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Code of Federal Regulations Pertaining to ESA |
| Employees' Benefits |
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| Office of Workers' Compensation Programs, Department of Labor |
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| Claims for Compensation Under the Federal Employees' Compensation Act, As Amended |
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| Continuing Benefits |
20 CFR 10.501 - What medical evidence is necessary to support continuing receipt of compensation benefits?
- Section Number: 10.501
- Section Name: What medical evidence is necessary to support continuing receipt of compensation benefits?
(a) The employee is responsible for providing sufficient medical
evidence to justify payment of any compensation sought.
(1) To support payment of continuing compensation, narrative medical
evidence must be submitted whenever OWCP requests it but ordinarily not
less than once a year. It must contain a physician's rationalized
opinion as to whether the specific period of alleged disability is
causally related to the employee's accepted injury or illness.
(2) The physician's opinion must be based on the facts of the case
and the complete medical background of the employee, must be one of
reasonable medical certainty and must include objective findings in
support of its conclusions. Subjective complaints of pain are not
sufficient, in and of themselves, to support payment of continuing
compensation. Likewise, medical limitations based solely on the fear of
a possible future injury are also not sufficient to support payment of
continuing compensation. See Sec. 10.330 for a fuller discussion of
medical evidence.
(b) OWCP may require any kind of non-invasive testing to determine
the employee's functional capacity. Failure to undergo such testing will
result in a suspension of benefits. In addition, OWCP may direct the
employee to undergo a second opinion or referee examination in any case
it deems appropriate (see Secs. 10.320 and 10.321).
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