(3) Orthopedic Shoes. The initial interaction with claimants occurs during the initial telephone call. However, only a Rehabilitation Specialist can authorize an FCE in connection with an ORP (see PM 2-813). Also, the FN may discuss the post-operative plan with the physician by telephone and monitor the claimant's compliance with these orders. 4. Under no circumstances, however, should the CE telephone the specialist for elaboration of the report as information obtained in this manner cannot be considered probative medical evidence and bias may be inferred as a result, leading to exclusion of the report. If the physician is late in submitting the report, the nurse contacts his or her office and appraises him or her of this fact and obtains a copy of the report as soon as possible. In scoring the application, it is important for the reviewer to first check to see if the work experiences indicating case-management and med-surgical expertise as well as the R.N. You are advised to seek legal and professional advice first. To do so, the nurse should keep in mind the following guidelines: (1) The focus of the program is the return to work and the claimant should be encouraged to participate actively in the treatment plan and in the resolution of problems which may impact on the recovery effort. Appliances may be either personal or non-personal in nature. The Regional Director will decide all reconsiderations within 90 days of receiving the request. Unless the case file already contains a reliable medical report which fully meets OWCP requirements, the CE should refer the claimant for audiological evaluation and otological examination which addresses the relationship of any hearing loss to the employment and the degree of any permanent impairment. (c) Upon receipt of any clarifying information, the CE should again review the report to ensure that it is complete and pertinent to the questions asked. 2. 8. If these are not forthcoming or if the physician refuses to communicate with the nurse, the intervention with the claimant and employing agency should continue and the MD's refusal to participate should be communicated to the CE. Medical Services. The primary focus of the nurses' activities will be to encourage recovery and the return to work through direct interventions with the claimants, treating physicians, and employing agencies. Supervising Field Nurses. The biggest adjustment from previous editions involves the rating of permanent impairment based on a specific diagnosis rather than the extremity or organ system. The Medical Management Assistant (MMA) should maintain careful records in order to demonstrate compliance with these procedures. (2) The name and address of the physician to whom he or she is being referred, as well as the date and time of the appointment. 3. Every effort should be made to correct unacceptable or deficient practices by letters and telephone calls before taking further action. General Information for Physicians, Form CA-21 (Link to Image) Pages 1-2, 4. (yrs 1-2) English 101. You may wish to itemize these charges in the bill. Follow-up phone calls should be made in cases where no report has been received in the office within 30 days of the examination. b. Transportation by ambulance may also be authorized if required, and if travel by air ambulance is indicated, or air ambulance is found to be more economical and expeditious than ordinary commercial air transportation, approval may be granted for this service. c. Arterial Blood Gas Study, administered at rest. This application provides for consistent rotation among physicians and records the information needed to document the selection of the physician. A return to work date is also captured on this system. (4) Advice to RD. d. Failed, neglected, or refused, on three or more occasions during a twelve-month period, to submit full and accurate medical reports, or to respond to requests by the Office for additional reports or information, as required by the FECA and by 20 C.F.R. b. Such procedures as rhizotomy, injection treatment for varicose veins, chordotomy, neurectomy, etc., will not normally be authorized solely because of chronicity of a condition. The functions of the DMD include the following: a. We pay our respects to all members of the Aboriginal communities and their cultures; and to Elders both past and present. Fractions should be rounded down from .49 or up from .50. Standardized recorded materials should be used rather than live voices. Specific supplies and appliances and the conditions under which they may be authorized are as follows: a. b. Serious or persistent occurrences of excessive billing should be reported to the District Director (DD), and the DMA or DD should telephone the provider to discuss the problem. If the claimant states that some services or supplies were never furnished and the provider is a physician, the CE will refer the case to the DMA, who should write to the physician, describe the apparent false billing, and request an explanation within 30 days. Evaluators will rate impairment according to the diagnosis representing the source of the most impairment in the given bodily region. ), the scheduler will update the application with an appropriate bypass code. The purpose of this chapter is to describe the procedures involved in medical evaluation of claims for such awards. Therefore, these reports are usually considered as supplemental information although some narrative fitness-for-duty reports may be sufficiently probative in and of themselves. 4. Please find below some details about our program, its requirements and claims processing system which may be of help to you and your office staff. 5. Failure to meet the above requirements or to return the form by the deadline date will result in disqualification of your application. For example, a claimant with an injury to the penis has a Class 3 penile (sexual) whole person impairment amounting to 15%, and Class 2 urethral impairment of 10%. c. All meausurements obtained. Calibration Requirements for Accreditation of an Audiological Facility by the Professional Services Board, 7. 2. Where significant amputation of the soft tissue of the tip of the first phalanx has occurred with no loss of bone or bony tuft, the award shall be one-fourth the amount payable for the loss of the first phalanx or 13 percent of the digit. Purpose. District offices may use various methods of recruitment, including: (1) Writing or telephoning physicians listed in national or local rosters of medical specialists. The staff nurse will refer cases sequentially to the field nurses using a geographic rotation. The physician's reasoned opinion as to the relationship between the condition found and factors of Federal employment. Otherwise, the implication of bias may arise. Detailed instructions for CEs concerning the preparation of SOAFs are contained in PM Chapter 2-809. The physician should be provided with the following: (1) A statement of accepted facts (SOAF); (2) A list of pertinent questions or issues to be addressed; (3) Copies of medical records from the case file based on the age of the case and/or the nature of the referral as follows: (a) For unadjudicated case referrals and all referrals for medical management, disability management or surgery: (i) All operative reports regardless of age; (ii) All diagnostic tests regardless of age; and. c. Identifies and evaluates the credentials of physicians willing to serve as consultants (DMAs) to manage workloads. Charges for child care, pet care, and home security may be paid when incurred in the course of securing medical services and supplies. As a sub-specialty under the Board of Preventive Medicine, occupational medicine physicians are specialists in the field of workplace injuries and illnesses and their causal associations. (b) A request to change from the care of a specialist to the care of a non-specialist may not be denied without considering whether the treatment provided by the new physician is reasonable and necessary. These facilities are equipped to provide immediate assistance and/or to refer employees to local physicians or emergency care facilities. b. It is customary to furnish copies of medical reports of authorized examinations in connection with an injury to medical departments of other Federal establishments upon request. Upon receiving the list, the district office should detach and reproduce the section of the list covering physicians within its jurisdiction and distribute it to local Federal agencies. Generally it will include some terms, either expressed or implied, that will form the basis of the agreement. Pure-tone air conduction thresholds should be obtained for each ear at 500, 1000, 2000, 3000, 4000, 6000 and 8000 Hz. You can keep up to date on everything at Boilermakers Country by liking and following our Facebook page: Purdue Boilermakers on Sports Illustrated/FanNation. The FECA provides that compensation may be paid for total or partial loss, or loss of use of, certain parts of the body which are specified in the FECA itself and in the regulations. If the CE has identified the need for examination by two kinds of specialists, for instance an orthopedist and a psychiatrist or clinical psychologist, the scheduler will arrange two separate examinations without asking either physician to coordinate the results. Where the DMA feels such emphasis is necessary, he or she should prepare a memorandum for the file. A claimant who refuses to be visited may nonetheless allow intervention by telephone. The RD will ensure that thorough and reasonable steps were taken by district office staff to curtail unacceptable provider practices. The medical specialist should be asked to consider the following issues: (a) Diagnosis. The staff nurse needs to issue verbal warnings to the field nurse after the first two violations, issue written warnings to the field nurse after the second two violations, and terminate the field nurse's working relationship with OWCP after the fifth violation, ensuring that there has been 30 days' prior written notice. 1. 10.455(c). (2) Description of Impairment. The Staff Nurse is responsible for procuring, training and managing Field Nurses who will work directly with OWCP claimants in the return to work effort. Referral for vocational rehabilitation services will likely be more appropriate in most occupational illness cases. by frustration where the contract cannot continue due to some unforeseen circumstances outside the parties control. WebWhat Are My Rights? (3) Need for Surgery. As a rule, no more than four hours of compensation or continuation of pay should be allowed for routine medical appointments. .manual-search ul.usa-list li {max-width:100%;} Undergrad. Payment may, however, be made to a physician for review of a file and preparation of a report. 1. Only those medical and related expenses of the donor which are necessary to secure treatment for the employee are allowable. Following are guidelines under 8107 of the Act for calculating schedule awards for specific conditions: a. Ph.D Degree. The Office relies on written medical reports to justify awards for compensation, support payment of medical expenses, and monitor the quality of care being provided. The selecting official (staff nurse) has the authority to determine the extent of the competitive range based on a fair and reasonable estimate. (1) After obtaining all pertinent factual evidence, the CE should consider referral to a pulmonary specialist. The law provides for repair or replacement of injured natural and fixed artificial teeth. f. X-rays, Electrocardiograms, and Slides. Procedures for developing and adjudicating requests for health club/spa membership are provided in PM Chapter 2-810.15. b. The purpose of this chapter is to describe the bases for exclusion and the procedures for excluding and reinstating medical providers.