The Federal Employees’ Compensation Act
(FECA): Workers’ Compensation for Federal
Employees
Updated March 17, 2021
Congressional Research Service
https://crsreports.congress.gov
R42107

link to page 23 The Federal Employees’ Compensation Act (FECA)

Summary
The Federal Employees’ Compensation Act (FECA) is the workers’ compensation program for
federal employees. Like al workers’ compensation programs, FECA pays disability, survivors,
and medical benefits, without regard to who was at fault, to employees who are injured or become
il in the course of their federal employment and to the survivors of employees kil ed 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 al 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 kil ed 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 overal 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.
In 2020, DOL issued guidance establishing 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.
Section 4016 of P.L. 117-2, the American Rescue Plan Act of 2021, created a presumption of
eligibility for FECA benefits for federal employees with COVID-19. FECA benefits determined
in accordance with this presumption are time-limited and are scheduled to be terminated on
September 30, 2030, regardless of the disability status of the employee or continued eligibility of
a deceased employee’s survivors.
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 al 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 bil ion in benefits, including approximately $1.959 bil ion in disability
benefits, $902 mil ion in medical benefits, and $153 mil ion in benefits to the survivors of federal
employees kil ed 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 al 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 al 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 il ness 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. Nonetheless, as discussed later in this report, Section 4016 of P.L. 117-2, the
American Rescue Plan Act of 2021, created a presumption of FECA eligibility for cases of
Coronavirus Disease 2019 (COVID-19). However, no injury, il ness, or death may be
compensated by FECA if the condition was
 caused by the wil ful 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 al 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
Al 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
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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.
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 normal y 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 partial y 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 al , then he or she is considered total y 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 total y 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 T he 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-PT 2/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 T he 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 al 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
stil 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 wil pay any costs
associated with shipping a body from the place of death to the employee’s home. An employee
kil ed 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, al medical costs—including medical devices, therapies, and medications—
associated with the treatment of a covered injury or il ness 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
General y, 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 initial y
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 smal er 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 federal y 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 general y 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
partial y 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: Sum m ary 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 Em ployees’
Retirem ent System : Benefits and Financing .
9 For additional information on the Thrift Savings Plan (T SP), see CRS Report RL30387, Federal Employees’
Retirem ent System : The Role of the Thrift Savings Plan .
10 T he 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
Retirem ent for Federal Em ployees.
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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. General y, 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, al 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
Presumption of Eligibility for COVID-19 Cases
In FY2020, there were 5,097 cases of federal employees with COVID-19 submitted to OWCP, of
which 4,249 of these cases resulted in lost work time, and 54 of these cases resulted in fatalities.14
Section 4016 of P.L. 117-2, the American Rescue Plan Act of 2021, provides for a presumption of
eligibility for FECA benefits for federal employees who contract COVID-19. This presumption
applies to any federal employee employed by the federal government at any time between
January 27, 2020, and January 27, 2023, who meets the following conditions:
 is diagnosed with COVID-19 during this eligibility period;
 did not exclusively telework during the eligibility period; and

13 42 U.S.C. §424a.
14 DOL, Occupational Safety and Health Administration, Federal Injury and Illness Statistics for Fiscal Year 2020,
https://www.osha.gov/enforcement/fap/statistics.
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 during a period to be determined by the Secretary of Labor, performed duties as a
federal employee that required contact with patients, members of the public, or
coworkers or that included a risk of exposure to COVID-19.
Federal employees who meet these conditions and their survivors are eligible for FECA without
having to demonstrate a causal link between their federal employment and exposure to the SARS-
CoV-2 virus or the contracting of COVID-19.
Termination of Benefits After September 30, 2030
For cases of FECA eligibility determined based on the COVID-19 presumption, no benefits are
authorized to be paid after September 30, 2030.15 A federal employee who becomes eligible for
FECA based on the COVID-19 presumption and remains disabled or in need of medical services
after September 30, 2030, or the survivors of a federal employee who was covered by the
COVID-19 presumption, wil not be eligible for any disability, medical, or survivors benefits after
the scheduled termination date of September 30, 2030.
This limitation on the duration of benefits does not apply to federal employees or survivors with
FECA eligibility not determined in accordance with the COVID-19 presumption created by
Section 4016 of P.L. 117-2, including those determined to be eligible for FECA before enactment
of the COVID-19 presumption under the OWCP COVID-19 guidance issued on March 30,
2020.16
Payment of Benefits and Administrative Costs
The costs of FECA benefits and administrative costs associated with cases determined in
accordance with the COVID-19 presumption created by Section 4016 of P.L. 117-2 are paid by
the Employees’ Compensation Fund. The costs of these benefits are not to be charged back to the
employees’ host agencies, and administrative costs for these cases are not to be subject to
reimbursement from the USPS and other government corporations under the “fair share” process.
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 21.9% of the federal civilian workforce, they
accounted for 51.8% of injuries, il nesses, and fatalities that resulted in FECA cases in FY2019.17

15 Pursuant to Section 313 of the Congressional Budget Act of 1974 , as amended (P.L. 93-344, 2 U.S.C. §644,
commonly referred to as the Byrd rule), a provision that would increase the deficit in any fiscal year beyond the budget
window provided in the budget resolution is considered extraneous and subject to a point of order in the Senate. T hus,
this provision in H.R. 1319, a budget reconciliation bill, limited federal spending to 10 years to comply with this rule.
For additional information on budget reconciliation and the Byrd rule, see CRS Report RL30862, The Budget
Reconciliation Process: The Senate’s “Byrd Rule”.
16 On March 30, 2020, OWCP issued guidance on how to process FECA claims related to COVID-19. Under this
guidance, if an employee engaged in high-risk employment files a COVID-19 claim, and the employer supports the
claim and concurs 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. Under this guidance an
employee would have to demonstrate a causal link between COVID-19 and his or her federal employment. For
additional information on t his guidance see OWCP, Federal Em ployees Contracting COVID-19 in Perform ance of
Duty, March 31, 2020, https://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECABulletins/FY2020-
2024.htm#FECAB2005.
17 DOL, Occupational Safety and Health Administration, Federal Injury and Illness Statistics for Fiscal Year 2019,
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The USPS reports short-term (within one year) FECA liabilities of $1.324 bil ion and long-term
(greater than one year) FECA liabilities of $18.795 bil ion. Total FECA liabilities of $20.119
bil ion make up nearly 18% of total USPS liabilities.18
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. Al 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, FY2019
Employeesa
FECA Casesb
Per 100
Category
Total
Percentage
Total
Percentage
Employees
Federal Government
2,878,019
100.0
70,701
100.0
2.5
U.S. Postal Service
630,195
21.9
36,634
51.8
5.8
Federal Government,
excluding U.S. Postal Service
2,247,824
78.1
34,067
48.2
1.5
Source: Congressional Research Service (CRS) table with data taken from Department of Labor, Occupational
Safety and Health Administration, Federal Injury and Il ness Statistics for Fiscal Year 2019, 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 al new injury, il ness, 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
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.
In a 2020 audit of the FECA program for USPS employees, the USPS Office of Inspector General
(OIG) reports that 14,941 postal employees are receiving FECA benefits for disabilities that are
expected to be permanent, with 2,619 of these employees aged 70 or older.19 In its response to

https://www.osha.gov/enforcement/fap/statistics.
18 U.S. Postal Service, Quarterly Report Pursuant to 39 U.S.C. §3654 and Section 13 or 15(d) of the Securities
Exchange Act of 1934 (Form 10-Q), For the Quarterly Period Ending June 30, 2020, August 2020,
https://about.usps.com/what/financials/financial-conditions-results-reports/fy2020-q3.pdf.
19 U.S. Postal Service, Office of Inspector General, Workers’ Compensation Program Cost Containment Activities,
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this audit, the USPS reports that there are 8,499 employees aged 60 or older receiving FECA
benefits with the oldest USPS FECA beneficiary being 105 years old.20
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 cal ing
the reduction of benefits at the age of 70 “discriminatory.”21
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 il ness, 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 automatical y
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
received.22 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 annual y
to reflect changes in the cost of living, a provision found in less than half of state systems.

Report Number 19-031-R20, August 6, 2020, p. 1, https://www.uspsoig.gov/sites/default/files/document -library-files/
2020/19-031-R20.pdf.
20 Ibid., p. 17.
21 S.Rept. 93-1081, p. 7.
22 Griffin Murphy et al., Workers’ Compensation: Benefits, Coverage, and Costs (2018 Data), National Academy of
Social Insurance, November 2020, pp. 94-100, hereinafter cited as Workers’ Com pensation: Benefits, Coverage, and
Costs, 2018.
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The maximum FECA benefit is based on 75% of the GS-15, step 10 pay rate, without any locality
adjustments whereas state maximums are general y based on state average wages or the worker’s
own pre-disability wage. For 2021, the annual salary at GS-15, step 10, is $143,598 whereas the
average federal salary for the executive branch in September 2020 was $90,446.23 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.24 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.25 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, especial y for
higher-wage workers, compared with those offered by state workers’ compensation systems.26
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. Essential y,
each federal entity acts like a self-insured employer with OWCP in the role of claims and benefit
manager.
State workers’ compensation benefits are general y provided by private insurance, state insurance
funds, or through self-insurance. Al but four states—North Dakota, Ohio, Washington, and
Wyoming—al ow 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

23 Information on the GS-15 salary rate is 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/pdf/2021/GS.pdf. Information on
average federal salary is taken form the OPM FedScope system online at http://www.fedscope.opm.gov/.
24 Workers’ Compensation: Benefits, Coverage, and Costs, 2018, pp. 94-100.
25 Elaine Weiss, Griffin Murphy, and Leslie I. Boden, Workers’ Compensation: Benefits, Coverage, and Costs (2017
Data), National Academy of Social Insurance, October 2019, pp. 24-25, hereinafter cited as Workers’ Com pensation:
Benefits, Coverage, and Costs, 2017.
26 T his conclusion is supported by the National Academy of Social Insurance which states “T he 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’ Com pensation: Benefits, Coverage, and
Costs, 2017, p. 71).
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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. Al states except North Dakota and
Wyoming al ow 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 2018, private
insurers paid 58.5% of total state workers’ compensation benefits whereas state funds paid 14.9%
and self-insured firms paid 26.6%.27 Thus, nearly three-quarters of al 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.28 In these settlements, the
insurer or firm agrees to pay the claimant lump-sum or periodic payments in exchange for being
released from al 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 general y 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, Il inois, 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.29
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 wel after retirement age.
Compounded Medications
Compounded medications are customized medications in which a physician or pharmacist mixes
two or more commercial y 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 al of workers’ compensation, including the
FECA program.

27 Workers’ Compensation: Benefits, Coverage, and Costs, 201 8, pp. 25-26.
28 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/.
29 Ibid., p. 43.
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In addition to concerns over the safety and efficacy of compounded medications, especial y when
compared against commercial y 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 mil ion
in FY2011 to $263 mil ion in FY2016, with costs rising from $80 mil ion to $214 mil ion in
FY2015 alone. In FY2015, total costs for compounded medications ($214 mil ion) surpassed
costs for al other medications ($199 mil ion) provided by the FECA program.30
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 mil ion in chargeback year 2011 to $98.7 mil ion 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.31 In response to these increases, in 2015, the USPS took the
unprecedented step of formal y requesting to DOL that the USPS chargeback be reduced by $68
mil ion (from a total chargeback of $1.4 bil ion) to account for increased costs associated with
what the agency felt was the improper use of compounded medications.32 This request was denied
by DOL.33
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
examples, a single tube of a compounded ointment that cost over $67,000 and a compounded
cream containing resveratrol34 that cost over $32,000 per prescription.35
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.36 These new guidelines require that al
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.

30 U.S. Congress, House Committee on Appropriations, Subcommittee on Labor, Health and Human Services,
Education, and Related Agencies, Managem ent Challenges at the Departm ents of Labor, Health and Hum an Services,
Education, and the Social Security Adm inistration: Views from the Inspectors General, 115th Cong., 1st sess., March 9,
2017 (statement of Scott S. Dahl, Inspector General, Department of Labor).
31 A chargeback year runs from July 1 to June 30. U.S. Postal Service, Office of Inspector General, Workers’
Com pensation Com pound Drug Costs, Management Advisory Report Number HR-MA-16-003, March 3, 2016, p. 7.
32 Ibid., pp. 17-19.
33 Ibid., pp. 20-21.
34 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). T here is no regulation or policy limiting FECA beneficiaries to only products
approved by the FDA.
35 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.
36 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.
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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),37 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
2018.38 The federal TRICARE program39 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 mil ion in April 2015 to $10 mil ion in June
2015.40
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.
Opioids
Opioids are drugs that bind to opioid receptors on nerve cel s 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 wil 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 il icit and prescription opioids. The increase in opioid-overdose deaths in
recent years has been wel -documented and the subject of significant attention from public health
authorities, the public, and Congress.
Since March 2016, the FDA has required that al 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)

37 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. T here 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.
38 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 .
39 T RICARE provides health benefits to members of the armed forces, their families and military retirees. For
additional information on T ricare see CRS In Focus IF10530, Defense Prim er: Military Health System .
40 Department of Defense, Office of Inspector General, Controls Over Compound Drugs at the Defense Health Agency
Reduced Costs Substantially, but Im provem ents 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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issued guidelines for prescribing opioids for chronic pain.41 States, PBMs, and private pharmacy
companies have also issued their own guidelines and policies designed to limit the dosage and
duration of opioid prescriptions.42
In part due to the nature of work injuries, which frequently involve pain, opioids have
traditional y 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 overal 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
2018.43 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.44 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
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.45

41 Deborah Dowell, T amara 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.
42 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.
43 myMatrixx: An Express Scripts Company, Workers’ Compensation Drug T rend Report, 2018, 2019, pp. 4, 16,
https://www.mymatrixx.com/wp-content/uploads/2019/04/
myMatrixx_2018_Workers_Comp_Drug_Trend_Report_FINAL.pdf
44 Bogdan Savych, David Neumark, and Randall Lea, “Do Opioids Help Injured Workers Recover and Get Back to
Work? T he Impact of Opioid Prescriptions on Duration of T emporary Disability,” National Bureau of Economic
Research, Working Paper No. 24528, April 2018, http://www.nber.org/papers/w24528.pdf.
45 Ibid., p. 31.
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OWCP Opioid Prescribing Guidelines
2017 Guidelines
On June 6, 2017, OWCP issued guidelines for prescribing opioids in the FECA program.46 These
guidelines followed earlier OWCP guidelines for prescribing Schedule II drugs47 and the specific
opioid fentanyl.48
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 fil of an opioid;
 Al fil s after the initial 60-day fil 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 al credible opioid
guidelines.”49 Despite these criticisms, OWCP reports significant reductions in opioid use,
duration, and dosage among FECA beneficiaries since 2017.50 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

46 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.
47 Department of Labor, Office of Workers’ Compensation Programs, Division of Federal Employees Compensation:
Pharm acy Schedule II Policy, December 1, 2009, https://www.dol.gov/owcp/dfec/pharmacy-schedule-II-policy.htm.
T he 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 Com bat the Opioid Crisis.
48 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.
49 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,
testimony of Joe Padua.
50 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-T erm Opioid Use,” news release, September 23,
2019, https://www.dol.gov/newsroom/releases/owcp/owcp20190923.
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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%.51
2019 Guidelines
OWCP updated its opioid prescription guidelines for the FECA program on September 9, 2019.52
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 initial y prescribed without the authorization of
OWCP;
 No prior authorization or LMN required for the initial seven-day fil of an opioid,
and up to three additional prescriptions with seven-day fil s for a total of 28 days;
 Prescriptions and fil s 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
fil ; 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.

51 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. T he 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 50m g and to avoid or carefully justify a decision to
increase a prescription to a daily total MED of 90mg.
52 Department of Labor, Office of Workers’ Compensation Programs, New Opioid Prescribing Guidelines in the FECA
Program Lim iting Initial Fills to Seven Days and Im posing 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 stil 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 overal 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.53 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 al
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.54 President Theodore Roosevelt recognized this
shortcoming of the law he would eventual y sign. Before the 1908 law’s passage, he cal ed on
Congress to pass a workers’ compensation bil that would cover “al 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.”55
In addition to only covering a smal 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 il nesses.
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 w orkers’

53 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.
54 Willis J. Nordlund, “ T he Federal Employees’ Compensation Act,” Monthly Labor Review, September 1991, p. 5.
(Hereinafter cited as Nordlund 1991.)
55 U.S. Congress, House Committee on Education and Labor, Subcommittee on Safety and Compensation, Amendments
to Federal Em ployees’ Com pensation 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, 1 960 (Washington: GPO, 1960),
p. 124.
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compensation system to nearly al 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 al civilian employees of the federal government
injured or kil ed in line of duty. Coverage was not provided for occupational il nesses. 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 kil ed 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 excel ent results.”56 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,” especial y those in Massachusetts, New York, and Ohio.57
Providing Coverage to all Federal Employees
An additional intention of Congress was to provide workers’ compensation coverage to al 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.58
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

56 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.
57 Ibid., p. 9.
58 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.59
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.”60
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 il nesses 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 il usory security for most workers or their families.”61
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 al 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
essential y not covered by the program because of the low maximum benefit level which resulted
in these workers not receiving full benefits.62

59 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.
60 Ibid.
61 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, Am endm ents to Federal
Em ployees’ Com pensation 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.
62 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.63
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 kil ed on the job could provide economical y for their
dependents. The two-thirds benefit level for dependents was criticized by the House and Senate
committees that reported the bil as “not sufficient as to ensure reasonable economic security to a
family of a deceased worker where there is a large family.”64 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.65
Reduced Benefits at Age 70
Although the 1949 amendments general y 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.66
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

63 T he 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.
64 H.Rept. 81-279, p. 11; and S.Rept. 81-836, p. 20.
65 U.S. Congress, House Committee on Education and Labor, Special Subcommittee, Federal Employees’
Com pensation Act Am endm ents of 1949 , hearing on H.R. 3191 and companion bills, 81st Cong., 1st sess., April 11-13
and May 2, 1949.
66 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.67
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, il nesses, and
deaths. This provision prohibited employees from seeking to recover economic or non-economic
damages from the government for injuries, il nesses, 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. Final y, 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.68
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 bil 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, il nesses, and deaths of their employees.69
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.

67 H.Rept. 81-279, p. 16; and S.Rept. 81-836, p. 24.
68 H.Rept. 81-279, p. 14; and S.Rept. 81-836, p. 23.
69 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 Em ployees’ Com pensation Act
Am endm ents 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 stil 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 1966.70 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 al 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.71
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 al 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.”72
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

70 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.
71 T he 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.
72 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
Com pensation Claim s to Disabled Federal Em ployees, 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 wel 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.73
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 partial y 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. Al 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.74
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

73 S.Rept. 93-1081, p. 7.
74 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 kil ed while serving in areas of combat,
especial y when compared with the benefits available to members of the Armed Forces from the
Departments of Defense and Veterans Affairs.75
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.
Presumption of Eligibility for COVID-19 Cases
Section 4016 of P.L. 117-2, the American Rescue Plan Act of 2021, created a presumption of
eligibility for FECA benefits for federal employees with COVID-19. FECA benefits determined
in accordance with this presumption are time-limited and are scheduled to be terminated on
September 30, 2030, regardless of the disability status of the employee or continued eligibility of
a deceased employee’s survivors.76

Author Information

Scott D. Szymendera

Analyst in Disability Policy

75 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 Arm s: A Review of Benefits for Deployed
Federal Em ployees, 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.
76 Pursuant to Section 313 of the Congressional Budget Act of 1974, as amended (P.L. 93-344, 2 U.S.C. §644,
commonly referred to as the Byrd rule), a provision that would increase the deficit in any fiscal year beyond the budget
window provided in the budget resolution is considered extraneous and subject to a point of order in the Senate. T hus,
this provision in H.R. 1319, a budget reconciliation bill, limited federal spending to 10 years to comply with this rule.
For additional information on budget reconciliation and the Byrd rule, see CRS Report RL30862, The Budget
Reconciliation Process: The Senate’s “Byrd Rule”.
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