United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.W., Appellant 

and 

DEPARTMENT OF THE AIR FORCE, 

MAXWELL AIR FORCE BASE, AL, Employer 

__________________________________________ 

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Docket No. 16-1554 

Issued: December 12, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se 

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 July 26, 2016 appellant filed a timely appeal from a June 30, 2016 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.2

ISSUE 

The issue is whether appellant met her burden of proof to establish more than 30 percent 

permanent impairment of the left upper extremity for which she received a schedule award. 

On appeal appellant asserts that she is entitled to a greater impairment, as shown by 

medical evidence contained in the record. 

 1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that appellant submitted evidence with her appeal to the Board. The Board cannot consider this 

evidence as its jurisdiction is limited to the evidence of record that was before OWCP at the time it issued its final 

decision. 20 C.F.R. § 501.2(c)(1); P.W., Docket No. 12-1262 (issued December 5, 2012). 
2

FACTUAL HISTORY 

OWCP accepted that on May 4, 1983 appellant, then a 40-year-old clerk typist, sprained 

her left wrist, and that on July 29, 1983 she sustained left carpal tunnel syndrome and left 

thoracic outlet syndrome (brachial plexus lesions). The claims were combined, with the July 29, 

1983 claim becoming the master file.3 Appellant had a left carpal tunnel release in August 1983 

and thoracic outlet procedures in July 1988 and January 1989. She received total disability 

compensation from August 1983 until she returned to work in January 1990 as a medical clerk at 

the employing establishment mental health clinic.4

 Appellant’s position was abolished on 

April 5, 1991. She was returned to the periodic compensation rolls at that time. In 1994 

appellant began treatment with Dr. Earl M. Simmons, a Board-certified surgeon, and other 

physicians at American Family Care in Montgomery, Alabama. 

In a November 20, 2002 decision, OWCP reduced appellant’s wage-loss compensation 

based on her capacity to earn wages as a hotel clerk, effective December 1, 2002. By utilizing 

the Shadrick formula,5

 it found that appellant had 48 percent loss of wage-earning capacity. 

Appellant filed a claim for a schedule award. A June 29, 2006 impairment evaluation 

was completed by Dave Bledsoe, an occupational therapist. Dr. Bledsoe opined that appellant 

had 39 percent left upper extremity permanent impairment due to loss of left shoulder motion 

and grade 3 sensory and motor deficits of the left upper extremity. 

An OWCP medical adviser reviewed Dr. Bledsoe’s report and noted that the therapist did 

not properly apply the fifth edition of the American Medical Association, Guides to the 

Evaluation of Permanent Impairment (hereinafter A.M.A., Guides).6 He found that, in 

accordance with Figure 16-40, Figure 16-43, and Figure 16-46, appellant had 11 percent left arm 

impairment due to loss of left shoulder motion. The medical adviser found that, for grade 3 

sensory and motor impairments, in accordance with Table 16-10, Table 16-11, and Table 16-15, 

appellant had a median nerve impairment of 12 percent and an ulnar nerve impairment of 10 

percent. He combined the total 22 percent sensory and motor impairments with the 11 percent 

impairment for loss of shoulder motion, and concluded that appellant had a total of 30 percent 

permanent impairment of the left upper extremity. 

By decision dated December 12, 2007, OWCP granted appellant a schedule award for 30 

percent permanent impairment of the left arm. For the period of the schedule award, 

December 1, 2007 to September 16, 2009, appellant received compensation at the total disability 

rate. Thereafter, she was then placed back on the periodic rolls at the loss of wage-earning 

capacity rate for the constructive position of a hotel clerk where she remains to date. 

 3

 The May 1983 claim was adjudicated by OWCP under File No. xxxxxx575, and the July 1983 claim under File 

No. xxxxxx901. 

4

 In a January 31, 1990 decision, OWCP reduced appellant’s compensation based on her earnings as a medical 

clerk. 

5 Albert C. Shadrick, 5 ECAB 376 (1953); see also 20 C.F.R. § 10.403. 

6

 A.M.A., Guides (5th ed. 2001). 
3

On May 11, 2016 appellant filed a claim for an increased schedule award (Form CA-7). 

Along with her claim she submitted treatment notes dated January 19 and February 5, 2016 in 

which Dr. Jesse Austin, a family physician, described her complaints of chronic arm pain of over 

30 years duration. Dr. Austin noted tenderness to palpation of the left shoulder and diagnosed 

chronic left upper arm pain secondary to thoracic outlet syndrome.7

By letter dated May 20, 2016, OWCP informed appellant that no medical evidence had 

been received to support an increase from the 30 percent permanent impairment for which she 

received a schedule award on December 12, 2007. It informed her that she should obtain an 

impairment evaluation in accordance with the sixth edition of the A.M.A., Guides.

8

 Appellant 

was given 30 days to obtain a report. 

In form reports dated June 2 and 18, 2016, Dr. Austin recorded diagnoses of left arm pain 

and brachial plexus lesions. He prescribed medication. 

By decision dated June 30, 2016, OWCP noted that appellant had not submitted medical 

evidence to establish increased impairment and denied her claim for an additional schedule 

award. 

LEGAL PRECEDENT 

It is the claimant’s burden to establish that he or she sustained a permanent impairment of 

a scheduled member or function as a result of any employment injury.9

 

The schedule award provision of FECA10 and its implementing federal regulations11 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 for all claimants, OWCP has adopted 

the A.M.A., Guides as the uniform standard applicable to all claimants.12 For decisions issued 

after May 1, 2009, the sixth edition of the A.M.A., Guides is used to calculate schedule awards.13

 7

 These reports had previously been submitted to the record. Dr. Austin also provided similar reports dated 

January 19 to March 7, 2016. 

8

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

9 See Tammy L. Meehan, 53 ECAB 229 (2001). 

10 5 U.S.C. § 8107. 

11 20 C.F.R. § 10.404. 

12 Id. at § 10.404(a). 

13 Federal (FECA) Procedure Manual, Part 3 -- Medical, Schedule Awards, Chapter 3.700, Exhibit 1 

(January 2010); see also Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, Chapter 2.808.5a 

(February 2013). 
4

ANALYSIS 

The Board finds that appellant did not establish that she has greater than 30 percent 

permanent impairment of the left arm for which she received a schedule award. As noted, it is 

her burden to establish that she sustained an increase of impairment of a scheduled member or 

function as a result of any employment injury.14 

On December 12, 2007 OWCP granted appellant a schedule award for 30 percent 

permanent impairment of the left upper extremity. On May 11, 2016 appellant filed a claim for 

an increased schedule award. Along with her claim she submitted treatment notes dated 

January 19 and February 5, 2016 from Dr. Austin. These treatment notes, however, did not rate 

permanent impairment under the sixth edition of the A.M.A., Guides. By letter dated May 20, 

2016, OWCP informed appellant of the type of medical evidence needed to support her schedule 

award claim. Appellant submitted form reports from Dr. Austin that did not rate permanent 

impairment under the A.M.A., Guides. 

OWCP procedures provide that, to support a schedule award, the record must contain 

competent medical evidence which shows that the impairment has reached a permanent and 

fixed state and indicates the date on which this occurred (date of maximum medical 

improvement), describes the impairment in sufficient detail for the claims examiner to visualize 

the character and degree of disability, and gives a percentage of impairment, based on a specific 

diagnosis, not the body as a whole, except for impairment to the lungs.15 If the claimant does not 

provide an impairment evaluation from his/her physician when requested, and there is no 

indication of permanent impairment in the medical evidence of file, the claims examiner may 

proceed with a formal denial of the award.16 

The procedures described above outline the evidence needed to establish impairment. 

None of the medical reports submitted by appellant with the May 2016 claim for an increased 

schedule award provide an impairment rating for appellant’s left upper extremity or describe 

impairment in any way. As the record does not contain a medical report supporting increased 

impairment, appellant did not meet her burden of proof to establish an increased schedule award. 

The Board finds the medical evidence submitted by appellant insufficient to establish entitlement 

to an increased schedule award.17

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. 

 14 See supra note 9. 

15 Supra note 13 at Chapter 2.808.5. 

16 Id. at Chapter 2.808.6c. 

17 Id.; see T.B., Docket No. 15-0889 (issued October 27, 2015). 
5

CONCLUSION 

The Board finds that appellant did not meet her burden of proof to establish more than 30 

percent permanent impairment of the left upper extremity. 

ORDER 

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

Workers’ Compensation Programs is affirmed. 

Issued: December 12, 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