doubt whether the disability of the employee is due to an injury coming within the purview of said act; also see § 2.5.

(b) Authorization may be given for emergency treatment before the issuance of Form C. A. 16: Provided, That this form is issued within 48 hours thereafter.

(c) In every case in which Form C. A. 16 or Form C. A. 17 is used, a copy of such form shall be transmitted to the Bureau together with the reports required by § 1.3 of this subchapter.

§ 2.4 Medical treatment for recurrence of disability.

If an injured employee complains of a recurrence of disability (whether or not he is disabled for work), after having recently been discharged from medical treatment, on account of an injury recognized as compensable by the Bureau, under circumstances from which it may reasonably be inferred that such disability is the result of such injury, the official superior in his discretion may issue Form C. A. 16 for treatment by a medical officer of the United States or a Government hospital, or a designated physician provided that not more than 6 months shall have elapsed since the final action of the Bureau upon the case. In any other case in which the employee complains of a recurrence of disability with respect to which there may be doubt that the disability is the result of the injury or in any case in which the final action of the Bureau shall have been taken more than 6 months prior to complaint, the official superior should

communicate

with the Bureau and request instructions, stating all of the pertinent facts in his communication. In all other cases the employee should communicate with the Bureau and request such treatment. § 2.5 Medical treatment in doubtful

cases.

Cases of a doubtful nature, so far as compensability in concerned, should be referred by the official superior to a medical officer of the United States, a Government hospital, or a designated physician for treatment, using Form C. A. 17 for this purpose in lieu of Form C. A. 16. Where such form has been furnished, a statement of all pertinent facts relating to the particular case, together with a statement of the reason for such doubt, shall be forwarded immediately to the Bureau for considera

tion. Form C. A. 17 authorizes only necessary emergency treatment pending receipt of advice from the Bureau, and shall be used only in cases where prima facie there is a causal relation between the alleged disability and the employment, and shall not be used as authority for operations in hernia cases unless the hernia is strangulated or incarcerated. If the medical examination or other information received subsequent to the issuance of authorization for treatment discloses that the condition for which the treatment was rendered is not due to an injury, the person issuing the authorization shall immediately notify the physician or hospital that no further treatment shall be rendered for the account of the Bureau. In cases of an emergency nature or cases involving unusual circumstances, the Bureau may in the exercise of its discretion authorize treatment otherwise than as provided for in this part, or it may approve payment for medical expenses incurred otherwise than as authorized in this section. No authority for examination or for medical or other treatment should be given in any case already disallowed by the Bureau. (For cases requiring emergency treatment, see § 2.2.)

§ 2.6 Authority for dental treatment.

All necessary dental treatment, including repairs to fixed false teeth or to natural teeth, needed to repair damage done by an injury will be furnished by the Bureau. Such treatment shall be rendered by or upon the order of a United States dental officer or United States medical establishment, when available and practicable. If such facilities are not available, or treatment by such facilities is not practicable, no dental work should be authorized without obtaining in advance the approval of the Bureau. (For cases requiring emergency treatment see § 2.2.) (For cases requiring artificial denture see § 2.9.) [6 F.R. 5305, Oct. 18, 1941]

§ 2.7 Medical examinations.

(a) An injured employee shall be required to submit to examination by a medical officer of the United States or by a designated physician or a duly qualified physician approved by the Bureau, as frequently and at such times and places as in the opinion of the Bureau may be reasonably necessary. The injured employee may have a duly qualified physician, paid by him, present at the time of

such examination. For any examination required by the Bureau an injured employee shall be paid all expenses incident to such examination which, in the opinion of the Bureau, are necessary and reasonable, including transportation and actual loss of wages incurred in order to submit to the examination authorized by the Bureau.

(b) If the employee refuses to submit himself for or in any way obstructs any examination, his right to claim compensation under said act shall be suspended until such refusal or obstruction ceases. No compensation shall be payable while such refusal or obstruction continues, and the period of such refusal or obstruction shall be deducted from the period for which compensation is payable to him.

§ 2.8

Medical referee examination.

If there should be a disagreement between the physician making an examination on the part of the United States and the injured employee's physician, application may be made to the Bureau for the appointment of a third physician, duly qualified, who shall make an examination.

§ 2.9 Furnishing of orthopedic and prosthetic appliances, and dental work.

When an orthopedic or prosthetic appliance, such as an artificial eye or limb, is deemed to be necessary by the attending physician by reason of an injury which has been found by the Bureau to have occurred while in the performance of duty, application therefor may be made to the Bureau, stating the necessity therefor, the approximate cost of such appliance, and a brief description thereof. Applications for repairs to such an appliance furnished by the Bureau will be made in the same manner. Where artificial denture is necessary in such cases, application therefor may similarly be made.

§ 2.10 Recording and submission of medical reports.

Medical officers, designated physicians, other physicians and hospitals shall keep adequate records of all injury cases treated by them sufficient to supply the Bureau with a history of the employee's accident, the exact description, nature, location and extent of

injury, the degree of disability arising therefrom, the X-ray findings if X-ray examination has been made, the nature of the treatment rendered, and the degree of disability arising from the injury. A medical officer or such physicians shall forward to the Bureau a full report with respect to each injury case treated by him under the provisions of the Compensation Act which results in charge for treatment or supplies against the Bureau, or involves any loss of time beyond the day, shift, turn or working period during which it occurs. Form C. A. 20 has been provided by the Bureau for use in submitting the initial medical report. Form C. A. 78 has been provided by the Bureau for use in forwarding initial report of operation. In hernia cases, Form C. A. 32 similarly has been provided. These reports should be forwarded promptly to the Bureau. Detailed supplementary report in the form of a letter should be made by the medical officer or such physician in all cases of serious injury, especially injuries of the head and back, including cases requiring hospital treatment or prolonged care. The supplementary report should show the date when case was first examined or treated, the patient's complaint, the condition found on examination, the diagnosis, medical opinion as to any relationship between the disability and the injury alleged, report as to any other disabilities found not due to injury, the treatment given or recommended for the industrial injury, the degree of disability for usual or other employment as a result of the injury, the actual degree of loss of active or passive motion of an injured member, the amount of atrophy or deformity in a member, the decrease, if any, in strength, the disturbance of sensation, the prognosis for recovery, and all other material facts. If the services of a specialist are required in the examination or treatment of a beneficiary, a report of his findings upon examination, his diagnosis, his opinion as to the relationship of disability to injury, the treatment recommended by him, a statement of the degree of disability for work as a result of injury and the prognosis should be forwarded to the Bureau for consideration in conjunction with other reports. The requirements of this section or of any section in this part with respect to the form of medical, dental, hospital or other reports may be waived by the Bureau.

§ 2.11

Submission of bills for medical services, appliances and supplies.

All charges for medical, hospital, surgical, or other treatment or care of injured employees shall be itemized on Form S-69 provided by the Bureau, and this form properly executed shall be forwarded promptly to the Bureau for consideration. A separate Form S-69 shall be submitted by each payee for services to each injured employee. Vouchers should be submitted when the employee is discharged from treatment, except when treatment extends for more than 30 days, in which event Form S-69 should be submitted at the end of each 30-day period. Vouchers shall be verified by the signature of the injured employee, and if such signature cannot be obtained, a concise explanation of the reason for the failure to secure such verification must be stated.

$ 2.12

Reimbursement for medical expense, transportation costs, loss of wages, and incidental expenses.

If bills for medical, surgical, nursing, dental or hospital services or supplies, or appliances, have been paid by an injured employee on account of an injury incurred while in the performance of duty, an itemized bill, receipted and signed by the person who has received payment, may be submitted to the Bureau for consideration. If payment has been made to a hospital, corporation or firm, the receipted bill should bear the signature or initials of the person acting for the payee. If receipted by mechanical stamp or device, which shows clearly its intent and purpose, the usual formalities attendant to the receipting of bills may be dispensed with. Where the means of transportation is not furnished by the Government, a claim for reimbursement of the cost of necessary transportation, and of necessary incidental expenses incurred by an injured employee who has been authorized to travel for the purpose of securing medical or hospital treatment, appliances or supplies or for medical examinations, may be submitted promptly to the Bureau for consideration. Standard Form 1012 properly executed should be used for this purpose. Where transportation by automobile is furnished by an employee of the United States or by a relative of the injured employee, reimbursement may be made at the rate per mile fixed by law, Executive, administrative or other order for

employees of the United States authorized to travel at Government expense. [13 F.R. 7669, Dec. 10, 1948]

PART 3-CASES INVOLVING THE LIABILITY OF A THIRD PARTY

Sec.

3.1 Prosecution of third party action by beneficiary.

3.2

3.3

Assignment of third party.

Refusal to assign or prosecute claim when required; effect.

3.4 Distribution of damages recovered by beneficiary.

3.5 Distribution of damages where cause of action is assigned.

3.6 Bureau may require beneficiary to settle or compromise third party suit.

AUTHORITY: The provisions of this Part 3 issued under sec. 32, 39 Stat. 749, as amended: 5 U.S.C. 783, 1946 Reorg. Plan No. 2, § 3, 3 CFR, 1943-1948 Comp., p. 1064; 60 Stat. 1095; 1950 Reorg. Plan No. 19, § 1, 3 CFR 19491953 Comp., p. 1010; 64 Stat. 1271.

SOURCE: The provisions of this Part 3 contained in Regulations under the United States Employees' Compensation Act, June 1, 1938, unless otherwise noted.

§3.1 Prosecution of third party action by beneficiary.

If an injury or death for which compensation is payable under said act is caused under circumstances creating a legal liability upon some person other than the United States to pay damages therefor, the Bureau may require the beneficiary to prosecute an action for damages against such third person. When required by the Bureau, such cause of action shall be prosecuted in the name of the injured employee or of his personal representative by attorneys designated or approved by the Bureau. § 3.2 Assignment of third party.

If an injury or death for which compensation is payable under said act is caused under circumstances creating a legal liability upon some person other than the United States to pay damages therefor, the beneficiary shall, if required by the Bureau, assign any right of action he may have to the United States. All such assignments shall be in writing and no such cause of action shall vest in the United States unless and until the assignment is accepted by the Bureau. § 3.3 Refusal to assign or prosecute claim when required; effect.

Refusal on the part of a beneficiary to assign his right of action to the United

States or to prosecute said action in his own name when required by the Bureau shall deprive the employee of all rights to compensation.

§ 3.4

Distribution of damages recovered by beneficiary.

If an injury or death for which compensation is payable under said act is caused under circumstances creating a legal liability upon some person other than the United States to pay damages therefor, and, as a result of suit brought by the beneficiary or by someone on his behalf, or as a result of settlement made by him or on his behalf in satisfaction of the liability of such other person, the beneficiary shall recover damages or receive any money or other property in satisfaction of the liability of such other person on account of such injury or death, the proceeds of such recovery shall be applied as follows:

(a) If an attorney is employed, a reasonable attorney's fee and cost of collection, if any, shall first be deducted from the gross amount of the settlement;

(b) There shall then be remitted to the Bureau the full amount of compensation which has been paid on account of the injury, which shall include payments made on account of medical or hospital treatment, funeral expense, and any other payments that have been made by the Bureau on account of the injury or death;

(c) Any surplus then remaining may be retained by the injured employee or his dependents, and the net amount of damages received by the beneficiary shall be credited against future payments of compensation to which the beneficiary may be entitled under the said act on account of the same injury.

§ 3.5

Distribution of damages where cause of action is assigned.

If the Bureau realizes upon a cause of action assigned to the United States pursuant to section 26 of said act, it shall apply the money or other property so received in the following manner; namely:

After deducting the amount of any compensation paid in respect of the injury or death on account of which the cause of action arose, and the expense of such realization or collection, which sum shall be placed to the credit of the proper fund of the Bureau, the surplus, if any, of such amount received shall be paid to the beneficiary and credited pro tanto upon

any future payments of compensation payable to him on account of the same injury.

§ 3.6 Bureau may require beneficiary to settle or compromise third party suit. Where a beneficiary under said act has commenced an action in his own name or has initiated such action through an administrator of a deceased person to recover damages against the third party liable for the injury or death, the Bureau shall, at all times, have authority to require the beneficiary or such administrator to settle or compromise such action whenever it shall appear to the Bureau that further prosecution of the cause of action is not warranted. Refusal on the part of such beneficiary or other person acting in the interest of the beneficiary to make such settlement or to effect such compromise when so directed by the Bureau shall be deemed to be sufficient cause for refusal on the part of the Bureau to pay compensation on account of the same injury or death, or the Bureau may suspend compensation during the period of such refusal.

[4 F.R. 4558, Nov. 11, 1939]

The provisions of this part shall apply in respect to compensation, under the United States Employees' Compensation Act, payable only to employees of the United States who are neither citizens nor residents of the United States, any Territory, or Canada, or payable to any dependents of such employees. It has previously been determined, pursuant to section 42 of such act, that the amount of compensation, as provided under such act, is substantially disproportionate to the compensation for disability or death which is payable in similar cases under local law, regulation, custom, or otherwise, in areas outside the United States, any Territory, or Canada. Therefore, in respect to cases of such employees whose injury (or injury resulting in death) has occurred subsequent to December 7, 1941, or may occur, the following provisions shall be applicable.

§ 25.2

General adoption of local law.

(a) Pursuant to the provisions of section 42 of such act, the benefit features of local workmen's compensation laws, or provisions in the nature of workmen's compensation, in effect in the areas referred to in § 25.1, shall, effective as of December 7, 1941, by adoption and adaptation, as recognized by the Director, Bureau of Employees' Compensation, apply in the cases of the employees specified in § 25.1; Provided however, That there is not established and promulgated under this part, for the particular locality, or for a class of employees in the particular locality, a special schedule of compensation for injury or death.

(b) The benefit provisions as thus adopted or adapted are those dealing with the money payments for injury and death (including provisions dealing with medical, surgical, hospital and similar treatment and care), as well as those dealing with services and purposes forming an integral part of the local plan, provided they are of a kind or character similar to services and purposes authorized by the Employees' Compensation Act. Procedural provisions, designations of classes of beneficiaries in death cases, limitations (except those affecting

amounts of benefit payments), and any other provisions not directly affecting the amounts of the benefit payments, in such local plans, shall not apply, but in lieu thereof the pertinent provisions of the Employees' Compensation Act shall apply, unless modified by further specification in this section.

(c) Compensation in all cases of such employees paid and closed prior to the effective date of the regulations in this part shall be deemed compromised and paid under section 42 of such act; in all other cases compensation may be adjusted to conform with the regulations in this part, or the beneficiary may by compromise or agreement with the Bureau have compensation continued on the basis of a previous adjustment of the claim.

§ 25.3

General provisions relating to special schedule.

The special schedule established by Subpart B of this part is intended as the vehicle of general basic provisions, to be adapted, with such modifications as may be necessary, and as local conditions outside the United States require. The application of this special schedule will be by specific and appropriate provision in the regulations in this part, such provision specifying the locality to which applied, and the particular modifications of or additions to the schedule, as may be made.

§ 25.4 Authority to settle and pay

claims.

In addition to the authority to receive, process and pay claims, when delegated such representative or agency receiving delegation of authority shall, in respect to cases adjudicated under this part, and when so authorized by the Director, have authority (a) to make lump sum awards (in the manner prescribed by section 14 of such act) whenever such authorized representative shall deem such settlement to be for the best interest of the United States, and (b) to compromise and pay claims for any benefits provided for under this part, including claims in which there is a dispute as to jurisdiction or other facts, or questions of law. The Director shall, in administrative instructions to the particular representative concerned, establish such procedures in respect to action under this section as may be deemed necessary, and may specify the scope of any administrative review of such action.