or by a State-recognized or nationally recognized accrediting agency or body;

or

(iii) A school or college or university not so accredited but whose credits are accepted on transfer by not less than three institutions which are so accredited, for credit on the same basis as if transferred from an accredited institution; or

(iv) A technical, trade, vocational, business, or professional school accredited or licensed by the Federal or a State government or any political subdivision thereof providing courses of not less than 3 months duration, that prepares the individual for a livelihood in a trade, industry, vocation, or profession.

An individual continues to be a student during any interim between school years if the interim does not exceed 4 months and the individual shows to the satisfaction of the Office that he or she has a bona fide intention of continuing to pursue a full-time course of education or training during the semester or other enrollment period immediately after the interim, or during periods of reasonable duration during which, in the judgment of the Office, the individual is prevented by factors beyond his or her control from pursuing his or her education. A student whose 23rd birthday occurs during a semester or other enrollment period is deemed a student until the end of the semester or other enrollment period.

(26) A year beyond the high school level

means

(1) The 12-month period beginning the month after the individual graduates from high school, provided he or she has indicated an intention to continue schooling within 4 months of high school graduation, and each successive 12-month period in which there is school attendance or the payment of compensation based on student attendance, or

(ii) If the individual has indicated that he or she will not continue schooling within 4 months of high school graduation, the 12-month period beginning with the month that the individual enters school to continue his or her education, and each successive 12month period in which there is school

attendance or the payment of compensation based on student status.

(b) Dependents and survivors. In addition to basic disability benefits for employees the Act provides in section 8133 that certain monthly benefits shall be payable to certain enumerated survivors of employees who have died from an injury sustained in the performance of duty. Section 8110 of the Act provides that any employee who is found eligible for a basic benefit shall be entitled to have such a basic benefit augmented at a specified rate for certain persons living in the beneficiary's household or who are dependent upon the beneficiary for support. The provisions of 5 U.S.C. 8101, 8110, and 8133 defining the nature of such survivorship or dependency necessary to qualify a beneficiary for a survivor's benefit or augmented benefit shall be applicable as appropriate to the provisions of this part.

[40 FR 6877, Feb. 14, 1975, as amended at 52 FR 10503, Apr. 1, 1987]

INFORMATION IN PROGRAM RECORDS

§ 10.10 Custody of records relating to Federal Employees' Compensation Act matters.

All records, medical and other reports, statements of witnesses and other papers relating to the injury or death of a civil employee of the United States or other persons entitled to compensation or benefits from the United States under the Act and all amendments and extensions thereof, are the official records of the Office and are not records of the agency, establishment or department making or having the care or use of such records. [52 FR 10504, Apr. 1, 1987]

§ 10.11 Confidentiality of records relating to Federal Employees' Compensation Act matters.

Records of the Office pertaining to an injury or death are confidential, and are exempt from disclosure to the public under section 552(b)(6) of title 5, United States Code. No official or employee of an agency, establishment or department who has investigated or secured statements from witnesses and others pertaining to a claim for benefits, or any person having the care or

use of such reports, shall disclose information from or pertaining to such records to any person, except in accordance with applicable regulations (see 29 CFR parts 70 and 70a).

[52 FR 10505, Apr. 1, 1987]

§ 10.12 Protection, release, inspection and copying of records.

(a) The protection, release, inspection and copying of records of the Office pertaining to an injury or death shall be accomplished in accordance with the rules, guidelines and provisions contained in 29 CFR parts 70 and 70a and the annual notice of systems of records and routine uses as published in the FEDERAL REGISTER. However, since the records of the Office are contained within a government-wide system of records under the control of the Department of Labor, 29 CFR 70a.1(b)(3) provides that the regulations of the agency in possession of such records shall govern the procedure for requesting access to, or amendment of the records, including initial determinations on such requests, while the Department of Labor regulations shall govern all other aspects of safeguarding these records established by the Privacy Act. Where requested to amend such records in possession of the agency is received, the agency shall so advise the Office and shall provide the Office with a copy of any amended record.

(b) Records of the Office pertaining to an employee or beneficiary which are in the possession of the employing agency may be released by the employing agency to that employee or beneficiary, or their representative, in accordance with the provisions contained in 29 CFR part 70a. This includes copies retained by the employing agency of records previously submitted to and in the possession of the Office.

(c) When an employee or beneficiary is prosecuting an action for damages under 5 U.S.C. 8131, records may be released as provided for in 29 CFR part 70a.

[52 FR 10505, Apr. 1, 1987]

MISCELLANEOUS PROVISIONS

§10.20 Forms.

(a) Notice of injury, claims and certain specified reports required to be made with respect to any claim shall be made on approved forms as are prescribed by the Office. Supervisors are expected to maintain an adequate supply of the basic forms needed for the proper recording and reporting of injuries. Pamphlet CA-136, obtainable from OWCP, lists the forms to be stocked by the agencies; and also tells where the forms may be obtained.

(b) The basic forms cited in this chapter are:

Form No.

(1) CA-1

(2) CA-2

(3) CA-2a

(4) CA-3

(5) CA-5

(6) CA-5b

(7) CA-6

(8) CA-7

(9) CA-8

(10) CA-12

(11) CA-16

(12) CA-17

(13) CA-20

(14) CA-20a

Title

Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation. Notice of Occupational Disease and Claim for Compensation.

Notice of Employee's Recurrence of Disability and Claim for Pay/Compensation.

Report of Termination of Disability and/or Payment.

Claim for Compensation by Widow, Widower and/or Children.

Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren.

Official Superior's Report of Employee's Death.

Claim for Compensation Due to Traumatic Injury of Occupational Disease.

Claim for Continuing Compensation on Account of Disability.

Claim for Continuance of Com-
pensation.

Authorization of Examination and/or
Treatment.

Duty Status Report.

Attending Physician's Report.
Attending Physician's Supplemental
Report.

(c) Copies of the forms enumerated in this paragraph are available for public inspection at the Office of Workers' Compensation Programs, Employment Standards Administration, U.S. Department of Labor, Washington, D.C. 20211.

[40 FR 6877, Feb. 14, 1975, as amended at 41 FR 2, Jan. 2, 1976; 52 FR 10505, Apr. 1, 1987]

§10.21 Waiver of compensation rights invalid.

No official superior or other person is authorized to require an employee or other claimant to enter into any agreement, either before or after an injury or death, to waive his or her right to claim compensation under the Act. No waiver of compensation rights shall be valid.

§10.22 Exclusiveness of remedy.

The benefits provided to employees and to survivors of employees by the Act constitute the exclusive remedy against the United States for employment related injuries or deaths. The injury or death of an employee gives rise to no right to recover damages from the United States exclusive of the Act.

$10.23 Penalties.

of

(a) Any employee, beneficiary, official superior, representative, or other person who knowingly makes, or knowingly certifies to, any false statement, misrepresentation, concealment fact, or any other act of fraud with respect to a claim under the Act, or who knowingly accepts compensation to which that person is not entitled, is subject to criminal prosecution and may, under appropriate U.S. Criminal Code provisions (e.g., 18 U.S.C. 287 and 1001), be punished by a fine of not more than $10,000 or imprisonment for not more than five years, or both.

(b) Any employee, beneficiary, offlcial superior, representative, or other person who, with respect to a claim under the Act, enters into any agreement, combination, or conspiracy to defraud the United States by obtaining or aiding to obtain the payment or allowance of any false, fictitious or fraudulent claim is subject to criminal prosecution and may, under appropriate U.S. Criminal Code provisions (e.g., 18 U.S.C. 286), be punished by a fine of not more than $10,000 or imprisonment for not more than ten years, or both.

(c) Any person charged with the responsibility of making reports in connection with an injury who willfully fails, neglects, or refuses to do so; induces, compels, or directs an injured employee to forego filing a claim; or willfully retains any notice, report, or

paper required in connection with an injury, is subject to a fine of not more than $500 or imprisonment for not more than one year, or both.

[52 FR 10505, Apr. 1, 1987]

Subpart B-Notice of Injury and Claim for Compensation, Administrative Procedures

NOTICE OF INJURY OR DEATH

§10.100 How to file a notice of injury or death.

(a) Traumatic injury. An employee who sustains a traumatic injury which the employee believes occurred while in the performance of duty shall give written notice of the injury on Form CA-1 to the official superior. If the employee is unable to give written notice, it may be given by any person acting on the employee's behalf.

(b) Occupational disease or illness. An employee who has a disease or illness which the employee believes to be employment-related shall give written notice of the condition on Form CA-2 to the official superior. If the employee is unable to give written notice, it may be given by any person acting on the employee's behalf. If it is impractical to give written notice to the employee's official superior, it may be given to any official of the employing agency, or directly to the Office. Form CA2 must be accompanied by a statement from the employee to include:

(1) A detailed history of the disease or illness with identification of part(s) of the body affected;

(2) Complete details of types of substances or conditions of employment believed responsible for the disease or illness;

(3) A description of specific exposures to substances or stressful conditions including locations, frequency and duration, and

(4) Whether the employee ever suffered a similar condition and, if so, full details of onset, history and medical care received with names and addresses of physicians rendering treatment.

(c) Death. If an employee dies because of a traumatic injury believed to have been sustained in the performance of duty or because of a disease or illness

believed to have been employment-related, the employee's survivor(s), or any person acting on behalf of the survivor(s), shall notify the official superior of the death. If it is impractical to give notice to the employee's official superior, it may be given to any official of the employing agency, or directly to the Office.

(d) The person submitting a notice under paragraph (a) or (b) of this section shall include the Social Security Number (SSN) of the injured worker. In cases where the worker dies as a result of an on-the-job injury and the notice is submitted under paragraph (c) of this section, the SSN of the person seeking benefits shall be disclosed in addition to the SSN of the deceased worker.

[52 FR 10505, Apr. 1, 1987, as amended at 58 FR 68032, Dec. 23, 1993]

§10.101 When a notice of injury or death must be given.

(a) Traumatic injury. Written notice of a traumatic injury or death due to a traumatic injury shall be given as soon as possible but, pursuant to 5 U.S.C. 8119, no later than 30 days from the date on which the injury or death occurred. Given the provisions of 5 U.S.C. 8122 and §10.105 of this part concerning the timely filing of a claim for compensation, the failure to give notice within 30 days may result in a loss of compensation rights.

(b) Occupational disease or illness. Written notice of disease or illness believed to be employment related shall be given as soon as possible but no later than 30 days from the date on which the employee was first aware, or by the exercise of reasonable diligence should have been aware, of a possible relationship between the disease or illness and the conditions or factors of employment. Given the provisions of 5 U.S.C. 8122 and §10.105 of this part concerning the timely filing of a claim for compensation, the failure to give notice within 30 days may result in a loss of compensation rights.

(c) Death. In the case of death, notice shall be given as soon as possible but no later than 30 days from the date of death or the date the employee's survivor first became aware, or by the exercise of reasonable diligence should

have been aware, of a possible relationship between the death and the conditions or factors of employment. Given the provisions of 5 U.S.C. 8122 and $10.105 of this part concerning the timely filing of a claim for compensation, the failure to give notice within 30 days may result in a loss of compensation rights.

[52 FR 10506, Apr. 1, 1987]

10.102 Report of injury by the official superior.

(a) As soon as possible but no later than 10 working days after receipt of written notice of injury from the employee, the official superior shall submit to the Office a written report of every injury or occupational disease or illness which is likely to:

(1) Result in a medical charge against the Office;

(2) Result in disability for work beyond the day or shift of injury;

(3) Require prolonged treatment (i.e., more than two instances of medical examination and/or treatment);

(4) Result in future disability;

(5) Result in permanent impairment or;

(6) Result in a continuation of pay pursuant to 5 U.S.C 8118.

Portions of Forms CA-1 or CA-2 are provided for this purpose. If the injury does not come under any of the categories enumerated in this paragraph, the Form CA-1 or CA-2 need not be submitted to the Office but shall be retained as a permanent record in the Employee Medical Folder in accordance with the guidelines established by the Office of Personnel Management. Regardless of whether the Form CA-1 of CA-2 is forwarded to the Office or retained by the employing agency, immediately upon receipt of the written notice of injury the official superior shall complete the "Receipt of Notice of Injury" and return it to the employee.

(b) If the official superior has reason to disagree with any particular of the injury as reported by the employee, the official superior or other agency official shall explore the circumstances of the injury and submit to the Office a full written explanation specifying the areas of disagreement and the findings upon which the disagreement is based. The report may be accompanied by

supporting documentation such as witness statements, medical reports or records, or any other relevant information. Any written explanation of disagreement shall be submitted to the Office at the same time as Form CA-1 in cases of traumatic injury, and within 30 calendar days from the date Form CA-2 is received from the employee in occupational disease cases. If written explanation in support of the disagreement is not submitted, the Office may accept as factual the report of injury made by the employee. Disagreement with the particulars of the injury as reported by the employee may not be used by the employing agency to delay the forwarding of the claim to the Office or to compel or induce the employee to change the claim.

(c) In cases of disease or illness, Form CA-2 must be accompanied by the following from the official superior:

(1) A detailed description of the employee's duty assignments including the nature, extent and duration of exposure to fumes, chemicals, or other irritants or situations;

(2) Copies of all physical examination reports, including x-ray reports and laboratory data, on file for the employee;

(3) A record of the employee's absences from work showing the reason for the absence in each instance, if known;

(4) Statements from each co-worker currently employed by the agency who has firsthand knowledge about the employee's condition and its cause, and;

(5) The official superior's comments on the accuracy of the employee's statement required by §10,100(b) of this part.

(d) Other reports shall be submitted by the official superior as described elsewhere in this part or as may be required by the Office.

(e) The official superior is authorized to furnish an employee or beneficiary, or the representative, with a copy of any notice of injury, claim form, or other document pertaining to that employee or beneficiary which has been completed and submitted to the Office by the employing agency. This includes any notice of injury, claim form, or

other document previously submitted to the Office, a copy of which was retained by the employing agency. While furnishing a copy of such forms and documents is not required on a routine basis in every case, the official superior shall furnish a copy of such forms and documents upon receipt of a written request from the employee or beneficiary, or the representative.

[52 FR 10506, Apr. 1, 1987]

§ 10.103 Report of death by the offical superior.

If an employee dies because of a traumatic injury or a disease or illness sustained in the performance of duty, the official superior shall immediately report the death to the Office by telephone or telegram. As soon as possible but no later than 10 working days after receipt of knowledge of death, the official superior shall complete and send Form CA-6 to the Office.

[52 FR 10506, Apr. 1, 1987]

§10.104 Report of the attending physician.

(a) In all cases reported, the employee must submit, or arrange for the submission of, a medical report to the Office from the attending physician. This report should include: dates of examination and treatment; history given by the employee; findings; results of x-rays and laboratory tests; diagnosis; course of treatment; and the physician's opinion, with medical reasons, regarding causal relationship between the diagnosed condition(s) and the factors or conditions of the employment. This report may be made:

(1) On Part B of Form CA-16; (2) On Form CA-20 or CA-20a; or (3) By narrative report on the physician's letterhead stationery. The report shall be submitted to the Office as soon as possible after medical examination or treatment is received. (See also §10.204(a)(1).)

(b) Additional reports shall be submitted by the attending physician as described elsewhere in this part or as may be required by the Office.