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. 14-1971 

Issued: July 2, 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 H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

JURISDICTION 

On March 20, 2014 appellant filed a timely appeal from a December 18, 2013 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 appellant has met her burden of proof to establish pelvic 

nerve/dysesthesia/lumbar conditions in the performance of duty. 

 1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that appellant submitted additional evidence to the record following OWCP’s December 18, 

2013 decision. The Board’s jurisdiction is limited to a review of evidence which was before OWCP at the time of 

its final review. 20 C.F.R. § 501(c). 
2

FACTUAL HISTORY 

Appellant, a 53-year-old security guard and police officer, filed a Form CA-2 

occupational disease claim for benefits on April 30, 2012, alleging that she experienced tingling 

in her pelvic area and a pinched nerve sensation near her thigh bone which was causing a twitch 

radiating down her legs. She stopped work on April 12, 2012 and returned to work on 

April 30, 2012. 

In support of her claim, appellant submitted a May 9, 2012 return to work note signed by 

a registered nurse and a May 11, 2012 report from Dr. Onyemas Amakiri, an osteopathic 

physician specializing in internal medicine. Dr. Amakiri noted that appellant was seen for “jerky 

movements.” He stated his diagnoses as abdominal pain, involuntary movements, restless leg 

syndrome, and uric acid nephroisthiosis. 

On June 12, 2012 OWCP advised appellant that the evidence of record was insufficient to 

establish her claim. Appellant was advised that she should complete the attached questionnaire 

and also submit a rationalized medical report from her treating physician explaining how her 

employment activities caused her diagnosed condition. 

By decision dated July 18, 2012, OWCP denied appellant’s claim finding that she did not 

establish a pelvic nerve/dysesthesia/lumbar condition in the performance of duty. It also found 

that she failed to establish fact of injury because she had not established that the employment 

events occurred as alleged. 

On July 23, 2012 appellant requested reconsideration. 

Appellant submitted statements dated July 23 and 26, 2012 in which she further 

explained her claim. In the July 23, 2012 statement, she alleged that she had been involved in a 

work-related incident on January 6, 2004 while she was on patrol duty and she fell over a 

railroad tie. Appellant related that due to the prior incident she sustained injury to her left 

shoulder, which required surgery, and injury to her right knee and foot. She explained that she 

had recurring symptoms of twitching in her feet since that time. In her July 26, 2012 statement, 

appellant further alleged that since the January 6, 2004 injury her job duties required a lot of 

standing while conducting traffic control and checking identification at access control points. 

She noted that she was required to wear a bullet proof vest and gun belt with accessories which 

placed pressure on her waist and caused nerve damage. Appellant alleged that she was suffering 

nerve damage in her pelvic area from a work-related injury. 

By decision dated August 28, 2012, OWCP modified the July 18, 2012 decision to find 

that appellant had established fact of injury. However, it denied her claim, finding that she failed 

to submit medical evidence sufficient to establish that she sustained her claimed pelvic 

nerve/dysesthesia/lumbar conditions in the performance of duty. 

By letter dated July 29, 2013, appellant requested reconsideration based on new unsigned 

evidence noting she was seen by a Dr. Steven P. Glusman, a specialist in neurosurgery, including 

a report containing a magnetic resonance imaging (MRI) scan of her lumbar spine. 
3

An unsigned report which noted that appellant had been seen by Dr. Glusman dated 

May 14, 2012, received by OWCP on July 31, 2013, found that she was experiencing 

dysesthesias, a twitching sensation in her legs which typically occurred when a patient is lying or 

sitting down for long periods of time. Dr. Glusman stated that she used to be a police office and 

had to wear a police duty belt for prolonged periods of time; the belt held a nine-millimeter 

pistol, a flashlight, ammunition, magazines, etc. He opined that appellant had possible lumbar 

myelopathy or polyradiculopathy, with restless leg syndrome. Dr. Glusman referred her for an 

MRI scan of the lumbar spine in addition to nerve conduction and electromyelogram (EMG) 

studies of both lower extremities. 

In an unsigned July 31, 2012 report, which noted that Dr. Glusman had seen appellant, 

the results of her EMG study were reviewed. Dr. Glusman stated that she probably had partial 

lumbosacral plexopathy. He advised that appellant had denervation potentials in the iliopsoas on 

the femoral nerve and at levels L1-3. Dr. Glusman stated that she also had fibrillation potentials 

in the gluteus medius on the superior gluteal nerve and at the L5-S1 nerve root levels. 

In an August 10, 2012 report, received by OWCP on July 31, 2013, Dr. William M. 

Boushka, a specialist in diagnostic radiology, indicated that appellant underwent an MRI scan of 

the lumbar spine which showed a small left foraminal annular tear without stenosis. He opined 

that this could be a source of significant discogenic pain. In a March 7, 2013 report, 

Dr. Glusman recommended that appellant be referred to neurosurgery for her torn disc at L4-5. 

In its December 18, 2013 decision, OWCP found that appellant had submitted reports 

from Dr. Boushka dated March 7, May 14, and July 31, 2013 which diagnosed several 

conditions, including lumbago; i.e., a lumbar disorder, but did not offer a medical explanation as 

to how these conditions are related to any specific work activities. It denied modification of the 

August 28, 2012 decision. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA3 has the burden of establishing that the 

essential elements of his or her claim including the fact that the individual is an employee of the 

United States within the meaning of FECA, that the claim was timely filed within the applicable 

time limitation period of FECA, that an injury was sustained in the performance of duty as 

alleged, and that any disability and/or specific condition for which compensation is claimed are 

causally related to the employment injury.4 These are the essential elements of each and every 

compensation claim regardless of whether the claim is predicated upon a traumatic injury or an 

occupational disease.5 

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (1) medical evidence establishing the 

presence or existence of the disease or condition for which compensation is claimed; (2) a factual 

 3 Id.

4 See S.P., 59 ECAB 184 (2007). 

5 Victor Woodhams, 41 ECAB 345 (1989). 
4

statement identifying employment factors alleged to have caused or contributed to the presence 

or occurrence of the disease or condition; and (3) medical evidence establishing that the 

employment factors identified by the claimant were the proximate cause of the condition for 

which compensation is claimed, or, stated differently, medical evidence establishing that the 

diagnosed condition is causally related to the employment factors identified by the claimant. 

The medical evidence required to establish causal relationship is usually rationalized medical 

evidence. Rationalized medical opinion evidence is medical evidence which includes a 

physician’s rationalized opinion on the issue of whether there is a causal relationship between the 

claimant’s diagnosed condition and the implicated employment factors. The opinion of the 

physician must be based on a complete factual and medical background of the claimant, must be 

one of reasonable medical certainty, and must be supported by medical rationale explaining the 

nature of the relationship between the diagnosed condition and the specific employment factors 

identified by the claimant.6 

In the case of William A. Couch,

7

 the Board held that, when adjudicating a claim, OWCP 

is obligated to consider all evidence properly submitted by a claimant and received by OWCP 

before the final decision is issued. 

ANALYSIS 

The Board has duly considered the matter and notes that in the case of William A. 

Couch,

8

 the Board held that, when adjudicating a claim, OWCP is obligated to consider all 

evidence properly submitted by a claimant and received by OWCP before the final decision is 

issued. While OWCP is not required to list every piece of evidence submitted to the record, the 

record is clear that the documents which appellant submitted in support of her July 29, 2013 

request for reconsideration were not properly or fully reviewed by OWCP in its December 18, 

2013 decision. It erroneously stated that it received and reviewed reports from Dr. Boushka, 

when in fact the reports it cited in its decision appear to be submitted by a Dr. Glusman.9

 

Dr. Boushka’s August 10, 2012 MRI scan report, which appellant referenced in her July 29, 

2013 reconsideration request, contained a finding of a torn annular tear in the lumbar spine. This 

report, however, was not mentioned or considered by OWCP in its December 18, 2013 decision. 

In the March 7, 2013 report, it was recommended that appellant be referred to neurosurgery for 

her torn disc at L4-5. OWCP, however, did not discuss or consider this report. 

OWCP, in its December 18, 2013 decision, did not adequately or thoroughly review all of 

the medical evidence. Its regulations require that a decision contain findings of fact and a 

statement of reasons.10 The inaccurate and incomplete adjudication of the medical evidence in 

 6 Mary J. Briggs, 37 ECAB 578 (1986); Ausberto Guzman, 25 ECAB 362 (1974). 

7

 41 ECAB 548 (1990). 

8 Id.

9

 The actual dates of these reports were May 14 and July 31, 2012 and March 7, 2013. 

10 20 C.F.R. § 10.126. 
5

the December 18, 2013 decision does not satisfy its obligation to provide a decision with 

appropriate findings and clear analysis.11 

For this reason, the case will be remanded to OWCP to require it to properly consider 

appellant’s request for reconsideration and all the evidence submitted prior to the issuance of the 

December 18, 2013 decision. Following further development as it deems necessary, it shall issue 

an appropriate decision on the merits. 

CONCLUSION 

The Board finds that the case is not in posture for decision. The decision dated 

December 18, 2013 is set aside and the case is remanded for further development consistent with 

this opinion. 

ORDER 

IT IS HEREBY ORDERED THAT the December 18, 2013 decision of the Office of 

Workers’ Compensation Programs be set aside and the case is remanded to OWCP for further 

action consistent with this decision of the Board. 

Issued: July 2, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 11 See generally Tonja R. Hiebert, 55 ECAB 706 (2004).