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Medical Benefits and Care
One of the most common issues that arise during a disputed federal workers’ compensation claim is that the medical evidence is lacking to causally relate the mechanism of injury to the work factors of a persons’ job which resulted in the injury or disease. Doctors need to understand the nuances of the information they are providing on behalf of their patients that can either help or hurt the injured workers’ claim.
Doctors need to:
- Use unequivocal language
- Describe a patient’s history accurately
- Detail the results of the objective medical tests they conducted
- Describe which medical records they reviewed
- Illustrate a clear understanding of the patient’s work duties
- Illustrate how those work duties caused the injury
- Hold this opinion within a reasonable degree of medical certainty.
Other issues for concern to injured federal employees and their physicians are entitlement to medical care, who qualifies as a physician, choice of physician, medical treatment and evaluation, exclusion of providers and how the medical care provider submits their bills for payment.
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