Printing - FECA-PT2 - National Association of Letter Carriers

Where appropriate, reports should include the physician's interpretation of laboratory tests and
diagnostic procedures. Tests for which such interpretation is necessary include, but are not limited
to, X-rays, EKG, EEG, EMG, cardiac and pulmonary stress tests, pulmonary function tests, biopsy
or surgical specimen pathology reports, ultrasound, visual field, echocardiograms, intravenous
pyelograms, MRIs, and CAT scans.
d. Medical Opinion with Rationale.
(1) Not all medical opinions require rationale. In a simple traumatic injury, such as a
knife cut which is reported to and seen by the physician promptly, there is no need to
obtain a rationalized explanation of causal relationship.
(2) When the relationship is not obvious or when there may have been an intervening
non-occupational cause, it is essential that the physician give his or her medical reasons for
relating the condition to the history obtained. A rationalized opinion is also necessary, and
should be requested, when disability appears to last beyond the time frame anticipated for
an injury of the type accepted (see the OWCP Medical Matrices, which are available on
Folioviews in MEDGUIDE).
(3) A medical opinion couched in such terms as "might be," "could be," or "may be"
does not have as much probative value as an opinion stated unequivocally. However, if a
sound medical reason is also given for the opinion, these expressions may sometimes
represent the physician's mode of expression and should not be taken as reflecting a lack of
conviction, whether for or against the claim.
Some physicians adhere more strongly than others to scientific methodology and prefer to
use qualified terminology. The word "probably" can nearly always be taken as a
redundancy, e.g. "probably related" means "related" and "probably preexisting" means
"preexisting." If there is any doubt, the District Medical Adviser should be consulted, and
clarification should be sought from the report physician if needed.
2-0810-7 Reviews by District Medical Advisers (DMAs)
7. Reviews by District Medical Advisers (DMAs). The purpose of this paragraph is to discuss the use
of DMAs' services.
a. DMAs have two broad technical medical functions:
(1) Evaluation of medical evidence and the rendering of medical opinions in the DMA's
own right. In this capacity the DMA may advise whether an accepted condition continues,
whether a newly claimed condition is employment-related, whether the length of disability
seems appropriate, or whether a recommended procedure or treatment is useful or
necessary.
(2) Interpretation and clarification of other physicians' reports. In this capacity the DMA
may evaluate a report for determination of the percentage of permanent partial impairment,
interpret test results, or "translate" technical language.
FECA-PT2 Printed: 06/08/2010 330