United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

R.K., Appellant 

and 

DEPARTMENT OF THE AIR FORCE, 

HANSCOM AIR FORCE BASE, MA, Employer 

__________________________________________ 

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Docket No. 14-1238 

Issued: September 23, 2014 

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

MICHAEL E. GROOM, Alternate Judge 

JURISDICTION 

On May 5, 2014 appellant filed a timely appeal from the April 24, 2014 merit decision of 

the Office of Workers’ Compensation Programs (OWCP), which denied authorization for a 

housing modification. 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 merits of this case. 

ISSUE 

The issue is whether OWCP properly denied authorization for the requested housing 

modification. 

 1

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

On October 9, 1975 appellant, then a 38-year-old contract negotiator, sustained a 

traumatic injury in the performance of duty while lifting and carrying a box of files. OWCP 

accepted his claim for lumbar sprain and for brachial neuritis or radiculopathy.2 

In 2013 appellant received radiofrequency treatment for chronic axial back pain. He was 

noted to have longstanding back pain “thought to be facet joint generated” and which was 

refractory to other therapies. Local anesthetic medial branch blocks or intra-articular facet joint 

injections resulted in appellant’s reporting a greater than 50 percent reduction of the usual axial 

component of pain for at least the duration of the local anesthetic effect. 

On September 6, 2013 appellant requested assistance to procure a handicap accessible 

entrance for his home. “My medical conditions relative to my established DOL/OWCP injuries 

have worsened and I need some form of help in this regard.” He submitted a proposal for new 

stairs going to a sunroom in his house. The final invoice was $2,102.55. 

OWCP asked appellant for further information to support his request, including a medical 

report addressing how his specific job-related physical limitations resulted in the need for the 

housing modification. 

Dr. Gilbert J. Fanciullo, a Board-certified specialist in pain management, began seeing 

appellant in February 2013. On October 4, 2013 he noted that appellant suffered from severe 

lumbar radiculopathy and low back pain that made it impossible for him to negotiate steps. “I 

understand that [appellant] is having a handicap ramp installed at his home ... and it is my 

opinion that this is medically necessary in order to enable him to continue to live at home, 

without this I do not believe he will be able to remain self-sufficient as he is now.” 

On February 26, 2014 Dr. Fanciullo advised that a modified entrance to appellant’s home 

was medically necessary for appellant to continue to live in his home. “We implore you to 

accept these modified steps as medically necessary for [his] situation. These shorter and wider 

steps have allowed him to navigate his way in and out of his home more effectively with his 

walker than a long, difficult to manage, handicap ramp.” 

On March 31, 2014 Dr. Robert Y. Pick, an OWCP medical adviser, reviewed the matter. 

He found that the requested modifications to appellant’s porch steps were not warranted by the 

accepted medical conditions. The medical records indicated that, although appellant had left 

lower extremity atrophy, the only apparatus or appliance he used was a cane. Further, the only 

access in question was for a sunroom and looking at the photograph of the house, the medical 

adviser assumed that the house had more entrances. Dr. Pick concluded that the requested entry 

was not a medical necessity. 

 2

 The record indicates that appellant suffered a nonjob-related automobile accident in 1973, a nonjob-related low 

back strain injury in 1974; a job-related acute low back strain on February 3, 1975 after moving room partitions, 

glass inserts and office furniture and equipment (OWCP File No. xxxxxx480); and a job-related acute low back 

strain on April 10, 1975 when a caster on his chair broke, causing him to tip over and fall to the floor (OWCP File 

No. xxxxxx637). 
3

In a decision dated April 24, 2014, OWCP denied authorization for the requested housing 

modification. It found that the medical evidence submitted was not sufficient to support that the 

modification of appellant’s porch steps was medically necessary as a result of the accepted 

medical conditions. 

LEGAL PRECEDENT 

The United States shall furnish to an employee who is injured while in the performance 

of duty, the services, appliances and supplies prescribed or recommended by a qualified 

physician, which the Secretary of Labor considers likely to cure, give relief and reduce the 

degree of the period of any disability or aid in lessening the amount of any monthly 

compensation. These services, appliances, and supplies shall be furnished by or on the order of 

the United States medical officers and hospital or at the employee’s option, by or on the order of 

physicians and hospitals designated or approved by the Secretary.3

OWCP has broad discretionary authority in the administration of FECA and must 

exercise that discretion to achieve the objectives of section 8103.4

 The only limitation on 

OWCP’s authority is that of reasonableness.5

To be eligible for housing modifications, the claimant must be severely restricted in terms 

of mobility, functionality and independence in normal living functions, on a permanent basis, 

due to the work-related injury. Examples are impairments that require the use of a prosthesis, 

wheelchair, motorized scooter, leg braces, crutches, cane or other self-help device. Such medical 

conditions include quadriplegia, paraplegia, amputation, total loss of use of limbs, blindness and 

profound deafness bilaterally.6

Before considering the technicalities of housing modification proposals, a determination 

must be made on the medical necessity of the requested modification. There are several aspects 

to consider when reviewing the evidence of record: 

(1) Does the level of impairment rise to the level delineated in the eligibility 

section above? 

(2) Does the medical evidence support that the claimant has restrictions or 

physical limitations which necessitate the modification? 

(3) Are these restrictions caused by the accepted work-related condition? 

 3

 5 U.S.C. § 8103(a). 

4 Marjorie S. Geer, 39 ECAB 1099 (1988). 

5 Daniel J. Perea, 42 ECAB 214 (1990). 

6

 Federal (FECA) Procedure Manual, Part 2 -- Claims, Housing and Vehicle Modifications, Chapter 2.1800.3 

(October 2009). 
4

(4) Does the physician provide detailed findings and rationale for the opinion 

that the claimant’s work injury has caused restrictions which necessitate the 

requested modification? This should come from a physician who is a recognized 

authority in the appropriate medical specialty.7

ANALYSIS 

Dr. Fanciullo, the attending pain specialist, generally supported the request for a housing 

modification in October 2013. He noted that appellant suffered from severe lumbar 

radiculopathy and low back pain that made it impossible for him to negotiate steps. OWCP did 

not accept appellant’s workers’ compensation claims for lumbar radiculopathy. It accepted three 

episodes of lumbar strain/sprain in 1975. To establish the medical necessity of the requested 

modification, Dr. Fanciullo must first explain how appellant’s present inability to negotiate steps 

was caused by the accepted soft tissue injuries that occurred 40 years earlier. He did not discuss 

the accepted injuries. Dr. Fanciullo did not acknowledge the mechanisms of injury, the 

contemporaneous clinical findings or the nature of the accepted medical conditions, nor did he 

account for the nonwork-related injuries in 1973 and 1974. 

Medical conclusions unsupported by rationale are of diminished probative value.8

 

Medical conclusions based on inaccurate or incomplete histories are also of diminished probative 

value.9

The medical record in 2013 indicated that appellant had longstanding back pain thought 

to be facet joint generated. Local anesthetic medial branch blocks or intra-articular facet joint 

injections reduced the axial component of his pain in half. Again, OWCP did not accept 

appellant’s work injuries in 1975 for a facet joint condition. If appellant’s inability to negotiate 

steps stemmed from facet joint arthritis or severe lumbar radiculopathy, Dr. Fanciullo did not 

adequately address how appellant’s work injuries caused this physical limitation. 

The record reflects that appellant could negotiate steps, so long as they were modified. In 

February 2014, Dr. Fanciullo advised that such a modified entrance to appellant’s sunroom was 

medically necessary for appellant to continue to live in his home. Although he implored OWCP 

to accept the medical necessity of these modified steps, he failed to provide sound medical 

rationale as to how appellant’s several low back strains in 1975 caused this medical necessity.10

The Board finds Dr. Fanciullo’s opinion lacks medical rationale and does not appear to 

be based on a complete or accurate history; the Board finds that it is of diminished probative 

 7 Id., Chapter 2.1800.4. 

8 Ceferino L. Gonzales, 32 ECAB 1591 (1981); George Randolph Taylor, 6 ECAB 968 (1954). 

9 James A. Wyrick, 31 ECAB 1805 (1980) (physician’s report was entitled to little probative value because the 

history was both inaccurate and incomplete). See generally Melvina Jackson, 38 ECAB 443, 450 (1987) (addressing 

factors that bear on the probative value of medical opinions). 

10 See A.H., Docket No. 08-2269 (issued August 17, 2009) (finding that the medical opinion evidence did not 

adequately explain how the modification was medical necessary due to the accepted medical condition). 
5

value. Dr. Pick, a medical adviser, reviewed appellant’s request but determined that the 

modification was not warranted by the accepted medical conditions. He noted that the only 

access at issue was for a sunroom. This raises the question whether appellant’s home had 

accessible entrances elsewhere, making it possible for him to continue to live there and thereby 

negating the necessity of the modification. 

The medical opinion evidence does not establish that the accepted work injuries caused a 

physical limitation that necessitated the requested modification. The Board finds that OWCP did 

not abuse its discretion in denying authorization. The Board will therefore affirm the 

April 24, 2014 decision. 

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 10.607.11

CONCLUSION 

The Board finds that OWCP properly denied authorization for the requested home 

modification. 

 11 On June 9, 2014 appellant filed an appeal of a May 29, 2014 OWCP’s decision denying authorization for a 

spinal procedure. As this is a separate OWCP decision and a separate issue than the one currently before the Board, 

the Board will assign a separate docket number under which the June 9, 2014 appeal may proceed. 
6

ORDER 

IT IS HEREBY ORDERED THAT the April 24, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: September 23, 2014 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Michael E. Groom, Alternate Judge 

 Employees’ Compensation Appeals Board