Printing - FECA-PT2 - National Association of Letter Carriers

evidence from physicians who have not examined the claimant.)
2-0810-8 Requesting Clarification from the Attending Physician
8. Requesting Clarification from the Attending Physician. This paragraph addresses when and how
the CE should obtain further medical information from the attending physician.
a. Sound medical decision-making will often require the CE to request clarification from the
attending physician rather than review by the DMA. Moreover, the attending physician will be a
primary source of contact regarding medical status, treatment plans, return to work projections
and descriptions of work limitations. For example, because of a discrepancy between complaints of
disability and objective findings of disability the CE questions whether or not an injury-related
disability continues; the appropriate first line of medical development may be a query to the
attending physician. If an OWCP Nurse (RN) is involved in the case, the CE may confer with the
RN regarding specific questions to be asked, and may also ask the RN to contact the attending
physician.
The advantage of this method of development is that a satisfactory reply from the attending
physician may neatly and quickly dispose of the issue. The CE must ensure, however, that the
attending physician's reply really does dispose of the issue (if the CE has doubts, referral of the
issue to the DMA would be appropriate). Other issues which may require such inquiry are the
extent of permanent impairment and disability, date of maximum improvement, work tolerance
limitation, and course of medical treatment.
b. If an examination, evaluation, or other specific service is requested, prompt pay procedures
must be followed. If the physician could provide information based on a review of records and
familiarity with the patient, the Prompt Payment Act is considered not to apply.
c. The time allowed for the attending physician's reply should be carefully monitored. If the
reply is not received within 45 days, or if the reply is equivocal, the CE should consider obtaining a
second opinion.
FECA-PT2 Printed: 06/08/2010 333