United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.S., Appellant

and

DEPARTMENT OF DEFENSE, DEFENSE 

PERSONNEL SUPPORT CENTER, 

Philadelphia, PA, Employer

__________________________________________

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Docket No. 17-1530

Issued: November 7, 2017

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 July 5, 2017 appellant filed a timely appeal from a June 20, 2017 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 to 

consider the merits of the case.2

ISSUE

The issue is whether OWCP properly suspended appellant’s compensation benefits

effective June 25, 2017 for failure to complete an EN1032 form as requested.

 

1

5 U.S.C. § 8101 et seq.

2 The Board notes that appellant submitted additional evidence after OWCP rendered its June 20, 2017 decision. 

The Board’s jurisdiction is limited to reviewing the evidence that was before OWCP at the time of its final decision. 

Therefore, this additional evidence cannot be considered by the Board. 20 C.F.R. § 501.2(c)(1).
2

FACTUAL HISTORY

OWCP accepted that in November 1992 appellant, a 41-year-old sewing machine 

operator, suffered left carpal tunnel syndrome as a result of factors of her federal employment. 

She received wage-loss compensation payments beginning December 3, 1992 and she was 

placed on the periodic rolls on August 7, 1996.

Once on the periodic compensation rolls OWCP regularly sends recipients of 

compensation a letter (Form CA-1032) requesting completion of an enclosed form (Form 

EN1032) with regard to employment activity, if any, within the past 15 months.3 By Form CA1032 dated April 19, 2017, it 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. OWCP notified appellant that she had to fully answer all 

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

suspended pursuant to 20 C.F.R. § 10.528. The letter was mailed to her address of record. No 

response was received. 

By decision dated June 20, 2017, OWCP suspended appellant’s compensation benefits 

effective June 25, 2017 for failing to complete 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 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

 

3 The EN1032 form also requests information with respect to dependents, receipt of other federal benefits, thirdparty settlements, and fraud offenses.

4

5 U.S.C. § 8106(b).

5

20 C.F.R. § 10.528. See also P.M., Docket No. 16-0382 (issued May 19, 2016); A.H., Docket No. 15-241 

(issued April 3, 2015).

6

Id.; see also 20 C.F.R. § 10.525.
3

ANALYSIS

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

effective June 25, 2017, for failure to complete the EN1032 form as requested. 

On April 19, 2017 OWCP provided appellant with the 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 Under the 

mailbox rule, a document mailed in the ordinary course of the sender’s business practices to the 

addressee’s last known address is presumed to be received by the addressee. 

Appellant failed to timely submit the EN1032 form within 30 days.8 She was receiving 

wage-loss compensation and she was required to complete the EN1032 form. The failure to file 

an EN1032 form within 30 days results in the suspension of compensation. Thus, the Board 

finds that OWCP properly suspended appellant’s compensation benefits effective June 25, 2017

pursuant to 20 C.F.R. § 10.528.9

On appeal appellant submitted additional evidence. The Board’s jurisdiction is limited to 

reviewing the evidence that was before OWCP at the time of its final decision.10 Therefore, this 

additional evidence cannot be considered by the Board. As noted, appellant’s benefits may be 

retroactively reinstated once she submits the EN1032 form to OWCP. 

CONCLUSION

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

effective June 25, 2017 for failure to complete an EN1032 form as requested. 

 

7

See Kenneth E. Harris, 54 ECAB 502, 505 (2003); J.J., Docket No. 13-1067 (issued September 20, 2013).

8

See I.S., Docket No. 15-0800 (issued July 7, 2015) (where the employee stated that she had not completed the 

forms in a timely manner because she had health issues and had been hospitalized for a short period on two 

occasions, the Board found that she had failed to timely submit the EN1032 form within 30 days and that suspension 

was proper. However, appellant was advised that compensation benefits would be reinstated retroactive to the date 

of suspension once she properly submitted the requested information to OWCP).

9

See P.M., supra note 5; M.W., Docket No. 15-0507 (issued June 18, 2015).

10 See supra note 2.
4

ORDER

IT IS HEREBY ORDERED THAT the June 20, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: November 7, 2017

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