Federal workers’ compensation (FECA): therapy rules from the Department of Labor
Federal employees hurt on the job are covered by the Federal Employees’ Compensation Act (FECA), run by the Department of Labor’s Office of Workers’ Compensation Programs (OWCP). Providers must enroll with OWCP to be paid. The FECA regulations name physical therapists among non-physician providers, and OWCP’s Procedure Manual sets rules for authorizing physical therapy, including a 120-day window after most orthopedic traumatic injuries. This page quotes DOL and copies no fee schedule amounts.
Quoted from official pages checked November 12, 2026. Confirm current requirements, fees, and dates on those sites. This page is not legal advice and does not guarantee eligibility, certification, or licensure.
Sources read on November 12, 2026: DOL’s FECA Information for Medical Providers page, its provider questions and answers page, its Helpful Information for Providers (PDF), 20 CFR Part 10, Subpart D on eCFR (displayed as up to date as of 11/09/2026), and FECA Procedure Manual Part 2 (chapters 2-0600 through 2-0816).
Enrolling with OWCP
DOL states: “Medical providers must be enrolled with OWCP to receive reimbursement for treatment of injured federal employees.” Its questions page adds: “To be paid for treating federal employees covered by the FECA, you must enroll.” And: “Enrollment is free and is simply a registration process to ensure proper payments. It is not a PPO enrollment.” The providers PDF says enrollment is “Not required prior to the claimant being seen for their work-related injury”.
Who may provide care
Under 20 CFR 10.310, “The employee is entitled to receive all medical services, appliances or supplies which a qualified physician prescribes or recommends and which OWCP considers necessary to treat the work-related injury.” It also states: “Non-physician providers such as physicians' assistants, nurse practitioners and physical therapists may also provide authorized services for injured employees to the extent allowed by applicable Federal and State law.”
Under 20 CFR 10.311, “A chiropractor may also provide services in the nature of physical therapy under the direction of, and as prescribed by, a qualified physician.”
Authorizing physical therapy
Procedure Manual chapter 2-0810 states: “For most orthopedic injuries, physical therapy (PT) services within the first 120 days after a traumatic injury are allowed without any prior authorization required.” It adds: “It is also customary to automatically authorize PT post operatively for orthopedic surgeries, usually for a period of 60 days post surgery.”
For more therapy, “PT requests must include the following”: “specific CPT-4 codes, number of units, frequency and duration of treatment.” The request “must also be accompanied by a prescription and treatment plan from the attending physician.” In weighing requests, the manual says: “Pain alone does not constitute a functional deficit.” For severe injuries such as brain or spinal cord injuries, “The CE may authorize physical therapy services for up to one year in these circumstances.”
DOL’s questions page says that when an employing agency has issued a Form CA-16, “NO authorization is needed for office visits and consultations, labs, hospital services (including inpatient), X-rays (including MRI and CT scan), physical therapy, and Emergency services (including surgery) related to the work injury.”
Therapy reports, OT, and speech therapy
The manual states: “While not useful for making adjudicatory or medical determinations in a case, therapy reports from physical and occupational therapy are useful for documenting treatment for a work related condition.” It cites a 1996 decision stating that “physical therapists are not physicians as defined under the FECA; their reports, therefore, do not constitute competent medical evidence to support a claim”.
In its disability management chapter, the manual says: “A referral may also be appropriate for speech therapy, orthotics, or prosthetics which would make the injured worker more employable;”. Of the pages read, the 120-day and request rules above are written for physical therapy; they do not set separate rules for occupational therapy or speech therapy, so ask OWCP how a request for those services is handled.
What this page does not do
It does not copy fee schedule amounts, does not cover state workers’ compensation, and does not say whether any treatment will be authorized. It is not legal, medical, billing, or immigration advice. Confirm current rules with the agency or organization that publishes them, your employer, and your state board.