Printing - FECA-PT2 - National Association of Letter Carriers

made. If the restriction leading to the wheelchair/scooter also prevents the claimant from driving without
it, then the vehicle modification would be compensable. On the other hand, if the scooter was provided
because the claimant cannot walk long distances but is able to drive an unmodified vehicle, then the
OWCP is not responsible for vehicle modifications. In this instance, there is no injury-related restriction
that requires the claimant to drive a modified vehicle. (See, M.B., Docket No. 06-701 (issued December 4,
2006) (ECAB held that appellant’s physician did not explain why appellant's employment-related accepted
conditions required medical treatment which could only be accommodated by purchase of a van.)
If the evidence of record fails to establish medical necessity in consideration of the above criteria, the
claimant should be provided with 30 days to submit the needed medical documentation. The questions to
the physician should be specific in regard to the injury related restriction which necessitates the requested
modification.
Requests for modification are not routinely sent to the District Medical Advisor (DMA). However, if there is
a complicated medical issue that requires DMA review, the medical evidence should be forwarded to the
DMA for an opinion on the necessity and work-relatedness of the requested modification(s).
If medical eligibility is established, then the CE should proceed with the technical development of the
proposed modification in conjunction with the criteria outlined in paragraphs 5, 6 and 7 by requesting a
detailed proposal for the requested modifications. These proposals will address the technical, financial and
practical elements of the requested modifications. Under certain circumstances, OWCP may assist in
developing such proposals by referring the case to a Rehabilitation Specialist (RS), who will assign a
Rehabilitation Counselor (RC) to assist the claimant in developing a detailed proposal for the requested
modifications. The case may also be referred to a Field Nurse (FN) in some instances to assist with this
process.
If the proposed modification is not supported, a formal decision is required as outlined in paragraph 8.
2-1800-5 Vehicle Modifications
5. Vehicle Modifications.
a. General Criteria. No vehicle modification should be undertaken without a signed agreement
that specifies the nature of the modification and the claimant’s responsibilities and obligations
under the agreement.
(1) Modifications to a vehicle must be established as necessary and desirable for
increased mobility or independence by a recommendation of a physiatrist or other medical
specialist appropriate to the type of injury sustained. The medical evidence must establish
that the requested modifications are needed because of restrictions caused by the accepted
condition(s). See paragraph 4.
(2) Modifications of the present vehicle must be explored before considering a new
purchase.
(3) Modifications must be consistent with the claimant's pre-injury standard of living and
should approximate that standard insofar as practical. If accessories and equipment are
needed for the claimant's present vehicle, OWCP will modify it if it is practical to do so, as
FECA-PT2 Printed: 06/08/2010 716