CHOICE OF PHYSICIAN AND CA-16 AUTHORIZATION

Ensuring Right to a Free Choice of Physician
Issue CA-16 to authorize medical treatment
Do not issue CA-16 to authorize medical treatment

Ensuring Right to a Free Choice of Physician

Initial medical examination and treatment must be authorized in accordance with FECA provisions and applicable OWCP regulations and policies governing medical care. FECA guarantees the employee the right to a free choice of physician. The employee may select a physician or hospital within approximately 25 miles of his or her home or work site.

A physician is any surgeon, podiatrist, dentist, clinical psychologist, optometrist, chiropractor, or osteopathic practitioner within the scope of his or he practice as defined by state law. Exceptions are as follows:

1. Chiropractors, if their reimbursable services are other than treatment consisting of manual manipulation of the spine to correct subluxation as demonstrated to exist by x-ray.
2. Naturopaths, faith healers and other practitioners of the healing arts, because they are not recognized as physicians within the meaning of FECA.

In non-emergency situations, a postal supervisor is not authorized to accompany the employee to the medical facility.

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Issue CA-16 to authorize medical treatment

1. For all traumatic injuries requiring medical attention when the employee elects outside treatment, even if the initial treatment is provided by the contract physician, except as cited below.
2. When the injured employee elects the USPS contract medical provider for continued medical treatment beyond the first-aid care (after the first two visits).
3. Following a recurrence of disability, provided the ICCO agrees

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Do not issue CA-16 to authorize medical treatment

• For first-aid injuries when medical care is provided by a USPS contract medical provider for the first two visits and the employee voluntarily accepts this care.
• Following the submission of an occupational disease or illness claim (CA-2) or an occupation disease or illness recurrence claim (CA-2a) that has not been accepted by OWCP. Issuance of CA-16 for occupational disease or illness claims must have prior OWCP approval.
• At some future time or as the need arises. Advanced or blanket authorization is not to be given. A CA-16 should not be provided after the initial choice of physician has been made.

When the employee elects a physician of choice, ask the employee to contact the selected physician by telephone to determine if the physician is available and will accept the employee for treatment. If not, the employee should be encouraged to select another qualified physician or hospital in order to obtain prompt medical attention. Inform the employee of his or her obligation to advise the physician of the availability of limited duty, letting the physician know that that USPS will accommodate most restrictions.

USPS personnel must not interfere with the medical care prescribed by the employee’s attending physician. Supervisory contact with a physician or a physician’s staff is to be limited to inquiries regarding the employee’s duty status.

The USPS has the authority to require the employee to undergo a medical examination to determine whether the employee meets the mandatory medical requirements of the position held or is able to perform the duties of that position. This examination cannot, however, interfere with issuance of CA-16, with the employee’s free choice of physician, or with any authorized examination or treatment. When the injury requires more than two visits, it is no longer considered a first-aid injury.

The USPS monitors the employee’s medical progress and duty status by obtaining periodic medical reports to determine if the employee will be able to return to work in the near future or to further clarify medical work restrictions imposed. Inquiries are limited to information regarding the employee’s ability to return to full or limited duty.

Consequential injuries (recurrences) may resemble traumatic injuries in certain cases. Like a traumatic injury, a consequential injury may be the result of a specific, identifiable traumatic event. This event, however, must be related in some way to a previously accepted, work-related condition.

A fitness-for-duty examination (FFD) is a physical examination conducted by a contract medical provider to determine the employee’s current medical status. The purposes of the FFD are to evaluate medical status, confirm or verify limited duty assignments and to assist in the rehabilitation effort. Fitness for duty examinations are under the authority of the Office of Personnel Management (OPM). They are unrelated to the Federal Employees’ Compensation Act or OWCP.

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