Continuation Of Pay Tracking Worksheet printable pdf download

Continuation of Pay Tracking Worksheet

Claimant Name:

OWCP Case Number:

Date of Injury:

Date of Notification:

Use this worksheet to track the dates and hours of Continuation of Pay (COP) authorized for this

claimant as a result of the injury case noted in the OWCP Case Number above.

Count

Date

Day Type*

# Hours

Count

Date

Day Type*

# Hours

__/__/__

*Day Type: W = Work Day; H = Holiday; N = Non-Scheduled Day

How to Track and Pay COP:

COP is payable for a maximum of 45 calendar days, and every day used is counted toward this

maximum.

•

Time lost on the day or shift of the injury does not count toward COP. Instead, the installation

must keep the employee in the pay status for that period using Hours Type Code LU and an

injury number equivalent to the month and day (MM/DD) of the injury.

•

The first COP day is the first day disability begins following the date of injury as long as that

date is within the 45 days following the date of injury. The only exception to this rule is when

the injury occurs before the beginning of the workday or shift, in which case the date of injury

is charged to COP. The installation must use Hours Type Code LT and an injury number

equivalent to the month and day (MM/DD) of the injury.

•

Any part of a day or shift, except on the day of the injury, counts as a full day toward the 45

calendar day total, however, the installation must only record Hours Type Code LT for the

portion of the day or shift where the employee was authorized for treatment or disability, and

code the remainder of the day to work hours, annual, or sick leave as appropriate.

•

Regular days off are included if COP has been used on the regular work days immediately

preceding or following the regular day(s) off, and medical evidence supports disability.

•

Leave used during a period when COP is otherwise payable is counted toward the 45-day

COP maximum as if the employee had been in a COP status.

Continuation Of Pay Tracking Worksheet