Printing - FECA-PT2 - National Association of Letter Carriers

(twice the award for loss of function of one lung) to obtain the number of weeks payable; all
such awards will be based on the loss of use of both lungs.
In cases involving anatomical loss by traumatic injury or surgery, the evaluation will also be
based on loss of lung tissue by weight or volume, and the award will be based on these
factors if it results in a greater percentage of loss than one based on loss of respiratory
function. Anatomical loss awards will be made for one or both lungs as appropriate.
(2) Impairment due to pain. Impairment applicable to pain is inclusive as a component
of the medical condition (diagnosis) and not measured separately unless the pain does not
correlate with objective findings or body part dysfunction. Chapter 3 of the Guides discusses
evaluation of pain if it is not classifiable in the diagnosis based impairment. An example
would be fibromyalgia or pain due to a sprain where no objective findings or identifiable
abnormalities are noted. In no circumstances though should the pain-related impairment
developed under Chapter 3 be considered as an add-on to impairment determinations based
on the criteria listed in Chapters 4 – 17. When pain is the sole impairment, the physician
should have the claimant complete Appendix 3-1 of the AMA Guidelines, Sixth Edition - Pain
Disability Questionnaire (PDQ), or obtain the necessary information in some other format.
(3) Impairment resulting from an injury to the spine. While the FECA does not allow
payment for impairment to the spine, a schedule award can be paid for the extremities if a
spinal injury leads to impairment of the arms or legs. Impairment to the upper or lower
extremities that is caused by a spinal injury should be rated consistent with the article
“Rating Spinal Nerve Extremity Impairment Using the Sixth Edition” in the July/August 2009
edition of the The Guides Newsletter published by the AMA. This newsletter, which has
been reproduced with the permission of the AMA, is Exhibit 4 in PM 3-0700.
b. Evidence Required. To support a schedule award, the file must contain competent medical
evidence which:
(1) Shows that the impairment has reached a permanent and fixed state and indicates
the date on which this occurred ("date of maximum medical improvement" or MMI);
(2) Describes the impairment in sufficient detail for the CE to visualize the
character and degree of disability; and
(3) Gives a percentage of impairment based on a specific diagnosis, not the body as a
whole (except for impairment to the lungs). In members with dual functions, the physician
should address both functions according to the AMA Guides.
c. Obtaining Medical Evidence. The attending physician should make the evaluation whenever
possible. The report of the examination must always include the following:
(1) A detailed report that includes history of clinical presentation, physical findings,
functional history, clinical studies or objective tests, analysis of findings, and the
appropriate impairment based on the most significant diagnosis, as well as a discussion of
how the impairment rating was calculated.
FECA-PT2 Printed: 06/08/2010 300