Can OWCP deny a claim solely on the basis that the TP (treating physician) did not obtain a diagnostic report for several months after the date of injury?

TIP OF THE WEEK - July 28, 2014TIP OF THE WEEK - July 28, 2014

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No, the board has held that, While diagnostic testing performed immediately after an alleged injury tends to increase the reliability of a medical opinion regarding the relationship between any condition documented by the testing and the employment injury, the Board has held that the timing of diagnostic testing alone should not be given dispositive weight to the exclusion of other circumstances.”

Immediate testing also carries a degree of uncertainty. Just because the testing was conducted promptly does not document that the injury did not occur prior to the alleged date of injury. Medical evidence must be based on factual history and include the TP’s rationalized medical opinion explaining the causation of injury.

Reference: ECAB http://www.dol.gov/ecab/decisions/2014/May/14-0269.htmFECA PM: Chapter 2-0803, Fact of Injury para, 5: http://www.dol.gov/owcp/dfec/regs/compliance/DFECfolio/FECA-PT2/group1.htm#208034