Printing - FECA-PT2 - National Association of Letter Carriers

d. The DMA has no authority to decide the facts in a case. However, the DMA may state
whether an accepted incident was competent to produce the injury claimed. The DMA must be
presented with a Statement of Accepted Facts (SOAF) to use as a framework for the medical
opinion requested. Where the DMA finds that a determination pertinent to the medical opinion has
been omitted, he or she should inform the CE of the additional factual determination needed to
place the case in posture for a rationalized medical opinion.
SOAFs and questions for referral to the DMA must not be entered on pre-printed forms. Such
forms offer structured questions which often do not meet the needs of the case, and they provide
limited space for SOAFs and rationale for medical opinions.
e. The ECAB has affirmed that a DMA may create a conflict in medical opinion necessitating
referee medical evaluation under the provisions of 5 U.S.C. 8123(a) (Harold Travis, 30 ECAB
1071). The CE must ensure, however, that the DMA's opinion is rationalized, and thus that it
creates a true conflict. For example, an unexplained "no" by a DMA to the question of whether
work-related disability continues is not sufficient. The rationalized opinion of the DMA will ensure
that a conflict in medical opinions of approximately equal weight truly exists. The value of any
report from a referee examination will be enhanced to the degree that well-reasoned opinions, both
"pro" and "con," are provided for review.
f. A DMA may provide an opinion which is not strong enough to constitute a conflict with the
opinion of the treating physician, but which is nevertheless of sufficient value to warrant additional
action. For instance, where an attending physician may state that a claimant is still disabled from
a work-related back strain six months post-injury, the DMA may state that a two-month recovery
period should have been sufficient. In this instance, referral for a second opinion examination
would be appropriate.
g. While a DMA may create a conflict in medical opinion, he or she may generally not resolve
it. Furthermore, a reasoned opinion by a DMA will not usually constitute the weight of the medical
evidence in an accepted disability case, even if the DMA is a Board-certified specialist in the
appropriate field of medicine and the attending physician is not a specialist and offers no rationale.
This is because the DMA has not examined the claimant while the attending physician has, a critical
function in determining extent and duration of injury-related disability.
h. In some instances, however, the DMA's opinion can constitute the weight of the medical
evidence. This occurs in schedule award cases where an opinion on the percentage of permanent
impairment and a description of physical findings is on file from an examining physician, but the
percentage estimate by this physician is not based on the AMA Guides. In this instance a detailed
opinion by the DMA which gives a percentage based on reported findings and the AMA Guides may
constitute the weight of the medical evidence (James Massenburg, 29 ECAB 850).
As long as the DMA explains his or her opinion, shows values and computation of impairment
based on the AMA Guides, and considers each of the reported findings of impairment, his or her
opinion may constitute the weight. The CE must ensure, however, that the DMA properly considers
all reported findings, gives rationale and uses the AMA Guides correctly in computing the
percentage. (See Susie Hall, 34 ECAB 1311, for a discussion concerning the weight of medical
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