The Right to Choose Your Own Doctor
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 in order to help get your case approved. Failure to contact me could result in your claim being denied.
I was recently reminiscing over this past holiday season I was thinking of one of my friends in my office how he would always say the day would be just a “ Walk in the Park”. That saying stayed in the office throughout our careers and everyone would joke about it prior to going out to delivering the mail no matter what the volume was or weather conditions. The opportunity of being out in the fresh air, unchained from a desk or stuck in an office all day, providing a valuable service to our customers, made the job rewarding.
Early in my buddies career he suffered a work-related injury while doing his “Walk in the Park”. He was walking up a stairway with a heavily loaded satchel when it slipped off of his shoulder, twisting his lower back. Back then it was not uncommon to deliver over 20 feet of mail including newspaper-sized mailings to every house, several days a week.
Like many Letter Carriers, he felt the injury was something he could “walk off.” He continued to deliver the route and reported the injury to the supervisor at the end of the day but did not fill out a claim form, thinking a night’s rest and a couple of Motrin would resolve the issue. He was wrong.
The next morning he could hardly get out of bed, so he called the office to report the injury and headed to the doctor’s office. He was lucky to be a career Letter Carrier with the NALC health care. His health plan allowed him to see an urgent care doctor who quickly diagnosed the injury and prescribed a combination of rest and physical therapy.
Later that day he went to the Post Office and filled out a CA-1, Notice of Traumatic Injury. Luckily, the injury completely healed over the course of the next week and he returned to work with no further problems.
Like most Letter Carrier injuries, his injury happened out on the street, away from any supervisor. There were no witnesses. Had he immediately stopped working after the injury and returned to the office, the supervisor would have been required to follow Federal Law and Postal Regulations in responding to the injury.
Know your rights
Foremost among those laws and regulations is the requirement to let injured workers know of their right to choose the doctor who will treat them. Some postal facilities have Postal Physicians or Contract Clinics and will take an injured worker for an initial examination. While the Postal Service has the right to take an injured worker to be examined, the injured worker has the right to refuse treatment.
Along with advising you of your right to choose a doctor, Federal Regulations require that the Postal Service issue you a Form CA-16 within four hours of reporting the injury. The CA-16 is a payment voucher that pays all medical benefits for up to 60 days. Form CA-16 must contain the full name and address of the qualified physician or qualified medical facility authorized to provide service. The authorizing official must sign and date the form and must state his or her title. Form CA-16 authorizes treatment for 60 days from the date of injury, unless OWCP terminates the authorization sooner.
A CA-16 should not be issued for an examination by a Postal Physician or Contract Clinic unless the injured worker agrees to be treated by them. For most injuries, it’s best that the injured worker, not the Postal Service, choose the treating doctor. After all who has your best interests at heart your doctor or a facility being paid by the Postal Service?
Employee and Labor Relations Manual (ELM), Section 545.21, clearly requires that the Postal Service promptly authorize medical treatment by issuing the employee a properly executed Form CA–16 within four hours of the claimed injury. The Postal Service is not required to issue a Form CA-16 more than one week after the occurrence of the claimed injury, so the form should be requested immediately.
In addition to providing payment for initial medical treatment, the doctor designated on Form CA-16 may refer the injured worker for further examination, testing or medical care. OWCP will pay this physician or facility’s bill on the authority of Form CA-16, and the Postal Service should not issue a second Form CA-16.
In some instances, postal officials may claim that the CA-16 “isn’t used anymore.” That is a violation of the contract, and a grievance should be initiated immediately.
Your choice of doctor is critical to your claim
If you do not have a regular physician, you may be forced to seek treatment at one of the many urgent care clinics that have popped up nationwide. Many urgent care clinics employ Physician Assistants (PAs) to diagnose and treat patients. While PAs can provide quality health care, the Office of Workers’ Compensation Programs (OWCP) requires medical evidence from a doctor and will not consider the PA’s medical report. However, a medical report from a PA or a nurse practitioner will be valid if a doctor co-signs the report.
Due to the nature of our work, Letter Carriers are best served by getting treatment from a board-certified orthopedic surgeon. OWCP gives greater weight to the opinion of an orthopedic surgeon than that of a family practitioner. Choosing the doctor who treats your work-related injury may be the most important decision in the life of your claim, so choose wisely.
