PART 1-CLAIMS FOR COMPENSATION AND ADMINISTRATIVE PROCEDURE

Sec.

1.1

1.2

1.3

1.4

1.5

1.6

1.7

1.8

1.9

1.10

1.11

1.12

1.13

General provisions; definitions.
Notice of injury by employee.

Reports by official superiors of injuries
to employees.

Claim for compensation for disability. Application for augmented compensasation for disability.

Report of termination of disability or return to work.

Recurrence of disability for work. Claims for continued compensation for disability.

Employee's obligation to return to work or to seek work when able.

Affidavit or report by employee of em-
ployment and earnings.

Claims for balance of schedule due at
death from other causes.
Report of death.

Original claims for death benefits.

1.14 Continuance of compensation on account of death.

1.15

Termination of the right to compensation for death.

1.16 Change in status of beneficiaries affecting compensation for death.

1.17 Burial expenses.

1.18

1.19

1.20

1.21

1.22

1.23

1.24

Embalming and transportation of bod-
ies of deceased employees.
Overpayments by mistake.
Injuries to members of the Officers'

Reserve Corps, Enlisted Reserve Corps, and Naval Reserve. Confidential nature of records and papers relating to injury or death of employees.

Inspection of records of Bureau.
Waiver not authorized.

Representation of claimants and ap-
proval of claims for legal and other
services.

1.25 Retroactive effective dates and procedures under Federal Employees' Compensation Act Amendments of

1949.

AUTHORITY: The provisions of this Part 1 issued under sec. 32, 39 Stat. 749, as amended; 5 U.S.C. 8145, 8149; 1946 Reorg. Plan No. 2, § 3, 3 CFR 1943-1948 Comp., p. 1064; 60 Stat. 1095; 1950 Reorg. Plan No. 19, § 1, 3 CFR, 1949-1953 Comp., p. 1010; 64 Stat. 1271, unless otherwise noted. § 1.1 General provisions; definitions.

(a) The administration of the United States Employees' Compensation Act of September 7, 1916 (39 Stat. 742; 5 U.S.C. 751-793), as amended, was vested by

said act in the United States Employees' Compensation Commission, but effective July 16, 1946, such Commission was abolished and its functions transferred to the Federal Security Agency by section 3 of Reorganization Plan No. 2 (3 CFR, 1943-1948 Comp., p. 1064). Effective July 16, 1946, the Federal Security Administrator established the Bureau of Employees' Compensation under the supervision of a Director and delegated to him all the duties, powers, and functions of the former United States Employees' Compensation Commission, with certain exceptions dealing with budgetary and legislative matters. By section 1 of Reorganization Plan No. 19 (3 CFR, 1949-1953 Comp., p. 1010; 64 Stat. 1271), the Bureau together with its compensation functions, was transferred to the Department of Labor under the direction and supervision of the Secretary of Labor or his designees in the Department, and the functions of the Federal Security Administrator and the Federal Security Agency with respect to the Bureau were transferred to the Secretary of Labor. The Bureau of Employees' Compensation is authorized under the compensation act to decide all questions arising under the act. The Bureau is authorized under such act, upon consideration of a claim presented by a beneficiary and official reports pertaining to injury or death sustained by a civil employee of the United States while in the performance of duty and upon completion of such investigation as it may deem necessary, to determine the facts and make an award for or against payment of the compensation provided for in said act. The Bureau has power, under the provisions of the said act to issue subpoenas for and compel the attendance of witnesses within a radius of 100 miles, to require the production of books, papers, documents, and other evidence, to administer oaths, and to examine witnesses, upon any matter within the jurisdiction of the Bureau.

(b) Reorganization Plan No. 2 required the Federal Security Administration to provide by regulation for a board

1 Agency Order 58 dated July 16, 1946. 11 F.R. 7943, July 23, 1946.

of three persons to be designated or appointed by the Federal Security Administrator with authority to hear and, subject to applicable law, make final decision on appeals taken from determinations and awards with respect to claims of employees of the Federal Government or of the District of Columbia, and pursuant to Agency order No. 58, the Federal Security Administrator established an Employees' Compensation Appeals Board to hold hearings and make decisions on appeals taken from such determinations and awards (Parts 501 and 502 of this title). By section 2 of Reorganization Plan No. 19 (3 CFR, 1949-1953 Comp., p. 1010; 64 Stat. 1272), the Board and its functions were transferred to the Department of Labor, and the functions of the Federal Security Administrator were transferred to the Department of Labor.

(c) All employees of the United States and other persons who may claim or be entitled to claim benefits under the said act, and the official superiors of all such persons, shall be bound by the regulations in this subchapter and shall conform to the procedure prescribed in said act and in the regulations under this subchapter. The term "official superior", as used in this subchapter, includes all officers and employees having responsible supervision, direction or control of civil employees, members of the Officer's Reserve Corps and of the Enlisted Reserve Corps of the Army, members of the Naval Reserve, or others employed in the service of the Federal Government or the government of the District of Columbia. For the purposes of the regulations in this subchapter the term "employee" as used in this subchapter shall include all civil officers and employees of all branches of the Government of the United States (including officers and employees of instrumentalities of the United States wholly owned by the United States), employees of the government of the District of Columbia (except members of the Police and Fire Departments of the District of Columbia), members of the Officers' Reserve Corps and of the Enlisted Reserve Corps of the Army, officers and enlisted men of the United States Naval Reserve, and other persons performing service for the United States within the purview of said act and all acts in amendments substitution or extension thereof.

(d) The term "einployee" shall also include persons rendering personal services of a kind similar to those of civilian

officers or employees of the United States to any department, independent establishment, or agency thereof (including instrumentalities of the United States wholly owned by it), without compensation or for nominal compensation, in any case in which acceptance or use of such services is authorized by an act of Congress or in which provision is made by law for payment of the travel or other expenses of such person.

(e) All definitions appearing in the act, as amended, shall be applicable with respect to the regulations promulgated under this subchapter. The provisions of the act, as codified, are set forth in 80 Stat. 531-556. Section 7(a) of that act saves, though it does not codify, the provisions of 80 Stat. 252-257 which was approved July 4, 1966, presumably too late for inclusion in the comprehensive recodification.

[13 F.R. 7668, Dec. 10, 1948, as amended at 14 F.R. 7374, Dec. 9, 1949; 25 F.R. 10793, Nov. 15, 1960; 32 F.R. 2699, Feb. 9, 1967]

§ 1.2 Notice of injury by employee.

(a) Whenever any injury is sustained by an employee of the United States while in the performance of his duty, he shall immediately give written notice to his official superior. If the injured employee is unable to give such notice, it may be given by someone in his behalf. Form C.A. 1, Notice of Injury, is provided by the Bureau for such purpose. Unless written notice of injury is given within 48 hours or unless the immediate superior has actual knowledge of the injury, compensation may be refused. For reasonable cause the Bureau may accept written notice of injury given later than 48 hours, but not later than 1 year after the injury. (See § 1.13 for waiver of limitation provision.)

(b) Whenever such an injury comes to the knowledge of the injured employee's official superior, a record of the cause, nature, and extent of the injury shall be made by the official superior, who should call to the attention of the employee the necessity of submitting, within 48 hours, or as soon after injury as practicable, a notice of the injury on Form C.A. 1. The official superior shall secure the signed statements of witnesses to the occurrence, and shall retain the employee's notice of injury until the injury is reported to the Bureau as required in § 1.3. [Regulations under the United States Employees' Compensation Act, June 1, 1938]

§ 1.3 Reports by official superiors of injuries to employees.

Every injury which is likely to result in any medical charge against the Compensation Fund or in any disability for work beyond the day, shift, or turn of the occurrence or which appears likely to require prolonged treatment or to result in future disability, or to result in any permanent disability, including the total or partial loss or loss of use of a member of the body, or serious disfigurement of the face, head or neck, shall be reported by the official superior on Form CA-2, Report of Injury, provided by the Bureau for this purpose, which shall be transmitted to the Bureau without delay. The employee's original Notice of Injury, on Form CA-1, or otherwise, should accompany the Report of Injury together with report of any investigation made and such statements or other data as may properly relate to the circumstances surrounding the injury. If the disability is likely not to exceed 3 days, the report may be withheld until the employee has returned to work.

[14 F.R. 7374, Dec. 9, 1949]

§ 1.4 Claim for compensation for disability.

(a) Compensation for disability under said act will not be paid unless written claim therefor is made by the employee or by someone in his behalf within the time limit prescribed by the said act. If such claim is not submitted within 60 days after the injury, an explanation of the delay must accompany the claim. For any reasonable cause shown the Bureau may allow claims for compensation for disability to be made at any time within 1 year. (For further waiver of limitation provisions see § 1.13). Form CA-4 is provided by the Bureau for making the original claim. Such claim may be filed by delivering it at the offices of the Bureau, or to any person designated by the Bureau to receive it. The employee's official superior is so designated to receive claims on behalf of the Bureau, and the injured employee should submit his claim to his official superior for transmission to the Bureau unless special circumstances require different procedure. Any claim or paper purporting to claim compensation submitted by an employee to his official superior shall be transmitted promptly to the Bureau. Whenever an employee, as a result of an injury in the perform

ance of duty, is disabled with loss of pay for more than 3 days or sustains permanent disability which involves the total or partial loss, or loss of use, of a member of the body, or serious disfigurement of the face, head or neck, his official superior, when practicable, should furnish to him Form CA-4 for the purpose of claiming compensation, and should advise him of his rights under the said act Form CA-4 should be filed with the Bureau upon termination of disability if the duration of disability should be less than 18 days, or at the expiration of 18 days from the date pay stops, if disability continues beyond that date. If no claim is filed by an injured employee or by someone on his behalf prior to his death, the right to claim compensation for disability ceases and does not survive.

(b) Claims for compensation for permanent disability which involve solely the loss, or loss of use, of a member of the body, should be filed on Form CA-4, and if any compensation has been paid or is payable for a prior injury to the same member the date of such prior injury, the amount of such compensation and the source thereof shall be set forth in the said CA-4 and filed in accordance with paragraph (a) of this section.

(c) Claims for serious disfigurement of the face, head, or neck should be made on Form CA-4, supplemented by Form CA-4B when required. If any compensation has been paid or is payable for any such prior disfigurement the date of such prior injury, the amount of compensation and the source thereof shall be stated in the said CA-4, or as supplemented by Form CA-4B.

(Sec. 18, 39 Stat. 746; 5 U.S.C. 8121) [14 F.R. 7374, Dec. 9, 1949]

§ 1.5

Application for augmented compensation for disability.

(a) While the disabled employee has one or more dependents as defined in 5 U.S.C. 8110, his basic compensation for disability shall be augmented as proIvided in said section. The Bureau may require application for such augmented compensation to be made on Form CA-4A in accordance with § 1.4. The Bureau may, however, pending the making of such application on such form, pay compensation under 5 U.S.C. 8110 upon other satisfactory proof.

(b) Augmented compensation payable while a disabled employee has an unmarried child as defined by 5 U.S.C. 8110, which would otherwise terminate be

cause the child reaches the age of 18, may be continued while the child is a student regularly pursuing a full-time course of study or training as defined by § 1.14(c).

(c) The disabled employee claiming augmented compensation under this section shall furnish, when so required by the Bureau, proof of continuing entitlement to augmented compensation as set forth in paragraph (a) of this section.

(d) The disabled employee receiving augmented compensation under this section shall promptly notify the Bureau of the happening of any event which would no longer entitle him to augmented compensation under the provisions of 5 U.S.C. 8110. Any checks or payments received after the occurrence of such event shall be returned promptly to the office from which it was received. [32 F.R. 2699, Feb. 9, 1967]

§ 1.6 Report of termination of disability or return to work.

Whenever an injured employee is able to return to work after a period of disability caused by an injury, his official superior shall immediately report that fact to the Bureau on Form CA-3, which is provided by the Bureau for this purpose, unless such report has been made on Form CA-2, or otherwise. Such report shall show the period of absence from work and shall show specifically the part of such period for which the employee has been or will be paid on account of leave or for any other reason, stating the basis of such wage payment. If when disability begins the employee has annual or sick leave to his credit, he may use such leave until it is exhausted, solely at the discretion of such employee. [14 F.R. 7375, Dec. 9, 1949]

§ 1.7

Recurrence of disability for work. When an injured employee, after returning to work, is again disabled and stops work as a result of the same injury, the official superior shall report the recurrence of disability promptly to the Bureau, showing clearly when the employee again stopped work and for what part of the new absence he has been or will be paid on account of leave or for any other reason. If the recurrent disability has ended when the report is made, the date and hour of return to duty should be stated; if not, an additional report should be made when the employee returns to work or his dis

ability ceases. If the employee has been examined or attended by a physician in connection with such recurrence of disability, a medical report, as required by § 2.10 of this subchapter should accompany the official superior's report of the recurrence, unless the physician has made his report to the Bureau.

[Regulations under the United States Employees' Compensation Act, June 1, 1938] § 1.8 Claims for continued compensation for disability.

An employee whose injury results in disability with loss of pay continuing beyond the time covered by the original claim on Form CA-4, may claim compensation for further periods of disability on Form CA-8 which is provided by the Bureau for that purpose. Compensation will not be paid unless such claim for further compensation, properly executed, is received by the Bureau. The certification of the attending physician as to the further disability should be obtained on the form and it should be submitted to the employee's official superior, who shall complete his portion of the certification thereon and forward the claim promptly to the Bureau. Claims on Form CA-8 should be submitted semi-monthly if disability is continuous. However, a Form CA-8 should not be submitted for continuing payments payable under a scheduled loss as provided in section 5 of the act. An employee whose disability is such that medical evidence of continuation thereof is not immediately necessary may be provided by the Bureau with Form CA-96 for use in submitting claim for continued compensation in lieu of Form CA-8. [14 F.R. 7375, Dec. 9, 1949]

§ 1.9 Employees' obligation to return to work or to seek work when able. When total disability to perform work ceases and the employee is able to perform a part of his usual duties, or to perform work of a different nature, he must seek such suitable work as he is able to perform, either in Government or private employment, unless it has already been provided for him, and shall accept such work or offer of work secured for him. An employee who has not been regularly employed during the period covered by his claim, and who is only partially disabled, shall state in his claim what efforts he has made to obtain suitable employment, giving the names and addresses of persons or concerns to

whom he has applied for work. If he has not been offered or has not been able to secure work which he is able to do, he shall so state. If a partially disabled employee refuses to seek suitable work or refuses or neglects to work after suitable work is offered to, procured by, or secured for him, he shall not be entitled to any compensation.

[14 F.R. 7375, Dec 9, 1949]

§ 1.10 Affidavit or report by employee of employment and earnings. The Bureau may require a partially disabled employee to file a Form CA-96 or to submit an affidavit or other report as to his earnings either from employment or self-employment. If such individual, when required, fails to submit such form or affidavit or other report or if in such form, affidavit or report the employee knowingly omits or understates any part of such earnings or remuneration he shall forfeit his right to compensation with respect to any period for which such report was required to be made, and any compensation already paid may be recovered by deducting the amount thereof from compensation payable to him or otherwise according to law. Earnings from employment referred to in this section or elsewhere in this part, means gross earnings or wages before any deductions whatsoever have been taken out of such wages, and include the value of subsistence, quarters, or other advantages received in kind as part of the wage or remuneration. [14 FR. 7375, Dec. 9, 1949]

§ 1.11 Claims for balance of schedule due at death from other causes.

(a) If an employee files a valid claim for a scheduled loss (permanent disability which involves solely the loss or loss of use of a member) in his lifetime and dies from causes other than the injury before the entire amount due for such schedule is paid, claim for such unpaid balance may be made on Form CA-5A pursuant to § 1.13 as follows-by the widow, widower or child in the proportions and upon the conditions and in the order named in subsection 5 (d) (1) of the act. If there is no surviving widow, widower or child then a claim on Form CA-5A may be made pursuant to 1.13 in the proportions and upon the conditions and in the order as follows to the parent or parents wholly dependent for support upon the decedent. If there is no parent wholly

dependent then to a partially dependent parent or parents in equal shares with any partially dependent brother, sister, grandparent or grandchild. If one or more of the brothers, sisters, grandparents or grandchildren are wholly dependent and a parent or parents and other brothers, sisters, grandparent or grandchildren are partially dependent then 75 per cent will be awarded to such wholly dependent person or persons equally and the balance divided equally among such partially dependent persons. In the event there is no surviving widow, widower, child, or wholly dependent parent, and the foregoing apportionment of such compensation would result in injustice, the Bureau may, in its discretion, make such other apportionment as justice would require.

(b) The right of any surviving beneficiary referred to in paragraph (a) of this section shall be conditioned upon his being alive to receive any payment and any such beneficiary shall not have a vested right to any such payment. Claims for continuance of payments under section 5 (d) (1) of the act shall be made in like manner and governed by § 1.14.

(c) The entitlement of any beneficiary to payments under section 5 (d) (1) (A) to (D) of the act shall cease upon the happening of any event which would terminate such right under section 10 of the act. The termination of such right shall be governed by § 1.15. In the event of any reapportionment made necessary by such termination prompt notification shall be made to the Bureau in accordance with § 1.16.

(d) As to the disposition of any balance not paid under the foregoing paragraphs see § 1.17(b) "Burial Expenses". [14 FR. 7375, Dec. 9, 1949]

§ 1.12 Report of death.

If an injury to an employee results in death, the official superior shall immediately report that fact to the Bureau by telegraph. If a report of injury has not previously been submitted on Form C.A. 2, such form, together with a copy of the death certificate and a report of death on Form C.A. 3, provided by the Bureau for such purpose, shall be forwarded to the Bureau. If the death does not immediately follow the injury, the report on Form C.A. 3, should also show, on the upper half, the exact period of absence from work prior to the date and hour of death, and the part of such period, if