Printing - FECA-PT2 - National Association of Letter Carriers

Leanna Garlington, 37 ECAB 849). Refusal to schedule an examination at the direction of the office
is also insufficient to invoke section 8123(d) (see Herbert L. Dazey, 41 ECAB 271.
2-0810-15 Health Facility Membership and Special Equipment
15. Health Facility Membership and Special Equipment. This section describes procedures to be followed
when a claimant requests authorization for membership in commercial health clubs/spas and/or purchase
of commercial equipment/furnishings not commonly prescribed by physicians. OWCP will not approve an
elaborate service or appliance where a more basic one is suitable.
a. Health Club/Spa Membership. Such memberships may be authorized if needed to treat the
effects of an injury. If the case is under nurse intervention, any question regarding the use of
health club or spa facilities should be discussed with the RN. In all cases where such memberships
are at issue, the CE must determine that the membership is likely to be effective and cost-efficient,
given that exercises performed at such facilities are generally done without supervision, the term
of membership may be incompatible with the duration of the prescribed program, and membership
dues often include charges for services not related to the treatment regimen.
Whenever a request for payment of health club/spa membership is received, the CE should obtain
the following information:
(1) From the treating physician (see Exhibit 1):
(a) A description of the specific therapy and exercise routine needed to address
effects of the work-related injury, including the frequency with which exercises
should be performed;
(b) The anticipated duration of the recommended regimen (is it a trial period or
an ongoing program);
(c) An opinion as to the actual/anticipated effectiveness of the regimen,
treatment goals attained/sought, and frequency of examinations to determine the
ongoing need for the program;
(d) A description of the specific equipment/ facilities needed to safely perform the
prescribed regimen;
(e) The nature and extent of supervision, if any, required for safety while
claimant is performing the exercises; and
(f) An opinion as to whether the exercise routine can be performed at home, or
recommendation as to what kind of public or commercial facility can provide the
exercise routine.
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