United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

Y.A., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS HEALTH ADMINISTRATION, 

North Las Vegas, NV, Employer 

__________________________________________ 

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Docket No. 16-0258 

Issued: April 13, 2016 

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 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On November 24, 2015 appellant filed a timely appeal of a June 5, 2015 merit decision of 

the Office of Workers’ Compensation Appeals (OWCP). Pursuant to the Federal Employees’ 

Compensation Act1

 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction to 

consider the merits of this case. 

ISSUE 

The issue is whether appellant met her burden of proof to establish a recurrence of total 

disability beginning April 4, 2013, causally related to her accepted July 10, 2008 employment 

injury. 

 1

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

On July 10, 2008 appellant, then a 48-year-old nurse, filed an occupational disease claim 

(Form CA-2) as of November 1, 2006. She alleged foot and lumbar conditions caused by 

walking and running as part of her work as a nurse in a medical-surgical unit. Appellant stopped 

work on January 31, 2008 and returned to light-duty work on March 4, 2008. On October 6, 

2008 OWCP accepted her claim for bilateral foot strain and paid compensation benefits. On 

December 30, 2009 OWCP expanded its acceptance to include lumbar sprain. 

By letter to appellant dated May 2, 2012, the employing establishment noted that on or 

about May 20, 2012 she had accepted a limited-duty position as a staff nurse II at the Women’s 

Health Clinic. Appellant was to work a shift no longer than eight hours, Monday through Friday. 

The offer of employment and its acceptance were confirmed by the employing establishment in a 

letter to OWCP dated August 2, 2012. 

On January 5, 2015 appellant filed a claim for compensation (Form CA-7) for a period 

commencing April 4, 2013. She claimed a recurrence of her earlier accepted condition. 

Appellant explained that she was unfairly terminated on April 3, 2013 from her limited-duty 

position as a staff nurse at the employing establishment in Las Vegas, Nevada. OWCP received 

a letter dated April 4, 2013, which related that the employing establishment terminated 

appellant’s appointment as a registered nurse because she failed to present a registered nurse 

license as a condition of continued employment. The letter explained that a valid, current license 

was a condition of appellant’s employment and noted that appellant’s license had expired 

April 3, 2013. 

OWCP sent appellant a letter dated January 15, 2015 advising her of the factual and 

medical evidence needed to establish her claim for recurrence. The letter noted that appellant’s 

claim had been accepted for sprain of the metatarsophalangeal region in both feet, plantar 

fibromatosis of the right foot, and lumbar sprain. The letter advised appellant it was her burden 

to offer factual and medical evidence to demonstrate a recurrence of disability and identify the 

type of evidence needed to establish her recurrence claim. Appellant was afforded 30 days in 

which to respond. 

To support her claim, appellant submitted reports prepared by Dr. Anthony Borgia,2

 a 

Board-certified podiatrist, dated February 4 and December 6, 2013, and May 19, 2014. In his 

February 2013 report, Dr. Borgia noted a history, reported appellant’s medications and unrelated 

health problems, diagnosed a number of foot conditions, and recorded and evaluated appellant’s 

treatment with orthotics, bracing, and medications. He noted that appellant fell in June 2012 and 

hurt her left foot. Dr. Borgia also noted a lifting injury at work which caused immediate back 

pain. In his December 6, 2013 follow-up report, he noted that appellant fell while on vacation. 

Appellant had pain walking, but it was “tolerable.” She also had back pain. Appellant visited 

the doctor for night splints and orthotic modifications. Dr. Borgia noted weakness to muscles in 

both feet, tightness in the calf muscles, and some limitation of motion in one ankle. He found 

chronic tendinosis, secondary to “remote injury” and exacerbated by hereditary factors. 

 2

 Dr. Borgia is referred to as “Dr. Borgie” in OWCP’s development letter dated January 15, 2015. 
3

Dr. Borgia’s final report listed certain medical supplies, but did not relate findings from an 

examination of appellant. 

Appellant also submitted a work capacity form with an illegible signature dated April 4, 

2013 which noted that appellant was at maximum medical improvement (MMI) and could work 

eight hours with restrictions. 

Appellant submitted additional evidence in support of her claim. A report dated July 20, 

2012 from Dr. Borgia diagnosed a contusion left foot with a possible fracture, pain resulting 

from an injury on June 28, 2012, and right foot tendinitis. Dr. Borgia identified other conditions 

including a congenital valgus deformity of both feet with a September 14, 2010 onset. Appellant 

submitted the July 27, 2012 magnetic resonance imaging scans of the right foot and left foot.3

 In 

the February 4, 2013 report, Dr. Borgia noted appellant’s conditions and medications without 

significant changes. He noted appellant’s status and treatment on May 19, 2014 without 

discussion. 

Appellant submitted a report by Dr. R.D. Prabhu, an internist, dated February 27, 2015 

which discusses only personal medical conditions irrelevant to the work injury or claim of 

recurrence. 

Appellant also submitted the previously noted letter from the employing establishment 

dated April 4, 2013 which terminated her employment because her license as a registered nurse 

had lapsed. She submitted a statement dated April 6, 2015 in which she responded to an OWCP 

questionnaire mailed to her along with the January 15, 2015 development letter. 

By decision dated June 5, 2015, OWCP denied appellant’s claim for recurrence of 

disability as the medical evidence of record is insufficient to establish a material worsening of 

her employment injuries. 

LEGAL PRECEDENT 

A recurrence of disability is defined as the inability to work after an employee has 

returned to work, caused by a spontaneous change in a medical condition which had resulted 

from a previous injury or illness, without an intervening injury or new exposure to the work 

environment that caused the illness.4

 The term also means the inability to work that takes place 

when a light-duty assignment made specifically to accommodate an employee’s physical 

limitations due to his or her work-related injury or illness is withdrawn, except when such 

withdrawal occurs for reasons of misconduct, nonperformance of job duties, or a reduction-inforce. The Board has held that when a claimant stops work for reasons unrelated to the accepted 

work injury there is no disability within the meaning of FECA.5

 3

 The record contains two reports of that date and appellant had MRI examinations of the right foot and the left 

foot. OWCP’s decision does not specify which reports appellant submitted. 

4

 20 C.F.R. 10.5(x); Cecelia M. Corley, 56 ECAB 662 (2005); Bryant F. Blackmon, 56 ECAB 752 (2005). 

5 Hubert Jones, Jr., 57 ECAB 467 (2006). 
4

A claimant who claims a recurrence of disability has the burden of proof to establish by 

the weight of substantial, reliable, and probative evidence that the disability for which he or she 

claims compensation is causally related to the employment injury. This burden includes the 

necessity of furnishing evidence from a qualified physician who, on the basis of a complete and 

accurate factual and medical history, concludes that the condition is causally related to the 

original compensable condition. Moreover, the physician’s conclusion must be supported by 

sound medical reasoning.6

 

ANALYSIS 

Appellant requested that OWCP accept her claim for a recurrence of her disability 

commencing April 4, 2013, the date of her termination from her light-duty job as a nurse with 

the employing establishment. OWCP denied her request by decision of June 5, 2015. The Board 

finds that appellant has not established that she sustained a recurrence of disability. 

Appellant was terminated from her light-duty employment as a nurse on April 3, 2013. 

According to the employing establishment’s letter of April 4, 2013, appellant was terminated 

because her license as a registered nurse had lapsed and she was unable to perform her job duties 

without that credential. She acknowledges the fact that her license lapsed in her statements to 

OWCP and in her appeal to the Board. Appellant has not submitted any evidence to establish 

that the lapse of her license was due to her accepted employment injury. The legal precedent 

makes clear that if a claimant is terminated from employment for reasons unrelated to his or her 

medical condition, a recurrence of disability is not established. Therefore, the Board concludes 

that appellant’s termination from employment was not related to her accepted employment 

injuries.7

The medical evidence of record does not contain a medical opinion based on substantial, 

reliable, and probative evidence sufficient to establish that appellant’s medical condition changed 

as a result of the work injury. The medical reports, treatment notes, and other records discuss 

appellant’s condition, note her progress, and chart her medications. However, there is no 

evidence of a spontaneous change in appellant’s medical condition related to her original injury 

without an intervening cause. There is no medical evidence to substantiate that appellant was 

disabled after April 4, 2013 due to her accepted injury. The Board will not require OWCP to pay 

compensation for disability in the absence of medical evidence directly addressing the specific 

dates of disability for which compensation is claimed. To do so, would essentially allow an 

employee to self-certify his or her disability and entitlement to compensation.8

 Appellant, 

therefore, has not met her burden of proof to establish a recurrence of disability causally related 

to her accepted injury. 

 6 D.W., Docket No. 11-1144 (issued July 19, 2012); Louise G. Malloy, 45 ECAB 613 (1994). 

7

 The Board explicitly does not reach the question of whether appellant’s termination was correct under the 

employment rules and procedures of the employing establishment. The Board lacks jurisdiction to consider or rule 

on this question. 

8 See William A. Archer, 55 ECAB 674 (2004); Fereidoon Kharabi, 52 ECAB 291 (2001). 
5

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 failed to meet her burden of proof to establish a 

recurrence of disability beginning April 4, 2013, causally related to her accepted July 10, 2008 

employment injury. 

ORDER 

IT IS HEREBY ORDERED THAT the June 5, 2015 decision of the Office of Workers’ 

Compensation Programs is affirmed. 

Issued: April 13, 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