Traumatic injuries continue to be an unfortunate reality for letter carriers.1 We are exposed to a variety of hazards, including vicious dogs, dangerous walking conditions, ill-maintained vehicles, crazy people, and many other less than ideal work factors. Inattention and haste by the employee also figure prominently in the cause of many accidents. Sensible policies aimed at preventing accidents are urgently needed. Although we must all try to work more safely, and insist on safer practices by the employer, the fact remains that letter carriers will continue to suffer injuries, and most of these injuries will require at least some medical attention.

When injured at work, it is crucial that the matter be reported promptly on Form CA-1. Waiting until the end of the tour poses serious problems in acquiring medical care. It also exposes the employee to the risk of formal discipline under USPS policy for delayed reporting. Conflict also arises when the employee tries to defer the medical attention to the following day, when it will occur on the clock, instead of seeking it on a no loss-no gain basis later the same day. This is because pay can generally only be granted for previously scheduled hours including scheduled overtime.2

An exceptional situation may occur when the employee selects a treating physician of their own, but management directs the employee to visit their contract clinic first for an evaluation. Seek administrative pay for this “employer-directed physical exam,” and grieve if denied. We have won some of the grievances on this issue, based on the fact circumstances.

Do you have the right to select the physician who will care for you? That is the question! The answer is yes! However, this is nowhere near as simple as it sounds.

(1) Does your physician accept patients under Federal injury compensation? Many HMO physicians do not, and a growing number of private practice doctors are fed up with the grief that they get from The Department of Labor (OWCP) and/or the Postal Service. You need to know now, not after the injury, if your doctor would see you under FECA procedures and would see you on very short notice.

(2) Will your physician see you that day? If not, you can specify your physician for follow-up care, but things get messy because the physician seeing you immediately will write your initial work restrictions. For potentially serious injuries, we strongly recommend selection of any convenient major hospital or trauma center in preference to using one of the USPS contract clinics. A hospital with trauma capability is fully staffed and equipped to handle medical emergencies, and the initial assessment of disability will be independent of USPS input. Our employer attempts to “manage the injury” through cooperation with its clinics, and phase one of managing the injury is getting the employee back at work, no matter what, to manage down “lost workday” statistics.

(3) Is your personal physician really the best doctor to care for your injury? Quite probably not if the injury is at all serious, in which case you will get inferior care or require referral to a specialist. It is often said that your doctor knows you best, but medicine is vastly more specialized now, and traumatic injuries respond to prompt and effective care. In trauma medicine, the first hour after the injury is called the “golden hour” because immediate and effective care greatly minimizes risk and long-term disability. Trauma medicine is a very specialized medical field.

(4) Must you choose an actual physician or can you select a clinic or hospital? Some USPS supervisors tell injured employees that they must chose a doctor by name, or else that will have to go to the contract clinic. This, of course, is nonsense. If the USPS can use clinics, not particular physicians, so can the employee, and their own regulations clearly state this.3 Violations should be grieved. However, if you do not know your rights initially, the damage will be done as far as treatment of that injury is concerned. The grievance will only serve to put management on notice that they were wrong.

(5) Are contract clinics to be avoided at all costs? Not necessarily. For relatively minor injuries, where significant disability is not expected, they are a highly convenient, hassle-free option. These clinics are very familiar with treatment of injured Federal workers and with the relevant paperwork. We would all profit if such clinics were seen as a more positive alternative for employees who don’t have a treating physician or for those not-so-serious injuries needing good first aid treatment. To improve this situation, we need to select only the best clinics, and such clinics need an adequate freedom from management meddling to put the welfare of the patient in proper perspective. That day is a long way away.

(6) Can you change physicians? Once you sign physician selection papers or visit the USPS clinic for a second visit, changing physicians is quite difficult. You can write to OWCP and request discretionary change of physicians, but this is granted for good cause, solely at OWCP’s discretion.4

The right to an initial selection of physician is very precious. Workers in private employment do not enjoy many of the benefits you may be taking for granted as Federal workers.

Each of you should stop right now and think about what you would do if and when you are seriously injured. You need to have a plan now. Ask your doctor now if he or she would accept you as a patient with a Postal Service work injury. Ask your doctor where you should go for emergency care if he or she were unavailable or were to be designated for follow up care.

After you are injured, you will be in no condition to think carefully and weigh your options. If you don’t have a plan of your own, you will find yourself sitting in the manager’s office, hurting or bleeding, while you listen to their plan to manage your injury.