United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

A.P., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Washington, DC, Employer 

__________________________________________ 

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Docket No. 14-1237 

Issued: September 18, 2014 

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 HOWARD FITZGERALD, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On May 5, 2014 appellant filed a timely appeal from a February 4, 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) and 501.3, the Board has jurisdiction over 

the merits of this case. 

ISSUE 

The issue is whether OWCP properly terminated appellant’s medical and wage-loss 

compensation benefits effective May 29, 2013 on the grounds that she no longer had residuals or 

employment-related disability causally related to her accepted April 4, 2011 employment 

injuries. 

 1

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

OWCP accepted that on April 4, 2011 appellant, then a 57-year-old mail clerk, sustained 

a back injury as a result of loading machines in the performance of duty. Appellant’s claim was 

accepted for lumbar sprain and lumbar radiculitis. She did not return to work and received 

disability compensation, while undergoing medical treatments and physical therapy. 

On April 17, 2012 OWCP referred appellant, together with a statement of accepted facts 

and the medical record, to Dr. Willie Thompson, a Board-certified orthopedic surgeon, for a 

second opinion examination to determine the extent of her continuing employment-related 

residuals and disability. In a June 14, 2012 report, Dr. Thompson reviewed the statement of 

accepted facts and the medical record. He provided an accurate history of the April 4, 2011 

employment injury and reviewed appellant’s medical treatment. Upon examination of the 

lumbar spine, Dr. Thompson observed no tenderness, paraspinous muscle spasms or motor or 

sensory deficits. Range of motion was full. Straight leg raise testing was negative bilaterally. 

Dr. Thompson reported that deep tendon reflexes were intact and equal bilaterally. Manual 

muscle testing revealed strength of 5/5. Dr. Thompson stated that the examination was 

completely within normal limits. 

Dr. Thompson reviewed appellant’s diagnostic reports. He stated that an April 29, 2011 

magnetic resonance imaging (MRI) scan examination of the lumbar spine revealed some 

moderate degenerative changes. A March 12, 2012 MRI scan of the cervical spine also 

demonstrated a C5-6 disc osteophyte complex with cord impingement. Dr. Thompson diagnosed 

a soft tissue sprain/strain injury to the lower back as a result of the April 4, 2011 employment 

injury. He opined that appellant was capable of returning to work without restrictions. 

Dr. Thompson concluded that there was no objective evidence of any ongoing pathology which 

could be related to the April 4, 2011 employment injury. 

In various reports dated May 2 to September 13, 2012, Dr. Daniel Ignacio, Boardcertified in physical medicine and rehabilitation, noted that appellant had been under his care 

since April 4, 2011 for a lumbar injury at work. He stated that she continued to experience 

increasing and severe pain along the hips and lower back, stiffness along the back and continuing 

paresthesia of numbness and weakness along her legs. Dr. Ignacio related that an MRI scan of 

the lumbar spine demonstrated lumbar disc narrowing and lumbar disc protrusion. Upon 

examination of the lumbar spine, he observed significant restriction of motion along the lumbar 

muscles. Dr. Ignacio also reported spasm and tenderness along L2, L3, L4 and L5 interspinous 

ligaments and paraspinal muscles. Straight leg raise testing was positive to 70 degrees 

bilaterally. Examination of the cervical spine demonstrated restricted motion and continuing 

tenderness. Examination of the lower extremities revealed limited motions along the legs due to 

pain and severe hypoesthesia and weakness in both legs. Dr. Ignacio diagnosed progressive 

lumbar disc syndrome, chronic lumbar radiculopathy, chronic thoracolumbar strain and chronic 

pain syndrome. He recommended that appellant continue with conservative care, including 

spinal injections, physical therapy, aquatic program and pain medication. 

In attending physician reports dated May 2, 2012 to March 4, 2013, Dr. Ignacio noted 

that appellant sustained a lumbar injury at work on April 4, 2011. He diagnosed lumbar strain, 

lumbar disc syndrome and L4-5 disc herniation as confirmed by an MRI scan. Dr. Ignacio 
3

indicated that appellant was disabled from August 1, 2012 to March 31, 2013. He reported that 

she needed continued medical care and conservative treatment. 

In a May 23, 2012 MRI scan of the lumbar spine, Dr. Paul L. Weiner, a Board-certified 

diagnostic radiologist, noted appellant’s complaints of low back pain extending into her right 

lower extremity. He opined that she had central and right lateral recess stenosis L3-4 and L4-5, 

most marked at L4-5, retrolisthesis L2-3 and L3-4, left paracentral protrusions T11-12 and 

T12-L1, central protrusions at L1-2 and L3-4, broad-based protrusions L2-3, L4-5 and L5-S1 and 

L5 degrees levoscoliosis. 

On September 28, 2012 OWCP issued a notice of proposed termination of appellant’s 

wage-loss and compensation benefits based on Dr. Thompson’s June 14, 2012 medical report.2

 

Appellant was advised that she had 30 days to submit additional relevant evidence or argument if 

she disagreed with the proposed action. 

In a handwritten letter received on October 23, 2012, appellant noted that she was 

enclosing another report by Dr. Ignacio in response to the proposed termination. 

In an October 15, 2012 report, Dr. Ignacio accurately described the April 4, 2011 

employment injury and appellant’s medical treatment. He noted that an April 29, 2011 MRI 

scan of the lumbar spine showed lumbar disc abnormality with narrowing of the lumbar disc and 

lumbar disc protrusion at the L4-5 level. Dr. Ignacio also related that April 4, 2011 and 

April 26, 2012 electromyography (EMG) and nerve conduction velocity (NCV) studies showed 

lumbar radiculopathy and neuritis at the L5-S1 level. Upon examination of the thoracolumbar 

spine, he observed spasm on motion restricted to flexion of 70 degrees and tenderness along the 

paraspinal muscles and sciatic notches. Straight leg raise testing was positive to 70 degrees on 

both sides. Examination of the lower extremities revealed hypoesthesia and weakness of the 

legs. Strength was 4/5 with diminished right ankle jerk. 

Dr. Ignacio diagnosed chronic lumbar strain, chronic lumbar radiculopathy, chronic 

lumbar disc syndrome and chronic thoracic strain syndrome. He stated that due to appellant’s 

complex medical conditions and spinal injury she was not able to return to work. Dr. Ignacio 

contended that Dr. Thompson disregarded the objective findings, such as the 

electrodiagnostic/EMG examination and MRI scan reports which demonstrated appellant’s 

defect along the lumbar spine. He concluded that appellant sustained a significant strain to the 

thoracolumbar spine and to the lumbar disc indicative of an increased muscular and disc injury, 

which was now causing a clinically progressive neuritis and radiculitis, which required continued 

medical treatment and caused her disability. 

OWCP determined that there was a conflict in medical opinion between Dr. Ignacio, 

appellant’s treating physician, and Dr. Thompson, an OWCP referral physician, as to whether 

appellant had any continuing residuals or disability due to her accepted employment injuries. It 

 2

 OWCP found that Dr. Thompson’s report represented the weight of medical evidence as he provided objective 

findings and a comprehensive, well-reasoned medical report. It noted that Dr. Ignacio continually reported no 

change in appellant’s diagnosis or condition and failed to provide any objective findings to support his opinion that 

appellant remained totally disabled. 
4

referred appellant, together with a statement of accepted facts and the medical record, to 

Dr. David Dorin, a Board-certified orthopedic surgeon, for an impartial medical examination. 

In a February 22, 2013 report, Dr. Dorin reviewed the record, including the statement of 

accepted facts and provided an accurate history of injury. He noted that an April 29, 2011 MRI 

scan of the lumbar spine demonstrated significant narrowing and lumbar disc protrusion at the 

L4-5 and L5-S1 levels, narrowing and lumbar disc bulging at the L3-4 and L2-3 and flattening of 

the ventral portion of the thecal sac. A September 20, 2011 NCV study also revealed bilateral 

L5, right S1 radiculopathy. Dr. Dorin stated that diagnostic studies were indicative of structural 

preexisting significant abnormalities of the lumbar spine. He further noted that a review of 

Dr. Ignacio’s reports in 2011 indicated no evidence of improvement in appellant’s symptoms 

related to her lower back and extremity. 

Upon examination, Dr. Dorin observed reasonable range of motion of the lumbar spine 

and pain in the lumbar area. He noted some issues with a numbing sensation to the right lower 

extremity, but stated that it was not a typical radiculopathy to the lower extremities, right or left. 

Straight leg raise testing while sitting and in the supine position was about 70 degrees with no 

typical exacerbation of pain in the lumbar spine. Dr. Dorin reported that muscular structures in 

the lower extremities had satisfactory strength against resistance with no evidence of weakness. 

He opined that based on his review of appellant’s different physicians, her symptoms indicated 

that she sustained a sprain of the lower back involving the muscular structures of the lumbar 

spine on April 4, 2011. 

Dr. Dorin explained that the multiple x-ray and MRI scan reports that he reviewed 

demonstrated that appellant had a significant, preexisting significant abgnormalities of the 

lumbar spine. He also noted that she had facet arthropathy at multiple levels in the lower 

segments of the lumbar spine, several bulging discs at L3-4, L4-5 and L5-S1 protruding into the 

spinal canal and narrowing of the neural foramina at several levels on the right and left sides. 

Dr. Dorin explained that these conditions could not be produced by a simple sprain of the lumbar 

spine on April 4, 2011. He opined that these conditions were preexisting and unrelated to 

appellant’s work activities. Dr. Dorin stated that she was able to work in a sedentary nature 

where she could alternate four hours standing and four hours sitting with no lifting over 10 

pounds. He noted that appellant’s lumbar sprain healed a long time ago and there was no 

indication that continuing medical treatment, such as physical therapy, enhancement cocktails or 

repeat thermal testing would improve the pain. 

In reports dated March 14 to May 7, 2013, Dr. Ignacio stated that appellant continued to 

suffer from chronic pain of the back and right leg as a result of the April 4, 2011 employment 

injury. He reviewed the medical treatment she received and various diagnostic reports. Upon 

examination of the lumbar spine, Dr. Ignacio observed flexion to 70 degrees and limited motion 

with complaint of pain on extremes. He also reported spasm and tenderness to palpation along 

T6, T7, T8, T9, T10 and T11 and along L2-3, L3-4 and L5-S1 interspinous ligaments and 

paraspinal muscles. Straight leg raise testing was positive to 70 degrees on the right and 80 

degrees on the left. Examination of the cervical spine demonstrated restricted motion and 

continuing tenderness. Examination of the lower extremities revealed moderate restricted 

motion with hypoesthesia and severe weakness. Dr. Ignacio diagnosed post-traumatic lumbar 

spinal stenosis, chronic lumbar disc syndrome, chronic lumbar radiculitis, chronic thoracolumbar 
5

strain and chronic pain syndrome. He recommended that appellant continue with conservative 

pain regimen. Dr. Ignacio reported that she remained unable to return to work due to her 

medical conditions. In attending physician’s reports dated March 14 to October 31, 2013, he 

indicated that appellant was disabled from April 1 to November 30, 2013 and needed continued 

medical care. 

In a decision dated May 29, 2013, OWCP finalized the termination of appellant’s medical 

and wage-loss benefits effective May 29, 2013. It found that Dr. Dorin’s February 22, 2013 

report represented the weight of the medical evidence in establishing that appellant’s accepted 

conditions had ceased and that she no longer had any residuals or disability causally related to 

her accepted April 4, 2011 employment injuries. 

On July 10, 2013 OWCP received appellant’s request for an oral hearing, which was held 

on November 21, 2013. Appellant’s husband and daughter were present. Appellant described 

the April 4, 2011 employment injury and stated that she did not have any other injuries before or 

after the incident. Dr. Ignacio, appellant’s treating physician, also presented testimony. He 

disagreed with Dr. Dorin’s opinion that appellant’s lumbar conditions were preexisting. 

Dr. Ignacio pointed out that appellant was very healthy and able to work prior to the 

April 4, 2011 employment injury. He also stated that the diagnostic reports demonstrate a 

traumatic injury, not a degenerative condition. Dr. Ignacio further alleged that objective findings 

confirmed that appellant continued to suffer residuals of her accepted back conditions. He stated 

that she had significant damage to the lumbar disc, a significant strain of the lower ligaments and 

a lumbar disc injury causing significant damage to the nerve, which caused nerve entrapment. 

Dr. Ignacio pointed out that at least two MRI scan reports and an EMG examination 

demonstrated significant nerve damage to the right L5, S1 nerve roots and a significant disc 

injury of the L4-5 and L5-S1. He reported that appellant needed ongoing treatment for pain 

management and physical therapy. 

In reports dated June 12 and 28, 2013, Dr. Ignacio provided an accurate history of the 

April 4, 2011 employment injury and examination findings similar to his previous reports. He 

diagnosed chronic lumbar strain syndrome and aggravated lumbar disc syndrome with lumbar 

neuritis. Dr. Ignacio stated that appellant needed continued medical treatment for her conditions 

and remained permanently and totally disabled to return to work. He noted that he reviewed 

OWCP’s termination letter and Dr. Dorin’s report and disagreed with the findings. Dr. Ignacio 

alleged that Dr. Dorin failed to notice the electrodiagnostic and EMG studies which confirmed 

appellant’s accepted condition of lumbar neuritis sustained on April 4, 2011. He contended that 

the MRI scan confirmed the injury to the lumbar disc and therefore, appellant’s aggravated 

lumbar disc syndrome with lumbar neuritis was causally related to the April 4, 2011 employment 

injury. 

Dr. Ignacio stated that appellant sustained an acute injury to the lumbar spine resulting in 

acute lumbar strain, aggravated lumbar disc syndrome with lumbar neuritis. He explained that 

“the mechanism of injury [was] that of significant flexion-rotation strain to the lumbar spine 

causing significant damage to the bio-ligamentous support to the lumbar spine and a significant 

strain to the lumbar disc causing significant lumbar disc injury at the L4-5 level and a lumbar 

neuritis which had been confirmed again by the diagnostic study outlined above.” Dr. Ignacio 

concluded that appellant’s medical conditions had been confirmed by the objective examinations, 
6

MRI scan, electrodiagnostic/electromyography examinations and have required continuing 

medical treatment outlined above. He stated that she was not able to perform her job due to the 

April 4, 2011 injuries and was totally and permanently disabled. Dr. Ignacio continued to submit 

medical reports with similar examination findings regarding his treatment of appellant’s back 

complaints. 

By decision dated February 4, 2014, an OWCP hearing representative affirmed the 

May 29, 2013 termination decision, finding that the medical evidence established that appellant’s 

accepted conditions had ceased and that she no longer had any residuals or disability causally 

related to her accepted employment injuries.3

 

LEGAL PRECEDENT 

According to FECA, once OWCP accepts a claim and pays compensation, it has the 

burden of justifying termination or modification of an employee’s benefits.4

 OWCP may not 

terminate compensation without establishing that the disability had ceased or that it was no 

longer related to the employment.5

 Its burden of proof includes the necessity of furnishing 

rationalized medical opinion evidence based on a proper factual and medical background.6

 The 

right to medical benefits for an accepted condition is not limited to the period of entitlement for 

disability compensation.7 To terminate authorization for medical treatment, OWCP must 

establish that appellant no longer has residuals of an employment-related condition, which 

require further medical treatment.8

 

Section 8123(a) of FECA provides that if there is a disagreement between the physician 

making the examination for the United States and the physician of an employee, the Secretary 

shall appoint a third physician (known as a referee physician or impartial medical specialist) who 

shall make an examination.9 

 3

 OWCP’s hearing representative determined that the additional medical reports and hearing testimony were 

insufficient to overcome the special weight of medical opinion afforded to Dr. Dorin as the referee physician. 

4 S.F., 59 ECAB 642 (2008); Kelly Y. Simpson, 57 ECAB 197 (2005); Paul L. Stewart, 54 ECAB 824 (2003). 

5 Jason C. Armstrong, 40 ECAB 907 (1989); Charles E. Minnis, 40 ECAB 708 (1989); Vivien L. Minor, 37 

ECAB 541 (1986). 

6 See Del K. Rykert, 40 ECAB 284, 295-96 (1988). 

7 T.P., 58 ECAB 524 (2007); Kathryn E. Demarsh, 56 ECAB 677 (2005); A.P., Docket No. 08-1822 

(issued August 5, 2009). 

8 A.P., Docket No. 08-1822 (issued August 5, 2009); James F. Weikel, 54 ECAB 660 (2003); Pamela K. 

Guesford, 53 ECAB 727 (2002). 

9

 5 U.S.C. § 8123(a); see R.S., Docket No. 10-1704 (issued May 13, 2011); S.T., Docket No. 08-1675 

(issued May 4, 2009). 
7

ANALYSIS 

OWCP found that a conflict in medical opinion existed between appellant’s physician, 

and the second opinion examiner Dr. Ignacio, appellant’s physician, who found that she 

continued to suffer residuals of her work-related injuries and remained disabled. Dr. Thompson, 

the second opinion examiner, found that her work-related injuries had resolved and that appellant 

could return to full duty. It referred appellant to Dr. Dorin for an impartial medical examination 

to resolve the conflict in medical opinion. In a February 22, 2013 report, Dr. Dorin determined 

that there was no objective medical evidence to establish that appellant had residuals of her 

accepted conditions. OWCP determined that his opinion constituted the weight of the evidence 

and thereafter terminated appellant’s entitlement to disability compensation. 

The Board finds that OWCP failed to meet its burden of proof to terminate appellant’s 

disability compensation and medical benefits because the medical evidence does not establish 

that her work-related injuries had resolved. 

OWCP terminated appellant’s compensation benefits based on Dr. Dorin’s 

February 22, 2013 report. Dr. Dorin provided an accurate history of the April 4, 2011 

employment injury and conducted an examination. He observed reasonable range of motion of 

the lumbar spine and pain in the lumbar area. Straight leg raising testing while sitting and in the 

supine position was about 70 degrees with no typical exacerbation of pain in the lumbar spine. 

Dr. Dorin reported that muscular structures in the lower extremities had satisfactory strength 

with no evidence of weakness. He concluded that appellant was capable of sedentary work. The 

Board finds that as she was employed as a mail clerk on the date of injury, a medical opinion that 

she could return to sedentary work does not establish that disability has ceased.10 The Board 

finds that Dr. Dorin did not conclude with certainty that appellant was capable of returning to 

work. Dr. Dorin’s opinion that appellant is capable of sedentary work is insufficient to justify 

the termination of appellant’s wage-loss compensation benefits. 

Regarding whether appellant continued to suffer residuals of her accepted conditions, 

Dr. Dorin explained that the multiple x-ray and MRI scan reports demonstrated that appellant 

had a significant preexistent scoliosis or curvature of the lumbar spine of about 10 to 15 degrees 

to the left side and significant narrowing of the intervertebral spaces from L2-3, L3-4, L4-5 and 

L5-S1, which was indicative of discogenic disc disease and arthrosis. He stated that these 

conditions could not be produced by a simple sprain of the lumbar spine on April 4, 2011. 

Dr. Dorin opined that appellant’s conditions were preexisting and unrelated to her work 

activities. He concluded that her lumbar sprain healed a long time ago and there was no 

indication that continuing medical treatment would improve her pain. The Board finds that, 

although Dr. Dorin provided an opinion regarding appellant’s lumbar sprain, he did not 

affirmatively conclude that appellant’s lumbar neuritis and radiculitis had resolved. Dr. Dorin’s 

opinion is inconclusive and incomplete regarding whether appellant continued to suffer residuals 

of all her accepted April 4, 2011 lumbar conditions. He also stated that she had a preexisting 

condition. Dr. Dorin did not, however, provide any medical rationale for his conclusion. He did 

not reference any diagnostic reports or medical reports which demonstrated that appellant had a 

 10 See T.C., Docket No. 13-441 (issued June 4, 2013). 
8

preexisting lumbar condition. On the other hand, Dr. Dorin referenced various diagnostic reports 

which revealed that she had a lumbar disc injury and merely concluded that it was a preexisting 

condition. The Board has found that medical conclusions unsupported by medical rationale are 

of little probative value.11 Because Dr. Dorin did not affirmatively conclude that all of 

appellant’s accepted lumbar conditions had resolved, his report is insufficient to justify 

termination of her medical benefits. 

In assessing medical evidence, the weight of medical evidence is determined by its 

reliability, its probative value and its convincing quality. The factors that comprise the 

evaluation of medical opinion evidence include the opportunity for and thoroughness of physical 

examination, the accuracy or completeness of the physician’s knowledge of the facts and medical 

history, the care of analysis manifested and the medical rationale expressed in support of the 

physician’s opinion.12 In this case, the Board finds that the medical evidence and rationale 

supporting Dr. Dorin’s opinion is lacking. Accordingly, Dr. Dorin’s opinion has diminished 

probative value and is not entitled to special weight in resolving the conflict between 

Drs. Ignacio and Thompson. As that conflict remains unresolved, the Board will reverse 

OWCP’s February 4, 2014 decision and will remand the case for a proper reinstatement of 

compensation benefits. 

CONCLUSION 

The Board finds that OWCP did not meet its burden of proof to justify termination of 

appellant’s disability compensation and medical benefits. 

 11 J.F., Docket No. 09-1061 (issued November 17, 2009); A.D., 58 ECAB 149 (2006). 

12 Nicolette R. Kelstrom, 54 ECAB 570 (2003); Anna M. Delaney, 53 ECAB 384 (2002). 
9

ORDER 

IT IS HEREBY ORDERED THAT the February 4, 2014 decision of the Office of 

Workers’ Compensation Programs is reversed. 

Issued: September 18, 2014 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board