« PreviousContinue »
persons who have died as a result of or of Workers' Compensation Programs. while in the performance of employ. The Director, Office of Workers' Comment or services rendered to the pensation Programs and his or her United States. In addition to dollar designees shall, therefore, except as is benefits, eligible beneficiaries who otherwise provided by law have the exhave become disabled as a conse- clusive authority for the administraquence of a service related injury, dis- tion, implementation, and enforceability, disease, or other compensable ment of the provisions of this chapter. condition, shall be entitled to receive
(b) In the case of employees of the the full range of medical benefits and
Canal Zone Government and the services made necessary by the com- Panama Canal Company, the Federal pensable condition, which shall be pro
Employees' Compensation Act is advided at the expense of the United ministered by the Governor of the States. In the case of death due to a Canal Zone, and inquiries pertaining compensable injury, disability, disease to such coverage and eligibility should or other condition certain burial ex
be directed to the Governor of the penses shall be paid, subject to the
Canal Zone. provisions of 5 U.S.C. 8134. In appropriate cases vocational rehabilitation $10.3 Purpose and scope of this part. services shall be provided to eligible beneficiaries.
(a) This Part 10 sets forth the rules (c) Each of the types of benefits and
applicable to the filing, processing, conditions of eligibility enumerated in
and payment of claims for workers' this section is subject to the applicable
compensation benefits under the proprovisions of the Act and the provi
visions of the Federal Employees' sions of this part. This section shall
Compensation Act, as amended. This not be construed to modify or enlarge part is applicable to all claims filed on upon the provisions of the Act except
or after November 6, 1974. The provi
or a to the extent that the provisions of sions of this part are intended to the Act shall be construed to permit afford guidance and assistance to any the payment of benefits to the victim
person seeking compensation benefits of an employment related latent or
under the Act, as well as to personnel progressive disease or disability if the
within the Department of Labor and nature and extent of such disease or
other agencies of the United States disability and the circumstances sur
who are required to perform some rounding the filing of a claim for bene
function with respect to the adminisfits predicated upon such disease or tration of any provision of the Act or disability may be reasonably construed the processing of any claim filed under to fall within the intent of the provi the Act. sions of the Act.
(b) This Subpart A describes gener
ally the statutory and administrative $ 10.2 Administration of the Act and this framework governing the manner in chapter.
which claims under the Act shall be (a) Pursuant to 5 U.S.C. 8145 and processed, contains a statement of Secretary of Labor's Orders 13-71 (36 purpose and scope, together with proFR 8755) and 16-73 (38 FR 19130) the visions pertaining to definition and responsibility for administering the use of terms, the disclosure of proprovisions of the Act were delegated to gram information, and other miscellathe Assistant Secretary of Labor for neous provisions relating to the adEmployment Standards. Pursuant to ministration of the Act. Employment Standards Order 2-74 ef (c) Subpart B of this part describes fective September 27, 1974 (39 FR the procedure by which an individual 34722-34723) the responsibility for the claimant shall file a notice of injury administration and implementation of and claim for benefits under the Act the Federal Employees' Compensation and further describes the administraAct, except for 5 U.S.C. 8149 thereof tive procedures applicable to the procas it pertains to the Employees' Com essing of each individual claim and the pensation Appeals Board, was delegat rules governing the termination and ed and assigned to the Director, Office continuation of eligibility for benefits
with respect to certain previously ap- (4) “Office" or "OWCP" means the proved claims.
Office of Workers Compensation Pro(d) Subpart C of this part describes grams, Employment Standards Adminspecial procedures applicable to the istration, of the Department. continuation of pay provisions con (5) "Director" means the Director of tained in 5 U.S.C. 8118 as amended by OWCP or a person designated by him Pub. L. 93-416, 88 Stat. 1146.
or her to carry out his or her func(e) Subpart D of this part contains tions under the Act. provisions relating to the procedures (6) "Benefits" or “Compensation" governing the payment of dollar bene means benefits or compensation paid fits for disability or death and further or payable under the Act and includes contains additions to the compensa- money paid on account of a loss of tion schedule mandated by the new wages, ability to earn wages, money paragraph 22 of 5 U.S.C. 8107(c), Pub. paid in the form of scheduled compenL. 93-416, 88 Stat. 1145.
sation, medical diagnostic and treat(f) Subpart E of this part contains ment services supplied pursuant to the the rules governing an employee's Act and this part, money paid on acrights to obtain medical evidence in count of death, and certain payments support of such employee's claim and to individuals participating in an apfurther contains information describ proved vocational rehabilitation proing the rights of a beneficiary to medi gram. cal benefits under the Act.
(7) "Claim" means an assertion in (g) Subpart F of this part is re- writing of an individual's entitlement served.
to benefits under or pursuant to the (h) Subpart G of this part contains Act, submitted in a form and manner the rules governing the adjustment authorized by the provisions of this and recovery from a third person part. under 5 U.S.C. 8132.
(8) "Claimant” means an individual
whose claim for entitlement to bene§ 10.4 Applicability of other parts within
fits under the Act has been filed in acthis chapter.
cordance with the Act and the proviThis revised Part 10 replaces many sions of this part. provisions contained in Subchapter A (9) “Beneficiary” means an individuof this chapter as well as all of Parts 1, al who is entitled to a benefit under 2, and 3 of Subchapter B of this chap the Act and this part. ter. The provisions of Subchapter A of (10) “Entitlement" means entitlethis chapter are applicable to this part ment to benefits as determined pursuonly insofar as such provisions do not ant to the provisions of the Act and conflict with the provisions of this the procedures set forth in this part. A part. This revised Part 10 is applicable beneficiary is entitled to benefits as so to Part 25 of this chapter except as determined when the determination is modified by said Part 25.
(11) "Employee" means: § 10.5 Definitions and use of terms.
(i) A civil officer or employee in any (a) Definitions. For purposes of this branch of the Government of the subchapter except where the content United States, including an officer or clearly indicates otherwise, the follow- employee of an instrumentality wholly ing definitions apply:
owned by the United States; (1) “The Act” means the Federal (ii) An individual rendering personal Employees' Compensation Act, 5 service to the United States similar to U.S.C. 8101 et seq., as amended by Pub. the service of a civil officer or employL. 93-416 and as it may be hereafter ee of the United States, without pay amended.
or for nominal pay, when a statute au(2) "Secretary" means the Secretary thorizes the acceptance or use of the of the United States Department of service, or authorizes payment of Labor or a person authorized to per- travel or other expenses of the individform his functions under the Act.
ual; (3) “Department” means the United (iii) An individual, other than an inStates Department of Labor.
dependent contractor or an individual employed by an independent contrac (C) A commissioned officer of the tor, employed on the Menominee Environmental Science Services, AdIndian Reservation in Wisconsin in op- ministration; erations conducted under a statute re- (D) A member of the Metropolitan lating to tribal timber and logging op- Police or the Fire Department of the erations on that reservation;
District of Columbia who is pensioned (iv) An individual employed by the or pensionable under Sections 521-535 government of the District of Colum- of Title 4, District of Columbia Code. bia;
(12) “Official Superior" means offi(v) An individual appointed to a posi- cers and employees having responsibiltion on the office staff of a former ity for the supervision, direction or President under section 1(b) of the Act control of employees. of August 25, 1958 (72 Stat. 838);
(13) “Employing Agency” or (vi) An individual selected pursuant "agency" means any civil agency or into Chapter 121 of Title 28, United strumentality of the United States States Code, and serving as a petit or Government or any other organizagrand juror and who is otherwise an tion, group or institution employing employee for the purposes of this part any individual defined as an “employ. as defined by paragraphs (a)(11)(i), ee” by this section. (ii), (iii), (iv), and (v) of this section;
(14) “Injury” means injury induced (vii) Members of the Reserve Offi- by accident or trauma and includes a cers Training Corps;
disease or latent disabling condition (viii) Civil Air Patrol Volunteers; proximately caused by the employ
(ix) Peace Corps Volunteers, volun- ment for which benefits are provided ieer leaders and volunteers with one under the Act. The term “injury” inor more minor children as defined in cludes damage or destruction of mediSecccection 2504 of Title 22, United cal braces, artificial limbs, and other States Code;
prosthetic devices which shall be re(x) Job Corps enrollees;
placed or repaired; except that eye(xi) Youth Conservation Corps en glasses and hearing aids would not be rollees;
replaced, repaired, or otherwise com(xii) Volunteers In Service To Amer pensated for, unless the damage or deica;
struction is incident to a personal (xiii) Members of the National injury requiring medical services. Teachers Corps;
(15) "Traumatic Injury” means a (xiv) Members of the Neighborhood wound or other condition of the body Youth Corps;
caused by external force, including (xv) Student employees as defined in stress or strain. The injury must be 5 U.S.C. 5351;
identifiable as to time and place of oc(xvi) Employees of the Canal Zone; currence and member or function of
(xvii) Employees of the Alaska Rail the body affected, and be caused by a road;
specific event or incident or series of (xviii) Law enforcement officers not events or incidents within a single day employees of the United States killed or work shift. Traumatic injuries are or injured under certain circumstances distinguished from occupational disinvolving a crime against the United eases or illnesses in that the latter are States; and,
produced by systemic infections; con(xix) Other persons performing serv- tinued or repeated stress or strain; exice for the United States within the posure to toxins, poisons, fumes, etc., purview of the Act and all acts in or other continued and repeated expoamendments, substitution or extension sure to conditions of the work environthereof;
ment over a longer period of time. (xx) But does not include.
Traumatic injuries also include (A) A commissioned officer of the damage or destruction to prosthetic Regular Corps of the Public Health devices or appliances, exclusive of eyeService;
glasses and hearing aids unless the (B) A commissioned officer of the eyeglasses and hearing aids were damReserve Corps of the Public Health aged incidental to a personal injury reService on active duty;
quiring medical services.
(16) “Monthly pay" means the (d) Inclusive terms. As used in this monthly pay at the time of injury, or part, the singular case includes the the monthly pay at the time disability plural. begins, or the monthly pay at the time compensable disability recurs, if the
INFORMATION IN PROGRAM RECORDS recurrence begins more than 6 months
§ 10.10 Custody of records relating to Fedafter the injured employee resumes regular full-time employment with the
eral Employees' Compensation Act United States, whichever is greater,
matters. except when otherwise determined All records, medical and other reunder section 8113 of the Act with re- ports, statements of witnesses and spect to any period.
other papers relating to the injury or (17) “Price index” means the Con death of a civil employee of the sumer Price Index (all items U Sasc United States or other person entitled ty average) published monthly by the to compensation or benefits from the Bureau of Labor Statistics.
United States under the Act and all (18) “Base month” means the month amendments or extensions thereof, of July 1966 and each later month are the official records of the Office which is used as a basis for calculating and are not records of the agency, esan increase under 5 U.S.C. 8146a.
tablishment or department making or (19) “Organ" means a part of the having the care or use of such records. body that performs a special function, Such records and papers pertaining to and for purposes of this part excludes any such injury or death are confidenthe brain, heart and back.
tial and no official or employee of a (20) “United States Medical Officers Government establishment who has and Hospitals" means medical officers investigated or secured statements and hospitals of the Army, Navy, Air from witnesses and others pertaining Force, Veterans' Administration, and to a claim for benefits, or any person United States Public Health Service, having the care or use of such reports, and any other medical officers or hos- shall disclose information from or perpital designated as a United States taining to such records to any person, medical officer or hospital by the Sec except upon the written approval of retary.
the Office. (b) Statutory terms. The definitions contained in this part shall not be con
$ 10.11 Inspection and copying of records. sidered to derogate from the terms of (a) Confidentiality of records. Recthe Act as amended.
ords of the Office pertaining to an (c) Dependents and survivors. In ad injury or death are confidential, and dition to basic disability benefits for are generally exempt from disclosure employees the Act provides in section to the public under Section 552(b)(6) 8133 that certain monthly benefits of Title 5 U.S.C., the terms of which shall be payable to certain enumerated are applied in this section. (See also survivors of employees who have died Part 70 of Title 29, Code of Federal from an injury sustained in the per- Regulations regarding Department of formance of duty. Section 8110 of the Labor documents exempt from discloAct provides that any employee who is sure.) found eligible for a basic benefit shall (b) Release to the employee or to his/ be entitled to have such basic benefit her beneficiary. If an employee or, in augmented at a specified rate for cer- the case of death, such employee's tain persons living in the beneficiary's beneficiary or the authorized reprehousehold or who are dependent upon sentative of an employee or beneficithe beneficiary for support. The provi ary requests information from the Of. sions of 5 U.S.C. 8101, 8110, and 8133 ficer's records, such individual shall at defining the nature of such survivor the discretion of the Office be permitship or dependency necessary to quali- ted to examine the records of the case fy a beneficiary for a survivor's benefit in which such employee is an interestor augmented benefit shall be applica ed party or representative of such ble as appropriate to the provisions of party. In considering any request for this part.
such information the Office shall judge the reasonableness thereof, and ords or information relating to Federal may in its discretion permit inspection Employees' Compensation Act matof such record or part thereof, which ters, the disclosure of which has not in its opinion, will not result in been authorized, regardless of whether damage or harm to the employee or it may or may not be authorized by beneficiary. Where the Office deter this section or Part 70 of Title 29, mines the release of information to Code of Federal Regulations, shall the employee or to the employee's promptly, and without awaiting apbeneficiary is not in the best interest pearance before the court or other auof the employee or his beneficiary, the thority, communicate through estabOffice may release the information to lished channels the contents of the the employee's or beneficiary's repre- demand to the Solicitor of Labor. sentative or personal physician upon Such officer or employee shall await receipt of written authorization from instructions concerning the response the employee or beneficiary. If the in- to the demand. If it is determined that dividual concerned is mentally incom- the demand should be opposed, the petent, insane or deceased, the next of United States attorney, his or her askin or legal representative must au sistant or other appropriate legal repthorize in writing the release of rec resentative shall be requested respectords to the representative.
fully to inform the court or other au(c) Release to other United States thority that the Secretary of Labor Government departments and agen has instructed the officer or employee cies. (1) Information may be released to refuse to disclose the records or into other departments and agencies formation sought. If instructions have which have proper need for the infor- not been received at the time when mation upon request stating the spe- the officer or employee is required to cific purpose for which it will be used. appear before the court or other au
(2) In appropriate cases, the request thority in response to the demand, the ing department will be advised that United States attorney, his or her asthe information will be withheld until sistant, or other appropriate legal repthe Department obtains the written resentative shall be requested to request of the employee or beneficiary appear with the officer or employee concerned.
upon whom the demand has been (3) In honoring requests, the Office served and request additional time in shall disclose only that information which to receive such instructions. which is germane to the request.
(f) Release to parties involved in ac(d) Release to medical research or tions brought under 5 U.S.C. 8131. scientific organizations. Information When an employee or beneficiary is shall be released, upon the request of prosecuting an action for damages medical research or scientific organiza under 5 U.S.C. 8131, records shall be tions or other qualified researchers released as provided for in paragraph when the Office finds that the release (b) of this section. Information from of the requested information will not such records requested by other parconstitute a clearly unwarranted inva ties in interest in said action for damsion of personal privacy. Where feasi. ages may be released only upon the ble, the Office shall delete identifying written authorization of the employee detail to prevent a clearly unwarrant or beneficiary, or of the authorized ed invasion of personal privacy. The representative, and all such requests requesting organization or individual shall be directed to the Office. shall be advised that the information must be held in confidence and that MISCELLANEOUS PROVISIONS any published reports resulting from such study shall not identify in any
§ 10.20 Forms. way the individuals whose records (a) Notice of injury, claims and cerwere examined.
tain specified reports required to be (e) Release to Federal or State courts made with respect to any claim shall or other administrative bodies. Any of. be made on approved forms as are preficer or employee of the United States scribed by the Office. Supervisors are who is served with a demand for rec- expected to maintain an adequate