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Welcome to Federal Mental Health
Call for Help: (214) 471-5837
We obtained and are publishing official materials that explain how OWCP psychiatric second-opinion (SECOP) exams are directed, evaluated, and reported, straight from a 2025 FOIA response.
You’ll find the referral template, FECA causation definitions, and the OWCP-5a Work Capacity form, all summarized in plain English and available to download.

Under OWCP, the Claims Examiner (CE) sets the factual framework (SOAF), the exact questions, testing requirements, and forms the physician must complete. The physician must base their opinion solely on the CE’s Statement of Accepted Facts (SOAF) and answer the CE’s causation questions under FECA.
Plain-English takeaway: The exam isn’t free-form—the CE tells the doctor the facts to assume, what to evaluate, and what to include in the report.
| Term | What it means (short) |
|---|---|
| Direct causation | Work factors lead to the condition in a natural, unbroken sequence. |
| Aggravation (temporary) | Work made a pre-existing condition worse for a limited time, then returned to baseline. |
| Aggravation (permanent) | Work materially worsened a condition so it won’t revert to prior severity. |
| Acceleration | Work hastened the development of an underlying condition beyond its ordinary course. |
| Precipitation | Work triggered a latent condition that would not have become manifest otherwise. |
Note: FECA does not apportion causation—if work contributed, causal relationship can be established.
The referral instructions specify: history tied to the SOAF, mental status exam, relevant testing, DSM diagnoses, answers on causation (including temp vs. permanent aggravation), current status/resolution, work capacity vs. date-of-injury job, restrictions via OWCP-5a, prognosis, and treatment recommendations.
OWCP-5a captures hours tolerances, usual job capability, suitable duties/work environments, and other factors to guide re-employment or vocational rehab. It’s the form the SECOP doctor completes to translate findings into functional restrictions.
Download: “owcp-5a”
Know the SOAF: Your exam hinges on the CE’s Statement of Accepted Facts; bring any prior medical that aligns with it.
List symptoms & timelines: Tie them to work factors in clear, chronological notes.
Functional reality: Be ready to discuss actual work tolerances; these inform OWCP-5a restrictions.
Treatment history: Dates, providers, medications, outcomes.
(Informational only; not legal/medical advice.)
Second opinion eval forms (1)
“Second Opinion Psychiatric Evaluation—Official Packet (FOIA 2025)”
How is the SECOP doctor guided?
By the CE, who supplies the SOAF, required tests, forms, and questions to answer under FECA.
What causation standards apply to psych claims?
FECA recognizes direct causation, aggravation (temporary/permanent), acceleration, and precipitation. No apportionment if work contributed.
What is OWCP-5a used for?
To document hours, restrictions, and suitable duties for return-to-work or rehab in psych conditions.
Content on this page is derived from a U.S. Department of Labor OWCP FOIA response dated August 5, 2025 (Tracking 2025-F-14233) and its enclosed sample psychiatric second-opinion referral and OWCP-5a (Rev. 08-14) form.
To find out more about how OWCP claims work visit here more OWCP forms visit OWCP Forms.
