The Federal Employees’ Compensation Act
(FECA): Workers’ Compensation for Federal
Employees
Updated May 26, 2020
Congressional Research Service
https://crsreports.congress.gov
R42107

link to page 24 The Federal Employees’ Compensation Act (FECA)

Summary
The Federal Employees’ Compensation Act (FECA) is the workers’ compensation program for
federal employees. Like all workers’ compensation programs, FECA pays disability, survivors,
and medical benefits, without regard to who was at fault, to employees who are injured or become
ill in the course of their federal employment and to the survivors of employees killed on the job.
The FECA program is administered by the Department of Labor (DOL) and the costs of benefits
are paid by each employee’s host agency. U.S. Postal Service (USPS) employees currently
comprise the largest group of FECA beneficiaries and are responsible for the largest share of
FECA benefits.
Elements of the FECA program include
 basic disability benefits equal to two-thirds of an injured worker’s pre-disability
wage, which rises to 75% of the pre-disability wage if the worker has any
dependents;
 disability benefits that continue for the duration of disability or the life of the
beneficiary; and in cases of traumatic injuries, beneficiaries can receive a
continuation of their full pay for the first 45 days;
 disability benefits for persons with specific permanent partial disabilities, such as
the loss of a limb, for a set number of weeks provided by schedules set by statute
and regulation;
 coverage of all medical costs associated with covered conditions without any
copayments, cost-sharing, or use of private insurance by the beneficiaries;
 cash benefits for the survivors of employees killed on the job based on the
worker’s wages and a benefit for funeral costs; and
 vocational rehabilitation services to assist beneficiaries in returning to work.
This report also focuses on several key policy issues facing the program, including the
disproportionate share of claims and program costs attributed to postal workers, the payment of
FECA benefits after retirement age, the overall level of FECA disability benefits as compared
with those offered by the states, the administration of the FECA program, the costs associated
with prescriptions for compounded medications, and efforts to limit the use of opioids by FECA
beneficiaries.
The DOL has established special procedures for federal employees with Coronavirus Disease
2019 (COVID-19) to determine if their exposure was related to their employment, and thus
compensable under FECA. Employees in certain high-risk groups, such as health care workers
and first responders, may be eligible for up to 45 days of continuation of pay after a COVID-19
diagnosis without having to establish a causal relationship between their job and exposure. In the
116th Congress, legislation that would create a presumption of FECA eligibility for certain federal
employees diagnosed with COVID-19 has been introduced in the House of Representatives (H.R.
6379, H.R. 6656, and H.R. 6800), with one bill (H.R. 6800) passed by the House.
The modern FECA program can trace its roots to 1916 and has not been significantly amended
since 1974. A legislative history of the FECA program is provided in Appendix B.

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Introduction
The Federal Employees’ Compensation Act (FECA) is the workers’ compensation system for
federal employees. Every civilian employee of the federal government, including employees of
the executive, legislative, and judicial branches, is covered by FECA, as are several other groups,
including federal jurors and Peace Corps volunteers.
Overview of the FECA Program
Statutory and Regulatory Authorities
The FECA program is authorized in statute at 5 U.S.C. Sections 8101 et seq. Regulations
implementing the FECA are provided at 20 C.F.R. Sections 10.00-10.826. The FECA program is
administered by the Department of Labor (DOL), Office of Workers’ Compensation Programs
(OWCP).
Program Financing
Benefits under FECA are paid out of the federal Employees’ Compensation Fund. This fund is
financed by appropriations from Congress that are used to pay current FECA benefits and that are
ultimately reimbursed by federal agencies through the chargeback process.
Each quarter OWCP provides to all federal agencies with employees receiving FECA benefits an
estimate of the cost of these benefits to assist these agencies in preparing their budget requests.
By August 15 of each year, OWCP sends each agency a statement of their FECA costs for the
previous fiscal year. Each agency must include in its next budget request an appropriation to
cover its FECA costs for the previous fiscal year. Upon receiving this appropriation, or if a non-
appropriated entity of the government, by October 15, the agency must reimburse the Employees’
Compensation Fund for the costs of the FECA benefits provided to its employees.
The administrative costs associated with the FECA program are provided to the DOL through the
appropriations process. In addition, the U.S. Postal Service (USPS) and certain other non-
appropriated entities of the federal government are required to pay for the “fair share” of the costs
of administering benefits for their employees.
FECA Benefit Costs
During the period between July 1, 2018, and June 30, 2019 (the chargeback year), the FECA
program paid out $3.014 billion in benefits, including approximately $1.959 billion in disability
benefits, $902 million in medical benefits, and $153 million in benefits to the survivors of federal
employees killed on the job.1 Table 1 provides data on FECA benefit costs.

1 Department of Labor (DOL), FY2021 Congressional Budget Justification, February 2020, p. OWCP-FPWC-16.
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Table 1. FECA Benefit Costs, July 1, 2018, Through June 30, 2019
Cost
Percentage of

(in millions of dollars)
Total Benefit Costs
Disability Benefits
1,959
65.0
Medical Benefits
902
30.0
Death Benefits
153
5.1
Total Benefits
3,014
100.0
Source: Department of Labor, FY2021 Congressional Budget Justification, February 2020, p. OWCP-FPWC-16.
Note: Numbers may not add due to rounding.
Employees Covered by FECA
The FECA program covers all civilians employed by the federal government, including
employees in the executive, legislative, and judicial branches of the government. Both full-time
and part-time workers are covered, as are most volunteers and all persons serving on federal
juries. Coverage is also extended to certain groups, including state and local law enforcement
officers acting in a federal capacity, federal jurors, Peace Corps volunteers, students participating
in Reserve Officer Training Corps programs, and members of the Coast Guard Auxiliary and
Civil Air Patrol.
Conditions Covered by FECA
Under FECA, workers’ compensation benefits are paid to any covered employee for any
disability or death caused by any injury or illness sustained during the employee’s work for the
federal government. There is no list of covered conditions nor is there a list of conditions that are
not covered. However, no injury, illness, or death may be compensated by FECA if the condition
was
 caused by the willful misconduct of the employee;
 caused by the employee’s intention to bring about the injury or death of himself
or another person; or
 proximately caused by the intoxication of the employee.
In addition, any person convicted of a felony related to the fraudulent application for or receipt of
FECA benefits forfeits his or her rights to all FECA benefits for any injury that occurred on or
before the date of conviction. The benefits of any person confined in jail, prison, or an institution
pursuant to a felony conviction are suspended for the duration of the incarceration and may not be
recovered.
FECA Claims Process
All FECA claims are processed and adjudicated by OWCP. Initial decisions on claims are made
by OWCP staff based on evidence submitted by the claimant and his or her treating physician.
The law also permits OWCP to order a claimant or beneficiary to submit to a medical
examination from a doctor contracted to the federal government. An employee dissatisfied with a
claims decision may request a hearing before OWCP or an OWCP review of the record of its
decision. A final appeal can be made to the Employees’ Compensation Appeals Board (ECAB).
The decision of the ECAB is final, cannot be appealed, and is not subject to judicial review.
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Time Limit for Filing FECA Claims
In general, a claim for disability or death benefits under FECA must be made within three years
of the date of the injury or death. In the case of a latent disability, such as a condition caused by
exposure to a toxic substance over time, the three-year time limit does not begin until the
employee is disabled and is aware, or reasonably should be aware, that the disability was caused
by his or her employment.
FECA Compensation Benefits
Continuation of Pay
In the case of a traumatic injury, an employee is eligible for continuation of pay for up to 45
days.2 Continuation of pay is paid by the employing agency and is equal to 100% of the
employee’s rate of pay at the time of the traumatic injury. Since continuation of pay is considered
salary and not compensation, it is taxed and subject to any deductions normally made against the
employee’s salary. Any lost work time beyond 45 days, or lost time due to a latent condition, is
considered either a partial or total disability under FECA.
Employees of the USPS must satisfy a three-day waiting period before becoming eligible for
continuation of pay.
Partial Disability
If an employee is unable to work full-time at his or her previous job, but is able to work either
part-time or at a job in a lower pay category, then he or she is considered partially disabled and
eligible for the following compensation benefits:
 if the employee is single, a monthly benefit equal to two-thirds of the difference
between the employee’s pre-disability and post-disability monthly wage or
 if the employee has at least one dependent or a spouse, a monthly benefit equal to
75% of the difference between the employee’s pre-disability and post-disability
monthly wage.
The compensation benefits paid for partial disability are capped at 75% of the maximum basic
pay at rate GS-15 (GS-15, step 10 without any locality adjustment) at the time of eligibility, are
not subject to federal taxation, and are subject to an annual cost-of-living adjustment. Benefits are
paid for the duration of the disability or the life of the beneficiary.
If an employee’s actual wages do not accurately represent his or her true wage-earning capacity,
or if he or she has no wages, then his or her partial disability benefit is based on his or her wage-
earning capacity as determined by OWCP using a combination of vocational factors and “degree
of physical impairment.”

2 A traumatic injury for the purposes of eligibility for continuation of pay is defined in the regulations at 20 C.F.R.
§10.5(ee) as “a condition of the body caused by a specific event or incident, or series of events or incidents, within a
single workday or shift.” Certain groups, including federal jurors, Peace Corps volunteers, and Civil Air Patrol
members, are not eligible for continuation of pay.
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Scheduled Benefits
In cases in which an employee suffers a permanent partial disability, such as the loss of a limb, he
or she is entitled to a scheduled benefit. The scheduled benefit is in addition to any other partial
or total FECA disability benefits received. An employee may receive a scheduled award even if
he or she has returned to full-time work.3 The list of scheduled benefits is provided in the
Appendix A to this report and for each type of permanent partial disability, an employee receives
the standard FECA benefits for the number of weeks indicated.4 If an employee suffers a
disfigurement of the face, head, or neck that is of such severity that it may limit his or her ability
to secure or retain employment, the employee is entitled to up to $3,500 in additional
compensation.
Total Disability
If an employee is unable to work at all, then he or she is considered totally disabled and eligible
for the following compensation benefits:
 if the employee is single, a monthly benefit equal to two-thirds of the employee’s
pre-disability monthly wage or
 if the employee has at least one dependent (including a spouse),5 a monthly
benefit equal to 75% of the employee’s pre-disability monthly wage.
The compensation benefits paid for total disability are capped at 75% of the maximum basic pay
at rate GS-15 (GS-15, step 10), without any locality adjustment, at the time of eligibility, are not
subject to federal taxation, and are subject to an annual cost-of-living adjustment. Benefits are
payable until it is determined that the employee is no longer totally disabled and may continue
until the employee’s death.
Death
If an employee dies in the course of employment or from a latent condition caused by his or her
employment, the employee’s survivors are eligible for the following compensation benefits:6
 if the employee had a spouse and no children, then the spouse is eligible for a
monthly benefit equal to 50% of the employee’s monthly wage at the time of
death or
 if the employee had a spouse and one or more children, then the spouse is eligible
for a monthly benefit equal to 45% of the employee’s monthly wage at the time
of death, and each child is eligible for a monthly benefit equal to 15% of the

3 The list of the Federal Employees’ Compensation Act (FECA) scheduled benefits are provided in statute at 5 U.S.C.
Section 8107(c) and in regulation at 20 C.F.R. Section 10.404(a).
4 In certain circumstances, if it is determined to be in the beneficiary’s best interest, the full amount of the scheduled
award may be paid in one lump sum. For additional information on the payment of a scheduled award in a lump sum,
see Section 2-1300 of the Division of Federal Employees’ Compensation Procedure Manual at https://www.dol.gov/
owcp/dfec/regs/compliance/dfecfolio/FECA-PT2/group2.htm#21300.
5 A dependent can be a spouse, unmarried child under the age of 18, unmarried child 18 or older who is incapable of
self-support, a student up to age 23 or until he or she completes four years of school beyond high school, or a
dependent parent.
6 The death must be related to the person’s work. For example, a person who dies of an unrelated medical condition in
the workplace would not be eligible for FECA benefits.
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employee’s monthly wage at the time of death, up to a maximum family benefit
of 75% of the employee’s monthly wage at the time of death.
Special rules apply in cases in which an employee dies without a spouse or children or with only
children.
If a spouse remarries before the age of 55, then he or she is entitled to a lump-sum payment equal
to 24 months of benefits, after which all benefits cease. If a spouse remarries at the age of 55 or
older, benefits continue for life. A child’s benefits end at the age of 18, or age 23 if the child is
still in school. A child’s benefits continue for life if the child is disabled and incapable of self-
support.
The compensation benefits paid for death are capped at 75% of the maximum basic pay at rate
GS-15, without any locality adjustment, at the time of eligibility, are not subject to federal
taxation, and are subject to an annual cost-of-living adjustment.
Additional Death Benefits
The personal representative of the deceased employee is entitled to reimbursement, up to $200, of
any costs associated with terminating the deceased employee’s formal relationship with the
federal government. The personal representative of the deceased employee is also entitled to a
reimbursement of funeral costs up to $800, and the federal government will pay any costs
associated with shipping a body from the place of death to the employee’s home. An employee
killed while working with the military in a contingency operation is also entitled to a special
gratuity payment of up to $100,000 payable to his or her designated survivors.
FECA Medical Benefits
Under FECA, all medical costs—including medical devices, therapies, and medications—
associated with the treatment of a covered injury or illness are paid for, in full, by the federal
government. A FECA beneficiary is not responsible for any coinsurance or any other costs
associated with his or her medical treatment and does not have to use any personal insurance for
any covered medical costs. A published fee schedule is used by OWCP to determine the rate or
reimbursement paid to medical providers.7
Generally, a beneficiary may select his or her own medical provider and is reimbursed for the
costs associated with transportation to receive medical services. Medical providers must be
authorized by OWCP and can have their authorization removed if it is determined that they are
violating program rules or are involved in fraud.
A FECA beneficiary who is blind, paralyzed, or otherwise disabled such that he or she needs
constant personal attendant care may receive an additional benefit of up to $1,500 per month.
Vocational Rehabilitation
The Secretary of Labor may direct any FECA beneficiary to participate in vocational
rehabilitation, the costs of which are paid by the federal government. While participating in
vocational rehabilitation, the beneficiary may receive an additional benefit of up to $200 per
month. However, any beneficiary who is directed to participate in vocational rehabilitation and

7 A copy of the current Office of Workers’ Compensation Programs (OWCP) medical fee schedule can be found on the
DOL website at http://www.dol.gov/owcp/regs/feeschedule/fee.htm.
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fails to do so may have his or her benefit reduced to a level consistent with the increased wage
earning capacity that likely would have resulted from participation in vocational rehabilitation.
Coordination with Other Benefits
Coordination with Retirement Benefits for Federal Employees
Most federal employees are covered by either the Civil Service Retirement System (CSRS) or the
Federal Employees’ Retirement System (FERS).8 The CSRS covers federal employees initially
hired before January 1, 1984. The FERS covers employees hired on or after that date and CSRS-
eligible employees who voluntarily switched to FERS coverage during “open seasons” held in
1987 and 1998. Employees contribute to the cost of the CSRS and FERS through payroll taxes.
Both the CSRS and FERS provide for defined benefit pensions for retired and disabled federal
employees. The FERS defined benefit pension is smaller than that provided by the CSRS,
however, the FERS also provides for participation in the Social Security system and the Thrift
Savings Plan (TSP), a federally managed defined contribution plan similar to a 401(k) plan
offered to private-sector workers.9
While an injured federal employee is receiving FECA benefits and not working, he or she does
not make any CSRS or FERS contributions, but does continue to accrue time in service for the
purposes of retirement eligibility.10 Because FECA benefits are not considered earnings under
either the Social Security Act or Internal Revenue Code, FECA beneficiaries generally may not
contribute to the Social Security system via the payroll tax or to the TSP.
Once a FECA beneficiary becomes eligible for CSRS or FERS retirement benefits, he or she may
elect to receive these retirement benefits or remain in the FECA program for the duration of
disability. Once this election is made, it may be changed at any time.
The amount of the FERS basic annuity is increased from 1% of the employee’s high-three
average pay to 2% of the high-three average pay for any period during which the employee was
receiving FECA benefits rather than earnings. This provision, enacted in 2003, is designed to
partially replace retirement income lost because of the employee’s inability to contribute to the
Social Security system or the TSP while receiving FECA benefits.11
Coordination with Disability Retirement Benefits
Both the CSRS and FERS offer federal employees who are unable to continue working because
of disabilities the option to take a disability retirement annuity before reaching normal retirement
age.12 For the purposes of the CSRS and FERS disability retirement systems, an employee is

8 Some federal employees, such as Foreign Service Officers or employees of non-appropriated fund instrumentalities
are covered by federal retirement systems other than the Civil Service Retirement System (CSRS) or Federal
Employees’ Retirement System (FERS). For additional information on the more than 30 types of federal retirement
systems, see U.S. General Accounting Office, Public Pensions: Summary of Federal Pension Plan Data, GAO/AIMD-
96-6, February 1996. For additional information on the FERS and CSRS, see CRS Report 98-810, Federal Employees’
Retirement System: Benefits and Financing.
9 For additional information on the Thrift Savings Plan (TSP), see CRS Report RL30387, Federal Employees’
Retirement System: The Role of the Thrift Savings Plan.
10 The only payroll deductions taken from FECA benefits are for Federal Employee Health Benefits (FEHB) and basic,
optional, and post-retirement basic life insurance if the employee is enrolled in these programs.
11 P.L. 108-92.
12 For additional information on disability retirement under CSRS and FERS, see CRS Report RS22838, Disability
Retirement for Federal Employees.
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considered disabled and eligible for an annuity if he or she is unable to perform his or her current
federal job and cannot be accommodated with a job at the same rate of pay by his or her
employing agency because of a medical condition that is expected to last at least one year. An
employee must have five years of service to qualify for disability retirement benefits under CSRS
and 18 months of service under FERS. Generally, the amount of an employee’s disability annuity
is lower than what the employee would have received had he or she worked until normal
retirement age and collected a CSRS or FERS retirement annuity.
As in the case of a FERS or CSRS retirement annuity, a FECA beneficiary who is also eligible for
CSRS or FERS disability retirement benefits may elect to receive these disability retirement
benefits or remain in the FECA program for the duration of disability. Once this election is made,
it may be changed at any time.
Coordination with Social Security Disability Insurance Benefits
Because FECA is a workers’ compensation program, it is covered by the public disability offset
provisions of Section 224 of the Social Security Act.13 If a FECA beneficiary is also receiving
Social Security Disability Insurance (SSDI) benefits, then the total amount of the beneficiary’s
monthly SSDI benefit, all SSDI benefits paid to his or her spouse or dependents, and his or her
FECA benefit cannot exceed 80% of his or her average monthly wage at the time of his or her
disability. The FECA beneficiary’s SSDI benefits, or the benefits for his or her spouse or
dependents, are reduced until the 80% threshold is reached.
Coordination with Social Security Retirement Benefits
Federal employees covered by the FERS system are also covered by the Social Security system
for their periods of federal employment. If a federal employee covered by FERS is entitled to
both FECA and Social Security retirement benefits, the amount of his or her monthly FECA
benefit is reduced by the amount of his or her Social Security retirement benefit attributable to his
or her federal service.
Selected Current Issues Facing the FECA Program
FECA Coverage of COVID-19 Exposure
A federal employee who contracts Coronavirus Disease 2019 (COVID-19) in the course of his or
her federal employment is eligible for FECA benefits. However, as in all other cases, the
employee must demonstrate a causal relationship between the disease and his her employment.
Due to the nature of COVID-19 transmission, including the lack of complete understanding about
how Sars-CoV-2, the virus that causes COVID-19, is transmitted by asymptomatic individuals
and how long the virus can remain viable on a variety of surfaces, there is concern that this could
prove difficult for some employees, preventing them from receiving FECA benefits. On March
30, 2020, OWCP issued guidance on how to process FECA claims related to COVID-19.14

13 42 U.S.C. §424a.
14 DOL, Office of Workers’ Compensation Programs, Federal Employees Contracting COVID-19 in Performance of
Duty, FECA Bulletin No. 20-05, March 31, 2020, https://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/
FECABulletins/FY2020-2024.htm#FECAB2005. (Hereinafter cited as DOL, Federal Employees Contracting COVID-
19 in Performance of Duty.)
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Continuation of Pay in COVID-19 Cases
If an employee engaged in high-risk employment files a COVID-19 claim, and the employer
supports the claim and that the exposure occurred, OWCP will “accept that the exposure to
COVID-19 was proximately caused by the nature of the employment” and authorize continuation
of pay for up to 45 days.
Employees not engaged in high-risk employment will be required to submit a factual statement
and any evidence regarding their exposure. If the employer supports the claim and that the
exposure occurred, continuation of pay will be authorized for up to 45 days.
High-Risk Employment
High-risk employment, for the purposes of processing COVID-19 FECA claims, is defined in the
OWCP guidance. The guidance states that
In the case of COVID-19, federal employees who are required to have in-person and close
proximity interactions with the public on a frequent basis—such as members of law
enforcement, first responders, and front-line medical and public health personnel—will be
considered to be in high-risk employment.15
The guidance adds
Conditions such as COVID-19 ... more commonly represent a work hazard in health care
facilities, correctional institutions, and drug treatment centers, among others. The
employment-related incidence of COVID-19 appears more likely to occur among members
of law enforcement, first responders, and front-line medical and public health personnel,
and among those whose employment causes them to come into direct and frequent in-
person and close proximity contact with the public.16
A footnote to the OWCP guidance states that “a real-time list of occupational codes and/or job
series, including the geographic locations where the high-risk determination has been flagged by
the agency, will be available to OWCP staff to assist OWCP’s determination that the position falls
within that category.”17 This list has not been made available to the public.
Testing for COVID-19
The OWCP guidance provides that if a federal employee encounters difficulty in getting tested for
COVID-19, OWCP will authorize testing if the employee is in high-risk employment or has a
confirmed employment-related exposure.
Establishing a Causal Relationship in COVID-19 Cases
To receive compensation for disability beyond the continuation of pay period, and medical
benefits under FECA, an employee with COVID-19 will have to establish a causal relationship
between the disease and his or her employment. The determination of a causal relationship is
based on the case’s factual and medical background. The OWCP guidance, citing a March 2020
decision by the ECAB, states that “in the case of high-risk employment, the factual and medical

15 DOL, Federal Employees Contracting COVID-19 in Performance of Duty.
16 DOL, Federal Employees Contracting COVID-19 in Performance of Duty.
17 DOL, Federal Employees Contracting COVID-19 in Performance of Duty, Footnote 1.
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background would include the physician’s recognition that the employee is engaged in high-risk
employment that included exposure to COVID-19 while in federal employment.”18
Legislation to Create a Presumption of FECA Eligibility for COVID-19 Cases
H.R. 6379
Section 150006 of H.R. 6379, the Take Responsibility for Workers and Families Act, would
create a presumption of FECA eligibility for any of the following groups of federal employees
diagnosed with COVID-19 between January 30, 2020, and January 30, 2022:
 health care workers;
 first responders;
 law enforcement officers (including corrections officers);
 Transportation Security Administration (TSA) officers;
 employees of the U.S. Postal Service (USPS), Department of Veterans Affairs
(VA), and Indian Health Service (IHS);
 employees carrying out duties that “require substantial contact with the public”;
and
 “any employee whose duties include a recognized risk of exposure to the
coronavirus.”
H.R. 6656
H.R. 6656, the Coronavirus Workers’ Compensation for TSA Employees Act, would create a
presumption of FECA eligibility for any of the following groups of Transportation Security
Administration (TSA) employees diagnosed with COVID-19 between January 30, 2020, and
January 30, 2022:
 transportation security officers;
 federal air marshals;
 canine handlers; and
 any TSA employee “carrying out duties that require substantial contact with the
public.”
H.R. 6800
Section 70303 of H.R. 6800, the Heroes Act, as passed by the House of Representatives, would
create a presumption of FECA eligibility for federal employees diagnosed with COVID-19 who
meet the following conditions:
 were employed in the federal service at any time between January 27, 2020, and
January 20, 2022;

18 In its March 20, 2020, guidance, OWCP states that the ECAB found in D.M (T.M) Docket No. 19-0358 (March 19,
2020) that “the employee’s death due to meningococcemia was causally related to her high-risk employment as a nurse
at the employing establishment, as her employment routinely presented situations which could lead to infection by
contact with human blood, bodily secretions, and other substances.” DOL, Office of Workers’ Compensation
Programs, Federal Employees Contracting COVID-19 in Performance of Duty, FECA Bulletin No. 20-05, March 31,
2020, https://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECABulletins/FY2020-2024.htm#FECAB2005.
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 carried out duties requiring contact with patients, the public, or coworkers;
 carried out duties that included a risk of exposure to SARS-CoV-2 or another
coronavirus with pandemic potential; and
 were not teleworking on a full-time basis for the entire duration of the period
between January 27, 2020, and January 20, 2022.
Under the presumptions of eligibility proposed in these bills, specified employees would not be
required to demonstrate a causal link between COVID-19 and their employment to be eligible for
all FECA benefits.
FECA and the U.S. Postal Service
The USPS and its employees make up the largest component of the FECA program, and postal
workers are injured on the job at rates disproportionate to the rest of the federal government. As
shown in Table 2, although postal workers made up 21.6% of the federal civilian workforce, they
accounted for 50.3% of injuries, illnesses, and fatalities that resulted in FECA cases in FY2018.19
In 2006, with the enactment of Section 901 of the Postal Accountability and Enhancement Act,
P.L. 109-435, Congress changed the application of the three-day waiting period for postal workers
with traumatic injuries with the goal of reducing FECA costs to the USPS. This provision requires
that postal employees satisfy the three-day waiting period before the continuation of pay period
can begin. All other federal employees continue to serve the three-day waiting period after the
conclusion of the continuation of pay period and before FECA compensation benefits begin.
Table 2. FECA Cases, FY2018
Employeesa
FECA Casesb
Per 100
Category
Total
Percentage
Total
Percentage
Employees
Federal Government
2,831,048
100.0
84,959
100.0
3.0
U.S. Postal Service
610,528
21.6
42,749
50.3
7.0
Federal Government,
2,220,520
78.4
42,210
49.7
1.9
excluding U.S. Postal Service
Source: Congressional Research Service (CRS) table with data taken from Department of Labor, Occupational
Safety and Health Administration, Federal Injury and Illness Statistics for Fiscal Year 2018, https://www.osha.gov/
enforcement/fap/statistics.
Notes: Numbers may not add due to rounding and the number of federal employees calculated at different
times during the year.
a. Most recent available employment data from Office of Personnel Management.
b. Includes all new injury, illness, and fatality cases submitted to FECA, less any denied claims.
FECA and Retirement Age
Both FECA compensation and medical benefits are payable for the duration of a person’s
disability. There is no maximum duration of benefits and no maximum age at which benefits must
be terminated. Beneficiaries who are eligible for CSRS or FERS retirement or disability annuities

19 DOL, Occupational Safety and Health Administration, Federal Injury and Illness Statistics for Fiscal Year 2018,
https://www.osha.gov/enforcement/fap/statistics.
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may chose to remain in the FECA program. Given the level of benefits, which can be as high as
75% of a worker’s pre-disability wage; the annual cost-of-living adjustment to benefits; and the
fact that FECA benefits are not taxed, in some cases the monthly FECA benefit is higher than
what would be paid by a CSRS or FERS annuity. However, because FECA beneficiaries who are
not working do not pay into either the Social Security system or the TSP, they may be unable to
rely on these programs as a significant source of retirement income.
The DOL reports that less than 2% of new injury cases stay on the FECA rolls for more than two
years. As of 2011, approximately 45,000 cases were receiving long-term disability benefits and
15,000, or one-third, of these cases involved beneficiaries aged 66 or older.20 The USPS Office of
Inspector General reported that in June 2013, the FECA rolls included 10,240 postal workers aged
55 or older of which 1,892 were aged 80 or older, including 2 over 100.21
The provision of FECA compensation benefits to workers after retirement age has changed during
the history of the FECA program. Although FECA benefits have always been paid for the
duration of disability, between 1949 and 1974, the administrator of the FECA program was
required to review the amount of benefits paid to each beneficiary at the age of 70 and was
authorized to reduce the amount of such benefits if it was determined that the beneficiary’s wage-
earning capacity had been reduced by his or her age, independent of his or her disability. This
provision was repealed in 1974 with the Senate Committee on Labor and Public Welfare calling
the reduction of benefits at the age of 70 “discriminatory.”22
Policy Considerations
The question of whether FECA benefits should continue past retirement age depends somewhat
on the intent of these benefits. If FECA disability benefits are intended solely to replace income
lost by a worker because of an injury or illness, then one can reasonably argue that these benefits
should stop at retirement age, when the worker would likely voluntarily stop working on his or
her own, and thus no longer have wages to be replaced. It could be argued that the provision of
FECA benefits for wage loss is analogous to the SSDI program, which stops paying benefits
when a disabled beneficiary reaches retirement age. However, SSDI benefits automatically
convert to Social Security retirement benefits at retirement age.
However, if FECA disability benefits are intended to provide some relief to the worker beyond
wage replacement, such as providing additional money that might have been paid by an at-fault
employer through the tort system or guaranteeing a certain minimum standard of living for a
disabled worker, then stopping benefits at any age while the disability continues would violate
this intent and deprive the beneficiary of deserved benefits.
Currently, 15 states place limitations on the duration or total amount of permanent total disability
benefits under their workers’ compensation systems. These limitations are in the form of a
maximum number of weeks benefits may be paid, a termination of benefits at retirement or some
other age, some combination of both, or a maximum amount of total benefits that can be

20 U.S. Congress, Senate Committee on Homeland Security and Governmental Affairs, Subcommittee on Oversight of
Government Management, the Federal Workforce, and the District of Columbia, Examining the Federal Workers’
Compensation Program for Injured Employees, 112th Cong., 1st sess., July 26, 2011 (statement of Gary Steinberg,
Acting Director, Office of Workers’ Compensation Programs).
21 U.S. Postal Service, Office of the Inspector General, Federal Employees’ Compensation Act Reform, White Paper,
Report Number HR-WP-14-003-R, August 20, 2014, p. 8, https://www.uspsoig.gov/sites/default/files/document-
library-files/2014/hr-wp-14-003-r.pdf.
22 S.Rept. 93-1081, p. 7.
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received.23 Federal workers’ compensation benefits paid through the Longshore and Harbor
Workers’ Compensation Act are paid for the duration of disability or the life of the beneficiary.
FECA Benefit Levels
In general, FECA disability benefits are greater than those offered by state workers’ compensation
systems. For workers with traumatic injuries, FECA offers continuation of pay, at full salary, for
the first 45 days. No state system currently provides any type of continuation of pay, absent the
use of some form of sick or personal leave. Disability benefits under FECA are adjusted annually
to reflect changes in the cost of living, a provision found in less than half of state systems.
The maximum FECA benefit is based on 75% of the GS-15, step 10 pay rate, without any locality
adjustments whereas state maximums are generally based on state average wages or the worker’s
own pre-disability wage. For 2020, the annual salary at GS-15, step 10, is $142,180 whereas the
average federal salary for the executive branch in December 2018 was $84,658.24 Thus, the
maximum FECA benefit under the current system is higher than it would be if the FECA system
based its maximum benefit level on average wages as is the case in the majority of the states.
The FECA basic benefit rate for total disability is two-thirds of the worker’s pre-disability wage.
Currently, 39 states and the District of Columbia have total disability benefit rates that are set at
this level.25 Benefits under the federal Longshore and Harbor Workers’ Compensation Act are
also set at two-thirds of the pre-disability wage.
Because of the augmented compensation provision of the FECA program, beneficiaries with
dependents, including spouses, may receive total disability benefits at a rate of 75% of their pre-
disability wages. No state pays augmented compensation for dependents, and the 75% benefit rate
is higher than that paid by any comparable state workers’ compensation system.
One comparison of the benefit levels of the FECA program with state workers’ compensation
programs involves the amount of disability benefits paid as a percentage of total program
benefits. In 2017, disability benefits made up 49.1% of the total costs of benefits paid by state
workers’ compensation programs and 66.2% of total benefits paid by the FECA program.26 If one
assumes that the types of injuries faced by federal employees and workers in the private and
nonfederal public sectors are not significantly different and that medical costs are also similar,
this difference can be attributed to the higher level of FECA disability benefits, especially for
higher-wage workers, compared with those offered by state workers’ compensation systems.27

23 Elaine Weiss, Griffin Murphy and Leslie I. Boden, Workers’ Compensation: Benefits, Coverage, and Costs (2017
Data), National Academy of Social Insurance, October 2019, pp. 78-84, hereinafter cited as Workers’ Compensation:
Benefits, Coverage, and Costs, 2017.
24 Information on the GS-15 salary rate taken from the website of the Office of Personnel Management (OPM) at
https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/20Tables/pdf/GS.pdf. Information
on average federal salary taken form the OPM FedScope system online at http://www.fedscope.opm.gov/.
25 Workers’ Compensation: Benefits, Coverage, and Costs, 2017, pp. 78-84.
26 Workers’ Compensation: Benefits, Coverage, and Costs, 2017, pp. 24-25.
27 This conclusion is supported by the National Academy of Social Insurance which states “The share of benefits for
medical care is lower than in most state programs because federal cash benefits, particularly for higher-wage workers,
replace a larger share of pre-injury wages than most state programs” (Workers’ Compensation: Benefits, Coverage, and
Costs, 2017, p. 71).
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Program Administration
Insurance
The administration of state workers’ compensation systems and the provision of insurance and
benefits differ significantly from the FECA program. The FECA program does not involve any
form of private insurance or private third-party administration of claims or benefits. Essentially,
each federal entity acts like a self-insured employer with OWCP in the role of claims and benefit
manager.
State workers’ compensation benefits are generally provided by private insurance, state insurance
funds, or through self-insurance. All but four states—North Dakota, Ohio, Washington, and
Wyoming—allow for private insurance. In Ohio and Washington, employers may either purchase
insurance from the state fund or self-insure, whereas employers in North Dakota and Wyoming
may not self-insure and must purchase coverage from the state fund. In 18 states, employers may
purchase insurance from either a state fund or private carriers. All states except North Dakota and
Wyoming allow self-insurance. Under the federal Longshore and Harbor Workers’ Compensation
Act, employers may purchase private insurance or self-insure.
Private insurance pays the majority of state workers’ compensation benefits. In 2014, private
insurers paid 58.6% of total state workers’ compensation benefits whereas state funds paid 15.7%
and self-insured firms paid 25.7%.28 Thus, nearly three-quarters of all state workers’
compensation benefits are paid through a system of third-party insurance rather than through the
self-insurance model used by the FECA program.
Settlements
In 43 states and the District of Columbia, workers’ compensation insurers or self-insured firms
may enter into compromise and release settlements with claimants.29 In these settlements, the
insurer or firm agrees to pay the claimant lump-sum or periodic payments in exchange for being
released from all future obligations under the claim. Compromise and release settlements are
commonly used to avoid protracted disputes or litigation involving claims and are common in
cases with potential for long-term payment of benefits. To accept a compromise and release
settlement, the claimant generally must agree to forgo future benefits, which may be higher over
his or her lifetime, in exchange for immediate payment. Insurers or firms must agree to forgo the
possibility of lower future payments because of successfully controverting parts of a claim or the
death, medical improvement, or return to work of the claimant, in exchange for clearing a claim
off of their books with an immediate payment.
A 2010 study by the W.E. Upjohn Institute for Employment Research found that for 14 large
states (California, Florida, Iowa, Illinois, Indiana, Louisiana, Massachusetts, Maryland, Michigan,
North Carolina, Pennsylvania, Tennessee, Texas, and Wisconsin), for claims that originated
between October 2003 and September 2004, and that had at least seven days of total lost work
time, by March 2007, a median of 19% of these cases had been settled.30

28 Workers’ Compensation: Benefits, Coverage, and Costs, 2017, pp. 24-25.
29 Peter S. Barth, Compromise and Release Settlements in Workers’ Compensation: Final Report, W.E. Upjohn
Institute for Employment Research, report prepared for the State of Washington, Department of Labor and Industries,
December 21, 2010, pp. 44-45, http://research.upjohn.org/reports/178/.
30 Ibid., p. 43.
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Federal law does not provide for the settlement of FECA claims. Thus, the FECA program and
FECA claimants are not able to take advantage of a tool used in approximately one-fifth of claims
with the potential for long-term benefits in the private-sector, including the types of claims that
are likely to result in beneficiaries receiving benefits well after retirement age.
Compounded Medications
Compounded medications are customized medications in which a physician or pharmacist mixes
two or more commercially available medications or ingredients to create a new medication. In
workers’ compensation, compounding is most frequently used to create non-sterile topical
medications for the treatment of neuropathic, muscle, or joint pain, which are often provided by
sources other than traditional retail pharmacies. Recent years have seen significant increases in
the use and cost of compounded medications in all of workers’ compensation, including the
FECA program.
In addition to concerns over the safety and efficacy of compounded medications, especially when
compared against commercially available medications, the DOL, USPS, and some Members of
Congress have raised concerns about the costs associated with compounded medications in the
FECA program. In congressional testimony in March 2017, the DOL Inspector General reported
that costs for compounded medications in the FECA program rose from approximately $2 million
in FY2011 to $263 million in FY2016, with costs rising from $80 million to $214 million in
FY2015 alone. In FY2015, total costs for compounded medications ($214 million) surpassed
costs for all other medications ($199 million) provided by the FECA program.31
The USPS Office of Inspector General found similar costs increases associated with compounded
medications for postal workers in the FECA program, with compounded drug costs rising from
$4.9 million in chargeback year 2011 to $98.7 million in chargeback year 2015. In addition, in
chargeback year 2015, compounded medications made up 34% of USPS FECA prescriptions and
53% of associated prescription costs.32 In response to these increases, in 2015, the USPS took the
unprecedented step of formally requesting to DOL that the USPS chargeback be reduced by $68
million (from a total chargeback of $1.4 billion) to account for increased costs associated with
what the agency felt was the improper use of compounded medications.33 This request was denied
by DOL.34
In a letter to the Office of Management and Budget, the ranking members of House Committees
on Education and the Workforce and Oversight and Government Reform expressed their concerns
over costs associated with compounded medications in the FECA program and cited, as

31 U.S. Congress, House Committee on Appropriations, Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies, Management Challenges at the Departments of Labor, Health and Human Services,
Education, and the Social Security Administration: Views from the Inspectors General, 115th Cong., 1st sess., March 9,
2017 (statement of Scott S. Dahl, Inspector General, Department of Labor).
32 A chargeback year runs from July 1 to June 30. U.S. Postal Service, Office of Inspector General, Workers’
Compensation Compound Drug Costs, Management Advisory Report Number HR-MA-16-003, March 3, 2016, p. 7.
33 Ibid., pp. 17-19.
34 Ibid., pp. 20-21.
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examples, a single tube of a compounded ointment that cost over $67,000 and a compounded
cream containing resveratrol35 that cost over $32,000 per prescription.36
OWCP Compounded Medication Prescription Guidelines
On October 14, 2016, OWCP announced new guidelines for the prescription and dispensing of
compounded medications in the FECA program.37 These new guidelines require that all
compounded prescriptions receive prior authorization from OWCP based on a Letter of Medical
Necessity (LMN) submitted by the claimant’s treating physician. Each compounded prescription
may be authorized for no more than a 30-day supply for a total of 90 days. After 90 days, a new
LMN and authorization is required to continue the use of the compounded medication.
State workers’ compensation programs have seen success at using policy reforms, including prior
authorization reforms similar to those adopted by OWCP, to reduce the use and costs associated
with compounded medications. Express Scripts, a pharmacy benefit manager (PBM),38 reports
that new state policies on compounded medications have contributed to annual decreases of more
than 28% in workers’ compensation spending on compounded drugs each year between 2014 and
2018.39 The federal TRICARE program40 reported similar costs savings after implementing
restrictions changes to its coverage of compounded drugs in May 2015, with monthly spending
on compounded medications dropping from $497 million in April 2015 to $10 million in June
2015.41
Many of the state reforms associated with savings on compounded medications included
provisions such as reimbursement caps, drug formularies, and the mandatory use of PBMs that
are not components of the new OWCP guidelines. In addition, the TRICARE strategy includes
the use of a proprietary list of compounded medication ingredients, developed by Express Scripts,
the TRICARE PBM, that are excluded from coverage.

35 Resveratrol is a natural phenol found in grapes, wine, and other foods that has not been approved for any use by the
Food and Drug Administration (FDA). There is no regulation or policy limiting FECA beneficiaries to only products
approved by the FDA.
36 Letter from Robert C. “Bobby” Scott, Ranking Member, House Committee on Education and the Workforce, and
Elijah E. Cummings, Ranking Member, House Committee on Oversight and Government Reform, to Howard
Shelanski, Administrator, Office of Information and Regulatory Affairs, Office of Management and Budget, October 5,
2016.
37 DOL, Office of Workers’ Compensation Programs, FECA Bulletin No. 17-01, October 14, 2016,
https://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECABulletins/FY2016-2020.htm#FECAB1701.
38 A PBM is a private third-party company that acts as an intermediary between drug manufacturers and payers and
handles the paperwork and other tasks involved in managing the drug benefit. PBMs may also use various strategies to
attempt to control prescription costs, including bulk pricing, formularies, utilization reviews, and required step
therapies. There is no mandatory PBM in the FECA program. However, agencies may contract with PBMs to provide
voluntary services to their employees in the FECA program within FECA program rules and guidelines.
39 myMatrixx: An Express Scripts Company, Workers’ Compensation Drug Trend Report, 2018, 2019, p. 13,
https://www.mymatrixx.com/wp-content/uploads/2019/04/
myMatrixx_2018_Workers_Comp_Drug_Trend_Report_FINAL.pdf.
40 TRICARE provides health benefits to members of the armed forces, their families and military retirees. For
additional information on Tricare see CRS In Focus IF10530, Defense Primer: Military Health System.
41 Department of Defense, Office of Inspector General, Controls Over Compound Drugs at the Defense Health Agency
Reduced Costs Substantially, but Improvements are Needed, Report No. DODIG-2016-105, July 1, 2016, p. 6,
https://media.defense.gov/2016/Jul/01/2001714256/-1/-1/1/DODIG-2016-105.pdf.
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Opioids
Opioids are drugs that bind to opioid receptors on nerve cells in the human body and brain.
Through this action, opioids have an analgesic effect and are therefore most frequently prescribed
and used for pain relief. As a class of drug, opioids include both natural derivatives of the opium
poppy plant (referred to as opiates) and synthetic formulations that emulate the effect of opiates.
Examples of opioids include heroin, fentanyl, morphine, oxycodone, hydrocodone, and codeine.
In addition to temporarily relieving pain, opioids can have other short-term effects, including
euphoria, drowsiness, confusion, nausea, constipation, and slowed breathing. Repeated use of
opioids can result in an increased physical tolerance for the drug resulting in a user’s need for
higher doses to get the same effects. Users may also develop dependence on the drug such that its
absence in the body will result in withdrawal symptoms or an addiction to the drug in which the
person compulsively seeks the drug despite increasing negative physical, psychological, or social
consequences associated with its use. Another concern is the potential for overdose and death
from the use of both illicit and prescription opioids. The increase in opioid-overdose deaths in
recent years has been well-documented and the subject of significant attention from public health
authorities, the public, and Congress.
Since March 2016, the FDA has required that all immediate-release opioids carry a boxed
warning with information on the risks of misuse, abuse, addiction, overdose, and death associated
with opioids. In addition, during that time, the Centers for Disease Control and Prevention (CDC)
issued guidelines for prescribing opioids for chronic pain.42 States, PBMs, and private pharmacy
companies have also issued their own guidelines and policies designed to limit the dosage and
duration of opioid prescriptions.43
In part due to the nature of work injuries, which frequently involve pain, opioids have
traditionally made up a large portion of the total utilization of prescription drugs in workers’
compensation programs. For example, the PBM myMatrixx reports that, despite recent decreases
in overall opioid use within workers’ compensation owing in part to legislative and regulatory
changes made in the states, among workers’ compensation prescriptions that it services, opioids
continue to constitute the largest class of medications prescribed in terms of total spending and
utilization with 17.6% of workers using at least one opioid medication for at least 30 days in
2018.44 A 2018 National Bureau of Economic Research (NBER) working paper looked at the
interaction of long-term opioid use and the duration of workers’ compensation disability benefits
and prospects for returning injured workers to their jobs.45 In this study, which focused on
individuals with employment-related low back pain, the authors conclude that long-term use of
opioids is linked to longer disability durations, stating
We find that prolonged prescribing of opioids leads to longer duration of temporary
disability benefits among workers with work-related low back injuries. Our estimates

42 Deborah Dowell, Tamara Haegerich, and Roger Chou, “CDC Guidelines for Prescribing Opioids for Chronic Pain-
United States, 2016,” Mortality and Morbidity Weekly Report, vol. 65, no. 1 (March 18, 2016), pp. 1-49.
43 National Conference of State Legislatures, Prescribing Policies: States Confront Opioid Overdose Epidemic, June
30, 2019, https://www.ncsl.org/research/health/prescribing-policies-states-confront-opioid-overdose-epidemic.aspx.
44 myMatrixx: An Express Scripts Company, Workers’ Compensation Drug Trend Report, 2018, 2019, pp. 4, 16,
https://www.mymatrixx.com/wp-content/uploads/2019/04/
myMatrixx_2018_Workers_Comp_Drug_Trend_Report_FINAL.pdf
45 Bogdan Savych, David Neumark, and Randall Lea, “Do Opioids Help Injured Workers Recover and Get Back to
Work? The Impact of Opioid Prescriptions on Duration of Temporary Disability,” National Bureau of Economic
Research, Working Paper No. 24528, April 2018, http://www.nber.org/papers/w24528.pdf.
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indicate that longer-term opioid prescriptions roughly triple the duration of temporary
disability benefits, compared to similar workers with similar injuries who do not get opioid
prescriptions. Thus, we do not find evidence, on average, of beneficial effects of opioids
prescribed in workers’ compensation cases—benefits that would need to be weighed
against the costs of opioid use.46
OWCP Opioid Prescribing Guidelines
2017 Guidelines
On June 6, 2017, OWCP issued guidelines for prescribing opioids in the FECA program.47 These
guidelines followed earlier OWCP guidelines for prescribing Schedule II drugs48 and the specific
opioid fentanyl.49
The 2017 guidelines were as follows:
 Only applied to non-cancer cases;
 Only applied to cases in which no opioid had been prescribed in the prior 180
days;
 No more than two opioids may be authorized at any given time, only one of
which may be a Schedule II drug;
 No prior authorization or letter of medical necessity (LMN) required for the
initial 60-day fill of an opioid;
 All fills after the initial 60-day fill require an LMN from the treating physician
and prior authorization from OWCP; and
 Opioid use may be authorized beyond 120 days after the initial 28-day period
only if OWCP communicates with the treating physician and receives a “rational
medical justification” for the ongoing prescription.
The 2017 guidelines were criticized for being too permissive when compared with state workers’
compensation policies and CDC guidelines. For example, in a May 2018 hearing on opioids and
the FECA program, Joe Padua, president of CompPharma, a consortium of PBMs, testified that
FECA was “five or six years behind the rest of the workers’ compensation industry” and that the
2017 guidelines were “far too permissive and wildly inconsistent with all credible opioid
guidelines.”50 Despite these criticisms, OWCP reports significant reductions in opioid use,

46 Ibid., p. 31.
47 Department of Labor, Office of Workers’ Compensation Programs, Opioid Prescribing Guidelines, FECA Bulletin
No. 17-07, June 6, 2017, https://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECABulletins/FY2016-
2020.htm#FECAB1707.
48 Department of Labor, Office of Workers’ Compensation Programs, Division of Federal Employees Compensation:
Pharmacy Schedule II Policy, December 1, 2009, https://www.dol.gov/owcp/dfec/pharmacy-schedule-II-policy.htm.
The Controlled Substances Act (CSA) establishes five schedules for various types of drugs, plants, and chemicals, with
Schedule II drugs, such as Vicodin, morphine, cocaine, methadone, and fentanyl, having the highest potential for abuse
and dependence of any drugs available by prescription. For additional information on the CSA and drug schedules see
CRS Report R45164, Legal Authorities Under the Controlled Substances Act to Combat the Opioid Crisis.
49 Department of Labor, Office of Workers’ Compensation Programs, Usage Guidelines for Fentanyl Products, FECA
Bulletin No. 11-05, May 3, 2011, https://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECABulletins/
FY2011-2015.htm#FECAB1105.
50 U.S. Congress, House Committee on Education and the Workforce, Subcommittee on Workforce Protections, The
Opioid Epidemic: Implications for the Federal Employees’ Compensation Act, 115th Cong., 2nd sess., May 8, 2018,
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duration, and dosage among FECA beneficiaries since 2017.51 OWCP reports a 34% decline in
the number of FECA beneficiaries with active (within the prior 180 days) opioid prescriptions, a
54% reduction in the number of new opioid prescriptions lasting more than 30 days, and declines
in the number of beneficiaries prescribed high dosages of opioids with morphine equivalent doses
(MEDs) of 90 mg or more declining by 43% and MEDs of 500 mg or more declining by 71%.52
2019 Guidelines
OWCP updated its opioid prescription guidelines for the FECA program on September 9, 2019.53
The 2019 guidelines are as follows:
 Only apply to non-cancer cases;
 Only apply to cases in which no opioid had been prescribed in the prior 180 days;
 No more than one opioid may be initially prescribed without the authorization of
OWCP;
 No prior authorization or LMN required for the initial seven-day fill of an opioid,
and up to three additional prescriptions with seven-day fills for a total of 28 days;
 Prescriptions and fills after the initial 28-day period require an LMN from the
treating physician and prior authorization from OWCP, with each such
authorization lasting 60 days; with limits of no more than a 30-day supply per
fill; and no more than two opioids authorized at any given time, only one of
which may be a Schedule II drug; and
 Opioid use may be authorized beyond 120 days after the initial 28-day period
only if OWCP communicates with the treating physician and receives a “rational
medical justification” for the ongoing prescription.

testimony of Joe Padua.
51 Department of Labor, Office of Workers’ Compensation Programs, “U.S. Department of Labor Implements Opioid
Safety Controls to Help Injured Federal Workers Avoid Risk of Long-Term Opioid Use,” news release, September 23,
2019, https://www.dol.gov/newsroom/releases/owcp/owcp20190923.
52 Morphine equivalent dose (MED, also referred to as morphine milligram equivalents, MME) is a standardized
measure of the potency of an opioid. It is calculated by converting the dose of a given medication to the equivalent dose
of the drug morphine. The CDC opioid guidelines advise prescribers to assess the evidence of individual benefits and
risks when prescribing more than a daily total MED of more than 50mg and to avoid or carefully justify a decision to
increase a prescription to a daily total MED of 90mg.
53 Department of Labor, Office of Workers’ Compensation Programs, New Opioid Prescribing Guidelines in the FECA
Program Limiting Initial Fills to Seven Days and Imposing LMN at 28 Days, FECA Bulletin No. 19-04, September 9,
2019, https://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECABulletins/FY2016-2020.htm#FECAB1904.
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Appendix A. FECA Scheduled Benefits
Table A-1. FECA Scheduled Benefits for Partial Disability Compensation
Loss of Use of Body System
Number of Weeks of Compensation
Scheduled benefits provided by statute [5 U.S.C. Section 8107(c)]
Arm
312
Leg
288
Hand
244
Foot
205
Eye
106
Thumb
75
First finger
46
Great toe
38
Second finger
30
Third finger
25
Toe other than great toe
16
Fourth finger
15
Loss of hearing in one ear
52
Loss of hearing in both ears
200
Scheduled benefits provided by regulation [20 C.F.R. Section 10.404(a)]
Breast
52
Kidney
156
Larynx
160
Lung
156
Penis
205
Testicle
52
Tongue
160
Ovary
52
Uterus or cervix
52
Vulva or vagina
52
Source: The Congressional Research Service from 5 U.S.C. §8107(c) and 20 C.F.R. §10.404(a).
Note: Compensation is equal to two-thirds of the pre-disability wage of a single employee or 75% of the pre-
disability wage of an employee with dependents for the number of weeks indicated.
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Appendix B. Legislative History of FECA
The FECA program has its origins in a law from the late 1800s that covered only the employees
of a federal agency that has long since ceased to exist on its own. The modern FECA system has
its roots in legislation enacted in 1916; many of the basic provisions of this original law, such as
the basic rate of compensation, are still in effect today. Congress passed major amendments to the
1916 legislation in 1949, 1960, 1966, and most recently in 1974. Although these amendments
made significant changes to the FECA program, the basic framework of the program endures as
does the overall intent of Congress through the years to maintain a workers’ compensation system
for federal employees that is in line with the basic principles that have governed workers’
compensation in this country for a century.
Limited Workers’ Compensation for the United States Life Saving
Service and Other Hazardous Federal Occupations
The first workers’ compensation law for federal employees was enacted in 1882 and provided up
to two years of salary to any member of the federal United States Life Saving Service disabled in
the line of duty and two years of salary to his or her survivors in case of a line of duty death.54 In
1908, Congress passed a more comprehensive workers’ compensation law for federal employees
engaged in certain hazardous occupations, such as laborers at federal manufacturing facilities and
arsenals or workers at the construction of the Panama Canal. This law provided workers with up
to one year of salary, after a 15-day waiting period, if disabled due to an employment-related
injury, and provided their survivors with up to a year of salary in case of death.
The 1882 and 1908 federal workers’ compensation laws did not provide universal coverage for all
federal employees. It is estimated that only one-fourth of the federal workforce was covered by
the 1908 law, and the law was clearly designed only to provide coverage for what were seen to be
the most hazardous jobs in the civil service.55 President Theodore Roosevelt recognized this
shortcoming of the law he would eventually sign. Before the 1908 law’s passage, he called on
Congress to pass a workers’ compensation bill that would cover “all employees injured in the
government service” and stated that the lack of such a comprehensive workers’ compensation law
was “a matter of humiliation to the nation.”56
In addition to only covering a small portion of the federal workforce, the 1882 and 1908 laws did
not provide for medical benefits for disabled workers, and the 1908 law only applied in cases of
disability or death arising from injuries and not illnesses.
The Federal Employees’ Compensation Act of 1916
President Woodrow Wilson signed the Federal Employees’ Compensation Act, P.L. 64-267, into
law on September 7, 1916, and in so doing extended the protections of the modern workers’

54 Act of May 4, 1882, ch. 117, 22 Stat. 55 (1882). In 1915 the United States Life Saving Service was merged with the
Revenue Cutter Service to form the United States Coast Guard.
55 Willis J. Nordlund, “The Federal Employees’ Compensation Act,” Monthly Labor Review, September 1991, p. 5.
(Hereinafter cited as Nordlund 1991.)
56 U.S. Congress, House Committee on Education and Labor, Subcommittee on Safety and Compensation, Amendments
to Federal Employees’ Compensation Act, hearings on H.R. 1196 and other bills to amend the Federal Employees’
Compensation Act, 86th Cong., 2nd sess., February 10, 23, 24 and March 8, 23, 24, 1960 (Washington: GPO, 1960),
p. 124.
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compensation system to nearly all federal employees. This original FECA law remains the basis
for the workers’ compensation system for the federal civil service.
The FECA law provided coverage for nearly all civilian employees of the federal government
injured or killed in line of duty. Coverage was not provided for occupational illnesses. The law
provided full medical coverage for covered injuries to be provided by government physicians and
hospitals or private medical services selected by the government. Disability compensation was
provided, after a three-day waiting period, at a rate of two-thirds of the worker’s wage for total
disability, with adjustments for partial disabilities. Disability benefits were subject to minimum
and maximum levels specified in the law and neither benefits nor these levels were subject to any
cost-of-living or other annual adjustments. The survivors of an employee killed on the job were
entitled to cash benefits based on the worker’s wage and were also entitled to a benefit to help
offset funeral costs.
The 1916 legislation created the Federal Employees’ Compensation Commission, with three
members appointed by the President with the advice and consent of the Senate, to administer the
FECA program. Benefit and administrative costs associated with the program were paid out of the
Employees’ Compensation Fund created by the law and financed with permanently authorized
appropriations.
Congressional Intent
Bringing the Federal System in Line with the States
Congress had several clear intentions when drafting the FECA program in 1916. One such
intention was to bring the protections offered to federal employees in line with those being
offered by a majority of the states at the time, with the House Judiciary Committee reporting that
such state laws were “working with most excellent results.”57 In addition, the committee reported
that the schedule of compensation for disability in FECA was “in line with the best precedents
found in State compensation acts,” especially those in Massachusetts, New York, and Ohio.58
Providing Coverage to all Federal Employees
An additional intention of Congress was to provide workers’ compensation coverage to all federal
employees regardless of occupation, thus correcting what was seen as a shortcoming of the 1908
act. The House Judiciary Committee’s report on the 1916 FECA legislation criticizes the limited
coverage of the 1908 law and states,
The present law, in denying compensation to an injured employee if his occupation was
not “hazardous” goes counter to the theory on which all compensation acts are based, viz,
that the industry shall bear the burden of injuries caused by it.59
This criticism of the limited coverage provided by the 1908 act, and the intention of the FECA
legislation to correct this shortcoming, was echoed by the FECA legislation’s sponsor in the

57 U.S. Congress, House Committee on the Judiciary, Compensation of Government Employees Suffering Injuries While
on Duty, report to accompany H.R. 15316, 64th Cong., 2nd sess., May 11, 1916, H. Rept. 64-678 (Washington: GPO,
1916), p. 7.
58 Ibid., p. 9.
59 Ibid., p. 8.
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Senate, Senator George Sutherland. Senator Sutherland, in a Senate Judiciary Committee hearing
on the legislation, stated,
The theory upon which compensation laws are drawn is that you are to compensate for the
injury, not for the risk that the man ran in bringing about the injury; and under modern
thought there is no logical reason for making distinction between what is hazardous and
non-hazardous employment.60
Senator Sutherland reinforced his point with a rather graphic example stating “the clerk who has
his leg cut off in his work about a store is just as effectively deprived of his leg as if it was cut off
by a machine.”61
Major FECA Amendments
Congress has passed major amendments to the FECA program in 1949, 1960, 1966, and most
recently in 1974. In addition, coverage for occupational illnesses was added to the FECA program
in 1924 by P.L. 68-196.
1949 Amendments
The Federal Employees’ Compensation Act Amendments of 1949, P.L. 81-357, brought about the
first set of significant changes to the FECA program since its inception in 1916. The 1949
amendments, in the words of the House Committee on Education and Labor, sought to
“modernize and liberalize” the FECA program, which, according to the Senate Committee on
Labor and Public Welfare, provided “only illusory security for most workers or their families.”62
Increased FECA Coverage
The 1949 amendments expanded the scope of workers covered by the FECA program to include
those classified as “officers” of the United States. The amendments also doubled the maximum
disability benefit level, thus providing for a replacement of a larger portion of federal employee
pay.
In addition to better meeting the goal of universal coverage of all employees, the inclusion of
federal government officers was intended to provide FECA protections to previously excluded
employees, such as Foreign Service Officers, who may serve in dangerous overseas areas. The
increase in the maximum benefit level was necessary since, at the time, it was estimated by the
Department of Labor (DOL) that 90% of FECA cases involved workers with wages that were
essentially not covered by the program because of the low maximum benefit level which resulted
in these workers not receiving full benefits.63

60 U.S. Congress, Senate Committee on the Judiciary, Accident Compensation to Government Employees, hearing on S.
2846, 64th Cong., 1st sess., February 26, 1916 (Washington: GPO, 1916), p. 27.
61 Ibid.
62 U.S. Congress, House Committee on Education and Labor, Amendments to Federal Employees’ Compensation Act,
report to accompany H.R. 3141, 81st Cong., 1st sess., June 6, 1949, H. Rept. 81-729 (Washington: GPO, 1949), p. 23,
hereinafter cited as H.Rept. 81-729; and U.S. Congress, Senate Labor and Public Welfare, Amendments to Federal
Employees’ Compensation Act, report to accompany H.R. 3141, 81st Cong., 1st sess., August 4, 1949, S.Rept. 81-836
(Washington: GPO, 1949), p. 29, hereinafter cited as S.Rept. 81-836.
63 Nordlund 1991, p. 10.
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Increased FECA Benefits
Several provisions of the 1949 amendments effectively increased FECA benefits for workers and
their survivors. The three-day waiting period for FECA disability compensation was eliminated in
cases of disability lasting more than 21 days. A schedule of benefits for permanent partial
disabilities was created for the first time, which permitted partial disability benefits to be paid
without regard to actual impairment or wage loss. The elimination of the waiting period and
creation of a benefits schedule were intended to bring the FECA program in line with state
workers’ compensation programs and the federal Longshore and Harbor Workers’ Compensation
Act program.64
The 1949 amendments provided for augmented compensation, in the amount of 8.33% of a
workers’ pre-disability wage, in cases in which an injured worker had at least one dependent. This
augmented compensation, along with the standard compensation rate of two-thirds of the
workers’ wage, brought the level of FECA benefits for workers with dependents up to the current
level of 75% of the worker’s pre-disability wage. The benefit level for survivors was similarly
increased. The intent of the augmented-compensation provision was to better ensure that disabled
workers and the survivors of workers killed on the job could provide economically for their
dependents. The two-thirds benefit level for dependents was criticized by the House and Senate
committees that reported the bill as “not sufficient as to ensure reasonable economic security to a
family of a deceased worker where there is a large family.”65 Similar concerns over the adequacy
of the two-thirds benefit level were expressed at a House Committee on Education and Labor
hearing on the 1949 amendments.66
Reduced Benefits at Age 70
Although the 1949 amendments generally increased the level of FECA benefits, the amendments
also required the FECA administrator to review the amount of compensation paid to any person
aged 70 or older. The administrator was provided the authority to reduce the amount of such
benefits if it was determined that the worker’s wage-earning capacity had been reduced because
of age, independent of his or her disability. This provision was opposed by several representatives
from federal employee organizations who testified before the House Education and Labor
Committee. They testified that such a provision was inconsistent with the mandatory federal
employee retirement age of 70, in place at the time, and could cause undue hardships to workers
who, because of their disabilities, had not been able to reach their full-earning potential or who
had reduced pensions because of many years of limited or no earnings.67
Provisions for Vocational Rehabilitation
The 1949 amendments permitted the FECA program administrator to send beneficiaries to receive
vocational rehabilitation services at the government’s expense. The amendments also created a

64 The Longshore and Harbor Workers’ Compensation Act Program was created in 1927. For additional information on
the Longshore and Harbor Workers’ Compensation Act, see CRS Report R41506, The Longshore and Harbor
Workers’ Compensation Act (LHWCA): Overview of Workers’ Compensation for Certain Private-Sector Maritime
Workers, by Scott D. Szymendera.
65 H.Rept. 81-279, p. 11; and S.Rept. 81-836, p. 20.
66 U.S. Congress, House Committee on Education and Labor, Special Subcommittee, Federal Employees’
Compensation Act Amendments of 1949, hearing on H.R. 3191 and companion bills, 81st Cong., 1st sess., April 11-13
and May 2, 1949.
67 Ibid.
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special supplemental benefit for workers participating in vocational rehabilitation programs.
These provisions were intended to improve the return-to-work prospects of FECA claimants,
which, it was thought, would ultimately benefit both the employee through a return to earning
wages and the government through a reduction in FECA-benefit costs.68
The Exclusive Remedy Rule
The 1949 amendments established that the FECA program would be the exclusive remedy against
the federal government for federal workers with employment-related injuries, illnesses, and
deaths. This provision prohibited employees from seeking to recover economic or non-economic
damages from the government for injuries, illnesses, and deaths covered by FECA and brought
the FECA program in line with one of the general principles of workers’ compensation that was
already written into the workers’ compensation laws in the states.
When the FECA program was created, an exclusive remedy rule was seen as unnecessary because
of the general prohibition against suits against the federal government. However, by 1949, three
factors had combined to result in significant numbers of federal employees choosing to bring
lawsuits against the federal government rather than file for FECA benefits. First, the passage after
1916 of laws, such as the Federal Tort Claims Act, which permitted some suits against the
government. Second, some injuries to federal employees occurred while they worked for
government corporations subject to lawsuits. Finally, because FECA benefits are limited by
statute to partial wage replacement and medical benefits, employees felt that they could secure
greater financial benefits from the courts than from the FECA program.69
1960 Amendments
The Chargeback Process
The Federal Employees’ Compensation Act Amendments of 1960, P.L. 86-767, created the
chargeback process in which the Secretary of Labor is required to bill each federal agency for the
costs of FECA benefits provided to their employees in the previous fiscal year so that these
agencies may reimburse the Employees’ Compensation Fund. In addition, these amendments
required that government corporations also pay their “fair share” of FECA administrative costs to
the government. The chargeback process was intended by Congress to “further the promotion of
safety” among federal agencies by making the agencies ultimately responsible for the costs of
injuries, illnesses, and deaths of their employees.70
1966 Amendments
The Federal Employees’ Compensation Act Amendments of 1966, P.L. 89-488, made two
significant changes to the FECA program. These changes continue to be in effect today.

68 H.Rept. 81-279, p. 16; and S.Rept. 81-836, p. 24.
69 H.Rept. 81-279, p. 14; and S.Rept. 81-836, p. 23.
70 U.S. Congress, House Committee on Education and Labor, Federal Employees’ Compensation Act Amendments of
1960, report to accompany H.R. 12383, 86th Cong., 2nd sess., June 2, 1960, H.Rept. 86-1743 (Washington: GPO, 1960),
p. 3; and U.S. Congress, Senate Committee on Labor and Public Welfare, Federal Employees’ Compensation Act
Amendments of 1960, report to accompany H.R. 12383, 86th Cong., 2nd sess., August 27, 1960, S.Rept. 86-1924
(Washington: GPO, 1960), p. 3.
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Use of the GS Scale to Set Minimum and Maximum Benefit Levels
Prior to the enactment of the 1966 amendments, the maximum and minimum levels of FECA
benefits were set by statute and not subject to any automatic adjustments. In 1966, FECA benefits
were still subject to levels enacted as part of the 1949 amendments. According to the Senate
Committee on Labor and Public Welfare, the statutory maximum provided for full benefits for
more than 99% of claimants in 1949, but only 85% of claimants by 1966.71 To address the
difficulty inherent in using statutory changes to keep pace with the growth in federal employees’
wages, the 1966 amendments provide for use of the general schedule (GS) scale as the basis for
the maximum and minimum FECA benefit levels with the maximum level set at 75% of the
highest rate of basic pay at the GS-15 level and the minimum level set at 75% of the lowest rate
of basic pay at the GS-2 level for all beneficiaries, including those without dependents.
Cost-of-Living Adjustment for Benefits
The 1966 amendments provided for an annual cost-of-living adjustment for FECA benefits.72
1974 Amendments
The Federal Employees’ Compensation Act Amendments of 1974, P.L. 93-416, made three major
changes to the FECA program. These three changes remain key elements of the program today.
Continuation of Pay
The 1974 amendments provided for up to 45 days of continuation of pay from a worker’s
employing agency in cases of traumatic injuries covered by FECA. During this period, an injured
employee may receive his or her full pay rather than FECA compensation. Because continuation
of pay is considered income rather than a benefit, it is subject to the federal income tax and is
reduced by all standard payroll deductions.
Congress felt that 45 days of continuation of pay were needed because of the time it often took
for FECA claims to be processed and compensation benefits to begin. In its report on the 1974
amendments, the Senate Committee on Labor and Public Welfare cited a General Accounting
Office report that stated that the average processing time for FECA claims was between 49 and 70
days, a delay that the committee found “creates economic hardship on the injured employee and
his or her family and causes difficult administrative problems for the Secretary of Labor and the
employing agencies.”73
Employee Choice of Physician
The 1974 amendments authorized employees to select their own treating physicians rather than
use doctors employed or selected by the federal government. The right of employees to have free
choice over who provides their medical care was one of the recommendations of the National

71 U.S. Congress, Senate Committee on Labor and Public Welfare, Federal Employees’ Compensation Act Amendments
of 1966, report to accompany H.R. 10721, 89th Cong., 2nd sess., June 16, 1966, S.Rept. 89-1285, p. 3.
72 The current cost-of-living adjustment is made each year on March 1 and is based on changes in the Consumer Price
Index for Urban Wage Earners and Clerical Workers (CPI-W; all items-United States city average) as measured in
December of each year.
73 U.S. Congress, Senate Committee on Labor and Public Welfare, Federal Employees’ Compensation Act of 1970,
report to accompany H.R. 13871, 93rd Cong., 2nd sess., August 8, 1974, S.Rept. 93-1081 (Washington: GPO, 1974), pp.
3-4, hereinafter cited as S.Rept. 93-1081; and U.S. General Accounting Office, Need for a Faster Way to Pay
Compensation Claims to Disabled Federal Employees, B-157593, November 21, 1973, p. 1.
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Commission on State Workmen’s Compensation Laws in 1972; this provision brought the FECA
program in line with that recommendation as well as with some other workers’ compensation
systems.
Elimination of Reduced Benefits After Age 70
The 1974 amendments removed the provision, enacted as part of the 1949 amendments, requiring
that FECA benefits be reviewed and permitting FECA benefits to be reduced after a claimant
reached the age of 70 to account for the reduced earning capacity that may come with age
independent of any disability. In its report on the 1974 amendments, the Senate Committee on
Labor and Public Welfare provided the following justification for eliminating the reduced benefit
provision:
The Committee finds that such a review places an unnecessary burden on both the
employees receiving compensation and the Secretary. Further, the fact that an employee
reaches 70 has no bearing on his or her entitlement to benefits and is considered
discriminatory in the Committee’s opinion.74
Recent FECA Amendments
There have been no major amendments to the FECA program since 1974. However, the 109th and
110th Congresses did make changes to FECA that partially address two of the issues currently
facing the program.
Change to the FECA Waiting Period for Postal Employees
Section 901 of the Postal Accountability and Enhancement Act, P.L. 109-435, changed the way
the FECA three-day waiting period for compensation is applied to employees of the USPS. This
provision requires that postal employees satisfy the three-day waiting period before the
continuation of pay period can begin. All other federal employees continue to serve the three-day
waiting period after the conclusion of the continuation of pay period and before FECA
compensation benefits begin.
This provision was based on a recommendation of the President’s Commission on the USPS. The
commission’s recommendation was part of a larger package of FECA reforms for postal
employees intended to reduce the USPS’s workers’ compensation costs. Because of what the
commission termed the “unique businesslike charter” of the Postal Service, the commission
recommended that the service’s workers’ compensation system become more in line with the
state workers’ compensation systems that provide coverage for most private-sector businesses.75
Death Gratuity for Federal Employees Killed While Serving Alongside the
Armed Forces
American military operations in Iraq and Afghanistan have been supported by an unprecedented
number of civilian employees, some of whom are serving in hostile areas alongside the Armed
Forces. These deployed civilian employees are covered by FECA, but concerns have been raised

74 S.Rept. 93-1081, p. 7.
75 President’s Commission on the United States Postal Service, Embracing the Future: Making the Tough Choices to
Preserve Universal Mail Service, Report of the President’s Commission on the United States Postal Service, July 31,
2003, p. 134.
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about the adequacy of FECA benefits for those injured or killed while serving in areas of combat,
especially when compared with the benefits available to members of the Armed Forces from the
Departments of Defense and Veterans Affairs.76
Section 1105 of the National Defense Authorization Act for Fiscal Year 2008, P.L. 110-181,
provides for a death gratuity of up to $100,000 to be paid by the FECA program to the survivors
of any federal employee, or employee of a non-appropriated fund instrumentality, who “dies of
injuries incurred in connection with the employee’s service with an Armed Force in a contingency
operation.” This death gratuity is paid in addition to the regular FECA compensation for
survivors, but is offset by any other death gratuities paid by the federal government.

Author Information

Scott D. Szymendera

Analyst in Disability Policy

Disclaimer
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan
shared staff to congressional committees and Members of Congress. It operates solely at the behest of and
under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other
than public understanding of information that has been provided by CRS to Members of Congress in
connection with CRS’s institutional role. CRS Reports, as a work of the United States Government, are not
subject to copyright protection in the United States. Any CRS Report may be reproduced and distributed in
its entirety without permission from CRS. However, as a CRS Report may include copyrighted images or
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copy or otherwise use copyrighted material.

76 See, for example, U.S. Congress, House Committee on Oversight and Government Reform, Subcommittee on
Federal Workforce, Post Office, and the District of Columbia, A Call to Arms: A Review of Benefits for Deployed
Federal Employees, hearing, 111th Cong., 1st sess., September 16, 2009; and U.S. Congress, Senate Committee on
Homeland Security and Governmental Affairs, Subcommittee on Oversight of Government Management, the Federal
Workforce, and the District of Columbia, Deployed Federal Civilians: Advancing Security and Opportunity in
Afghanistan, hearing, 111th Cong., 2nd sess., April 14, 2010.
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