OWCP and Medical Reports

[jimespivey]

Today, just like everyday, I recieved another e-mail about getting a claim denied. An employee was sent a denial because the was not sufficiant evidence to support claim. This is not an uncoomon occurance. BUT there is an easy fix to all of this. It's called....educating your doctor. According to the Federal Employees Compensation Act (FECA governs all Federal Work Comp), employees MUST have certain things in there Medical Reports. The following is the exact law:

TITLE 20--EMPLOYEES' BENEFITS

CHAPTER I--OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR

PART 10_CLAIMS FOR COMPENSATION UNDER THE FEDERAL EMPLOYEES' COMPENSATION ACT,

Subpart D_Medical and Related Benefits

Sec. 10.330 What are the requirements for medical reports?

In all cases reported to OWCP, a medical report from the attending
physician is required. This report should include:
(a) Dates of examination and treatment;
(b) History given by the employee;
(c) Physical findings;
(d) Results of diagnostic tests;
(e) Diagnosis;
(f) Course of treatment;
(g) A description of any other conditions found but not due to the
claimed injury;
(h) The treatment given or recommended for the claimed injury;
(i) The physician's opinion, with medical reasons, as to causal
relationship between the diagnosed condition(s) and the factors or
conditions of the employment;
(j) The extent of disability affecting the employee's ability to
work due to the injury;
(k) The prognosis for recovery; and
(l) All other material findings.


I cannot stress how important it is to have this. What I have done for all of the docors I use is a form letter. I have made up each one of these as a bullet and have them copy and paste on their letter head and fill it out. I have NEVER had one go the second time to denial after using these guidelines. I hope this helps someone out....

Jimmy

[buda]

JP,

Could you post a copy of this form for to donwload? Wordperfect would do.

Thanks

buda

[Rocky]

I am a new user on this chat room, I like to find out if I take the vocational training which is one of my option can I retired with in seven years I have left on the BOP. I was told by someone from work that in seven years I will receive a letter saying if I want to retired. I like to find out if is true before I make any decisions. if someone knows about this issue and can help me I'll appreciate your response.

[buda]

Originally Posted by Rocky

I am a new user on this chat room, I like to find out if I take the vocational training which is one of my option can I retired with in seven years I have left on the BOP. I was told by someone from work that in seven years I will receive a letter saying if I want to retired. I like to find out if is true before I make any decisions. if someone knows about this issue and can help me I'll appreciate your response.

Look I met Jim at at the Regional Caucus in LA this year. He is very educated in this area and I'm sure he will contact you. Good Luck...and be ready for a fight.

[SeaLom94]

Originally Posted by buda

Look I met Jim at at the Regional Caucus in LA this year. He is very educated in this area and I'm sure he will contact you. Good Luck...and be ready for a fight.

I was at the Caucus too. Were you in his class?