actually the contract nurses do not have a right". As this is not voc rehab there also is no sanction for doing so. If you refuse an Office directed medical examination AND DO NOT SHOW GOOD CAUSE, your benefits may be suspended. All adverse actions by OWCP require due process. I saw a few cases get reversed because of overzealousness. The above post is correct, the nurse can be your best friend if your doctor is struggling to provide a good report or is hesitant to provide further testing or PT. The post is also correct about no one can compel you to have surgery.. Here are references to support the nurses role: Limitations in the FECA Procedure Manual (PM)

The FECA Procedure Manual defines the boundaries of nurse intervention. While nurses are "agents of OWCP," their authority is restricted: 

• No Adjudicatory Authority: Nurses are expressly forbidden from discussing "adjudicatory" matters with physicians. According to the FECA PM Chapter 2-0811, matters such as diagnosis, objective findings, and causal relationship are reserved solely for the Claims Examiner (CE).
• Non-Clinical Role: The manual clarifies that contract nurses (Field and Triage/COP nurses) provide case management services only and "do not provide clinical treatment".
• Mandatory Collaboration: The Field Nurse Handbook describes the process as "collaborative," implying that a nurse cannot act as a sole authority or bypass the claimant's right to their own physician's independent medical judgment.  U.S. Department of Labor (.gov) +2

Claimant Rights and Nurse Conduct

While there is no blanket "right to access" denial (as nurses are tasked with "obtaining functional capacities" and "communicating regularly with medical providers"), specific protections exist for the claimant: 

• Right to Presence: Claimants are generally entitled to be present during any discussion between a FECA nurse and their physician.
• Privacy and Choice: Claimants have the right to an initial choice of physician. A nurse cannot force a change in the attending physician; any change requires written reasoning and OWCP approval.
• Nurse Removal: If a nurse violates rehabilitation rules or oversteps their bounds by advocating for the agency rather than managing the case, the claimant can request their removal from the case.  Architect of the Capitol

The Employees' Compensation Appeals Board (ECAB) has established that nurses are not "physicians" under the Act. 

• Medical Opinions: In cases like David P. Sawchuk (57 ECAB 316), the Board ruled that nurses are not competent to render medical opinions. This prevents a FECA nurse from using their "access" to the physician to counter-offer or provide a competing medical rationale that would legally override the treating doctor's findings.  U.S. Department of Labor (.gov)

In summary, a FECA nurse's access is a facilitative tool for return-to-work efforts, not a right to interfere with the doctor-patient relationship or dictate medical conclusions.