D.C. Mun. Regs. tit. 7, r. 7-110

Current through Register 71, No. 45, November 7, 2024

Rule 7-110 - CONTROVERSION OF COP

110.1

COP shall not be furnished if controverted. COP may be controverted in the following situations:

(a) When the traumatic injury occurred off the employing agency's premises and the employee was not in the course of employment. For the purpose of this section, course of employment means acting in furtherance of the scope of the employing agency;

(b) The employee was not in the course of employment;

(c) When the traumatic injury was caused by the employee's willful misconduct, when the employee intended to bring about the injury or death on himself or herself or another person, or when the employee's intoxication was the cause of the injury;

(d) When the traumatic injury does not prevent the employee from working;

(e) When the employee was not in active pay status at the time of traumatic injury (for example, in the case of leave without pay or absence without official leave);

(f) When the stoppage of work first occurs thirty-one (31) days or more after the date of injury;

(g) When the employee initially reports the injury after termination of employment;

(h) When the Program denies the compensation claim;

(i) When the disability was not caused by a traumatic injury;

(j) No notice was provided pursuant to 2319 of the Act;

(k) When the employee fails to comply with §§ 107 and 108 of this chapter;

(l) If the employee is not eligible for COP;

(m) When the employee fails to return to work, when offered alternative work that accommodates any limitations arising out of the disability; or

(n) When the medical evidence does not support the claim for COP.

110.2

If any provisions of § 110.1 apply, the employing agency may controvert COP by completing the indicated portion of Form 2 and submitting detailed information in support of the controversion to the Program. The employing agency may rely on information submitted by the employee or obtained through investigation.

110.3

Failure to provide evidence in support of an employee's out-of-work status may result in controversion of COP for that pay period.

D.C. Mun. Regs. tit. 7, r. 7-110

Notice of Final Rulemaking published at 28 DCR 2307 (May 22, 1981); repealed and replaced by Final Rulemaking published at 59 DCR 8766, 8775 (July 27, 2012); amended by Final Rulemaking published at 64 DCR 6325 (7/7/2017); amended by Final Rulemaking published at 66 DCR 4246 (4/5/2019)

Authority: Chief Risk Officer of the Office of Risk Management (ORM), Executive Office of the Mayor, pursuant to the authority set forth in section 2344 of the District of Columbia Government Merit Personnel Act of 1978 (CMPA), effective March 3, 1979 (D.C. Law 2-139; D.C. Official Code § 1-623.44 (2012 Supp.)); section 7 of Reorganization Plan No. 1 of 2003 for the Office of Risk Management, effective December 15, 2003; and Mayor's Order 2004-198, effective December 14, 2004