Printing - FECA-PT2 - National Association of Letter Carriers

(3) Additional Medical Opinion. The CE may need to obtain additional medical evidence.
Unless the medical history of the case demonstrates that an inquiry to the attending
physician will not be productive, it is usually proper to make at least one request to that
physician before arranging a second opinion referral.
c. Request Information. Further medical opinion may be requested from attending physicians,
second opinion specialists, and referee specialists. The roles of these physicians and the weighing
of medical evidence are addressed in FECA PM 2-0810.
(1) Mechanics of Referral. The procedures for referring cases to second opinion and
referee specialists are addressed in FECA PM 3-0400.
For referrals to an attending physician, the CE should write directly to the physician and
provide the information shown in Exhibit 1. (In psychiatric cases, the CE should ask the
physician to provide a copy of the report to the claimant only if he or she feels it would not
be detrimental to the claimant.)
The CE should send the claimant a copy of this and all other letters to the attending
physician and advise the claimant that it remains his or her responsibility to ensure that the
required evidence is submitted, even though the OWCP is attempting to obtain the evidence
needed to adjudicate the claim.
(2) Statement of Accepted Facts. If a SOAF is needed, it should describe accepted
exposure and distinguish between factors which are accepted as occurring within the
performance of duty and those which are not.
(3) Questions to Physicians. The questions should address all unresolved medical issues
(see MEDGUIDE for sample questions related to specific diseases). The CE should:
(a) Include questions about diagnosis, causal relationship (with medical
reasoning), and nature and extent of injury-related disability for regular and light
duty.
With respect to causal relationship, it may be useful to provide the physician with the
OWCP's definitions of direct causation, aggravation, etc. (see FECA PM 2-805).
With respect to injury-related disability, the CE should be particularly careful to
clarify its extent and duration in cases involving aggravation of an underlying
condition.
(b) Word questions without using legal terms such as "causal relationship" and
"rationale".
For example, a request for rationale on the relationship between a claimant's heart
condition and factors of employment might be phrased as follows: "Please explain
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