Short Form Closure FECA-PT2 Procedure Manual

Administrative Review (AR) — an uncontroverted traumatic injury claim in which medical bills are not expected to exceed $1,500 and a wage loss claim has not been filed. These cases are automatically closed upon case creation, without a Claims Examiner (CE) review.

AR cases can be reopened automatically or manually. Such reopened cases will usually contain some medical evidence and may be adjudicated immediately.

Extent and duration of injury-related disability do not have to be fully developed before adjudication. However, if one or more of the five basic requirements (timeliness, civil employee, fact of injury, performance of duty, causal relationship) is not met, the CE will proceed with development as with any other T1 case. See 2-0800-4.

• Automatic Reopening. AR cases will be automatically reopened if the medical bills exceed $1,500, a wage loss or recurrence claim is received, or if the case record is changed due to receipt of a late agency controversion [challenge], or the COP nurse has closed the case without a return to full-time employment by the claimant.
• Manual Reopening. AR cases may also be reopened manually. The case should be reopened when, for example, a request for surgery is received.

Information Above per FECA Procedure Manual