Surge of workers' comp claims could impact processing

Effects of the COVID-19 pandemic are expected to slow claims processing at the Division of Federal Employees' Compensation, according to a July 6 audit of the Office of Workers’ Compensation Programs by the Labor Department’s Office of Inspector General.

Effects of the COVID-19 pandemic are expected to slow claims processing at the Division of Federal Employees' Compensation (DEFC), according to a July 6 audit of the Office of Workers’ Compensation Programs by the Labor Department’s Office of Inspector General.

As of June 16, DFEC had received 2,866 COVID-19 claims, including 48 death claims, and paid out approximately $30,000 in medical benefits and compensation. The division estimates it will receive 6,000 COVID claims through Aug. 4, straining resources and delaying claims processing.

To prepare to meet these challenges, DFEC developed a contingency plan, issued new procedures for handling COVID-19 claims and created a COVID-19 task force to oversee claims development and adjudication.

DEFC plans to dedicate two Medical Benefit Examiner teams – reassigning two of four examiner units focusing on opioid cases -- to COVID-19 claims to ensure greater consistency and oversight.

To streamline processing for COVID-infected federal employees in high-risk positions, DFEC will accept that the exposure to the virus “was proximately caused by the nature of the employment and will only require medical evidence that establishes a diagnosis of COVID-19, such as a positive COVID-19 test result,” the report said. COVID-related claims filed by employees in positions not considered high-risk will be treated the same as all other FECA claims, DFEC said, meaning claimants must provide evidence that the disease was employment-related.

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