United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

R.R., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Albany, OR, Employer 

__________________________________________ 

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Docket No. 15-644 

Issued: June 3, 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 

ALEC J. KOROMILAS, Alternate Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On January 29, 2015 appellant filed a timely appeal of the December 11, 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. 

ISSUE 

The issue is whether OWCP abused its discretion by denying appellant authorization for 

osteopathic manipulative treatment. 

FACTUAL HISTORY 

On November 6, 2010 appellant, a 56-year-old rural mail carrier, injured her right shoulder 

and neck when the vehicle she was driving was struck from behind by another vehicle. She filed a 

 1

 5 U.S.C. § 8101 et seq.
2

claim for benefits, which OWCP accepted for right shoulder sprain, neck sprain, contusions of 

multiple sites, and right-sided superior glenoid labrum lesion. 

On April 7, 2014 Dr. Hannah Eucker, an osteopath, requested authorization for osteopathic 

manipulative treatment for appellant’s “neck, shoulders, arms ... right and left” pursuant to 

diagnostic codes 719.91 and 725.1. 

By letter dated May 22, 2014, OWCP asked appellant and her treating physician, 

Dr. Eucker, to submit additional medical evidence supporting her request for authorization for 

osteopathic manipulative treatment for pain in joint shoulder region, diagnosis code 719.41, or 

725.1, polymyalgia rheumatic. It stated that this claim for right upper extremity, treatment for the 

left upper extremity is not authorized at this time. Further, that these were not accepted 

conditions and therefore additional osteopathic manipulations were not authorized. OWCP asked 

appellant to provide a medical report describing the injury-related medical residuals based on a 

current physical examination. It stated that the report should include a medical explanation of the 

necessity of prolonged or intensive treatment and a statement of the progress made in her 

functional abilities that could be attributed to the osteopathic treatment already provided. 

By letter dated June 30, 2014, OWCP advised appellant that it could not approve her 

request for authorization, as further medical development was needed before the request could be 

approved or denied. 

In a July 23, 2014 report, Dr. Charles Pederson, a specialist in occupational medicine, 

stated that appellant had been evaluated on February 20, 2013, at which time she undertook a 

program of acupuncture and osteopathic manipulative treatment due to flaring of pain in the right 

trapezius, right paracervical, and right shoulder regions. He diagnosed chronic cervical strain and 

superior labral tear from anterior to posterior (SLAP) tear. Dr. Pederson recommended a course 

of acupuncture and osteopathic manipulative treatment. He opined that this was palliative care 

which was directly related to appellant’s accepted conditions and was necessary to allow her to 

continue to work. 

In an August 20, 2014 report, Dr. Pamela Chapin, a Board-certified family practitioner, 

submitted a report in response to OWCP’s May 22, 2014 development letter regarding the rational 

for appellant’s ongoing treatment of her injuries with acupuncture and osteopathic manipulative 

treatment. She indicated that appellant was involved in a work accident on November 6, 2010 

resulting in a cervical and right shoulder injury. Dr. Chapin related that appellant underwent 

surgery on June 6, 2011 to repair a SLAP tear in her right shoulder and on November 15, 2011 to 

repair arthroscopic lysis of adhesions with manipulation under anesthesia due to a frozen right 

shoulder. She advised that she had been administering acupuncture treatments to appellant 

since June 2012. 

Dr. Chapin noted, following her second surgery, appellant continued to experience right 

shoulder pain and poor mobility (frozen shoulder) as well as chronic neck pain. The acupuncture 

treatments helped appellant return to light duty, be able to maintain her workload, and also helped 

to control appellant’s pain. Dr. Chapin stated that appellant switched to osteopathic manipulation 

treatments in July 2013 with Dr. Eucker, as associate of her clinic. She advised that her 

occupational medicine physician, Dr. Pederson, had approved these treatments but her office had 
3

difficulty getting treatments approved without interruption. Dr. Chapin stated that, in summary, 

appellant had a chronic soft tissue injury of the neck and right shoulder, with physical examination 

showing chronic, reduced right shoulder range of motion, chronic fibrotic tissue changes along 

with recalcitrant trigger points, and a myofacial pain pattern. She asserted that appellant had 

benefited significantly from maintenance acupuncture and osteopathic manipulation treatments. 

In a November 17, 2014 report, Dr. Chapin advised that appellant was being treated for 

continuing right frozen shoulder and neck/upper back pain due to her November 2010 work injury. 

She stated that appellant had experienced increased right neck and upper back pain the previous 

week which had slightly diminished. Dr. Chapin asserted that her left shoulder and upper back 

pain had been much better. 

By decision dated December 11, 2014, OWCP denied appellant’s request for authorization 

for osteopathic manipulative treatment for her nonaccepted left shoulder and rheumatic 

polymyalgia conditions. It stated that it did not receive any evidence to support Dr. Eucker’s 

authorization request. OWCP informed appellant that additional evidence was needed in order to 

establish that the request was medically necessary to address the effects of her work-related injury 

or condition(s). It stated that the requested procedures were for diagnoses that were not accepted in 

this case, for left shoulder sprain and rheumatic polymyalgia conditions. Accordingly, OWCP 

found that the evidence of record did not support that the requested osteopathic manipulative 

treatment was medically necessary to address the effects of a work-related injury or condition(s). 

LEGAL PRECEDENT 

Section 8103 of FECA2 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 OWCP considers likely to cure, give relief, reduce 

the degree or the period of disability or aid in lessening the amount of the monthly 

compensation.3

 In interpreting this section of FECA, the Board has recognized that OWCP has 

broad discretion in approving services provided under FECA. OWCP has the general objective 

of ensuring that an employee recovers from his or her injury to the fullest extent possible in the 

shortest amount of time. It therefore has broad administrative discretion in choosing means to 

achieve this goal. The only limitation on OWCP’s authority is that of reasonableness. Abuse of 

discretion is generally shown through proof of manifest error, clearly unreasonable exercise of 

judgment, or actions taken which are contrary to both logic and probable deductions from 

established facts. It is not enough to merely show that the evidence could be construed so as to 

produce a contrary factual conclusion.4

 2 Id. 

3 Id. at § 8103. 

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

ANALYSIS 

In this case, OWCP accepted that appellant had sustained the conditions of right shoulder 

sprain, neck sprain, contusions of multiple sites, and right-sided superior glenoid labrum lesion. 

Appellant began receiving acupuncture and osteopathic manipulative treatment for her right 

shoulder and neck, which OWCP approved. On April 7, 2014 Dr. Eucker appellant’s treating 

osteopath, requested authorization for osteopathic manipulative treatment to ameliorate pain in the 

joint shoulder region, “neck, shoulders, arms ... right and left” pursuant to diagnosis codes 719.41, 

and 725.1; i.e., rheumatic polymyalgia. In its May 22, 2014 letter, OWCP requested additional 

medical evidence from appellant and Dr. Eucker to support the treatment for left shoulder strain, 

and rheumatic polymyalgia, because these were not accepted conditions. It had not received 

sufficient medical documentation to authorize these additional osteopathic manipulations. OWCP 

asked appellant to provide a medical report based on a current physical examination describing the 

injury-related medical residuals with an explanation of the need for prolonged or intensive 

treatment and a statement of appellant’s progress as a result of osteopathic treatment already 

provided. By letter dated June 30, 2014, it advised appellant that further medical development was 

required before her request for authorization of treatment could be approved. 

In a July 23, 2014 report, Dr. Pederson related that appellant had undergone a program of 

acupuncture and osteopathic manipulative treatment to treat flaring of pain in the right trapezius, 

right paracervical, and right shoulder regions. He advised that this was palliative care directly 

related to her accepted conditions and was necessary for her to continue working. In her 

August 20, 2014 report, Dr. Chapin, advised that appellant had suffered a cervical and right 

shoulder injury on November 6, 2010 and had surgery on June 6 and November 15, 2011. She 

began acupuncture treatments in June 2012 and switched to osteopathic manipulation treatments in 

July 2013 with Dr. Eucker. Dr. Chapin reported a chronic soft tissue injury of the neck and right 

shoulder, with physical examination showing chronic, reduced right shoulder range of motion, 

chronic fibrotic tissue changes along with recalcitrant trigger points, and a myofacial pain pattern. 

She stated that appellant had significant benefits from maintenance acupuncture and osteopathic 

manipulation. Dr. Chapin noted in her November 17, 2014 report, that appellant was being treated 

for continuing right frozen shoulder and neck/upper back pain related to her work injury. 

The only restriction on OWCP’s authority to authorize medical treatment is one of 

reasonableness. Dr. Eucker requested authorization for osteopathic manipulative treatment for left 

shoulder strain and rheumatic polymyalgia; however, these were not accepted conditions. None 

of the reports discussed above, explained the need for treatment of unaccepted conditions. They 

merely reiterated that osteopathic manipulative treatment had provided relief for appellant’s 

accepted right shoulder and neck conditions. The Board finds that OWCP did not abuse its 

discretion when it denied her request for osteopathic manipulative treatment of her nonaccepted 

left shoulder and rheumatic polymyalgia conditions. The Board affirms the December 10, 2014 

decision. 

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. 
5

CONCLUSION 

The Board finds that OWCP did not abuse its discretion to deny appellant authorization 

for osteopathic manipulative treatment for her nonaccepted left shoulder and rheumatic 

polymyalgia conditions. 

ORDER 

IT IS HEREBY ORDERED THAT the December 11, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: June 3, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board