A postal letter carrier, a VA nurse, a TSA officer and a federal corrections officer all have something in common that most local clinics miss: if they are injured at work, their claim is not a Missouri or Kansas workers' compensation claim at all. It is a federal claim under the Federal Employees' Compensation Act, administered by the Office of Workers' Compensation Programs.
The medicine is the same. Almost everything around the medicine is different. These are the five differences that decide whether a federal claim goes smoothly.
1. The injured federal employee chooses the physician
This is the most consequential difference, and the one most often gotten wrong. Under FECA, the injured federal employee selects their own initial treating physician. An agency, a supervisor, or a contract occupational health provider cannot direct that choice.
Compare that to Missouri, where the employer or its insurer generally does direct care. A safety manager who supervises both federal and non-federal staff has to keep two different rules straight, and applying the state rule to a federal employee creates a real problem.
What a federal agency can properly request is evaluation and documentation: a duty status report, a fitness-for-duty examination, a second opinion, an impairment rating. Those are legitimate agency needs and entirely separate from directing treatment.
Under FECA, the choice of treating physician belongs to the injured federal employee. Agencies request documentation; they do not direct care.
2. The forms are federal, and each one does one job
State systems have their own paperwork, but no state form set maps cleanly onto these. A clinic that hands a federal employee a state work-status slip has just created a document their agency cannot act on.
- CA-1 — traumatic injury from a single identifiable event, filed with the agency as soon as possible.
- CA-2 — occupational disease that developed over time from work exposure or repetitive duties.
- CA-16 — agency authorization for initial examination and treatment; bring it to the first visit if issued, but never delay care waiting for it.
- CA-17 — duty status report; the agency describes the job, the physician describes current capacity.
- CA-20 — attending physician's report, where the causation opinion lives.
- CA-7 — the employee's claim for compensation for wage loss or a schedule award.
3. Continuation of pay instead of state wage-loss benefits
For a traumatic injury with a timely CA-1, a federal employee may be entitled to continuation of pay from their agency for a limited period, rather than the temporary disability benefits a state claim would pay. Beyond that period, wage-loss compensation is claimed from OWCP on a CA-7.
Because continuation of pay depends on timely filing and supporting medical evidence of disability, the gap between the injury date and the first properly documented visit has direct financial consequences.
4. The causation standard is written differently
Missouri asks whether the work event was the prevailing factor in the condition. FECA requires a rationalized medical opinion establishing a causal relationship between the accepted employment factors and the diagnosed condition.
In practice, "rationalized" is the operative word. A one-line statement that an injury is work related carries almost no weight in a federal claim. What carries weight is an opinion that identifies the specific employment factors, describes the mechanism by which they produced the diagnosed condition, and explains the reasoning — including why other explanations do not account for the findings.
This is the single largest reason otherwise valid federal claims are denied. It is a documentation failure, not a medical one.
5. Impairment ratings follow the federal standard
Schedule awards under FECA are rated using the AMA Guides edition OWCP requires, applied to the specific body parts the schedule covers. State systems may use a different edition or a different framework entirely, and a rating prepared for a state claim is not interchangeable with one prepared for OWCP.
A federal rating report needs to name the edition and tables used, show the measurements, and address apportionment where prior conditions exist. Anything less invites a request for clarification and months of delay.
What this means if you supervise a mixed workforce
- Triage jurisdiction before you triage the injury: federal employee or not.
- Never tell a federal employee where they must go for treatment.
- Send the CA-17 job-side description with any evaluation request.
- Request second opinions, fitness-for-duty exams and ratings — all appropriate.
- Keep separate intake paths so a federal injury never lands on a state form.
Frequently asked questions
Talk to a clinic that handles these claims every day
Our Kansas City and St. Louis clinics evaluate state and federal work injuries, write job-specific restrictions, and prepare the documentation adjusters, agencies and TPAs need.
This article is general information about claim procedure and is not legal advice or a substitute for individual medical evaluation.