referee doctors

I'm a federal employee, for now, that was injured on the job in 2007.  After 2 major surgeries in 2009 and 7 months of rehab, OWCP sent me to their 2nd opinion doctor.  She subsequently concurred with my treating doctor, basically stating that I would never be able to return to my job.  Then 3 months later I received a notice that I was being sent to a referee doctor because there was a conflict of medical information...Where?

How can the OWCP legally send me to a referee doc if their 2nd opinion doc and mine already agree?  Also, if the ref. doc. now goes against the other 2, would I not have a decent cause for appeal?

Any help trying to swim thru the mirk would be appreciated.

You ask:

"How can the OWCP legally send me to a referee doc if their 2nd opinion doc and mine already agree?  Also, if the ref. doc. now goes against the other 2, would I not have a decent cause for appeal?"

If there is not a true conflcit then the easy answer to your question is that they cannot simply create a conflict for the purpose of sending you to a referee. However, OWCP decided if there is a conflcit and not the nurse. If OWCP is wrong in their assessment, the Board will iron things out if necessary.

I've already been to the referee appointment, and have just received notice that my case rests with that doctor's opinion and that my employer is to offer me a job within his restrictions.  But neither my employer or myself have received this elusive IME (I have made the written request for it).

So now I ask: Can I request, from OWCP, what brought them to believing there was a conflict? If this IME is not concurrent with the other 2 doctors, and is against me, what are my options? And, what is the Board that you spoke of?

Thank you, again.

There should be a memo in your file from your CE as to what the conflict is. Ask for it. Also ask for the questions and the SOAF that was sent to the referee. These are important document in understanding why a referee's report is acceptable.

If the referee finds against you and if the referee report is acceptable, you will have little recourse. Notice that I say if acceptable. Not all referee reports are acceptable and those that are not, cannot be relied upon by OWCP. There are many reasons why these reports do not cut it and that is why you should hire someone to review the report once you receive it.

Thank you for your answers.  It all seems a bit backwards and shady (on DOL/OWCP's part) because the injured person has to find out what questions to ask and how to protect themselves.  I have one final question on this matter; If the IME of the referee doctor states that, with minimal restrictions, I can return to my job, but I continue to experience pain in performing these tasks, what options do I now have?  Am I forever stuck with the restrictions, or lack thereof, from the referee doctor and any opinions of my treating doctor are no longer given any merit?

Thank you, again.

If a referee opines that you can retrun to work with minimal restrictions, and assum,ing that the referee's report is supported by sufficient medical rationale, then you must return to work or if you fail to do so, then your benefits may be terminated.  If the referee's opinion is valid, that is the weight of the medical evidence and all other opinions regarding that issue are not valid.

Hi Gordon,

I am having almost this same issue. My primary requested a referee exam to resolve the extent of my permanent limitations. Both he and the second opinion doctor agree that I have limitations and they are permanent but my primary wants me off duty for now, and the second said I can work light duty. Both said not to put me back to my former job.

OWCP granted his request, and the referee doctor says I have no limitations and to return to my previous job. What???? When my attorney asked for the SOAF, he did not recieve it in time to respond, nor to participate in the decision on the referee doctor. Now he did write an objection letter to that, but they still said no to everything. They only gave me 14 days notice of exam, which by the time I got it in the mail, it was less than 10 days.As a result, I was sent to a knee specialist. {ortho surgeon is good enough for them} and they've sent me my 30 day proposal to terminate benefits. They have also said I have 30days to reapply for my former job.

What is your take on this? Can we argue his conflicts in his exam, lack of participation in referee choice, and no SOAF prior to exam, or can we only argue with additional medical evidence?

Thanks