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General Information
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HR Advisor
May Human Resources Advisor Volume 2, Issue 5

Medical Care

If you are claiming a traumatic injury, your employing agency may have issued you a Form CA-16 so that you could obtain medical treatment right away. This authorization covers non-surgical treatment and continues for up to 60 calendar days from the date of injury.

If your case is approved, you will remain entitled to medical treatment for your accepted condition. However, if your case is denied, the authorization provided by Form CA-16 will not be valid after the date of denial.

Form CA-16 is not issued for occupational disease cases.

You have the right to select the first doctor who treats you for your injury. If that physician refers you to a specialist, OWCP will honor that referral as long as it is for the work-related condition. If you are first seen by a physician designated by your employer, you still have the right to choose your treating physician. If you wish to change physicians from this initial choice, you must request approval from OWCP. Send a letter stating your reasons for wanting this change, along with the name, address and specialty of the physician to whom you wish to change. OWCP will advise you of their decision in this matter. OWCP will only pay bills from the physician you chose first, until a change in physician is approved.

The FECA recognizes chiropractors as physicians only to the extent that their treatment consists of manual manipulation of the spine and only where the accepted condition is a subluxation of the spine. This subluxation must be shown by x-ray to exist. The x-ray must be taken shortly after the claimed injury. The chiropractor's report must provide an exact diagnosis of your condition based upon this x-ray and explain how the subluxation is related to the claimed injury. Referrals by a chiropractor for other treatment must be approved by OWCP in advance.

If your injury requires physical therapy, it is usually authorized for the first 120 days from the date of injury. OWCP will need further medical support for physical therapy beyond 120 days. OWCP must approve in advance any surgery or procedure other than emergency surgery (that is, a procedure which must be performed right away to preserve life or the function of an organ or body part). You (or your medical provider) should contact OWCP for authorization at least 30 days before the intended date of the procedure. OWCP will advise you of the information needed to determine whether they can pay for the requested procedure.