Printing - FECA-PT2 - National Association of Letter Carriers

7. Adjudicating the Claim. The purpose of this paragraph is to address the factors leading to
acceptance or denial of OD claims.
a. Acceptance.
(1) Conditions. The claim may be accepted if:
(a) The medical condition is demonstrated by objective findings (clinical tests);
(b) The accepted factors of employment are competent to cause or contribute to
the diagnosed condition; and
(c) The accepted factors of employment are shown to have caused or contributed
to the accepted condition. The CE need not define in detail what portion of the
disability is due to employment factors and what is not.
For example, an individual with chronic bronchitis is exposed to fumes at work which
aggravate the bronchitis. It is not necessary to determine what portion of the
current disability predated the exposure and what did not. (However, it is important
to establish when the exposure no longer contributes to the symptoms or disability.
(2) Notification. The CE should advise the claimant by letter of the condition(s)
accepted, as required by 20 CFR 10.130. If the acceptance is for aggravation, acceleration,
or precipitation of a condition, the CE should so indicate in the letter. It may be helpful to
provide the claimant with the relevant definition.
Where the agency has challenged the claim, the CE should discuss the evidence supporting
the acceptance and explain how the evidence presented by the agency was considered.
b. Denial.
(1) Conditions. The claim should be denied if:
(a) Either fact of injury or performance of duty is not met.
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