Periodic Review of Disability Cases
All cases on the periodic roll require completion of Form EN-1032 on a yearly basis, and cases where disability compensation is being received also require review of medical evidence to determine continuing entitlement. If the CA-1032 is not received, compensation benefits may be suspended until the report is received.
To that end, FECA has updated their Procedure Manual Chapter 2-0812 to address medical development actions to be taken when benefits are suspended for failure to return a CA-1032, a review of the medical evidence is sufficient to continue compensation for lost wages should be continued at the current level: total disability (TTD) or partial disability (LWEC). If medical evidence is not sufficient to support current benefit level, they should proceed with medical development until sufficient medical evidence is received. Sending the individual for a second opinion examination to determine the claimant’s entitlement to at the level previously authorized.
If a CA-1032 is not received in Schedule Award (PS) cases, that schedule award payments should not be suspended. The claims examiner should reduce compensation rate to the 2/3s, if being paid at an augmented compensation rate (3/4), but no action should be taken if compensation is being paid at the 2/3 rate.
Posted by Ed Daniel
Thursday, June 16, 2022 12:05:00 PM