FOREST SERVICE HANDBOOK ALAMOGORDO, NM FSH 6109.12 - EMPLOYMENT AND BENEFITS LNF SUPPLEMENT 6109.12-98-1 Effective September 25, 1998 POSTING NOTICE. Supplements to this title are numbered consecutively by title and calendar year. Post by document name. Remove entire document and replace with this supplement. Retain this transmittal as the first page of this document. The last supplement to this Title was Supplement 6109.12-96-1 to Chapter 30. Superseded New Document Name (Number of Pages) 30 7 6109.12, 30 6 Digest: 31.2 - The Forest APMC Coordinator will be the Forest Compensation Specialist located in the Supervisor's Office in the Personnel Section. /s/M. Louise Kennemur for JOSE M. MARTINEZ Forest Supervisor FSH 6109.12 - EMPLOYMENT AND BENEFITS HANDBOOK LNF SUPPLEMENT 6109.12-98-1 Effective 09/25/98 CHAPTER 30 - INJURY/ILLNESS COMPENSATION 31.2 - Medical Benefits. Agency Provided Medical Care (APMC). The objectives of APMC procedures are to reduce OWCP costs by providing direct payment to medical facilities for treatment and prescription drugs, avoid delayed payments to medical providers, lower injury administration costs, and eliminate the multi-tier OWCP charge-back cost. It is used in cases where it is apparent that the injury is such that it will not require more than two follow-up doctor visits, after initial treatment. The Forest is responsible for paying the medical provider and for resolving any disputed matters with the individual treated. Employees who suffer a job-related injury or illness have the right to initial selection of physician through APMC. If the injury or illness requires medical upgrade (beyond two followup doctor visits) then the entire case must be submitted to OWCP. 1. Responsibility a. Personnel Officer. Responsible for the overall Forest Program, ensuring that persons responsible for handling APMC cases are fully informed on the governing law and regulations, and adequately reviewing the program to ensure compliance with regulations and reporting requirements. b. Supervisors. Responsibilities of each supervisor include: (1) ensuring employees are informed of their rights and responsibilities under APMC procedures when injured; (2) authorizing APMC medical treatment for employees suffering job-related injuries or illnesses; (3) furnishing employees with the necessary APMC forms to report injuries and illnesses and providing assistance in completing the forms when necessary; and (4) submitting required forms to the designated APMC coordinator or Compensation Specialist responsible for processing injury cases for their unit within the established time frames for reporting injuries. c. Compensation Specialist. Primary responsibility for compensation functions (such as case processing), receiving and reviewing all APMC forms for completion and accuracy, and insuring timely submission of forms. 2. Individuals Covered by APMC Any individual who becomes injured or ill while engaged in work activities for the Forest may be provided medical assistance through APMC. 3. Procedures and Forms Required for APMC The Forest APMC Coordinator is the Forest Compensation Specialist located in the Supervisor's Office in the Personnel Section. The Business Management Officer at each District will serve as the District APMC Coordinator. Each unit will maintain a log of medical control numbers ("M" numbers) followed by fiscal year (FY) designator. Each individual APMC case will be assigned an "M" number. This same "M" number will be shown on all bills, doctor's reports, prescriptions, etc., for that individual case. Ex- Smokey Bear RD would assign an APMC "M" number of ample: "M-100-FY95" to their first APMC Case, "M-101-FY95" to second case, etc. Sacramento RD would assign "M-200-FY95", "M-201-FY95", etc. Guadalupe RD would assign "M-300-FY95", "M-301-FY95", etc. Supervisor's Office would assign "M-001-FY95", "M-002-FY95", etc. a. Traumatic Injury or Illness Requiring APMC. Forms Required Action Taken CA-1 (Injury) Complete CA-1/CA-2 by established OWCP guidelines. or CA-2 (Illness) Assign "M" number and insert that number on top of the CA-1/CA-2. FS-6100-16, Issue FS-6100-16 for APMC treatment to a APMC duly qualified physician of the employee's Authorization choice. In an emergency, any duly and Medical qualified physician or hospital may be Report (See used for initial treatment. Exhibit A) DO NOT CONFUSE APMC PROCEDURE WITH OWCP. DO NOT ISSUE CA-16 FOR APMC. The injured employee's supervisor will complete Part A of the FS-6100-16,which authorizes treatment. If the supervisor is not available, i.e., emergency situation,the Unit APMC Coordinator or other employee who has authority to authorize treatment will complete the form for the employee. Procurement Identification on the FS-6100-16 will reflect the FS Credit Card Number and the Management Code to be charged for the treatment and services provided, or the management code and the notation "Forest Service check", indicating a check will be issued. The medical provider will complete Part B of the FS-6100-16 and give to employee to return to the employee's unit. Treatment under APMC may be for initial medical care and one or two followup visits. The medical provider must complete a report for each visit; therefore, it is appropriate to issue the FS-6100-16 for up to two followup visits. The same "M" number should be used on Followup FS-6100-16's. b. Method of Payment. Either the Forest Service Credit Card (VISA) or Forest Service check will be used to make payment to medical care providers for services, supplies, and prescriptions. Monies for payment will be charged to project dollars. Instructions to the medical provider regarding payment for services provided will be attached to the FS-6100-l6 (See Exhibit B). District APMC Coordinators will make payment to local medical providers for services provided for their respective employees. The Forest Compensation Specialist will make payment to local medical providers for employees located in the Supervisor's Office. In situations where a Forest employee is treated outside the geographic area of their duty station, i.e., a District employee treated in Alamogordo, or a field-going employee from the SO treated by a physician or hospital/clinic at a facility located in a District Office community, the District APMC Coordinator and Forest APMC Coordinator will coordinate efforts to handle the situation in the most efficient manner. Since most pharmacies are reluctant to issue prescriptions without payment,it is recommended that APMC Coordinators contact the pharmacies in their local communities and negotiate the most efficient procedures to make direct payment to them. It is important to impress upon employees that when using APMC, they cannot be reimbursed directly for pharmacy costs. Unlike OWCP procedures, we can only make payment to the pharmacy. c. Records. A system of records must be maintained on all APMC transactions. The District Office will submit the CA-1/CA-2 to the Forest Compensation Specialist, with the appropriately assigned "M" number, within 48 hours of the reported injury. All other documents and transactions will be submitted as soon as they are completed. All APMC case files will be kept in the SO and maintained in the Employee's Medical Folder (EMF). 33 - CONTINUATION OF PAY (COP) 33.11 - Eligibility Requirements. COP leave (TC 67) cannot be granted unless the case is being submitted to the Office of Worker's Compensation. Requests for COP for APMC cases cannot be approved. However,if an employee so chooses,they may elect to use either sick leave, annual leave, or leave without pay for a maximum of 3 working days. If the situation will require more than 3 days off, or the employee does not wish to use any of his/her personal leave, the case must be submitted to OWCP before COP can be granted. (Note: COP cannot, at any time, be granted for an occupational illness claim.) Example Form FS-6100-16 is attached (in hard copy only). Exhibit B Instructions to treating Physician or Medical Facility Medical treatment for this injury/illness is provided by our Agency under the Agency Provided Medical Care (APMC) Program. These procedures are entirely apart from and not under the authority or provisions of the Federal Employee Compensation Act (FECA)/Office of Worker's Compensation (OWCP), and do not require issuing a CA-16. APMC allows our agency to make direct payment to you for treatment provided to this employee who has incurred an on-the-job injury/illness that will not result in more than three days lost work time due to the injury/illness, or treatment will not require more than two followup visits after initial treatment. If more than two followup visits for treatment are required, the injury/illness will then be required to be processed through OWCP and a CA-16 will be issued. Complete Part B, Attending Physician's Report, on the attached FS-6100-16. If additional pages are needed to complete your evaluation and diagnosis, or if you have your own form that addresses the information requested, you may attach that report to the FS-6100-16. Please write the "M Number" on any documents that you attach to the FS-6100-16. If medication is prescribed for this injury/illness, please indicate the "M Number" on the prescription form. You may give the employee the FS-6100-16 to return to our office, along with the bill for your services. Or,if you prefer, you may mail both to our office at: In either situation, the documents should be returned as soon as possible in order to expedite payment. Upon receipt of your report and billing for services provided, the Forest Service will make payment. Payment will be by Forest Service Credit Card (VISA) or by Forest Service check. If you have any questions in this matter, please feel free to call our APMC Coordinator: Phone No.: