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Office of Workers' Compensation Programs

Office of Workers' Compensation Programs (OWCP)

Division of Federal Employees' Compensation (DFEC)

District Office 2 — New York — Medical Treatment and Authorization

Initial medical treatment

When an employee requires medical treatment due to a work-related traumatic injury, the employing agency should authorize medical treatment by completing form CA-16, Authorization for Examination and/or Treatment. If an employee requires medical treatment because of a disease or illness which is believed to be work-related, the employee should arrange for necessary medical treatment. If OWCP accepts the claim, payment will be made for medical treatment that is required for the condition, including treatment rendered prior to acceptance.

An employee is entitled to initial selection of physician or facility for treatment of an injury. The medical provider must meet the definition of "physician" under the Federal Employees Compensation Act. The term "physician" includes surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by State law. The term "physician" includes chiropractors only to the extent that their reimbursable services are limited to treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by X-ray to exist. A subluxation is defined as an incomplete dislocation, off-centering, misalignment, fixation or abnormal spacing of the vertebrae as demonstrated on an x-ray film to individuals trained in the reading of x-rays.

Authorization for medical treatment

Requests for authorization for treatment must be made in writing. This includes requests for surgery, diagnostic treating, physical therapy and supplies.

Your physician may fax the request for authorization to (800)215-4901. If the request must be expedited, he or she may call (866)335-8319. Both of these numbers are toll-free. The request may also be sent to our mailing address at:

U.S. Department of Labor
DFEC Central Mailroom
P.O. Box 8300
London, KY 47042-8300

All documents submitted to this office should have our case file number in the upper right hand corner. This will assist in identifying the proper file to associate it with.

Medical appliances, supplies or prostheses recommended by the treating physician will be authorized if likely to provide relief or reduce the degree of disability. The request for authorization should include the physician's reasons for believing the item to be necessary.

Continuing medical treatment

An employee who wishes to change physicians after the initial choice must contact OWCP in writing for approval, and include the reason for requesting the change.

If the treating physician has released the employee from treatment, or if over 6 months have passed since the last treatment date, ongoing authorization for treatment should be confirmed by OWCP.