D.C. Mun. Regs. tit. 7, r. 7-137

Current through Register 71, No. 45, November 7, 2024

Rule 7-137 - REPORT OF MEDICAL EVIDENCE

137.1

The claimant is responsible for providing sufficient medical evidence to justify the continuation of payment of any compensation sought.

137.2

To support payment of continuing compensation where an employee has been found entitled to temporary indemnity benefits, the claimant shall:

(a) Continuously supplement medical evidence to substantiate the nature and extent of ongoing disability; and

(b) Annually submit Form 3RC - Annual Medical Recertification, from the date the compensation commenced and at the Program's requests. The medical evidence within Form 3RC must contain a physician's rationalized opinion as to the nature and extent of disability and whether the specific period of alleged disability is causally related to the employee's accepted injury and condition or disability.

137.3

The physician's rationalized opinion must be based on the facts of the case and the complete medical background of the employee, must be one of reasonable medical certainty, and must include objective findings in support of its conclusions. Subjective complaints of pain are not sufficient, in and of themselves, to support payment of continuing compensation. Likewise, medical limitations based solely on the fear of a possible future injury are also not sufficient to support payment of continuing compensation.

137.4

The Program may require any kind of non-invasive testing to determine the employee's functional capacity. Failure to undergo such testing will result in a suspension of benefits. In addition, the Program may direct the employee to undergo an Additional Medical Examination in any case it deems appropriate.

D.C. Mun. Regs. tit. 7, r. 7-137

Final Rulemaking published at 59 DCR 8766, 8807 (July 27, 2012); amended by Final Rulemaking published at 64 DCR 6325 (7/7/2017)

Authority: Chief Risk Officer of the Office of Risk Management (ORM), Executive Office of the Mayor, pursuant to the authority set forth in section 2344 of the District of Columbia Government Merit Personnel Act of 1978 (CMPA), effective March 3, 1979 (D.C. Law 2-139; D.C. Official Code § 1-623.44 (2012 Supp.)); section 7 of Reorganization Plan No. 1 of 2003 for the Office of Risk Management, effective December 15, 2003; and Mayor's Order 2004-198, effective December 14, 2004