United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

C.H., Appellant 

and 

DEPARTMENT OF THE ARMY, NATIONAL 

GEOSPATIAL-INTELLIGENCE AGENCY, 

Springfield, VA, Employer 

__________________________________________ 

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Docket No. 15-0735 

Issued: July 23, 2015 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On February 2, 2015 appellant filed a timely appeal from the January 14, 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. 

ISSUE 

The issue is whether OWCP met its burden of proof to terminate appellant’s 

compensation benefits effective February 8, 2015 as she had no residuals of the accepted 

conditions or continued disability from work. 

 1

 5 U.S.C. § 8101 et seq. 
2

FACTUAL HISTORY 

On June 18, 2013 appellant, then a 39-year-old intelligence specialist, filed a traumatic 

injury claim alleging that on June 10, 2013 she sustained a left foot injury in the performance of 

duty when she slipped on a wet floor at the employing establishment resulting in a sprained left 

foot. She stopped work that day and returned on June 18, 2013. Thereafter, appellant stopped 

work again on September 19, 2013 and did not return. OWCP accepted the claim for sprained 

left foot and sprain of the lumbar region. It began paying wage-loss compensation on 

October 29, 2013. 

Initial x-ray reports of the left foot revealed that appellant had no evidence of fracture, 

dislocation, or acute osseous abnormality, and x-ray reports of the lumbar spine were 

unremarkable. A magnetic resonance imaging (MRI) scan of the lumbar spine revealed a mild 

disc bulge at L5-S1 without associated neural foraminal or central canal narrowing. In a 

September 18, 2013 report, Dr. Roy Bands, a Board-certified orthopedic surgeon, assessed disc 

herniation at L5-S1, degenerative disc disease at L5-S1, and left lumbar radiculopathy. He noted 

that appellant’s symptoms began after she fell at work on June 10, 2013. Dr. Bands continued 

submitting reports indicating that she remained symptomatic. A December 11, 2013 

electromyography (EMG) study found no radiculopathy.2

 

In a December 4, 2013 report, Dr. Susan Zimmerman, a Board-certified physiatrist, 

advised that appellant complained of lumbar pain radiating to the posterior lower extremity with 

swelling in the left foot. On physical examination she noted that there was no limited range of 

motion, localized joint stiffness, lumbosacral tenderness on palpation, muscle spasm, or pain 

elicited by motion. Dr. Zimmerman assessed lumbar sprain and noted that findings were 

consistent with sacroiliitis. 

On January 17, 2014 OWCP referred appellant, together with the medical record and a 

statement of accepted facts to Dr. Robert Smith, a Board-certified orthopedic surgeon, for a 

second opinion regarding her status and whether she had residuals of her accepted conditions. 

In a February 18, 2014 report, Dr. Smith advised that appellant had injured her back and 

left foot when she slipped on a wet floor. He noted that she currently complained of low back 

pain radiating into the left leg down to the foot. On examination of the left foot, Dr. Smith noted 

normal bone and soft tissue structures with a normal arch, normal and complete range of motion 

of the ankle and subtalar joints, no instability, no calf atrophy, and normal motor strength. 

Examination of the back revealed no spasm, atrophy, trigger points, or deformity. Appellant had 

active spinal range of motion. Dr. Smith also advised that neurologic examination of the lower 

extremities was normal with no atrophy, weakness, or reflex asymmetry. He opined that 

appellant had no residuals of the accepted condition and that minor disc bulging at L5-S1 was 

preexisting and age related, not caused either directly or aggravated by the work incident. 

Dr. Smith noted that she had no radiculopathy or trigger points on clinical examination or 

diagnostic testing that would require further treatment. He further opined that there was no 

evidence of ongoing organic abnormalities that would prevent appellant from returning to work. 

 2

 The record also indicates that appellant underwent a cervical fusion on October 29, 2013. The cervical fusion is 

not part of the present claim. 
3

On June 10, 2014 OWCP sent Dr. Bands a copy of Dr. Smith’s second opinion report and 

requested that he submit any comments to OWCP within 30 days. In an August 3, 2014 report, 

Dr. Bands advised that appellant had radiographic and clinical evidence of lumbar degenerative 

and disc bulging at L5-S1. He recommended telecommuting on a permanent basis in an attempt 

to reduce stress on her lumbar spine and to avoid further deterioration of her underlying spinal 

disorder. 

OWCP determined that there was a medical conflict between the treating physician, 

Dr. Bands, and OWCP referral physician, Dr. Smith, regarding whether appellant had continuing 

residuals of her employment injury, and by letter dated August 28, 2014, it referred her for a 

referee examination with Dr. Mohammad Zamani, a Board-certified orthopedic surgeon. 

In his September 22, 2014 report, Dr. Zamani noted the history of appellant’s injury and 

treatment history. In reviewing the medical records, he noted that she was seen initially in an 

emergency room and had x-rays taken on June 10 and 11, 2013, which were normal or 

unremarkable. Thereafter, appellant was diagnosed with sacroiliac compression and received 

two steroid injections. Dr. Zamani questioned why she was diagnosed with and treated for 

sacroiliac compression, noting that the origin of this diagnosis was unclear. On examination of 

the back he noted normal trunk alignment, pain on palpation in lower lumbar area, no tenderness 

over the sacroiliac joint or thoracic area, no pain upon sacroiliac stressing, and a normal gait. On 

physical examination of the foot, Dr. Zamani noted full mobility of the toes, foot, and ankle, no 

redness, no warmth, and no swelling of the joints. He noted that the examination was absolutely 

normal with no positive objective finding. Dr. Zamani opined that appellant’s accepted injury 

was temporary and her symptoms had subsided. He advised that there were no residuals of the 

work injury and that full recovery had been obtained. Dr. Zamani acknowledged that appellant 

had subjective pain complaints, but reiterated that her examination was without objective 

findings. He explained that MRI scanning from August 26, 2012 showed a minor disc bulge, but 

revealed no compression of the nerve. Dr. Zamani further opined that appellant required no 

further treatment as a result of the work-related injuries and expressed that the pain management 

and injection treatments that she underwent appeared unnecessary and unrelated. He found that 

her back was better than average for a person of her age and advised that she was capable of 

returning to work full time. 

By letter dated October 20, 2014, OWCP advised appellant that it proposed a termination 

of wage-loss and medical compensation benefits. It advised that the weight of the evidence was 

represented by Dr. Zamani who found that there were no residuals of her accepted conditions and 

that she was no longer disabled from work. Appellant was advised that she had 30 days to 

submit additional evidence or argument if she disagreed with the proposed termination. 

Appellant submitted October 20 and November 21, 2014 progress reports from Dr. James 

Huang, a Board-certified physiatrist and associate of Dr. Zimmerman. In his October 20, 2014 

report, Dr. Huang noted that appellant had a June 10, 2013 work injury and currently presented 

with low back pain. He noted her symptoms, examination findings, and diagnosed lumbar disc 

degeneration, spondylosis, and radiculopathy. In his November 21, 2014 report, Dr. Huang 

advised that on physical examination there was lumbosacral tenderness on palpation on the left, 

no muscle atrophy, no lumbosacral spine weakness, and no lower extremity weakness. He 

assessed sacroiliitis, lumbar disc degeneration, lumbar spondylosis, and lumbar radiculopathy. 
4

Dr. Huang referenced the report from Dr. Zamani and opined that appellant’s pain was radicular 

in etiology and most likely due to radiculopathy. He noted that EMG testing had poor sensitivity 

for radiculopathy and recommended a lumbar epidural steroid injection. 

In a November 13, 2014 statement, appellant argued that the second opinion physician 

and referee physician did not come to the right conclusion. She alleged that Dr. Zamani was 

rude and that he had made up his mind prior to conducting the examination. Appellant advised 

that she recently went to an independent physician who addressed her pain and opined that it was 

related to the work incident. She advised that she would have him complete the necessary 

paperwork. Appellant also submitted printed patient reviews of Dr. Zamani and Dr. Smith. 

In a November 25, 2014 work capacity evaluation, Dr. Huang advised that there were 

severe symptoms of pain limiting sitting and standing and noted that appellant could only work 

one to two hours per day. 

By decision dated January 14, 2015, OWCP terminated appellant’s wage-loss and 

medical benefits effective February 8, 2015. It found that the weight of medical opinion was 

represented by Dr. Zamani. 

LEGAL PRECEDENT 

Once OWCP has accepted a claim, it has the burden of justifying termination or 

modification of compensation benefits,3 which includes furnishing rationalized medical opinion 

evidence based on a proper factual and medical background.4 Having determined that an 

employee has a disability causally related to his or her federal employment, OWCP may not 

terminate compensation without establishing that the disability ceased or was no longer related to 

the employment.5

 The right to medical benefits for an accepted condition, on the other hand, is 

not limited to the period of entitlement to disability compensation. To terminate authorization 

for medical treatment, OWCP must establish that an employee no longer has residuals of an 

employment-related condition, which would require further medical treatment.6

FECA provides that, if there is a disagreement between the physician making the 

examination for the United States and the physician of the employee, the Secretary shall appoint 

a third physician who shall make the examination.7

 The implementing regulations state that if a 

conflict exists between the medical opinion of the employee’s physician and the medical opinion 

of either a second opinion physician or an OWCP medical adviser, OWCP shall appoint a third 

physician to make an examination. This is called a referee or impartial examination and OWCP 

 3 I.J., 59 ECAB 408 (2008); Fermin G. Olascoaga, 13 ECAB 102, 104 (1961). 

4 D.C., Docket No. 09-1070 (issued November 12, 2009); Larry Warner, 43 ECAB 1027 (1992). 

5 I.J., supra note 3. 

6 L.G., Docket No. 09-1692 (issued August 11, 2010); Furman G. Peake, 41 ECAB 361, 364 (1990). 

7

 5 U.S.C. § 8123(a). 
5

will select a physician who is qualified in the appropriate specialty and who has no prior 

connection with the case.8

 

It is well established that, when a case is referred to an impartial medical specialist for the 

purpose of resolving a conflict, the opinion of such specialist, if sufficiently well rationalized and 

based on a proper factual, and medical background, must be given special weight.9

 

ANALYSIS 

OWCP accepted appellant’s claim for sprained left foot and sprain of the lumbar region. 

Appellant received wage-loss compensation and medical benefits based on the accepted 

conditions. OWCP referred her to Dr. Smith for a second opinion regarding the status of her 

accepted conditions. In his February 18, 2014 report, Dr. Smith noted appellant’s history and 

opined that she had no residuals of the accepted condition. He found that the minor disc bulging 

at L5-S1 was preexisting and age related and noted that there was no radiculopathy or trigger 

points on clinical examination or diagnostic testing. Dr. Smith opined that appellant was able to 

return to work full time. However, appellant’s treating physician, Dr. Bands, indicated that 

radiographic and clinical evidence supported ongoing symptoms and suggested lumbar 

degenerative disc disease and disc bulging at L5-S1. OWCP found that this created a conflict of 

medical opinion, and under 5 U.S.C. § 8123(a), referred the case to Dr. Zamani for a referee 

examination and an opinion as to whether appellant continued to have employment-related 

residuals. 

In his September 22, 2014 report, Dr. Zamani reviewed appellant’s history, reviewed the 

medical evidence of record, and noted findings on examination. He found that there were no 

positive objective findings on examination. Dr. Zamani acknowledged that appellant had 

subjective pain complaints, but reiterated that her examination was without objective findings. 

He explained that, while MRI scanning showed a minor disc bulge, it showed no nerve 

compression. Dr. Zamani indicated that appellant’s accepted sprain conditions required only 

limited treatment and that she had no disability. He opined that there were no residuals of the 

accepted injury and that full recovery was obtained. Dr. Zamani further opined that appellant 

required no further treatment and that she was capable of returning to work full time. He found 

no basis on which to attribute any continuing condition or disability to the accepted injury. 

The Board finds that the weight of the medical evidence rests with the well-rationalized 

report of Dr. Zamani. Dr. Zamani’s opinion is based on a complete and accurate factual and 

medical history and is entitled to special weight. The Board finds that OWCP met its burden of 

proof to terminate wage-loss compensation effective February 8, 2015. 

Appellant submitted October 20 and November 21, 2014 progress reports from 

Dr. Huang. In his October 20, 2014 report, Dr. Huang noted that she had a June 10, 2013 work 

injury and currently presented with low back pain. He noted appellant’s symptoms, examination 

findings, and diagnosed lumbar disc degeneration, spondylosis, and radiculopathy. On 

 8

 20 C.F.R. § 10.321. 

9 Gloria J. Godfrey, 52 ECAB 486, 489 (2001). 
6

November 21, 2014 Dr. Huang assessed sacroiliitis, lumbar disc degeneration, lumbar 

spondylosis, and lumbar radiculopathy. He opined that appellant’s pain was radicular in etiology 

and most likely due to radiculopathy. In his November 25, 2014 work capacity evaluation, 

Dr. Huang advised that there were severe symptoms of pain limiting sitting and standing and 

noted that she could only work one to two hours per day. The Board finds that these reports are 

of diminished probative value and do not overcome the weight of Dr. Zamani’s report because 

they fail to specifically address how the accepted left foot and back sprain caused appellant’s 

sacroiliitis, lumbar disc degeneration, lumbar spondylosis, and lumbar radiculopathy. This is 

especially important where Dr. Zamani diagnosed preexisting conditions that were not accepted 

by OWCP as employment related.10 He also did not provide any medical reasoning to support 

continuing disability due to the accepted sprains. 

In a statement, appellant alleged that Dr. Zamani was rude and biased during the 

examination. She also submitted on-line patient reviews for both Dr. Smith and Dr. Zamani. 

However, the Board has held that mere allegations are not sufficient to establish bias. There 

must be evidence of actual bias or unfairness by the physician used by OWCP as a referral 

physician.11 Here, appellant provided no evidence showing that Dr. Zamani acted in a biased 

manner toward her. 

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 OWCP met its burden of proof to terminate wage-loss compensation 

effective February 8, 2015. 

 10 See Jaja K. Asaramo, 55 ECAB 200 (2004) (where an employee claims that a condition not accepted or 

approved by OWCP was due to an employment injury, he or she bears the burden of proof to establish that the 

condition is causally related to the employment injury). 

11 J.C., Docket No. 08-1833 (issued March 23, 2009). 
7

ORDER 

IT IS HEREBY ORDERED THAT the January 14, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: July 23, 2015 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board