Printing - FECA-PT2 - National Association of Letter Carriers

(b) The medical evidence presented by the claimant's physician supports the fact
that the claimed condition or disability is not related to the accepted factors of
employment, or the physician fails to provide any opinion on causal relationship
following a request from the OWCP.
(2) Notification. See FECA PM 2-1400 for a discussion of disallowances. If one of the
five basic requirements is not met because information requested by OWCP was not been
received, the decision must explain in detail why the missing evidence is so crucial that the
unresolved issue cannot be resolved or further developed without it.
2-0806-8 Managing the Claim
8. Managing the Claim. The purpose of this paragraph is to describe the actions which the CE should
take in accepted claims with injury-related disability.
a. Payment of Benefits. Where a case is accepted, the CE should initiate payment of medical
and wage loss benefits. The CE should determine the date of return to work according to the
medical matrix or by the physician's estimated return to work date, whichever is later. Appropriate
letters should be released.
b. Nurse and Vocational Rehabilitation Services. Where the case has been accepted within 90
days of submission, the CE should refer it for OWCP nurse services to assist in medical
management and return to work (see FECA PM 2-0600.5). Where the case has been accepted
later than 90 days from submission, the CE should consider referral to a nurse if such services
would likely be beneficial. Otherwise, the case should be referred for OWCP vocational
rehabilitation services to assist in return to work (see FECA PM 2-0813).
(1) If the claimant has not returned to work at the estimated time, an intervention is
required. If the physician opines that disability is ongoing, the CE must obtain a progress
report questioning the physician as to how long the injury-related component is expected to
continue and the level (total or partial) of the injury-related component.
(2) If permanent impairment has resulted, or is likely to result (either with or without
disability for work), it may be necessary to develop the claim further to establish its extent
and degree so that a schedule award may be paid.
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