United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.J., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Indianapolis, IN, Employer 

__________________________________________ 

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Docket No. 15-1148 

Issued: November 19, 2015 

Appearances: Case Submitted on the Record

Alan J. Shapiro, 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 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On April 27, 2015 appellant, through counsel, filed a timely appeal from a November 4, 

2014 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.2

 

ISSUE 

The issue is whether OWCP properly terminated appellant’s compensation benefits 

effective November 4, 2014 because her accepted right biceps strain had resolved by July 3, 

2014 without residuals. 

On appeal counsel contends that OWCP’s decision is contrary to fact and law. 

                                                             1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that, following the issuance of the November 4, 2014 OWCP decision, appellant submitted new 

evidence. The Board is precluded from reviewing evidence which was not before OWCP at the time it issued its 

final decision. See 20 C.F.R. § 501.2(c)(1). 
2

FACTUAL HISTORY 

On December 11, 2013 appellant, then a 46-year-old mail handler, filed a traumatic 

injury claim (Form CA-1) alleging that she strained her upper right arm on December 10, 2013 

while pushing an overloaded cart in the performance of duty. 

Appellant submitted two duty status reports dated January 11 and February 8, 2014 and 

physical therapy notes dated December 11, 2013 through January 11, 2014. 

In a December 11, 2013 report, Dr. Alfredo Lopez-Yunez, a neurologist, diagnosed right 

biceps strain and noted that appellant was pushing an overload cart at work after which severe 

pain developed in the right arm. In a work release form dated December 11, 2013, he advised 

that appellant was able to return to work on December 13, 2013 with the following restrictions: 

no lifting or carrying more than 15 pounds; no pulling or pushing more than 15 pounds; no 

reaching above shoulder, overhead right; and occasional reaching right arm in other directions. 

On January 11, 2014 Dr. Lopez-Yunez reported that appellant’s right biceps strain was 

improving with physical therapy but was still symptomatic, particularly with pulling mail 

repeatedly. He noted that there was no paresthesia. On February 8, 2014 Dr. Lopez-Yunez 

reported that appellant continued physical therapy. 

In a March 21, 2014 report, Dr. Lopez-Yunez reviewed a magnetic resonance imaging 

(MRI) scan of the right shoulder dated March 18, 2014 and diagnosed moderate tendinopathy of 

the supraspinatus and infraspinatus, mild atrophy of the infraspinatus muscle, mild-to-moderate 

subacromial-subdeltoid bursitis, and mild degenerative joint disease at the acromioclavicular 

(AC) joint. 

In a May 30, 2014 letter, OWCP notes that when appellant’s claim was received it 

appeared to be a minor injury that resulted in minimal or no lost time from work and, based on 

these criteria and because the employing establishment did not controvert continuation of pay 

(COP) or challenge the case, payment of a limited amount of medical expenses was 

administratively approved. It stated that it had reopened the claim for consideration because the 

medical bills had exceeded $1,500.00. OWCP requested additional evidence and afforded 

appellant 30 days to respond to its inquiries. 

Appellant submitted a May 16, 2014 work release form from Dr. Lopez-Yunez which 

advised that appellant was able to return to work on May 17, 2014 without restrictions. 

By decision dated July 2, 2014, OWCP denied appellant’s claim finding that she failed to 

establish fact of injury. 

On August 7, 2014 appellant, through counsel, requested reconsideration. She submitted 

a July 31, 2014 narrative statement and an attending physician report dated June 30, 2014 from 

Dr. Lopez-Yunez who reiterated his diagnosis and medical opinions. 

In a report dated July 3, 2014, Dr. Lopez-Yunez reported that appellant’s injury occurred 

on December 10, 2013 when she was pushing an overloaded cart at work and immediately 

developed severe pain in the right shoulder and the anterior aspect of the arm associated with 

aching sensation, burning, and paresthesias. He indicated that the initial diagnosis was right 
3

biceps strain as well as right shoulder strain. Appellant completed 28 sessions of physical 

therapy showing improvement in range of motion and progressive decrease in pain. Dr. LopezYunez noted that she also achieved functional gains, progressively. On follow-up examination 

appellant showed improved range of motion and improvement of the strength of the biceps and 

infraspinatus and supraspinatus muscles. On May 16, 2014 her examination showed “full range 

of motion, no pain, and full strength of all the motor system.” Dr. Lopez-Yunez concluded that 

appellant had reached maximum medical improvement and her “right biceps strain/right shoulder 

strain [had] recovered fully without sequelae.” 

By decisions dated November 4, 2014, OWCP vacated its prior decision and accepted 

appellant’s claim for right biceps strain. However, terminated appellant’s compensation benefits 

effective that day because the medical evidence established that her accepted condition had 

resolved by July 3, 2014. 

LEGAL PRECEDENT 

Once OWCP accepts a claim and pays compensation, it has the burden of justifying 

modification or termination of an employee’s benefits.3 After it has determined that an 

employee has disability causally related to his or her federal employment, OWCP may not 

terminate compensation without establishing that the disability has ceased or that it is no longer 

related to the employment.4 OWCP’s burden of proof includes the necessity of furnishing 

rationalized medical opinion evidence based on a proper factual and medical background.5

 The 

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

disability.6 To terminate authorization for medical treatment, OWCP must establish that 

appellant no longer has residuals of an employment-related condition, which would require 

further medical treatment.7

 

ANALYSIS 

The Board finds that OWCP properly terminated appellant’s compensation benefits 

because, her accepted right biceps strain had resolved by July 3, 2014 without residuals. 

On November 4, 2014 OWCP accepted appellant’s claims for right biceps strain. It 

terminated her compensation benefits that same day because the accepted employment-related 

conditions had resolved without residuals based on the opinion of appellant’s attending 

physician, Dr. Lopez-Yunez. The issue to be determined is whether OWCP met its burden of 

proof to terminate appellant’s compensation benefits. 

                                                             3 See S.F., 59 ECAB 642 (2008); Kelly Y. Simpson, 57 ECAB 197 (2005); Paul L. Stewart, 54 ECAB 824 (2003). 

4 See I.J., 59 ECAB 524 (2008); Elsie L. Price, 54 ECAB 734 (2003). 

5 See J.M., 58 ECAB 478 (2007); Del K. Rykert, 40 ECAB 284 (1988). 

6 See T.P., 58 ECAB 524 (2007); Kathryn E. Demarsh, 56 ECAB 677 (2005). 

7 See James F. Weikel, 54 ECAB 660 (2003). 
4

In his July 3, 2014 report, Dr. Lopez-Yunez reported that appellant’s injury occurred on 

December 10, 2013 when she was pushing an overloaded cart at work and immediately 

developed severe pain in the right shoulder and the anterior aspect of the arm associated with 

aching sensation, burning, and paresthesias. He noted that the initial diagnosis was right biceps 

strain as well as right shoulder strain. Appellant completed 28 sessions of physical therapy 

showing improvement in range of motion and progressive decrease in pain. Dr. Lopez-Yunez 

noted that she also achieved functional gains, progressively. On follow-up examination, 

appellant showed improved range of motion and improvement of the strength of the biceps and 

infraspinatus and supraspinatus muscles. On May 16, 2014 her examination showed “full range 

of motion, no pain, and full strength of all the motor system.” Dr. Lopez-Yunez concluded that 

appellant had reached maximum medical improvement and her “right biceps strain/right shoulder 

strain [had] recovered fully without sequelae.” 

The Board finds that Dr. Lopez-Yunez’s July 3, 2014 report represents the weight of the 

medical evidence at the time OWCP terminated benefits and OWCP properly relied on his report 

in terminating appellant’s compensation benefits. The Board finds that he had full knowledge of 

the relevant facts and evaluated the course of appellant’s condition. Dr. Lopez-Yunez is a 

specialist in the appropriate field. His opinion is based on a proper factual and medical history 

and his report contained a detailed summary of this history. Dr. Lopez-Yunez addressed the 

medical records to make his own examination findings to reach a reasoned conclusion regarding 

appellant’s condition.8

 At the time benefits were terminated, he found no basis on which to 

attribute any residuals or continued disability to appellant’s accepted condition. 

Dr. Lopez-Yunez’s opinion as set forth in his July 3, 2014 report is found to be probative 

evidence and reliable. The Board finds that his opinion constitutes the weight of the medical 

evidence and is sufficient to justify OWCP’s termination of benefits for the accepted right biceps 

strain had ceased. 

On appeal counsel contends that OWCP’s decision is contrary to fact and law. However, 

his arguments are not substantiated based on the Board’s findings in this case. 

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. 

CONCLUSION 

The Board finds that OWCP properly terminated appellant’s compensation benefits 

effective November 4, 2014 because her accepted right biceps strain had resolved by July 3, 

2014 without residuals. 

                                                             8 See Michael S. Mina, 57 ECAB 379 (2006) (the opportunity for and thoroughness of examination, the accuracy 

and completeness of the physician’s knowledge of the facts and medical history, the care of analysis manifested and 

the medical rationale expressed in support of the physician’s opinion are facts, which determine the weight to be 

given to each individual report). 
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ORDER 

IT IS HEREBY ORDERED THAT the November 4, 2014 termination decision of the 

Office of Workers’ Compensation Programs is affirmed. 

Issued: November 19, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board