United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

T.T., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Philadelphia, PA, Employer 

__________________________________________ 

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Docket No. 15-1117 

Issued: July 6, 2016 

Appearances: Case Submitted on the Record

Michael D. Overman, Esq., for the appellant 

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 April 21, 2015 appellant, through counsel, filed a timely appeal of a December 9, 

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)(1) and 501.3, the 

Board has jurisdiction to consider the merits of the case. 

ISSUE 

The issue is whether appellant has met her burden of proof to establish either cervical 

radiculopathy or a brachial plexus injury, causally related to factors of her federal employment. 

On appeal counsel alleges that the impartial medical specialist failed to provide sufficient 

medical reasoning to resolve the existing conflict of medical opinion evidence. 

 1

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

This case has previously been on appeal before the Board.2 The facts and the 

circumstances outlined in the Board’s prior decision are incorporated herein by reference. The 

facts relevant to this appeal are set forth below. On March 20, 2008 appellant, then a 44-year-old 

distribution clerk, filed a timely occupational disease claim (Form CA-2), alleging that she 

developed neck and shoulder conditions due to repetitive work tasks, commencing June 1, 2006. 

OWCP accepted the claim for neck sprain, brachial plexus injury, and brachial neuritis. 

Appellant has several other claims concerning prior work-related injuries which have been 

combined with the present claim, with the present claim serving as the master file.3 On 

March 20, 2000 and January 26, 2001 appellant underwent right and left wrist release surgeries, 

both authorized by OWCP. 

Appellant returned to light-duty work following her surgeries in 2001. In June 2006, she 

began work in the position of a modified clerk. Appellant stopped work again on 

January 25, 2010. 

On January 31, 2010 appellant filed a claim for a recurrence of disability (Form CA-2a) 

alleging that on January 25, 2010 she sustained a recurrence of disability due to her June 1, 2006 

employment injury. She noted that she had returned to work with restrictions, but experienced 

pain in her neck and shoulder. Appellant’s hands became swollen and she was unable to move 

her neck.4

In a report dated January 25, 2010, appellant’s treating physician, Dr. Bruce Grossinger, 

an osteopath Board-certified in neurology and pain management, provided results on 

examination and diagnosed chronic pain due to cervical radiculopathy and brachial plexopathy, 

with a component of tendinitis of the wrists. He attributed the diagnosed conditions to 

appellant’s employment and found that she was totally disabled. Dr. Grossinger opined that she 

had an aggravation of her clinical status in January 2010, following an increased volume of mail 

during the December 2009 holiday season. He noted, “It remains my opinion that [appellant] has 

objective evidence of aggravation of the accepted injuries involving her neck and upper 

extremities.” Appellant underwent a nerve conduction velocity (NCV) study and an 

electromyogram (EMG) on March 10, 2010. These tests were normal for bilateral median and 

ulnar nerves, but suggestive of right C5-8 and left C6-8 radiculopathy. 

In a report dated March 10, 2010, Dr. Najmi I. Sheikh, a Board-certified physiatrist, 

noted a history of the 2006 work injury as well as diabetes mellitus and right rotator cuff surgery. 

 2

 Docket No. 12-736 (issued February 4, 2013). 

3

 Appellant’s prior claims include: OWCP File No. xxxxxx897 (August 2, 1980 date of injury) accepted for right 

wrist strain; OWCP File No. xxxxxx091 (November 2, 1999 date of injury) accepted for bilateral wrist 

tenosynovitis; OWCP File No. xxxxxx995 (October 1, 2991 date of injury) accepted for right shoulder strain and 

adhesive capsulitis; OWCP File No. xxxxxx815 (October 25, 2001 date of injury) accepted for right shoulder 

contusion; OWCP File No. xxxxxx235 (March 8, 1994 date of injury) accepted for right shoulder strain, 

impingement, partial rotator cuff tear and acromioclavicular (AC) joint arthritis. 

4

 Appellant retired from the employing establishment on April 2, 2011. 
3

He diagnosed chronic cervical sprain with myofascitis and bilateral shoulder sprain with 

myofascitis referable to the 2006 injury. Dr. Sheikh also noted restricted cervical and right 

shoulder range of motion, pain/tenderness to palpation of the cervical paravertebral, upper dorsal 

paravertebral, and bilateral trapezius muscles, and diminished right grip strength. 

On May 5, 2010 OWCP referred appellant for a second opinion examination 

Dr. Noubar A. Didizian, a Board-certified orthopedic surgeon, for further evaluation of the 

nature of her condition, the extent of disability, and appropriate treatment. In his May 10, 2010 

report, Dr. Didizian reported examination findings and reviewed the medical history and 

statement of accepted facts. He found that appellant’s current symptoms were not due to her 

accepted 2006 employment injury, but were rather due to degenerative disease of the cervical 

spine which was part of appellant’s genetic makeup and the aging process. Dr. Didizian further 

found that appellant no longer required treatment due to the 2006 employment injury, as she had 

no evidence of ongoing neck sprain or any brachial plexus involvement. He noted that appellant 

had returned to baseline with no residuals due to the 2006 work injury. Dr. Didizian concluded, 

“The claimant in my opinion has been over diagnosed and over treated for the date of injury of 

June 1, 2006 as being related to the nature of the job. At the present time, there is no objective 

finding to support that there is any evidence of ongoing symptomatology related to the June 1, 

2006 date of injury and accepted injury related to that date.” 

In a note dated May 19, 2010, Dr. Grossinger found chronic evidence of cervical 

radiculopathy and brachial plexopathy and opined that these conditions were caused by work 

activities at the employing establishment. He completed a report on July 26, 2010 noting that 

appellant experienced a worsening of her clinical condition on January 25, 2010. Dr. Grossinger 

reported swelling in her right wrist and tenderness of the cervical facet joint, limited range of 

motion of the cervical spine, and muscle spasm in the mid-scapular region. He determined that 

appellant had objective findings consistent with cervical radiculopathy including restriction in 

mobility and palpable changes in muscles in the cervical and trapezius areas, as well as 

electrodiagnostic abnormalities. 

In a letter dated June 25, 2010, OWCP notified appellant of the factual and medical 

evidence needed to support her recurrence claim. 

By separate letter dated June 25, 2010, OWCP proposed to terminate appellant’s wageloss compensation and medical benefits. It accorded the weight of the medical evidence to 

Dr. Didizian, finding that appellant was no longer disabled due to her 2006 accepted work injury. 

OWCP advised appellant that she could submit additional medical evidence within 30 days. 

On August 12, 2010 OWCP denied appellant’s claim for recurrence of disability 

commencing January 25, 2010. On August 20, 2010 counsel requested a hearing.5

 5

 A video hearing on the recurrence claim was held on August 10, 2011. 
4

In a separate decision dated August 12, 2010, OWCP finalized the termination of 

appellant’s wage-loss compensation and medical benefits, effective that same date. On 

August 17, 2010 counsel requested an oral hearing.6 

By decision dated February 15, 2011, the hearing representative found that an unresolved 

conflict of medical opinion existed between appellant’s treating physicians and the second 

opinion physician, Dr. Didizian, as to whether appellant had continuing, injury-related disability. 

He set aside the August 12, 2010 termination decision and remanded the case for an impartial 

medical examination and a de novo decision. 

On remand, OWCP prepared an updated statement of accepted facts and a list of specific 

questions, and referred appellant to Dr. Karl Rosenfeld, a Board-certified orthopedic surgeon, for 

an impartial medical examination.7

 In a report dated April 19, 2011, Dr. Rosenfeld reviewed the 

statement of accepted facts and medical history. He noted that appellant reported neck pain and 

pain radiating down her neck to both hands, which became swollen on occasion. Dr. Rosenfeld 

found full range of motion of her neck with pain and normal muscle strength in the arms. He 

noted slight thenar atrophy of the right hand and found that percussing her median nerves caused 

pain up to the shoulder rather than distally. Dr. Rosenfeld reviewed appellant’s magnetic 

resonance imaging (MRI) scan dated November 23, 2010 which reflected a central left-sided disc 

protrusion at C6-7 and minor bulging from C3-6. He diagnosed chronic cervical problems and 

noted that appellant had sustained an employment injury. Dr. Rosenfeld noted, “It appears to me 

that, if any work-related condition was accepted, then obviously [appellant’s] symptoms at the 

present time date back to 2006 when she [noted] the pain began.” He also noted that he found no 

evidence for brachial plexopathy and that only a degenerative state was causing her current 

symptoms. 

Dr. Rosenfeld concluded that appellant’s current symptoms stemmed only from her neck, 

due to her chronic degenerative cervical state, but that she had no acute injury, no brachial 

plexopathy, and no carpal tunnel syndrome as she had no objective findings. He diagnosed 

cervical degenerative disc disease and noted that, if a cervical condition was accepted as work 

related, then her current condition was due to ongoing problems from 2006. Dr. Rosenfeld 

opined that appellant had no evidence of radiculitis or brachial plexus injury. He noted that 

appellant’s symptoms were ongoing from 2006 and were not a new problem. Dr. Rosenfeld 

stated that the accepted 2006 injury did not aggravate, accelerate, exacerbate, or precipitate any 

active conditions or disability on or after January 25, 2010. He opined that appellant could 

perform her date-of-injury position of modified distribution clerk. In response to the question of 

whether any additional conditions should be added, Dr. Rosenfeld noted, “The diagnosis in my 

opinion is cervical disc disease.” He concluded that appellant did not require further medical 

treatment. 

 6

 An oral hearing on the termination issue was held on December 17, 2010. 

7

 The record contains a Memorandum of Referral to Specialist, an ME023 -- Appointment Schedule Notification 

referring appellant to Dr. Rosenfeld, a report of telephone call dated March 2, 2011 indicating that the appointment 

with Dr. Rosenfeld was scheduled by OWCP, and a screen capture indicating that Dr. John Benner, a Boardcertified orthopedic surgeon, was bypassed to perform the impartial medical examination as he was not interested in 

performing the examination. 
5

OWCP requested a supplemental report from Dr. Rosenfeld on June 2, 2011 addressing 

whether appellant’s degenerative cervical disease was caused or aggravated by factors of her 

federal employment. In a June 9, 2011 response, Dr. Rosenfeld noted, “it is my opinion, with 

reasonable medical certainty, that if there were an aggravation of her cervical disc disease, a high 

probability, that at least by the time I saw her, April 19, 2011, the problem from the aggravation 

was resolved and that her continued pain was from her underlying cervical state.” He based his 

conclusions on the fact that appellant had no objective findings at the time of his examination 

and that she had not worked for 14 months. Dr. Rosenfeld noted that since appellant was no 

longer working, any pain due to her employment should have abated. He noted that appellant 

had a temporary aggravation of neck pain due to her employment which would have ceased a 

month after she stopped work. 

On July 8, 2011 OWCP issued a de novo decision terminating appellant’s wage-loss 

compensation and medical benefits, effective July 1, 2011, based on the reports of Dr. Rosenfeld. 

Counsel requested an oral hearing on July 14, 2011. 

On September 14, 2011 appellant filed a new occupational disease claim (Form CA-2) 

alleging that, as of January 25, 2010, she developed neck pain, shoulder pain radiating to both 

hands, numbness, and tingling.8

 OWCP requested additional factual and medical evidence in 

support of appellant’s new occupational disease claim on November 10, 2011. Appellant 

submitted a narrative statement dated September 14, 2011, noting that she lifted trays of mail 

weighing approximately 10 pounds to sort letters in a case which required reaching above her 

head. She stopped work on January 25, 2010. 

Following the August 20, 2011 hearing, by decision dated November 22, 2011, an 

OWCP hearing representative affirmed the August 12, 2010 decision denying the January 25, 

2010 recurrence claim. She found that the worsening of appellant’s condition on January 25, 

2010 was not spontaneous, but was instead due to aggravation of her injuries caused by increased 

volume of mail during the December 2010 holiday season. 

By decision dated January 25, 2012, an OWCP hearing representative affirmed the 

July 8, 2011 de novo termination decision, finding that appellant had no residuals of her accepted 

work-related conditions. She determined that Dr. Rosenfeld was selected through the 

appropriate process and that Dr. Grossinger’s reports were not sufficient to create an additional 

conflict with Dr. Rosenfeld. The hearing representative found that Dr. Rosenfeld’s reports were 

entitled to the weight of the medical opinion evidence. 

Appellant, through counsel, appealed to the Board both the November 22, 2011 decision 

denying her recurrence claim and the January 25, 2012 decision terminating her benefits. 

On February 2, 2012 OWCP denied appellant’s September 14, 2011 occupational disease 

claim. Counsel subsequently requested an oral hearing before an OWCP hearing representative. 

By decision dated August 7, 2012, the OWCP hearing representative vacated the February 2, 

2012 decision denying appellant’s September 14, 2011 occupational disease claim, finding that 

 8

 The new occupational disease claim, OWCP File No. xxxxxx223, was administratively combined with the 

present claim. 
6

there was a new conflict of medical opinion evidence between Dr. Grossinger and Dr. Rosenfeld 

as to whether employment factors between June 2006 and January 25, 2010 caused a brachial 

plexus injury or a temporary aggravation of underlying cervical radiculopathy. The hearing 

representative remanded the case for a referee medical examination and a de novo decision. 

By decision dated February 4, 2013, the Board affirmed the November 22, 2011 decision 

denying appellant’s recurrence claim, but reversed the January 25, 2012 decision terminating 

appellant’s benefits. The Board found that the medical evidence of record was insufficient to 

establish that appellant sustained a recurrence of disability on or after January 25, 2010. The 

Board further found that OWCP failed to meet its burden of proof to terminate appellant’s wageloss and medical compensation benefits as Dr. Rosenfeld’s reports were insufficiently 

rationalized and there remained an unresolved conflict of medical opinion concerning appellant’s 

entitlement to wage-loss compensation and medical benefits. 

By letter dated February 21, 2013, OWCP notified appellant that, in response to the 

Board’s February 4, 2013 decision, it reopened her case for all necessary and related medical 

treatment for the accepted conditions. 

On April 10, 2013 OWCP referred appellant to Dr. Heidar Jahromi, a Board-certified 

neurologist, to resolve the conflict in medical opinion evidence which was noted to exist between 

Dr. Grossinger and Dr. Rosenfeld in the August 7, 2012 decision concerning appellant’s new 

occupational disease claim. OWCP asked Dr. Jahromi to determine whether modified-duty work 

tasks performed by appellant between June 1, 2006 and January 25, 2010 caused a brachial 

plexus injury or a temporary aggravation of her cervical radiculopathy. 

In a report dated May 20, 2013,9

 Dr. Jahromi listed appellant’s job duties and accepted 

injuries through her retirement. He found that she had a normal neurological examination except 

for hypoactive-to-absent reflexes. Dr. Jahromi noted that appellant was a diabetic and that she 

had used anti-diabetic medications for a number of years. He attributed her hyporeflexia to a 

mild form of diabetic neuropathy. Dr. Jahromi requested additional diagnostic studies. 

Appellant underwent electrodiagnostic studies on May 23, 2013 which noted her history of 

diabetes since 2000. These nerve conduction studies were intact with no significant delay of the 

median nerve or ulnar nerve. Appellant’s EMG was normal except for mild polyphasics at the 

right deltoid muscle. The report concluded that there was no electrical evidence of a significant 

cervical radiculopathy, brachial plexopathy, peripheral neuropathy, peripheral nerve entrapment 

lesion, or myopathy. Appellant demonstrated mild chronic C5-6 nerve root changes which were 

worse on the right. Dr. Jahromi reviewed the May 23, 2013 EMG and NCV study and found no 

electrodiagnostic evidence to show a significant cervical radiculopathy, brachial plexopathy, 

peripheral neuropathy, peripheral nerve entrapment, or myopathy. He noted, “There was only 

some possibly abnormal polyphasics in the deltoid muscle on the right side which may suggest a 

possibility of C5-6 nerve impairment as a result of mild chronic C5-6 radiculopathy.” 

Dr. Jahromi found minimal evidence of a possible C5 root lesion which was chronic, but no 

objective basis for the impairment appellant claimed. He concluded, “The minimal abnormality 

this is described above is a finding that can be seen on anybody with any degree of degenerative 

 9

 The date of this report appears to be a typographical error as the report was written subsequent to review of 

May 23, 2013 EMG and NCV studies. 
7

changes of the spine that anybody at that age can have regardless of injury or without injury; 

specifically I reviewed [appellant’s] job description and the type of work that she has been doing 

especially since 2001 is not the type that can cause any significant amount of radicular injury.” 

By de novo decision dated June 10, 2013, OWCP denied appellant’s occupational disease 

claim based on Dr. Jahromi’s report. Counsel requested an oral hearing before OWCP’s Branch 

of Hearings and Review on June 14, 2014. 

Dr. Grossinger continued to opine that appellant had work-related chronic pain in the 

neck and arms. He noted that she had features of cervical radiculopathy and brachial plexopathy 

as well as cervical facet pain, which were related to her employment activities. Appellant 

underwent a cervical MRI scan on May 17, 2013 which was normal. 

In a report dated September 23, 2013, Dr. Jason Brajer, an associate of Dr. Grossinger, 

reported treating appellant with cervical epidural steroid injections and cervical facet blocks. He 

noted that her radicular symptoms were returning. Dr. Brajer reviewed an October 2009 EMG 

and found radiculopathy and brachial plexopathy. He noted that appellant’s most recent MRI 

scan was normal and “doubted the veracity of the most recent MRI [scan].” 

Counsel appeared at the oral hearing held on October 23, 2013 and argued that 

Dr. Jahromi’s report was not based on an accurate knowledge of appellant’s employment duties, 

was speculative, and failed to constitute the weight of the medical opinion evidence. 

By decision dated December 16, 2013, the hearing representative set aside OWCP’s 

June 10, 2013 denial and remanded the case for further development and a new de novo decision. 

She instructed OWCP to prepare an updated statement of accepted facts that described 

appellant’s modified-duty work tasks performed between June 1, 2006 and January 25, 2010. 

The hearing representative further instructed OWCP to request a supplemental report from 

Dr. Jahromi, containing his opinion as to causal relationship between such factors and a brachial 

plexus condition or aggravation of underlying cervical radiculopathy, as well as a description of 

motor and sensory testing conducted on May 20, 2013. 

OWCP prepared an updated statement of accepted facts on January 27, 2014 which 

included a detailed description of appellant’s work duties performed from May 27, 2006 through 

her work stoppage on January 25, 2010. Appellant’s restrictions included: no lifting over five 

pounds, limited pushing and pulling, no strenuous use of the right hand and wrist, and no 

working over 40 hours a week. OWCP also included the dates of injury and the accepted 

conditions from her other claims. On January 29, 2014 it requested a supplemental report from 

Dr. Jahromi. OWCP asked that he provide medical rationale in support of his conclusions and 

that he specifically address appellant’s motor and sensory test results and whether her job duties 

from 2006 until January 25, 2010 caused or contributed to an aggravation of an underlying 

cervical radiculopathy or brachial plexus condition. 

Appellant underwent additional EMG and NCV studies. In a February 24, 2014 report, 

Dr. Brajer opined that the new EMG and NCV studies showed right brachial plexopathy and no 

evidence of cervical radiculopathy. 
8

On February 24, 2014 Dr. Grossinger found that the electrodiagnostic testing 

demonstrated moderate right upper trunk brachial plexopathy. He found clinical evidence of 

cervical facet syndrome and opined that appellant’s conditions were related to her June 1, 2016 

employment injury. 

In a report dated March 27, 2014, Dr. Steven Grossinger, an osteopath and associate of 

Dr. Bruce Grossinger, diagnosed right brachial plexopathy referable to work tasks conducted as 

of June 1, 2006. 

Dr. Jahromi completed a supplemental report on April 17, 2014 and noted that 

appellant’s initial sensory and motor examination was normal with sensation to pinprick, touch, 

heat, vibration, and position sense. Muscle strength of deltoids, trapezii, triceps, biceps, brachial 

radialis, wrist extensor and flexor, finger flexors, extensors, abductors, and adductors bilaterally 

were also normal with no evidence of atrophy or weakness. Dr. Jahromi reported: 

“[M]y opinion is that on my examination and review of the record ... no evidence 

for plexopathy, neuropathy, or radiculopathy except for a very minimal evidence 

of possibly C5 root impairment, as I have indicated above the function of the 

deltoid being normal rules out the possibility of C5-6 nerve root lesion of 

significant degree and, therefore, it is a moot point as to whether or not return to 

work in 2006 has aggravated anything whatsoever since there is no indication that 

this is the case.” 

By decision dated June 2, 2014, OWCP denied appellant’s occupational disease claim for 

cervical radiculopathy or a brachial plexus condition causally related to federal employment 

factors between June 2006 and January 25, 2010. It found that Dr. Jahromi’s report was entitled 

to the weight of the medical evidence. On June 4, 2014 counsel requested an oral hearing before 

an OWCP hearing representative. 

OWCP received additional medical evidence including reports dated June 17 and July 15, 

2014 from Dr. Steven Grossinger, who found restricted cervical range of motion with reduced 

sensation along the lateral aspect of appellant’s arms and noted that appellant had chronic 

features of cervical radiculopathy and brachial plexopathy. 

By decision dated September 5, 2014, OWCP accepted that appellant sustained nerve 

root and plexus disorder, other, as a result of her employment.10

Counsel appeared at the oral hearing held on October 27, 2014 and argued that 

Dr. Jahromi’s supplemental report was insufficient to resolve the existing conflict of medical 

opinion evidence and to constitute the weight of the medical opinion evidence. He further 

argued that Dr. Jahromi’s opinion that cervical radiculopathy did not exist was at odds with the 

results of appellant’s May 2013 EMG and NCV studies. The record was held open for 30 days 

to allow for the submission of additional evidence. 

 10 This acceptance of additional employment-related conditions due to the 2006 occupational disease does not 

address the issue currently before the Board, which is whether appellant sustained a new occupational disease as a 

result of her employment duties as of January 25, 2010. 
9

In a report dated October 31, 2014, Dr. Bruce Grossinger opined that appellant sustained 

an aggravation of cervical degenerative joint disease as well as rotator cuff injuries and right 

brachial plexopathy as a result of her 2006 employment injury. 

Dr. Brajer completed a report on November 4, 2014 and attributed her cervical 

radiculopathy secondary to brachial plexopathy as well as cervical facet dysfunction to her 2006 

employment injury. 

By decision dated December 9, 2014, the hearing representative found that the 

supplemental report from Dr. Jahromi dated April 17, 2014 was sufficiently detailed and wellreasoned to constitute the weight of the medical evidence. He further found that Dr. Jahromi 

established the existence of an employment-related C5-6 nerve root lesion, but did not establish 

the existence of plexopathy, neuropathy, or radiculopathy and that, therefore, appellant’s 

employment duties had not resulted in a diagnosed condition. 

LEGAL PRECEDENT 

OWCP regulations define an occupational disease as “a condition produced by the work 

environment over a period longer than a single workday or shift.”11 To establish that an injury 

was sustained in the performance of duty in an occupational disease claim, a claimant must 

submit the following: (1) medical evidence establishing the presence or existence of the disease 

or condition for which compensation is claimed; (2) a factual statement identifying employment 

factors alleged to have caused or contributed to the presence or occurrence of the disease or 

condition; and (3) medical evidence establishing that the employment factors identified by the 

claimant were the proximate cause of the condition for which compensation is claimed or, noted 

differently, medical evidence establishing that the diagnosed condition is causally related to the 

employment factors identified by the claimant. The evidence required to establish causal 

relationship is rationalized medical opinion evidence, based upon a complete factual and medical 

background, showing a causal relationship between the claimed condition and identified factors. 

The belief of a claimant that a condition was caused or aggravated by the employment is not 

sufficient to establish causal relation.12

When there are opposing reports of virtually equal weight and rationale, the case will be 

referred to an impartial medical specialist pursuant to section 8123(a) of FECA which provides 

that, if there is 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 

an examination and resolve the conflict of medical evidence.13 This is called a referee 

examination and OWCP will select a physician who is qualified in the appropriate specialty and 

who has no prior connection with the case.14

 11 20 C.F.R. § 10.5(q). 

12 Lourdes Harris, 45 ECAB 545, 547 (1994). 

13 5 U.S.C. § 8123; M.S., 58 ECAB 328 (2007); B.C., 58 ECAB 111 (2006). 

14 R.C., 58 ECAB 238 (2006). 
10

In situations where there are opposing medical reports of virtually equal weight and 

rationale, and the case is referred to an impartial medical specialist for the purpose of resolving 

the conflict, the opinion of such specialist, if sufficiently well rationalized and based on a proper 

factual background, must be given special weight.15

ANALYSIS 

The Board finds that the reports of Dr. Jahromi are sufficiently detailed and wellreasoned to constitute the weight of the medical opinion evidence. 

Appellant filed a claim on September 14, 2011 and alleged that her disability and medical 

conditions on and after January 25, 2010 should be considered as the result of an occupational 

disease arising as the result of employment duties beginning on May 15, 2006 when she returned 

to work as a modified distribution clerk, casing letter or flat mail, lifting no more than five 

pounds, standing intermittently, and walking or bending intermittently.16 She submitted reports 

from her attending physicians in support of her new occupational disease claim diagnosing 

brachial plexopathy with a component of tendinitis of the wrists and cervical radiculopathy as a 

result of her employment duties beginning in May 2006. Dr. Bruce Grossinger found that 

appellant was totally disabled beginning January 25, 2010. 

Dr. Rosenfeld examined appellant on behalf of OWCP and found no evidence for 

brachial plexopathy and that only a degenerative state was causing her current symptoms. He 

also found that she had no disability due to her work-related conditions. The Board finds that 

OWCP properly determined that there was a conflict of medical opinion evidence between 

Drs. Bruce Grossinger and Rosenfeld17 regarding appellant’s diagnosed conditions and period of 

disability. To resolve this conflict of medical opinion evidence, OWCP referred appellant to 

Dr. Jahromi for an IME. 

In a report dated May 20, 2013, Dr. Jahromi listed appellant’s job duties and accepted 

injuries through her retirement in 2010. He found that she had a normal neurological 

examination except for hypoactive-to-absent reflexes. Dr. Jahromi noted that appellant was a 

diabetic and that she had used anti-diabetic medications for a number of years. He attributed her 

hyporeflexia to a mild form of diabetic neuropathy. Dr. Jahromi reviewed appellant’s May 23, 

2013 electrodiagnostic studies which found no significant delay of the median nerve or ulnar 

nerve. He found that there was no electrodiagnostic evidence of significant cervical 

radiculopathy, brachial plexopathy, peripheral neuropathy, peripheral nerve entrapment, or 

myopathy. Dr. Jahromi concluded, “The minimal abnormality that is described above is a 

 15 Nathan L. Harrell, 41 ECAB 401, 407 (1990). 

16 In the Board’s prior decision on February 4, 2013, the Board found that the evidence of record was not 

sufficient to establish that appellant sustained a recurrence of disability due to her 2006 occupational disease claim 

which was accepted for “injury to brachial plexus, sprain of neck and brachial radiculitis.” 

17 Although OWCP initially selected Dr. Rosenfeld as an IME, as the Board previously found that his reports 

were not sufficient to constitute the weight of the medical opinion evidence, OWCP properly considered him to be a 

second opinion physician for the purposes of appellant’s ongoing claims. Federal (FECA) Procedure Manual, 

Part 2 -- Claims, Developing and Evaluating Medical Evidence, Chapter 2.810.12 (June 2015). 
11

finding that can be seen on anybody with any degree of degenerative changes of the spine that 

anybody at that age can have regardless of injury or without injury; specifically I reviewed 

[appellant’s] job description and the type of work that she has been doing especially since 2001 

is not the type that can cause any significant amount of radicular injury.” 

Dr. Jahromi completed a supplemental report on April 17, 2014 and explained that 

appellant’s initial sensory and motor examination demonstrated normal sensation and muscle 

strength. He concluded that appellant had “very minimal evidence of possibly C5 root 

impairment.” Dr. Jahromi noted, “as I have indicated above the function of the deltoid being 

normal rules out the possibility of C5-6 nerve root lesion of significant degree and, therefore, it is 

a moot point as to whether or not return to work in 2006 has aggravated anything whatsoever 

since there is no indication that this is the case.” 

The Board finds that Dr. Jahromi’s reports are sufficiently detailed and well-reasoned to 

constitute the weight of the medical opinion evidence. Dr. Jahromi’s reports establish that 

appellant has no employment-related C5 nerve root impairment. He noted that appellant’s 

normal deltoid function eliminated the possibility of C5 nerve root lesion. Dr. Jahromi reviewed 

the May 23, 2013 EMG and NCV studies and found no electrodiagnostic evidence to show 

cervical radiculopathy, brachial plexopathy, peripheral neuropathy, peripheral nerve entrapment, 

or myopathy. Furthermore, he based his report on an accurate history and explained that 

appellant’s employment duties would not cause radicular injury. 

Following Dr. Jahromi’s reports, appellant submitted additional medical evidence from 

Drs. Bruce Grossinger, Steven Grossinger, and Brajer. These reports do not contain the 

necessary medical rationale and detail to overcome the special weight accorded Dr. Jahromi as 

the independent medical examiner. Furthermore, as Dr. Bruce Grossinger was on one side of the 

conflict that Dr. Jahromi resolved, his additional reports are insufficient to overcome the special 

weight accorded Dr. Jahromi’s reports or to create a new conflict with them.18 The additional 

opinions of the associates of Drs. Bruce Grossinger, Steven Grossinger and Brajer are merely 

repetitive of the reports and opinions previously provided by Dr. Bruce Grossinger and they 

therefore fail to set forth any basis for overcoming the weight afforded to the opinions of 

Dr. Jahromi. 

For the reasons listed above, the Board disagrees with counsel’s contentions on appeal 

that Dr. Jahromi failed to provide sufficient medical reasoning to resolve the existing conflict of 

medical opinion evidence. 

CONCLUSION 

The Board finds that appellant has failed to meet her burden of proof to establish either 

cervical radiculopathy or a brachial plexus injury causally related to her job duties from 

May 2006 through June 2010. 

 18 Dorothy Sidwell, 41 ECAB 857, 874 (1990). 
12

ORDER 

IT IS HEREBY ORDERED THAT the December 9, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: July 6, 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