NURSE INTERVENTION

OWCP’s Early Nurse Intervention Program
Reviewing the Medical Documentation to Assess the Duty Status
Authority for Medical Issues

OWCP’s Early Nurse Intervention Program

The OWCP Early Nurse Intervention Program uses registered nurses to intervene in identified compensation cases for purposes of assisting the injured employee, shortening the period of disability, and reducing compensation costs. The nurses interact with the injured employee, treating physician, employing office, and claims examiner to hasten the worker’s recovery from the effects of the injury, and to promote a return to the pre-injury level of activities.

The role of the nurse is as follows:

• Establish a supportive relationship with the injured worker and instill confidence that the medical management efforts can be effective, beneficial, and lead to resumption of activities of the pre-injury level.
• Provide the injured worker an opportunity to discuss the injury and the medical treatment.
• Gather sufficient information about the injured worker’s condition and ongoing medical treatment to recommend and coordinate appropriate medical services designed to expedite recovery.
• Assist the treating physician and injured worker to establish the best timing for and choice of medical services and treatment modalities.
• Monitor the injured worker’s medical condition and the treatment provided.
• If necessary, assist the injured worker in obtaining authorizations or other services from OWCP district offices as well as provide information to OWCP about non-work-related medical conditions that may affect recovery.
• Encourage the injured worker to cooperate with medical treatment and other efforts to prepare for return to a higher level of activity, and, as feasible, return to work.
• Assist in identifying and reviewing limited duty assignments.

Currently, OWCP attempts to have nurse intervention occur within 45-90 days after the date of injury. The OWCP claims examiner decides which cases will be referred to the program. The program is especially useful in cases of orthopedic disability. Cases involving surgery, prolonged treatments such as physical therapy without clear goals or direction, multiple concurrent medical and psychological issues, and catastrophic injuries are also likely to benefit from the program.

Although the claims examiner decides whether a case should be referred for inclusion in this program, the ICCO may request the claims examiner to consider specific cases for referral. While the program is designed to target new injuries, other cases may also be recommended (e.g., medically stagnant cases).

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Reviewing the Medical Documentation to Assess the Duty Status

When an employee is not totally disabled or has partially overcome the injury or disability, the USPS must make every effort to assign the employee to limited duty consistent with the employee’s work limitation tolerance. The ICCO or the control point may contact the treating physician concerning the employee’s work limitations and restrictions imposed by the effects of the injury and possible job assignment. However, when possible, this contact should be made by either the health unit or USPS medical provider personnel. No other contact with the treating physician for medical information is authorized by OWCP for any reason.

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Authority for Medical Issues

No administrative action may be taken to change the employee's compensation or duty status until all medical issues are resolved. When the USPS contract medical provider does not agree with the treating physician, the injured employee’s duty status may not be changed without the concurrence of the treating physician.

OWCP has sole authority regarding the disposition of medical issues, and the medical data on which the OWCP decision is based become the ruling medical authority. OWCP will determine if a second opinion or an independent medical examination (IME) is required and will schedule the appropriate examinations.

For purposes of work assignment, the USPS contract medical provider is permitted to further restrict an employee’s work activities, but cannot less the restrictions placed on the employee by the treating physician or the OWCP’s medical authority determination.

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