United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

K.S., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Martinsburg, WV, Employer 

__________________________________________ 

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Docket No. 14-740 

Issued: October 2, 2014 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA HOWARD FITZGERALD, Judge 

MICHAEL E. GROOM, Alternate Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On February 12, 2014 appellant filed a timely appeal from a January 31, 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 appellant has established a recurrence of disability commencing 

January 25, 2010 causally related to her June 20, 1994 employment injury. 

FACTUAL HISTORY 

The case was previously before the Board.2

 The Board noted that OWCP had accepted 

post-traumatic stress disorder (PTSD) and acute anxiety reaction resulting from a June 20, 1994 

 1

 5 U.S.C. § 8101 et seq. 

2

 Docket No. 13-221 (issued April 18, 2013). 
2

employment incident, where appellant had been informed of a threat to kill her made by another 

employee. With respect to her claim for a recurrence of disability commencing 

January 25, 2010, the Board found the medical evidence was insufficient to establish the claim. 

The April 9, 2012 report from Dr. Shanoor Khan, a psychiatrist, had referred to intervening, 

nonindustrial events as triggering flashbacks to the 1994 trauma. As the Board noted, the 

evidence did not establish that the claimed disability was the direct and natural result of the 

original injury. The relevant facts as contained in the Board’s prior decision are incorporated 

herein by reference. 

On November 4, 2013 OWCP received a request for reconsideration. Appellant 

discussed the history of her case and argued that the symptoms from her condition had never 

gone into remission and it was not a new injury. She contended that any consequences that flow 

from the original injury are compensable. Appellant referred to provisions of the diagnostic and 

statistical manual of mental disorders, stated that OWCP records did not accurately reflect the 

accepted conditions, and noted that she had filed an equal employment opportunity complaint. 

With respect to the medical evidence, appellant submitted additional reports from 

Dr. Khan that were not before OWCP at the time of the July 12, 2012 decision. In a report dated 

March 1, 2010, Dr. Khan provided a history similar to that in an April 9, 2012 report submitted 

on April 30, 2012. He noted an August 2008 incident at home where appellant discovered her 

former coworker had received a decision indicating he could return to work in three years. 

Dr. Khan also noted a September 2009 incident when she received notice from the employing 

establishment that they “had opted to remove her from the cornerstone of her original settlement 

-- exempt status.” He stated that appellant’s current episode was an acute exacerbation of her 

underlying chronic condition which resulted from her work injury. Dr. Khan concluded, “The 

removal from protected status as well as the coincidental reading of her assailant’s case on line 

has aroused dormant symptoms.” 

In a report dated August 26, 2010, Dr. Khan stated that appellant’s mental health had 

worsened. He stated that her “current exacerbation” began with the threat and then loss of her 

protected status and this led to reexperiencing symptoms including flashbacks, nightmares and 

intrusive thoughts. Dr. Khan reported that appellant’s condition was subsequently further 

intensified by a supervisor who routinely appeared at a bowling alley where she went for 

recreation and socialization.” 

By report dated March 26, 2011, Dr. Khan repeated the history provided in the 

March 1, 2010 report. He again stated that appellant’s current episode was an acute exacerbation 

of an underlying chronic condition which resulted from her original injury. Dr. Khan stated, 

“PTSD is an anxiety condition which clearly can be retriggered. The acute anxiety reaction and 

a new depressive episode are seen as concurrent and part of the original work-related symptoms 

set.” 

In a report dated June 10, 2011, Dr. Khan stated that “course of PTSD invariably involves 

exacerbations and remissions.... What may retrigger symptoms may often seem totally 

unconnected to the original trauma.” Dr. Khan stated that he “would contend that the original 

condition had never completely resolved and consequently a causal relationship is moot.” 
3

By report dated September 24, 2012, Dr. Khan stated that appellant remained disabled 

due to her chronic PTSD and major depressive disorder. He asserted that the conditions were “a 

reactivation of an original on-the-job injury.” Appellant also submitted reports from Dr. Khan 

dated October 31, November 30 and December 31, 2012, stating that she remained disabled due 

to a reactivation of her condition. In an October 1, 2013 report, Dr. Khan again referred to a 

September 2009 personnel action and a supervisor routinely coming to her recreational activity 

at a bowling alley. 

In a decision dated January 31, 2014, OWCP reviewed the case on its merits and denied 

modification. 

LEGAL PRECEDENT 

A recurrence of disability means “an inability to work after an employee has returned to 

work, caused by a spontaneous change in a medical condition which has resulted from a previous 

injury or illness without an intervening injury or new exposure to the work environment that 

caused the illness.”3 

A person who claims a recurrence of disability due to an accepted employment-related 

injury has the burden of establishing by the weight of the substantial, reliable and probative 

evidence that the disability for which she claims compensation is causally related to the accepted 

injury. This burden of proof requires that a claimant furnish medical evidence from a physician 

who, on the basis of a complete and accurate factual and medical history, concludes that the 

disabling condition is causally related to the employment injury and supports that conclusion with 

sound medical reasoning.4 

ANALYSIS 

Appellant submitted an application for reconsideration and submitted additional medical 

evidence. The Board notes that she raised an issue with respect to OWCP’s recognition of the 

accepted conditions in this case. OWCP has accepted PTSD and an acute anxiety reaction. The 

January 31, 2014 decision acknowledged that these are the accepted conditions and there is no 

evidence the decision was based on an improper factual background. 

On reconsideration, appellant submitted additional medical reports from Dr. Khan dated 

March 1, 2010 through October 1, 2013. Dr. Khan referred to an exacerbation of appellant’s 

condition from reading information on her home computer, or seeing a supervisor at a bowling 

alley. He also refers to removal of her “protected status” by the employing establishment with 

respect to an original settlement agreement. In the March 1, 2010 report, Dr. Khan noted that the 

home computer incident and actions of the employing establishment had “aroused dormant 

symptoms.” In an August 26, 2010 report, he refers to a bowling alley incident as intensifying 

appellant’s condition. 

 3

 20 C.F.R. § 10.5 (x). 

4 Robert H. St. Onge, 43 ECAB 1169 (1992); Dennis J. Lasanen, 43 ECAB 549 (1992). 
4

As the Board noted in its prior decision, medical evidence detailing that there were 

intervening events that exacerbated appellant’s condition or triggered flashbacks to the 1994 

incident do not result in an employment-related disability. The disability is not considered 

employment-related unless it is the direct and natural result of the employment injury. The 

intervening incidents or events break the causal connection with the employment injury and the 

current disability.5 A recurrence of disability, as noted above, is a “spontaneous change” in the 

medical condition without an intervening injury. In addition, if appellant is referring to 

allegations of new employment incidents, such as administrative error by a supervisor or other 

allegation, then this would be a new claim, even if it represented an aggravation of a prior 

injury.6 The Board finds that appellant did not submit probative evidence establishing a 

recurrence of disability as of January 25, 2010. 

On appeal, appellant reiterated her arguments that she feels this is not a new injury but a 

triggering of the accepted conditions. She refers to a Utah State case involving a prior 

employment-related back condition, where the court held a sneeze triggering a disc herniation 

was compensable. The facts in the present case are not similar and the issues are resolved by 

application of the provisions of FECA and Board precedent. To the extent appellant is alleging 

additional employment factors, this is a new claim for injury and she may pursue such a claim in 

an appropriate manner. As to the accepted PTSD and acute anxiety reaction, the medical 

evidence must establish causal relationship between disability commencing January 25, 2010 and 

the accepted conditions. For the reasons noted, the evidence is not sufficient to meet appellant’s 

burden of proof. 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 appellant has not established a recurrence of disability commencing 

January 25, 2010 causally related to her June 20, 1994 employment injury. 

 5 See Stuart K. Stanton, 40 ECAB 859 (1989). 

6 See Federal (FECA) Procedure Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.3(c)(5) (June 2013). 
5

ORDER 

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ 

Compensation Programs dated January 31, 2014 is affirmed. 

Issued: October 2, 2014 

Washington, DC 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 

 Michael E. Groom, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board