Agency Strategy: Denial at the Earliest Element
Agencies strategically aim to challenge dubious claims early in the process. Why? To prevent the Department of Labor (DOL) from later accepting an element of the claim that lacks proper support. When OWCP denies a claim based on an agency challenge, the earlier elements won’t be reevaluated during a hearing.
Key Elements for Challenge and Investigation
1. Safety Reports: Agencies rely on safety records to assess the validity of claims in the context of usual and routine performance of duty.
2. Supervisor Statements: Supervisors’ insights of intent, mindset, and moral, help evaluate the circumstances surrounding the alleged injury or illness.
3. Witness Statements: Eyewitness accounts contribute to the overall understanding of the events. Their perspectives are important for understanding contributory elements that might not be readily apparent.
4. Statistics: Analyzing trends and patterns aids in identifying anomalies or potential red flags.
5. Reports: Detailed incident reports provide essential information for all factors of the claim assessment.
6. Photographs and Video: Visual evidence can corroborate or challenge the claimant’s account of events.
7. Diagrams: Schematics help reconstruct events and understand spatial relationships.
Narrative Rationale for Accepted Challenges
When DOL accepts a challenged claim within 30 days, the employing agency is entitled to a narrative rationale. This explanation clarifies why the claim was accepted despite the challenge.
Non-Compensable Injuries
Situations that fall outside compensable claims:
• Willful Misconduct: Deliberate actions, not mere carelessness or accidents.
• Intoxication: If proven to be directly related to the injury.
• Intent to Harm: Self-inflicted or aimed at others.
Please note that this information serves as a general guide, and specific cases may vary. Always consult official regulations and legal experts for personalized advice regarding OWCP claims.
Frasco Government Services has the required knowledge, skills, and breadth of experience to assist your agency acquire and assemble factual evidence for presentation to the OWCP.