United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.B., Appellant 

and 

DEPARTMENT OF THE ARMY, 

INSTALLATION MANAGEMENT 

COMMAND, Fort Bliss, TX, Employer 

__________________________________________ 

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Docket No. 14-959 

Issued: February 23, 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, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On March 20, 2014 appellant filed a timely appeal from an Office of Workers’ 

Compensation Programs’ (OWCP) decision dated November 7, 2013. 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 appellant has more than a two percent impairment to her right lower 

extremity and a one percent impairment to her left lower extremity for which she has received 

schedule awards. 

 1

 5 U.S.C. § 8101 et seq. 
2

FACTUAL HISTORY 

Appellant, a 51-year-old security guard, filed a Form CA-2 claim for benefits on 

November 9, 2010, alleging that she developed a bilateral foot condition causally related to 

employment factors. OWCP accepted the claim for bilateral achilles tendinitis and bilateral 

plantar fibromatosis. 

In an October 12, 2011 report, Dr. Andrew J. Palafox, Board-certified in orthopedic 

surgery, rated each of appellant’s lower extremities as with a one percent permanent impairment, 

pursuant to the American Medical Association, Guides to the Evaluation of Permanent 

Impairment (sixth edition) (A.M.A., Guides). 

On June 7, 2012 appellant filed a Form CA-7 claim for a schedule award based on a 

partial loss of use of her right and left lower extremities. 

In a report dated August 7, 2012, Dr. Ronald Blum, Board-certified in orthopedic surgery 

and an OWCP medical adviser, reviewed Dr. Palafox’s October 12, 2011 report and found that 

appellant had a one percent impairment of the right lower extremity and a one percent 

impairment of the left lower extremity pursuant to the sixth edition of the A.M.A., Guides. He 

stated that, under Table 16-2, Foot and Ankle Regional Grid, Lower Extremity Impairments, at 

page 501 of the A.M.A., Guides,

2

 the section pertaining to muscle/tendon impairments, 

appellant’s achilles tendinitis yielded a class 1 rating for no significant objective abnormal 

findings of muscle or tendon injury at maximum medical improvement, which had a default 

score of one percent lower extremity impairment based on “palpatory findings and/or 

radiographic findings,” for a mild problem. Using the Adjustment Grid, Functional History, at 

Table 16-6, page 516 of the A.M.A., Guides,

3

 Dr. Blum found that appellant had a grade 

modifier of one for functional history, a grade modifier of two for physical examination pursuant 

to Table 16-7, Section 16.3b, page 517 of page 509 of the A.M.A., Guides, and no grade 

modifier for clinical studies pursuant to Section 16.3c and Table 16-8, page 519 of the A.M.A., 

Guides4

 since there were no clinical studies. He utilized this method to calculate a one percent 

impairment for each lower extremity, choosing to rate appellant’s diagnosis-based impairment 

based on appellant’s accepted bilateral achilles tendinitis condition. 

By decision dated September 7, 2012, OWCP granted appellant a schedule award for a 

one percent permanent impairment of the left lower and her right lower extremity for the period 

February 27 to April 7, 2012, for a total of 5.76 weeks of compensation. 

Appellant continued to submit medical documents to the record which did not evaluate 

her degree of permanent impairment. 

On September 12, 2012 appellant requested reconsideration. 

 2

 A.M.A., Guides 501. 

3 Id. at 516. 

4 Id. at 519. 
3

By decision dated October 24, 2012, OWCP denied modification of the September 7, 

2012 decision. 

On October 30, 2012 appellant requested reconsideration. 

By decision dated March 7, 2013, OWCP denied modification of the September 7, 2012 

decision. Appellant again requested reconsideration on July 24, 2013. 

In a report dated August 6, 2013, Dr. Michael M. Mrochek, a specialist in physical 

medicine and rehabilitation, found that appellant had a two percent right lower extremity 

impairment and a one percent left lower extremity impairment pursuant to the sixth edition of the 

A.M.A., Guides. After stating findings on examination and reviewing the medical history, he 

stated: 

“According to page 501, [appellant] was class 1 grade C for the planter fascia, 

which is a one percent for both feet. For the right side, she does have a tendinitis 

of the Achilles tendon, which is a class 1, grade C injury as well a one percent 

[impairment], but I do not find any evidence of this on the left. With regard to the 

adjustment grid summary for functional history, she is a grade modifier 1 mild 

problem, which keeps her in the same class. Physical examination, grade 

modifier 1, mild problem; clinical studies are nearly confirmatory. Thus, she 

remains at one percent impairment for the left lower extremity for the plantar 

fasciitis, plus one percent, which is two percent for the right lower extremity for 

the achilles tendinitis and the plantar fasciitis.” 

In a report dated October 3, 2013, Dr. Michael M. Katz, Board-certified in orthopedic 

surgery and an OWCP medical adviser, reviewed Dr. Mrochek’s report and concurred with his 

finding of a one percent impairment of the left lower extremity pursuant to the A.M.A., Guides, 

based solely on her accepted plantar fibromatosis condition, which did not provide a basis for an 

additional award. He stated, however, that Dr. Mrochek’s rating for the right lower extremity 

was not proper as it was based on two accepted conditions, plantar fibromatosis and achilles 

tendinitis. Dr. Katz asserted that this rating was not in conformance with the applicable 

protocols and tables set forth in the A.M.A., Guides in regard to a claimant with two accepted 

conditions which were covered by the same regional grid, Table 16-2. Dr. Blum advised that, 

pursuant to the A.M.A., Guides at page 497, “If a patient has two significant diagnoses ... the 

examiner should use the diagnosis with the highest causally related impairment rating for the 

impairment calculation.”5

 Based on this criteria, he found that appellant’s achilles tendinitis 

produced the higher rating at Table 16-2. Relying on the section pertaining to muscle/tendon 

impairments, Dr. Katz found that her achilles tendinitis yielded a class 1 rating for strain, which 

had a default score of one percent lower extremity impairment based on palpatory and/or 

findings, for a mild problem. Using the Adjustment Grid, Functional History, at Table 16-6, 

page 516 of the A.M.A., Guides,

6

 he found that appellant had a grade modifier of one for 

functional history; a grade modifier of two for physical examination pursuant to Table 16-7, 

 5 Id. at 497. 

6 Id. at 516. 
4

Section 16.3b, page 517 of page 509 of the A.M.A., Guides, and no grade modifier for clinical 

studies pursuant to Section 16.3c and Table 16-8, page 519 of the A.M.A., Guides.

7

 Dr. Katz 

found that this calculation produced a class 1 impairment with a net adjustment of plus 1, from 

the default value C, which equaled a class 1, grade D, two percent impairment for the right lower 

extremity. He concluded that appellant now had a net additional award of one percent right 

lower extremity impairment based on subtracting the two percent award calculated above from 

the one percent impairment he was previously awarded. Dr. Katz reiterated that she was not 

entitled to an additional award for the left lower extremity. 

By decision dated October 23, 2013, OWCP set aside the September 7, 2012 decision in 

part, finding based on Dr. Katz’s October 3, 2013 report that appellant was entitled to a schedule 

award based on an additional one percent impairment for the right lower extremity. 

By decision dated November 7, 2013, OWCP granted appellant a schedule award for an 

additional one percent permanent impairment of the right lower extremity for the period 

August 6 to 26, 2013, for a total of 2.88 weeks of compensation. 

LEGAL PRECEDENT 

The schedule award provision of FECA8 and its implementing regulations9 set forth the 

number of weeks of compensation payable to employees sustaining permanent impairment from 

loss, or loss of use, of scheduled members or functions of the body. However, FECA does not 

specify the manner in which the percentage of loss shall be determined. For consistent results 

and to ensure equal justice under the law to all claimants, good administrative practice 

necessitates the use of a single set of tables so that there may be uniform standards applicable to 

all claimants. The A.M.A., Guides has been adopted by the implementing regulations as the 

appropriate standard for evaluating schedule losses.10 The claimant has the burden of proving 

that the condition for which a schedule award is sought is causally related to her employment.11

ANALYSIS 

In the instant case, OWCP accepted the conditions of bilateral achilles tendinitis and 

bilateral plantar fibromatosis. Based on the bilateral achilles tendinitis condition, it granted 

aappellant a schedule award for a one percent impairment of the right and left lower extremities 

in its September 7, 2012 decision. Appellant subsequently sought an additional award and 

submitted Dr. Mrochek’s August 6, 2013 report. 

 7 Id. at 519. 

8

 5 U.S.C. § 8107. 

9

 20 C.F.R. § 10.404. Effective May 1, 2009, OWCP began using the A.M.A., Guides. (6th ed. 2009). 

10 Id.

11 Veronica Williams, 56 ECAB 367, 370 (2005). 
5

The Board notes that the A.M.A., Guides directs examiners to rate diagnosis-based 

impairments for the lower extremities pursuant to Chapter 16, which states at page 497, Section 

16.2a that impairments are defined by class and grade.12 In accordance with this section the 

examiner is instructed to utilize the net adjustment formula outlined at pages 521-22 of the 

A.M.A., Guides,

13 to obtain the proper impairment rating. In his October 3, 2013 report, 

Dr. Katz, OWCP medical adviser, reviewed the August 6, 2013 report from Dr. Mrochek. He 

agreed with Dr. Mrochek’s rating of a one percent impairment for plantar fibromatosis in the left 

lower extremity; however, he found that Dr. Mrochek failed to relate his findings for the right 

lower extremity to the applicable tables and figures of the A.M.A., Guides and found that 

appellant had a two percent impairment of the right lower extremity for achilles tendinitis based 

on the Foot and Ankle Regional Grid, Lower Extremity Impairments at Table 16-2, page 501 of 

the A.M.A., Guides. Dr. Katz applied the section on muscle/tendon impairments and found that 

appellant had a class 1 rating for achilles tendinitis, a default score of one percent lower 

extremity impairment based on palpatory/and or radiographic findings. He then utilized the net 

adjustment formula, applying the grade modifiers of one for functional history and two for 

physical examination and no grade modifier for clinical studies. Dr. Katz compared these net 

adjustments and calculated the diagnosis for class 1 of plus two; for a grade D, two percent lower 

extremity impairment. Based on his report, OWCP determined that appellant had an additional 

one percent impairment of the right lower extremity, as he calculated this rating based on the 

applicable protocols and tables of the sixth edition of the A.M.A., Guides. 

As noted above, Dr. Katz chose to rate his diagnosis-based impairment based on 

appellant’s achilles tendinitis condition, rather than according an impairment rating based on the 

plantar fibromatosis condition. He based this rating on the fact that where a claim has two 

significant diagnoses, the examiner is instructed by the A.M.A., Guides to use the diagnosis with 

the highest causally related impairment rating for the impairment calculation. Pursuant to the 

criteria, Dr. Katz properly relied on the diagnosis-based method for rating appellant’s accepted 

achilles tendinitis condition, which yielded the higher rating.14 With regard to the left lower 

extremity, both Dr. Katz and Dr. Mrochek found that there was no basis for an award greater 

than the one percent impairment already awarded. Therefore, as OWCP medical adviser 

provided an impairment rating in accordance with its applicable protocols and tables, it properly 

granted a schedule award for an additional one percent right lower extremity impairment and 

denied an additional award for left lower extremity in its November 7, 2013 decision. The Board 

finds that appellant has not established that she has a greater impairment of her lower 

extremities. 

Appellant may request a schedule award or increased schedule award based on evidence 

of a new exposure or medical evidence showing progression of an employment-related condition 

resulting in permanent impairment or increased impairment. 

 12 A.M.A., Guides 497. 

13 Id. at 521-22. 

14 The Board notes that a description of appellant’s impairment must be obtained from appellant’s physician, 

which must be in sufficient detail so that the claims examiner and others reviewing the file will be able to clearly 

visualize the impairment with its resulting restrictions and limitations. See Peter C. Belkind, 56 ECAB 580, 

585 (2005). 
6

CONCLUSION 

The Board finds that appellant has no more than a two percent impairment to her right 

lower extremity and a one percent impairment to her left lower extremity. 

ORDER 

IT IS HEREBY ORDERED THAT the November 7, 2013 decision of the Office of 

Workers’ Compensation Programs be affirmed. 

Issued: February 23, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees' Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees' Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees' Compensation Appeals Board