Federal personnel manual system

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Material Information

Title:
Federal personnel manual system
Portion of title:
FPM letter
Physical Description:
Book
Language:
English
Creator:
United States Civil Service Commission
United States -- Office of Personnel Management
Publisher:
United States Civil Service Commission
Place of Publication:
Washington, D.C
Frequency:
irregular
completely irregular

Subjects

Subjects / Keywords:
Personnel management -- Handbooks, manuals, etc -- United States   ( nal )
Civil service -- Handbooks, manuals, etc -- United States   ( lcsh )
Personnel management -- Handbooks, manuals, etc -- United States   ( lcsh )
Genre:
federal government publication   ( marcgt )
periodical   ( marcgt )

Notes

Issuing Body:
Vols for 1979- issued by: Office of Personnel Management.
General Note:
Description based on: 410-19 (Aug. 22, 1977); title from caption.
General Note:
Latest issue consutled: 292-23 (No. 3, 1983); title from caption.

Record Information

Source Institution:
University of Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
aleph - 021549616
oclc - 06727309
lccn - 2009238041
System ID:
AA00012996:00082


This item is only available as the following downloads:


Full Text


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Attachment to PPM Ltr. 810 -8


ve the employee the signed and dated receipt portion of the CA-2.

LIe the employee's statement about work factors reviewed by one or more
. who can comment on its accuracy and completeness. Their statement
b* attached to this package.

I4d all collected information to OWCP. If more than ten days will
*rqm: the time the employee submits the information to the time the
is ready, send what is ready and indicate when the rest is
,the cheekllat. Be sure to supply an address and telephone number
one who is familiar with the claim can be reached.
Dl OWG V'S PROCESSING OF THE CASE

'A-2 is filed, a postcard with the employee's claim number will
siahould be used for any further submissions. OWCP may also ask
detailedd information or for additional items. Each claim has
lvidual circumstances which the examiner must explore. For most
examiner t-l11 have, to develop a complete statement of the facts
g,.ae, for presentation to .a medical consultant. Until all the
:1 "in, medieal development can't proceed. FPM Letter 810-7 tells
'WOP will follow if either the claimant or the agency does not
ZSUiested information.
E-a ask the employee to be. examined by another physician before
is reached. OWCP will provide the physician with background
and. instructions, and will pay. the physician's bill.

eoopeorative efforts by agency personnel to give good directions
and to collect essential information will lead to earlier
or coupatioal disease cases, with fewer requests for infor-
t t frustrations for agency, employee, and examiner.


(3)




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Attachment to FTM Ltr. 810-8 (5)


Required in Support of A Claim for
neS DObsa


U.S. Department of Labor
Employment lSandvude Admlntamtlon
QCM of Workers'Co Impmtlon Pronmem


u EiitonIEMfmtaud ie uihnatiid with Powm CA-2. o rMtur ti ohkllnt with your itmmin attahed. Chak off ouh leam m
im. a' whkSw G .Inm unpsRMt the InfoIbtion.f All mitacl 4ubmltfid should beo logte anld peoifl.
." ..... ... .. ..


Form CA-34A
Augut 198.


FROM EMPLOYING AGENCY


V


5. Review and comment on employee's
statement provided in response to Item
no. 1.

6. If employee's job differs from official
description, describe exactly his/her
duties.

7. Give a day-by-day listing of leave and
leave without pay used due to: this
condition,

8. Attach copies of the employee's:

a. SF-171, Application for Employment.

b. Position description with physical.
requirements.

c. Pertinent dispensary records.

d. 'Most recent SF-50, Notification of
Personnel Actjion.








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Attachment to FPM Ltr. 810-8 (7)


lRequired in Support of a Claim for US. Department of Labor
Offlcm of Workr' Comnpenstlon Prorams
1 PILING A CLAIM PO HEARING LOSS, THIS CHECKLIST DESCRIBES THE INFORMATION NEEDED FROM YOU AND YOUR
IMl'lNCY. All of te ilowuln IntfwraMln should be submitted with Form CA23. PIlu return t hel cehilt with your sutemn attah.
Itmt in Itoeomplel or let us know whAn wem o expt th Inft nation. All material submitted should be legible and ipeIe.
,- h U -


employment history by am-
Stitle, and inclusive dates.
ioin-Federal employment and


lb i.. tle, desCribe source of
ifi'! houb of exposure per
s 6of any saftydevices to pro-
Al slle exposure State when:
i0 1aM iprwida ed

y of any previous -ear or


uhich involve e*-


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Foun CA-BB
August Is


PROM EMPLOYING AGENCY


I te


9. Review and comment on the employee's
statement in response to questions 1 -5.

10. Describe all work-related exposure to
hazardous noise, including:

a. Locations of job sites.

b. Nature of exposure to noise
(machinery, etc.)

c. Decibel and frequency level (noise
survey report) for each job site.

d. Period of exposure, hours per day,
days per week.

., Type of ear protection provided.

11. Attach copies of the employee's:

a. SFt171, Application for Employment.

b. Job sheet and employment record.

c. All medical examinations pertaining
to hearing or ear problems, including
preemployment examination and all
audiograms.


12. If the employee is no longer exposed to
hazardous noise, give date of last exposure
and the payrate in effect on that date.









Attacierant to FRM Ltr. 810-8 (9)


hin. Required in Support of A Claim
AbIstol-Relatetd Illness


U.S. Department of Labor
eUmploymt SndrwIm AmInln|urnu.
Offm of Wworkm' Oompwleton Prownr


AI PIUNG A CLAIm EASED ON EXPOSURE TO ASBESTOS. THI CHECKLIST DESCRIBES THE INFORMATION NEEDED FROM
rUa EWLMPOYVING AGANCY. AN ose fullewlq InaSlDton .h.uld bllE hmlIl wth Porm CAt2.Plos retunm thoehakllt ith your
SMklt. uChMak of nht I i t is enptaued wiort knew whm Wm pt th io mw-tion. AN merW bmitad ihold be lWgbl
C-.-, I..


mam suuwovae

kw emipymmt binatory by enm-
Stitles, and nclusive dates. In-
d employment and mill-


Einti, dimerib.e the work you


Kw-1ir nmiumber of houhs per
i Pe wagk -expoasd., and the
umnsY' of safety precaution n
*plrftor. lift.) used.

iii 'm iltpeanure you hvew had to
WHbIle siuBstewi.s. If none, state

irswg biasibing or bung problems
hi ble is the iest and treatment


1 Smeklqlg hittry to include
day awd years (date) you

brepart irmVa your physician,
x_4y t42ort, higaory, phy-
flpt diagvii fip opinbiri am toh e
Iof thdepditNOR to OuLpl,-


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e .ts of e. ainhaid, tra.t-
r hoeiuatiquain for any previous
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Imanu wariL AoEMcY

9. Review and comment on the accuracy of
the employee's description of work per-
formed and exposure to asbestos and
other substances.

10. Provide exposure data, including air
sample surveys or statements of the type
of abestos exposure, frequency, degree
and duration for each job held. Air
sample results should be reported in
units of fiber/cc time weighted averages
Also report concentrations of other
pollutants and chemicals.


11. Give the date employee was last exposed
to asbestos at work. If the employee was.
removed from exposure, give the circum-
stances.


12. Attach copies of the employee's:

a. SF-171, Application for Employment.

b. Position description with physical re-
quirements for last job held.

c. Job sheet and employment record.

d. Pertinent dispensary records.

e. Most recent SF-50, Notification of
Personnel Action. :
f. Laboratory test results and chest
X-ray reports on file.


13. Deosribe safety regulations and protec-
tive devices in use by employee, with
period and frequency of use.


Form CA-3SC
August 19MB


iod and frequency of use.


Form CA-36C
August 198




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ad in Support of A Claim
SVironary/Vascular Condition


U.S. Department of Labor
SAnploymmt aUndrdh AdMInslar-on
OPife of rkein OmpeOpMneln horein


t.in A CLAiM R CORONARY CO VAABULAR CONDITIONS (fr rwmapl, hmeen atk, nos.,hyptunuon). THIS CHaCI.
iTE, 4NPORHRMATIN NEEDED PROM YOU AND YOUR EMPLOY1NO A3CYW. All of titr Hotowing Inferimnin sheMu Yt
piiti A4.i.PWig imm v aaiIth Whiah your aImaMA aChe. ChOtk offgakh ln a it I oamppletd aw lst ku hnowwm can
ink. All i wri(l Ubillttl should be lgitle ad spiift.
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PROM MPrLOwIIM AsiNWC


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6. Review and comnient on the employees
statement In response to questions 1-5.

7. Describe in detail the duties of the
employee and the manner in which the
duties were performed. If the work wa
different t or more streihul than that per-
formed by other employees, this should
ie explained.

8. Document any personnel actions describ-
edl in the employee's statement, such as
changes in sPsignment, -giteynce filed by
lthe employee, and other adverse person-
nl action.

S9A e the i number of hours worked per
day, days per .week and the extent of
wovrtime dty worked.

10. Provid a day4y-day citing of leal e and
leave without pay used due to this condi-
tin.

11. Attach copiesofte employee's:

a. SF-171. App04eM0ion for Employment

b. PosiUin dc friptian with physical re-
quirements.

c. Presmptoyame t medical examination.

d. All. other pertinent medical eportsp
waillable.

e. Moat recen S 0, iNoticatdion of
Pesoninal AcPnf.
I'-jt^tar^rc k j~iii


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Attachment to WPM Ltr. 810-8




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Attachment to FPM Ltr. 810-8


Required in Support of a Claim for
ated Pulmonary Illness (not asbestosis)


UAS. Department of Labor
Employment toandr Admlnistration
Dins of Workers' Campwntion Progrmis


ARI FILING A CLAIM POR A PULMONARY CONDITION NOT RELATED TO EXPOSURE TO ASBESTOS. THIS CHECKLIST
*a THE INOR11MATIONteSDSD PROM YOU AND YOUR EMPLOYING AGENCY. All of thM following nfomtion should be ubmltud
wCA2. Pissme Mtus the shm dilit with your tumwnnt oetached. Chck off msh inm h is completed or let us know when w cn umen the
5t. All entdw fubmlit shonuM i bi fbgl and mletc.
p I- U-- p- --


PROM EMPLOYSe


bh the work conditions which
:,wor aggravated your pulmonary
it in luiltd types of irritants, dates
mWii and hours per day. Describe
v Oy naliar taken.

ii lg:' development of the present
irFw condItion and treatment from.


F Kpur smoking history to include
lttaend years (dates) you smoked.

Owi hisbtn of previous .pulmonary
|i~sc include dates and nature of
nad: treatment records from all
ain* hospitals where you were


,ta: Iward a medical report which


BdB POfeanminnat onand treatment.



hl.u. ds.riptmion of findings.

M baul of all diiostic tesm.



e cliniua course of treatment


icts opinion, with"reasons for
sl iht opinion, as to the relationship
ibewnen any condition you may have
iw factors of employment listed in
hiale.1.


4 I I .


Forn CA-3P5
Augut 1985


S


FROM EMPLOYING AGENCY J

6. Review and comment on the employee's
statements provided in response to ques-
tions 1-5. Give periods, degree and
nature of exposure. Explain safety pre-
cautions. Give full details of any tests
which were made to determine the con-
centration of irritants. Have other em-
ployees been similarly affected?

7. Provide a day-by-day listing of leave and
leave without pay used due to this condi-
tion.

8. Attach copies of the employee's:

a. SF-171, Application for Employment.

b. Position description with physical re-
quirements.

c. Preemployment medical examination
and any other pertinent medical re-
cords.

d. Most recent SF-60, Notification of
Personnel Action.


(15)




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Attachment to FPM Ltr. 810-8 (17)



,6vkjvme Required in Support of a Claim for U.S. Department of Labor
Vo(brkr9ftated Psychiatric Illness Employmentn Standards. Administration
Office Workers' Compenaton Proarams
t0,,0AEt FILING A CLAIM FOR A PSYCHIATRIC CONDITION, THIS CHECKLIST DESCRIBES THE INFORMATION NEEDED FROM YOU
0 R" EMPLOYMN AOENCY, AJI of the fallowing Information should be submitted with Form CA-2. Please return the checklist vwth Vowr
11tool od. Chock off each itm aso it Is completed or lot us know whop we can expect the Information. All material i submitted should be loomsl

FROM EMPLOYEE FROM EMPLOYING AGENCY V*0

ak detailed chronological description 7. Review and comment on the employee's
O'articular employment factors statements provided in response to ques-
quY believe caused your condition. tions 1-5. Submit statements from wit-
W, *tify dame, periods, events, nesses, if appropriate.
Ikaokved, atc.
8. Provide a detailed statement describing
progress and development of the the duties of the employee and the man-
oondition from its beginning. ner in which the duties were performed. If,.
the work was different or more stressful
'previously suffered from this or than that performed by other employees,
o ition? If so, give details this should be explained.
,disability and treatment
Wrssalphysicians and hospitals 9. Document any personnel actions describe,
you wone triiated. ad in the employee's statement, such as
J changes in assignment, grievances filed by
'brie desripton o you peronalthe employee ', and other adverse person-
twfobbes, and any other em- e ctos
10. Give the number of hours worked per -
day, days per week and the extent of,
riarges or other sources of stress overtime duty worked.
sesnllife occurring in the same.
11. Provide a day-by-day listing of leave and
leave without pay used due to this condi-
irforward a medical report as de- tion.
-nthe revems.

12. Attach copies of the employee's:

a. SF-171, Application for Employment.

b. Position description with physical re-
quirements.

c. Preemployment medical examination.

d. All other pertinent medical reports
available.
e. Mont recerit SF-50, Notification of
Personnel Action.




I t1 1112 l8lII1 IIHI i li 111
3 1262 08741 8595




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