[House Report 119-394]
[From the U.S. Government Publishing Office]
119th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 119-394
======================================================================
IMPROVING ACCESS TO WORKERS' COMPENSATION FOR INJURED
FEDERAL WORKERS ACT OF 2025
_______
December 4, 2025.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Walberg, from the Committee on Education and Workforce, submitted
the following
R E P O R T
[To accompany H.R. 3170]
[Including cost estimate of the Congressional Budget Office]
The Committee on Education and Workforce, to whom was
referred the bill (H.R. 3170) to amend chapter 81 of title 5,
United States Code, to cover, for purposes of workers'
compensation under such chapter, services by physician
assistants and nurse practitioners provided to injured Federal
workers, and for other purposes, having considered the same,
reports favorably thereon with an amendment and recommends that
the bill as amended do pass.
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Improving Access to Workers'
Compensation for Injured Federal Workers Act of 2025''.
SEC. 2. INCLUSION OF PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS IN
FEDERAL EMPLOYEES' COMPENSATION ACT.
(a) Inclusion.--Section 8101 of title 5, United States Code, is
amended--
(1) in paragraph (3), by inserting ``, other eligible
providers,'' after ``osteopathic practitioners'';
(2) by striking ``and'' at the end of paragraphs (18) and
(19);
(3) by striking the period at the end of paragraph (20) and
inserting ``; and''; and
(4) by adding at the end the following:
``(21) `other eligible provider' means a nurse practitioner
or physician assistant within the scope of their practice as
defined by State law.''.
(b) Conforming Amendments.--Chapter 81 of title 5, United States
Code, is amended--
(1) in section 8103(a)--
(A) by inserting ``or other eligible provider'' after
``physician'' each place it appears; and
(B) in paragraph (3), by inserting ``or other
eligible providers'' after ``physicians'';
(2) in section 8121(6), by inserting ``or other eligible
provider'' after ``physician''; and
(3) in section 8123(a)--
(A) by inserting ``or other eligible provider'' after
``The employee may have a physician''; and
(B) by inserting ``or other eligible provider'' after
``United States and the physician''.
(c) Regulations.--Not later than 6 months after the date of enactment
of this Act, the Secretary of Labor shall finalize rules to carry out
the amendments made by this Act.
Purpose
H.R. 3170, the Improving Access to Workers' Compensation
for Injured Federal Workers Act of 2025, expands the role of
nurse practitioners (NPs) and physician assistants (PAs) in
providing services to injured federal workers under the Federal
Employees' Compensation Act (FECA) program within the scope of
the practices of NPs and PAs as defined by state law.
Committee Action
117TH CONGRESS
First Session--Hearing
On December 2, 2021, the Subcommittee on Workforce
Protections held a hearing entitled ``Strengthening the Safety
Net for Injured Workers.'' The Subcommittee heard testimony on
the difficulty injured federal workers face finding a physician
willing to participate in the FECA program and the need for
increased access to care for this population. The witnesses
were Mr. Christopher J. Godfrey, Director, Office of Workers'
Compensation Programs, U.S. Department of Labor, Washington,
D.C., and Mr. Thomas M. Costa, Director of Education,
Workforce, and Income Security, Government Accountability
Office, Washington, D.C.
Second Session--Legislative Action
On November 30, 2021, Representative Joe Courtney (D-CT)
introduced H.R. 6087, the Improving Access to Workers'
Compensation for Injured Federal Workers Act, with
Representative Tim Walberg (R-MI) as an original cosponsor. The
bill was referred solely to the Committee on Education and
Labor. On March 16, 2022, the Committee considered H.R. 6087 in
legislative session. The Committee considered an Amendment in
the Nature of a Substitute offered by Representative Courtney
making technical changes. The amendment was adopted by voice
vote. The Committee then reported the bill favorably, as
amended, to the House of Representatives by voice vote. On June
7, 2022, the House agreed to a motion to suspend the rules and
pass H.R. 6087 by a vote of 325-83.
118TH CONGRESS
Second Session--Hearing
On May 1, 2024, the Committee on Education and the
Workforce held a hearing entitled ``Examining the Policies and
Priorities of the Department of Labor'' to examine the
Department of Labor's (DOL) Fiscal Year 2025 budget priorities
and evaluate the effectiveness of its enforcement programs. The
sole witness was the Honorable Julie A. Su, Acting Secretary of
Labor, Washington, D.C. Representatives Walberg and Courtney
inquired about DOL's position on H.R. 618, the Improving Access
to Workers' Compensation for Injured Federal Workers Act.
Second Session--Legislative Action
On January 30, 2023, Representative Walberg introduced H.R.
618, the Improving Access to Workers' Compensation for Injured
Federal Workers Act, with Representative Courtney as an
original cosponsor. The bill was referred solely to the
Committee on Education and the Workforce. On June 13, 2024, the
Committee considered H.R. 618 in legislative session. The
Committee considered an Amendment in the Nature of a Substitute
offered by Representative Walberg making technical changes. The
amendment was adopted by voice vote. The Committee then
reported the bill favorably, as amended, to the House of
Representatives by a vote of 36-0.
119TH CONGRESS
First Session--Hearing
On May 6, 2025, the Subcommittee on Workforce Protections
held a hearing entitled ``FECA Reform and Oversight:
Prioritizing Workers, Protecting Taxpayer Dollars.'' The
Subcommittee heard testimony on the difficulty injured federal
workers face finding a physician willing to participate in the
FECA program and the need for increased access to care for this
population. The witnesses were Mr. Scott Szymendera,
Congressional Research Service, U.S. Library of Congress,
Washington, D.C.; Mr. Luiz Santos, Acting Inspector General,
U.S. Department of Labor, Washington, D.C.; Mr. Brian Renfroe,
National President, National Association of Letter Carriers;
and Ms. Tammy Hull, Inspector General, U.S. Postal Service,
Washington, D.C.
First Session--Legislative Action
On May 1, 2025, Committee on Education and Workforce
Chairman Walberg introduced H.R. 3170, the Improving Access to
Workers' Compensation for Injured Federal Workers Act, with
Representative Courtney as an original cosponsor. The bill was
referred solely to the Committee on Education and Workforce. On
June 25, 2025, the Committee considered H.R. 3170 in
legislative session. The Committee considered an Amendment in
the Nature of a Substitute offered by Chairman Walberg making
technical changes. The amendment was adopted by voice vote. The
Committee then reported the bill favorably, as amended, to the
House of Representatives by a vote of 34-0.
Committee Views
INTRODUCTION
H.R. 3170 allows NPs and PAs to act as eligible providers
under the FECA program within the scope of their practice
according to state law.
CURRENT LAW
Under FECA, which was enacted in 1916,\1\ only a physician
may make the diagnosis, certify the injury and extent of the
disability, and oversee the patient's treatment and care.\2\
``Physician'' includes surgeons, podiatrists, dentists,
clinical psychologists, optometrists, chiropractors, and
osteopathic practitioners within the scope of their practice as
defined by state law.\3\ As such, under current law, NPs and
PAs are unable to diagnose, certify an injury and extent of
disability, or oversee the treatment and care of FECA
beneficiaries without physician oversight.
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\1\Act of Sept. 7, 1916, Pub. L. No. 64-267, 39 Stat. 742 (1916).
\2\5 U.S.C Sec. 8101(2).
\3\Id.
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NURSE PRACTITIONERS
NPs are advanced practice registered nurses who obtain
graduate education at the master's, post-master's, or doctoral
level and obtain national board certification. NPs are educated
under the nursing model, where clinical training is integrated
into their core curriculum. NP programs are competency-based,
not time-based; as such, a student must demonstrate mastery of
content before advancing.\4\ Daily NP responsibilities often
include making physical examinations, diagnosing and treating
common acute and chronic problems, interpreting lab results and
X-rays, prescribing and managing medications and therapies, and
providing teaching and counseling to support healthy lifestyle
behaviors.\5\
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\4\Memorandum from MaryAnne Sapio, Vice President of Fed. Gov't
Aff., Am. Ass'n of Nurse Prac., to Kimberly Latimore, Leg. Assistant,
Off. of Sen. Sherrod Brown, and Maria Olson, Leg. Assistant, Off. of
Sen. Susan Collins (Jan. 8, 2024) (on file with Comm.).
\5\Mayo Clinic C. of Med. & Science, Nurse Practitioner,
college.mayo.edu/academics/
explore-health-care-careers/careers-a-z-/nurse-practitioner/ (last
visited July 18, 2025).
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PHYSICIAN ASSISTANTS
A PA is a licensed medical professional who holds an
advanced degree and may provide direct patient care. The
specific duties of a PA are determined by their supervising
physician and state law, but PAs provide many of the same
services as a primary care physician.\6\ They practice in every
state and in a wide variety of clinical settings and
specialties.\7\ PA daily responsibilities include making rounds
and performing patient exams, diagnosing illnesses, assisting
in surgery, ordering and interpreting lab tests and X-rays,
prescribing medications, developing and managing treatment
plans, and advising patients on preventative care and optimal
health practices.\8\
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\6\Mayo Clinic C. of Med. & Science, Physician Assistant,
college.mayo.edu/academics/
explore-health-care-careers/careers-a-z-/physician-assistant/ (last
visited July 18, 2025).
\7\Letter from Lisa Gables, Chief Exec. Off., AAPA, to Reps. Joe
Courtney & Tim Walberg (Mar. 15, 2022) (on file with Comm.).
\8\Mayo Clinic C. of Med. & Science, Physician Assistant, supra
note 6.
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OTHER FEDERAL PROGRAMS
The FECA program's prohibition on the utilization of NPs
and PAs to treat beneficiaries distinguishes it from other
federal programs. In Medicare, Medicaid, the Federal Employees
Health Benefits Program, and TRICARE, NPs and PAs may provide
and oversee care consistent with state scope-of-practice laws.
This is also the case within the Veterans' Health
Administration, the Department of Defense, the Indian Health
Service, and the U.S. Coast Guard, among other federal
agencies. Since 2017, the Social Security Administration has
considered NPs and PAs, along with physicians, to serve as
acceptable sources of information for documenting the existence
of an impairment for purposes of determining a disability.
Additionally, NPs and PAs are medical examiners listed on the
National Registry of Certified Medical Examiners for the
purpose of performing mandatory medical examinations for
drivers of commercial motor vehicles.\9\
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\9\Memorandum from MaryAnne Sapio, supra note 4.
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STATE LAWS
In the majority of state workers' compensation programs
that oversee private sector employees, NPs and PAs may provide
services. As of 2024, NPs may make a diagnosis and oversee and
coordinate care in 28 states.\10\ PAs are included as covered
providers in 44 states, while six states defer to the insurance
carrier. Thirty-five states allow PAs to submit claims under
their own National Provider Number (NPI), nine states defer to
the insurance carrier, and another six do not permit PAs to
file under their own NPI.\11\
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\10\Am. Ass'n of Nurse Prac. (AANP), AANP Workers' Compensation
State List (on file with Comm.).
\11\Am. Academy of Physician Assistants, Workers' Comp Chart 2020
(on file with Comm.).
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ACCESS TO CARE
According to the Medicare Payment Advisory Commission, NPs
and PAs account for one third of all primary care clinicians
treating Medicare beneficiaries nationwide. In rural
communities, their presence is closer to half of the primary
care clinicians.\12\ During a 2021 Workforce Protections
Subcommittee hearing titled ``Strengthening the Safety Net for
Injured Workers,'' Christopher Godfrey, the director of the
Office of Workers' Compensation Programs, testified on the
challenges of accessing care in rural communities. He said
there is often no doctor in town, and an NP or PA may be the
only clinician who can provide the immediate treatment or
ongoing care needed following a workplace injury. He also
stated that utilizing NPs and PAs will make it much easier for
FECA beneficiaries to access the care they need.\13\
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\12\Medicare Payment Advisory Comm'n, Medicare and the Health Care
Delivery System 27 (June 2022) https://www.medpac.gov/wp-content/
uploads/2022/06/Jun22_MedPAC_
Report_to_Congress_SEC.pdf.
\13\Strengthening the Safety Net for Injured Workers: Hearing
Before the Subcomm. on Workforce Protections of the H. Comm. on Educ. &
Lab., 117th Cong. 57-58 (2021).
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Mr. Scott Szymendera of the Congressional Research Service
testified at a hearing on May 6, 2025, before the Subcommittee
on Workforce Protections. In response to a question asked by
Chairman Walberg about the current FECA program's limitation on
physicians being allowed to certify a worker's compensation
claim, Mr. Szymendera stated:
Expanding the pool of providers to include nurse
practitioners, physician assistants, or as I think
their national academy now prefers referred physician
associates could expand the pool, and allow greater
access to physicians. It also could bring certain non-
traditional facilities such as urgent care clinics, or
medical clinics and retail stores into a greater role
in providing care.\14\
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\14\FECA Reform and Oversight: Prioritizing Workers, Protecting
Taxpayer Dollars: Hearing Before the Subcomm. on Workforce Protections
of the H. Comm. on Educ. & Workforce, 119th Cong. (2025) (testimony of
Scott D. Szymendera, Analyst of Disability Pol'y, Cong. Research
Serv.).
Mr. Brian Renfroe, National President, National Association
of Letter Carriers, testified at the same hearing. In response
to a question from Representative Ilhan Omar (D-MN) about
potential reforms that Congress should consider to improve the
FECA claims process, he testified that H.R. 3170 ``is
bipartisan legislation that would expand that access to include
physician assistants, and nurse practitioners. It really is a
common sense solution to that problem that follows a trend that
we have seen . . . around the country.''\15\
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\15\Id. (testimony of Brian L. Renfroe, President, Nat'l Ass'n of
Letter Carriers).
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EXPEDITED RETURN TO WORK
An essential goal of any workers' compensation program is
to safely return injured workers back to work. By providing
workers with more opportunities to access care, H.R. 3170
assists workers' abilities to return to work in a more timely
manner. H.R. 3170 serves both injured workers and taxpayers by
updating the FECA program in a manner that the Congressional
Budget Office (CBO) estimates will not add costs for taxpayers.
CBO has reiterated that H.R. 3170's impact on the budget--a
zero score--is the same as its estimate for H.R. 618 from the
118th Congress.\16\ Such a policy change assists workers,
ensures government efficiency, and costs the taxpayer nothing.
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\16\Cong. Budget Off., Cost Estimate for H.R. 618 (June 18, 2024),
https://www.cbo.gov/
system/files/2024-06/hr618EdW.pdf.
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CONCLUSION
For years, the Committee has examined issues of fraud and
access to benefits in the FECA program. Comprehensive changes
are needed to ensure the FECA program is meeting the needs of
workers and taxpayers. In particular, injured federal workers
need increased access to care, especially in rural communities
where the closest physician may be several hours away. H.R.
3170 takes an important step to authorize NPs and PAs to act as
eligible providers under the FECA program within the scope of
their practice according to state law, as NPs and PAs are often
the only clinicians within many communities. This legislation
will increase health care access for FECA beneficiaries at a
time when many areas of the country are grappling with provider
shortages. H.R. 3170 will help bring the nation one step closer
to a program that prevents abuse by bad actors, reflects the
realities of the 21st century, and provides adequate support to
workers. Committee Republicans recognize that maintaining the
status quo is not an option. Federal workers and taxpayers
deserve a more efficient and effective program.
Summary
H.R. 3170 SECTION-BY-SECTION SUMMARY
Section 1. Short title
Section 1 provides that the short title is ``Improving
Access to Workers' Compensation for Injured Federal Workers Act
of 2025.''
Section 2. Inclusion of physician assistants and nurse practitioners in
Federal Employees' Compensation Act
Section 2 allows nurse practitioners and physician
assistants acting within the scope of their practice under
state law to (1) prescribe or recommend treatment for injured
federal workers; (2) certify the nature of an injury and
probable extent of disability; (3) provide prescribed treatment
for injured federal workers; and (4) participate, with a
physician designated by DOL, in a mandatory workers'
compensation examination of an injured worker. Section 2 also
directs DOL to finalize rules to carry out Section 2 within six
months of enactment.
Statement of General Performance Goals and Objectives
In accordance with clause (3)(c) of rule XIII of the Rules
of the House of Representatives, the goal of H.R. 3170 is to
increase access to care for injured federal workers.
Explanation of Amendments
The amendment in the nature of a substitute is explained in
the body of this report.
Application of Law to the Legislative Branch
Section 102(b)(3) of Public Law 104-1 requires a
description of the application of this bill to the legislative
branch. H.R. 3170 increases access to care for injured federal
workers, including eligible employees of the legislative
branch.
Unfunded Mandate Statement
Pursuant to Section 423 of the Congressional Budget and
Impoundment Control Act of 1974, Pub. L. No. 93-344 (as amended
by Section 101(a)(2) of the Unfunded Mandates Reform Act of
1995, Pub. L. No. 104-4), the Committee traditionally adopts as
its own the cost estimate prepared by the Director of the
Congressional Budget Office (CBO) pursuant to section 402 of
the Congressional Budget and Impoundment Control Act of 1974.
Earmark Statement
H.R. 3170 does not contain any congressional earmarks,
limited tax benefits, or limited tariff benefits as defined in
clause 9 of House rule XXI.
Roll Call Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee Report to include for
each record vote on a motion to report the measure or matter
and on any amendments offered to the measure or matter the
total number of votes for and against and the names of the
Members voting for and against.
Statement of General Performance Goals and Objectives
In accordance with clause (3)(c) of House of
Representatives rule XIII, the goal of H.R. 3170, the Improving
Access to Workers' Compensation for Injured Federal Workers Act
of 2025, expands the role of nurse practitioners (NPs) and
physician assistants (PAs) in providing services to injured
federal workers under the Federal Employees' Compensation Act
(FECA) program within the scope of the practices of NPs and PAs
as defined by state law.
Duplication of Federal Programs
No provision of H.R. 3170 establishes or reauthorizes a
program of the Federal Government known to be duplicative of
another Federal program, a program that was included in any
report from the Government Accountability Office to Congress
pursuant to section 21 of Public Law 111-139, or a program
related to a program identified in the most recent Catalog of
Federal Domestic Assistance.
Statement of Oversight Findings and Recommendations of the Committee
In compliance with clause 3(c)(1) of rule XIII and clause
2(b)(1) of rule X of the Rules of the House of Representatives,
the Committee's oversight findings and recommendations are
reflected in the body of this report.
Required Committee Hearing
In compliance with clause 3(c)(6) of rule XIII of the Rules
of the House of Representatives the following hearing held
during the 119th Congress was used to develop or consider H.R.
3170: On May 6, 2025, the Subcommittee on Workforce Protections
held a hearing on ``FECA Reform and Oversight: Prioritizing
Workers, Protecting Taxpayer Dollars.''
New Budget Authority and CBO Cost Estimate
Clause 3(d)(1) of rule XIII of the Rules of the House of
Representatives requires an estimate and a comparison of the
costs that would be incurred in carrying out H.R. 3170.
However, clause 3(d)(2)(B) of that rule provides that this
requirement does not apply when, as with the present report,
the Committee adopts as its own the cost estimate for the bill
prepared by the Director of the Congressional Budget Office.
H.R. 3170 would allow nurse practitioners and physician
assistants to diagnose, treat, and certify an injury and extent
of disability for the purposes of compensating federal workers
under the Federal Employees' Compensation Act (FECA). Using
information from the Department of Labor, CBO expects that
nonphysician providers would be compensated at the same rate as
physicians and that total benefits provided to injured federal
workers would not significantly change. Some people may receive
treatment more quickly under the bill, which could increase
costs over the 10-year period because some payments to medical
providers that would have occurred in 2036 under current law
could be paid in 2035. On the other hand, if injured workers
receive treatment faster, some may return to work more quickly,
which could reduce costs. CBO has no basis to estimate which
effect would predominate, but expects that those effects would
roughly offset each other. Thus, CBO estimates that enacting
H.R. 3170 would affect net direct spending by an insignificant
amount.
Although FECA payments are mandatory, the costs are charged
back to a claimant's employing agency and those amounts are
paid from the agency's salaries and expense accounts. Any
effect on spending would be subject to future appropriation
actions.
The CBO staff contact for this estimate is Meredith Decker.
The estimate was reviewed by Christina Hawley Anthony, Deputy
Director of Budget Analysis.
Phillip L. Swagel,
Director, Congressional Budget Office.
Committee Cost Estimate
Clause 3(d)(1) of rule XIII of the Rules of the House of
Representatives requires an estimate and a comparison of the
costs that would be incurred in carrying out H.R. 3170.
However, clause 3(d)(2)(B) of that rule provides that this
requirement does not apply when, as with the present report,
the Committee has requested a cost estimate for the bill from
the Director of the Congressional Budget Office.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, and existing law in which no
change is proposed is shown in roman):
TITLE 5, UNITED STATES CODE
* * * * * * *
PART III--EMPLOYEES
* * * * * * *
SUBPART G--INSURANCE AND ANNUITIES
* * * * * * *
CHAPTER 81--COMPENSATION FOR WORK INJURIES
* * * * * * *
SUBCHAPTER I--GENERALLY
Sec. 8101. Definitions
For the purpose of this subchapter--
(1) ``employee'' means--
(A) a civil officer or employee in any branch
of the Government of the United States,
including an officer or employee of an
instrumentality wholly owned by the United
States;
(B) an individual rendering personal service
to the United States similar to the service of
a civil officer or employee of the United
States, without pay or for nominal pay, when a
statute authorizes the acceptance or use of the
service, or authorizes payment of travel or
other expenses of the individual;
(C) an individual, other than an independent
contractor or an individual employed by an
independent contractor, employed on the
Menominee Indian Reservation in Wisconsin in
operations conducted under a statute relating
to tribal timber and logging operations on that
reservation;
(D) an individual employed by the government
of the District of Columbia;
(E) an individual appointed to a position on
the office staff of a former President under
section 1(b) of the Act of August 25, 1958 (72
Stat. 838);
(F) an individual selected pursuant to
chapter 121 of title 28, and serving as a petit
or grand juror; and
(G) an individual who is a System member of
the National Urban Search and Rescue Response
System during a period of appointment into
Federal service pursuant to section 327 of the
Robert T. Stafford Disaster Relief and
Emergency Assistance Act;
but does not include--
(i) a commissioned officer of the Regular
Corps of the Public Health Service;
(ii) a commissioned officer of the Reserve
Corps of the Public Health Service on active
duty;
(iii) a commissioned officer of the
Environmental Science Services Administration;
or
(iv) a member of the Metropolitan Police or
the Fire Department of the District of Columbia
who is pensioned or pensionable under sections
521-535 of title 4, District of Columbia Code;
and
(2) ``physician'' includes surgeons, podiatrists,
dentists, clinical psychologists, optometrists,
chiropractors, and osteopathic practitioners within the
scope of their practice as defined by State law. The
term ``physician'' includes chiropractors only to the
extent that their reimbursable services are limited to
treatment consisting of manual manipulation of the
spine to correct a subluxation as demonstrated by X-ray
to exist, and subject to regulation by the Secretary;
(3) ``medical, surgical, and hospital services and
supplies'' includes services and supplies by
podiatrists, dentists, clinical psychologists,
optometrists, chiropractors, osteopathic practitioners,
other eligible providers, and hospitals within the
scope of their practice as defined by State law.
Reimbursable chiropractic services are limited to
treatment consisting of manual manipulation of the
spine to correct a subluxation as demonstrated by X-ray
to exist, and subject to regulation by the Secretary;
(4) ``monthly pay'' means the monthly pay at the time
of injury, or the monthly pay at the time disability
begins, or the monthly pay at the time compensable
disability recurs, if the recurrence begins more than 6
months after the injured employee resumes regular full-
time employment with the United States, whichever is
greater, except when otherwise determined under section
8113 of this title with respect to any period;
(5) ``injury'' includes, in addition to injury by
accident, a disease proximately caused by the
employment, and damage to or destruction of medical
braces, artificial limbs, and other prosthetic devices
which shall be replaced or repaired, and such time lost
while such device or appliance is being replaced or
repaired; except that eyeglasses and hearing aids would
not be replaced, repaired, or otherwise compensated
for, unless the damages or destruction is incident to a
personal injury requiring medical services;
(6) ``widow'' means the wife living with or dependent
for support on the decedent at the time of his death,
or living apart for reasonable cause or because of his
desertion;
(7) ``parent'' includes stepparents and parents by
adoption;
(8) ``brother'' and ``sister'' mean one who at the
time of the death of the employee is under 18 years of
age or over that age and incapable of self-support, and
include stepbrothers and stepsisters, half brothers and
half sisters, and brothers and sisters by adoption, but
do not include married brothers or married sisters;
(9) ``child'' means one who at the time of the death
of the employee is under 18 years of age or over that
age and incapable of self-support, and includes
stepchildren, adopted children, and posthumous
children, but does not include married children;
(10) ``grandchild'' means one who at the time of the
death of the employee is under 18 years of age or over
that age and incapable of self-support;
(11) ``widower'' means the husband living with or
dependent for support on the decedent at the time of
her death, or living apart for reasonable cause or
because of her desertion;
(12) ``compensation'' includes the money allowance
payable to an employee or his dependents and any other
benefits paid for from the Employees' Compensation
Fund, but this does not in any way reduce the amount of
the monthly compensation payable for disability or
death;
(13) ``war-risk hazard'' means a hazard arising
during a war in which the United States is engaged;
during an armed conflict in which the United States is
engaged, whether or not war has been declared; or
during a war or armed conflict between military forces
of any origin, occurring in the country in which an
individual to whom this subchapter applies is serving;
from--
(A) the discharge of a missile, including
liquids and gas, or the use of a weapon,
explosive, or other noxious thing by a hostile
force or individual or in combating an attack
or an imagined attack by a hostile force or
individual;
(B) action of a hostile force or individual,
including rebellion or insurrection against the
United States or any of its allies;
(C) the discharge or explosion of munitions
intended for use in connection with a war or
armed conflict with a hostile force or
individual;
(D) the collision of vessels on convoy or the
operation of vessels or aircraft without
running lights or without other customary
peacetime aids to navigation; or
(E) the operation of vessels or aircraft in a
zone of hostilities or engaged in war
activities;
(14) ``hostile force or individual'' means a nation,
a subject of a foreign nation, or an individual serving
a foreign nation--
(A) engaged in a war against the United
States or any of its allies;
(B) engaged in armed conflict, whether or not
war has been declared, against the United
States or any of its allies; or
(C) engaged in a war or armed conflict
between military forces of any origin in a
country in which an individual to whom this
subchapter applies is serving;
(15) ``allies'' means any nation with which the
United States is engaged in a common military effort or
with which the United States has entered into a common
defensive military alliance;
(16) ``war activities'' includes activities directly
relating to military operations;
(17) ``student'' means an individual under 23 years
of age who has not completed 4 years of education
beyond the high school level and who is regularly
pursuing a full-time course of study or training at an
institution which is--
(A) a school or college or university
operated or directly supported by the United
States, or by a State or local government or
political subdivision thereof;
(B) a school or college or university which
has been accredited by a State or by a State-
recognized or nationally recognized accrediting
agency or body;
(C) a school or college or university not so
accredited but whose credits are accepted, on
transfer, by at least three institutions which
are so accredited, for credit on the same basis
as if transferred from an institution so
accredited; or
(D) an additional type of educational or
training institution as defined by the
Secretary of Labor.
Such an individual is deemed not to have ceased to be a
student during an interim between school years if the
interim is not more than 4 months and if he shows to
the satisfaction of the Secretary that he has a bona
fide intention of continuing to pursue a full-time
course of study or training during the semester or
other enrollment period immediately after the interim
or during periods of reasonable duration during which,
in the judgment of the Secretary, he is prevented by
factors beyond his control from pursuing his education.
A student whose 23rd birthday occurs during a semester
or other enrollment period is deemed a student until
the end of the semester or other enrollment period;
(18) ``price index'' means the Consumer Price Index
(all items--United States city average) published
monthly by the Bureau of Labor Statistics; [and]
(19) ``organ'' means a part of the body that performs
a special function, and for purposes of this subchapter
excludes the brain, heart, and back; [and]
(20) ``United States medical officers and hospitals''
includes medical officers and hospitals of the Army,
Navy, Air Force, Department of Veterans Affairs, and
United States Public Health Service, and any other
medical officer or hospital designated as a United
States medical officer or hospital by the Secretary of
Labor[.]; and
(21) ``other eligible provider'' means a nurse
practitioner or physician assistant within the scope of
their practice as defined by State law.
* * * * * * *
Sec. 8103. Medical services and initial medical and other benefits
(a) The United States shall furnish to an employee who is
injured while in the performance of duty, the services,
appliances, and supplies prescribed or recommended by a
qualified physician or other eligible provider, which the
Secretary of Labor considers likely to cure, give relief,
reduce the degree or the period of disability, or aid in
lessening the amount of the monthly compensation. These
services, appliances, and supplies shall be furnished--
(1) whether or not disability has arisen;
(2) notwithstanding that the employee has accepted or
is entitled to receive benefits under subchapter III of
chapter 83 of this title or another retirement system
for employees of the Government; and
(3) by or on the order of United States medical
officers and hospitals, or, at the employee's option,
by or on the order of physicians or other eligible
providers and hospitals designated or approved by the
Secretary.
The employee may initially select a physician or other eligible
provider to provide medical services, appliances, and supplies,
in accordance with such regulations and instructions as the
Secretary considers necessary, and may be furnished necessary
and reasonable transportation and expenses incident to the
securing of such services, appliances, and supplies. These
expenses, when authorized or approved by the Secretary, shall
be paid from the Employees' Compensation Fund.
(b) The Secretary, under such limitations or conditions as he
considers necessary, may authorize the employing agencies to
provide for the initial furnishing of medical and other
benefits under this section. The Secretary may certify vouchers
for these expenses out of the Employees' Compensation Fund when
the immediate superior of the employee certifies that the
expense was incurred in respect to an injury which was accepted
by the employing agency as probably compensable under this
subchapter. The Secretary shall prescribe the form and content
of the certificate.
* * * * * * *
Sec. 8121. Claim
Compensation under this subchapter may be allowed only if an
individual or someone on his behalf makes claim therefor. The
claim shall--
(1) be made in writing within the time specified by
section 8122 of this title;
(2) be delivered to the office of the Secretary of
Labor or to an individual whom the Secretary may
designate by regulation, or deposited in the mail
properly stamped and addressed to the Secretary or his
designee;
(3) be on a form approved by the Secretary;
(4) contain all information required by the
Secretary;
(5) be sworn to by the individual entitled to
compensation or someone on his behalf; and
(6) except in case of death, be accompanied by a
certificate of the physician or other eligible provider
of the employee stating the nature of the injury and
the nature and probable extent of the disability.
The Secretary may waive paragraphs (3)-(6) of this section for
reasonable cause shown.
* * * * * * *
Sec. 8123. Physical examinations
(a) An employee shall submit to examination by a medical
officer of the United States, or by a physician designated or
approved by the Secretary of Labor, after the injury and as
frequently and at the times and places as may be reasonably
required. The employee may have a physician or other eligible
provider designated and paid by him present to participate in
the examination. If there is disagreement between the physician
making the examination for the United States and the physician
or other eligible provider of the employee, the Secretary shall
appoint a third physician who shall make an examination.
(b) An employee is entitled to be paid expenses incident to
an examination required by the Secretary which in the opinion
of the Secretary are necessary and reasonable, including
transportation and loss of wages incurred in order to be
examined. The expenses, when authorized or approved by the
Secretary, are paid from the Employees' Compensation Fund.
(c) The Secretary shall fix the fees for examinations held
under this section by physicians not employed by or under
contract to the United States to furnish medical services to
employees. The fees, when authorized or approved by the
Secretary, are paid from the Employees' Compensation Fund.
(d) If an employee refuses to submit to or obstructs an
examination, his right to compensation under this subchapter is
suspended until the refusal or obstruction stops. Compensation
is not payable while a refusal or obstruction continues, and
the period of the refusal or obstruction is deducted from the
period for which compensation is payable to the employee.
* * * * * * *
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