United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

B.G., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS ADMINISTRATION MEDICAL 

CENTER, Pittsburgh, PA, Employer 

__________________________________________ 

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Docket No. 14-6 

Issued: March 21, 2014 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

RICHARD J. DASCHBACH, Chief Judge 

PATRICIA HOWARD FITZGERALD, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On October 7, 2013 appellant filed a timely appeal from a September 24, 2013 

termination decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to 

the Federal Employees’ Compensation Act1

 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the 

Board has jurisdiction over the termination issue of this case.2

 1

 5 U.S.C. § 8101 et seq.

2

 The record also contains a June 27, 2013 decision denying appellant’s March 23, 2013 recurrence claim and an 

August 1, 2013 decision denying authorization for physical therapy. On July 2, 2013 appellant’s attorney requested 

a hearing of the June 27, 2013 recurrence decision. On August 22, 2013 he also requested reconsideration of the 

August 1, 2013 decision. Because the Board and OWCP cannot share jurisdiction on the same case over the same 

issue, the only issue being considered on appeal is the termination of appellant’s compensation benefits. The 

subsequent decisions of OWCP, dated November 25, 2013 and February 4, 2014 will not be disturbed as they 

review different issues. See 20 C.F.R. § 501.2(c)(3); Leon Haynes, Docket No. 94-2292 (issued January 15, 1997). 
2

ISSUE 

The issue is whether OWCP met its burden of proof to terminate appellant’s wage-loss 

compensation and medical benefits effective September 24, 2013 on the grounds that she no 

longer had any residuals or disability causally related to her accepted October 25, 2012 

employment-related injury. 

FACTUAL HISTORY 

OWCP accepted that on October 25, 2012 appellant, then a 36-year-old nursing assistant, 

sustained a left hip injury in the performance of duty when she was pinned to a wall by an 

electronic wheelchair. Her claim was accepted for left hip contusion and left inguinal strain. 

In an October 29, 2012 work status report, Dr. Brad J. Wolk, Board-certified in 

emergency medicine, noted a diagnosis of left hip contusion. He authorized appellant to return 

to work with restrictions of no climbing, bending, twisting, pushing or pulling and no lifting 

greater than 20 pounds. 

On October 29, 2012 appellant accepted a limited-duty work assignment as a nurse 

manager. Her duties included administrative duties such as sitting at the south nursing station, 

answering telephone calls and opening electronic doors. The restrictions included no climbing, 

bending, twisting, lifting, pushing or pulling. 

In a November 2, 2012 report, Dr. Susan A. Eisenman, Board-certified in occupational 

medicine, related appellant’s complaints of increased left hip pain. Appellant was not able to 

identify any inciting factor or new injury but stated that she started to develop increasing left hip 

and groin pain. Upon examination, Dr. Eisenman observed mild tenderness over the left inguinal 

ligament, but no mass or swelling. Range of motion of the hip was painful in all directions. 

Strength testing and trunk range of motion was grossly normal. Dr. Eisenman diagnosed left hip 

contusion with inguinal strain. She recommended that appellant continue modified duty at work. 

In reports dated November 5, 11 and 19, 2012, Dr. Walter Hoover, Board-certified in 

internal and occupational medicine, noted that appellant was a nurse’s aide with a left hip 

contusion and inguinal strain. He stated that she worked modified duty and only noticed some 

discomfort in the left hip with palpation. Upon examination, Dr. Hoover observed some slight 

tenderness to palpation of the left hip area. Range of motion of the hip was satisfactory. 

Dr. Hoover diagnosed resolving left hip contusion and inguinal strain. 

In a December 21, 2012 magnetic resonance imaging (MRI) scan of the left hip, 

Dr. Michelle L. Pohland, a Board-certified diagnostic radiologist, observed no joint effusion in 

the hips bilaterally and no abnormal signal in the bone marrow. She stated that there was no 

abnormal signal in the bone marrow of the left hip and no joint effusion present. 

In January 3 to 31, 2013 reports, Dr. Hoover related appellant’s complaints of recurrent 

left groin pain and left hip discomfort. Examination revealed tenderness to palpation of the left 

hip and trochanteric bursa area and pain with flexion of the hip. Dr. Hoover diagnosed left 

trochanteric bursitis and groin pain. 
3

In a January 18, 2013 ultrasound of the left lower extremity, Dr. Warren Ostlund, a 

Board-certified diagnostic radiologist, related appellant’s complaints of left hip pain into the calf. 

He observed normal flow and compressibility of the visualized portions of the common femoral 

vein, femoral vein and popliteal vein. No thrombi were visualized on the examination. 

Appellant stopped work on January 27, 2013 and requested disability compensation. 

In a February 5, 2103 handwritten hospital report, a physician with an illegible signature 

indicated that appellant was examined for a work-related injury and noted that she was unable to 

return to work. 

In a letter dated March 7, 2013, appellant’s attorney requested that appellant’s claim be 

expanded to include left hip trochanter bursitis. 

In a March 21, 2013 letter, Dr. Hoover stated that he was treating appellant for 

trochanteric bursitis that was related to the original October 25, 2012 employment injury. He 

explained that she developed an inflammatory response in the trochanteric bursa but it was not 

recognized until several months after the injury when imaging studies showed changes in the 

trochanteric bursa. 

In medical reports dated March 7 to 27, 2013, Dr. Hoover noted that appellant was a 

nurse’s aide with left trochanteric bursitis and groin pain. Upon examination, he observed some 

tenderness to palpation of the lateral aspect of the left thigh, mild pain and discomfort with 

abduction of the left hip and mild tenderness of the trochanteric bursa area and the left groin. 

Appellant had some difficulty squatting. Range of motion of the lumbar spine was satisfactory. 

Dr. Hoover diagnosed left trochanteric bursitis and groin pain improving and left sacroiliac (SI) 

joint discomfort. 

OWCP referred appellant, together with a statement of accepted facts and the medical 

record, to Dr. Scott J. Szabo, a Board-certified orthopedic surgeon, for a second opinion 

examination to determine the extent of her continuing employment-related residuals and 

disability. In an April 29, 2013 report, Dr. Szabo provided an accurate history of injury of the 

October 25, 2012 employment injury and reviewed her history, including the statement of 

accepted facts. He noted that a December 21, 2012 MRI scan of the left hip showed no abnormal 

signal within the bone marrow, no joint effusion and some increased signal change adjacent to 

the greater trochanter of the left hip which may be indicative of bursitis. Dr. Szabo related 

appellant’s complaints of left anterior groin pain that radiated into the lateral aspect to her SI 

joint and anterior into her knee, calf and foot. Appellant stated that she felt capable of lifting 15 

pounds to her waist, sitting for 45 minutes, standing for an hour and walking. 

Upon examination, Dr. Szabo observed normal gait and ability to walk on her heels and 

toes. He also noted tenderness overlying the left SI joint, greater trochanteric region but 

nontender over the anterosuperior and anterior inferior iliac crests and hip adductors. Seated and 

supine straight leg raise testing was negative. Appellant also had negative Faber testing and 

nontender to pelvic compression and roll maneuvers. She demonstrated 5/5 hip flexion, hip 

extension and hip adduction. Dr. Szabo reported that each hip demonstrated 30 degrees of 

internal and external rotation as well as 120 degrees flexion. Provocative maneuvers to test the 
4

hip labrum were unremarkable. Dr. Szabo noted that ancillary testing on April 29, 2013 were 

performed and demonstrated normal acetabular morphology without hip dysplasia, spherical 

femoral heads, normal appearing hip joints, no abnormal calcifications, normal appearing SI 

joints and no abnormal mineralization about the pelvis. He stated that appellant had sustained 

left hip contusion and inguinal strain from the vocational injury of October 25, 2012. Dr. Szabo 

explained that the physical examination and review of imaging did not demonstrate evidence of 

residuals from the injury or impairment. He reported that appellant’s subjective complaints were 

not substantiated by objective findings. Dr. Szabo explained that she had recovered from the 

vocational injury that required no restrictions, limitations or treatment. He concluded that there 

were no other nonaccepted conditions causally related to October 25, 2012 injury. 

In a June 13, 2013 report, Dr. Hoover related that appellant was a nurse’s aide with left 

trochanteric bursitis and left-sided lower back pain. He noted increased symptoms with 

prolonged weight bearing and walking. Upon examination, Dr. Hoover observed tenderness to 

palpation of the left paralumbar buttock area into the lateral aspect of the thigh. Range of motion 

of the lumbar spine was mildly limited in flexion and gait was moderately antalgic. Dr. Hoover 

diagnosed left trochanteric bursitis and possible SI joint dysfunction. 

In a July 11, 2013 report, Dr. Hoover noted that appellant had some improvement in leg 

symptoms but still experienced intermittent episodes of pain in her left groin and lower back 

area. He stated that she worked modified duty but experienced increased discomfort with 

standing or walking that was relieved with sitting down for a short period of time. Examination 

revealed satisfactory range of motion of the lumbar spine with some mild pain with abduction of 

the hip. Appellant was able to squat without difficulty and her gait was normal. Dr. Hoover 

diagnosed left trochanteric bursitis improved and possible SI dysfunction unchanged. 

On August 22, 2013 OWCP issued a notice of proposed termination of appellant’s 

medical and wage-loss compensation benefits based on Dr. Szabo’s April 29, 2013 report. 

Appellant was advised that she had 30 days to submit additional relevant evidence or argument if 

she disagreed with the proposed action. 

In a September 1, 2013 letter, appellant stated that she disagreed with the proposal of 

termination of medical and wage-loss compensation and was obtaining medical documents from 

providers during her injury period in order to show how her injury progressed and was caused by 

the original October 25, 2012 employment injury. She noted her concerns regarding the notice 

of proposed termination. 

In an August 8, 2013 report, Dr. Hoover related that he treated appellant for left 

trochanteric bursitis and left-sided lower back pain. He noted continued improvement in her 

symptoms and that she continued to work modified duty. Upon examination, Dr. Hoover 

observed no tenderness to palpation of the left trochanteric bursa or lower back. Range of 

motion of the lumbar spine was normal and appellant was able to squat without difficulty. 

Dr. Hoover diagnosed left trochanteric bursitis and sacroiliac dysfunction resolving. He opined 

that appellant may continue using ibuprofen as needed and may be able to resume regular-duty 

work. Appellant also resubmitted Dr. Hoover’s treatment notes from 2012. 
5

By decision dated September 24, 2013, OWCP finalized the termination of appellant’s 

compensation benefits effective September 24, 2013. It found that Dr. Szabo’s April 29, 2013 

report represented the weight of the medical evidence in establishing that her accepted conditions 

had resolved and that she no longer had any residuals or disability causally related to her 

accepted October 25, 2012 employment injury. 

LEGAL PRECEDENT 

According to FECA, once OWCP accepts a claim and pays compensation, it has the 

burden of justifying termination or modification of an employee’s benefits.3

 OWCP may not 

terminate compensation without establishing that the disability had ceased or that it was no 

longer related to the employment.4

 Its burden of proof includes the necessity of furnishing 

rationalized medical opinion evidence based on a proper factual and medical background.5

 The 

right to medical benefits for an accepted condition is not limited to the period of entitlement for 

disability compensation.6

 To terminate authorization for medical treatment, OWCP must 

establish that appellant no longer has residuals of an employment-related condition, which 

require further medical treatment.7

 

ANALYSIS 

OWCP accepted that on October 25, 2012 appellant sustained a left hip contusion and left 

inguinal strain in the performance of duty. She worked modified duty. OWCP terminated 

appellant’s compensation and medical benefits effective September 24, 2013 based on the 

second opinion report of Dr. Szabo who found that she did not need additional medical treatment 

and was capable of returning to work with no restrictions. The Board finds that it met its burden 

of proof to terminate her compensation benefits as the medical evidence establishes that her 

accepted left hip contusion and left inguinal strain had resolved and that she no longer suffered 

residuals of her October 25, 2012 employment injury. 

OWCP terminated appellant’s compensation and medical benefits based on Dr. Szabo’s 

April 29, 2013 second opinion report. Dr. Szabo provided an accurate history of the October 25, 

2012 employment injury and reviewed her history. He noted that a December 21, 2012 MRI 

scan of the left hip showed no abnormal signal within the bone marrow, no joint effusion and 

some increased signal change adjacent to the greater trochanter of the left hip which may be 

indicative of bursitis. Examination revealed tenderness over the left SI joint but nontender over 

the anterosuperior and anterior inferior iliac crests and hip adductors. Seated and supine straight 

 3 S.F., 59 ECAB 642 (2008); Kelly Y. Simpson, 57 ECAB 197 (2005); Paul L. Stewart, 54 ECAB 824 (2003). 

4 Jason C. Armstrong, 40 ECAB 907 (1989); Charles E. Minnis, 40 ECAB 708 (1989); Vivien L. Minor, 37 

ECAB 541 (1986). 

5 See Del K. Rykert, 40 ECAB 284, 295-96 (1988). 

6 T.P., 58 ECAB 524 (2007); Kathryn E. Demarsh, 56 ECAB 677 (2005); A.P., Docket No. 08-1822 (issued 

August 5, 2009). 

7 A.P., Docket No. 08-1822 (issued August 5, 2009); James F. Weikel, 54 ECAB 660 (2003); Pamela K. 

Guesford, 53 ECAB 727 (2002). 
6

leg raise testing was negative. Range of motion of the hip demonstrated 30 degrees of internal 

and external rotation and 120 degrees flexion. Dr. Szabo reported that provocative maneuvers to 

test the hip labrum were unremarkable. Appellant also had negative Faber testing and nontender 

to pelvic compression and roll maneuvers. She demonstrated 5/5 hip flexion, hip extension and 

hip adduction. Dr. Szabo diagnosed left hip contusion and inguinal strain caused by the 

vocational injury of October 25, 2012. He explained that the physical examination and review of 

imaging did not demonstrate evidence of residuals from the injury or impairment. Dr. Szabo 

reported that appellant’s subjective complaints were not substantiated by objective findings. He 

opined that she had recovered from the vocational injury that required no restrictions, limitations 

or treatment. Dr. Szabo concluded that there were no other nonaccepted conditions causally 

related to the October 25, 2012 injury. 

The weight of the medical evidence is determined by the opportunity for and 

thoroughness of examination, the accuracy and completeness of physician’s knowledge of the 

facts of the case, the medical history provided, the care of analysis manifested and the medical 

rationale expressed in support of stated conclusions.8

 Dr. Szabo provided an accurate history of 

the October 25, 2012 employment injury and findings on examination. He explained that there 

were no objective findings to support appellant’s subjective complaints. The Board finds that 

Dr. Szabo’s opinion is supported by Dr. Pohland’s December 21, 2012 diagnostic report which 

indicated no abnormal signal in the bone marrow and no joint effusion in the left hip. The Board 

finds, therefore, that OWCP met its burden of proof to terminate appellant’s medical and 

compensation benefits as the medical evidence established that her accepted October 25, 2012 

left hip condition had resolved and that she was capable of returning to full duty. 

Appellant submitted various reports by Dr. Hoover who related appellant’s complaints of 

intermittent episodes of pain in her left groin and lower back area. He noted that he treated her 

for left trochanteric bursitis and left-sided lower back pain. While Dr. Hoover treated appellant 

for complaints of left hip and lower back pain, his reports fail to provide support that she 

continued to suffer residuals of her accepted left hip contusion and inguinal strain.9 The Board 

notes that OWCP has not accepted that appellant sustained left trochanteric bursitis from the 

employment injury. Instead, the Board finds that Dr. Hoover’s reports demonstrate that 

appellant’s accepted conditions had resolved and that she may be capable of regular-duty work. 

In an August 8, 2013 report, Dr. Hoover observed no tenderness to palpation of the left 

trochanteric bursa or lower back. He diagnosed resolving left trochanteric bursitis and SI 

dysfunction and stated that appellant may be able to resume regular-duty work. The Board finds, 

therefore, that Dr. Hoover’s reports are insufficient to establish that appellant’s left hip condition 

had not resolved and that she continued to suffer residuals of the October 25, 2012 employment 

injury. 

The Board finds that Dr. Szabo’s opinion continues to constitute the special weight of 

medical opinion and supports OWCP’s decision to terminate appellant’s wage-loss and 

compensation benefits. There is no other medical evidence contemporaneous with the 

 8 K.W., 59 ECAB 271 (2007); Ann C. Leanza, 48 ECAB 115 (1996). 

9 See D.R., Docket No. 12-1441 (issued February 13, 2013). 
7

termination of appellant’s benefits which supports that she has any continuing residuals related 

to her accepted work-related injuries. 

Appellant may submit new evidence or argument with a written request for 

reconsideration to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) 

and 20 C.F.R. §§ 10.605 through 10.607. 

CONCLUSION 

The Board finds that OWCP properly terminated appellant’s wage-loss compensation and 

medical benefits effective September 24, 2013 on the grounds that she no longer had any 

residuals or disability causally related to her accepted October 25, 2012 employment-related 

injury. 

ORDER 

IT IS HEREBY ORDERED THAT the September 24, 2013 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: March 21, 2014 

Washington, DC 

 

 Richard J. Daschbach, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board