OWCP Second Opinion Supplemental Report Request Tutorial

Today we’re talking about a common challenge: when an OWCP second opinion (SECOP) doctor gives an opinion you disagree with, leaves key questions unanswered, or when the claims examiner misinterprets the report.

You don’t have to accept incomplete or unclear medical evidence. There are established procedures under the FECA Act, the DFEC Procedure Manual, and related guidance that allow you (or your treating physician) to push for clarification through a supplemental report. Let’s walk through the steps.

Section 1: When a Supplemental Report Makes Sense

OWCP often refers claimants for a second opinion exam (authorized by 5 U.S.C. §8123) to clarify the accepted condition, disability status, work capacity, treatment needs, or other issues.

Common scenarios where a supplemental report is appropriate:

The report is equivocal, lacks sufficient rationale, or fails to address the specific medical questions posed.

It contains incomplete information or overlooks key records.

The claims examiner (CE) appears to misinterpret the findings.

New evidence from your treating physician creates a need for the second opinion doctor to review and respond.

For more information click on the show's transcript...

The podcaster is Dr. Stephen Taylor, OWCP medical-legal consultant & DOL expert for Oberheiden Law Firm.  Dr. Taylor’s contact email information is:

fedcompconsultants@protonmail If you need a medical provider or assistance with an OWCP /  DOL claim in  Pensacola, Tampa or Jacksonville Florida you can make an appointment to see Dr. Taylor  at the clinic at  FWC Medical Centers or check out the webiste at fedcompconsultants.com To make a consultation with Dr. Taylor  call the clinic at 813-215-4356  in Florida.

For responses email Dr. Taylor at fedcompconsultants@protonmail.com

Transcript

Welcome to Federal Workers Compensation Coffee Break Podcast. I’m Dr. Stephen Taylor a Federal Workers Compensation Consultant and a medical provider in Pensacola,  Tampa, Jacksonville & Florida and Daphne Alabama, who has been helping government employees with work-related injuries, disability, FERS Disability, VA disability and other types of Federal program filings for 30+ years. I have assisted hospitals, clinics and doctors for over 27 years with being successful with OWCP. I have also worked with injured Federal Workers all over the country with properly filing their Federal Workers Compensation Claims and/or disability claims for about three decades. I  decided  to create a tutorial podcast to assist with the type of topics that have needed the most assistance over the years, related to injured federal workers and/or contractors as a resource for people who are looking for assistance with DOL-OWCP federal workers . The name of this tutorial podcast is  Federal Workers Compensation Coffee break Podcast. It is based on the lunch and learn short learning format.  Here at this podcast we discuss all sorts of topics related to federal workers compensation, Department of Labor, OWCP, FECA ACT, FERS, longshore-maritime, DOD contractors, VA benefits over a cup of coffee. 

Ok …so let's get our coffee going…

and dive into more information to assist with your requesting a supplemental report from an OWCP  second opinion doctor who you have some type of disagreement with. 

Today we’re covering how to handle an OWCP requested second opinion medical exam (SECOP) who writes a report that’s unclear, incomplete, draws incorrect conclusion based on incomplete medical or medical fact history or whose findings are misinterpreted by the claims examiner. We have discussed recent episodes how new third party vendors such as the insurance company Sedgewick and a couple of new 2nd opinion groups have been contracted to assist in claims management issues with OWCP. One of the biggest changes in contracting out claims management issues with OWCP is the utilization of 2nd opinions for everything that is claims related. Now that 2nd opinion doctors are being utilized in so many ways…I want to help you and or your union rep and doctor to know the steps on how to fight back against 2nd opinions with supplemental report requests. We’ll walk through the step-by-step process utilizing both the  FECA ACT and the DFEC Procedure Manual.

We’ll also address a common and important scenario: when the second opinion doctor performs an in-person exam and provides an impairment rating examination for a schedule award. 

Section 1: General Overview & When to Request a Supplemental Report

Today we’re talking about a common challenge: when an OWCP second opinion (SECOP) doctor gives an opinion you disagree with, leaves key questions unanswered, or when the claims examiner misinterprets the report.

You don’t have to accept incomplete or unclear medical evidence. There are established procedures under the FECA Act, the DFEC Procedure Manual, and related guidance that allow you (or your treating physician) to push for clarification through a supplemental report. Let’s walk through the steps.

Section 1: When a Supplemental Report Makes Sense

OWCP often refers claimants for a second opinion exam (authorized by 5 U.S.C. §8123) to clarify the accepted condition, disability status, work capacity, treatment needs, or other issues.

Common scenarios where a supplemental report is appropriate:

The report is equivocal, lacks sufficient rationale, or fails to address the specific medical questions posed.

It contains incomplete information or overlooks key records.

The claims examiner (CE) appears to misinterpret the findings.

New evidence from your treating physician creates a need for the second opinion doctor to review and respond.

Key Reference: FECA Procedure Manual (Part 2 & Part 3) states that when OWCP develops evidence via a second opinion and receives an inadequate report, the CE has an obligation to seek clarification or a supplemental report to address discrepancies or inadequacies.and legal basis under 5 U.S.C. §8123 and FECA Procedure Manual.)

Key Guidance: If the second opinion report is equivocal, lacks rationale, fails to address OWCP’s specific questions, or is otherwise inadequate, the Claims Examiner (CE) should seek clarification or a supplemental report.

Section 2: Step-by-Step Guide to Requesting a Supplemental Report

Review the Report Thoroughly

Obtain and carefully read the full second opinion report (and any CE memo).

Identify specific deficiencies: missing rationale, unanswered questions, overlooked records, or inconsistencies with your medical history/treating physician’s notes.

Note dates and keep copies of everything.

Submit a Written Request to the Claims Examiner

Send a formal letter (or for faster responses use ECOMP if appropriate) to your CE.

Clearly state the deficiencies and request a supplemental report from the second opinion physician.

Reference: FECA Procedure Manual guidance on seeking clarification when a second opinion report is inadequate.

Attach supporting evidence (e.g., your treating doctor’s detailed rebuttal narrative).

Request a reasonable deadline (often 30–60 days for development). Remember the DFEC procedure manual requires that all written correspondence that is uploaded into ECOMP requires a 30 day written response. 

Involve Your Treating Physician

Have your doctor prepare a strong narrative report addressing the second opinion’s weaknesses point-by-point.

Ask your doctor to explicitly request (or support your request for) a supplemental opinion from the OWCP doctor.

Form CA-20a (Attending Physician’s Supplemental Report) can be useful for structured updates.

Follow Up and Escalate if Needed

If the CE does not act, follow up in writing and reference OWCP’s duty to properly develop the medical evidence.

If benefits are threatened (e.g., Notice of Proposed Termination), submit your request as part of your response within the 30-day window.

Consider requesting a hearing or reconsideration if an adverse decision issues without proper clarification.

Additional Tools

District Medical Advisor (DMA) review: Sometimes the CE routes questions through the DMA for an opinion on the existing evidence.

Referee Exam: If a true conflict arises after proper development, a third impartial opinion may be ordered.

Document all communications — this builds your record for appeals.  

Section 3: Relevant Authorities & Best Practices- Source material to utilize for your request.

FECA Act (5 U.S.C. §8123): Authorizes OWCP to order medical examinations as reasonably required.

DFEC Procedure Manual: Emphasizes that OWCP must ensure reports are clear and well-rationalized. When they aren’t, clarification via supplemental report is the proper step.

FECA Bulletins: Provide additional procedural guidance on second opinion processes and evidence development (check current district resources for the latest).

I will attach all of my current source material that are relevant in the show transcript for you to click on and review of all current FECA bulletin updates on 2nd opinion supplemental report requests and evidence development. 

The core procedural rules for second opinion examinations, referee examinations, Statement of Accepted Facts (SOAF), conflict resolution, and medical evidence development remain primarily in the FECA Procedure Manual (especially Parts 2 and 3, Chapters addressing Developing and Evaluating Medical Evidence and OWCP-Directed Medical Examinations). These are supplemented by the FECA statute (5 U.S.C. § 8123) and 20 C.F.R. Part 10.

Relevant Active Bulletins That Touch on Medical Development

While not dedicated solely to second opinions, the following active bulletins contain guidance that can affect evidence development, DMA referrals, or when second opinion/referee exams may be used in specific claim types:

 | Bulletin | Subject | Relevance to Second Opinion / Evidence Development | FECA Bulletin No. 24-04 | Additional and Consequential Conditions in Anomalous Health Incidents (AHI) Claims | Requires full medical development (including possible DMA review) for additional/consequential conditions beyond traumatic brain injury.
| FECA Bulletin No. 25-01 | Designation of High-Risk Cancers for Federal Firefighters | Involves medical development and DMA review for firefighter cancer claims.
| FECA Bulletin No. 25-02 | Amended Special Case Handling in Certain Firefighter FECA Claims Processing and Adjudication | Provides specific development instructions (including DMA referral) for certain firefighter claims.
| FECA Bulletin No. 23-02 | Processing Claims for COVID-19 Diagnosed After January 27, 2023 | Addresses medical evidence requirements and development for post-ARPA COVID claims.
| FECA Bulletin No. 22-03 | Processing Claims for Anomalous Health Incidents (AHI) | Earlier guidance on medical development in AHI claims (partially updated by 24-04).
| FECA Bulletin No. 21-11 | Retention of the AMA Guides, 6th Edition (2009) | Relevant when second opinion or referee physicians perform impairment ratings for schedule awards.

Notes

• Older bulletins that previously addressed second opinion processes more directly (or specific medical development scenarios) have generally been incorporated into the FECA Procedure Manual or superseded.
• Secondary sources occasionally reference older or misnumbered bulletins (e.g., claims of a “Bulletin 21-05” specifically on second opinions), but the official active list shows FECA Bulletin 21-05 addresses payment authorization for reimbursements exceeding $50,000.
• For the most current and authoritative guidance on second opinion and referee processes, the FECA Procedure Manual (Part 3 – Medical) remains the primary reference, along with 5 U.S.C. § 8123 and 20 C.F.R. §§ 10.320–10.323.

Recommendation: Always cross-check the latest official DOL FECA Bulletins page and the current Procedure Manual, as bulletins can be updated or incorporated without notice.

Tips: Stay professional and factual. Focus on medical accuracy rather than accusations. Timeliness matters — act promptly after receiving the report.

Important Note: These are general educational steps based on publicly available FECA procedures. Every case is unique—consult a qualified representative or attorney for your specific situation.

Requesting a supplemental report is a legitimate and often effective way to ensure the medical evidence is complete and fairly weighed. Don’t let an unclear second opinion derail your claim.

Section 4: Special Scenario – When the Second Opinion Includes an Impairment Rating

Impairment ratings (often for schedule awards under 5 U.S.C. §8107) add another layer. OWCP may specifically request a second opinion physician to evaluate permanent impairment during the in-person exam using the AMA Guides to the Evaluation of Permanent Impairment (or other approved editions).

How the Rules Apply in This Scenario:

The second opinion doctor must provide a well-rationalized rating, explaining how they arrived at the percentage, which body parts/functions were rated, and how it ties to the accepted work injury.

Common issues: The rating may be incomplete (e.g., misses certain conditions), conflicts with your treating physician’s rating, uses the wrong edition of the AMA Guides, or lacks sufficient objective findings/explanation.

Steps Tailored to Impairment Rating Cases:

Carefully Review the Rating — Compare it to your treating doctor’s report and your accepted conditions. Note any discrepancies in methodology, missed impairments, or lack of rationale.

Submit Targeted Request for Supplemental Report — In your letter to the CE, specifically ask the second opinion doctor to:

Address and reconcile differences with your treating physician’s impairment rating.

Provide additional detail on objective findings, range of motion, diagnostic test results, or how specific impairments were calculated.

Clarify application of the AMA Guides (correct edition, tables, etc.).

Consider any new or overlooked medical evidence you submit.

Support with Strong Counter-Evidence — Have your treating physician or a specialist submit a detailed rebuttal narrative. This can trigger OWCP’s obligation to go back to their second opinion doctor for clarification rather than simply adopting the lower rating.

Reference Relevant Procedures:

FECA Procedure Manual (Part 2) guidance on schedule awards and second opinions: If the second opinion report on impairment is inadequate, OWCP should seek a supplemental report before finalizing a schedule award decision.

When OWCP undertakes development with a second opinion, it must ensure the report properly addresses the issues — including impairment — and obtain clarification if needed.

If a conflict persists after supplementation, it may lead to a referee examination.

Referee Doctor (also called an Impartial Medical Examiner or Referee Specialist) in OWCP / FECA Claims

A referee doctor is a neutral, third-party physician selected by the Office of Workers’ Compensation Programs (OWCP) to resolve a genuine conflict in medical opinion.

When a Referee Doctor Is Used

Under 5 U.S.C. § 8123(a) and the DFEC Procedure Manual, a referee examination is ordered only when:

There is a clear conflict of medical opinion between the claimant’s attending (treating) physician and an OWCP-selected physician (usually a second opinion doctor or the District Medical Advisor/DMA).

The conflicting opinions are of equal weight (both are well-rationalized, based on accurate history, and supported by objective findings).

If the opinions are not of equal weight, OWCP may simply give greater weight to one side without ordering a referee exam.

How the Process Works

The Claims Examiner (CE) identifies a true conflict.

OWCP prepares a Statement of Accepted Facts (SOAF) and specific medical questions for the referee to answer.

A referee physician is selected through a strict rotational system (Physicians’ Directory System) to ensure impartiality. The physician must be in the appropriate specialty and have no prior connection to the case.

The claimant must attend the examination. Refusal can result in suspension of benefits under 5 U.S.C. § 8123(d).

The referee issues a report. If the report is thorough, well-reasoned, and based on a proper factual background, OWCP gives it special weight. In most cases, the referee’s opinion becomes the decisive medical evidence and overrides both the attending physician and the second opinion/DMA.

Key Points for Claimants

The referee is intended to be truly impartial.

Claimants (or their representatives) can request a copy of the SOAF and the questions posed to the referee in advance and may challenge inaccuracies.

In limited circumstances, the claimant may participate in the selection process (e.g., by choosing from a short list of three physicians).

Once the referee issues a properly reasoned report, it carries significant authority and is difficult to overcome on appeal unless clear procedural or factual errors exist.

In short, the referee doctor is OWCP’s mechanism for breaking a medical “tie” so the claim can move forward with a single authoritative medical opinion.

Timing & Strategy — Act quickly, especially if a schedule award decision is pending. Include your request in responses to any proposed decisions. OWCP cannot properly issue or rescind a schedule award without adequate medical evidence, and failing to obtain a proper supplemental report has been grounds for reversal on appeal.

Best Practice Tip: Impairment ratings are highly technical. A supplemental report can be crucial for ensuring all ratable impairments are considered fairly.

Section 4: Practical Tips, Common Pitfalls & Takeaways

Always communicate in writing.

Keep your treating doctor actively involved.

Document everything for potential appeals.

Remember: OWCP has an obligation to properly develop the medical evidence when they rely on a second opinion.

Whether it’s a general medical opinion or a specific impairment rating, requesting a supplemental report is a key tool to ensure fairness in your FECA claim. Use these steps, stay organized, and don’t hesitate to seek qualified help.

Also I want to give some shoutouts and updates with information and corrections. A regular listener that is a union representative sent me a correction on a previous episode about CA-2A recurrence filing. I misspoke in that episode and advised that the CA-2A needs to be uploaded into ECOMP. David …a superstar in the union and regular listener sent me a correction of the following… The CA-2a form has to be submitted on paper to your employing agency. It's the one form that cannot be filed through ECOMP. There is a selection available on the drop-down menu when uploading documents for the CA 2a, but if you send it directly to OWCP without going through the agency first, OWCP will return it to you for processing through the agency. Thanks David…for sending that correction …and good catch by the way. As an old dog of 30+ years I have lived through several different changes of OWCP communication via snail mail, faxes, email all the way to now ECOMP and have to modernize my thinking to the ECOMP changes.

Another listener asked about latent effects of psychological injuries in government personnel that work in very high risk jobs such as firefighters, soldiers, and law enforcement where they are exposed to very traumatic events and even death of co-workers and people.  

Sherri thanks for the great question and being a listener…

Her questions is the following:

At times, some of our EMERGENCY WORKERS are involved in traumatic incidents, for example burnovers or being onsite when a coworker is injured or dies while working in traumatic scenes, and their mental health is impacted.   Sometimes, their symptoms are immediate and consistent what will eventually likely result in a PTSD diagnosis.  At other times, individuals do not experience symptoms related to the trauma until weeks, months or years after the incident.  What is the appropriate form to fill out for the above mentioned scenarios. 

Great question… here I will give the short answer for the listeners…

When a worker suffers a traumatic event either to themselves or experienced a traumatic event (exposure) that is emotionally difficult for a day...the right approach is to complete an incident report, OSHA 301 form and an OWCP CA-1 if the incident is traumatic in nature. Often these type of emergency workers are tougher than the average person on the street and develop latent effects from these types of incidents. The Ca-1 affords them the opportunity to be seen immediately by a psychologist, psychiatrist of physician  for the first two months after the traumatic work accident with a CA-16 medical authorization form. This should be encouraged. 

The second scenario is very common. If a traumatic incident occurs but the "tough' Emergency personnel  do not want to file an incident report CA-1 and decide to just  "live with it." If this decision to not file a CA-1 traumatic injury form develops into latent depression or PTSD or other psychological conditions over months or years, then you would file a CA-2 for the diagnosis of (psychological conditions like depression or PTSD etc). The big difference in this scenario is that if your emergency personnel  feel the symptoms are developing over a period of time due to seeing too much death or trauma, they would need to go to a psychiatrist or psychologist FIRST to find out if they are developing a post traumatic event, (latent depression, anxiety or PTSD etc). If the psychiatrist, psychologist or doctor feels they are developing latent effects of a psychological condition due to chronic work-related exposure, that would be an example of a CA-2 filing.

The steps are backwards for a CA-2 filing

Here are the suggested steps for this filing

1.  The employee who is experiencing these symptoms would first use their own insurance to see a doctor.

2.  The doctor would have to agree that the symptoms are related to occupational exposure (illness) 

3.  The doctor would have to write a causation narrative that explains the causation of the traumatic exposure over a date range of days, weeks, months or years, that  the employee has developed a chronic exposure to traumatic events post (psychological diagnosis). The doctor does not have to pick a specific date, if over a period of time there are multiple events for the chronic exposure depression/PTSD to occur. The OWCP standard is when the employee "became aware" that these exposure events are effecting them.

4.  After a causation narrative from the doctor diagnosis is confirmed a development of a work-related type of psychological diagnosis from the chronic exposure or acute exposure of a period of a date range while working....you are ready to complete a CA-2.

5.  The injured worker would need to complete an injury statement of fact that is signed by the injured worker that explains the fact of injury in detail. This would need to be provided to OWCP via the ECOMP portal. 

6.  The CA-2 would be completed in the ECOMP portal, attach the signed injury statement, doctor's causation medical report with an OWCP  CA-35H form.

7.  Add additional OWCP form CA-35H: Other specified occupational diseases 

    Evidence Required

    For variant, CA-35H lists:

    Employee’s statement – detailed description of work factors believed to cause the condition, duration, and nature of exposure (e.g., chemicals used, lifting, distances walked) U.S. Department of Labor.

    Medical history – onset date, symptoms, home and professional treatment, prior similar problems, and copies of medical records U.S. Department of Labor.

    Physician’s report – must include:

    History as given by the employee

    Detailed findings

    Results of all diagnostic tests

    Diagnosis

    Clinical course of treatment

    Rationalized medical opinion linking the condition to identified work factors U.S. Department of Labor+1.

    Employing agency’s review – comments on the employee’s statement, job duties, leave records, and relevant personnel documents

Then the OWCP claims examiner would be able to adjudicate the merits of the case.

Thanks again for all of the listener questions and emails. Most do not make the show but I do answer all of your email questions. 

Ok… I think that is enough for today…I need to warm up this coffee and get going. So,  Thanks for joining me on this coffee break. If you found this tutorial podcast helpful, like, subscribe, or share with a fellow federal worker, and drop any questions in the comments or on our site. if  you have benefitted  from this information please leave a 5 star review on the platform you found this podcast, so others will also find this information online. 

Also, if you need an approved  medical provider for your DOL -OWCP Or Longshore case in Florida you can still  find me in Tampa, Jacksonville  and Pensacola. To make a consultation with me to discuss your case or if you know someone in Florida who is recently injured you can call the clinic at 813-215-4356  or go  to our website at https://fedcompconsultants.com/   & fwcmedicalcenters.net  Also if you are in  another state and you want me to assist you with claim questions or assistance for your  doctor you can email me at fedcompconsultants@protonmail.com 

As usual I want to thank all of you who put on that uniform, that badge, deliver that mail, take care of our veterans and make this government run… a big thank you. I do this for free just for you…We could not do this  without all of the work all of you out there do…so this is my big  thank you. And remember if you  have an injured federal claim and you need assistance…I am  here to help!

See you next time. Everyone stay blessed, pray for our soldiers and our nation to heal and for peace in war time and we will see you soon  with for another cup of coffee discussion on  Federal Workers Comp Coffee Break podcast. 

Off to get my coffee! See  you next time!