United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

L.R., Appellant 

and 

TENNESSEE VALLEY AUTHORITY, 

Soddy Daisy, TN, Employer 

__________________________________________ 

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Docket No. 14-1942 

Issued: March 25, 2015 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA HOWARD FITZGERALD, Deputy Chief Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On September 8, 2014 appellant filed a timely appeal from an April 8, 2014 merit 

decision and a June 25, 2014 nonmerit 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 merits of this case. 

ISSUES 

The issues are: (1) whether OWCP met its burden of proof to terminate appellant’s 

medical and wage-loss compensation benefits effective April 7, 2013 on the basis that she no 

longer had any residuals or disability causally related to her accepted employment-related injury; 

(2) whether appellant has established continuing employment-related residuals or disability on or 

after April 7, 2013 as a result of her accepted June 24, 1985 employment injury; and (3) whether 

OWCP properly denied her request for further merit review under 5 U.S.C. § 8128(a). 

 1

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

On June 28, 1985 appellant, then a 32-year-old plant laborer, filed a traumatic injury 

claim alleging that on June 24, 1985 she sustained a concussion when she was opening a fire 

door and the pressure from the door knocked her into scaffold, causing her to fall and become 

unconscious. She sought emergency treatment, stopped work on June 24, 1985, and did not 

return. Appellant’s position was terminated on August 8, 1985 due to lack of work. 

By decision dated November 6, 1986, OWCP accepted the claim for concussion. It later 

expanded the claim to include cervical strain and cervical facet joint syndrome. On 

September 16, 1987 appellant received wage-loss compensation benefits for which she was 

placed on periodic rolls. She sought treatment with various providers since the onset of her 

work-related injury, including treatment with Dr. Cornelius Mance, a Board-certified 

neurologist. 

On September 19, 2011 OWCP referred appellant, the case file, a series of questions, and 

a statement of accepted facts (SOAF)2 to Dr. Tejanand G. Mulpur, a Board-certified neurologist, 

for a second opinion evaluation regarding appellant’s current disability status. Dr. Mulpur 

detailed the employment incident and stated that appellant sustained a concussion approximately 

25 years ago when she was thrown against steel scaffolding and lost consciousness. Appellant 

was taken to the hospital and was discharged that same date after review of imaging studies. She 

began to gradually experience headaches and severe pain all over her body which persisted to 

present day complaints. Dr. Mulpur provided findings on physical examination and noted that 

the neurological examination did not reveal any focal findings and appellant had good muscle 

strength. He diagnosed fibromyalgia, migraine headaches, and anxiety with depression. 

Dr. Mulpur noted that it was hard to believe that the concussion from 25 years ago was 

contributing to her symptomatology, especially since the injury did not result in any contusions 

or abnormal computerized tomography or neurological findings at that time. 

On February 13, 2012 OWCP requested that Dr. Mulpur answer the previously provided 

questions and to arrange a functional capacity evaluation (FCE) to determine appellant’s work 

capabilities. 

In a February 16, 2012 addendum report, Dr. Mulpur concluded that appellant’s 

work-related head injury had resolved and was unrelated to her current diagnoses of 

fibromyalgia, vascular headaches, anxiety, and depression. He noted that, while vascular 

headaches, fibromyalgia, anxiety, and depression could be exaggerated by a head injury, it would 

be unusual for these to last 25 years. Dr. Mulpur also noted that appellant should be referred for 

an FCE as he was not trained to evaluate her in that capacity. Because appellant had no focal 

motor deficits and her diagnosed conditions were treatable, he opined that she could return to 

work. 

 2

 The SOAF noted the following concurrent or preexisting conditions that were not considered work related: 

congenital abnormality 51 vertebral body, mild scoliosis, appendectomy 1973, hysterectomy 1978, hearing loss right 

ear, history of breast biopsy, fibromyalgia, chronic musculoskeletal recurring pains, hypothyroidism, bilateral carpal 

tunnel syndrome, temporomandibular joint, and right knee injury and surgery. 
3

On June 11, 2012 OWCP notified appellant of a proposal to terminate her medical and 

wage-loss compensation benefits based on Dr. Mulpur’s report that she was not experiencing any 

residuals or disability connected to the June 24, 1985 employment injury as her conditions had 

ceased. Appellant was provided 30 days to submit additional information. 

In a June 24, 2012 narrative statement, appellant disputed the proposed termination and 

attributed her chronic pain and current diagnoses to the June 24, 1985 employment incident. In 

support of her claim, she submitted various medical reports previously of record. 

By decision dated July 25, 2012, OWCP terminated appellant’s medical and wage-loss 

compensation benefits effective July 29, 2012 finding that the weight of the medical evidence 

rested with Dr. Mulpur. It noted that the medical evidence provided by her was largely outdated 

and did not relate to her accepted conditions or establish continuing disability. 

On August 17, 2012 appellant requested an oral hearing before the Branch of Hearings 

and Review disputing the July 25, 2012 termination decision. 

By decision dated December 7, 2012, the Branch of Hearings and Review set aside the 

July 25, 2012 termination decision finding that OWCP failed to meet its burden of proof to 

terminate appellant’s compensation benefits.3

 OWCP’s hearing representative noted that 

Dr. Mulpur’s reports were not well rationalized, his opinion was speculative, and he failed to 

mention any review of medical records or the SOAF. OWCP remanded the case for a second 

opinion evaluation with a Board-certified neurologist to determine the nature and extent of 

appellant’s employment-related condition and disability. 

On remand, OWCP referred appellant, the SOAF, a series of questions, and the case file 

to Dr. Steven D. Graham, a Board-certified neurologist, for a second opinion examination. 

In his January 16, 2013 medical report, Dr. Graham provided a history of injury, findings 

on physical examination, and noted review of prior medical reports and the SOAF. He 

diagnosed somatoform pain disorder which was negatively affected by underlying psychological 

factors such as depression and anxiety. Dr. Graham noted that appellant’s preexisting 

fibromyalgia was likely a strong component contributing to the continuation of her pain and 

there was no clear, objective, neuropathological process which explained the continuation of her 

symptoms. He stated that, because the injury occurred in 1985 and was at best described as a 

mild head injury, her current complaints and examination findings could not be directly 

connected to the remote work-related injury. Dr. Graham further noted that appellant’s 

subjective complaints of pain overshadowed examination findings, primarily because of the 

discrepancy in her complaints of pain versus normal neurological examination. He stated that 

her fibromyalgia and musculoskeletal pain had been diagnosed prior to her injury, noting that 

these preexisting conditions were likely aggravated by her underlying psychological factors 

leading to the continuation of the subjective complaints over the past 27 years, in the absence of 

any permanent brain or cervical spine anatomical derangement from the injury. Due to 

appellant’s subjective complaints over the last 27 years, Dr. Graham stated that he did not 

 3

 The Board notes that no hearing was held as the hearing representative determined based on preliminary review 

that the July 25, 2012 decision should be set aside and remanded for further development. 
4

recommend additional treatment and was guarded in regard to prognosis for improvement of the 

somatoform pain disorder. He opined that, from a neurological standpoint, appellant was no 

longer experiencing direct residuals from the work injury. Dr. Graham’s opinion was primarily 

based on the lack of objective examination or radiological findings, and the 27 years that had 

elapsed since the injury. With respect to resuming normal work activities, he explained that, 

from a neurological standpoint, there clearly was no anatomical derangement of the central or 

peripheral nervous system, specifically the brain, spinal cord, peripheral nerves, or muscles. 

However, because appellant had somatoform pain disorder with significant psychological factors 

negatively influencing her symptoms, Dr. Graham opined that it was doubtful she could return to 

any type of employment situation. 

In medical reports submitted dated April 6 to October 6, 2011, Dr. Mance provided 

findings on physical examination and diagnosed fibromyalgia and soft tissue dysfunction. 

On February 8, 2013 OWCP notified appellant of a proposal to terminate her medical and 

wage-loss compensation benefits based on Dr. Graham’s report that she was not experiencing 

any residuals or disability connected to the accepted work-related conditions. Appellant was 

provided 30 days to submit additional information. 

In a February 22, 2013 narrative statement, appellant disputed OWCP’s proposed 

termination and argued that she continued to suffer from residuals and disability as a result of the 

June 24, 1985 employment incident. 

In support of her claim, appellant submitted an August 30, 2012 narrative from 

Dr. Mance, who stated that he treated her post injury to her neck and shoulder on June 24, 1985 

when a pressure door knocked her into a scaffold. Dr. Mance noted that she complained of 

continued neck and shoulder pain which was caused by soft tissue dysfunction. He stated that he 

had been treating appellant for both fibromyalgia and soft tissue problems which continued to be 

present since he initially treated her. Dr. Mance noted that, after treating her for multiple years 

without any benefit through use of various medications, she was basically living with continuous 

dysfunction and increased pain in her neck, shoulder, and headaches with increased activity or 

any activity that caused her to exert herself for any length of time. He stated that, even though 

the diagnosis of fibromyalgia was given, appellant’s symptoms had always been the same with 

intractable neck and shoulder pain and soft tissue dysfunction. 

In a February 19, 2013 treatment note, Dr. Mance reported complaints of pain and 

provided findings on physical examination. He diagnosed chronic pain with associated 

depression, other chronic pain, muscle spasm, and myalgia/myositis. 

By decision dated March 13, 2013, OWCP terminated appellant’s medical and wage-loss 

compensation benefits effective April 7, 2013 finding that the weight of the medical evidence 

rested with Dr. Graham. 

On March 23, 2013 appellant requested an oral hearing before the Branch of Hearings 

and Review. She argued that Dr. Graham did not perform any medical testing to the brain, spinal 

cord, peripheral nerves, muscles, or cervical joints. Appellant further argued that Dr. Mance’s 

report was more credible as it he had treated her over the last 28 years. 
5

A telephone hearing was held on June 10, 2013. At the hearing, appellant argued that her 

current conditions and disability were caused by the June 24, 1985 employment incident. 

By decision dated July 23, 2013, the Branch of Hearings and Review affirmed the 

March 13, 2013 decision terminating appellant’s medical and wage-loss compensation benefits 

finding that she failed to establish ongoing disability on or after April 7, 2013 causally related to 

one or more of the accepted employment-related conditions. It noted that the weight of the 

medical evidence rested with Dr. Graham. 

On August 28, 2013 appellant filed a timely appeal before the Board, which was 

docketed as No. 13-1989. By letter dated December 19, 2013, she requested that the appeal 

before the Board be dismissed and the case be filed for reconsideration with OWCP in light of 

new medical evidence. By order dated March 13, 2014, the Board granted appellant’s request 

for dismissal of her appeal.4

 

On April 1, 2014 appellant requested reconsideration of OWCP’s decision. 

In support of her claim, appellant resubmitted Dr. Mance’s August 30, 2012 narrative 

report and also submitted new diagnostic reports. 

In a September 9, 2013 diagnostic report, Dr. Kilton D. Kingsman, a Board-certified 

diagnostic radiologist, reported that lateral chest x-rays revealed no acute cardiopulmonary 

disease. Seven views of the cervical spine revealed moderate right bony neural foraminal 

narrowing at C4-5 of uncertain clinical significance and moderate degenerative disc disease at 

C7-Tl. The thoracic spine revealed unremarkable other than moderate disc disease at C7-T1 and 

mild multilevel degenerative disc disease T5-8. Dr. Kingsman stated that the lumbar spine 

revealed moderate dextroscoliosis and mild-to-moderate hypertrophic facet degenerative joint 

disease changes at L4-S1 while left hip series revealed unremarkable. 

In a September 20, 2013 diagnostic report, Dr. Jeffrey E. Tipps, a Board-certified 

diagnostic radiologist, reported that a magnetic resonance imaging (MRI) scan of the cervical 

spine revealed cervical spondylosis, no evidence of myelomalacia or cord edema, and moderate 

neuroforaminal stenosis C3 through C5. 

By decision dated April 8, 2013, OWCP affirmed the July 23, 2013 decision finding that 

appellant failed to establish ongoing disability on or after April 7, 2013 causally related to the 

accepted June 24, 1985 incident or injury sustained as a result thereof. 

By letter dated June 16, 2013, appellant requested reconsideration of OWCP decision. 

She stated that her deteriorating cervical spine condition was caused by the June 24, 1985 injury 

which she argued was a major trauma. Appellant further stated that Dr. Graham failed to provide 

objective testing which she had recently submitted through x-ray and MRI scan reports. She 

argued that he was not a qualified psychiatrist and her depression and anxiety had been properly 

documented in her medical reports since the onset of her injury in 1985. Appellant noted that 

she had no preexisting injuries and was fully functional prior to the June 24, 1985 employment 

 4

 Docket No. 13-1989 (issued March 13, 2014). 
6

incident. Due to the injury, she argued she was unable to work and would not be able to return to 

work in the future. In support of her claim, appellant resubmitted Dr. Tipps’ September 20, 2013 

MRI scan report of the cervical spine. 

By decision dated June 25, 2014, OWCP denied appellant’s request for reconsideration 

finding that she neither raised substantive legal questions nor included new and relevant 

evidence. 

LEGAL PRECEDENT -- ISSUE 1 

Once OWCP has accepted a claim and pays compensation, it bears the burden to justify 

modification or termination of benefits.5 Having determined that an employee has a disability 

causally related to his or her federal employment, OWCP may not terminate compensation 

without establishing either that the disability has ceased or that it is no longer related to the 

employment.6

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

entitlement for disability compensation.7

 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.8 Its burden of proof includes the necessity of furnishing 

rationalized medical opinion evidence based on a proper factual and medical background.9

For conditions not accepted by OWCP as being employment related, it is the employee’s 

burden to provide rationalized medical evidence sufficient to establish causal relation, not 

OWCP’s burden to disprove such relationship.10

ANALYSIS -- ISSUE 1 

OWCP accepted that appellant sustained a concussion, cervical strain, and cervical facet 

joint syndrome as a result of the June 24, 1985 work-related incident. The issue is whether it 

properly terminated her medical and wage-loss compensation benefits effective April 7, 2013 as 

she was not experiencing any residuals or disability of the June 24, 1985 injury. The Board finds 

that OWCP properly terminated appellant’s medical and wage-loss benefits. 

In its termination decision, OWCP determined that the weight of the medical evidence 

rested with Dr. Graham, a Board-certified neurologist serving as the second opinion physician. 

 5 Bernadine P. Taylor, 54 ECAB 342 (2003). 

6 Id. 

7 Roger G. Payne, 55 ECAB 535 (2004). 

8 Pamela K. Guesford, 53 ECAB 726 (2002). 

9 T.P., 58 ECAB 524 (2007); Furman G. Peake, 41 ECAB 351 (1975). 

10 G.A., Docket No. 09-2153 (issued June 10, 2010); Jaja K. Asaramo, 55 ECAB 200 (2004); Alice J. Tysinger, 

51 ECAB 638 (2000). 
7

The Board finds that Dr. Graham’s well-rationalized report, which was based upon a proper 

factual and medical background, represents the weight of the medical evidence and establishes 

that appellant’s concussion, cervical strain, and cervical facet joint syndrome ceased and was no 

longer experiencing residuals or disability related to the June 24, 1985 employment incident.11

In his January 16, 2013 medical report, Dr. Graham diagnosed somatoform pain disorder 

which was negatively affected by underlying psychological factors such as depression and 

anxiety. He noted that appellant’s preexisting fibromyalgia was likely a strong component 

contributing to the continuation of her pain and there was no clear, objective, neuropathological 

process which would explain the continuation of her symptoms. Dr. Graham stated that because 

the injury occurred in 1985 and was at best described as a mild head injury, her current 

complaints and examination findings could not be directly connected to the remote work-related 

injury. He opined that appellant was no longer experiencing direct residuals from the work 

injury because neurologically there was no objective examination or radiological findings and 27 

years had elapsed since the injury. 

The Board has carefully reviewed the opinion of Dr. Graham and finds that it has 

reliability, probative value and convincing quality with respect to its conclusions regarding the 

relevant issue in the present case.12 Dr. Graham’s opinion is based on a proper factual and 

medical history and he thoroughly reviewed the SOAF and medical records.13 He provided 

medical rationale for his opinion by explaining that appellant’s current complaints were related 

to her preexisting fibromyalgia and musculoskeletal pain which were likely aggravated by her 

underlying psychological factors, leading to the continuation of the subjective complaints over 

the past 27 years, in the absence of any permanent brain or cervical spine anatomical 

derangement from the injury. Dr. Graham further explained that, from a neurological standpoint, 

there was no anatomical derangement of the central or peripheral nervous system, specifically 

the brain, spinal cord, peripheral nerves, or muscles. As there were no objective findings related 

to appellant’s concussion, cervical strain, and cervical facet joint syndrome, he opined that her 

disability had ceased and any limitations on her physical ability to work did not relate to the 

June 24, 1985 injuries. Rather, Dr. Graham attributed appellant’s inability to work to 

somatoform pain disorder influenced by significant psychological factors, conditions not 

accepted by OWCP. Thus, his opinion establishes that she was no longer experiencing residuals 

or disability related to the June 24, 1985 employment incident. 

In support of her claim, appellant submitted medical reports from Dr. Mance, her treating 

physician. In medical reports dated April 6 to October 6, 2011, Dr. Mance noted findings on 

physical examination and diagnosed fibromyalgia and soft tissue dysfunction. In a February 19, 

2013 treatment note, he diagnosed chronic pain with associated depression, other chronic pain, 

muscle spasm, and myalgia/myositis. The Board has held that medical evidence that does not 

offer any opinion regarding the cause of an employee’s condition is of limited probative value on 

 11 Y.M., Docket No. 14-1050, 14-1193 (issued December 24, 2014). 

12 See R.W., Docket No. 12-375 (issued October 28, 2013). 

13 See Melvina Jackson, 38 ECAB 443 (1987). 
8

the issue of causal relationship.14 While these reports provided various diagnoses, Dr. Graham 

failed to provide an opinion that appellant was experiencing residuals or disability as a result of 

her accepted June 24, 1985 injuries.15 

In an August 30, 2012 narrative report, Dr. Mance stated that he treated appellant post 

injury to her neck and shoulder on June 24, 1985 when a pressure door knocked her into a 

scaffold. He noted that she complained of continued neck and shoulder pain which was caused 

by soft tissue dysfunction. Dr. Mance stated that he had been treating appellant for both 

fibromyalgia and soft tissue problems which had continued to be present since he initially treated 

her. He noted that, after treating her for multiple years without any benefit through use of 

various medications, she was basically living with continuous dysfunction and increased pain in 

her neck, shoulder, and headaches with increased activity or any activity that caused her to exert 

herself for any length of time. Dr. Mance stated that, even though the diagnosis of fibromyalgia 

was given, appellant’s symptoms had always been the same with intractable neck and shoulder 

pain and soft tissue dysfunction. 

The Board finds that the opinion of Dr. Mance is not well rationalized and insufficient to 

overcome the weight of the medical evidence afforded to Dr. Graham.16 Dr. Mance attributed 

appellant’s symptoms to fibromyalgia and soft tissue dysfunction, conditions not accepted by 

OWCP. He failed to provide any opinion that her current conditions were caused or aggravated 

by the June 24, 1985 employment incident. Dr. Mance only generally noted that he had been 

treating appellant for fibromyalgia and soft tissue problems since the employment incident but 

did not relate the conditions to the traumatic injury. To be of probative value, a physician’s 

opinion on causal relationship should be one of reasonable medical certainty.17 Dr. Mance’s 

report is speculative and equivocal and does not support causation or continuing residuals of the 

accepted injuries. 

Furthermore, Dr. Mance failed to address why appellant’s head, neck, and shoulder 

complaints were not caused by her preexisting fibromyalgia disorder or soft tissue dysfunction. 

His report provided no discussion regarding whether the preexisting conditions had progressed 

beyond what might be expected from the natural progression of that condition.18 A 

well-rationalized opinion is particularly warranted when there is a history of preexisting 

conditions.19 Dr. Mance did not adequately explain why appellant continued to suffer from 

residuals or disability of the June 24, 1985 employment incident, more than 25 years after the 

initial incident, and made no reference to objective examination findings. As he failed to state 

 14 C.B., Docket No. 09-2027 (issued May 12, 2010); S.E., Docket No. 08-2214 (issued May 6, 2009).

15 J.H., Docket No. 12-1848 (issued May 15, 2013). 

16 See generally Floyd Stilley, Docket No. 02-2016 (issued February 19, 2003). 

17 See Beverly R. Jones, 55 ECAB 411 (2004). 

18 R.E., Docket No. 14-868 (issued September 24, 2014). 

19 The Board has held that an opinion that a condition is causally related because the employee was asymptomatic 

before the injury is insufficient, without adequate rationale, to establish causal relationship. T.M., Docket 

No. 08-975 (issued February 6, 2009); Michael S. Mina, 57 ECAB 379 (2006). 
9

that appellant continued to suffer from residuals or disability of the accepted concussion, cervical 

strain, and cervical facet joint syndrome injuries, his report is of limited probative value.20 

The Board further notes that Dr. Mance’s August 30, 2012 report, as well as older 

medical reports previously of record, did not discuss appellant’s disability as of April 7, 2013. 

Dr. Graham’s January 16, 2013 second opinion examination report provided a current 

assessment pertaining to the nature and extent of disability. The Board has held that stale 

medical evidence cannot form the basis for current evaluation of residual symptomology or 

disability determination.21 For this reason, the Board finds that these reports are of limited 

probative value regarding the current issue and do not create a conflict in medical evidence.22

The Board finds that Dr. Graham’s opinion constitutes the weight of the medical 

evidence and is sufficient to justify OWCP’s termination of benefits for the accepted conditions. 

The Board also notes that there are no current reports from appellant’s treating physicians 

establishing employment-related disability or supporting any continuing residuals of the accepted 

conditions. Because appellant no longer has residuals or disability related to her accepted 

employment conditions, OWCP properly terminated entitlement to compensation and medical 

benefits effective April 7, 2013.23 Accordingly, it met its burden of proof and its decision to 

terminate her compensation and medical benefits shall be affirmed.24

On appeal, appellant argues that her injuries were not preexisting and that her medical 

records show a history of injury stemming back 27 years, which also includes a well-documented 

history of anxiety and depression. She further argues that Dr. Graham’s report establishes that 

she is unable to resume employment. As previously noted, the conditions to which appellant is 

referring to have not been accepted by OWCP and Dr. Graham’s disability findings related to 

these nonindustrial injuries. 

Appellant may submit additional evidence, together with a written request for 

reconsideration, to OWCP within one year of the Board’s merit decision, pursuant to 5 U.S.C. 

§ 8128(a) and 20 C.F.R. §§ 10.606 and 10.607. 

LEGAL PRECEDENT -- ISSUE 2 

 After termination of compensation benefits clearly warranted on the basis of the 

evidence, the burden for reinstating compensation shifts to the claimant. To prevail, the claimant 

 20 J.A., Docket No. 13-1657 (issued February 3, 2014). 

21 See Keith Hanselman, 42 ECAB 680 (1991); Ellen G. Trimmer, 32 ECAB 1878 (1981) (reports almost two 

years old deemed invalid basis for disability determination and loss of wage-earning capacity determination.) 

22 Id. 

23 G.I., Docket No. 13-19 (issued April 2, 2013). 

24 L.C., Docket No. 12-1177 (issued August 19, 2013). 
10

must establish by the weight of the reliable, probative, and substantial evidence that she had an 

employment-related disability which continued after the termination of compensation benefits.25

ANALYSIS -- ISSUE 2 

OWCP met its burden of proof to termination compensation benefits as of April 7, 2013. 

Appellant therefore has the burden of proving by the weight of the substantial, reliable, and 

probative evidence a causal relationship between her claimed disability on or after April 7, 2013 

and the accepted June 24, 1985 injuries.26 The reports of her physicians do not provide a 

rationalized medical opinion finding her disabled for work after April 7, 2013 due to her 

accepted injuries. Therefore, the medical evidence submitted is insufficient to meet appellant’s 

burden of proof.27

In diagnostic reports dated September 9 and 20, 2013, Dr. Kingsman and Dr. Tipps 

provided radiographic findings pertaining to the chest, cervical spine, thoracic spine, lumbar 

spine, and left hip. These reports failed to discuss appellant’s employment and medical history 

and did not provide any opinion regarding the cause of appellant’s conditions. As the reports 

simply interpreted imaging studies and provided no opinion that she was totally disabled on or 

after April 7, 2013 due to the June 24, 1985 employment injuries, the reports are insufficient to 

meet her burden of proof.28 

The Board notes that it is appellant’s burden to establish that the findings made in the 

diagnostic reports were causally related to the June 24, 1985 employment injury.29 Because 

appellant has not submitted any reasoned medical opinion evidence to show that she was 

disabled on or after April 7, 2013 as a result of her accepted concussion, cervical strain, and 

cervical facet joint syndrome, the Board finds that OWCP properly denied her claim for 

disability compensation.30

 25 See I.J., 59 ECAB 408 (2008). 

26 See Amelia S. Jefferson, 57 ECAB 183 (2005). 

27 Alfredo Rodriguez, 47 ECAB 437 (1996). 

28 L.J., Docket No. 14-523 (issued August 7, 2014). 

29 Medical reports without adequate rationale on causal relationship are of diminished probative value and do not 

meet an employee’s burden of proof. Ceferino L. Gonzales, 32 ECAB 1591 (1981). The opinion of a physician 

supporting causal relationship must rest on a complete factual and medical background supported by affirmative 

evidence, address the specific factual and medical evidence of record and provide medical rationale explaining the 

relationship between the diagnosed condition and the established incident or factor of employment. See Lee R. 

Haywood, 48 ECAB 145 (1996). 

30 The Board will not require OWCP to pay compensation for disability in the absence of any medical evidence 

directly addressing the specific dates of disability for which compensation is claimed. To do so would essentially 

allow employees to self-certify their disability and entitlement to compensation. L.L., Docket No. 13-2146 (issued 

March 12, 2014). See also William A. Archer 55 ECAB 674, 679 (2004). 
11

Appellant may submit additional evidence, together with a written request for 

reconsideration, to OWCP within one year of the Board’s merit decision, pursuant to 5 U.S.C. 

§ 8128(a) and 20 C.F.R. §§ 10.606 and 10.607. 

LEGAL PRECEDENT -- ISSUE 3 

To require OWCP to reopen a case for merit review under FECA section 8128(a), OWCP 

regulations provide that the evidence or argument submitted by a claimant must: (1) show that 

OWCP erroneously applied or interpreted a specific point of law; (2) advance a relevant legal 

argument not previously considered by it; or (3) constitute relevant and pertinent new evidence 

not previously considered by OWCP.31 Section 10.608(b) of OWCP regulations provide that 

when an application for reconsideration does not meet at least one of the three requirements 

enumerated under section 10.606(b)(2), OWCP will deny the application for reconsideration 

without reopening the case for a review on the merits.32

ANALYSIS -- ISSUE 3 

The Board finds that the refusal of OWCP to reopen appellant’s case for further 

consideration of the merits of her claim, pursuant to 5 U.S.C. § 8128(a), did not constitute an 

abuse of discretion. 

The issue presented on appeal is whether appellant met any of the requirements of 

20 C.F.R. § 10.606(b)(2), requiring OWCP to reopen the case for review of the merits of the 

claim. In her June 16, 2013 application for reconsideration, appellant did not show that OWCP 

erroneously applied or interpreted a specific point of law. She did not advance a new and 

relevant legal argument. Appellant repeated previously made arguments and alleged that she 

suffered from continued disability as a result of the June 24, 1985 employment incident. The 

underlying issue in this case was whether she was experiencing any residuals or disability of the 

June 24, 1985 injury. That is a medical issue which must be addressed by relevant medical 

evidence.33 Appellant, however, failed to submit new and relevant medical evidence in support 

of her claim. 

The only medical evidence submitted was Dr. Tipps’ September 20, 2013 MRI scan 

report of the cervical spine. As the report repeats evidence already in the case record, it is 

duplicative and does not constitute relevant and pertinent new evidence. Material which is 

duplicative of that already contained in the case record does not constitute a basis for reopening a 

case.34 A claimant may obtain a merit review of an OWCP decision by submitting new and 

 31 D.K., 59 ECAB 141 (2007). 

32 K.H., 59 ECAB 495 (2008). 

33 See Bobbie F. Cowart, 55 ECAB 746 (2004). 

34 See Kenneth R. Mroczkowski, 40 ECAB 855 (1989). 
12

relevant evidence. In this case, appellant failed to submit any new and relevant evidence 

addressing continued disability.35 

The Board accordingly finds that appellant did not meet any of the requirements of 20 

C.F.R. § 10.606(b)(2). Appellant did not show that OWCP erroneously applied or interpreted a 

specific point of law, advance a relevant legal argument not previously considered by OWCP, or 

submit relevant and pertinent evidence not previously considered. Pursuant to 20 C.F.R. 

§ 10.608, OWCP properly denied merit review. 

CONCLUSION 

The Board finds that OWCP met its burden of proof to terminate appellant’s 

compensation benefits effective April 7, 2013. The Board further finds that appellant failed to 

establish she continued to suffer from employment-related residuals or disability on or after 

April 7, 2013 as a result of her accepted June 24, 1985 employment injuries. The Board also 

finds that OWCP properly refused to reopen appellant’s case for further review of the merits 

pursuant to 5 U.S.C. § 8128(a). 

ORDER 

IT IS HEREBY ORDERED THAT the June 25 and April 8, 2014 decisions of the 

Office of Workers’ Compensation Programs are affirmed. 

Issued: March 25, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board 

 35 M.H., Docket No. 13-2051 (issued February 21, 2014).