United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.M., Appellant 

and 

DEPARTMENT OF THE NAVY, NAVAL AIR 

SYSTEMS COMMAND CENTERS, 

China Lake, CA, Employer 

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Docket No. 15-1724 

Issued: February 16, 2016 

Appearances: Case Submitted on the Record

Sally F. LaMacchia, Esq. for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On August 6, 2015 appellant, through counsel, filed a timely appeal from a July 30, 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 over the merits of this case. 

ISSUE 

The issue is whether OWCP abused its discretion by denying appellant’s request for 

reimbursement of travel expenses exceeding 100 miles roundtrip. 

FACTUAL HISTORY 

On January 10, 2006 appellant, then a 56-year-old information technology specialist, 

filed a traumatic injury claim (Form CA-1) alleging that she injured her right knee, right hand, 

 1

 5 U.S.C. § 8101 et seq. 
2

and wrist, after tripping on a hose and falling onto a sidewalk on December 21, 2005. She 

stopped work on July 24, 2008 and has not returned. OWCP initially accepted the claim for right 

knee contusion and contusions of right hand and wrist. It subsequently accepted right carpal 

tunnel syndrome, enthesopathy of the right wrist and carpus, right knee lateral meniscus tear, 

psychogenic pain, and aggravation of degenerative joint disease of the right knee. 

OWCP paid wage-loss benefits. It also authorized appellant’s surgical procedures, which 

included: a May 31, 2007 right knee surgery; a July 24, 2008 right carpal tunnel and right flexor 

tenosynevectomy; an August 12, 2009 right knee total arthroplasty and patelloplasty; and a 

December 2, 2011 right knee closed reduction. All surgeries were performed by 

Dr. Mohamed Z. Lameer, an orthopedic surgeon, in Lancaster, CA, or Palmdale, CA.2

 From 

August 2008 to July 2012 and in October 2012, appellant received approved physical therapy at 

the Heritage Physical Therapy Facility and the Total Rehabilitation Services Facility located near 

her home in Ridgecrest, CA. 

On May 23, 2012 appellant underwent an approved revision right knee total arthroplasty 

with polyethylene exchange, performed by Dr. Paul Burton, an orthopedic surgeon, in 

Redlands, CA. She then underwent approved right-sided peroneal nerve injections under 

fluoroscopy by Dr. Shanin A. Sadik, a Board-certified anesthesiologist, in Palmdale, CA, and 

approved acupuncture treatments and physical therapy also in Palmdale, CA from October 2013 

to the present as prescribed by Dr. Sadik. 

Appellant resides in Ridgecrest, CA. She currently receives medical care in 

Palmdale, CA from Dr. Sadik and other practitioners at Universal Pain Management Group, as 

well as medical care in Redlands, CA from Dr. Burton. Appellant, through counsel, requested 

authorization for reimbursement of travel expenses related to obtaining treatment from Dr. Sadik 

in Palmdale, CA and Dr. Burton in Redlands, CA. OWCP determined that travel to Dr. Sadik in 

Palmdale, CA from appellant’s home in Ridgecrest, CA was approximately 92 miles each way, 

and travel to Dr. Burton’s office in Redlands, CA from appellant’s home in Ridgecrest, CA was 

approximately 125 miles each way.3

In an August 23, 2013 letter, OWCP indicated that it had received requests for 

authorization for mileage reimbursements for the following dates of service: April 9, 2013 for 

294 miles; April 10, 2013 for 294 miles; May 21, 2013 for 294 miles; May 22, 2013 for 294 

miles; June 7, 2013 for 275 miles; June 13, 2013 for 275 miles; July 1, 2013 275 miles; July 3, 

2013 for 275 miles; July 8, 2013 for 275 miles; and July 15, 2013 for 275 miles. Appellant was 

notified that her request for mileage reimbursement in excess of 100 miles roundtrip for 

treatment was not authorized and informed of the provision of 20 C.F.R. § 10.315. OWCP 

approved reimbursement for travel up to 100 miles roundtrip. 

 2

 Dr. Lameer’s last medical note of file dated February 29, 2012 indicated that he would see appellant in one to 

two weeks. 

3

 OWCP advised that travel distances were based on online mapping website entry of the starting and ending 

cities. 
3

In a January 27, 2014 letter, appellant’s counsel disagreed with OWCP’s denial of 

reimbursement for travel over 100 miles roundtrip. She quoted the relevant regulations and 

noted that several of her clients who live in Ridgecrest, CA could not find nearby treating 

physicians and all had to travel over 100 miles roundtrip for treatment. Counsel requested 

written approval or a formal disallowance on this issue. 

In a February 10, 2014 letter, appellant requested approval to travel beyond the 100 miles 

roundtrip allowed by OWCP. She indicated that, other than emergency care, there was no 

adequate medical staff in Ridgecrest, CA where she lives. Appellant needed a specialist and that 

the doctors she called refused to take her case due to the nature of her injury or because they did 

not accept OWCP claimants. She noted that at some unspecified point in the past, an emergency 

room doctor told her that he would not treat her knee when she had a dislocation.

In a March 1, 2014 letter, appellant advised that she had to travel to the closest location 

that would treat her. She noted that her workplace was in a very remote area and that the 

medical care in Ridgecrest, CA where she lives was very limited. Appellant described an 

incident when she had a fourth dislocation of her knee and that the emergency room in 

Ridgecrest refused to treat her. She had made calls to all the orthopedic doctors in Ridgecrest, 

Lancaster, and Palmdale, but none would treat her complicated case. 

In an April 14, 2014 letter, OWCP advised appellant that her general statements were 

insufficient and requested that she provide specific information to support the need to travel over 

100 miles roundtrip to obtain medical treatment. Appellant was asked to provide a detailed 

statement explaining why she believed it was reasonable and necessary for her to travel 

approximately 92 miles each way to and from Palmdale, CA to see Dr. Sadik and travel 

approximately 124 miles each way to and from Redlands, CA to see Dr. Burton. She was also 

requested to provide documentation of medical providers from whom she sought treatment and 

evidence of their refusal to provide her with treatment for the work injury. Appellant was 

afforded 30 days to provide the requested information. 

In a May 15, 2014 letter, appellant’s counsel indicated that it was OWCP’s responsibility 

to determine what is considered a reasonable distance and the criteria for such determination; 

appellant only needed to submit a written request for prior authorization. She requested either 

written approval for travel beyond 100 miles roundtrip to attend medical appointments or a 

formal disallowance with appeal rights. No additional information was received. 

By decision dated June 12, 2014, OWCP denied travel mileage reimbursement for 

distances in excess of 100 miles round trip for appellant’s medical appointments in Palmdale, 

CA and Redlands, CA. It found that although she lived in a “relatively remote” area, she had not 

provided evidence that physicians closer to her home would not treat her. OWCP advised that 

the medical authorization and billing service’s (ACS) online provider search portal revealed 

several doctors in the city of Ridgecrest, CA where appellant resides and numerous doctors in 

Lancaster, CA (approximately 84 miles one way) and Barstow, CA (approximately 77 miles one 

way) who could treat her and provided the list of these physicians. It noted that neither appellant 

nor counsel provided evidence to explain the necessity of travelling to Palmdale and Redlands to 

seek treatment and why such travel was reasonable and necessary. OWCP noted that appellant 
4

remained entitled to reimbursement of travel up to the maximum generally allowable distance of 

100 miles roundtrip. 

On June 19, 2014 OWCP received appellant’s request for a review of the written record 

by an OWCP hearing representative. In a September 9, 2014 brief, appellant’s counsel reiterated 

some of her prior arguments. She also noted that Dr. Lameer, appellant’s initial physician in 

Lancaster, CA, had treated her until early 2012, when he refused to treat her any longer. Counsel 

noted that appellant had made many calls to doctors in the Ridgecrest area and found that those 

doctors either did not accept workers’ compensation patients or were not suited to treat her 

medical needs. She advised that the medical groups which accepted workers’ compensation 

patients and which might meet some of her medical needs, did not perform full knee 

replacements or revisions at their Ridgecrest location. It was noted that appellant had contacted 

SoCal Orthopedic Institute and Valley Orthopedic Institute. Counsel indicated that appellant 

began treatment with Dr. Burton in Redlands, CA in April 2012 and saw him on a quarterly 

basis. Appellant also saw Dr. Sadik approximately once a month. Counsel cited FECA Bulletin 

No. 14-02 and argued that OWCP had failed to determine what was a reasonable distance to 

travel based on availability of services, when it would pay mileage in excess of 100 miles round 

trip to see a physician in Lancaster or Barstow, but deny reimbursement of her current 

physicians. A signed affidavit from appellant summarizing the same was attached. 

By decision dated January 30, 2015, an OWCP hearing representative affirmed the 

June 12, 2014 decision, determining that there was no basis to authorize travel to Dr. Sadik in 

Palmdale, CA and Dr. Burton in Redlands, CA as there were closer facilities with appropriate 

specialists who could treat appellant’s conditions. She found that there was no evidence that 

Dr. Lameer had discharged appellant from his care in early 2012 and nothing in the file indicated 

that he had released her from his care or he refused to continue to treat her. The hearing 

representative noted that there were orthopedic facilities nearer to appellant’s residence which 

had pain management specialists and orthopedists in one facility. These were Antelope Valley 

Orthopedics in Lancaster, CA, a distance of 81.5 miles one way; Ridgecrest AVORS Medical 

Group, a distance of 4.29 miles from appellant’s home; and LA Orthopedic Institute in Palmdale, 

CA, a distance of 89 miles away. The hearing representative noted that while appellant may 

continue to receive treatment from Drs. Sadik and Burton, she was not entitled to reimbursement 

for travel expenses, over 100 miles. 

On May 8, 2015 OWCP received appellant’s counsel’s request for reconsideration dated 

May 8, 2015. Counsel made the following contentions: that there are no physicians closer to 

appellant’s residence who were willing and able to provide the medical treatment appellant 

required; that driving caused appellant a great deal of pain and she would travel a shorter 

distance for treatment if she knew of a closer facility that would treat her, that appellant had met 

her burden to prove that it was reasonable and necessary to travel 90 to 125 miles each way for 

her treatment with Drs. Sadik and Dr. Burton, respectively, and that OWCP failed to provide any 

evidence to support its finding that other appropriate physicians and physical therapy facilities of 

the appropriate specialty were available to appellant. She indicated that once a month appellant 

saw Dr. Sadik in Palmdale for a total of 2,160 miles a year and that she saw Dr. Burton in 

Redlands quarterly, for a total of 1,000 miles per year. If appellant was to be treated at the 

facilities noted by OWCP, the difference in mileage would only be 24 to 204 miles, depending 

on the facility. Counsel further argued that it was speculation on OWCP’s part that appellant 
5

would be able to schedule appointments with both an orthopedic and pain management specialist 

in the same trip. She contended that appellant had to travel the requested distance as Drs. Sadik 

and Burton were the only physicians able to treat her medical needs. Counsel noted that 

appellant traveled the distance even though her accepted knee injuries made the trip very hard. 

She argued that since OWCP appeared willing to reimburse for travel to facilities at distances of 

163 to 178 miles round trip and appellant currently traveled 180 miles roundtrip to Dr. Sadik in 

Palmdale and 250 miles roundtrip to Dr. Burton, OWCP should reimburse appellant fully or 

provide her reimbursement of 178 miles roundtrip with Dr. Burton. 

In an attached May 3, 2015 statement, appellant indicated that on or about April 19, 

2012, she called Valley Orthopedic Institute, the Antelope Valley Orthopedics, and LA 

Orthopedic Institute and was told that neither facility had the ability to perform or treat a knee 

revision and they did not accept workers’ compensation. 

By decision dated July 30, 2015, OWCP denied modification of its prior decision. It 

noted that The Heritage Physical Therapy Facility and the Total Rehabilitation Services Facility, 

both in Ridgecrest, where appellant previously had physical therapy, had not been reexplored for 

continuing care and there was no evidence that Dr. Lameer, appellant’s initial orthopedic 

surgeon, had released appellant from his care in early 2012. 

LEGAL PRECEDENT 

Section 8103 of FECA provides that 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, reduce the degree of the period of any disability, or aid in lessening the amount of 

any monthly compensation. The employee may initially select a physician to provide medical 

services, appliances, and supplies, in accordance with such regulations and instructions as 

OWCP considers necessary and may be furnished reasonable and necessary transportation and 

expenses incident to the securing of such services, appliances, and supplies.4 

OWCP regulations provide that the employee is entitled to reimbursement of reasonable 

and necessary expenses, including transportation needed to obtain authorized medical services, 

appliances, or supplies. To determine a reasonable travel distance, it will consider the 

availability of services, the employee’s condition, and the means of transportation. Effective 

August 29, 2011, the most recent regulations provide that a roundtrip distance of up to 100 miles 

is considered a reasonable distance to travel.5

 If roundtrip travel of more than 100 miles is 

contemplated, or air transportation or overnight accommodations will be needed, the employee 

must submit a written request to OWCP for prior authorization with information describing the 

circumstances and necessity for such travel expenses. OWCP will approve the request if it 

 4

 5 U.S.C. § 8103(a). 

5

 20 C.F.R. § 10.315(a). 
6

determines that the travel expenses are reasonable and necessary and are related to obtaining 

authorized medical services, appliances, or supplies.6 

Pursuant to FECA Bulletin No. 14-02, issued January 29, 2014, when a claimant submits 

a travel reimbursement in excess of 100 miles for a single date of service, the bill will 

automatically be suspended and the Central Bill Processing provider will send notification to the 

OWCP claims examiner.7

 FECA Bulletin No. 14-02 notes that in some limited circumstances it 

may be necessary for a claimant to travel more than 100 miles on a regular basis, such as when 

the claimant lives in a remote area.8

In interpreting this section, the Board has recognized that OWCP has broad discretion in 

approving services provided under FECA. The only limitation on OWCP’s authority is that of 

reasonableness.9

 OWCP may authorize medical treatment but determine that the travel expense 

incurred for such authorized treatment was unreasonable or unnecessary.10 

ANALYSIS 

 The Board finds that OWCP did not abuse its discretion in denying appellant’s requests 

for travel reimbursement over 100 miles roundtrip. It is noted that issues of authorization for 

medical treatment and reimbursement of travel expenses for medical treatment are separate and 

distinct. OWCP may authorize medical treatment but determine that the travel expense incurred 

for such authorized treatment was unreasonable or unnecessary, as in this case.11

 The record reflects Dr. Lameer, located in Lancaster, CA within 100 miles round trip of 

appellant’s residence, performed her 2007, 2009, and 2011 right knee surgeries and the 2008 

right wrist surgery. Prior to 2013, appellant underwent physical therapy at the Heritage Physical 

Therapy Facility and the Total Rehabilitation Services Facility located near in her home in 

Ridgecrest, CA. On May 23, 2012 Dr. Burton, located in Redlands, CA, performed a revision 

surgery on her right knee. Appellant then began seeing Dr. Sadik in Palmdale, CA, who, in turn, 

made the physical therapy and acupuncture treatment referrals to Universal Pain Management 

Center in Palmdale. Appellant currently travels 184 to 250 miles roundtrip to obtain medical 

services for her injury from Dr. Sadik and Dr. Burton, respectively. OWCP accepted that 

appellant lives in a relatively remote location, but denied reimbursement for travel to Dr. Sadik 

in Palmdale, CA, approximately 92 miles each way, and Dr. Burton in Redlands, CA, 

approximately 125 miles each way as there is no supporting factual evidence to establish that it 

 6 Id. at § 10.315(b). 

7

 FECA Bulletin No. 14-02 (issued January 29, 2014). 

8 Id. 

9 A.O., Docket No. 08-580 (issued January 28, 2009); see also Marjorie S. Geer, 39 ECAB 1099 (1988) (OWCP 

has broad discretionary authority in the administration of FECA and must exercise that discretion to achieve the 

objectives of section 8103). 

10 W.M., 59 ECAB 132 (2007); Mira R. Adams, 48 ECAB 504 (1997). 

11 W.M., id. 
7

was reasonable and necessary for her to travel such distances to obtain medical services for her 

injury. 

As noted above, OWCP regulations provide that, generally, a round trip of up to 100 

miles is a reasonable distance to travel.12 There may be circumstances where travel 

reimbursement of more than 100 miles is appropriate. An example of those circumstances might 

be an appellant who lives in a remote area with limited medical services and physicians of an 

appropriate specialty. To establish that a travel reimbursement of more than 100 miles is 

warranted, OWCP regulations indicate that the claimant must provide information describing the 

circumstances and necessity for such travel expenses. 

 Appellant was seeing Dr. Lameer, an orthopedic specialist, for her knee and it is 

reasonable that she would continue to need care from an orthopedist following her knee revision. 

While she asserted that Dr. Lameer had discharged her from his care in early 2012, the evidence 

fails to establish that he either released appellant from his care or informed her that he would not 

continue to treat her. OWCP also provided a list of closer facilities with appropriate specialists 

who could treat appellant’s conditions. 

With regard to the availability of services, appellant and her counsel have not provided 

evidence to explain the necessity of traveling the specifically requested distances to Palmdale 

and Redlands to seek care and why such travel is reasonable. She generally contends that there 

were no available services in her area, or that the facilities she contacted from OWCP’s list did 

not accept workers’ compensation cases or could not treat her medical needs. While appellant 

provided a signed affidavit advising that on or about April 19, 2014 she contacted the Valley 

Orthopedic Institute in Lancaster, the Antelope Valley Orthopedics, and LA Orthopedics 

Institute in Palmdale and that these facilities do not accept workers’ compensation cases, there is 

no evidence to show that this rejection was due to the complexity of her case or that the facilities 

have an actual policy of denying medical care to injured workers. She provided no evidence to 

support her statements about the lack of available services or the specific need for the distances 

for which she was requesting authorization for reimbursement. 

As noted, OWCP provided appellant a list of facilities with appropriate specialists who 

were willing to accept federal workers’ compensation patients. It additionally noted that the 

Heritage Physical Therapy Facility and the Total Rehabilitation Services Facility, both in 

Ridgecrest, where appellant previously had physical therapy, had not been reexplored for 

continuing care. 

Appellant’s counsel suggested that OWCP compromise and provide payment for at least 

168 miles roundtrip with Dr. Sadik and for at least 178 miles roundtrip for visits to Dr. Burton 

based on the contention that OWCP appeared willing to reimburse appellant at distances of 163 

to 178 miles. However, neither appellant nor counsel have provided any compelling reason to 

show why treatments with Dr. Sadik and associated therapy/acupuncture treatments at Universal 

Pain Management, and quarterly follow-up visits with Dr. Burton was reasonable and necessary 

when there are appropriate specialists and facilities closer to appellant’s home. 

 12 20 C.F.R. § 10.315(a). 
8

While appellant lives in a relatively remote area, appellant and counsel have not provided 

evidence to explain the necessity of traveling the specifically requested distances to Palmdale 

and Redlands to seek care and why such travel is reasonable. Although OWCP had authorized 

travel expenses to Dr. Sadik and Dr. Burton in the past, this past practice does not establish a 

right to continuing authorization.13 As indicated in FECA Bulletin No. 14-02, any travel 

reimbursement request of more than 100 miles was to be reviewed by an OWCP claims 

examiner.14

The Board finds that OWCP did not abuse its discretion in denying appellant’s travel 

reimbursement requests.15 No probative evidence was presented with respect to the necessity of 

travel over the 100-mile standard set forth in OWCP regulations or that OWCP abused its 

discretion in denying reimbursement for travel expenses. OWCP has administrative discretion 

with respect to authorization of travel reimbursement.16

On appeal, appellant’s counsel offers arguments pertaining to OWCP’s conflict statement 

and an upcoming impartial medical examination. However, this issue is not presently before the 

Board. 

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. 

CONCLUSION 

The Board finds that OWCP did not abuse its discretion by denying appellant’s request 

for travel reimbursement. 

 13 See W.H., Docket No. 14-1662 (issued February 3, 2015). 

14 Supra note 7. 

15 See V.K., Docket No. 12-1103 (issued October 12, 2012). 

16 Daniel J. Perea, 42 ECAB 214 (1990) (abuse of discretion by OWCP is generally shown through proof of 

manifest error, clearly unreasonable exercise of judgement, or administrative actions which are contrary to both 

logic and probable deductions from established facts). 
9

ORDER 

IT IS HEREBY ORDERED THAT the July 30, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: February 16, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board