Filing a CA-2 Claim
ATTENTION ALL CARRIERS THAT HAVE FILED A CLAIM TO OWCP. Once you receive a Development Letter YOU MUST CONTACT ME IMMEDIATELY. Call (631)-789-1616 so we can review your claim to determine what you need to do to help get your case approved. Failure to contact me could result in your claim being denied.
When you experience an occupational disease or illness, as a medical condition, that occurred due the work environment, over a period of time longer than a single work day or shift, a CA-2 should be filled out. Some of the most widely recognized occupational diseases / illnesses include carpal tunnel syndrome, arthritis and tendonitis.
A claim based on an occupational disease is filed with the Office of Workers Compensation Program (OWCP) on Form CA-2, “Federal Employee’s Notice of Occupational Disease and Claim for Compensation”. Employees must develop the medical information to support their claim of occupational disease at their own expense and submit the medical and factual evidence, through the employing agency, to OWCP. When you file a claim a CA-2 the employee has the burden of proving that the occupational disease is casually related to the employment.
A CA-2 claim can be more difficult to prove than a claim for a traumatic injury. An employee must provide two (2) documents when pursuing the claim to OWCP.
A detailed statement from the claimant, signed and dated by the employee, describing in very specific detail the conditions or factors of employment believed to be the cause of the occupational disease, and the time periods involved. Also the claimant must give a description of his/ her specific duties.
A detailed narrative medical report from the employee’s physician that is signed and dated, remember a Physician Assistant (PA) by itself is not acceptable under the guidelines of OWCP. Make sure it also contains dates of examinations and treatment(s), descriptions of tests given, results of X-rays, etc.
1. A written statement by the physician reflecting knowledge of the employee’s condition(s) of employment believed to be the cause of the claimed medical condition and resulting disability.
2. A definitive or conclusive diagnosis.
3. The physician’s opinion is written in definitive or conclusive terms.
4. Medical reasons for the physician’s opinion.
5. Period(s) of disability and the extent of disability during the period(s).
The claimant’s factual statement and the detailed medical report are related. Without the claimant’s factual statement, the physician does not have a proper “frame of reference” for his or her medical opinion. Many claims are denied due to the medical report does not reflect the full conditions of employment.
Many claims also fail due to the diagnosis and / or medical opinion are not provided in positive terms.
A speculative diagnosis is of little value, as is a medical opinion based on indecisive language such as “might be related” or “could very possibly be related”.
Finally, unless medical rational is provided by the physician, adjudication of the claim will be delayed until OWCP is satisfied that a full explanation of the basis of the physician’s medical opinion is in the case record, or the claim will, in all probability, fail.
Any questions on filing a CA-2 you can contact me at the branch at (631) 789-1616.
Have a safe summer brothers and sisters.
