United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.M., Appellant 

and 

DEPARTMENT OF COMMERCE, BUREAU 

OF THE CENSUS, Denver, CO, Employer 

__________________________________________ 

) 

) 

) 

) 

) 

) 

) 

) 

Docket No. 15-0814 

Issued: July 16, 2015 

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On February 26, 2015 appellant filed a timely appeal from a February 12, 2015 merit 

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 to review the merits of this case. 

ISSUE 

The issue is whether appellant is entitled to reimbursement for the insurance he 

purchased for his authorized neuromonics device. 

FACTUAL HISTORY 

On June 18, 2007 appellant, a 50-year-old field representative, sustained a traumatic 

injury in the performance of duty when, while traveling from one assigned housing unit to 

another, he hit his head on a tree limb as he passed under it. OWCP accepted his claim for neck 

 1

 5 U.S.C. § 8101 et seq.
2

strain, neck muscle spasms, post-traumatic muscle tension headaches, lower back strain, 

aggravation of endolymphatic hydrops (preexisting ear-related balance disturbance), ringing in 

ears (bilateral tinnitus), numbness (paresthesias) in right arm and hand, and postconcussive 

syndrome. 

After an audiological evaluation in 2008, appellant was found to be an excellent 

candidate for neuromonics tinnitus treatment, which was shown to reduce awareness of tinnitus 

and dramatically reduce disturbance levels. OWCP authorized the purchase of a durable 

neuromonics device. 

On October 14, 2009 appellant advised that he wanted OWCP to pay the insurance 

premium on his neuromonics device, which was $170.00. As OWCP had paid the premium the 

previous year he felt it should pay the insurance again. It responded on March 9, 2011 advising 

appellant that such insurance was a not reimbursable expense under FECA. 

In a decision dated December 4, 2014, OWCP denied authorization for the payment of 

insurance for appellant’s authorized neuromonics device. It explained that, as opposed to the 

underlying property itself, insurance was a financial product providing coverage by contract. 

The United States was by and large a self-insurer and able to incur the cost of repair or 

replacement of such medical equipment as a neuromonics device. Although appellant argued 

that private insurance would reduce the wait time for replacement should the device fail, OWCP 

found his argument speculative. 

Appellant requested reconsideration and submitted information regarding OWCP’s 

payment in August 2008 of $170.00 for the insurance on his neuromonics device, for dates of 

service listed as August 28 to 29, 2008. He argued that this initial coverage established a 

reasonable expectation that this was a reimbursable expense, and as such, he continued his 

insurance policy for the next three years, i.e., 2009, 2010, and 2011, until OWCP made him 

aware that it was not going to reimburse the expense. 

In a decision dated February 12, 2015, OWCP reviewed the merits of appellant’s claim 

and denied modification of its prior decision. It found that its initial reimbursement in 2008 was 

erroneously paid. OWCP added that appellant’s argument could not overcome its policy not to 

reimburse for insurance or warranties, including those on devices authorized by OWCP. It 

explained that only services and supplies that meet the statutory criteria of being likely to cure, 

give relief, reduce the degree or period of disability, or aid in lessening the amount of monthly 

compensation may be approved. While appellant may have expected future reimbursement, this 

was not sufficient to warrant continuing authorization in conflict with its policy on insurance and 

warranties. OWCP found the evidence insufficient to establish that insurance on the 

neuromonics device would be expected to cure, give relief, or reduce the degree or period of 

disability. 

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 that the Secretary of Labor considers likely to cure, give relief, reduce the degree or 
3

the period of any disability, or aid in lessening the amount of any monthly compensation.2 

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

discretion to determine whether the particular service, appliance, or supply is likely to effect the 

purposes specified in FECA.3

 The only limitation on OWCP’s authority is that of 

reasonableness.4

ANALYSIS 

Insurance coverage cannot reasonably be described as a medical service, appliance, or 

supply within the scope of section 8103 of FECA. OWCP does not consider the insurance 

necessary, as it would repair or replace the device if the need ever arose. Insurance on the device 

would not likely cure, give relief, reduce the degree or period of any disability, or lessen the 

amount of monthly compensation under section 8103. 

In reviewing OWCP’s February 12, 2015 decision, the Board must determine whether 

OWCP abused its discretion or acted unreasonably in denying continued reimbursement for 

insurance on an authorized device. Although appellant argues that he reasonably expected 

OWCP to continue paying for the insurance after initially reimbursing him in 2008, this 

expectation arose from an erroneous payment, a benefit to which he was not entitled. Having 

made the initial payment in error, OWCP is not bound to continue making erroneous payments. 

The situation is akin to cases in which OWCP gratuitously authorizes and pays for treatment of a 

medical condition that has not been accepted as related to the employment. As the Board 

explained in Sophia Maxim (Edward Gerard Maxim), 10 ECAB 61 (1958): 

“It is axiomatic that [OWCP] has no obligation to provide surgery, medical 

appliances and services for a condition not related to the employment.... 

Gratuitous authorizations of period examinations ... emergency surgery and 

follow-up care do not constitute an acceptance that the condition for which such 

services were extended was causally related to the employment.... Nor does 

authorization of such medical services for a condition found to be unrelated to the 

employment create a liability on [OWCP] to furnish further benefits either by way 

of medical care or by way of payment of compensation to the employee or his 

beneficiaries in the event of his death due to the condition for which he received 

gratuitous treatment. Causal relation must be established in each case for the 

employee or his beneficiary to be eligible to receive compensation benefits, 

medical or monetary.” 

Similarly, the gratuitous payment OWCP made in August 2008 for insurance on 

appellant’s neuromonics device did not create a liability to make further payments for an expense 

to which appellant was not entitled under section 8103. 

 2

 5 U.S.C. § 8103(a). 

3 See Marjorie S. Geer, 39 ECAB 1099 (1988). 

4 Daniel J. Perea, 42 ECAB 214 (1990). 
4

The Board finds that OWCP did not abuse its discretion in determining that insurance 

payments would not effect the purposes specified in section 8103. There is no basis under FECA 

for authorizing the insurance coverage he received for the period in question. The statute does 

not afford the relief he seeks. As appellant is not entitled to reimbursement for the insurance he 

purchased for his neuromonics device, the Board will affirm OWCP’s February 12, 2015 

decision denying reimbursement. 

CONCLUSION 

The Board finds that appellant is not entitled to reimbursement for the insurance he 

purchased for his authorized neuromonics device. 

ORDER 

IT IS HEREBY ORDERED THAT the February 12, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: July 16, 2015 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board