United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

R.J., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS ADMINISTATION MEDICAL 

CENTER, Ann Arbor, MI, Employer 

__________________________________________ 

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Docket No. 15-1525 

Issued: February 1, 2016 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On July 2, 2015 appellant, through counsel, filed a timely appeal of a March 3, 2015 

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 to proof to establish total disability for 

an additional four hours per day on and after December 16, 2013. 

 1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that, following the March 3, 2015 hearing representative’s decision, OWCP received additional 

evidence. However, the Board may only review evidence that was in the record at the time OWCP issued its final 

decision. See 20 C.F.R. § 501.2(c)(1); M.B., Docket No. 09-176 (issued September 23, 2009); J.T., 59 ECAB 293 

(2008); G.G., 58 ECAB 389 (2007); Donald R. Gervasi, 57 ECAB 281 (2005); Rosemary A. Kayes, 54 ECAB 

373 (2003). 
2

FACTUAL HISTORY 

On October 15, 2008 appellant, then a 34-year-old medical technician, filed a traumatic 

injury claim (Form CA-1) alleging that on October 10, 2008 she sustained a left knee contusion 

when she struck her left knee on the corner of a metal bed rail in the performance of duty. 

OWCP accepted the claim for left knee contusion.3

 Appellant stopped work on October 10, 

2008 and returned to limited-duty work on October 13, 2008. OWCP thereafter paid 

compensation for intermittent periods of wage loss. 

On September 18, 2009 appellant filed a Form CA-1 alleging that on September 14, 2009 

she sustained a reinjury to her left knee when it was hit by a wheelchair which had been pushed 

and released by a patient’s companion. OWCP accepted the claim for left knee contusion.4 

Appellant stopped work on September 15, 2009 and returned to work two hours per day on 

October 15, 2009, which was gradually increased to eight hours per day, with restrictions, on 

April 19, 2010. OWCP paid wage-loss compensation for the hours appellant was disabled from 

work. 

Appellant continued to file intermittent claims for wage loss, which OWCP paid through 

January 17, 2012. 

On August 15, 2013 Dr. Athar Siddiqui, Board-certified in internal medicine, reported toe 

discoloration and, upon physical examination, diagnosed reflex sympathetic dystrophy (RSD). 

Appellant had complained of terrible left lower extremity, pain, and bluish discoloration. 

Dr. Siddiqui advised that appellant should not work, but that if she must return to work that it 

was not to exceed four hours per day. 

On September 16, 2013 OWCP received an August 15, 2013 disability note from 

Dr. Siddiqui diagnosing acute exacerbation of patella/left knee injury finding appellant totally 

disabled beginning August 12, 2013. Dr. Siddiqui found, however, that appellant could return to 

work four hours per day on August 19, 2013. 

On September 16, 2013 the employing establishment offered appellant a modified 

temporary limited-duty job as a medical technician for four hours of work per day based on 

restrictions set by her treating physician in effect as of August 15, 2013. Appellant accepted this 

position. 

By decision dated October 24, 2013, OWCP expanded acceptance of appellant’s claim to 

include left patellae chondromalacia, left closed patella dislocation, and left lower limb complex 

regional pain syndrome (CRPS)/RSD. 

OWCP paid wage-loss compensation for intermittent periods of disability from 

October 21 to December 13, 2013. 

 3

 This claim was assigned OWCP File No. xxxxxx773. On October 26, 2011 appellant filed a claim for a 

schedule award under that file number. 

4

 This claim was assigned OWCP File No. xxxxxx073. On April 19, 2010 OWCP combined OWCP 

File Nos. xxxxxx773 and xxxxxx073, with the latter number serving as the master file number. 
3

On December 30, 2013 appellant filed another claim for total disability for the period 

December 16 to 27, 2013. On the back of the form, the employing establishment checked the 

box marked “no” as to whether the employee had returned to work. It noted that appellant was 

off work based on her doctor’s recommendation. The record establishes that she continued to 

receive four hours of wage-loss compensation per day. 

Dr. Shahida H. Khan, an examining Board-certified internist, in a December 12, 2013 

disability note, released appellant to return to work on December 16, 2013 and diagnosed left leg 

pain and RSD. In December 26, 2013 disability note, he indicated that she was covered from 

December 16 to 20, 2013 and could return to work on December 20, 2013. 

Dr. Siddiqui, in his December 26, 2013 progress report, noted that appellant was seen for 

complaints of increased severe leg pain and noted that she had been working four hours per day. 

He diagnosed acute post-traumatic RSD aggravation with severe knee pain. Due to appellant’s 

severe knee pain and acute aggravation, Dr. Siddiqui opined that she was unable to even work 

four hours per day. He recommended that she “go on a medical for four weeks” as she was 

incapable of working at that time. In the December 26, 2013 disability note, Dr. Siddiqui 

released appellant to return to work on January 26, 2014 and diagnosed acute RSD exacerbation. 

By letter dated January 6, 2014, OWCP informed appellant that the evidence submitted 

was insufficient to support her claim for wage-loss compensation for total disability. It noted 

that Dr. Khan’s report was unclear regarding whether she was totally disabled prior to or after 

her December 12, 2013 appointment. OWCP advised appellant as to the medical evidence 

required to support her claim of disability and gave her 30 days to provide this information. 

OWCP received additional (Forms CA-7) claiming wage-loss compensation beginning 

December 28, 2013. 

On February 20, 2014 OWCP received a December 12, 2013 report from Dr. Khan. 

Dr. Khan noted appellant’s complaints of left leg pain and history of RSD. Appellant 

complained of fatigue, tiredness, left leg muscle spasm, and neck problems. A physical 

examination revealed left leg and knee discoloration and neck pain. Dr. Khan diagnosed 

exacerbation of left leg RSD with the cold aggravating the condition. 

In progress notes dated January 10, 2014, Dr. Khan reported seeing appellant for left leg, 

knee, and calf pain, numbness, on and off discoloration, tingling, and severe muscle spasm. He 

noted a history of RSD which had worsened over time. Dr. Khan opined that appellant was 

incapable of working due to severe worsening left leg pain. 

Dr. Khan, in progress notes dated January 24, 2014, reported that appellant was seen for 

left knee complaints of pain, discoloration, and swelling. Appellant related that she was unable 

to sit or stand for more than one hour due to muscle spasms. A physical examination revealed 

left leg discoloration, some swelling, and muscle weakness. Dr. Khan diagnosed acute 

exacerbation of RSD. He concluded that appellant was disabled from working as “[a]ll of 

symptoms are exaggerated to the point that she cannot work more than one hour.” 

In a February 7, 2014 report, Dr. Siddiqui reported that over the past six months to a year 

appellant had been working four hours per day. A physical examination revealed left lower 
4

extremity redness and discoloration. Dr. Siddiqui noted that appellant’s condition had been 

progressively worsening. Appellant related that after a half hour of sitting at work her leg 

becomes red, starts to swell, and she experiences pain with a throbbing sensation. Dr. Siddiqui 

noted her history of RSD, which occurs at work, that the condition is worsening and there was 

“No cure insight (sic).” He opined that appellant’s current sedentary job was aggravating her 

RSD and that she was unable to perform her job due to her condition. Specifically, Dr. Siddiqui 

noted that her sedentary job of sitting and standing continuously was going to aggravate her 

RSD. He recommended that appellant apply for social security disability benefits. 

In reports dated March 5 and April 4, 2014, Dr. Siddiqui noted that appellant had 

developed RSD and nerve damage. On March 5, 2014 a physical examination revealed left knee 

pain, tenderness in the ankle and knee areas, and left lower extremity blood vessel dilation. On 

April 4, 2014 Dr. Siddiqui reported appellant’s problems as knee area trauma which developed 

into RSD. He noted that she attempted to work four hours a day, but was unable to work even 

four hours due to her left leg swelling which resulted in vasodilation and throbbing pain. 

Dr. Siddiqui stated that these symptoms were due to sitting for four hours. Physical examination 

findings included pain during left knee range of motion testing, thigh area muscle spasm, and left 

leg vasodilation. 

Dr. Siddiqui, in progress notes dated May 2, 2014, provided physical examination 

findings of no calf tenderness and restricted left knee movement, which he noted were consistent 

with RSD. 

By letter dated May 14, 2014, OWCP advised Dr. Siddiqui of the conditions it had 

accepted and requested that he provide a narrative detailed report responding to questions 

regarding appellant’s ability to work. It also requested that he explain why she was disabled 

from performing her modified job of four hours of sedentary/limited-duty work. OWCP 

requested that any report be submitted by June 13, 2014. There was no response from 

Dr. Siddiqui. 

By decision dated July 2, 2014, OWCP denied appellant’s claim for compensation for 

total disability on and after December 16, 2013. It noted that by decision dated October 24, 2013 

her claim was expanded to include CRPS/RSD, that she was able to work four hours per day, and 

therefore she received wage-loss compensation for four hours of disability per day. OWCP 

found that appellant failed to submit sufficient medical evidence establishing total disability due 

to her accepted employment conditions. 

In a letter dated July 2, 2014, appellant’s counsel requested a telephonic hearing before 

an OWCP hearing representative, which was held on January 13, 2015. 

On February 2, 2015 OWCP received progress reports dated January 10 and August 14, 

2015 from Dr. Khan and progress reports from Dr. Siddiqui covering the period May 29, 2014 to 

January 6, 2015. 

In an August 14, 2014 progress report, Dr. Khan reported appellant had been seen for a 

follow-up visit for left leg pain, foot, and hip pain complaints. Appellant related that she was 

unable to perform any home duties, could not stand or bend for long periods of time, and that she 
5

was miserable. She also complained that she only received partial wage-loss compensation 

instead of wage-loss compensation for total disability. 

Dr. Siddiqui, in the various progress notes covering the period June 30, 2014 to 

January 16, 2015, detailed physical examination findings including constant pain and throbbing 

in the left lower extremity, vasodilation, painful and restricted left knee range of motion, and 

motor weakness. On June 30, 2014 appellant informed him that even a “[l]ittle bit of work 

makes it miserable” and that she is unable to do any work or duties at home. In the progress 

notes, Dr. Siddiqui recommended full medical retirement. He opined that appellant was unable 

to perform any type of work in his October 22, 2014 notes. On December 19, 2014 Dr. Siddiqui 

observed that she was unable to work for even two or three hours per day as she experienced 

throbbing, pain, and swelling of her leg when sitting for two to three hours. He, in January 16, 

2015 notes, observed that appellant’s prognosis was poor and that she would eventually have to 

apply for social security disability benefits. Dr. Siddiqui reported that appellant had constant left 

leg burning pain and throbbing. He advised she that there was no cube. 

By decision dated March 3, 2015, an OWCP hearing representative affirmed the July 2, 

2014 decision denying appellant’s claim for an additional four hours of wage-loss compensation. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA5 has the burden of proof to establish the 

essential elements of his or her claim by the weight of the evidence.6 For each period of 

disability claimed, the employee has the burden of establishing that he or she was disabled for 

work as a result of the accepted employment injury.7 Whether a particular injury causes an 

employee to become disabled for work, and the duration of that disability, are medical issues that 

must be proved by a preponderance of probative and reliable medical opinion evidence.8 

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 resulted from a previous 

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

caused the illness.9 Absent a change or withdrawal of a light-duty assignment, a recurrence of 

disability following a return to light duty may be established by showing a change in the nature 

and extent of the injury-related condition such that the employee could no longer perform the 

light-duty assignment.10 

 5 Supra note 1. 

6 See Amelia S. Jefferson, 57 ECAB 183 (2005); see also Nathaniel Milton, 37 ECAB 712 (1986); Joseph M. 

Whelan, 20 ECAB 55 (1968). 

7 See Amelia S. Jefferson, id.; see also David H. Goss, 32 ECAB 24 (1980). 

8 See Edward H. Horton, 41 ECAB 301 (1989). 

9

 20 C.F.R. § 10.5(x). 

10 Theresa L. Andrews, 55 ECAB 719 (2004). 
6

Where an employee claims a recurrence of total disability due to an accepted 

employment-related injury, he or she has the burden of establishing that the recurrence is 

causally related to the original injury.11 This burden includes the necessity of furnishing 

evidence from a qualified physician who concludes that the disability is causally related to the 

employment injury.12 The physician’s opinion must be based on a complete and accurate factual 

and medical history and supported by sound medical reasoning.13 

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 their disability and 

entitlement to compensation.14

ANALYSIS 

OWCP accepted appellant’s claim for left knee contusion, left patellae chondromalacia, 

left closed patella dislocation, and left lower limb CRPS/RSD. By decision dated October 24, 

2013, it found her partially disabled for four hours per day. OWCP has paid appellant partial 

disability for four hours a day since October 21, 2013. 

Appellant claimed total disability beginning December 16, 2013. By decision dated 

July 2, 2014, OWCP denied compensation for the additional four hours and that decision was 

affirmed by an OWCP hearing representative on March 3, 2015. The issue on appeal is whether 

appellant has established total disability as of December 16, 2013. 

The Board finds that appellant has not met her burden of proof. 

Initially, it is noted that appellant has not claimed that her light-duty job requirements 

changed, or that her light-duty work was withdrawn. Rather, she claims that her condition 

worsened sufficient to render her totally disabled effective December 16, 2013. 

In support of her claim appellant submitted reports and disability notes from 

Drs. Siddiqui and Khan. Both physicians attributed her inability to work a four-hour modified 

job to pain and acute RDS exacerbation. In various reports, Dr. Siddiqui noted appellant’s 

symptoms of fatigue, leg pain, spasms, swelling, and discoloration rendering her unable to work 

even one hour of her modified sedentary job. In his February 7, 2014 report, he opined that her 

sedentary job had aggravated her RSD. Dr. Siddiqui did not, however, provide objective 

findings of a worsening of appellant’s accepted condition. He contended that her condition 

could only deteriorate if she continued to work and recommended that she apply for social 

security disability benefits. The Board has found that subjective complaints are not sufficient, in 

 11 J.W., Docket No. 15-465 (April 29, 2005); 20 C.F.R. § 10.104(b). 

12 See S.S., 59 ECAB 315 (2008). 

13 Id.

14 See William A. Archer, 55 ECAB 674 (2004); Fereidoon Kharabi, 52 ECAB 291 (2001). 
7

and of themselves, to support payment of compensation.15 Likewise, the Board finds medical 

limitations based solely on the fear of a possible future injury are insufficient to support payment 

of compensation.16 

Dr. Siddiqui failed to provide any medical rationale explaining how or why the accepted 

left knee contusion, left patellae chondromalacia, left closed patella dislocation, and left lower 

limb CRPS/RSD were the cause of appellant’s inability to perform her part-time modified job. 

Without such rationale, these reports are insufficient to establish disability on and after 

December 16, 2013.17 

Appellant also submitted medical evidence from Dr. Khan. On December 12, 2012 

Dr. Khan first noted that the cold weather had aggravated her RSD, while in his January 10, 2014 

report, he noted that she had a history of RSD, which had worsened over time. On January 10, 

2014 he concluded that appellant was disabled from working even four hours per day due to due 

to severe worsening left leg pain. In a subsequent January 24, 2014 note, Dr. Khan diagnosed 

acute exacerbation of RSD and opined that she was disabled from working even one hour due to 

exaggeration of all her symptoms. He failed to provide any medical rationale explaining how or 

why her accepted conditions caused total disability. Dr. Khan opined that symptoms of her 

accepted conditions increased, but he did not support with rationalized medical findings that her 

accepted condition had worsened sufficient to cause total disability. The Board finds these 

reports, which fail to provide a rationalized medical opinion connecting the accepted conditions 

to the disability, lack probative value.18 

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

on the findings and reasons stated above, the Board finds that counsel’s arguments are not 

substantiated. 

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 met her burden of proof to establish total disability 

after December 16, 2013. 

 15 A.G., Docket No. 14-1590 (issued September 9, 2015). 

16 Id. 

17 Deborah L. Beatty, 54 ECAB 340 (2003). 

18 Id. 
8

ORDER 

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

Compensation Programs dated March 3, 2015 is affirmed. 

Issued: February 1, 2016 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board