United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.C., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Chicago, IL, Employer 

__________________________________________ 

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Docket No. 16-0284 

Issued: June 27, 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 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On December 1, 2015 appellant filed a timely appeal of a November 6, 2015 merit 

decision and a November 18, 2015 nonmerit 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

ISSUES 

The issues are: (1) whether appellant has established a recurrence of disability for 

intermittent periods from August 1 to 10, 2015 causally related to her accepted right shoulder 

condition; and (2) whether OWCP properly denied appellant’s November 11, 2015 claim for 

reconsideration of the merits under 5 U.S.C. § 8128(a). 

 1

 5 U.S.C. § 8101 et seq.

2

 The Board notes that appellant submitted additional evidence following the November 18, 2015 nonmerit 

decision. Since the Board’s jurisdiction is limited to evidence that was before OWCP at the time it issued its final 

decision, the Board may not consider this evidence for the first time on appeal. See 20 C.F.R. § 501.2(c)(1); 

Sandra D. Pruitt, 57 ECAB 126 (2005). 
2

FACTUAL HISTORY 

This case has previously been before the Board.3 The pertinent facts are set forth below. 

On October 26, 2009 appellant, then a 44-year-old part-time, flexible city carrier, filed an 

occupational disease claim (Form CA-2) alleging that she experienced right shoulder pain and 

tingling in her right arm. She explained that she noticed in September that her right arm would 

be painful after work. Appellant did not stop work. OWCP accepted her claim for right 

shoulder pain, partial tear of the right shoulder with tendinosis, right rotator cuff impingement, 

and internal derangement of the right acromioclavicular (AC) joint. 

On January 25, 2010 appellant stopped work and filed a claim for compensation 

beginning January 25, 2010. OWCP paid disability compensation until June 16, 2010 when she 

accepted a modified job offer as a part-time, flexible carrier. Appellant continued to receive 

medical treatment and intermittent disability compensation for medical appointments. 

On December 6, 2010 appellant underwent authorized right shoulder arthroscopic 

subacromial decompression surgery. She stopped work and received disability compensation. 

On September 2, 2011 appellant returned to light duty. She again stopped work on October 23, 

2011, when the employing establishment could no longer accommodate her work restrictions, 

and was placed on the periodic rolls. On January 17, 2012 appellant returned to light-duty work, 

but continued to receive medical and intermittent disability compensation benefits. 

On February 27, 2012 OWCP expanded the accepted condition to include right shoulder 

superior lateral tear from anterior to posterior (SLAP) tear and adhesive capsulitis. Appellant 

stopped work again on February 28, 2012 when she underwent another right shoulder surgery 

and was placed back on the periodic rolls. On September 4, 2012 she returned to full-time light 

duty. 

By decision dated April 12, 2013, OWCP granted appellant a schedule award for 15 

percent permanent impairment of the right upper extremity. 

On June 2, 2014 appellant underwent a third right shoulder surgery, stopped work, and 

was paid disability compensation. On February 17, 2015 she was returned to the periodic rolls. 

On April 27, 2015 appellant returned to full-time light duty. She stopped work again on 

May 21, 2015 and received disability compensation benefits. Appellant continued to receive 

medical treatment. 

 3

 This case was previously before the Board in Docket No. 12-1274 (issued December 3, 2012). The Board 

affirmed in part and set aside in part the May 7, 2012 decision of OWCP. The Board found that appellant had 

received an overpayment of compensation in the amount of $4,757.39 because she continued to receive total 

disability compensation benefits even though she had returned to limited duty on September 2, 2011, but it also 

determined that she was not at fault with regard to the first compensation payment via direct deposit that she 

received after her return to work. The Board remanded the case for OWCP to determine whether she was entitled to 

waiver of recovery of the overpayment. The Board also found that appellant had abandoned her request for a 

prerecoupment hearing. The facts and circumstances of the case, as set forth in the Board’s prior decision, are 

incorporated herein by reference. 
3

On July 13, 2015 appellant underwent a magnetic resonance imaging (MRI) scan 

examination of her right shoulder by Dr. Eric Fitzcharles, a Board-certified diagnostic 

radiologist. He related that appellant experienced pain and limited range of motion following a 

2009 work injury. Dr. Fitzcharles reported a partial tear in the distal subscapularis tendon, 

possibly with a slender contact of the deep margin of the tendon, a cyst in the anterior 

infraspinatus musculotendinous junction and in the posterior supraspinatus musculotendinous 

junction, and slight interstitial partial tearing in the supraspinatus tendon insertion. He also noted 

acromioplasty changes, mild-to-moderate AC joint arthrosis, mild subacromial bursitis, and 

rotator cuff tendinosis. 

In a July 21, 2015 report, Dr. Ankur Chhadia, a Board-certified orthopedic surgeon, 

related appellant’s complaints of pain, swelling, knotting, and tightness in her neck and right 

shoulder area and some numbness and tingling in her right arm. He reviewed her most recent 

MRI scan, which found bursitis, but no rotator cuff tear. Upon examination of appellant’s right 

shoulder, Dr. Chhadia observed no effusion, swelling, or atrophy. He provided range of motion 

findings and reported no tenderness on impingement or rotator cuff. Neurovascular examination 

also revealed 5/5 strength and 2+ distal pulses. Upon examination of appellant’s neck, 

Dr. Chhadia observed no tenderness on palpation and full range of motion with no pain. He 

diagnosed right shoulder bursitis and tendinitis. In a work-duty status, Dr. Chhadia reported that 

appellant could work light duty beginning July 28, 2015 with restrictions of no lifting more than 

30 pounds. 

On July 28, 2015 appellant returned to light duty. A telephone memorandum of record 

related that she informed OWCP that her physician took her off work from time to time due to 

swelling and inflammation in her right shoulder. 

Dr. Chhadia continued to treat appellant. In an August 3, 2015 note, he noted that she 

was seen in his office that day and he opined that she should be off work due to swelling of her 

right shoulder, bursitis, and tendinitis. 

In an August 4, 2015 medical report, Dr. Chhadia related that he had examined appellant 

for complaints of pain, swelling, tightness, and stiffness in her shoulder and neck area. He noted 

a history of an unspecified rotator cuff tear or rupture of the right shoulder. Dr. Chhadia reported 

that appellant performed extensive repetitive work and observed pain in her shoulder over time. 

Upon examination, he observed no effusion, swelling, or atrophy of the right shoulder and no AC 

joint tenderness on palpation. Dr. Chhadia reported range of motion findings of forward flexion 

to 100 degrees, external rotation to 10 degrees, and internal rotation to the lower thoracic spine. 

Neer and Hawkin’s impingement signs were positive. Dr. Chhadia further observed no 

tenderness of the right shoulder rotator cuff. He indicated that the right shoulder MRI scan 

revealed bursitis with no rotator cuff tear. Dr. Chhadia diagnosed shoulder bursitis and 

tendinitis. He related that appellant requested a work note for August 1 to 4, 2015 due to 

worsening pain levels to her right shoulder. Dr. Chhadia reported that appellant could continue 

to work light duty. He provided a work-duty status note, which indicated that appellant was on 

permanent light-duty restrictions of occasional lifting up to 25 pounds, occasional pushing, 

pulling, and carrying up to 30 pounds, and working above the shoulder with her right arm for up 

to one hour. 
4

On August 27, 2015 OWCP received appellant’s compensation claim for intermittent 

periods of disability (Form CA-7) from August 1 to 10, 2015 for a total of 32 hours. On the time 

analysis form, appellant indicated that on August 1, 3, 4, and 10, 2015 the physician took her off 

work because of a swollen shoulder. 

In narrative reports dated August 31 to October 20, 2015, Dr. Chhadia related appellant’s 

complaints of pain, swelling, stiffness, and tightness in her right shoulder. He noted that he 

examined her on August 4, 2015 and recounted that she had been feeling worse since her last 

visit with severe aches and pain. Dr. Chhadia reviewed appellant’s history and noted that she 

had undergone three surgeries for the right shoulder. Upon examination of her right shoulder, he 

observed no swelling, effusion, or atrophy. Dr. Chhadia also noted no tenderness of the AC joint 

and no tenderness of the right rotator cuff. Subscapularis strength and infraspinatus strength 

were 5/5. Dr. Chhadia provided range of motion findings and diagnosed right shoulder bursitis 

and tendinitis. In an October 20, 2015 report, he opined that appellant had 12 percent permanent 

impairment of the right upper extremity. In work status notes, Dr. Chhadia indicated that she 

was on permanent light duty of lifting up to 25 pounds and pushing, pulling, and carrying up to 

30 pounds. 

On October 22, 2015 Dr. Chhadia examined appellant and provided a work-duty status 

note. He noted that she could perform the duties of her current route with permanent restrictions 

of occasional lifting up to 20 pounds, occasional pushing/pulling and carrying up to 30 pounds, 

and working above the right shoulder for one hour. Dr. Chhadia explained that “the repetition of 

[appellant’s] job periodically aggravates her condition which causes swelling, inflammation, and 

tenderness.” He noted that this was the reason appellant was out periodically from work to rest 

the shoulder. 

In a letter dated September 8, 2015, OWCP advised appellant that the evidence submitted 

was insufficient to establish total disability for the intermittent periods claimed. It requested 

additional medical evidence to establish that she was unable to work on the dates claimed as a 

result of her employment injury. 

By e-mails dated September 29 to 30, 2015, OWCP inquired from Jessie Tucker, a 

human resource specialist for the employing establishment, if appellant’s limited-duty job was 

still available. Mr. Tucker informed OWCP that the limited-duty position was still available. He 

also noted that appellant had been taking off and on from work from August 13 to 

September 28, 2015. Mr. Tucker explained that this was a pattern for her to be absent without 

leave for some days and then return to work for a day or two. 

In a decision dated November 6, 2015, OWCP denied appellant’s claim for disability 

compensation for the period August 1 to 10, 2015. It found that the medical evidence failed to 

establish total disability on the claimed dates due to her employment injury. 

On November 11, 2015 OWCP received appellant’s handwritten statement requesting 

reconsideration. Appellant noted that August 4 and 18, 2015 were the physician’s appointments 

and that on the other days Dr. Chhadia had her off work due to swelling of her right shoulder. 

Appellant resubmitted Dr. Chhadia’s October 20, 2015 impairment evaluation report. 
5

By decision dated November 18, 2015, OWCP denied appellant’s November 11, 2015 

reconsideration request. It found that the evidence submitted in support of reconsideration was 

insufficient to warrant further merit review under 5 U.S.C. § 8128(a). 

LEGAL PRECEDENT -- ISSUE 1 

An employee seeking benefits under FECA bears the burden of proof to establish the 

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

claimed, the employee must establish that she was disabled for work as a result of the accepted 

employment injury. 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 reliable, probative, and substantial medical opinion evidence.4 Findings on 

examination and a physician’s opinion, supported by medical rationale, are needed to show how 

the injury caused the employee’s disability for his or her particular work.5

 For each period of 

disability claimed, the employee must establish that she was disabled for work as a result of the 

accepted employment injury. 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 

his or her disability and entitlement to compensation.6

When the employee who is disabled from the job she held when injured on account of 

employment-related residuals returns to a light-duty position or the medical evidence establishes 

that she can perform the light-duty position, the employee has the burden of establishing by the 

weight of the evidence that she cannot perform such light duty. As part of this burden, the 

employee must show a change in the nature and extent of the injury-related condition or a change 

in the nature and extent of the light-duty job requirements.7

With respect to claimed disability for medical treatment, section 8103 of FECA provides 

for medical expenses, along with transportation and other expenses incidental to securing 

medical care, for injuries.8 Appellant would be entitled to compensation for any time missed 

from work due to medical treatment for an employment-related condition. OWCP’s obligation 

to pay for medical expenses and expenses incidental to obtaining medical care, such as loss of 

wages, extends only to expenses incurred for treatment of the effects of any employment-related 

condition. Appellant has the burden of proof, which includes the necessity to submit supporting 

rationalized medical evidence.9

 4 Amelia S. Jefferson, 57 ECAB 183 (2005); William A. Archer, 55 ECAB 674 (2004). 

5 Dean E. Pierce, 40 ECAB 1249 (1989). 

6 Amelia S. Jefferson, supra note 4. 

7 Terry R. Hedman, 38 ECAB 222 (1986).

8

 5 U.S.C. § 8103(a). 

9 Dorothy J. Bell, 47 ECAB 624 (1996); Zane H. Cassell, 32 ECAB 1537 (1981). 
6

ANALYSIS -- ISSUE 1 

On May 6, 2010 OWCP accepted that appellant sustained several right shoulder 

conditions, including partial tear of the right shoulder with tendinosis, right rotator cuff 

impingement, internal derangement of the right AC joint, right shoulder SLAP tear, and adhesive 

capsulitis, as a result of her employment as a mail carrier. She worked modified duty beginning 

June 16, 2010. Appellant underwent three surgeries to her right shoulder. She was on and off 

work due to recovery from surgery and withdrawal of her light-duty assignment. 

On August 27, 2015 OWCP received appellant’s claim for intermittent periods of 

disability from August 1 to 10, 2015 for a total of 32 hours. Appellant indicated that on 

August 1, 3, 4, and 10, 2015 the physician took her off work because of a swollen shoulder. 

The medical evidence relevant to appellant’s claimed dates of disability include various 

reports by Dr. Chhadia. In an August 3, 2015 note, he indicated that she needed to be off work 

due to swelling of her right shoulder, bursitis, and tendinitis. Although Dr. Chhadia opined that 

appellant was unable to work due to her right shoulder condition, the Board finds that he did not 

provide any objective examination findings or explanation for why she could no longer work in 

her modified-duty position. The Board has held that medical conclusions unsupported by 

rationale are of diminished probative value and insufficient to establish causal relationship.10 

Dr. Chhadia did not provide any medical rationale or objective evidence that explained why 

appellant was no longer able to work modified duty on August 3, 2015 as a result of her 

employment injury. 

In an August 4, 2015 report, Dr. Chhadia related appellant’s complaints of pain, swelling, 

tightness, and stiffness in her right shoulder and neck. He reviewed her history and noted that 

she did a lot of repetitive work. Upon examination, Dr. Chhadia observed no effusion, swelling, 

or atrophy of the right shoulder and no AC joint tenderness on palpation. He provided range of 

motion findings and noted that Neer and Hawkin’s impingement signs were positive. 

Dr. Chhadia reported that the right shoulder MRI scan revealed bursitis with no rotator cuff tear. 

He diagnosed shoulder bursitis and tendinitis and opined that appellant could continue to work 

light duty. Dr. Chhadia related that appellant requested a work note for August 1 to 4, 2015, but 

he found that she was able to continue to work light duty. 

The Board has held that when a physician’s statement regarding an employee’s ability to 

work consists only of repetition of the employee’s complaints that he or she hurts too much to 

work, without objective findings of disability being shown, the physician has not presented a 

medical opinion on the issue of disability.11 In this case, Dr. Chhadia merely reiterated 

appellant’s complaints that she was unable to work due to worsening right shoulder pain, but 

opined that she could continue to work light duty. The Board finds that as Dr. Chhadia did not 

provide any physical examination findings to support that appellant was totally disabled from 

work on the claimed dates due to her right shoulder condition, his report is insufficient to 

establish her intermittent disability claim. 

 10 P.D., Docket No. 14-744 (issued August 6, 2014); S.B., Docket No. 13-1162 (issued December 12, 2013). 

11 P.D., id.; G.T., 59 ECAB 447 (2008). 
7

In an October 22, 2015 work status note, Dr. Chhadia again examined appellant and 

opined that she could perform the duties of her current route with permanent restrictions. He 

reported that the repetitive nature of her job periodically aggravated her condition, causing 

swelling, inflammation, and tenderness. Dr. Chhadia explained that this was the reason appellant 

was out periodically from work in order to rest the shoulder. The Board notes that even though 

Dr. Chhadia opined that appellant would periodically be out of work due to her right shoulder 

condition, he did not cite to objective examination findings of disability nor provide specific 

dates for when she was unable to work light duty due to her accepted right shoulder condition. 

Accordingly, the Board finds that Dr. Chhadia’s opinion lacks both medical rationale and 

particularity for the claimed dates of disability.12 Because Dr. Chhadia failed to provide a 

rationalized medical opinion explaining how appellant was unable to work modified duty for 

intermittent periods from August 1 to 10, 2015 his reports are of diminished probative value. 

On appeal, appellant alleges that her physician’s statements should be sufficient to 

establish disability for the period since her physician reported that there would be periodic times 

when she will be off work due to swollen shoulder. As previously noted, self-certification of 

disability is not sufficient13 and the medical reports she submitted failed to establish the claimed 

periods of intermittent disability from August 1 to 10, 2015. Because appellant did not submit 

medical reports providing rationalized medical opinion explaining why she was unable to work 

light duty on the specific dates of disability, the Board finds that OWCP properly denied her 

claim for intermittent periods of disability for the period August 1 to 10, 2015. 

The Board finds, however, that the case is not in posture for decision regarding whether 

appellant is entitled to compensation on August 3 and 4, 2015 for medical treatment. OWCP’s 

procedures provide that wages lost for compensable medical examination or treatment may be 

reimbursed.14 It notes that a claimant who has returned to work following an accepted injury or 

illness may need to undergo examination or treatment and such employee may be paid 

compensation for wage loss while obtaining medical services and for a reasonable time spent 

traveling to and from the medical provider’s location.15 As a rule, no more than four hours of 

compensation or continuation of pay should be allowed for routine medical appointments. 

Longer periods of time may be allowed when required by the nature of the medical procedure 

and/or the need to travel a substantial distance to obtain the medical care.16 

The record contains medical evidence that establishes that appellant received medical 

treatment on August 3 and 4, 2015 from Dr. Chhadia. If appellant were receiving medical 

treatment for her accepted right shoulder condition on these dates, the Board finds that she could 

be paid wage-loss compensation up to four hours for obtaining medical services and for a 

 12 See V.C., Docket No. 14-1230 (issued December 29, 2014). 

13 Supra note 6. 

14 Federal (FECA) Procedure Manual, Part 2 -- Claims, Computing Compensation, Chapter 2.901.19 

(February 2013). 

15 Daniel Hollars, 51 ECAB 355 (2000); Jeffrey R. Davis, 35 ECAB 950 (1984). 

16 Supra note 14 at Part 3 -- Medical, Administrative Matters, Chapter 3.900.8 (November 1998). 
8

reasonable time spent traveling to and from the medical provider’s location. The case will be 

remanded for OWCP to determine whether she is entitled to up to four hours of wage-loss 

compensation for both dates of these medical appointments and travel time. 

LEGAL PRECEDENT -- ISSUE 2 

Section 8128(a) of FECA vests OWCP with discretionary authority to determine whether 

to review an award for or against compensation. The Secretary of Labor may review an award 

for or against payment of compensation at any time on her own motion or on application.17 

To require OWCP to reopen a case for merit review pursuant to FECA, the claimant must 

provide evidence or an argument that: (1) shows that OWCP erroneously applied or interpreted 

a specific point of law; (2) advances a relevant legal argument not previously considered by 

OWCP; or (3) constitutes relevant and pertinent new evidence not previously considered by 

OWCP.18 

A request for reconsideration must also be received by OWCP within one year of the date 

of OWCP’s decision for which review is sought.19 If OWCP chooses to grant reconsideration, it 

reopens and reviews the case on its merits.20 If the request is timely but fails to meet at least one 

of the requirements for reconsideration, OWCP will deny the request for reconsideration without 

reopening the case for review on the merits.21

ANALYSIS -- ISSUE 2 

The Board finds that appellant has not shown that OWCP erroneously applied or 

interpreted a specific point of law, she has not advanced a relevant legal argument not previously 

considered by OWCP, and she has not submitted relevant and pertinent new evidence not 

previously considered by OWCP. 

By decision dated November 6, 2015, OWCP denied appellant’s claim finding that the 

evidence failed to establish that she was unable to work modified duty for intermittent periods 

from August 1 to 10, 2015. In a narrative statement received by OWCP on November 11, 2015, 

she requested reconsideration. Appellant submitted an October 20, 2015 report by Dr. Chhadia 

that OWCP had previously considered. This report, however, is insufficient to warrant further 

merit review as the submission of evidence which repeats or duplicates evidence already in the 

case record does not constitute a basis for reopening a case.22 

 17 5 U.S.C. § 8128(a). 

18 20 C.F.R. § 10.606(b)(3); see also L.G., Docket No. 09-1517 (issued March 3, 2010); C.N., Docket No. 08-

1569 (issued December 9, 2008). 

19 Id. at § 10.607(a). 

20 Id. at § 10.608(a); see also M.S., 59 ECAB 231 (2007). 

21 Id. at § 10.608(b); E.R., Docket No. 09-1655 (issued March 18, 2010). 

22 E.M., Docket No. 09-39 (issued March 3, 2009); D.K., 59 ECAB 141 (2007). 
9

As appellant also failed to submit any evidence along with her request for reconsideration 

to show that OWCP erroneously applied or interpreted a specific point of law, or that advances a 

relevant legal argument not previously considered by OWCP, she did not meet the necessary 

requirements, for a further merit review.23 

The Board finds that appellant failed to submit relevant and pertinent new evidence, a 

relevant legal argument not previously considered by OWCP, or evidence or argument which 

shows that OWCP erroneously applied or interpreted a specific point of law. Therefore, OWCP 

properly refused to reopen her case for further consideration of the merits of her claim under 5 

U.S.C. § 8128. 

CONCLUSION 

The Board finds that OWCP properly denied appellant’s claim for intermittent disability 

from August 1 to 10, 2015 but that this case is not in posture for a decision as to whether she is 

entitled to wage-loss benefits for the August 4 and 5, 2015 medical appointments. On remand 

OWCP shall issue a de novo decision on this issue. The Board also finds that OWCP properly 

denied further merit review of appellant’s claim. 

 23 L.H., 59 ECAB 253 (2007). 
10

ORDER 

IT IS HEREBY ORDERED THAT the November 6, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed in part and remanded in part and the 

November 18, 2015 decision is affirmed. 

Issued: June 27, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board