completeness and timeliness prior to authorizing payment of bills; and communicates with the CE as needed with regard to issues that arise during the nurse intervention phase.
As mentioned above, the QCM disability management process is a collaborative effort. While the CE maintains authority over the case management actions, communication between the SN, CE, and contract nurse is essential to reaching the goals and objectives established for any given disability case. The SN is in a unique position to timely identify and bring to the CE's attention medical issues or obstacles that need prompt attention. In addition, active involvement of the SN facilitates the interactions and communications between the CE and contract nurse.
A CE or other district office staff member may consult with the SN in order to assess medical treatments and protocols; discuss whether a particular treatment or surgery is appropriate; or seek recommendations on alternative avenues for continued treatment. The SN is also able to provide clarification and explanation related to medical issues or treatment requests that may be unfamiliar to the CE.
The SN also serves as a liaison and resource for EA representatives. The EA may contact the SN directly regarding any concerns or questions it may have about a specific contract nurse, nurse assignment, or the OWCP nurse intervention program in general. The SN may also participate in agency training sessions offered by the district office.
6. Continuation of Pay (COP) Nurses. COP Nurses (CN) are contracted nurses assigned in traumatic injury cases where the injured worker has immediate disability and has not returned to work within 7 days following the date of work stoppage (this information is taken from the data contained on the Form CA-1). The CN enables the district offices to identify cases in need of prompt adjudication and assists the CEs in prioritizing their adjudication efforts. The CNs have a role only during the COP period and are strictly triage nurses whose work is performed telephonically. (CNs are not assigned in occupational disease cases.)
Within 7 days of case assignment, the CN should contact the claimant, the EA and the treating physician. At a minimum, the CN should obtain a history of the injury from the claimant; confirm the work status with the EA and ascertain whether work accommodations are available; and contact the physician's office to obtain a history of the medical treatment provided and the expected treatment plan. This information is then used by the CE to make decisions about the best case management path for that particular case, which may include expedited adjudication of the case and referral for Field Nurse (FN) assignment.
7. Field Nurses. The FN is a contracted registered nurse who assists in the management of disability claims in a number of ways. FN services are a valuable tool for assisting in the claimant's recovery process by coordinating medical care, facilitating a safe and timely return to work, and aiding the CE in moving a disability case towards resolution. The FN's contact is generally in person; however, in some instances the activity may be only telephonic in nature.
Early referral for FN intervention services is critical to ensuring successful disability management. FN assignment should occur as soon as possible after the injury occurs and the claim has been approved for a work-related injury. FN assignment should occur if the claimant has not returned to work and may also occur if the claimant has returned to work but remains disabled from performing his or her date of injury position. An FN is usually initially assigned to a case for 120 days, but this assignment period may be extended.
Specific FN activities may include the following: making assessments of the initial extent of the injury; coordinating treatment necessary for recovery; communicating return-to-work expectations; attending the claimant's medical appointments to facilitate communication about return to work and ease any authorization difficulties the claimant may be encountering; identifying possible barriers to the claimant's return to work and then developing a plan of action with the CE to resolve the identified barriers; making recommendations for vocational rehabilitation; and acting as a liaison between the CE, claimant, EA, and medical providers.
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1. Background. The Office of Workers' Compensation Programs (OWCP) has been using Continuation of Pay (COP) Nurses for many years. Federal Employees' Compensation Act (FECA) Bulletin 00-15 (COP Nurse Intervention), issued September 18, 2000, introduced the implementation of the COP Nurse (CN) intervention program as an effort to provide early identification and triaging of certain traumatic injury cases involving disability from work during the 45-day COP period. By utilizing early intervention of the CN process, there has been a favorable impact upon expedited adjudication of traumatic injury disability cases, thus allowing early disability management interventions to assist with medical recovery and return to work (RTW) efforts.
Since the release of FECA Bulletin 00-15, subsequent updates have been made to the CN intervention program to facilitate quicker assignments to the CN and more efficient follow-up actions by the OWCP claims staff. FECA Bulletin 01-09 (COP Nurse Intervention), issued February 5, 2001, incorporated changes to the CN intervention program which further enabled the district offices to identify traumatic injury cases in need of prompt adjudication and assisted Claims Examiners (CE) in prioritizing their adjudication efforts. Specific triage codes were created whereby the CN was able to identify the disability status of a claimant upon closure of his/her intervention activities. These CN disability triage closure codes, along with the automated updates and processes to both the CN's web-based 'home page' and the district office's case management system, assisted the CEs in identifying and prioritizing the adjudication of these cases. In addition, case management reports were revised so that OWCP claims staff were better able to track and monitor traumatic injury cases that included the prioritized triaged closure coding.
FECA Bulletin 10-04 (COP (Continuation of Pay) Nurse Intervention Process Updates), issued September 10, 2010, was the latest update to the CN intervention process. This Bulletin provided guidance to OWCP claims staff, the district office Staff Nurse (SN), and employing agencies (EA) regarding significant updates and revisions to the CN intervention program. Those updates and revisions included earlier CN case eligibility, quicker CN assignments, specific expectations for CN intervention activities, shorter timeframes for CN activities and reporting, allowance of CN access to view certain applications within OWCP's case management system, and expansion of CN closure codes. The EAs' access to view case statuses through the Agency Query System (AQS) was updated to allow them to see which cases were assigned to a CN, and upon CN closure, they were able to see the CN closure status and date. EAs were also provided information regarding the preferred method of prompt reporting of an injured worker's RTW via electronic submission of Form CA-3. Finally, OWCP claims staff was advised of necessary case management actions in regard to CN assignments, CN closures, and notices of RTW. Additional reports were made available to assist the OWCP claims staff to more effectively manage cases during the CN intervention process.
2. Purpose and Scope. This chapter defines the objectives and purpose of the CN intervention program and the roles and responsibilities of the stakeholders involved.
FECA Procedure Manual (PM) 2-0600 (Disability Management) discusses disability management from a CE's perspective, and FECA PM 2-0811 (Nurse Case Management) discusses the role of nurse intervention in the Disability Management process.
3. Introduction. Involving nurses in the early stages of disability cases (even prior to case adjudication) facilitates expedited medical care and recovery and can result in shortening the length of disability from work.
The CN is a registered nurse who is assigned to traumatic injury cases where the injured worker has immediate time loss and has not returned to work within seven (7) days following the date of work stoppage. The CN assignment occurs prior to case adjudication. The CN is strictly a triage nurse who performs all work telephonically.
The information obtained by the CN is then used to make decisions about the best path for that particular case. In particular, the information provided by the CN should assist the CE by triaging the severity of the injury and/or disability. This most often leads to the CE being able to expedite adjudication of traumatic injury disability cases and subsequently determine whether a referral for Field Nurse intervention would be beneficial to assist with the medical recovery and RTW efforts integral to the success of early disability case management.
Note: COP is not payable in occupational disease cases, and occupational disease cases are ineligible for CN assignments.
4. Identification of Cases for Assignment of COP Nurse.
a. Based on the data entered when a traumatic injury case is created from Form CA-1 (specifically, the date the injured worker stopped working), a case becomes automatically eligible for CN assignment if all of the following conditions are met:
(1) It is a traumatic injury case;
(2) The injured worker stopped work at least 7 days ago;
(3) The injured worker stopped work less than 31 days ago;
(4) The injured worker has not returned to work;
(5) The injured worker is in a COP status (based on the checkbox on the Form CA-1); and
(6) The case is an administratively closed case or its current pay status is either Unreviewed (UN) or Under Development (UD).
b. COP cases are automatically referred to the SN for assignment through the office's case management system based on the criteria noted above. When the SN makes the assignment, it is recorded and tracked. The CN is usually assigned on a rotational basis if there is more than one CN per state/territory. The CN assignment occurs even though the case has not yet been formally accepted.
c. CN assignments are made electronically through the office's case management system, and necessary information is accessed by the CN via remote access to select applications of the office's case management system. The CN can view his/her open cases, cases requiring action, and new assignments.
d. If the EA reports a RTW after the Form CA-1 has been submitted but prior to the CN assignment, the RTW date should be immediately updated in OWCP's case management system so that a CN is not assigned. If a RTW is reported after the CN assignment but before the CN closure, the RTW date should be immediately updated in OWCP's case management system so that CN intervention can be closed (whether the CN has taken any actions or not).
5. COP Nurse Intervention Actions. Although CN intervention is not extensive during the COP period, the medical knowledge and experience of a CN assists with the identification of cases that require more extensive intervention due to the severity of the injuries, contemplated surgical intervention, or lost time from work.
a. In order to effectively triage the case, within 7 days of case assignment the CN should:
(1) Contact the injured worker to obtain a history of injury, history of treatment, and current work status, as well as physician contact information.
(2) Contact the EA to confirm the injured worker's current work status and ascertain whether light duty work accommodations are available, if needed.
(3) Contact the treating physician's office to obtain a verbal history of treatment, the expected treatment plan, and, if available, the date of the injured worker's next appointment. At that time, the CN can also provide general information regarding communication with the OWCP (such as the address for submission of treatment notes/reports), how to submit medical authorization requests, and how to submit bills should the case be approved. The CN should also advise the physician's office whether light duty job accommodations can be provided based on the prior contact with the EA and, if appropriate, provide a Form CA-20, Attending Physician's Report, requesting that it be completed and submitted to OWCP.
b. The CN should obtain the necessary information, as outlined above, and submit a closure report within 7 days. However, if the CN determines that the injured worker will be returning to work within the following week, and the specific contact information supporting a definitive RTW date has been has been entered into the case management system, the CN assignment can remain open beyond the 7-day time limit in order to verify and report the RTW date and status. However, in these specific situations, the CN closure should still occur no later than 14 days after assignment.
c. Once the CN has gathered the information, he/she enters it into the case management system. These entries are then automatically part of the COP Nurse Report. The CN should also include any other relevant information pertaining to possible issues or concerns regarding the recovery process or potential barriers to the RTW effort. The CN should make a specific recommendation pertaining to whether a Field Nurse assignment would be beneficial. The CN closure report should contain the RTW status and provide a recommendation regarding early intervention and assignment to a Field Nurse.
d. When the CN closes the case, he/she should also confirm appropriate handling/destruction of case file records.
6. COP Nurse Reimbursement. When the CN closes a case, the SN reviews the closure for appropriateness and accuracy. Once the SN has approved the closure, the COP Nurse Report is automatically generated for processing into the electronic case file, and the bill is processed electronically and submitted for payment to the central bill payment processing facility.
7. Claims Examiner Action Upon COP Nurse Closure. After the SN approves the CN closure, the CN report will be viewable in the case file.
a. If the CN closes the case and the injured worker has not returned to work in a full-time capacity, the case should be reviewed for expedited adjudication action. The information provided in the CN closure report may also be used to determine whether a referral for Field Nurse intervention is needed.
b. For an administratively closed case, any CN closure code that denotes less than a full-time RTW will 'flip' the case to UN status so that it can be adjudicated. Since Field Nurses are not assigned to unadjudicated cases, the CE should attempt to expedite the adjudication process in these cases where the claimant has not achieved a RTW in a full-time capacity. If the case cannot be accepted upon first review, prompt development action should be undertaken. The claimant will be afforded 30 days to submit necessary evidence, but the claim should be monitored during that 30-day period so that it can be accepted as soon as the proper supporting documentation is received.
c. If a traumatic injury case has been accepted, and the claimant has not returned to work in a full-time capacity, the case should be referred for Field Nurse assignment promptly after acceptance. This referral should occur even if the COP period has not elapsed. In addition, a Field Nurse referral should also be considered if the claimant has returned to work full time but in a light-duty status.
8. COP Nurse Closure Codes. Every case assigned to a CN is closed with a COP Nurse Closure Code in the case management system.
COP Nurse Closure codes are outlined below:
Code | Description |
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9A: | COP Case Closed-Case Accepted |
9B: | COP Case Closed by CE with FT/LD RTW |
9C: | COP Case Closed by CE with FT/RD RTW |
9D: | COP Case Closed-Case Denied |
9E: | COP Case Closed by CE with PT RTW |
9F: | COP Case Closed Using CA-3 with FT/RD RTW |
9G: | COP Case Closed Using CA-3 with FT/LD RTW |
9H: | COP Case Closed-Emergency Hospitalization |
9K: | COP Case Closed Using CA-3 with PT RTW |
9L: | COP Case Closed by Nurse with FT/LD RTW |
9N: | COP Case Closed-No RTW |
9O: | COP Case Closed-Claimant Not Cooperating |
9P: | COP Case Closed by Nurse with PT RTW |
9R: | COP Case Closed by Nurse with FT/RD RTW |
9S: | COP Case Closed-Surgery Imminent |
9T: | COP Case Closed-Catastrophic Case |
9U: | COP Case Closed-RTW Unknown |
9X: | COP Case Closed-Stopped Work >45 days |
9Y: | COP Case Closed Using CA-3-RTW without status |
Vocational Rehabilitation Counselor Handbook
Part 6
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1. Overview. Most often, vocational rehabilitation services begin with a request for the Rehabilitation Counselor (RC) to explore a possible return to work with the Injured Worker's (IW) previous Federal employer. While this may be done in conjunction with, or parallel to, other rehabilitation services, it is an important part of the FECA rehabilitation effort and is always the first priority.
Section 8151 of the FECA provides civil service retention rights to Federal employees who have recovered either fully or partially from an employment-related injury or illness, and who can perform the duties of the original job or its equivalent. The FECA regulations at 20 C.F.R. §10.505 explain that the employer should make all reasonable efforts to place the employee in his or her former, or an equivalent, position in accordance with 5 U.S.C. 8151 if the employee has fully recovered after one year. Under 5 U.S.C. 8151, the Federal employer must restore a permanent employee (i.e., one with career or career-conditional status) who recovers within one year after beginning disability/wage loss compensation to that position or its equivalent. This provision does not apply to temporary or term employees. The Office of Personnel Management (OPM), not the OWCP, has jurisdiction over retention and restoration rights and is responsible for enforcing this provision. The OPM regulations at 5C.F.R §353.301 provide an overview of restoration rights for fully recovered and partially recovered employees.
2. Benefits of Placement - Previous Employer (PPE). IWs most often prefer to return to work with previous employers and there are a variety of advantages for both parties because:
a. It is often the quickest way to return the IW to duty.
b. It reduces potential salary loss for the IW that may come with a new employer or career change.
c. It may preserve the IW's pension, benefits and seniority rights.
d. It places the IW in a familiar environment and may decrease anxiety about returning to work.
e. It allows the employer to maintain an experienced employee, saving recruitment and training costs.
f. It can reduce or eliminate disability/wage loss compensation payments and costs incurred by the employer.
3. Initial Steps. Unless the previous employer has already explicitly refused reemployment for the IW, and/or the Rehabilitation Specialist (RS) instructs otherwise, the RC should contact the previous employer first to explore return to work possibilities. The employer's point of contact information will be included in the DFEC referral information.
Often, a contracted DFEC Field Nurse assigned to the IW's case has already been in contact with the employer and may have initially addressed return to work possibilities. Usually, however, a Field Nurse will no longer be assigned to the case when it is referred for vocational rehabilitation services, but there are exceptions. See paragraph 12 of this Part: Dual Tracking.
If a Field Nurse is no longer assigned to the case, the RC should review the nurse's reports along with the referral information and confer with the RS, if necessary, to discuss the status of the return to work effort to avoid duplicating efforts. If it is not absolutely clear that the previous employer cannot accommodate the IW, the RC should independently contact that employer to inquire about the availability of work accommodations.
As noted in paragraph 12, if a Field Nurse is still assigned to the case, the RC should approach the employer in conjunction with the nurse, as appropriate.
4. PPE Process.
a. The RC should contact both the IW and the previous employer within 10 business days of receipt of the referral. Initial contacts with both the IW and the employer may be telephonic.
b. The RC should schedule an in-person initial interview with the IW in an accessible location as quickly as possible after the first contact in order to ensure prompt action and provision of services. In rare circumstances, if an in-person interview is not possible, the RC may receive authorization from the RS to use an alternate method to complete the interview.
c. The RC should work with both parties to determine whether a return to previous duties is possible, with or without accommodations. Exploration and discussion of other options should take place as well, e.g. light or modified duty, gradual return to work, telework ,or reassignment to a different job within the agency. As noted in paragraph 6 below, any job offer must meet certain pre-established criteria.
d. Within 30 days, the RC should assess prospects for return to work placement with the previous employer. At that time, if the employer has not identified a position, the RC should contact the RS to discuss how to proceed. If exploration of modified or alternate duty is in process, it may be appropriate to extend the PPE phase and continue to work with the previous employer while also initiating services which may lead to placement with a new employer. In some circumstances, the RS may direct the RC to begin working jointly on both placement with the previous employer and plan development for a new position/employer from the start of the referral.
e. Even if the original PPE phase is extended, the PPE process should usually not exceed 60 days unless a return to work is imminent. If there is an actual return to work, the RC should provide follow-up services for an additional 60 days.
f. Requests for time extensions in exceptional circumstances must be made to the RS as early as possible for consideration. The requests should be in writing and include a justification of the need for extra time.
5. Rehabilitation Counselor (RC) Services. RCs are expected to provide support in the following ways, though this list is not exclusive:
a. Technical advice and counseling related to accommodations and disability issues, as well as exploration with the employer to identify other job possibilities within the agency.
Note - Questions concerning an employing agency's legal responsibility to accommodate its employees under Section 501 of the Rehabilitation Act (and related laws) should not be answered by the RC, as that is the responsibility of the employing agency's legal counsel.
b. Time-limited medical rehabilitation services – Functional Capacities Evaluation (FCE), Work Hardening – to assist with clarification of work tolerances, work restrictions and/or accommodations. See Part 4 of this handbook.
c. Ergonomic and assistive technology assessments to identify accommodations in same or new job. See Part 5 of this handbook.
d. Job Site Analysis in which the RC documents the physical and/or other requirements that a specific job entails and then makes recommendations as to whether or not the job is within the work tolerance limitations of the IW and/or if it could be adapted ergonomically or with other accommodations to do so.
e. Vocational testing and transferrable skills analysis to identify the IW's aptitudes and abilities which may transfer to new positions within the agency. See Part 5 of this handbook.
f. Short-term, targeted training which may qualify the IW for an alternate position with the employer (e.g. computer, clerical skills). See Part 5 of this handbook.
g. Guidance and counseling with the IW on disability and return to work issues; foster motivation and engagement in the return to work process.
6. Job Offer from Previous Employer. If a position is identified and a return to work is intended, the employer must first provide a written job offer.
a. Job Offer Requirements. The RC should work with the employing agency (EA) to craft an offer that includes the following elements:
(1) A description of the duties to be performed;
(2) The specific physical requirements of the position and any special demands of the workload or unusual working conditions;
(3) The organizational and geographical location of the job;
(4) The date on which the job will first be available;
(5) The claimant's work schedule;
(6) Pay rate (salary) information; and
(7) The date by which a response to the job offer is required.
b. A job offer should be consistent with the employee's vocational qualifications and medical restrictions as determined by the Claims Examiner (CE). When a job offer is made by the previous employer, the RC should review it to determine whether these criteria have been met. The ultimate determination regarding suitability of the job offer, however, can only be made by the CE (see Part 7, paragraph 5, of this handbook and the FECA Procedure Manual 2-814 for a further discussion of job offer suitability).
(1) Vocationally – The job should be compatible with IW's educational and vocational capabilities. This is usually not an issue with PPE since the EA will have greater knowledge of the IW's vocational skills and abilities than OWCP based on the IW's initial application and work experience and/or would be able to provide any training necessary to perform the job. Therefore, an extensive assessment of these criteria is usually not necessary unless there is evidence suggesting a vocational inability to perform the job or an objection is raised by the IW, in which case the RC should address the issue with the EA and advise the RS of this information immediately.
(2) Medically – The medical evidence should establish that the IW is able to perform the job, taking into consideration medical conditions due to the accepted work-related injury or disease, and any other medical conditions (including those that pre-existed the work injury and those that have arisen since the injury). If pre- or post-existing conditions disable the IW from an offered job, the job cannot be considered suitable by the CE. For example, an IW with an accepted back condition may have developed a nonemployment-related cardiac condition of sufficient severity to render the job unsuitable.
(3) Other factors to consider -
(a) Ideally, a job offer should be made for the number of hours for which the IW has been released to work. When this is not possible, the previous employer may offer a job for fewer hours. As long as the offer is for at least half of the total hours for which the IW has been released to work, it may be found suitable. However, a job offer of less than two hours per day (or less than 20 hours per pay period) will always be considered unsuitable. If the previous employer cannot accommodate the full number of hours for which the IW has been released to work, the employer must provide written verification that it is unable to do so.
(b) A seasonal job will usually be unsuitable unless the IW was a seasonal employee when injured. Seasonal positions, if suitable, must last 90 or more days.
(c) A temporary job is usually unsuitable unless an IW was a temporary employee when injured. A temporary position, if suitable, must last for 90 or more days.
c. The RC should verify that the job offer is received by the IW and OWCP. The CE will review the job offer and issue a suitability determination if the IW does not return to work.
d. When considering the job offer, the IW should be aware that under the FECA an employee is required to accept a suitable offer of employment from his/her previous employer.
5 U.S.C. 8106(c) provides that a partially disabled employee who refuses to seek suitable work, or refuses to or neglects to work after suitable work is offered to or arranged for him or her, is not entitled to compensation. An employee who refuses or neglects to work after suitable work has been offered or secured for him or her has the burden to show that this refusal or failure to work was reasonable or justified.
The IW must be flexible with regard to duties, hours, shift, pay, position location, travel requirements, environment, or other benefits which may have changed. If the IW has questions related to the impact of reemployment on Federal benefits, he/she should be encouraged to discuss the job offer with the employer or CE.
7. Job Offer Accepted. If the IW accepts the employer's job offer, the RC should immediately document and communicate this information to the RS and assist with the identification of a start date and any VR services needed to assist with the transition back to work.
a. Once a return to work date has been established the RC should immediately notify the RS and submit a Rehabilitation Action Report, Form OWCP-44 (or DFEC specified equivalent).
b. Unless otherwise instructed, the RC should provide follow-up services over the next 60 days. These services may include technical assistance, counseling and guidance and/or any additional vocational rehabilitation services needed by the IW or employer and approved by the RS.
c. The RC should contact the IW and employer at minimum during the first day on the job, at the end of the first and second months of employment, and prior to closure of the file. At least one of these contacts should be an in-person job site visit. However, the RC is not limited to only these contacts and should maintain communications with both parties, as needed, to assist with problem solving and to ensure a smooth transition back to work.
d. All regular communications and any problems which may arise should be documented and reported promptly to the RS. If the RC feels that a time extension for additional services or increased professional hours is required, a request with justification should be submitted promptly in writing for the RS's consideration.
8. Job Offer Rejected. If the IW rejects the employer's offer, the RC should immediately notify the RS and submit a Rehabilitation Action Report, Form OWCP-44 (or DFEC specified equivalent), providing the IW's reasons for concern and rejection of the offer, if known. The RC should discuss with the RS how to proceed with VR services. The RC should also advise the IW to contact his/her CE to discuss concerns. If these are related to the need for accommodations or the ability to perform certain job tasks, the RC may be asked to arrange for additional vocational rehabilitation services such as the aforementioned job site analysis to assist with clarification of these issues.
If the IW cannot be contacted and/or is not cooperative with additional services, the RC should inform the RS immediately. As noted above in paragraph 6 of this Part, the CE may need to determine whether the job offer is suitable and/or whether additional services are needed.
9. No Job Offer from Previous Employer. If, after a reasonable amount of time (usually 30 days) and follow-up by the RC, the previous employer does not identify a position and there is no expectation that a job offer will be made, the RC should arrange and hold a final meeting with the previous employer, either in person or by telephone.
a. This meeting must take place prior to the 60th day in PPE status at the latest, but may take place sooner if there is no activity toward a job offer.
b. During the meeting, the RC should remind the employer of the following, which should have already been discussed in the initial contact:
(1) The IW's current functional capacities.
(2) Any opportunities the RC sees for modified or alternate duty possibilities.
(3) Vocational services and support which may be available to assist with the return to work if a specific job offer is made.
(4) The advantages of reemployment to the agency and the IW.
(5) The potential consequences to the agency if the IW needs to pursue employment elsewhere, which includes the expense to the agency of funding additional vocational services for the IW, as well as the agency's long-term responsibility to pay partial wage loss compensation if the IW obtains a lower paying job with a new employer (based on the loss of wage-earning capacity).
(6) The date on which the RC will consider the PPE process complete and move the case into the next phase of the rehabilitation process.
c. If there is no job offer or further expression of interest by the date noted in number 6 above, the RC should document it, contact and inform the RS, and discuss how to proceed. At this point, it is likely that the RS will instruct the RC to begin or continue plan development with services focusing on placement with a new employer. As always, any request for consideration of time extensions should be made promptly in writing, including justification.
10. Time Frames. Unless otherwise authorized, RCs should provide the following services within the identified time frames during the PPE process:
a. Initial contact with the IW and previous employer should be completed within 10 (business) days from receipt of referral. At the time of initial contact, the RC should schedule the initial interview as soon as possible to ensure prompt initiation of rehabilitation services.
b. An initial determination as to whether a return to work with the previous employer is possible should be made within 30 (calendar) days. If not, the RC should contact the RS to discuss the status and whether to continue to pursue PPE and/or initiate additional vocational rehabilitation services. The RC should be prepared to provide recommendations for upcoming actions and vocational rehabilitation direction.
c. The PPE process should be completed within 60 (calendar days) unless a return to work occurs or an extension is authorized because a return to work is imminent.
d. If the IW returns to work with the previous employer 60 (additional calendar) days are allowed for follow-up.
11. Allowed Professional Hours. Unless otherwise authorized, throughout the PPE process, RCs may use up to 20 professional hours for counseling, guidance and employer (and IW) contacts. Reasonable travel and clerical time may be charged in addition to the professional time.
During the 60 day post-placement period, RCs may use 10 professional hours.
Any requests for increase in professional hours or extension of time frames must be forwarded to RS in writing with justification as early as possible.
12. Dual Tracking. Based on the circumstances of a case, the RC may sometimes be assigned to work in conjunction with a contracted DFEC Field Nurse (FN) to facilitate a return to work with the IW's previous employer. Consistent with DFEC's sense of urgency, this partnership may promote earlier intervention and quicker return to work.
a. Referrals. Dual tracking referrals may be appropriate when:
(1) The EA is having difficulty identifying a suitable position within the IW's work restrictions.
(2) Clarification of work tolerances and restrictions are needed.
(3) Assistance is needed to determine whether there are reasonable accommodations which could make a return to work possible.
(4) Assistance is needed to determine whether there are other jobs within that agency that the IW can perform.
b. Complementary roles. During dual tracking, the FN and RC have different, but complementary, roles.
The FN will focus on the medical aspects of the case in order to obtain stable, well-defined work restrictions and to coordinate any necessary medical intervention.
The RC will concentrate on vocational aspects of the case. The RC may also assist with facilitating medical rehabilitation interventions (FCE, work hardening), if needed, to clarify work tolerances and restrictions and will also assist with services as discussed previously (paragraph 5 of this Part) to determine whether a return to work in the same job or a different job within the agency is possible.
c. Lines of Communication. During dual tracking, the FN will be the designated point of contact with the physician and other medical personnel. Any questions that the RC may have regarding those issues should go through the FN. The RC, RS and FN (and the OWCP District Office Staff Nurse, if necessary) can decide on the best approach for working with the employer in order to facilitate streamlined communications and the best outcome. Unless otherwise authorized, the FN's involvement in the case will usually end once stable and well-defined work restrictions are established. RC interventions will continue as needed and as authorized by the RS.