United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

M.B., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

San Antonio, TX, Employer

__________________________________________

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Docket No. 17-1679

Issued: February 8, 2018

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 August 1, 2017 appellant filed a timely appeal from a February 8, 2017 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 abused its discretion by denying appellant authorization for 

durable medical equipment consisting of an adjustable bed, elliptical machine, and recumbent 

cycle. 

On appeal appellant asserts that the medical evidence establishes his need for the 

requested equipment. 

 

1 Appellant initially timely requested oral argument pursuant to section 501.5(b) of the Board’s Rules of

Procedure. 20 C.F.R. § 501.5(b). By correspondence dated August 30, 2017, he withdrew the request.

2 5 U.S.C. § 8101 et seq. 
2

FACTUAL HISTORY

On October 11, 2000 appellant, then a 44-year-old letter carrier, filed a traumatic injury 

claim (Form CA-1) alleging that he injured his lower back on that date while lifting mail trays. 

OWCP initially denied the claim on November 30, 2000. Appellant requested reconsideration 

and, in a February 16, 2001 decision, OWCP reversed its prior decision and accepted 

aggravation of facet syndrome. He stopped work on the date of injury and returned to modified 

duty on August 11, 2001. OWCP adjudicated the claim under File No. xxxxxx082.

On April 2, 2002 OWCP expanded acceptance of the claim to include aggravation of 

lumbar degenerative disc disease. Appellant stopped work on May 3, 2002 and filed Form CA-7 

claims for compensation. In an August 28, 2002 decision, OWCP accepted his claims for 

compensation beginning May 3, 2002,

3

and he was placed on the periodic compensation rolls. 

On August 30, 2002 appellant underwent lumbar spine fusion surgery. On December 6, 

2002 OWCP expanded his claim to include prolonged post-traumatic stress disorder (PTSD) and 

major depressive disorder, recurrent episode.

On November 18, 2003 appellant filed a traumatic injury claim for a November 5, 2002 

injury that occurred while descending stairs to attend a second opinion evaluation. The claim 

was adjudicated by OWCP under File No. xxxxxx385. On April 1, 2003 OWCP accepted left 

shoulder sprain/strain. Appellant underwent arthroscopic shoulder repair on February 10, 2003. 

On October 3, 2003 appellant had a second lumbar surgical procedure. 

By decision dated December 13, 2005, OWCP denied appellant’s request for an 

adjustable orthopedic mattress.4 Following appellant’s requests for reconsideration, in merit 

decisions dated May 18, 2006 and January 11, 2007, it denied modification of the December 13, 

2005 decision.

Appellant returned to modified duty for four hours daily on June 11, 2007. He increased 

his work hours to six hours daily on August 7, 2007. Appellant’s compensation was 

appropriately adjusted. He began working eight hours of modified duty daily on 

September 15, 2007. 

In February 2008 OWCP authorized the purchase of durable medical equipment. On 

February 28, 2008 it accepted dental caries extending to pulp and dental caries root as a 

consequence of medications prescribed for appellant’s employment injuries. 

Appellant retired on disability effective September 2, 2008. On that day he filed an 

occupational disease claim (Form CA-2) for right cubital syndrome and bilateral carpal tunnel 

 

3 OWCP previously denied appellant’s claims for compensation in decisions dated June 20 and July 9, 2002. 

Appellant requested reconsideration and in the August 28, 2002 decision reversed the June 20 and July 9, 2002 

decisions.

4 The bed had been recommended by Dr. Dmitriy Buyanov, appellant’s attending Board-certified pain 

management specialist. An OWCP medical adviser reviewed the record and request and advised that it would not 

affect appellant’s outcome in any significant way. 
3

syndrome. OWCP adjudicated the occupational disease claim under File No. xxxxxx230 and 

accepted bilateral carpal tunnel syndrome and lesion of ulnar nerve on November 12, 2008. On 

September 11, 2008 it expanded the claim under OWCP File No. xxxxxx385 to include complete 

rotator cuff rupture, left. OWCP administratively combined File Nos. xxxxxx082, xxxxxx385, 

and xxxxxx230 on November 12, 2008, with File No. xxxxxx082 serving as the master file.

In separate letters dated December 3, 2014, Dr. Buyanov described the medical necessity 

for the acquisition of a hospital bed, recumbent cycle, and elliptical machine. Regarding the 

hospital bed, he maintained that it was appropriately indicated due to appellant’s ongoing 

recurrent, persistent pain, muscle spasm, and muscle cramping that was a result of his underlying 

pain syndrome. Dr. Buyanov noted that appellant’s current medical regimen included a hospital 

bed which had provided a substantial improvement in overall baseline pain control by increasing 

bed rest time, thereby allowing appellant to adequately rest and then be able to adequately 

perform the activities of daily living as well as maintain an acceptable quality of life. He

continued that a hospital bed facilitated treatment because it could be adjusted to provide 

appellant less painful access to both entry and exit from the bed with the least amount of stress, 

tension, and aggravation of his underlying painful condition which, in turn, enhanced the healing 

process significantly and would reduce swelling of the upper and lower extremities because he 

would be more comfortable and could access bed rest when needed. Dr. Buyanov indicated that, 

if the hospital bed were not approved, pain control and the ability to perform activities of daily 

living and an acceptable quality of life would be significantly impaired and this would lead to the 

increased use of opioid narcotic analgesics.

With regard to the recumbent cycle and elliptical machine, Dr. Buyanov also maintained 

that these were appropriately indicated due to appellant’s ongoing recurrent, persistent pain, 

muscle spasm, and muscle cramping that was a result of his underlying pain syndrome. He noted 

that both machines would provide appellant with a low impact cardiovascular workout that 

would burn calories and help build lean muscle mass, and that, while each machine used similar 

muscle groups, there were unique advantages to each and appellant should choose the one that 

best fit his personal fitness needs.

By development letter dated February 4, 2015, that was resent on March 13, 2015, 

OWCP informed appellant of the type of evidence needed to support his request for a mattress 

and exercise equipment. This was to include a statement from his physician that described the 

basic equipment and the medical reasons for recommending the equipment, the specific goals of 

or benefits expected from this equipment, how often appellant would utilize the equipment, the 

expected duration of its use, and a description of alternative treatment that might achieve the 

same results. He was also to provide at least two detailed quotes for the equipment. 

On March 26, 2015 Dr. Buyanov advised that appellant would use a hospital bed, 

elliptical machine, and recumbent cycle on a daily basis. He maintained that there was no 

alternative treatment. Dr. Buyanov forwarded his December 3, 2014 letters of medical necessity.

In correspondence dated May 1, 2015, appellant indicated that an orthopedic bed, which 

had been authorized in 2008, was worn out and broken, and that his exercise equipment was also 

worn out, which caused him to gain weight and increased his pain. He forwarded two quotes for 

a recumbent cycle and elliptical machine, and two quotes for adjustable beds. 
4

On September 2, 2015 OWCP asked its medical adviser for an opinion on the 

recommended mattress/hospital bed, elliptical machine, and recumbent cycle. He was informed 

of the accepted conditions. In a September 3, 2015 report, Dr. Ronald Blum, an OWCP medical 

adviser and a Board-certified orthopedic surgeon, noted the accepted conditions and history of 

injury. Regarding Dr. Buyanov’s recommendations, Dr. Blum opined that the requested bed was 

not medically necessary, indicating that the effect of an adjustable bed could be achieved by a 

bed board under the mattress and a simple pad on top of the mattress to simulate the feeling and 

support provided by an adjustable hospital bed, with the judicious use of pillows to achieve the 

correct position in the bed. As to the recommended purchase of a recumbent cycle and elliptical 

machine, Dr. Blum advised that he was not aware of any scientific proof that the use of these 

devices was of medical benefit in treating chronic pain syndrome. He concluded that he could 

not support the purchase of either machine.

In a September 23, 2015 decision, OWCP denied the claim for purchase of an adjustable 

bed, elliptical machine, and recumbent cycle. It found the weight of the medical evidence rested 

with the OWCP medical adviser, noting that the record contained no objective medical evidence 

to establish that the requested durable medical equipment was medically necessary.

On September 12, 2016 appellant requested reconsideration. He noted that after receipt 

of the September 23, 2015 denial, he had been attending a fitness center at a nearby military base 

but that it became very busy with wait times of more than an hour. Appellant’s physician then 

requested physical therapy, which was denied. Appellant maintained that the documentation 

provided by Dr. Buyanov was sufficient to approve the requested exercise equipment and 

adjustable bed. He submitted Dr. Buyanov’s December 3, 2014 letters of medical necessity and 

his March 26, 2015 correspondence. Appellant also submitted an April 28, 2015 letter that was 

an exact copy of May 1, 2015 his letter, also previously of record. 

In a merit decision dated February 8, 2017, OWCP denied modification of its 

September 23, 2015 decision. It found that the medical evidence of record did not reflect that the 

purchase of the requested durable medical equipment would cure, give relief, reduce the degree 

or period of disability, or aid in lessening the amount of monthly compensation. 

LEGAL PRECEDENT

Section 8103 of FECA provides that the United States shall furnish to an employee who 

is injured while in the performance of duty, the services, appliances, and supplies prescribed or 

recommended by a qualified physician, which OWCP considers likely to cure, give relief, reduce 

the degree, or the period of disability, or aid in lessening the amount of monthly compensation.5 

While OWCP is obligated to pay for treatment of employment-related conditions, the employee 

has the burden of proof to establish that the expenditure is incurred for treatment of the effects of 

an employment-related injury or condition.6 

 

5 5 U.S.C. § 8103; see Thomas W. Stevens, 50 ECAB 288 (1999).

6 Kennett O. Collins, Jr., 55 ECAB 648 (2004).
5

Section 10.310(a) of OWCP’s implementing regulations provides that employee is

entitled to receive all medical services, appliances or supplies which a qualified physician 

prescribes or recommends and which it considers necessary to treat the work-related injury.7 Its

procedures provide that nonmedical equipment such as waterbeds, saunas, weight-lifting sets, 

exercise bicycles, etc., may be authorized only if recommended by the attending physician and if 

OWCP finds that the item is likely to cure, give relief, reduce the degree or the period of 

disability, or aid in lessening the amount of monthly compensation.8

In interpreting section 8103 of FECA, the Board has recognized that OWCP has broad 

discretion in approving services provided, with the only limitation on OWCP’s authority being 

that of reasonableness.9 OWCP has the general objective of ensuring that an employee recovers 

from his or her injury to the fullest extent possible, in the shortest amount of time. It therefore 

has broad administrative discretion in choosing means to achieve this goal. 

Abuse of discretion is generally shown through proof of manifest error, clearly 

unreasonable exercise of judgment, or actions taken which are contrary to both logic and 

probable deductions from established facts. It is not enough to merely show that the evidence 

could be construed so as to produce a contrary factual conclusion.10 

ANALYSIS

The Board finds that OWCP did not abuse its discretion in denying appellant’s request to 

purchase durable medical equipment. Under File No. xxxxxx082, OWCP accepted lumbar and 

lumbosacral strain, aggravation of lateral facet syndrome, aggravation of lumbar degenerative 

disc disease, prolonged PTSD and major depressive disorder, left shoulder strain, dental caries, 

impotence of organic origin, thoracic and lumbosacral neuritis or radiculitis, lumbar 

degeneration, and spinal stenosis. Under File No. xxxxxx230, bilateral carpal tunnel syndrome 

and lesion of the ulnar nerve, right were accepted. A complete rotator cuff rupture was accepted 

under File No. xxxxxx385.

Appellant requested authorization to purchase an adjustable hospital-type bed, elliptical 

machine, and recumbent cycle. In decisions dated September 23, 2015 and February 8, 2017,

OWCP denied appellant’s request. It found the weight of the medical evidence rested with the 

opinion of Dr. Blum, its medical adviser. 

On December 3, 2014 Dr. Buyanov advised that the acquisition of a hospital bed, 

recumbent cycle, and elliptical machine would relieve appellant’s ongoing recurrent, persistent 

pain, muscle spasm, and muscle cramping which resulted from his underlying pain syndrome. 

 

7 20 C.F.R. § 10.310(a).

8 Federal (FECA) Procedure Manual, Part 3 -- Medical, Medical Services and Supplies, Chapter 3.400.3.d(5) 

(October 1995); Federal (FECA) Procedure Manual, Part 2 -- Claims, Durable Medical Equipment, Chapter 

2.810.17.h (June 2014); D.J., Docket No. 13-1637 (December 2013).

9 See D.K., 59 ECAB 141 (2007).

10 Minnie B. Lewis, 53 ECAB 606 (2002).
6

He noted that appellant’s current regimen included a hospital bed which provided a substantial 

improvement in overall baseline pain control by increasing bed rest time, which allowed

appellant to adequately perform the activities of daily living and maintain an acceptable quality 

of life. Dr. Buyanov continued that a hospital bed facilitated treatment because it could be 

adjusted to provide appellant less painful access to both entry and exit from the bed with the least 

amount of stress, tension, and aggravation of his underlying painful condition which, in turn, 

enhanced the healing process significantly and would reduce swelling of the upper and lower 

extremities because he would be more comfortable and could access bed rest when needed. With 

regard to the recumbent cycle and elliptical machine, he indicated that both would provide 

appellant with a low-impact cardiovascular workout that would burn calories and help build lean 

muscle mass. 

The Board finds that Dr. Buyanov did not provide a sufficient explanation as to how the 

adjustable bed, elliptical machine, or recumbent cycle would cure, give relief, reduce the degree 

or period of disability, or aid in lessening the amount of monthly compensation.11 OWCP’s 

obligation to pay for medical treatment under section 8103 of FECA extends only to treatment of 

employment-related conditions.12 As noted, OWCP’s medical adviser concluded that the 

requested equipment was not medically necessary.

As to appellant’s assertion on appeal that OWCP had paid for a similar bed and 

equipment in 2008, previously authorizing the expense for an orthopedic mattress did not 

preclude OWCP from exercising its discretion to deny authorization for a new mattress in 2015 

or 2017.13

The Board finds that the medical evidence submitted provided insufficient explanation 

for the necessity of the items requested and the weight of the evidence rested with Dr. Blum, 

who advised that there was no evidence that the requested durable medical equipment would aid 

the accepted conditions. For these reasons, the Board finds that OWCP did not abuse its 

discretion in denying appellant’s request to authorize the purchase of an adjustable bed, 

recumbent cycle, and elliptical machine.14

Appellant may submit new evidence or argument with a written request for 

reconsideration to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) 

and 20 C.F.R. §§ 10.605 through 10.607.

CONCLUSION

The Board finds that OWCP did not abuse its discretion in denying authorization to 

purchase durable medical equipment consisting of an adjustable bed, elliptical machine, and 

recumbent cycle.

 

11 Supra note 6.

12 D.J., Docket No. 13-1637 (issued December 16, 2013).

13 Id.

14 Supra note 9.
7

ORDER

IT IS HEREBY ORDERED THAT the February 8, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: February 8, 2018

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