United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

K.L., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS ADMINISTRATION MEDICAL 

CENTER, Philadelphia, PA, Employer

__________________________________________

)

)

)

)

)

)

)

)

)

Docket No. 17-2003

Issued: April 16, 2018

Appearances: Case Submitted on the Record

Jeffrey P. Zeelander, Esq., for the appellant1

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 September 26, 2017 appellant, through counsel, filed a timely appeal from a July 13, 

2017 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the 

 

1

In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for legal 

or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. § 501.9(e). 

No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An attorney or 

representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject to fine or 

imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation.
2

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.3

ISSUES

The issues are: (1) whether OWCP properly terminated appellant’s wage-loss 

compensation and medical benefits effective March 22, 2017 as she had no further disability or 

need for medical treatment causally related to her September 4, 2015 employment injury; and 

(2) whether appellant has established continuing employment-related disability after 

March 22, 2017.

FACTUAL HISTORY

On September 9, 2015 appellant, then a 41-year-old nurse, filed a traumatic injury claim 

(Form CA-1) alleging that, on September 4, 2015, a patient kicked her left knee when she 

intervened in an altercation at work. She stopped work on September 4, 2015. OWCP accepted 

the claim for a left knee contusion and a left anterior cruciate ligament sprain. Appellant returned 

to part-time, limited-duty employment on July 25, 2016. 

A magnetic resonance imaging (MRI) scan dated October 5, 2015 revealed a partial tear of 

the anterior cruciate ligament.4

In a report dated August 1, 2016, Dr. Marc L. Harwood, an attending physician Boardcertified in family practice, evaluated appellant for knee pain subsequent to an employment injury. 

On examination he found no effusion, crepitus, instability, weakness, or tenderness on palpation. 

Dr. Harwood diagnosed left knee pain and recommended against a diagnostic arthroscopy. He 

found that appellant could continue performing modified employment.

On August 8, 2016 Dr. Harwood noted that appellant had undergone six months of physical 

therapy and a steroid injection for an “essentially unremarkable MRI [scan] of the left knee.” He 

advised that she did not have any “catching, locking, instability, or other mechanical symptoms.” 

On examination he found no tenderness, effusion, or laxity and negative McMurray’s and 

Lachman’s tests. Dr. Harwood diagnosed left knee pain. He noted that appellant had no 

improvement after the steroid injection which he found revealed a lack of intraarticular pathology. 

Dr. Harwood related, “At this point, I suggest that she return to full duty, but [she] is rather fearavoidant about going back to work and being put in the position where she would need to break 

 

2 5 U.S.C. § 8101 et seq.

3 The record provided the Board includes evidence received after OWCP issued its July 13, 2017 decision. The 

Board’s jurisdiction is limited to the evidence that was in the case record at the time of OWCP’s final decision. 

Therefore, the Board is precluded from reviewing this additional evidence for the first time on appeal. 20 C.F.R. 

§ 501.2(c)(1).

4 OWCP referred appellant to Dr. Lawrence Barr, an osteopath, for a second opinion examination. On February 17, 

2016 Dr. Barr discussed the history of the September 4, 2015 work injury and her continued complaints of left knee 

pain and swelling. He found a positive grind test and parapatellar tenderness with no effusion or loss or strength. 

Dr. Barr diagnosed a left knee contusion and chondromalacia patella without normal tracking. He recommended a 

diagnostic arthroscopy of the left knee and found that appellant could work limited duty.
3

up an altercation on the psychiatric unit.” He recommended a functional capacity evaluation (FCE) 

given appellant’s fear, noting that she had obtained maximum medical improvement (MMI). 

An FCE performed on September 13, 2016 demonstrated that appellant could perform 

work at a medium physical demand level. 

A September 22, 2016 MRI scan of the left knee demonstrated a patellar tilt with mild 

chondromalacia, a small popliteal cyst, and small effusion.

OWCP, by letter dated September 29, 2016, notified appellant of its proposed termination 

of her wage-loss compensation and medical benefits. It advised that her attending physician,

Dr. Harwood, found on August 8, 2016 that she could resume her usual employment. 

In a report dated October 10, 2016, Dr. Mark J. Reiner, an osteopath, evaluated appellant 

for knee pain after an injury. He noted that she was currently working as a nurse, but continued to 

experience soreness. Dr. Reiner reviewed the results of MRI scans of the left knee and her 

complaints of left knee “swelling, clicking, popping, and intermittently giving way.” He diagnosed 

internal derangement of the left knee with a possible occult meniscal tear. Dr. Reiner

recommended possible arthroscopic surgery.

On October 10, 2016 Dr. Harwood reviewed the September 22, 2016 MRI scan, which he 

found showed mild chondromalacia, a small effusion, an intact anterior cruciate ligament, and no 

injury to the meniscus. He noted that the FCE indicated that appellant could perform mediumlevel work. Dr. Harwood diagnosed left knee pain. He related:

“At this point, I have two MRI [scans] that are essentially unremarkable except for 

mild chondromalacia. I have an FCE report that reveals that she is capable of 

medium duty and pain out of proportion to any objective data that I have obtained 

over the past year that I have seen her. At this point, we had an extensive 

negotiation with regard to her work status. It is difficult to argue with an FCE that 

reveals that restrictions are recommended and as such I have provided her 

permanent work restrictions to include medium[-]duty work....” 

Dr. Harwood also found that appellant could not perform repetitive bending or kneeling. 

He recommended against arthroscopic surgery. In a form report dated October 10, 2016,

Dr. Harwood indicated that appellant could perform modified-duty work at a medium level with 

no repetitive bending or kneeling. 

Appellant returned to full-time limited-duty work in October 2016.

On October 19, 2016 Dr. Franklin Scarlett, who specializes in family medicine, discussed 

appellant’s history of a work injury attempting to stop an altercation between patients. He 

indicated that, at his last evaluation on October 3, 2016, she complained of continued left knee 

pain and swelling such that she had difficulty performing daily activities. Dr. Scarlett noted that 

a left knee MRI scan showed mild chondromalacia, a popliteal cyst, small effusions, a grade 1 to 

2 intrameniscal signal, and mild thinning of the articular hyaline cartilage. He opined that the 

findings on the MRI scan study were “directly correlated to [appellant’s] workplace injury....”

Dr. Scarlett disagreed with Dr. Harwood’s opinion that she could resume her usual employment. 
4

He opined that appellant could perform medium work in accordance with the FCE results without 

repetitive bending, squatting, or kneeling.

The employing establishment provided a position description for a staff nurse on 

November 18, 2016. The physical requirements included heavy lifting up to 45 pounds and 

carrying under 15 pounds, walking up to four hours per day, and standing for four hours per day.

OWCP, on December 8, 2016, referred appellant to Dr. Stanley Askin, a Board-certified 

orthopedic surgeon, for a second opinion examination. In the statement of accepted facts, it noted 

that, as a staff nurse, she provided full nursing care to patients with physical and behavior 

problems.

In a December 20, 2016 progress report, Dr. Reiner found synovitis, tenderness, crepitus, 

and clicking on examination of the left knee.5 He diagnosed internal derangement of the left knee 

with a possible meniscal tear and again recommended possible arthroscopic surgery.

On December 22, 2016 Dr. Askin discussed appellant’s history of a September 9, 2015 left 

knee injury at work. He advised that she also reported a history of two prior work injuries that 

occurred during assaults by patients. Dr. Askin noted that appellant experienced left knee 

discomfort with bending over a half hour, driving over 15 minutes, or after a day at work. He 

found no significant findings on review of the September 22, 2016 MRI scan study. On 

examination, Dr. Askin found no effusion, patellar subluxation, loss of sensation, or laxity of the 

knee, but some tenderness at the anteromedial joint line. He opined that appellant had no objective 

findings of the accepted employment injury and that the accepted conditions had resolved, noting 

that “her left knee examines equivalently to her right knee, and in fact there are no clinical 

imperfections evident.” Regarding her continued subjective complaints, Dr. Askin advised that 

she might have “a phenomenon termed perseveration.” He related:

“I have no injury-related reason to preclude her return to the employment that was 

described in her formal job description. Please note, however, that I would not 

counsel a nonathletic lady of average build to be ‘mixing it up’ with aggressive or 

violent male patients. Doing so would be beyond what is offered as the formal job 

description, and I do not approve that sort of activity for [appellant] as she is likely 

to have additional injuries going forward under similar circumstances.”

Dr. Askin recommended against surgery given that he had not identified any left knee issue 

that would benefit from such intervention. Regarding medical treatment, he found that appellant 

should maintain physical fitness and perhaps have training in restraining violent patients, noting 

that this did not seem necessary for the position of staff nurse. In a December 22, 2016 work 

capacity evaluation (OWCP-5c), Dr. Askin found that appellant could resume work without 

restrictions, but indicated that she should not try to “restrain violent patients.”

On February 6, 2017 OWCP advised appellant of its proposed termination of her wageloss compensation and medical benefits as the weight of the evidence, as represented by the 

 

5 Dr. Reiner provided a similar progress report on November 15, 2016.
5

opinion of Dr. Askin, established that she had no further employment-related condition or 

disability.

In a note dated December 28, 2016, Dr. Carlos P. Borromeo, Jr., who specializes in family 

medicine, advised that appellant was disabled from employment due to “anxiety related to [the] 

work injury and setting.”

Appellant submitted an impairment evaluation dated January 24, 2017 from Dr. Nicholas 

Diamond, an osteopath. On examination, Dr. Diamond found tenderness and crepitus with no 

instability. He diagnosed a post-traumatic left knee contusion and sprain, patellar chondromalacia, 

and an anterior cruciate ligament sprain and provided an impairment rating. 

Appellant returned to her usual employment without restrictions on February 13, 2017. 

In a report dated February 14, 2017, Dr. Reiner noted that Dr. Askin believed that appellant 

required no further treatment and could resume her usual employment. He indicated that a left 

knee MRI scan dated December 22, 2016 showed chondromalacia patella, effusion, and a small 

cyst. On examination, Dr. Reiner found synovitis, crepitus, clicking, and popping of the left knee 

with quadriceps weakness. He diagnosed left knee internal derangement with a possible occult 

meniscal tear and chondromalacia patella. Dr. Reiner related, “[Appellant] does have an abnormal 

MRI [scan] and has an abnormal evaluation. She does continue to be symptomatic at this time. I 

disagree with Dr. Askin’s findings and recommendations.” He recommended a diagnostic 

arthroscopy.

Appellant, on February 18, 2017, filed a notice of recurrence (Form CA-2a), claiming 

disability commencing on February 15, 2017 causally related to her September 4, 2015 

employment injury.6 She advised that she had continued problems with her knee and also was 

receiving psychiatric treatment due to being attacked by a patient. Appellant related that she 

returned to work in a locked psychiatric unit, but began experiencing panic attacks. 

On February 22, 2017 Dr. Harry A. Doyle, a Board-certified psychiatrist, found that 

appellant was totally disabled from work due to post-traumatic stress disorder (PTSD) related to 

employment factors.

Counsel, by letter dated February 28, 2017, asserted that a conflict existed between

Dr. Askin and appellant’s attending physicians regarding her physical findings and work ability. 

He noted that she experienced panic attacks after being returned to work in the locked psychiatric 

floor due to “the severity of her PTSD arising from being injured by a patient in this claim, as well 

as the several prior accepted claims where she was also injured by patients.” Counsel further 

asserted that Dr. Askin found that appellant could not work with violent patients.

 

6 On February 24, 2017 appellant filed a claim for a schedule award (Form CA-7). OWCP, on May 11, 2017, 

advised her that it would not take any further action regarding her schedule award claim as the evidence did not 

demonstrate that she had reached MMI from her September 4, 2015 work injury. It noted that appellant had filed a 

notice of recurrence claiming disability for the injury that had been converted into a new occupational disease claim.
6

By letter dated March 17, 2017, OWCP advised appellant that it was adjudicating her 

notice of recurrence as an occupational disease claim as she described an injury due to work 

exposure that occurred over the course of more than one work shift.

In a decision dated March 22, 2017, OWCP terminated appellant’s wage-loss 

compensation and authorization for medical benefits due to her September 4, 2015 employment 

injury effective that date. It found that the opinion of Dr. Askin constituted the weight of the 

evidence and established that she had no further disability or residuals of her accepted employment 

injury. OWCP advised that it was separately considering her occupational disease claim for a 

psychological condition subsequent to resuming employment on February 13, 2017.

7

Appellant, through counsel, on April 10, 2017 requested a review of the written record 

before an OWCP hearing representative. He maintained that a conflict in medical opinion existed 

regarding whether she had residuals of her left knee condition and further asserted that she had 

sustained a consequential emotional condition. Counsel advised that the employing establishment 

withdrew appellant’s limited-duty position after OWCP’s proposed termination of her 

compensation and returned her to work with locked psychiatric patients. He noted that the 

evidence supported that she sustained an emotional condition due at least in part to her 

September 4, 2015 work injury.

In a February 23, 2017 psychiatric evaluation, received by OWCP on June 21, 2017,

Dr. Doyle reviewed the history of the September 4, 2015 work injury and the medical evidence of 

record. He diagnosed PTSD. Dr. Doyle noted that appellant had a history of being assaulted at 

work on August 1, 2009, March 18, 2011, and September 4, 2015. He opined that the 

September 4, 2015 assault caused an aggravation of preexisting employment-related acute stress 

disorder and adjustment disorder with depressed mood and precipitated PTSD. Dr. Doyle found 

that appellant was disabled from employment.8

Counsel, on June 29, 2017, asserted that Dr. Askin’s report was inconsistent and 

unrationalized. He further maintained that a conflict existed between Dr. Askin and appellant’s 

physicians, Dr. Reiner, Dr. Diamond, and Dr. Scarlett. Counsel noted that the employing 

establishment withdrew her limited-duty position when it received OWCP’s proposed termination 

of her compensation. Appellant tried to resume her regular employment, but experienced panic 

attacks and her physicians advised her not to work. Counsel contended that she sustained a 

recurrence of disability due to the withdrawal of her modified employment. He also asserted that

Dr. Doyle’s report established that she has a disabling employment-related psychiatric condition

and that Dr. Askin found that she might have a somatoform disorder. Counsel advised that

Dr. Askin found it was not appropriate for appellant to contend with violent patients.

 

7 OWCP noted that appellant had not submitted probative medical evidence that she sustained a psychological 

condition due to her February 17, 2016 work injury.

8 On June 28, 2017 Dr. Doyle again discussed the history of injury and medical evidence of record. He asserted 

that due to the third assault on September 4, 2015, appellant sustained an aggravation of preexisting psychiatric 

disorders and opined that the aggravation precipitated PTSD. Dr. Doyle opined that she was totally disabled from 

employment.
7

By decision dated July 13, 2017, OWCP’s hearing representative affirmed the March 22,

2017 decision. He found that Dr. Askin’s opinion constituted the weight of the evidence and 

established that appellant had no residuals of her accepted left knee contusion and sprain. The 

hearing representative noted that OWCP was separately adjudicating whether she sustained an 

emotional condition due to the August 1, 2009, March 18, 2011, and September 4, 2015 

employment incidents. He thus found that considering her emotional condition claim would 

duplicate the other claim. The hearing representative also found that OWCP was separately 

considering appellant’s notice of recurrence of disability as a new claim. 

LEGAL PRECEDENT -- ISSUE 1

Once OWCP accepts a claim and pays compensation, it has the burden of justifying 

modification or termination of an employee’s benefits.9 After it has determined that an employee 

has disability causally related to his or her federal employment, OWCP may not terminate 

compensation without establishing that the disability has ceased or that it is no longer related to 

the employment.10 Its burden of proof includes the necessity of furnishing rationalized medical 

opinion evidence based on a proper factual and medical background.11

The right to medical benefits for an accepted condition is not limited to the period of 

entitlement for disability.12 To terminate authorization for medical treatment, OWCP must 

establish that appellant no longer has residuals of an employment-related condition, which would 

require further medical treatment.13

ANALYSIS -- ISSUE 1

OWCP accepted that appellant sustained a left knee contusion and a sprain of the left 

anterior cruciate ligament due to a September 4, 2015 work injury. She returned to part-time,

modified employment on July 25, 2016 and to full-time, modified employment in October 2016. 

Appellant returned to work without restriction on February 13, 2017, but stopped work on 

February 15, 2017 and filed a notice of recurrence of disability. By decision dated March 22, 

2017, OWCP terminated her wage-loss compensation and medical benefits effective that date 

based on the report of Dr. Askin, the second opinion physician. 

The Board finds that OWCP properly terminated appellant’s wage-loss compensation and 

medical benefits as the opinion of Dr. Askin constitutes the weight of the evidence and establishes 

that she had no further residuals of her work injury effective March 22, 2017.14

 

9 See S.F., 59 ECAB 642 (2008); Kelly Y. Simpson, 57 ECAB 197 (2005).

10 See I.J., 59 ECAB 408 (2008); Elsie L. Price, 54 ECAB 734 (2003).

11 See J.M., 58 ECAB 478 (2007); Del K. Rykert, 40 ECAB 284 (1988).

12 See T.P., 58 ECAB 524 (2007); Kathryn E. Demarsh, 56 ECAB 677 (2005).

13 See Kathryn E. Demarsh, id.; James F. Weikel, 54 ECAB 660 (2003).

14 See A.H., Docket No. 16-1828 (issued August 17, 2017).
8

On December 22, 2016 Dr. Askin discussed appellant’s history of the September 4, 2015 

work injury and reviewed the medical evidence of record, including the results of diagnostic 

testing. He found that the most recent MRI scan demonstrated no significant findings. Dr. Askin 

found no effusion, patellar subluxation, laxity, or reduced sensation on examination, but noted that 

appellant had some anteromedial joint line tenderness. He found that the accepted conditions had 

resolved and that her continued subjective complaints might indicate perseveration. Dr. Askin 

provided rationale for his opinion by explaining that there were no objective examination findings 

of the accepted employment injury and that her left knee was the equivalent of her right knee with 

no “clinical imperfections.” He found that appellant could resume her usual employment, but 

recommended against her restraining violent patients in order to prevent future injury, noting that 

such action was outside of her normal job description. Dr. Askin further found that she did not 

need surgery for her left knee as she had no further left knee condition. He recommended physical 

training if appellant was going to engage with aggressive patients, again noting that such action 

did not seem required for a staff nurse position. Dr. Askin provided a thorough review of the 

factual and medical background and accurately summarized the relevant medical evidence. 

Moreover, he provided detailed findings on examination and reached conclusions regarding 

appellant’s condition which comported with his findings.15 Consequently, Dr. Askin’s opinion is 

entitled to the weight of the evidence and establishes that she had no further disability or need for 

medical treatment due to her employment injury of a left knee contusion and strain of the anterior 

cruciate ligament after March 22, 2017.16

The remaining evidence of record submitted prior to OWCP’s termination of appellant’s 

compensation is insufficient to demonstrate that she had continuing disability or need for medical

treatment due to her September 4, 2015 work injury. On August 8, 2016 Dr. Harwood noted that 

she had undergone extensive physical therapy and a steroid injection after an unremarkable left 

knee MRI scan. He found no tenderness, effusion, laxity, instability, or locking on examination 

and recommended appellant return to her usual employment. Dr. Harwood noted that she was 

fearful of return to work and having to break up altercations with psychiatric patients, and referred 

her for an FCE, which demonstrated that she could perform medium work. On October 10, 2016 

he indicated that both of appellant’s left knee MRI scans were unremarkable demonstrating only 

mild chondromalacia. Dr. Harwood found that she had pain out of proportion to objective 

findings. He opined that appellant could perform medium work in accordance with the FCE. 

Dr. Harwood, however, did not specifically attribute her work restrictions to the September 4, 

2015 work injury or identify the diagnosed condition that necessitated the work restrictions. 

Consequently, his opinion is of diminished probative value.

Dr. Reiner, on October 10, 2016, found clicking, swelling, and popping of the left knee. 

He diagnosed internal derangement of the left knee and a possible occult meniscal tear. Dr. Reiner 

did not, however, specifically address causation. Medical evidence that does not offer any opinion 

regarding the cause of an employee’s condition is of diminished probative value on the issue of 

 

15 See Pamela K. Guesford, 53 ECAB 726 (2002).

16 See S.W., Docket No. 17-0215 (issued September 19, 2017).
9

causal relationship.17 Additionally, Dr. Reiner did not address the relevant issue of whether 

appellant was disabled from work due to her accepted injury.18 

In a report dated October 19, 2016, Dr. Scarlett discussed appellant’s history of a work 

injury breaking up an altercation between patients. He noted that she had continued complaints of 

left knee pain and difficulty with activities, and disagreed with Dr. Harwood’s finding that she 

could resume her usual employment. Dr. Scarlett attributed the findings on the MRI scan study

chondromalacia, a small cyst, and small effusions to the accepted work injury. OWCP, however, 

only accepted appellant’s claim for a left knee contusion and left anterior cruciate ligament sprain. 

Where a claimant alleges that a condition not accepted or approved was due to her employment 

injury, she bears the burden of proof to establish that the condition is causally related to the 

employment injury through the submission of rationalized medical evidence.19 Dr. Scarlett, 

however, did not provide any rationale for his opinion that the work injury caused the findings on 

the left knee MRI scan study. Medical conclusions unsupported by rationale are of little probative 

value.20

Dr. Reiner, on December 20, 2016, provided left knee examination findings of synovitis, 

tenderness, crepitus, and clicking. He diagnosed left knee internal derangement and a possible 

tear and recommended arthroscopic surgery. In a report dated February 14, 2017, Dr. Reiner 

diagnosed internal derangement of the left knee with a possible occult meniscal tear and 

chondromalacia patella. On examination he found synovitis, crepitus, and clicking of the left knee 

with quadriceps weakness. Dr. Reiner disagreed with Dr. Askin’s finding that appellant did not 

require further treatment and could return to her usual employment. As discussed, however, 

OWCP did not accept internal derangement of the left knee as work related, and Dr. Reiner has 

not provided any rationale explaining how the condition resulted from the September 4, 2015 

employment injury.21 Consequently, his opinion is of diminished probative value.

The Board finds that the weight of the evidence, as represented by Dr. Askin the second 

opinion physician, establishes that appellant had no employment-related disability or need for 

medical treatment, effective March 22, 2017, the date OWCP terminated her compensation.22

On appeal counsel asserts that a conflict exists between Dr. Askin and appellant’s attending 

physicians. He further contends that Dr. Askin’s opinion is contradictory and not well reasoned. 

As discussed, however, Dr. Askin provided rationale for his opinion that appellant had no further 

disability or need for medical treatment due to her accepted work injury. Dr. Harwood and

Dr. Reiner did not sufficiently explain how she had continued work restrictions or need for 

 

17 See S.E., Docket No. 08-2214 (issued May 6, 2009); Conard Hightower, 54 ECAB 796 (2003).

18 Carol A. Lyles, 57 ECAB 265 (2005) (whether a particular injury caused an employee disability from employment 

is a medical issue which must be resolved by competent medical evidence).

19 Jaja K. Asaramo, 55 ECAB 200, 204 (2004).

20 Willa M. Frazier, 55 ECAB 379 (2004); Jimmy H. Duckett, 52 ECAB 332 (2001).

21 See E.C., Docket No. 15-1943 (issued May 5, 2016).

22 See A.H., Docket No. 16-1828 (issued August 17, 2017).
10

treatment for her left knee contusion and sprain. Dr. Diamond addressed only the extent of 

appellant’s permanent impairment. Consequently, their opinions are insufficient to create a 

conflict with the opinion of Dr. Askin.23

Regarding counsel’s argument that Dr. Askin found that appellant was unable to manage 

violent patients, he indicated that in order to prevent future injury she should not engage in 

altercations with patients, noting that this appeared outside her job description. A fear of future 

injury, however, is not compensable under FECA.24

Counsel also maintains that Dr. Askin found a possible somatoform disorder, and that he 

submitted medical evidence demonstrating that appellant had a psychiatric condition due in part 

to the September 4, 2015 work injury. OWCP, however, is adjudicating the emotional aspect of 

the claim under a separate OWCP file number.

Counsel additionally contends that the employing establishment withdrew appellant’s 

limited-duty employment and she sustained a recurrence of disability. The evidence establishes 

that she resumed her usual employment on February 13, 2017, but stopped work on February 15, 

2017 and filed a notice of recurrence of disability. OWCP is adjudicating the notice of recurrence 

of disability as an occupational disease claim under a separate file number.

LEGAL PRECEDENT -- ISSUE 2

Once OWCP properly terminates a claimant’s compensation benefits, he or she has the 

burden of proof to establish that he or she has continuing disability after that date related to the

accepted injury.25 To establish causal relationship between the condition as well as any attendant 

disability claimed and the employment injury, an employee must submit rationalized medical 

evidence based on a complete medical and factual background, supporting such causal 

relationship.26 Causal relationship is a medical issue and the medical evidence required to establish 

causal relationship is rationalized medical evidence.27 A claimant must establish by the weight of 

the reliable, probative, and substantial evidence that he or she had an employment-related disability 

which continued after termination of compensation benefits.28

 

23 See S.P., Docket No. 16-0341 (issued November 7, 2016).

24 See M.S., Docket No. 17-0105 (issued December 7, 2017).

25 See T.M., Docket No. 17-0915 (issued August 29, 2017); Manuel Gill, 52 ECAB 282 (2001).

26 Id.

27 Paul Foster, 56 ECAB 208 (2004); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

28 See J.A., Docket No. 15-0908 (issued August 6, 2015).
11

ANALYSIS -- ISSUE 2

Given the Board’s finding that OWCP properly relied upon the opinion of Dr. Askin in 

terminating wage-loss compensation and medical benefits, the burden of proof shifted to appellant 

to establish that she remained entitled to compensation after that date.29

Appellant submitted February 23 and June 28, 2017 reports from Dr. Doyle diagnosing a 

psychiatric condition due in part to her September 4, 2015 work injury. Dr. Doyle also noted that 

she had a history of two other assaults at work. OWCP, however, is separately adjudicating 

appellant’s emotional condition arising from her history of assaults at work. Additionally, this 

evidence is not relevant to the pertinent issue of whether she had any continuing employmentrelated disability or need for medical treatment after March 22, 2017. Appellant, therefore, has 

not met her burden to proof to establish employment-related disability after March 22, 2017.

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 and 20 C.F.R. 

§§ 10.605 through 10.607.

CONCLUSION

The Board finds that OWCP properly terminated appellant’s wage-loss compensation and 

medical benefits, effective March 22, 2017, as she had no further disability or need for medical 

treatment causally related to her September 4, 2015 employment injury. The Board further finds 

that she has not established continuing employment-related disability after March 22, 2017.

 

29 See Manuel Gill, supra note 25.
12

ORDER

IT IS HEREBY ORDERED THAT the July 13, 2017 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: April 16, 2018

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