United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.B., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS HEALTH ADMINISTRATION, 

Biloxi, MS, Employer 

__________________________________________ 

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Docket No. 16-1112 

Issued: September 19, 2016 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On May 2, 2016 appellant, through counsel, filed a timely appeal from a March 30, 2016 

merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the 

Federal Employees’ Compensation Act2 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board 

has jurisdiction over the merits of this case. 

 1

 In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for 

legal or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. 

§ 501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An 

attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject 

to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation. 

2

 5 U.S.C. § 8101 et seq. 
2

ISSUE 

The issue is whether appellant met her burden of proof to establish that she has more than 

five percent permanent impairment of her right thumb, for which she received a schedule award. 

FACTUAL HISTORY 

On July 22, 2011 appellant, then a 49-year-old nurse, filed a traumatic injury claim (Form 

CA-1) claiming that on July 18, 2011 she sustained injury when she hit her right thumb on a 

medical cart tray. OWCP initially accepted that appellant sustained a sprain of hand (right 

thumb) and it later expanded her claim to include acceptance of ulnar collateral ligament rupture 

of her right thumb.3

On July 21, 2011 Dr. Alexander Blevins, an attending Board-certified orthopedic 

surgeon, performed an ulnar collateral ligament repair of the metacarpophalangeal joint of 

appellant’s right thumb. The surgery was authorized by OWCP. 

In a June 12, 2012 report, Dr. Blevins noted that appellant reported her right thumb 

condition was “still the same” and that she was unable to bring her thumb all the way up to her 

palm. He indicated that she had five percent permanent impairment of her right thumb under 

Table 15-2 of the sixth edition of the American Medical Association, Guides to the Evaluation of 

Permanent Impairment (6th ed. 2009) (A.M.A., Guides). 

On November 20, 2014 appellant filed a claim for compensation (Form CA-7) claiming a 

schedule award due to her accepted work injury. 

Due to a lack of a recent impairment evaluation, OWCP referred appellant in March 2014 

for an examination and impairment evaluation to Dr. Joseph McGowin, III, a Board-certified 

orthopedic surgeon. 

In an April 15, 2015 report, Dr. McGowin described appellant’s factual and medical 

history and detailed the findings of his physical examination on that date. He noted that she 

reported pain in the metacarpophalangeal joint of her right thumb. Dr. McGowin recorded right 

thumb range of motion findings and noted that neurovascular examination of both hands was 

unremarkable. He diagnosed right thumb sprain, ulnar collateral ligament rupture, and surgical 

repair with objective findings of laxity and limited range of motion and subjective complaints of 

pain along the ulnar border of the metacarpophalangeal joint of the right thumb. Appellant had 

15 degrees of laxity of the right metacarpophalangeal joint upon extension and 10 degrees of 

laxity of the right metacarpophalangeal joint upon flexion. Dr. McGowin noted, “Impairment 

Rating from Table 15-2, page 392, is a class 1 impairment with a [grade modifier for functional 

history] equal to 1, a [grade modifier for physical examination] equal to 2, and [grade modifier 

for clinical studies] equal to 0. This results in an adjustment of 0 and a default impairment of 

five percent of the digit.” 

 3

 After her injury, appellant began working in a light-duty position for the employing establishment. She returned 

to full duty in April 2012. 
3

In a supplemental report dated April 28, 2015, Dr. McGowin noted, “Utilizing Table 15-2 

as provided in your notice, the five percent impairment rating of the thumb noted on the 

April 15, 2015 [second opinion evaluation] would translate to a two percent impairment of the 

hand or a two percent impairment of the upper extremity.” 

On May 1, 2015 an OWCP medical adviser indicated that he had reviewed the medical 

evidence of record, including the reports of Dr. McGowin. He noted that, under Table 15-2 on 

page 392 of the sixth edition of the A.M.A., Guides, appellant’s right thumb condition fell under 

the diagnosis category of thumb metacarpophalangeal sprain with 10 to 20 degrees of laxity. 

The medical adviser indicated that appellant fell under the class 1, grade C default value of five 

percent and noted that he agreed with Dr. McGowin’s assessment that she had a total right thumb 

impairment of five percent. 

In a May 1, 2015 report, another OWCP medical adviser indicated that appellant’s right 

thumb was the only area affected by the July 18, 2011 work injury. 

In a May 7, 2015 decision, OWCP granted appellant a schedule award for five percent 

permanent impairment of her right thumb. The award ran for 3.75 weeks from June 12 to July 8, 

2012 and was based on the impairment rating of OWCP’s medical adviser who evaluated the 

medical findings of record, including those of Dr. McGowin. 

Appellant, through counsel, requested a telephone hearing with an OWCP hearing 

representative. During the hearing held on January 12, 2016, counsel argued that appellant 

should have been given an impairment rating for her right hand or upper extremity. 

By decision dated March 30, 2016, OWCP’s hearing representative affirmed OWCP’s 

May 7, 2015 decision noting that appellant had not shown that she has more than five percent 

permanent impairment of her right thumb, for which she received a schedule award. She 

determined that the evidence of record did not show that appellant had permanent impairment 

that extended beyond her right thumb into other parts of her right hand or right upper extremity. 

LEGAL PRECEDENT 

The schedule award provision of FECA4 and its implementing regulations5 set forth the 

number of weeks of compensation payable to employees sustaining permanent impairment from 

loss, or loss of use, of scheduled members or functions of the body. However, FECA does not 

specify the manner in which the percentage of loss shall be determined. For consistent results 

and to ensure equal justice under the law to all claimants, good administrative practice 

necessitates the use of a single set of tables so that there may be uniform standards applicable to 

all claimants. The A.M.A., Guides has been adopted by the implementing regulations as the 

appropriate standard for evaluating schedule losses.6

 4

 5 U.S.C. § 8107. 

5

 20 C.F.R. § 10.404 (1999). 

6 W.B., Docket No. 14-1982 (issued August 26, 2015). For OWCP decisions issued after May 1, 2009, the sixth 

edition of the A.M.A., Guides is used. B.M., Docket No. 09-2231 (issued May 14, 2010). 
4

In determining impairment for the upper extremity under the sixth edition of the A.M.A., 

Guides, an evaluator must establish the appropriate diagnosis for each part of the upper extremity 

to be rated. With respect to the right thumb, the relevant portion of the right upper extremity for 

the present case, reference is made to Table 15-2 (Digit Regional Grid) beginning on page 391.7

 

After the Class of Diagnosis (CDX) is determined from the Digit Regional Grid (including 

identification of a default grade value), the net adjustment formula is applied using the grade 

modifier for Functional History (GMFH), grade modifier for Physical Examination (GMPE) and 

grade modifier for Clinical Studies (GMCS). The net adjustment formula is (GMFH-CDX) + 

(GMPE-CDX) + (GMCS-CDX).8

OWCP procedures provide that where the residuals of an injury to a member of the body 

specified in the schedule award provisions of FECA extend into an adjoining area of a member 

also enumerated in the schedule, such as an injury of the finger into the hand, or of the hand into 

the arm, the schedule award should be made on the basis of the percentage loss of use of the 

larger member.9 OWCP procedures also advise that in general, loss of one digit should be 

computed in terms of impairment to the digit itself, unless there is impairment extending to an 

adjoining member.10

ANALYSIS 

OWCP found that on July 18, 2011 appellant sustained a sprain of the hand (right thumb) 

and ulnar collateral ligament rupture of her right thumb. On July 21, 2011 she underwent 

OWCP-authorized ulnar collateral ligament repair of the metacarpophalangeal joint of her right 

thumb. Appellant claimed entitlement to schedule award compensation and on May 7, 2015 

OWCP granted her a schedule award for five percent permanent impairment of her right thumb. 

The award was based on the May 2015 impairment rating of OWCP’s medical adviser who 

evaluated the medical findings of record, including those obtained by Dr. McGowin. 

The Board finds that appellant did not meet her burden of proof to establish that she has 

more than five percent impairment of her right thumb, for which she received a schedule award. 

The Board finds that the May 1, 2015 evaluation of OWCP’s medical adviser shows, 

which includes the clinical findings of Dr. McGowin, that appellant does not have more than five 

percent impairment of her right thumb. The medical adviser properly noted that, under Table 15-

2 on page 392 of the sixth edition of the A.M.A., Guides, appellant’s right thumb condition fell 

under the diagnosis category of thumb metacarpophalangeal sprain with 10 to 20 degrees of 

laxity.11 He indicated that appellant fell under the class 1, grade C default value of five percent 

 7 See A.M.A., Guides 391-405 (6th ed. 2009). 

8 Id. at 405-11. 

9

 Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, 

Chapter 2.808.5e (February 2013); see Tonya D. Bell, 43 ECAB 845, 849 (1992). 

10 See id.

11 A.M.A., Guides 392, Table 15-2. 
5

on Table 15-2 and correctly noted that application of the net adjustment formula to the grade 

modifiers (grade modifier for functional history of 1, grade modifier for physical examination of 

2, and grade modifier for clinical studies of 0) meant that appellant did not move from the default 

value of five percent.12 Therefore, appellant has a total right thumb impairment of five percent. 

The record does not contain a rationalized impairment rating showing that appellant has more 

than five percent permanent impairment of her right thumb. 

On appeal counsel argues that appellant’s impairment rating extends beyond her right 

thumb into her right upper extremity and that she has two percent permanent impairment of her 

right upper extremity. As noted above, when residuals of an injury to a member of the body 

specified in the schedule award provisions of FECA extend into an adjoining area of a member also 

enumerated in the schedule, the schedule award should be made on the basis of the percentage of 

loss of use of the larger member.13 In the present case, the evidence demonstrates that appellant 

sustained five percent permanent impairment of her right thumb. There is no evidence that 

residuals of appellant’s work injury extended into an adjoining area of the affected member.14 

Therefore, there is no basis for converting the schedule award to an award for the right hand or 

right upper extremity. For these reasons, appellant has not shown that she has more than five 

percent impairment of her right thumb. 

Appellant may request a schedule award or increased schedule award based on evidence 

of a new exposure or medical evidence showing progression of an employment-related condition 

resulting in permanent impairment or increased impairment. 

CONCLUSION 

The Board finds that appellant did not meet her burden of proof to establish that she has 

more than five percent permanent impairment of her right thumb, for which she received a 

schedule award. 

 12 See supra note 7. 

13 See supra note 8. 

14 In a report dated April 28, 2015, Dr. McGowin noted, “Utilizing Table 15-2 as provided in your notice, the five 

percent impairment rating of the thumb noted on the April 15, 2015 [second opinion evaluation] would translate to a 

two percent impairment of the hand or two percent impairment of the upper extremity.” However, Dr. McGowin 

did not provide any explanation of how appellant’s right thumb impairment extended into her right hand or right 

upper extremity. 
6

ORDER 

IT IS HEREBY ORDERED THAT the March 30, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: September 19, 2016 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board