United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.M., Appellant 

and 

DEPARTMENT OF THE NAVY, 

COMMANDER FLEET FORCES, 

Portsmouth, VA, Employer 

__________________________________________ 

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Docket No. 16-0989 

Issued: October 13, 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 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On April 8, 2016 appellant filed a timely appeal from a January 7, 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. 

ISSUE 

The issue is whether appellant has established an increased schedule award for permanent 

impairment of the left upper extremity. 

 1

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

This case has previously been before the Board.2 The facts and circumstances set forth in 

the Board’s prior decision are incorporated herein by reference. The relevant facts are set forth 

below. The facts relevant to the present appeal are as follows. 

OWCP accepted that on November 30, 1987 appellant, then a 38-year-old woodworker, 

sustained left adhesive capsulitis of the shoulder as a result of cutting plywood in the 

performance of duty. On June 6, 1995 it accepted the claim for a recurrence of disability 

beginning on August 23, 1993. 

Appellant filed a claim for a schedule award (Form CA-7) and by decision dated 

March 25, 1997, OWCP granted a schedule award for five percent permanent impairment of the 

left upper extremity. On October 24, 2001 it accepted the claim for a recurrence of disability 

beginning on September 9, 1998. 

Appellant continued seeking medical treatment and subsequently requested a claim for an 

increased schedule award on July 22, 2008. In support of his claim, he submitted medical 

reports from Dr. Donald Holzer, a Board-certified neurologist, who provided impairment ratings 

utilizing the fifth edition of the American Medical Association, Guides to the Evaluation of 

Permanent Impairment (A.M.A., Guides). 

In a report dated February 25, 2009, Dr. Holzer related that appellant had reached 

maximum medical improvement in 1993. He opined that using the A.M.A., Guides, appellant 

had 41 percent permanent impairment of the left upper extremity due to his left shoulder 

impairment. Dr. Holzer related that appellant had 15 percent impairment in abduction, 1 percent 

impairment in adduction, 16 percent impairment in forward flexion, 2 percent impairment in 

extension, 5 percent impairment in internal rotation, and 2 percent impairment in external 

rotation. 

On July 31, 2009 OWCP informed Dr. Holzer that his February 25, 2009 impairment 

rating appeared to be based upon the fifth edition of the A.M.A., Guides, however he had been 

asked to provide a rating pursuant to the sixth edition. 

By letter dated August 4, 2009, Dr. Holzer responded that the sixth edition of the A.M.A., 

Guides, was not available at the time appellant’s original impairment evaluation was scheduled, 

therefore his rating was based upon the fifth edition of the A.M.A., Guides. He provided the 

same impairment ratings as contained in his February 25, 2009 report. 

On August 13, 2009 an OWCP district medical adviser (DMA) reviewed appellant’s 

record. He related that Dr. Holzer simply provided an impairment rating, but did not provide the 

actual measured ranges of motion, therefore his impairment rating could not be verified. The 

DMA also noted that Dr. Holzer had not utilized the sixth edition of the A.M.A., Guides in 

preparing the impairment rating. 

 2

 Docket No. 13-494 (issued March 8, 2013); Docket No. 13-661 (issued July 24, 2013). 
3

The case was again referred to a DMA for review in December 2010. In a report dated 

December 22, 2010, a DMA reviewed Dr. Holzer’s August 4, 2009 report. He noted that an 

impairment rating could be made utilizing the August 4, 2009 report, under the diagnosis-based 

impairment method, and the sixth edition of the A.M.A., Guides. The DMA related that the 

closest diagnosis for appellant’s condition was impingement syndrome, as the sixth edition did 

not provide rating for appellant’s diagnosis of adhesive capsulitis. He then explained that the 

default rating would be three percent impairment, but appellant would receive a grade modifier 

of 2 for functional history, as well as a grade modifier of 1 for physical examination, therefore 

with a net adjustment factor of 1, the upper extremity impairment rating would total four percent. 

By decision dated January 7, 2011, OWCP found that appellant failed to establish that he 

had impairment of the left upper extremity greater than the five percent already awarded. It 

noted that the DMA calculated appellant’s schedule award based on the sixth edition of the 

A.M.A., Guides3

 and determined that he was only entitled to four percent left upper extremity 

impairment. As he had previously received a schedule award for five percent impairment of the 

left upper extremity, the medical evidence of record did not support an increase in the 

impairment already compensated. 

By letter dated February 24, 2012, appellant requested reconsideration of OWCP’s 

decision and submitted additional medical reports, which did not provide an impairment rating. 

By decision dated May 18, 2012, OWCP denied appellant’s reconsideration request as it 

was untimely filed and failed to demonstrate clear evidence of error. It informed appellant that 

the DMA utilized reports from his attending physicians and Dr. Holzer in accordance with the 

sixth edition of the A.M.A., Guides.

4

 OWCP further noted that appellant should have Dr. Holzer 

refer him to another physician who could calculate his impairment rating based on the sixth 

edition of the A.M.A., Guides and to file a new schedule award claim if the impairment rating 

was greater than five percent of the left upper extremity. 

On December 27, 2012 appellant appealed to the Board.5

 In a March 8, 2013 order, the 

Board dismissed appellant’s appeal finding that it was untimely filed. 

On January 28, 2013 appellant appealed a purported decision of December 3, 2012 to the 

Board.6

 In a July 24, 2013 order, the Board dismissed appellant’s appeal, finding that the record 

did not include a final adverse decision dated December 3, 2012 or a final OWCP decision 

regarding a new schedule award claim filed by appellant 

Following the Board’s dismissals of his appeals, appellant continued seeking medical 

treatment with his treating physicians. On April 3, 2014 he filed a claim for an increased 

schedule award. 

 3

 A.M.A., Guides (2009). 

4

 On March 15, 2009 the Director exercised authority to advise that as of May 1, 2009 all schedule award 

decisions of OWCP should reflect use of the sixth edition of the A.M.A., Guides. 

5

 Docket No. 13-494 (issued March 8, 2013). 

6

 Docket No. 13-661 (issued July 24, 2013). 
4

By letter dated April 28, 2014, OWCP requested that appellant submit an impairment 

evaluation from his attending physician in accordance with the sixth edition of the A.M.A., 

Guides. It afforded him 30 days to submit the requested impairment evaluation. 

In support of his claim, appellant submitted treatment notes from physician assistants 

dated March 12, 2014 through December 3, 2015. He also submitted treatment notes dated 

April 9, 2014 through March 5, 2015 from Dr. Holzer documenting left shoulder trigger point 

injections. 

In a May 5, 2014 report, Dr. Holzer reported that appellant was being treated for left 

shoulder adhesive capsulitis and had reached maximum medical impairment (MMI). He noted 

no prior impairments of the left shoulder and explained that he was unable to provide a 

permanent impairment rating. Dr. Holzer requested referral to a physical therapy facility for 

such determination.7

 

By decision dated January 7, 2016, OWCP denied appellant’s claim for a schedule award 

as the evidence was insufficient to establish that he sustained a measurable impairment to a 

member or function of the body. 

LEGAL PRECEDENT 

The schedule award provision of FECA and its implementing regulations 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.8 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 (6th ed. 2009) has been adopted by the implementing 

regulations as the appropriate standard for evaluating schedule losses.9

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

the scheduled member or function as a result of any employment injury10. OWCP procedures 

provide that, to support a schedule award, the file 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 so that it can be visualized on review, and computes the percentage of 

impairment in accordance with the A.M.A., Guides.

11

 7

 The record did not contain a request for authorization form from the physician for a physical therapy location. 

8

 5 U.S.C. § 8107; 20 C.F.R. § 10.404. 

9 K.H., Docket No. 09-341 (issued December 30, 2011). For decisions issued after May 1, 2009, the sixth edition 

will be applied. B.M., Docket No. 09-2231 (issued May 14, 2010). 

10Tammy L. Meehan, 53 ECAB 229 (2001). 

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

Chapter 2.808.5 (February 2013). 
5

The sixth edition requires identifying the impairment for the Class of Diagnosis (CDX) 

condition, which is then adjusted by grade modifiers based on Functional History (GMFH), 

Physical Examination (GMPE), and Clinical Studies (GMCS).12 The net adjustment formula is 

GMFH-CDX + GMPE-CDX + GMCS-CDX. 

ANALYSIS 

OWCP accepted appellant’s claim for left shoulder adhesive capsulitis. By decision 

dated March 25, 1997, it granted a schedule award for five percent permanent impairment of the 

left upper extremity. Appellant continued seeking treatment with his treating physicians. On 

April 3, 2014 he filed a claim for an increased schedule award. By decision dated January 7, 

2016, OWCP denied appellant’s claim for an increased schedule award finding that he had not 

submitted an impairment evaluation to establish that he sustained a permanent impairment 

resulting from his work injury. 

Appellant has not submitted sufficient evidence to establish that, as a result of his 

employment injury, he sustained increased impairment to a scheduled member such that he 

would be entitled to an additional schedule award. By letter dated April 28, 2014, OWCP 

informed him of the type of evidence necessary to establish his schedule award claim and 

specifically requested that he submit an impairment evaluation from his attending physician in 

accordance with the sixth edition of the A.M.A., Guides. 

In support of his claim, appellant submitted a May 5, 2014 report from Dr. Holzer, his 

treating physician. Dr. Holzer reported that appellant was being treated for left shoulder 

adhesive capsulitis and had reached MMI. He noted no prior impairments of the left shoulder 

and explained that he was unable to provide a permanent impairment rating. 

The Board finds that Dr. Holzer’s report is insufficient to establish that appellant is 

entitled to an increased schedule award. While Dr. Holzer may have determined that MMI had 

been reached, he failed to give a proper impairment rating in accordance with the A.M.A., 

Guides.

13 He noted in his May 5, 2014 report that he was unable to provide a permanent 

impairment rating. Thus, Dr. Holzer’s report is insufficient to establish that appellant sustained 

an increased impairment of his left shoulder adhesive capsulitis. 

Appellant did not submit other medical evidence substantiating a permanent impairment. 

The Board has held that an opinion from a physician assistant has no probative medical value in 

establishing a schedule award claim as physician assistants are not considered physicians as 

defined under FECA.14

The Board notes that it is appellant’s burden of proof to establish a permanent 

impairment of a scheduled member as a result of an employment injury.15 The medical evidence 

 12 A.M.A., Guides 494-531. 

13 Supra note 11. 

14 A.A., Docket No. 16-0041 (issued February 11, 2016). 

15 Supra note 10. 
6

must include a description of any physical impairment in sufficient detail so that the claims 

examiner and others reviewing the file would be able to clearly visualize the impairment with its 

resulting restrictions and limitations.16 Appellant did not submit such evidence and thus he has 

not met his burden of proof.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. 

CONCLUSION 

The Board finds that appellant has not established an increased schedule award for 

permanent impairment of the left upper extremity. 

ORDER 

IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’ 

decision dated January 7, 2016 is affirmed. 

Issued: October 13, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board 

 16 See A.L., Docket No. 08-1730 (issued March 16, 2009). 

17 V.W., Docket No. 09-2026 (issued February 16, 2010); L.F., Docket No. 10-343 (issued November 29, 2010).