ROTC Injured workers Claims

While Reserve Officer Training Corps (ROTC) cadets are not Department of Defense (DOD) employees DOD does have a limited role in assisting the universities with processing worker's compensation claims for ROTC cadets who sustain injuries while in the performance of duty.

All cadets in the ROTC Program who are injured while not under orders or while participating in unit-related activities may file a claim to receive medical benefits under the Federal Employees’ Compensation Act. This program is administered by the Department of Labor, the Office of Workers' Compensation Program (OWCP). All ROTC claims are processed in the Special Claims section of the Cleveland, Ohio OWCP office.

If a cadet has sustained an injury that occurred during one “work” day, he/she should complete and submit a form CA-1 (Notice of Traumatic Injury) as soon as possible. For example, if the cadet falls and injures his/her knee while on a training run, a form CA-1 would be completed.

If the cadet has been diagnosed with a medical condition that he/she thinks is related to exposures incurred while participating in unit-related activities over a period of time, a CA-2 (Notice of Occupational Disease) can be filed. For example, if a cadet suffers from a medical condition such as asthma and believes that repeated exposure to dust while on training exercises is the cause of the asthma, then a CA-2 would be the appropriate form to complete.

All claim forms are available on the OWCP website (http://www.dol.gov/owcp/dfec/) and should be submitted as soon as possible to the OWCP case create center:

US Department of Labor - OWCP/DFEC
400 West Bay Street Room 827
Jacksonville, FL 32202

The claim will be created and forwarded to Cleveland for processing. Do not delay the submission of claim forms for any reason.

If the cadet is seriously injured and unable to complete the claim form, the proper form can be completed for him/her and submitted with an explanation as to why the cadet was unable to sign the form.

If a cadet requires immediate medical treatment, a form CA-16 (Authorization for Examination and/or Treatment) should be completed and given to the cadet to take with him/her to the medical provider. The CA-16 is an assurance to the provider that OWCP will pay for this treatment, even though a claim has not yet been established or accepted. This form can be given only for traumatic injuries and can only be given one time per injury. This form is not available on the Department of Labor website and the ROTC point of contact should have these forms. If the point of contact does not have a form CA-16, contact the Department of Defense liaison, listed below.

All claim forms (CA-1 or CA-2) must be completed in their entirety or the form will be rejected by OWCP. On page 2 of each claim form, there is a block entitled “OWCP Agency Code”. The proper code to enter is 9999 52 (Army), 9999 51 (Air Force), 9999 53(Navy). If a form is rejected, the cadet will receive written notification that the claim form is incomplete and provided with specific instructions as to how to properly complete the claim form so OWCP can create a claim. Claims are usually created within 3-5 business days and the cadet will receive a postcard with the claim number. Claim numbers begin with the prefix “TC”. Please ensure that cadets are informed to watch for the postcard and to inform the ROTC point of contact at the university anytime they receive correspondence from OWCP.

Many ROTC claims, once received by OWCP, are accepted and closed without review because the injuries are minor. Medical expenses will be paid up to $1500 in these cases. If the injury is more serious and requires additional treatment such as physical therapy, an MRI, a CT scan or surgery, a written request from the provider must be submitted. OWCP must approve these requests before the procedure can be scheduled. All requests are to be submitted using the OWCP automated bill pay system (ACS). OWCP will require a medical report from the treating physician that contains a history of the injury, physical findings present upon examination, any test results, a diagnosis and an opinion as to how the diagnosed condition is related to incident or exposures as alleged. OWCP will render a decision on the requested procedure. The link to ACS is: http://owcp.dol.acs-inc.com

If the cadet chooses to have the procedure before receiving approval, and the procedure is subsequently denied by OWCP, the cadet can submit the bill to his/her private insurance company for payment. The cadet may also submit the bill to the insurance company and if OWCP approves the procedure at a later date, the insurance company can be reimbursed by OWCP.

Documents other than requests for medical authorization can be mailed or faxed to the OWCP Cleveland office:

United States Department of Labor, Office of Workers’ Compensation Programs
U.S. Dept. of Labor/OWCP
P.O. Box 8300 District 9 CLE
London, KY 40742-8300

The fax number is 216-902-5601. Documents can also be uploaded using the Department of Labor “ecomp” system. The cadet’s claim number, last name, date of birth and date of injury are required. When submitting documents to OWCP, ensure that the claim number is on every page. The link to the ecomp system is: https://www.ecomp.dol.gov/ If the direct contact with the OWCP claims examiner is necessary, call the OWCP Cleveland office at 216-902-5600. This is an automated system in which the claim number is required. Use “8,2” for “T,C”. Press “ # “ when finished recording a voicemail message to ensure that the message will be sent to the claims examiner.

Cadets can also check the status of claims online by using the OWCP Claimant Query System (CQS): http://owcp.dol.acs-inc.com CQS provides the cadet with the conditions accepted in the claim as well as information on medical bills, reimbursement request and the status of authorization requests. The Department of Defense liaison that assists with workers’ compensation for ROTC can be reached at 216-522-2786.

Department of Defense
Defense Civilian Personnel Advisory Service
HR Operational Programs & Advisory Services
Benefits and Worklife Division
Injury Compensation & Unemployment Compensation Branch
4800 Mark Center Drive, Suite 05G21
Alexandria, VA 22350-1100

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DSN FAX: 372-1662
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