United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.S., Appellant 

and 

U.S. POSTAL SERVICE, PROCESSING & 

DELIVERY CENTER, Merrifield, VA, Employer 

__________________________________________ 

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Docket No. 15-1880 

Issued: June 16, 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 

COLLEEN DUFFY KIKO, Judge 

JURISDICTION 

On September 14, 2015 appellant filed a timely appeal from a March 16, 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 abused its discretion by denying appellant’s request for 

physical therapy as of January 2014. 

FACTUAL HISTORY 

On December 5, 2011 appellant, then a 51-year-old mail handler, filed a traumatic injury 

claim (Form CA-1) alleging that on that date he felt a sharp pain in his back while setting down a 

 1

 5 U.S.C. § 8101 et seq. 
2

flat mail tub. He did not stop work. Appellant was offered, and he accepted, on October 20, 

2011, a light-duty mail handler position with four hours sitting and four hours standing. 

In a January 4, 2012 progress note, Dr. William H. Carter, appellant’s treating Boardcertified family practitioner, noted that appellant was receiving physical therapy and was 

gradually improving. Appellant presented receipts from appointments for physical therapy for 

the period December 20, 2011 through January 30, 2012. 

On March 26, 2012 OWCP accepted appellant’s claim for lumbar back sprain. 

The record includes duty status forms (Form CA-17) from Dr. Carter, noting that 

appellant could work full time with work restrictions. The Forms CA-17 were dated 

December 6, 2011, May 18, September 25, and November 23, 2012, November 1, 2013, and 

February 26, 2014. These forms noted the accepted injury of lumbar back sprain. 

Appellant also submitted copies of employing establishment forms completed by 

Dr. Carter regarding appellant’s ability to return to work. These forms were dated May 18, 

October 4, and November 23, 2012, and February 26, 2014 and reflected both that appellant 

continued to have some residuals of the work injury and that he had not reached maximum 

medical improvement. The October 4, 2012 form related that appellant would be expected to 

recover fully by December 1, 2012. The November 30, 2012 form related that he would be 

expected to fully recover by April 1, 2013. The February 26, 2014 form related that appellant 

was being referred to physical therapy and no date of full recovery was noted. 

In a form letter dated January 30, 2014, Dr. Carter ordered physical therapy for the 

diagnoses of sprain/strain, lumbar region and spasm, lumbar region. OWCP received a physical 

therapy authorization request from Inova Physical Therapy on February 7, 2014 for dates of 

service from February 6 to April 6, 2014, for treatment of lower back pain from a December 5, 

2011 injury. 

OWCP denied the request for physical therapy pending further medical development of 

the case. By letter dated February 24, 2014, it advised appellant of the additional information 

needed to support his claim for a recurrence of his medical condition, noting that his last medical 

treatment of record was on January 30, 2012 from Dr. Carter. 

By letter to appellant dated April 2, 2014, a nurse at Dr. Carter’s office indicated that 

appellant had seen Dr. Carter multiple times since January 30, 2012, and that Dr. Carter thought 

that OWCP must not be receiving all the reports. The nurse suggested that appellant follow up 

the medical documentation. 

Appellant submitted additional reports from Dr. Carter. In a March 29, 2012 note, 

Dr. Carter noted reevaluating appellant’s occupational injury and he described it as back strain 

with sciatic radiation. As the physical therapy was unable to effectuate continued progress, he 

ordered a magnetic resonance imaging (MRI) scan to look for nerve impingement, and that 

appellant would return for evaluation of the next steps. Dr. Carter noted that appellant should 

continue to work limited duty with work restrictions. 
3

In a note dated January 14, 2013, Dr. Carter reported that appellant had been seen for 

follow-up and monitoring of his occupational back spasms/lumbar strain. He discussed 

appellant’s restrictions, and noted that he had instructed appellant to continue with daily home 

back stretches. Dr. Carter reduced appellant’s work restrictions and indicated that he would be 

reassessed in four to six weeks. 

Appellant responded to questions from OWCP on April 11, 2014, stating that no 

recurrence had occurred. Rather, physical therapy was requested for the same injury. Appellant 

noted: “I think physical therapy may help my original injury. Doctor also believes so.” 

On April 11, 2014 OWCP referred appellant for a second opinion evaluation. In an 

April 29, 2014 report, Dr. Willie E. Thompson, a Board-certified orthopedic surgeon, noted that 

at the time of his evaluation there was no objective evidence of any ongoing pathology to 

appellant’s back. He saw no evidence of any disability and no objective evidence to document 

the need to prescribe any restrictions. Dr. Thompson opined that appellant could return to fullduty work without restrictions, effective that date. He stated that there was no indication for any 

additional formal medical care or any additional diagnostic testing. 

In a May 29, 2014 decision, OWCP denied appellant’s claim for a recurrence of medical 

condition as the evidence of record was insufficient to establish a worsening of his accepted 

employment-related conditions. This decision found that appellant had failed to establish the 

need for further treatment due to a worsening of the accepted condition. OWCP found that 

Dr. Thompson’s report constituted the weight of the medical evidence. 

On June 27, 2014 appellant requested an oral hearing. At the hearing held on 

December 30, 2014, he testified that he was never out of work, but that accommodations had 

been provided so that he worked five hours standing and three hours sitting and did not lift heavy 

items from floor. Appellant testified that his treating doctor advised him to attend physical 

therapy for the second time. He claimed that there was no gap in his treatment and no 

recurrence. Appellant claimed rather that this was just a continuation of the original treatment of 

his accepted lumbar condition. 

Prior to the hearing, appellant submitted a February 6, 2015 letter from Dr. Christopher P. 

Ryan, a Board-certified family practitioner, indicating that he was appellant’s new primary care 

physician. Dr. Ryan noted that on December 5, 2011 appellant sustained back pain while lifting 

a heavy package during the course of his federal employment. He noted that appellant’s 

April 15, 2012 MRI scan clearly documented an L4-5 disc herniation and L5-S1 disc bulge 

pressing against the sac around his spinal cord. Dr. Ryan contended that heavy lifting and 

bending of the spine would cause additional pressure against the sac which contains spinal fluid, 

causing pain. He opined that appellant should have lifting restrictions due to the chance of 

exacerbating his pain, but could continue to work in a light-duty capacity. 

By decision dated March 16, 2015, the OWCP hearing representative affirmed OWCP’s 

May 29, 2014 decision. He found that appellant had not submitted rationalized medical evidence 

to establish the need for further medical treatment for the accepted condition. 
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LEGAL PRECEDENT 

Section 8103(a) of FECA provides for the furnishing of services, appliances, and supplies 

prescribed or recommended by a qualified physician which OWCP, under authority delegated by 

the Secretary, considers likely to cure, give relief, reduce the degree or the period of disability or 

aid in lessening in the amount of monthly compensation.2

 In interpreting the section 8103(a), the 

Board has recognized that OWCP has broad discretion in approving services provided under 

FECA to ensure that an employee recovers from his or her injury to the fullest extent possible in 

the shortest amount of time.3

OWCP regulations define a recurrence of medical condition as the documented need for 

further medical treatment after release from treatment of the accepted condition when there is no 

work stoppage. Continued treatment for the original condition is not considered a renewed need 

for medical care, nor is examination without treatment.4

 

OWCP’s procedure manual provides that, after 90 days of release from medical care 

(based on the physician’s statement or instruction to return as needed (PRN), or computed by the 

claims examiner from the date of last examination), a claimant is responsible for submitting an 

attending physician’s report which contains a description of the objective findings and supports 

causal relationship between the claimant’s current condition and the previously accepted work 

injury.5 

ANALYSIS 

The Board finds that OWCP did not abuse its discretion in denying appellant’s request 

for physical therapy. 

OWCP accepted appellant’s claim for sprain of the lumbar region of the back. OWCP 

developed the claim as one for a recurrence. 

The Board finds that OWCP properly found that Dr. Thompson’s report constituted the 

weight of the medical evidence and that appellant had failed to establish his claim for a 

recurrence of medical condition and a need for further physical therapy. Dr. Thompson indicated 

in an April 29, 2014 report that there was no objective evidence of any ongoing pathology to 

appellant’s back, and that there was no indication for any additional formal medical care or any 

medical diagnostic testing. 

OWCP also received several reports from appellant’s treating physician, Dr. Carter. In 

his January 30, 2014 report, Dr. Carter ordered physical therapy for appellant. He, however 

 2

 5 U.S.C. § 8103; see Thomas W. Stevens, 50 ECAB 288 (1999). 

3 W.T., Docket No. 08-812 (issued April 3, 2009); A.O., Docket No. 08-580 (issued January 28, 2009). 

4

 20 C.F.R. § 10.5(y). 

5

 Federal (FECA) Procedure Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.5(b) (September 2003). 
5

never provided any medical explanation as to how physical therapy would cure, provide relief, or 

reduce the degree of appellant’s disability. 

The record also contains Dr. Ryan’s February 6, 2015 report which diagnosed L4-5 disc 

bulge and herniation, based upon an April 15, 2012 MRI scan. OWCP has not accepted the disc 

bulge or herniation or any other sciatica-type condition. Dr. Ryan’s February 6, 2015 report does 

not address appellant’s request for physical therapy as of January 2014 for the accepted back 

sprain condition and is, therefore, insufficient to establish appellant’s claim. 

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.6 

The Board finds that OWCP properly relied upon the opinion of Dr. Thompson, who 

provided a well-rationalized opinion that appellant did not require additional medical care, as 

there was no longer objective evidence of ongoing pathology of the lumbar spine. 

CONCLUSION 

The Board finds that OWCP did not abuse its discretion in denying appellant’s request 

for physical therapy as of January 2014. 

 6 J.G., Docket No. 15-1784 (October 2, 2015); see also Daniel J. Perea, 42 ECAB 214 (1990). 
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ORDER 

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

Compensation Programs dated March 16, 2015 is affirmed. 

Issued: June 16, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board