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a clearly unwarranted invasion of per- with the demand (United States ex rel sonal privacy. Where feasible, the Bur- Touhy v. Ragen, 340 U.S. 462). This paraeau shall delete identifying detail to pre- graph shall not apply to final decisions vent a clearly unwarranted invasion of requiring production of records pursuant personal privacy. The requesting orga- to 5 U.S.C. 552(a) (3), as the foregoing nization or individual shall be advised limitations are not intended to preclude that the information must be held in compliance with lawful court orders callconfidence and that any published re- ing for the production of records in conports resulting from such study shall not nection with civil litigation or criminal identify in any way the individuals proceedings, nor to preclude release of whose records were examined.
information from records when required (e) Release to Federal or State courts by law. or other administrative bodies—(1) Pro- (35 F.R. 1286, Jan. 31, 1970] cedure. Any officer or employee of the United States who is served with a de
8 1.23 Waiver not authorized. mand for records or information relat- No oficial superior is authorized to reing to Federal Employees' Compensa- quire an employee to enter into any tion Act matters, the disclosure of which agreement, either before or after an inhas not been authorized, regardless of jury, to waive his right to claim compenwhether it may or may not be authorized sation. by this section or Part 70 of Title 29, (Regulations under the United States Em. Code of Federal Regulations, shall ployees' Compensation Act, June 1, 1988. promptly, and without awaiting appear- Redesignated at 14 F.R. 7875, Dec. 9, 1949) ance before the court or other authority,
§ 1.24 Representation of claimants and communicate through established chan
approval of claims for legal and other nels the contents of the demand to the
services. Under Secretary of Labor. Such officer or employee shall await instructions con
(a) A claimant may be represented becerning the response to the demand. If
fore the Bureau in any proceeding under it is determined that the demand should
the act by any duly authorized person. be opposed, the U.S. attorney, his assist
(A former member of the Employees' ant or other appropriate legal represent
Compensation Appeals Board or a forative shall be requested respectfully to
mer Director of the Bureau shall not be inform the court or other authority that
considered a duly authorized person the Secretary of Labor has instructed
within the meaning of this section for a the officer or employee to refuse to dis
period of two years following terminaclose the records or information sought.
tion of his services as a Board member If instructions have not been received
or as Directors. The Bureau shall reat the time when the officer or employee
quire satisfactory proof of the representis required to appear before the court
ative's authorization. or other authority in response to the de
(b) No claim for legal services or for mand, the U.S. attorney, his assistant,
other services rendered in respect of a or other appropriate legal representative
case, claim, or award for compensation, shall be requested to appear with the
to or on account of any person shall be officer or employee upon whom the de
valid unless approved by the Bureau. mand has been served and request addi
Any person who receives any fee, other tional time in which to receive such
consideration, or gratuity on account of instructions.
services so rendered, unless such fee, con(2) Action in event of adverse ruling.
sideration or gratuity is approved by the If the court or other authority declines
Bureau, or who solicits employment for to stay the effect of the demand in
himself or another in respect of any case, response to a request made in accordance
claim, or award for compensation under with subparagraph (1) of this paragraph
(or to be brought under) this act shall pending receipt of instructions from the
be guilty of a misdemeanor and upon Secretary of Labor, or if the court or
conviction thereof, for each offense, be other authority rules that the demand punished by a fine of not more than must be complied with irrespective of $1,000 or by imprisonment not to exceed the instructions from the Secretary of one year, or by both such fine and imLabor not to produce the material or dis- prisonment. The Bureau cannot pay close the information sought, the em- any claim so approved by it nor can it ployee upon whom the demand has been assist in the collection of any sum so made shall respectfully decline to comply approved.
(c) No fee for services shall be ap- cause he has a dependent as set forth in proved except upon an application to 5 U.S.C. 8110 such person may receive the Bureau supported by an itemized augmented benefits irrespective of the statement of the necessary work done date of his injury. However, such payon behalf of a claimant. Should such ments shall not commence prior to Nostatement be deemed insuficient by the vember 1, 1949; see $ 1.5. Bureau, further details may be required (e) The amendments with respect to and the Bureau may require the person increasing the rate of compensation are for whom such services were rendered to applicable to cases of injury or death certify to the correctness thereof. Ex- which occurred before enactment of cept where it has been established that these amendments but only with respect representation was to be rendered gra- to any period beginning the first of tuitously, the fee approved by the Bureau November 1949. shall be reasonably commensurate with (f) Whenever a person is entitled to the actual necessary work performed by compensation by virtue of the amendsuch representative. The Bureau will ment broadening the scope of the term consider for approval only the necessary "employee”, such entitlement shall apply services performed by applicant on be- to injuries or deaths which occurred on half of the claimant, taking into account or after December 7, 1941: Provided, the capacity in which the representative however, That no payments for medical has served and the circumstances of the expenses or compensation shall be payclaimant.
able for any period prior to November 1, (d) The Bureau will not recognize any 1949, and shall be limited to cases involycontract for the payment of an agreed ing permanent partial or permanent total sum, or any contingent contract, with disability or death; see $ $ 1.4, 1.5 and 1.12. respect to legal or other services rendered
(14 F.R. 7376, Dec. 9, 1949, as amended at in respect of a claim or award for com- 35 F.R. 1286, Jan. 31, 1970] pensation. (14 F.R. 7376, Dec. 9, 1949, as amended at 24 PART 2 FURNISHING OF MEDICAL F.R. 1157, Feb. 14, 1959)
TREATMENT § 1.25 Retroactive effective dates and
Sec. procedures under Federal Employees'
2.1 Medical treatment, hospital service, Compensation Act Amendments of
transportation, etc. 1949.
2.2 Medical treatment. (a) The amendments classifying the
2.3 Official authorization for treatment. loss or loss of use of both hands, or both
2.4 Medical treatment for recurrence of
disability. arms, or both feet or both legs or both
2.5 Medical treatment in doubtful cases, eyes, or the sight thereof, as prima facie
2.6 Authority for dental treatment. constituting permanent total disability, 2.7 Medical examinations. is applicable to injuries sustained before 2.8 Medical referee examination. October 14, 1949, but only with respect to 2.9 Furnishing of orthopedic and prosthetic any period of disability beginning on or
appliances, and dental work. after the first of November 1949.
2.10 Recording and submission of medical (b) The amendments apply retroac
2.11 Submission of bills for medical services, tively for injuries which occurred on or
appliances and supplies. after January 1, 1940, involving the total
2.12 Reimbursement for medical expenses, loss or loss of use of an arm, leg, hand,
transportation costs, loss of wages, foot or eye or total and permanent loss
and incidental expenses. of hearing of both ears or serious dis
AUTHORITY: The provisions of this Part 2 figurement of the face, head or neck,
issued under 5 U.S.C. 8145, 8149; 1946 Reoron or after January 1, 1940.
ganization Plan No. 2, sec. 3, 3 CFR, 1943– (c) If an employee has sustained the 1948 Comp., p. 1064; 60 Stat. 1095; 1950 permanent partial loss or loss of use of an Reorganization Plan No. 19, sec. 1, 3 CFR, arm, leg, foot, hand, eye or hearing or the
1949–1953 Comp., p. 1010; 64 Stat. 1271. total or partial loss or loss of use of any SOURCE: The provisions of this Part 2 apother member of the body on or after pear at 35 F.R. 1287, Jan. 31, 1970, unless
otherwise noted. October 14, 1948, he is required to make an election as provided in 5 U.S.C. $ 2.1 Medical treatment, hospital serv8116(b)
ice, transportation, etc. (d) Whenever a disabled person is en- (a) All medical services, appliances, titled to augmented compensation be- drugs, and supplies which in the opinion
of the Bureau of Employees' Compensation (hereinafter referred to as the Bureau) are necessary for treatment of an injury as provided by 5 U.S.C. 8103 shall be furnished to employees of the United States and to others by law entitled to medical and other benefits, by or upon the order of U.S. medical officers and hospitals, when available and practicable, for injuries sustained while in the performance of duty, including diseases proximately caused by the conditions of employment, whether resulting in loss of time or not, as well as the necessary means of transportation incident to the securing of such services, appliances, drugs and supplies. An injured employee will be furnished transportation or reimbursed for transportation expense, and shall be reimbursed for expenses incident to the securing of services, appliances and supplies necessary in the treatment of a condition the result of injury, when authorized by the Bureau or by his official superior. If there should be no U.S. medical officer or hospital available, medical services shall be furnished by designated private physicians listed in the Bureau's Pamphlet BEC-576. If there is no U.S. medical officer or hospital or designated private physician available, medical services shall be furnished by any qualified local physician. Authorization for prolonged treatment from such a physician shall be obtained from the Bureau. The attending physician may arrange for necessary hospital care at semiprivate rates, unless the nature of the case requires care in private room, special nursing services (if indicated by the nature of the ase), X-ray examinations, and consultations by specialists. In cases of an emergency nature or cases involving unusual circumstances the Bureau may in the exercise of its discretion authorize treatment otherwise than as provided for in this part, or it may approve payment for medical expenses incurred otherwise than as authorized in this part.
(b) The term “physician” as used in this part includes surgeons and osteopathic physicians within the scope of their practice as defined by State law. The term "medical, surgical, and hospital services and supplies” as used in this part includes services and supplies by osteopathic physicians and hospitals within the scope of their practice as defined by State law.
Medical treatment. In all cases of injury by accident where emergency treatment is necessary, any qualified local physician may render first aid treatment. Further treatment, if necessary, shall be obtained as soon as practicable from a U.S. medical officer or hospital or, if not available, from a local designated physician. It shall be the duty of the official superior to authorize initial adequate medical treatment (except for disease or illness) and thereafter to follow up the matter of such treatment to see that the employee is placed under the care of a U.S. medical officer when available, or a designated physician, for any treatment subsequently needed. If unable to comply promptly with this requirement, the official superior shall communicate immediately with the Bureau for instructions, giving full information as to the nature and cause of the injury and any treatment that has been rendered with respect thereto.
Official authorization for treatment. (a) When an employee receives an injury by accident under circumstances entitling him to compensation or medical treatment, his official superior shall issue promptly to him a request for examination and/or treatment on Form CA-16. The employee shall carry the Form CA16, where practical for him to do so, from his place of employment to the medical officer or physician. It is important and emphasized that Form CA-16 is designed solely for use when injury is sustained by accident. In all instances of disease or illness, the official superior shall contact the proper office of the Bureau for instructions on authorizing treatment. In emergency situations, the office should be contacted by telephone.
(b) If the Bureau's office is closed and an emergency exists, the employee should seek medical attention for the disease or illness on an interim basis pending contact with the Bureau's office on the next workday.
(c) Authorization may be given for emergency treatment for injuries by accident prior to the issuance of a Form CA-16, provided that this form is issued within 48 hours thereafter.
$ 2.4 Medical treatment for recurrence
of disability. If an injured employee complains of a recurrence of disability (whether or not he is disabled for work), after having recently been discharged from medical treatment, on account of an injury by accident recognized as compensable by the Bureau, under circumstances from which it may reasonably be inferred that such disability is the result of such injury, and the place of employment is the same as at the time of such injury, the official superior in his discretion may issue a Form CA-16 as provided by $ $ 2.1 and 2.3 provided that not more than 6 months shall have elapsed since the final action of the Bureau upon the case. In any case in which the employee complains of a recurrence of disability with respect to which there may be doubt that the disability is the result of the injury or in any case in which the final action of the Bureau shall have been taken more than 6 months prior to complaint, the official superior shall communicate with the Bureau and request instructions, stating all of the pertinent facts in his communication. In all other cases the employee shall communicate with the Bureau and request such treatment. $ 2.5
Medical treatment in doubtful
cretion, authorize treatment otherwise than as provided for in this part, or it may approve payment for medical expenses incurred otherwise than as authorized in this section. No authority for examination or for medical or other treatment shall be given by the official superior in any case already disallowed by the Bureau. $ 2.6 Authority for dental treatment.
All necessary dental treatment, including repairs to fixed false teeth or to natural teeth, needed to repair damage done by an injury will be obtained from a U.S. medical officer or hospital or, if not available, upon authorization obtained in advance from the Bureau. § 2.7
Medical examinations. (a) An injured employee shall be required to submit to examination by a U.S. medical officer or by a designated physician or a qualified physician approved by the Bureau, as frequently and at such times and places as in the opinion of the Bureau may be reasonably necessary. The injured employee may have a qualified physician, paid by him, present at the time of such examination. For any examination required by the Bureau an injured employee shall be paid all expenses incident to such examination which, in the opinion of the Bureau, are necessary and reasonable, including transportation and actual loss of wages incurred in order to submit to the examination authorized by the Bureau.
(b) If the employee refuses to submit himself for or in any way obstructs any examination, his right to claim compensation under said Act shall be suspended until such refusal or obstruction ceases. No compensation shall be payable while such refusal or obstruction continues, and the period of such refusal or obstruction shall be deducted from the period for which compensation is payable to him. § 2.8 Medical referee examination.
If there should be a disagreement between the physician making the examination on the part of the United States and the injured employee's physician, the Bureau shall appoint a third physician, qualified in the appropriate specialty, who shall make an examina
Cases of a doubtful nature, so far as compensability is concerned, shall be referred by the official superior to a United States medical officer or hospital, or as otherwise provided in § 2.1, using a Form CA-16 for medical services as indicated in 6B of the form. This authorizes the necessary diagnostic studies and emergency treatment pending receipt of advice from the Bureau. A statement of all pertinent facts relating to the particular case shall also be forwarded immediately to the Bureau for consideration. If the medical examination or other information received subsequent to the issuance of authorization for treatment discloses that the condition for which treatment was rendered is not due to an injury, the person issuing the authorization shall immediately notify the physician or hospital that no further treatment shall be rendered at the expense of the Bureau. In cases of an emergency or cases involving unusual circumstances, the Bureau may, in the exercise of its dis
tion. The physician appointed shall be one not previousiy connected with the case. $ 2.9 Furnishing of orthopedic and pros
thetic appliances, and dental work. When an orthopedic or prosthetic appliance, such as an artificial eye or limb, is deemed to be necessary by the attending physician by reason of an injury which has been found by the Bureau to have occurred while in the performance of duty, application therefor may be made to the Bureau, stating the necessity therefor, the approximate cost of such appliance, and a brief description thereof. Applications for repairs to such an appliance furnished by the Bureau will be made in the same manner. Where an artificial denture is necessary in such cases, application therefor may similarly be made. § 2.10 Recording and submission of
medical reports. Medical officers, designated physicians, other physicians and hospitals shall keep adequate records of all injury cases treated by them sufficient to supply the Bureau with a history of the employee's accident, the exact description, nature, location and extent of injury, the X-ray findings if X-ray examination has been made, the nature of the treatment rendered, and the degree of impairment arising from the injury. Physicians shall forward to the Bureau full reports with respect to each injury case treated under the provisions of 5 U.S.C. 8103 which results in a charge for treatment or supplies against the Bureau, or involves any loss of time beyond the day, shift, turn or working period during which it occurs. Form CA-16 provides for the furnishing of the initial medical report. Form CA20 is available for submitting subsequent reports in instances where no compensation is claimed. The medical certificates on the back of Forms CA-4 and CA8, as appropriate, are to be utilized in submitting subsequent report in instances where compensation is claimed. These reports shall be forwarded promptly to the Bureau. Detailed supplementary report in narrative form shall be made by the physician at approximately monthly intervals in all cases of serious injury, especially injuries of the head and back, and including all cases requiring hospital
treatment or prolonged care. The supplementary report shall show the date when case was first examined or treated, the patient's complaint, the condition found on examination, the diagnosis, medical opinion as to any relationship between the impairment and the injury alleged, report as to any other impairments found not due to injury, the treatment given or recommended for the injury alleged, the extent of impairment affecting the employment as a result of the injury, the actual degree of loss of active or passive motion of an injured member, the amount of atrophy or deformity in a member, the decrease, if any, in strength, the disturbance of sensation, the prognosis for recovery, and all other material facts. If the services of a specialist are required in the examination or treatment of a beneficiary, a report of his findings upon examination, his diagnosis, his opinion as to the relationship between the impairment and the injury, the medical rationale for his opinion, the treatment recommended by him, a statement of the extent of impairment as a result of the injury and the prognosis shall be forwarded to the Bureau for consideration in conjunction with other reports. The requirement of this section or of any section in this part with respect to the form of medical, dental, hospital or other reports may be waived by the Bureau. § 2.11 Submission of bills for medical
services, appliances, and supplies. All charges for medical, hospital, surgical, or other treatment or care of injured employees, supported by medical evidence as provided in $ 2.10, shall be itemized on the physician's billhead stationery and shall be forwarded promptly to the Bureau for consideration. Charges may also be submitted at the time of submission of the initial report by completing item 14 on the back of Form CA-16. A separate bill shall be submitted when the employee is discharged from treatment, except when treatment extends for more than 30 days, in which event, bills shall be submitted at the end of each 30-day period.. $ 2.12
Reimbursement for medical expenses, transportation costs, loss of
wages, and incidental expenses. If bills for medical, surgical, nursing, dental, or hospital services or supplies,