United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

P.M., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS HEALTH ADMINISTRATION, 

DC VETERANS MEDICAL CENTER, 

Washington, DC, Employer 

__________________________________________ 

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Docket No. 15-0674 

Issued: July 10, 2015 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

JURISDICTION 

On February 9, 2015 appellant filed a timely appeal from a December 16, 2014 merit 

decision of the Office of Workers’ Compensation Programs (OWCP).1

 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. 

ISSUE 

The issue is whether OWCP properly suspended appellant’s compensation for failing to 

submit a Form EN1032, as requested. 

 1

 Subsequent to the filing of her appeal, appellant passed away on April 27, 2015. 

2

 5 U.S.C. § 8101-8193. 
2

FACTUAL HISTORY 

OWCP accepted that on July 20, 1992 appellant, then a 43-year-old employee, suffered a 

sprain of left shoulder and upper arm and displacement of cervical intervertebral disc without 

myelopathy and paid FECA benefits. She was eventually retained on the periodic compensation 

rolls. 

On October 7, 2014 OWCP informed appellant that federal regulations required her to 

make an affidavit relative to any earnings or employment during the previous year and that an 

EN1032 form was enclosed for that purpose. It notified her that she had to fully answer all 

questions on the form and return the statement within 30 days or her benefits would be 

suspended. The letter was mailed to appellant’s address of record. Appellant did not respond. 

By decision dated December 16, 2014, OWCP suspended appellant’s compensation 

benefits, effective January 11, 2014,3 for failing to submit the EN1032 form, as requested. It 

noted that, if she completed and returned an enclosed copy of the form, her compensation 

benefits would be restored retroactively to the date they were suspended. 

LEGAL PRECEDENT 

FECA authorizes the Secretary of Labor to require a partially disabled employee to report 

his or her earnings from employment or self-employment, by affidavit or otherwise, in the 

manner and at the times the Secretary specifies.4 

Under section 10.528 of OWCP’s implementing federal regulations, an employee in 

receipt of compensation benefits must complete an affidavit as to any work or activity indicating 

an ability to work which the employee has performed for the prior 15 months.5

 If an employee 

who is required to file such a report fails to do so within 30 days of the date of the request, his or 

her right to compensation for wage loss is suspended until OWCP receives the requested report. 

At that time, OWCP will reinstate compensation retroactive to the date of suspension if the 

employee remains entitled to compensation.6

 

ANALYSIS 

On October 7, 2014 OWCP provided appellant with an EN1032 form. It notified her that 

federal regulations required her to complete the form and answer all questions concerning her 

employment or earnings. OWCP properly notified appellant that, if she did not completely 

answer all questions and return the statement within 30 days, her benefits would be suspended. 

The record reflects that OWCP’s letter was properly sent to her address of record.7

 The record 

 3

 The record reflects that benefits were suspended as of January 11, 2015. 

4 Id. at § 8106(b). 

5

 20 C.F.R. § 10.528. 

6 Id.; see also id. at § 10.525. 

7 See J.J., Docket No. 13-1067 (issued September 20, 2013). 
3

does not establish that appellant responded prior to the December 16, 2014 OWCP decision. 

Based on the evidence of record, the Board finds that OWCP properly suspended her 

compensation benefits pursuant to 20 C.F.R. § 10.528.8 

On appeal appellant contends that she was hospitalized from November 2014 until 

January 23, 2015 and could not get her paperwork ready as she was not home to check on her 

mail. She argued that she should not be penalized for being ill and she would prepare the 

appropriate paperwork and mail it to OWCP. Appellant provided the name and number of her 

physician and social worker to verify that she was hospitalized during the claimed time frame. 

OWCP properly informed her that her benefits would be retroactively reinstated when she 

completed and submitted the EN1032 form to OWCP. 

CONCLUSION 

The Board finds that OWCP properly suspended appellant’s compensation benefits for 

failing to submit information on a EN1032 form, as required. 

ORDER 

IT IS HEREBY ORDERED THAT the December 16, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: July 10, 2015 

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 

 8 J.J., Docket No. 09-1724 (issued March 1, 2010). See also James A. Igo, 49 ECAB 189 (1997).