In all cases reported to OWCP, a medical report from the attending physician is required. This report should include:

1. (a) Dates of examination and treatment;
2. (b) History given by the employee;
3. (c) Physical findings;
4. (d) Results of diagnostic tests;
5. (e) Diagnosis;
6. (f) Course of treatment;
7. (g) A description of any other conditions found but not due to the claimed injury;
8. (h) The treatment given or recommended for the claimed injury;
9. (i) The physician's opinion, with medical reasons, as to causal relationship between the diagnosed condition(s) and the factors or conditions of the employment;
10. (j) The extent of disability affecting the employee's ability to work due to the injury;
11. (k) The prognosis for recovery; and
12. (l) All other material findings.