PRIVACY ACT 2016 SUPPLEMENTAL INFO. Document Title. Index 1 20 C.F.R GOVT-1 Privacy Act Systems Notice Excerpts 3-7
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1 PRIVACY ACT 2016 SUPPLEMENTAL INFO Document Title Pages Index 1 20 C.F.R GOVT-1 Privacy Act Systems Notice Excerpts 3-7 Web Links Regulations, Systems Notice, OWCP Procedure Manual 8 FECA Bulletin No , issued November 1, OWCP Bulletin No , issued January 23, FECA Circular No , issued August 26, FECA Circular No , issued February 24, FECA Circular No , issued May 13,
2 INFORMATION IN PROGRAM RECORDS (DOL REGULATIONS, 20 C.F.R.) Are all documents relating to claims filed under the FECA considered confidential? All records relating to claims for benefits, including copies of such records maintained by an employer, are considered confidential and may not be released, inspected, copied or otherwise disclosed except as provided in the Freedom of Information Act and the Privacy Act of 1974 or under the routine uses provided by DOL/GOVT-1 if such release is consistent with the purpose for which the record was created Who maintains custody and control of FECA records? All records relating to claims for benefits filed under the FECA, including any copies of such records maintained by an employing agency, are covered by the government-wide Privacy Act system of records entitled DOL/GOVT-1 (Office of Workers Compensation Programs, Federal Employees Compensation Act File). This system of records is maintained by and under the control of OWCP, and, as such, all records covered by DOL/GOVT-1 are official records of OWCP. The protection, release, inspection and copying of records covered by DOL/GOVT-1 shall be accomplished in accordance with the rules, guidelines and provisions of this part, as well as those contained in 29 CFR parts 70 and 71, and with the notice of the system of records and routine uses published in the Federal Register. All questions relating to access/disclosure, and/or amendment of FECA records maintained by OWCP or the employing agency, are to be resolved in accordance with this section How may a FECA claimant or beneficiary obtain copies of protected records? (a) A claimant seeking copies of his or her official FECA file should address a request to the District Director of the OWCP office having custody of the file. A claimant seeking copies of FECA-related documents in the custody of the employer should follow the procedures established by that agency. (b) (1) While an employing agency may establish procedures that an injured employee or beneficiary should follow in requesting access to documents it maintains, any decision issued in response to such a request must comply with the rules and regulations of the Department of Labor which govern all other aspects of safeguarding these records. (2) No employing agency has the authority to issue determinations with respect to requests for the correction or amendment of records contained in or covered by DOL/GOVT-1. That authority is within the exclusive control of OWCP. Thus, any request for correction or amendment received by an employing agency must be referred to OWCP for review and decision. (3) Any administrative appeal taken from a denial issued by the employing agency or OWCP shall be filed with the Solicitor of Labor in accordance with 29 CFR 71.7 and What process is used by a person who wants to correct FECA-related documents? Any request to amend a record covered by DOL/GOVT-1 should be directed to the district office having custody of the official file. No employer has the authority to issue determinations with regard to requests for the correction of records contained in or covered by DOL/GOVT-1. Any request for correction received by an employer must be referred to OWCP for review and decision. 2
3 DEPARTMENT OF LABOR PRIVACY ACT SYSTEMS NOTICE--EXCERPTS Universal Routine Uses General Prefatory Statement The following routine uses of the records apply to and are incorporated by reference into each system of records published below unless the text of a particular notice of a system of records indicates otherwise. These routine uses do not apply to DOL/OASAM-5, Rehabilitation and Counseling File; DOL/OASAM-7, Employee Medical Records, and DOL/CENTRAL-3, Internal Investigations of Harassing Conduct. 1. To disclose the records to the Department of Justice when: (a) The agency or any component thereof; or (b) any employee of the agency in his or her official capacity; or (c) the United States Government, is a party to litigation or has an interest in such litigation, and by careful review, the agency determines that the records are both relevant and necessary to the litigation, and the use of such records by the Department of Justice is for a purpose that is [1730] compatible with the purpose for which the agency collected the records. 2. To disclose the records in a proceeding before a court or adjudicative body, when: (a) The agency or any component thereof; or (b) any employee of the agency in his or her official capacity; or (c) any employee of the agency in his or her individual capacity; or (d) the United States Government, is a party to litigation or has an interest in such litigation, and by careful review, the agency determines that the records are both relevant and necessary to the litigation, and that the use of such records is a purpose that is compatible with the purpose for which the agency collected the records. 3. When a record on its face, or in conjunction with other information, indicates a violation or potential violation of law, whether civil, criminal or regulatory in nature, and whether arising by general statute or particular program statute, or by regulation, rule, or order issued pursuant thereto, disclosure may be made to the appropriate agency, whether Federal, foreign, State, local, or tribal, or other public authority responsible for enforcing, investigating or prosecuting such violation or charged with enforcing or implementing the statute, or rule, regulation, or order issued pursuant thereto, if the agency determines by careful review that the records or information are both relevant and necessary to any enforcement, regulatory, investigative or prosecutive responsibility of the receiving entity, and that the use of such records or information is for a purpose that is compatible with the purposes for which the agency collected the records. 4. To a Member of Congress or to a Congressional staff member in response to an inquiry of the Congressional office made at the written request of the constituent about whom the record is maintained. 5. To the National Archives and Records Administration or to the General Services Administration for records management inspections conducted under 44 U.S.C and To disclose to contractors, employees of contractors, consultants, grantees, and volunteers who have been engaged to assist the agency in the performance of or working on a contract, service, grant, cooperative agreement or other activity or service for the Federal Government. Note 1. Recipients shall be required to comply with the requirements of the Privacy Act of 1974, as amended, 5 U.S.C. 552a; see also 5 U.S.C. 552a(m). 7. To the parent locator service of the Department of Health and Human Services or to other authorized persons defined by Pub. L the name and current address of an individual for the purpose of locating a parent who is not paying required child support. 8. To any source from which information is requested in the course of a law enforcement or grievance investigation, or in the course of an investigation concerning retention of an employee or other personnel action, the retention of a security clearance, the letting of a contract, the retention of a grant, or the retention of any other benefit, to the extent necessary to identify the individual, inform the source of the purpose(s) of the request, and identify the type of information requested. 9. To a Federal, State, local, foreign, or tribal or other public authority of the fact that this system of records contains information relevant to the hiring or retention of an employee, the granting or retention of a security 3
4 clearance, the letting of a contract, a suspension or debarment determination or the issuance or retention of a license, grant, or other benefit. 10. To the Office of Management and Budget during the coordination and clearance process in connection with legislative matters. 11. To the Department of the Treasury, and a debt collection agency with which the United States has contracted for collection services to recover debts owed to the United States. 12. To the news media and the public when (1) the matter under investigation has become public knowledge, (2) the Solicitor of Labor determines that disclosure is necessary to preserve confidence in the integrity of the Department or is necessary to demonstrate the accountability of Department's officers, employees, or individuals covered by this system, or (3) the Solicitor of Labor determines that there exists a legitimate public interest in the disclosure of the information, except to the extent that the Solicitor of Labor determines in any of these situations that disclosure of specific information in the context of a particular case would constitute an unwarranted invasion of personal privacy. 13. To disclose information to a State or local government entity which has the legal authority to make decisions concerning the issuance, retention or revocation of licenses, certifications or registrations required to practice law or a health care profession, when requested in writing by an investigator or supervisory official of the licensing entity for the purpose of making a decision concerning the issuance, retention or revocation of the license, certification or registration of a named attorney or health care professional. 14. To disclose information to the United States Department of Justice and/or the Federal Bureau of Investigation for inclusion in the National Instant Criminal Background Check System (NICS), pursuant to the reporting requirements of the Brady Handgun Violence Prevention Act, as amended by the NICS Improvement Amendments Act of DOL/GOVT-1, viewable at System Name: Office of Workers Compensation Programs, Federal Employees Compensation Act File. Security Classification: Most files and data are unclassified. Files and data in certain cases have Top Secret classification, but the rules concerning their maintenance and disclosure are determined by the agency, which has given the information the security classification of Top Secret. *** Purpose(s): The FECA establishes the system for processing and adjudicating claims that federal employees and other covered individuals file with the Department of Labor's OWCP, seeking monetary, medical and similar benefits for injuries or deaths sustained while in the performance of duty. The records maintained in this system are created as a result of and are necessary to this process. The records provide information and verification about the individual's employment-related injury and the resulting disabilities and/or impairments, if any, on which decisions awarding or denying benefits provided under the FECA must be based. Routine Uses Of Records Maintained In The System, Including Categories Of Users And The Purposes Of Such Uses: In addition to those Department-wide routine uses set forth above in the General Prefatory Statement to this document, disclosure of information from this system of records may be made to the following individuals and entities for the purposes noted when the purpose of the disclosure is both relevant and necessary and is compatible with the purpose for which the information was collected: a. To any attorney or other representative of a FECA beneficiary for the purpose of assisting in a claim or litigation against a third party or parties potentially liable to pay damages as a result of the FECA beneficiary's 4
5 FECA-covered injury and for the purpose of administering the provisions of sections of the FECA. Any such third party, or a representative acting on that third party's behalf, may be provided information or documents concerning the existence of a record and the amount and nature of compensation paid to or on behalf of the FECA beneficiary for the purpose of assisting in the resolution of the claim or litigation against that party or administering the provisions of sections of the FECA. b. To federal agencies that employed the claimant at the time of the occurrence or recurrence of the injury or occupational illness in order to verify billing, to assist in administering the FECA, to answer questions about the status of the claim, to consider rehire, retention or other actions the agency may be required to take with regard to the claim or to permit the agency to evaluate its safety and health program. Disclosure to federal agencies, including the Department of Justice, may be made where OWCP determines that such disclosure is relevant and necessary for the purpose of providing assistance in regard to asserting a defense based upon the FECA's exclusive remedy provision to an administrative claim or to litigation filed under the Federal Tort Claims Act. c. To other federal agencies, other government or private entities and to private-sector employers as part of rehabilitation and other return-to-work programs and services available through OWCP, where the entity is considering hiring the claimant or where otherwise necessary as part of that return-to-work effort. d. To federal, state or private rehabilitation agencies and individuals to whom the claimant has been referred for evaluation of rehabilitation and possible reemployment. e. To physicians, pharmacies, and other health care providers for their use in treating the claimant, in conducting an examination or preparing an evaluation on behalf of OWCP and for other purposes relating to the medical management of the claim, including evaluation of and payment for charges for medical and related services and supplies. f. To medical insurance or health and welfare plans (or their designees) that cover the claimant in instances where OWCP had paid for treatment of a medical condition that is not compensable under the FECA, or where a medical insurance plan or health and welfare plan has paid for treatment of a medical condition that may be compensable under the FECA, for the purpose of resolving the appropriate source of payment in such circumstances. g. To labor unions and other voluntary employee associations from whom the claimant has requested assistance for the purpose of providing such assistance to the claimant. h. To a federal, state or local agency for the purpose of obtaining information relevant to a determination concerning initial or continuing eligibility for FECA benefits, and for a determination concerning whether benefits have been or are being properly paid, including whether dual benefits that are prohibited under any applicable federal or state statute are being paid; and for the purpose of utilizing salary offset and debt collection procedures, including those actions required by the Debt Collection Act of 1982, to collect debts arising as a result of overpayments of FECA compensation and debts otherwise related to the payment of FECA benefits. i. To the Internal Revenue Service (IRS) for the purpose of obtaining taxpayer mailing addresses for the purposes of locating a taxpayer to collect, compromise, or write-off a federal claim against such taxpayer; and informing the IRS of the discharge of a debt owed by an individual. Records from this system of records may be disclosed to the IRS for the purpose of offsetting a federal claim from any income tax refund that may be due to the debtor. j. To the Occupational Safety and Health Administration (OSHA) for the purpose of using injury reports filed by Federal agencies pursuant to the FECA to fulfill agency injury reporting requirements. Information in this system of records may be disclosed to OSHA by employing agencies as part of any MIS system established under OSHA regulations to monitor health and safety. k. To contractors providing services to DOL or any other federal agency or any other individual or entity specified in any of these routine uses or in the Department's General Prefatory Statement who require the data to perform the services that they have contracted to perform, provided that those services are consistent with the routine use for which the information was disclosed to the contracting entity. Should such a disclosure be made 5
6 to the contractor, the individual or entity making such disclosure shall insure that the contractor complies fully with all Privacy Act provisions, including those prohibiting unlawful disclosure of such information. l. To the Defense Manpower Data Center--Department of Defense and the United States Postal Service to conduct computer matching programs for the purpose of identifying and locating individuals who are receiving Federal salaries or benefit payments and are delinquent in their repayment of debts owed to the United States under programs administered by the DOL in order to collect the debts under the provisions of the Debt Collection Act of 1982 (Pub. L ) by voluntary repayment, or by salary or administrative offset procedures. m. To a credit bureau for the purpose of obtaining consumer credit reports identifying the assets, liabilities, expenses, and income of a debtor in order to ascertain the debtor's ability to repay a debt incurred under the FECA, to collect the debt, or to establish a payment schedule. n. To consumer reporting agencies as defined by section 603(f) of the Fair Credit Reporting Act (15 U.S.C. 1681a(f)) or in accordance with section 3(d)(4)(A)(ii) of the Federal Claims Collection Act of 1966 as amended (31 U.S.C. 3711(f)) for the purpose of encouraging the repayment of an overdue debt, the amount, status and history of overdue debts, the name and address, taxpayer identification (SSN), and other information necessary to establish the identity of a debtor, the agency and program under which the claim arose, may be disclosed pursuant to 5 U.S.C. 552a(b)(12). o. To a Member of Congress or to a Congressional staff member in response to an inquiry made by an individual seeking assistance who is the subject of the record being disclosed for the purpose of providing such assistance. p. To individuals, and their attorneys and other representatives, and government agencies, seeking to enforce a legal obligation on behalf of such individual or agency, to pay alimony and/or child support for the purpose of enforcing such an obligation, pursuant to an order of a state or local court of competent jurisdiction, including Indian tribal courts, within any State, territory or possession of the United States, or the District of Columbia or to an order of a State agency authorized to issue income withholding notices pursuant to State or local law or pursuant to the requirements of section 666(b) of title 42, United States Code, or for the purpose of denying the existence of funds subject to such legal obligation. q. To the National Institute for Occupational Safety and Health (NIOSH), for the purpose of performing statistical analyses of injury and illness patterns to identify patterns and locations of high incidence, help devise safety and return-to-work interventions, and guide worker safety and health research. The statistical analyses performed by NIOSH will assist OWCP and OSHA in their efforts to reduce the occurrence of employment injuries, assist employees in achieving a smooth transition and return to work following employment injuries, and improve Federal employee safety and health. r. To the General Services Administration (GSA), for the purpose of permitting GSA and its investigators to evaluate information about potential exposures to hazardous substances to non-gsa federal employees in buildings or complexes managed by GSA. s. To investigators in employing agency Offices of Inspector General, for the purpose of assisting in the investigation of potential fraud by recipients of compensation benefits under the FECA for their agencies, and for the purpose of assisting in evaluation of compliance by employing agencies with timely filing requirements under the FECA and its implementing regulations as well as for audits related to the employing agencies handling of their portion of the FECA claims process. t. To a Federal, State or local agency charged with the responsibility for investigating compliance with laws relating to health and safety, for the purpose of assisting such agency in fulfilling its statutory or regulatory responsibilities. u. For claims arising under 42 U.S.C. Sections 1701 and 1704 of the WHCA, to insurance carriers or selfinsured employers and their attorneys, for the purpose of assisting in administering the claim, and for the purpose of verifying eligibility for payments to claimants and reimbursements of amounts already paid. 6
7 Note: Disclosure of information contained in this system of records to the subject of the record, a person who is duly authorized to act on his or her behalf, or to others to whom disclosure is authorized by these routine uses, may be made over the telephone or by electronic means. Disclosure over the telephone or by electronic means will only be done where the requestor provides appropriate identifying information. Telephonic or electronic disclosure of information is essential to permit efficient administration and adjudication of claims under the FECA. Pursuant to 5 U.S.C. 552a(b)(1), information from this system of records may be disclosed to members and staff of the Employees Compensation Appeals Board, the Office of Administrative Law Judges, the Office of the Solicitor and other components of the Department who have a need for the record in the performance of their duties. *** 7
8 Web Links Federal Employees' Compensation Act (FECA) (5 U.S.C et seq.) FECA Regulations (20 C.F.R. Part 10) Department of Labor Privacy Act Systems (Main Page) DOL/GOVT-1 (FECA Systems Notice) Universal Routine Uses DFEC Procedure Manual OWCP Procedure Manual (Privacy) 8
9 FECA BULLETIN NO THIS SUPERCEDES BULLETIN 99-08, ISSUED JANUARY 4, 1999 Issue Date: November 1, 1999 Expiration Date: November 1, 2000 Subject: New Regulations Privacy Act Background: FECA Bulletin No , issued January 4, 1999, discussed new regulations involving the handling of requests submitted by FECA claimants under the Privacy Act. Paragraph five of that bulletin erroneously indicated that a claimant s access to his or her FECA claims file could be denied in only two situations. Additionally, paragraph six indicated, in error, that the 90-day appeal time did not begin to run until the requester received the denial letter. The 90-day period runs from the date of the denial. In light of these misstatements, the bulletin has been revised. Reference: 20 CFR through (1999); 29 CFR Part 71 effective December 1, 1998 (63 FR (October 22, 1998)). Purpose: To inform OWCP staff, employing agencies and other interested parties of Privacy Act compliance requirements. Applicability: Claims Examiners, Senior Claims Examiners, Supervisors, Fiscal Personnel, Technical Assistance and Systems Personnel, and Hearing Representatives. Action: 1. All records in OWCP claim files and all copies of records relating to an on-the-job injury that are in the possession of the employer are considered to be OWCP records covered by the Privacy Act system of Records DOL/GOVT-1. Although employing agencies may establish procedures employees must follow to obtain access to employer-maintained records, any decision to grant or deny access must comply with Department of Labor rules and regulations. 2. Under the amended regulations, only OWCP may respond to requests for the correction or amendment of any FECA-related record. Employing agencies must forward any request they receive seeking to correct or amend such a record to OWCP. 3. The subject of a FECA file is entitled to receive the first copy of the file at no cost. The same rule would apply if the claimant requests copies of any documents not previously provided. OWCP or an employing agency may charge $.15 per page for each additional copy requested. 4. The filing of a request, or multiple requests, for more than one copy of a Privacy Act record will be viewed as an agreement by the requester to pay all applicable fees up to $ When acknowledging a request, the disclosure officer should confirm this agreement by letter to the requester. The requester must be consulted before higher fees are assessed. 9
10 5. OWCP may require payment in advance of fees over $ If such a fee is anticipated, a letter should be sent to the requester, noting the amount of the projected fee and advising the person that a designated staff person may be contacted to assist him or her in reformulating the request so that his or her needs may be met at a reduced cost. 6. OWCP may refuse to process any request submitted by an individual who has failed to pay an earlier fee, until the earlier fee is paid. 7. Any decision approving or denying a Privacy Act request must be in writing and signed by the designated Privacy Act disclosure officer. District Directors have been designated as OWCP disclosure officers. If copying of the requested documents will be delayed, an interim response should be sent indicating the reason for the delay and the date on which the documents will be mailed to the requester; this also should be under the signature of the disclosure officer. 8. As a general rule, the claimant may have access to each document in the claim file. There may be exceptions, however, such as where disclosure of medical records may be harmful to the individual. If there is question, the District Office should contact the appropriate regional office of the Solicitor of Labor to determine whether a document or documents may be exempt from disclosure. It should be noted that a request for access by the subject of the claim file shall not be denied unless both a Privacy Act exemption and a Freedom of Information Act exemption apply to the requested document(s). 9. If access to a particular record(s) is being denied, including those cases where OWCP is unable to find the requested record, the letter denying the request should include a statement of the reasons why access is being denied, and should cite to the specific statutory exemption applicable to the request. 10. When a request is denied, in whole or in part, the letter should advise the requester that he or she may, within 90 days of the date of the denial, file an appeal with the Solicitor of Labor. The appeal must be in writing and addressed to the Solicitor of Labor, United States Department of Labor, 200 Constitution Avenue, N.W., Room N-2428, Washington, D.C The requester should also be told that both the letter and the envelope should be clearly marked Privacy Act Appeal. 11. Even if the Disclosure Officer believes that all requested documents are being provided, the letter transmitting the documents should advise the requester that if he or she does not believe the letter to be fully responsive to the request, an appeal may be filed by writing to the Solicitor of Labor within 90 days of the decision. The letter should be sent to the address set forth in Item 10. Please no longer use the letter attached to FECA Bulletin Disposition: Retain until incorporated into the Federal (FECA) Procedure Manual. NANCY L. RICKER Acting Director for Federal Employees Compensation 10
11 OWCP BULLETIN NO Issue Date: May 9, 2008 Expiration Date: Until Further notice (Replace previous OWCP Bulletin 04-01) Subject: Case-specific transactions Background: With the increased emphasis on securing Privacy Act information, it is critical that the office maintain policies that guard against any possible privacy violations in communication, while still being responsive to inquiries. The Department defines Protected PII (Personally Identifiable Information) as information: whose disclosure could result in harm to the individual whose name or identity is linked to that information. Examples include, but are not limited to, social security number; credit card number; bank account number; residential address; residential or personal telephone; biometric identifier (image, fingerprint, iris, etc.); date of birth; place of birth; mother s maiden name; criminal records; medical records; and financial records. The conjunction of one data element with one or more additional elements, increases the level of sensitivity and/or propensity to cause harm in the event of compromise. Purpose: To establish clear guidance on when and how is to be used for communication regarding a specific case file. Applicability: All OWCP staff, contractor staff, District Medical Advisers, Telephonic and Field Nurses, Rehabilitation Counselors, Second Opinion Examination Contractors. Action: Employees and contractors will comply with the following guidance when communicating claimant and case information via within the DOL network: 1. sent from one OWCP employee to another DOL employee through the ESA wide-area network (WAN) is considered secure. to and from contractors who use the ESA network (ESA owned and properly configured equipment, including remote laptops that access the ESA WAN) is also considered secure. As such, reference to the employee s name and case number may be used in the message. However, no reference to the employee s name or Protected-PII (see definition above) should be made in the subject portion of the . Central Bill Process (CBP) threads, provided through ACS s secured website conform to this policy, as they are secured within an accredited network. 2. Any internal that is forwarded to outside parties becomes non-secure, and PII must be deleted as explained below in outside the DOL Network. 11
12 outside the DOL network: 3. between OWCP employees and outside parties is outside the ESA network, and therefore does not guarantee security. As such, no reference to the claimant s complete SSN, name or other Protected PII should be made in any part of the message. A person s claim number may be referenced if that claim number is not the claimant s SSN. The last four digits of a person s SSN may be referenced along with the last name only, as long as the remainder of the SSN, full name, or other PII is not used anywhere in the message or in attachments that are not password protected or encrypted. Attachments that are encrypted with Point Sec may contain the full SSN and name. (See instructions for sending encrypted documents to non-point Sec users: FOR DFEC EMPLOYEES AND CONTRACTORS ONLY: DFEC has been granted approval by the Department to transmit Protected-PII via MS Office password-protected files sent as attachments to messages. Protected-PII is only to be included in the password-protected file (not the message itself), and the password must be sent to the recipient in a separate message. NOTE: OWCP staff is reminded that substantive responses to outside parties who are not OWCP contractors and not a party to the case are strictly prohibited. An acknowledgement may be sent, but reference to any personal identifiers must be removed, and we never confirm existence of cases for specific claimants to members of the public who are not a party to the case. 4. When Black Lung and Energy employees exchange messages with ACS concerning claimants, the communications should reference the claimant s CBP Member ID (from the CBP claimant eligibility file). FECA employees may use case number as FECA case numbers are not the same as SSN. Claimant names should not be included in the same message as these Member IDs or case numbers, unless they are provided in an encrypted attachment. 5. Attachments and message chains must be reviewed, and if necessary altered to remove reference to the claimant s name, SSN or other protected PII if that trail is being forwarded outside of DOL. If it is not possible to alter or redact the document or , or if it is important that the attachment or include both the claimant s name and case number or SSN, it must be sent as an encrypted attachment, faxed, or be sent via USPS or courier to the appropriate party. Packages containing extracts of multiple Protected PII records sent via mail or courier must be tracked (E.g. Registered Mail, Return Receipt, Fed Ex, etc.). Please refer to Working with Personally Identifiable Information (PII) POL-O If a case-specific message is received from an outside party containing Protected PII, the message should be printed or bronzed for inclusion in the case file. If an OWCP response containing Protected PII is required, the response should be made in accordance with the above guidance. If an OWCP response does not require Protected PII, the response may be made via a reply message, but the Protected PII from the originating request must be deleted or redacted. The 12
13 response should also include a statement encouraging the party to write or call with future requests that include Protected PII. 7. OWCP does not handle claims communications with our claimants over . OWCP staff should always encourage claimants to communicate with us via telephone or letter if they have specific questions regarding their individual claims, as cannot be considered secure. 8. Staff may respond to inquiries and communications regarding deceased claimants without protecting the decedent s information, as the right to privacy ends upon death. Staff members are cautioned, however, that living beneficiaries' information must continue to be protected. This policy addresses claimant- and case-specific containing Protected PII. Any information sent via continues to be subject to the provisions of the Privacy Act and should be released only if appropriate to do so. Disposition: The bulletin is to be retained until further notice. CECILY RAYBURN Director, Division of Planning, Policy and Standards Distribution: List No. 1 (All OWCP Employees, Contractors) FECA CIRCULAR NO August 26, 2009 SUBJECT: Release of Documents from Federal Employees Compensation (FECA) Files This circular is intended to provide guidance in situations where information or copies of information are requested from a claimant s FECA case file. While such requests may come from the claimant or his/her authorized representative, the Department of Labor or employing agency Office of Inspector General, claimant s former spouse or other entity, this circular focuses primarily on what information may be requested by the employing agency and when it may be provided. Because FECA case files are governed by the Privacy Act of 1974 and because FECA case file documents contain Personally Identifiable Information (PII), great care must be taken in handling requests for information. The extent to which information may be released out of a FECA case file is governed by the Privacy Act. Descriptions of the agency s role in the claims process are set forth in the FECA statute, its implementing regulations, and guidance such as the program Procedure Manuals and the Agency Handbook, CA-810. While the agency is not a party to the claim, the agency plays a critical role in the FECA process, particularly in return to work; it may request and receive documentation, including medical reports, to fulfill its role in the claims process. Background: All records relating to claims for FECA benefits are covered by the government-wide Privacy Act system of records entitled DOL/GOVT-1. Information from the FECA file may only be released pursuant to a need to 13
14 know within DOL, a published routine use, a signed Privacy Act waiver, or a court order from a court of competent jurisdiction. Release of information in accordance with a routine use must be consistent with the purpose for which the file was created, which is the administration of the FECA case. The FECA regulations at 20 C.F.R make clear that the protection, release, inspection and copying of records covered by DOL/GOVT-1 should be carried out in accordance with the rules, guidelines and provisions of Subpart A of the FECA regulations, as well as those contained in 29 C.F.R. parts 70 and 71, which are the Department s regulations implementing the Freedom of Information Act (5 U.S.C. 552) and the Privacy Act (5 U.S.C. 552a) respectively, as well as with the notice of system of records and routine uses published in the Federal Register. The Office of Workers Compensation Programs (OWCP) has determined that records covered by DOL/GOVT-1 may not be used in connection with a personnel action absent consent of the subject of the record. It is not permissible to use or release FECA documents in connection with personnel matters unless they have first obtained the claimant's written consent. Any questions an agency has concerning the disclosure of FECA-related documents or uses of such documents by the agency should be referred to the OWCP for resolution. 63 Federal Register 56752, (October 22, 1998). A routine use authorizes disclosing information from the FECA claim file without first obtaining the claimant's permission such disclosure is acceptable because the routine use is listed and published in the Privacy Act Systems Notice for DOL/GOVT-1, and because OWCP has concluded that the anticipated use of the document is consistent with the purpose for which the information was collected. These routine uses include: sending the record to medical providers asked by OWCP to examine or treat the claimant; providing relevant information about the nature and mechanism of the injury or illness to health and safety officials within the employing agency1; providing relevant documents to nurses and rehabilitation counselors assigned by OWCP to work on the case; providing documents to employing agency personnel (but only for purposes related to the claim, and not for other reasons such as personnel actions); providing documents pertaining to the factual circumstances of the case to credit bureaus; and others. A listing of the universal routine uses which apply to all Department of Labor (DOL) system of records can be found at A listing of the routine uses specific to DOL/GOVT-1 can be found at 1.htm. [See DOL Privacy Act System of Record Notices, 67 FR 16825, at (April 8, 2002).] Routine use b for DOL/GOVT-1 authorizes release of case file information To federal agencies that employed the claimant at the time of the occurrence or recurrence of the injury or occupational illness in order to verify billing, to assist in administering the FECA, to answer questions about the status of the claim, to consider rehire, retention or other actions the agency may be required to take with regard to the claim or to permit the agency to evaluate its safety and health program. Handling requests: 1. Regarding general requests from employing agencies, OWCP s Division of Federal Employees Compensation (DFEC) may grant requests from agencies for records pertaining to their employees. If records are to be released, Claims Examiners (CEs) should ensure that the requestor is agency-authorized, and should require proper identification before releasing only that information directly relevant to the request. For example, if an agency needs to formulate a job offer and needs to know a claimant's medical restrictions, relevant medical reports may be released. Blanket release of the entire case record is not appropriate, except to an investigative body (DOL Office of Inspector General (OIG) or Employing Agency OIG), or to an Agency Injury Compensation Specialist who must understand that indiscriminate or widespread further release of the FECA record within the employing agency is not authorized or permitted by OWCP/DFEC.2 14
15 2. Employing agency personnel who inquire about releasing claims-related material from their files should be referred to 20 C.F.R , as well as paragraph 9-2 of Injury Compensation for Federal Employees (Publication CA-810). 3. An agency representative may ask to inspect files at the district office. OWCP will accommodate all such requests subject to logistical and physical limitations, including reasonable advance notice of the visit and a list of cases to be reviewed. Once the agency representative has presented satisfactory identification, requested documents from the FECA claim file may be released. However, the agency representative must provide a separate statement regarding the reason for any requested documents for each FECA claim for which copies of documents are requested. Release of complete case records to employing agencies will occur very infrequently and the employing agency must establish a reasonable need for such a request. 4. Release of documents within the FECA case record to employing agencies is a permitted routine use. However, the Office may decline to release information not pertinent to the investigation or audit or may request the agency to provide additional rationale for requesting the information. 5. While documents within the FECA case record may be released to employing agencies, the use of these copies must be consistent with the reason the information was collected. In practice, this means that the use must be connected in some way with the compensation claim. Absent truly unusual circumstances (such as a FECA claimant s improper actions in the FECA claim forming the basis of a disciplinary action and with explicit DOL permission), agencies may not use copies of information from claim files in connection with EEO complaints, disciplinary actions or other administrative actions without the employee s consent. 6. A request for copies of documents contained in the FECA case record received from an employing agency must contain a reason for the request. If the reason stated is consistent with the purpose for which the information was collected, such copy requests will generally be honored. The CE is not required to determine whether the evidence of record indicates the claimant is currently capable of returning to work before providing the employing agency injury compensation specialist (or an individual performing those duties) with current medical reports for the stated purpose of attempting re-employment of the injured worker. 7. Whether in writing or in person, the agency representative may make a copy request using a standard request form attached to this Circular, or may use any signed statement which includes the required information. All such copy requests will be included in the FECA case record. DOUGLAS C. FITZGERALD Director for Federal Employees' Compensation Distribution: List No. 2 Folioviews Groups A, B, and D (Claims Examiners, All Supervisors, District Medical Advisors, Technical Assistants, Rehabilitation Specialists, Staff Nurses and Fiscal Personnel) 15
16 Attachment EMPLOYING AGENCY REQUEST FOR COPIES OF DOCUMENTS FROM FECA CASE RECORDS (place in case file) Claim Number: Claimant Name: As an authorized representative of I am requesting a copy of the following documents from the above noted FECA claim record: These copies are being requested for the following reason(s): I understand that the use of these document copies must be consistent with the reason for which they were collected and may not be used in connection with personnel actions without the employee s consent. Signature: Date: 16
17 FECA CIRCULAR NO Issue Date: February 24, 2012 SUBJECT: Agency Query System (AQS) Access for Agency Employees, Contractors and Inspector General Offices PURPOSE: Because of continued heightened concerns over disclosure of personal information, the Office of Workers' Compensation Programs (OWCP) is instituting this formal policy on AQS access. While OWCP realizes that AQS information could be useful to other entities such as pharmacy providers, OWCP believes that the very limited information needed by these entities is available through other means, such as the bill pay portal. BACKGROUND: 1. AQS is a secure internet site that provides access to certain information on Federal Employees' Compensation Act (FECA) claims to authorized personnel from federal agencies. The information available includes the claimant's name, social security number, home address, current claim status, compensation payment history, medical bill payment history, and COP Nurse assignment information. 2. Within each federal agency, there is a designated Intra-Agency Coordinator (IAC) recognized by DFEC as the sole point of contact for AQS user access within that particular agency. Any employing agency personnel who contact DFEC directly for AQS access are routed to the applicable IAC. The IAC then contacts the Division of Federal Employees' Compensation (DFEC) to gain permission for that user. A specific user name is assigned to that user; access is password protected. 3. Access to AQS cannot be granted on a case-by-case basis, nor can AQS data fields be limited by user. Access is granted based on employing agency chargeback codes. 4. All records relating to claims for FECA benefits are covered by the government-wide Privacy Act system of records entitled DOL/GOVT-1. Information from the FECA file may only be released pursuant to a need to know (applicable only to disclosures within the Department of Labor), a published routine use, a signed Privacy Act waiver, or a court order from a court of competent jurisdiction. Release of information in accordance with a routine use must be consistent with the purpose for which the file was created; that purpose is the administration of the FECA claim. The FECA regulations at 20 C.F.R make clear that the protection, release, inspection, and copying of records covered by DOL/GOVT-1 should be carried out in accordance with the rules, guidelines, and provisions of Subpart A of the FECA regulations, as well as those contained in 29 C.F.R. parts 70 and 71, which are the Department of Labor's regulations implementing the Freedom of Information Act (5 U.S.C. 552) and the Privacy Act (5 U.S.C. 552a) respectively, as well as with the notice of system of records and routine uses published in the Federal Register. 5. A "routine use" authorizes disclosing information from the FECA claim file without first obtaining the claimant's permission. Such disclosure is acceptable because the routine use is listed and published in the Privacy Act Systems Notice for DOL/GOVT-1; because OWCP has concluded that disclosure in the particular circumstance is compatible with the routine use; and because the anticipated use of the information is consistent 17
18 with the purpose for which the information was collected. A listing of the universal routine uses which apply to all Department of Labor (DOL) systems of records can be found at A listing of the routine uses specific to DOL/GOVT-1 can be found at 1.htm. [See DOL Privacy Act System of Record Notices, 67 FR 16825, at (April 8, 2002).] Further guidance can also be found at A. Access for Employing Agency Personnel and Certain Agency Contractors 1. A routine use published in the Federal Register permits disclosure to "federal agencies that employed the claimant at the time of the occurrence or recurrence of the injury or occupational illness in order to verify billing, to assist in administering the FECA, to answer questions about the status of the claim, to consider rehire, retention or other actions the agency may be required to take with regard to the claim, or to permit the agency to evaluate its safety and health program." This, combined with another routine use, permits access to contractors performing workers' compensation functions for agencies, e.g. federal contractors retained to provide claims filing, case management and return to work services. In limited circumstances, other individuals may be granted access based on a particular routine use. 2. Based on DOL OWCP's responsibility to protect the information that resides in a Privacy Act System of Records, AQS access must be limited to authorized users in federal agencies (and, where appropriate, contractor employees) who are performing activities authorized by the language in the routine use above. Examples of such authorized users include agency injury compensation specialists. Other employing agency personnel (such as immediate supervisors, safety and health officials without any workers' compensation duties, and Accident Review Panels) generally do not have a sufficient business reason for access to this level of personal information and will not qualify as authorized users. 3. DOL does not consider medical providers and entities that perform ancillary functions (for example, pharmacy billing and management) authorized users, as AQS provides a level of detail and personal information far beyond what is needed by those entities. If such providers and entities need information on a particular claim, other methods for accessing the more limited information needed by them are available through the billing portal or from the agency, but direct access to AQS will not be authorized. 4. Agencies may wish to encourage their employees to utilize the Claimant Query System as an additional resource to meet their needs. B. Access for Employing Agency Inspector general Offices 1. FECA Circular (DFEC Protocol Statement - OIG Audits, Evaluations and Investigations) was released in response to the increased number of requests for information received from the Office of Inspector General (OIG) community as they performed audits, evaluations, inspections and investigations. DFEC recognizes that employing agencies and their respective OIG offices have an interest in reducing costs, returning people to work, and identifying and preventing fraud. In an effort to fully cooperate with the OIG community, while simultaneously coordinating the interaction in a way that would not interfere with our ability to perform our mission, DFEC outlined a specific protocol that would be used to respond to such requests that would preserve program resources and avoid duplication of effort. This circular detailed that when an employing agency OIG investigator requests to view a case record, he/she will be required to sign a brief statement prior to gaining access to the file indicating that access to the file is being requested based on an investigation into a potential violation of law. The guidance provided in FECA Circular has not changed. 18
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