In the OWCP, claims examiners handle all cases which are identified as QCM and do all the processing, handling and decision-making on these cases. A Staff Nurse at OWCP assigns field nurses to those cases and monitors their performance. The majority of cases identified as QCM are assigned contract field nurses. These nurses are contracted as close to the injured employee as possible, to ensure immediate assistance with all medical issues.

Contract Field Nurses work for OWCP, not your employer. They do cooperate with your employer in many situations.

OWCP intends for field nurses to be the injured employees’ advocate. The field nurse maintains regular contact with the claims examiner assigned to your case, most often by telephone. The claims examiner is in charge of the case and directs the field nurse’s activities. The nurses strive to assist the employee with receiving the best medical care, treatment and with their return to work.

Field nurse responsibilities:

• Assure proper medical care is provided to the injured employee
• Assist the injured employee with returning to work
• Assist the injured employee on restrictions to return to full unrestricted duty
• Contact the injured employee, employer and physician(s) and any other parties involved in the case
• Serve as a liaison between these parties and the OWCP
• Monitor and Coordinate medical care for the injured employee
• Direct and expedite claims to the claims examiner for approval of diagnostic testing, physical therapy, surgery, and other treatment and services
• Assure that the attending physician has an adequate treatment plan
• Assure that the treatment plan progresses appropriately
• Accompany the injured employee to one or more office visits
• Contact physicians, employers and injured employee by telephone
• Provide a copy of work restrictions imposed by the attending physician to the employer and attempt to obtain appropriate restricted duty work consistent with the work restrictions.
• Monitor an employee who returns to work for 30 days to make sure it’s successful
• Assist an employee with permanent restrictions to obtain a permanent restricted duty assignment
• Obtain work restrictions from the attending physician if no permanent duty assignment is available, and refer the injured employee to vocational rehabilitation services.

The authorized period of nurse intervention is up to 120 days. Normally it is less than that. Once an employee has successfully returned to work for 30 days or the field nurse has been working on the case for 120 days, the nursing intervention will usually end.

Vocational rehabilitation is the second part of QCM. If an employee cannot return to his/her former job but has permanent work restrictions, the claims examiner will refer the case to a vocational rehabilitation specialist. The rehab specialist will provide services such as evaluation, plan development, placement, training, education and assisted reemployment.

If you have been injured on the job and receive a letter and phone call from a field nurse, expect a visit from them promptly thereafter. They will want to interview you in person, go over all treatment received so far, and communicate with your physician and employer. They may also want to talk with any witnesses or other parties directly involved with your injury. Expect the nurses to attend at least some doctor’s appointments with you. This sounds somewhat far-fetched but it is happening. The OWCP determined a need for this program, and it’s up for reconsideration in the near future. For the time being, it is definitely functioning and those nurses are out there visiting injured employees on a regular basis.

If you should receive such a letter and phone call from an OWCP contracted field nurse, it’s always a good idea to notify your shop steward immediately for advice. And remember to keep everything you receive from OWCP and the Postal Service regarding your injury in a file where you have immediate access to it if necessary.