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Indian Health Service The Federal Health Program for American Indians and Alaska Natives


     Indian Health Manual
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Part 1, Chapter 9:  Manual Appendix 1-9-C

Claim for Damage or Injury

  1. CLAIM FOR DAMAGE OR INJURY (SF-95).

  2. Any valid Claim for Damage or Injury (SF-95) and subsequent written material concerning the claim shall be sent directly to the IHS Claims Officer by the Area Property Management Branch.  Employees as well as members of the public, may submit claims if their personal property is damaged while on the premises of a Government installation.

    Tribal facilities under contract with the IHS, as per P.L. 93-638, have been extended coverage under the Federal Tort Claims Act (FTCA).  This is fully described in Indian Self-Determination Memorandum No. 92-1.  The FTCA states that a person covered by the FTCA is not personally liable for any negligent act committed while in the scope of employment under the contract.  The injured party's remedy is restricted to filing a claim against the appropriate U.S. Government Agency pursuant to the FTCA.  The employee is not subject to suit.

  3. Penalties for Supervisors Added to Compensation Act.

  4. Supervisors are reminded of the seriousness of failing to report incidents of injured employees as required.  Under the regulations for administering the Federal Employees' Compensation Act, an immediate superior is required to make a prompt report through established agency channels to the Office of Worker Compensation Programs for every injury which: (1) is likely to result in any medical charge against the Compensation Fund; (2) is likely to result in any disability for work beyond the shift in which the injury occurs; (3) appears likely to require prolonged treatment, result in future disability, or result in any permanent disability, loss of use of a member of the body, serious disfigurement, etc.; or (4) results in immediate death, or is likely to result in death.

    1. Public Law 86-767 (18 U.S. Code 1922) includes an amendment to the Act by the 86th Congress that makes supervisors liable to a fine of not more than $500, or imprisonment of not more than 1 year, or both, if convicted of:

      1. Willfully failing, neglecting, or refusing to make a report of any of the above.

      2. Knowingly filing a false report.

      3. Inducing, compelling, or directing an injured employee to forego filing of any claim for compensation of other benefits provided for under the Act, extension or application of it.

      4. Willfully retaining any notice, report, claim or paper which is required to be filed under the Act, extension, application or other regulations promulgated under it.

    2. The supervisor must see that prompt treatment is given the employee and that required compensation forms for civilian employees (CA-1, CA-2, etc.) are properly completed in duplicate and forwarded in accordance with established procedure.



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