Training Resources
Training Resources
Many times, patients have a diagnosis such as a sprain / strain that are later found to be a herniated disk or a torn ligament. Claims Examiners assume that minor conditions will require minor treatment and minimal time away from work. So, when a minor condition like a sprain / strain is the accepted condition, but the patient doesn’t seem to be improving, doctors will often request further imaging and other diagnostics. When it’s discovered that the actual condition is more severe (herniations, tears, etc), the doctor has to write a narrative report explaining the more severe condition and how it is causally related to the reported work injury. This is called a Diagnosis Expansion and the report is called a Diagnosis Expansion Report.
The same guidelines apply to diagnosis expansions as in initial medical narrative reports. However, the goal of the diagnosis expansion report is to get the claims examiner to “upgrade” the patient’s accepted conditions to include the newly-found, more-severe diagnoses. Incredible details are still required. Causation remains critical. The doctor’s medical opinion statement is still key to getting the new diagnoses added to the patient’s claim.
Once the diagnosis expansion is successful, claims examiners will approve the necessary treatments to help patients get better and back to work at the highest capacity possible.
Federal employees need help from expert, trained, and compliant doctors and staff who understand their unique needs, concerns, and struggles after they’re hurt at work. Work injuries may be inevitable, but losing is not. We have the power to help them. Federal employees make this country go. When they break, we have to fix them.