Was Your Referee Impartial?

If you are a federal worker with a right to seek benefits under the Federal Employment Compensation Act (FECA), and there is a difference of opinion between the doctor you select and the doctor appointed by the government, FECA specifies that the Secretary of Labor must appoint an independent third-party physician, known as a referee, to resolve the conflicting claims.

It is important to understand, however, that not every disagreement between medical professionals will require a referee to resolve. The Office of Workers’ Compensation Programs is given authority under FECA to determine when a difference of opinion is a true conflict, and has responsibility for initiating the process of appointing a referee. The referee’s opinion is not controlling but is given “special weight,” provided it is based on the facts and an accurate medical history, and provided it can be shown that the referee was chosen in compliance with the statute.

The Process for Selecting a Referee

The OWCP must follow strict guidelines when appointing a referee so as not to raise any reasonable concerns about fairness. Among the proscriptions placed upon OWCP are:

• Doctors who are employed by or associated with federal agencies must be excluded from consideration
• Physicians having any previous association with the claimant or with the claimant’s agency or employer must be exclude
• Doctors who have consulted to or with OWCP under contract are not allowed as referees

Qualified doctors are chosen randomly by a computer program, using the claimant’s zip code as the initial limiting factor. The program identifies five potential doctors and OWCP contacts them sequentially. The first doctor who agrees to conduct the examination is chosen, provided that he or she is board certified in his or her respective field.

If the doctor chosen has an excludable bias under the statute, the claimant may participate in the selection of a new doctor after filing an objection to the initial appointment. If OWCP concludes that the objection is appropriate, OWCP will provide a list of three names, and the claimant is allowed to choose from that list.

Unfortunately, evidence has come to light that shows fairly conclusively that OWCP can get around the “random selection” of referees. A means of bypassing certain doctors is possible in the software. In addition, a review of OWCP files shows that the agency has only documented chosen referees. There are no records of which doctors were not chosen, so there’s no way to know if more than one doctor was ever considered.

Contact Uliase & Uliase

At Uliase & Uliase, we have extensive knowledge of the federal workers’ compensation system. To schedule an appointment, contact our office online or call us at (856) 310-9002. We will meet with you weekdays between 9 a.m. and 5 p.m. We offer a free consultation for injured workers.