You may have heard that you can receive workers’ compensation benefits if you are injured on the job.
But did you know that there are different sets of rules for state and federal workers?
State workers’ compensation laws apply to almost everyone—except federal employees. State workers’ comp claims are administered through insurance companies. There is a state agency that hears and resolves disputes.
Federal employees have their own system. It’s called the Federal Employees’ Compensation Act (FECA), 5 U.S.C. § 8101 et seq. If you’re hurt on the job as a U.S. government employee, you don’t turn to state workers’ compensation for benefits. Instead, you make a FECA claim.
Similarities and Differences – State and Federal Workers’ Comp
In some ways, federal workers’ compensation is like state workers’ compensation. If you’re hurt on the job, you make a claim, and you may receive benefits. However, there are some key differences.
Chart Overview of FECA and State Workers’ Compensation
| State Workers’ Compensation | Federal Employees’ Compensation Act | |
| What is it? | Benefits if you’re hurt on the job | Benefits if you’re hurt on the job |
| What law applies? | State workers’ compensation laws | Federal workers’ compensation laws |
| Different in every state? | Yes | No |
| Who does it apply to? | Most public and private sector employees | Federal employees |
| Who administers? | State workers’ compensation commissions or insurance companies, depending on the state | Office of Workers’ Compensation Program (OWCP), Department of Labor |
| Choose your own doctor? | Varies, depending on the state | Yes |
| Occupational illness covered? | Yes | Yes |
| Permanent loss schedule award? | Yes | Yes |
| Rate of pay | 66 2/3% of income (in most states) | 66 2/3% of income or 75% with an eligible dependent |
| Pain and suffering? | No | No |
| Cost of Living Adjustments? | No | Yes |
| Right to a hearing? | Yes | Yes |
| Settlements? | Yes | No |
| Court? | Yes | No |
| Employer a party? | Yes | No |
Coverage and Eligibility Differences
Most state workers’ compensation claims are paid by insurance policies. Employers take out insurance and pay premiums; the insurance companies administer benefits and decide claims. By contrast, federal workers’ comp is paid by the Office of Workers’ Compensation Programs. Each employing agency must reimburse FECA for their expenses through an annual chargeback process.
Some workers’ compensation provisions vary by state. In FECA, there is one rule that applies to workers nationwide. For example, federally, workers have 30 days to give notice of traumatic injury using Form CA-1 to receive Continuation of Pay (COP). In state workers’ compensation programs, the time period to report the injury varies, usually from 30 to 90 days.
Is FECA expensive to taxpayers?
The U.S. Department of Labor reports that FECA benefits amount to 1.8% of federal and postal payrolls. By comparison, state workers’ compensation payments account for 2.3% of overall payrolls.
Types of Benefits Provided
Types of benefits provided under FECA include:
- Medical care, at no cost to the injured worker
- Replacement wage benefits
- Disability compensation
The benefits available to an injured federal employee are like what is available in a state workers’ compensation claim.
Choosing your own doctor
One significant difference is that FECA claims allow the worker to choose their own physician, whereas state workers’ compensation programs vary on this rule.
Do FECA benefits depend on who is at fault for the injury?
No. Like state workers’ compensation claims, FECA benefits are decided without regard for fault. The worker does not have to prove their employer’s negligence to receive benefits.
Claims Process and Procedures
There are some differences in the claims process and procedures for federal workers’ compensation as compared to state programs. In all cases, the employee should report the injury to their supervisor as soon as possible. Federal claims begin with supervisor authorization of medical treatment using Form CA-16. Prior approval is not needed for emergency treatment.
Then, the employee should complete Form CA-1 within 30 days of a traumatic injury. The federal system offers continuation of pay (COP) benefits for up to 45 days, or the worker may use leave. A worker may receive periodic wage loss payments. Short-term FECA benefits are paid weekly while long-term FECA benefits are paid every 28 days.
Legal and Administrative Differences
State workers’ compensation differs on how claims are administered, and disputes are resolved. Most end up in some form of state hearing with the ability for the losing side to appeal to another court for judicial review.However, a significant difference with federal claims is that there is no right to judicial review.
FECA is the exclusive remedy for injured federal workers. Batuyoung v. Sec’y of Dep’t of Defense, 1:07-CV-944 (N.D. Ohio 2008). There is no right to judicial review. Dietrich v. U.S., 1:09-cv-68 (W.D. Mich. Jun. 4, 2009).
That doesn’t mean that a worker is without a review process under FECA. There are three methods of appeal and review:
- Reconsideration (district office)
- Hearing before an OWCP officer (Office of Workers’ Compensation Programs)
- Appeal to the Employees’ Compensation Appeals Board (ECAB)
Reconsideration
A request for reconsideration must be submitted in writing to the address given in the OWCP final decision. When requesting reconsideration, the employee must state that the OWCP erroneously applied or interpreted the law, make a legal argument, or present evidence not previously considered.
Hearing
A hearing can be oral or based on a written record. The claimant can choose the format. An oral hearing can be in person, by telephone, or by video conference. The hearing representative decides how to conduct the oral hearing. The claimant may submit new evidence.
The claimant has 30 days from the date of the decision to send their request for the hearing date.
Appeal to ECAB
Final decisions may be appealed to the ECAB. Some decisions are not appealable, mostly relating to medical services and providers. The Office of the Solicitor or Labor represents the OWCP on appeal. You may still have a lawyer to represent you. A federal workers’ compensation lawyer can represent you.
Contact a FECA Claims Lawyer
There are differences between state and federal workers’ compensation claims.
You can get legal help now by contacting FECA claims lawyer Daren Sarphie. He handles FECA claims, representing injured workers. Contact us now.