UPGRADE OF MEDICAL CONDITIONS

What Is an Upgrade of Medical Condition?

It is a worsening of your current accepted work injury. There are several reasons why an injury needs an upgrade of the medical condition.

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Who Determines If Your Claim Is Ready for an Upgrade of Medical Condition?

The attending physician.

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Can All Claims Be Upgraded?

The answer is definitely no. First, patients should consider the following questions and their individual answers as potential qualifiers for upgrading their claim:

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• Do you have a work injury?

• Did you have MRI done in the past year?

• How often do you see your physician?

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What Is Needed to Upgrade Medical Condition?

The physician must have full knowledge of the case to make a good opinion on whether it is ready for an upgrade of medical condition.

Oftentimes an employee can have an accepted condition that begins to worsen over time. An example would include a sprain injury that over a period of time could develop into a tear of the muscle or ligament. Most times when the OWCP accepts a claim, it is often accepted as a sprain, contusion, or strain. However, there may be other conditions or findings drawn from your diagnostic tests that may need to be included in your injury claim to the DOL/OWCP. An injured federal worker may have a claim accepted as a lower back sprain when actually he/she may have a herniated disc of L2 vertebrae. One would need a detailed medical report that describes the herniated disc and other diagnostic tests ordered. Our DOL certified doctors are experts in assisting with medical reports to help getting you condition upgraded.

Some common DOL injuries that may worsen during course of treatment to require are upgrade includes:

• Sprain/Strains

• Fractures

• Contusions

• Frostbite

• Abrasion

• Laceration

• Dislocation.

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If you feel that your current injury requires a medical upgrade, please contact our DOL-OWCP office staff for assistance with scheduling you for a visit with our DOL doctor.