Printing - FECA-PT2 - National Association of Letter Carriers

In addition, a primary goal of case management is to assist the claimant in returning to work within one
year if possible. The one year period is significant because Section 8151(b) of the FECA requires the
employing agency to offer the claimant his or her former position or its equivalent, "if the injury or
disability has been overcome within one year" after compensation begins. If the disability is overcome
after one year, the employer must make "all reasonable efforts" to rehire the claimant. In practice, this
means that in most cases there is a one-year window of opportunity for return to work with the employing
agency. It is therefore essential that a return-to-work agenda be emphasized early in the life of an
accepted disability claim, to take advantage of this limited opportunity.
2-0811-3 Intervention
3. Intervention. This term refers to an action by the CE, OWCP Nurse, or Rehabilitation Specialist, as
reasonable and appropriate to achieve the objectives in paragraph 2 above. An intervention may occur
when the medical evidence is incomplete or contradictory, or at a specific time, such as a date of
projected recovery, completion of a course of physical therapy, release from the hospital, or return to light
duty. At these times the CE will need to assess the case and intervene as necessary to achieve the
desired objectives.
The nature and extent of the intervention will be determined by what is necessary to resolve any medical
shortcomings and to ensure that indicated nurse and/or rehabilitation referrals are proceeding as desired.
2-0811-4 Initial Case Actions
4. Initial Case Actions. Once a claim has been accepted, certain actions will follow, tailored to fit the
circumstances of the particular case. The CE should:
a. Monitor medical care and evidence by considering any requests for diagnostic testing and
procedures after approving the claim. The CE should also request an updated medical report if
necessary. When an injury which is originally seen as minor results in disability exceeding early
expectations or in additional or changed diagnoses, the CE should ensure that this is fully explained
in the medical evidence and should request any clarification necessary, preferably via the OWCP
RN.
If the attending physician's estimate of the length of disability seems excessive for the injury
involved, or if it appears that the time frame of the medical matrix will be exceeded, the CE should
confer with the OWCP RN if the case is open to such referral, and if indicated, the CE or the RN
should ask the attending physician for an explanation or clarification of the estimate for the return
to work.
b. Determine the appropriate intervention if disability exceeds the period shown in the medical
matrix or the estimated recovery period stated by the attending physician. In some cases, a nurse
should intervene as soon as continuation of pay (COP) expires or when Form CA-7 is received.
c. Review the medical evidence to see that the following information is on file from the
attending physician:
(1) History of injury as given by the claimant.
(2) Objective findings from physical examination.
FECA-PT2 Printed: 06/08/2010 363