FECA Chiropractic Benefits
The Federal Employees’ Compensation Act (FECA) manages the payment of workers’ compensation benefits to personnel of all branches of the United States government. Under FECA the definition of “physician” includes surgeons, podiatrists, dentists, clinical psychologists, optometrists, osteopathic practitioners, and doctors of chiropractic within the scope of their practice as defined by state law.
Reimbursable services for doctors of chiropractic (DCs) consist of, “treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by x-ray to exist.” Subluxation, as defined by the Office of Workers’ Compensation Programs (OWCP), is “an incomplete dislocation, offcentering, misalignment, fixation or abnormal spacing of the vertebrae.” FECA restricts DC’s reimbursable services to treatment for the correction of spinal subluxation; however, any tests necessary to diagnose the subluxation are also payable.
A DC may interpret his/her own x-rays to determine if they confirm the diagnosis of subluxation and to decide if a period of disability resulting from that condition is necessary. The OWCP will not necessarily require that the x-ray be submitted, but the report must be available upon request. A report from a doctor of chiropractic must contain a diagnosis of “spinal subluxation as demonstrated by x-ray to exist,” in order for the OWCP to consider payment of the bill. A DC may provide services in the nature of physical therapy; however, these must be under the direction of and prescribed by a qualified physician.
Should a claimant request to change from the care of a medical doctor to that of a doctor of chiropractic, the claims examiner should consult the district medical advisor to determine whether the services of the DC would qualify as medical treatment under the Act, and whether the treatment is considered reasonable and necessary.
Questions? Contact ACA.