Printing - FECA-PT2 - National Association of Letter Carriers

(5) SUE - - Suspension for no CA-1032. Used by the CE when the claimant fails to
complete and return Form CA-1032.
2-0812 Exhibit 1: PN Memo Example
Subject: PN Memorandum to the File
File Number: 123456789
Employee: Claimant Name
Issue: The issue is whether the case should be placed in a “PN” status since the claimant has no
wage-earning capacity or re-employment potential for the indefinite future.
Requirements for Entitlement: In order for the case status to be updated to PN, the medical evidence
must demonstrate that the accepted medical condition(s) has reached maximum healing or that no further
improvement is anticipated. Additionally, the file must reflect that the claimant has no wage-earning
capacity due to the severity of the claimant's medical condition and/or vocational prospects in the
claimant's commuting area.
Background: The claimant, born 03/08/1944, was employed as Border Patrol Agent with the U.S.
Department of Homeland Security. On 07/25/2002, the claimant was injured when he lifted a tire from
the bottom of a stack and then slipped and fell, hitting his head. The claimant was unconscious for 45
minutes and hospitalized for several weeks. The claim was accepted for a herniated disc L4/5 without
myelopathy, cervical herniated disc C4/5 and closed head injury. The claimant has not returned to work.
He has had two work related surgeries for his cervical condition and a lumbar fusion.
A request for an updated medical report was sent to the attending physician, Dr. John, on 06/10/2009. No
response was received so it was determined that a second opinion evaluation was necessary. The
appointment was scheduled for 08/21/2009 with Dr. Henry, a neurologist. Prior to the appointment, the
physician was provided with a copy of the medical records on file, a Statement of Accepted Facts, and
specific questions to answer. Dr. Henry provided a thorough and well rationalized report. He opined that
the claimant continues to suffer from a herniated disc in the cervical spine and failed back syndrome as a
result of the spinal surgeries. Dr. Henry also indicated that the claimant continues to have severe
cognitive deficits from the closed head injury. He may not return to work and continues to have severe
physical restrictions as indicated on the OWCP-5.
Basis for Decision: Dr. Henry provided a well-rationalized, comprehensive opinion, including objective
findings, and his opinion was based on an accurate history of the work injury. He provided a substantial,
detailed discussion of his medical opinion. Based on Dr. Henry’s report of 08/21/2009, the claimant is
totally disabled due to the work injury, and his condition is not expected to improve.
Recommendation: The employee’s wage-earning capacity has been considered, including the following
factors: nature of injury, degree of impairment, usual employment, age, qualifications for other
employment and availability of suitable employment. The evidence of file establishes that the claimant
remains totally disabled for all work and his condition is not expected to improve. The case therefore
FECA-PT2 Printed: 06/08/2010 394