Where's My CA-7?

I hear the same story over and over...claimant's who file a CA-7, Claim for Compensation are not getting their CA-7's properly submitted by their Agencies. I hear this story too often for the problem to be random, un-trained personnel. My personal opinion is that it's done on purpose.

When the processing of your CA-7 is delayed, your compensation is delayed, which in turn causes a financial hardship. By law, your Agency has five days to process your CA-7 and file it with OWCP. If you're having serious problems with your Agency processing your CA-7, I've found this works pretty well...

On your next trip out of the house, stop by your local Post Office and pick up some Delivery Confirmation or Certified Mail receipts (the choice is yours) and Priority Mail envelopes. Pick up a small stack, since it's handy to have them when you need them.

After you complete your CA-7 write the tracking number on the CA-7 you're submitting and using the Priority Mail envelope, submit the CA-7 as you normally would. If you know the name of the person you're sending your CA-7 to, make sure you put their name on both the tracking receipt AND the envelope. Make sure you write the same tracking number on each page you're submitting.

When you write the tracking number on the document, no one can come back later and say they didn't receive it, that wasn't the document submitted under that particular tracking number or that a different document was submitted under that tracking number. The tracking number now identifies the document.

After you mail the CA-7, track it online and once it's delivered, print out a copy of the delivery receipt. Now you have absolute proof, including the time, the CA-7 was received by your Agency. I've included the link to USPS Track and Confirm on the "Links" page.

If your CA-7 is not processed timely, write a letter to your Agency, but go up the "food chain". Address your letter to the supervisor, manager, department head, district director or whoever is above the person or department that processes your CA-7's. You can't expect the person or department that's creating the problem to fix the problem...so you should go above their head.

The laws that govern the processing of your CA-7 fall under The Code of Federal Regulations, known as C.F.R. and the United States Code, known as U.S.C. These are the C.F.R. and U.S.C. that apply to processing your CA-7:

"Upon receipt of Form CA-7 from the employee, or someone acting on his or her behalf, the employer shall complete the appropriate portions of the form. As soon as possible, but no more than five working days after receipt from the employee, the employer shall forward the completed Form CA-7 and any accompanying medical report to OWCP, 20 C.F.R section 10.111 Subpart B (c)."

"Whoever, being an officer or employee of the United States, charged with the responsibility for making the reports of the immediate superior specified by the FECA, 5 U.S.C. section 8120, who willfully fails, neglects, or refuses to make any of the reports, or knowing files a false report, or induces, compels, or directs an injured employee to forego filing of any claim for compensation or other benefits provided under sub-chapter I of chapter 81 of Title 5 or any extension or application thereof, or willfully retains any notice, report, claim, or paper which is required to be filed under that sub-chapter or any extension or application thereof, or regulations prescribed thereunder, shall be fined $500.00 under this title or imprisoned for not more than one (1) year, or both, 18 U.S.C. section 1922."

In your letter to the Agency, state the facts; the date the CA-7 was submitted, the date the CA-7 was received and the person the CA-7 was sent to for processing (if  known). Quote the C.F.R. and the U.S.C. and make a statement regarding the violation(s) your Agency has committed.

Include a copy of the CA-7 that shows the tracking number and the USPS track and confirm receipt showing the date and time the Agency received the CA-7. Send a copy of the letter, including the attachments to OWCP and the person (if known) who was in charge of processing your CA-7. Make sure all this information is included in your letter.

Every situation is different, but the body of your letter should go something like this:

On 00/00/0000 via Delivery Confirmation Number: 123-456-7890, I submitted a CA-7, Claim for Compensation to Ms. Jane Doe Injury Compensation Specialist for the period 00/00/0000 through and including 00/00/0000.

The attached USPS Track and Confirm receipt indicates the Agency received the CA-7 on 00/00/0000. It has now been eight (8) working days since the Agency received my CA-7 dated 00/00/0000 and yet the CA-7 has not been processed and sent to OWCP as required by law.

Quote the C.F.R. and U.S.C from above just as I've written them.

Immediately process my CA-7 dated 00/00/0000 or provide a legitimate, written explanation why my CA-7 Claim for Compensation will not be processed in a timely manner in violation of C.F.R section 10.111 Subpart B (c) and 18 U.S.C. Section 1922.

Sincerely,
Your Name
Your Address
Your Phone Number

Cc: Your Claims Examiners Name
       Name of the person who was supposed to process your CA-7 (if known)

Attached hereto and set forth as if fully incorporated herein:

1. CA-7 dated 00/00/0000; and
2. USPS Track and Confirm receipt, Delivery Confirmation Number: 123-456-7890

In my personal experience once I've sent this letter, the delays stop. If the problem persists, write to OWCP and request that OWCP inform your Agency of its responsibilities of processing your CA-7 and request you be able to submit your CA-7's directly to OWCP because your Agency continues to violate the C.F.R. and U.S.C. delaying your rightful compensation. 

The ECAB

If you've done any reading on the subject of OWCP, you've probably heard about the Employees Compensation Appeals Board, also known as the ECAB or the Board. You've probably heard you should read an ECAB decision or look up a decision in support of your case, but what do you do with it once you find it?

The ECAB is the highest authority in the OWCP system. What the Board says goes. The ECAB sets and holds precedent. If the ECAB says it and the precedent has held, then that's the law of OWCPLand.

The point of reading ECAB decisions, is that you become familiar with what the actual rules are as opposed to what OWCP tells you the rules are. So if, for instance, you have an issue with your Statement of Accepted Facts, (SOAF) and you read three or ten ECAB decisions, the Board will repeat the same policy, procedure or law that pertains to the situations of the SOAF.

Every case is different, but policy, procedure and law surrounding the issues are the same. Job offers, Loss of Wage Earning Capacity, (LWEC), vocational rehabilitation, fact of injury, consequential injuries, SOAF's, occupational injuries, recurrences, you name it, there's an ECAB decision about it. The more common the issue, the more plentiful the ECAB decisions on the subject.

If you need to respond to a letter or especially an appeal in support of your case, you need to back your claim up with citations from the FECA Manuals and the ECAB. It's not enough to tell OWCP they made an error or incorrect decision, you must show them. The OWCP MUST follow its own policies and procedures, but as we know, a lot of times they don't. It is your responsibility to point out where OWCP got it wrong, because let's face it, the OWCP isn't going to police itself.

Almost every topic that could come up regarding your claim is in the FECA Manuals and the same applies to ECAB decisions. When looking for an ECAB decision regarding a specific topic, use the ECAB by Topic link on the "Links" page. Once you get to the ECAB web site, type in your topic in the search bar on the left hand side of the screen. Check the Federal Employees Workers' Compensation box on the right hand side of the page. More than likely you will get results. If not, keep playing with it until you do.

An ECAB decision will tell the facts of the case and will then discuss the issue on appeal citing precedent cases on the topic. The Board will then make one of three decisions;

1. Affirmed, which means the claimant lost and the Board agrees with OWCP;
2. Remanded, which means something is missing or something else needs to be done so the file goes back to the OWCP to get the missing information; or
3. Reversed which means the claimant won and the Board reverses OWCP's decision

The Board will cite precedent setting cases in every decision. Those citings will be listed at the very end of every decision. When you're using ECAB decisions to support your claim, use appeals that are as similar as possible and have been reversed.

At the top of every ECAB appeal, there will be a Docket Number and the date of the decision. This is the information used to find an ECAB decision by Month and Year. Quote the ECAB decision that you're using in your argument(s) to OWCP and then cite the case where you found the information.

ECAB decisions aren't just for use when attempting to overturn an OWCP decision, you can actually learn from them. Read ECAB decisions on your topic and you'll learn what the specific requirements are. Even decisions that are affirmed are useful as learning tools. ECAB decisions lay out exactly where a claimant went wrong and exactly where a claimant went right. If you're attempting to get a claim accepted, ECAB decisions on your topic will lay out exactly what information is required from you.

For instance, if you're being sent to an Independent Medical Evaluation, (IME) and you read ECAB decisions regarding IME's, then you'll see over and over again that an IME is to be chosen at random according to strict guidelines. If you received an inaccurate Statement of Accepted Facts, (SOAF), you'll see over and over again that a medical report based on an inaccurate SOAF is of little or no value. If stale medical evidence was used, you'll see over and over again that the Board has held that medical evidence that is not contemporaneous (or current) is of no value. If you're trying to prove causal relationship, you'll see over and over that causal relationship must be established by rationalized medical opinion evidence.

If you want to learn what's required for any OWCP circumstance, try reading ECAB decisions. Quoting ECAB decisions to OWCP is also one of the best ways to rebut any OWCP decision, opinion or conclusion. OWCP cannot come back and say the ECAB is wrong.

As an example, we'll say that OWCP found a job offer suitable based on the stale medical evidence and as a result, the claimant was injured, but OWCP denies the claim. We would respond to OWCP like this:

The Board has recognized the importance of medical evidence being contemporaneous with a job offer in order to ensure that a claimant is medically capable of returning to work, Ruth Churchwell, Docket No. 02-0792 (2002), John Perez, Docket No. 99-0816 (2000).

The Office relied on stale medical evidence on which claimant's job offer is based. The Board has stated that, consistent with case precedent, stale medical evidence cannot form the basis for current evaluation of residual symptomology or disability determination, Diane M. James, Docket No. 90-1944 (February 13, 2006), Keith Hanselman, 42 ECAB 680 (1991), Ellen G. Trimmer, 32 ECAB 1878 (1981).

Claimant was provided an unsuitable job offer based on obsolete medical evidence. As a consequence, every injury and/or aggravation that arises from the inappropriate job offer is compensable and must be determined to be in performance of duty.

When you respond to OWCP by citing the ECAB, OWCP must then either reverse the decision or show where you and the ECAB are wrong, which they can't do since the ECAB out ranks OWCP.

OWCP relies on you not knowing what the "rules" are, they rely on you to believe whatever they tell you. Show them you do understand the "rules", that you won't put up with bad decisions and that you'll fight back by citing the FECA Manuals and the ECAB. If you do, you might find that suddenly they can make the right decisions.