United States Department of Labor

Employees’ Compensation Appeals Board

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R.C., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

JOYFIELD STATION, Detroit, MI, Employer

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Docket No. 18-0612

Issued: October 19, 2018

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On January 30, 2018 appellant filed a timely appeal from an August 1, 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 the claim.

ISSUE

The issue is whether OWCP abused its discretion in denying authorization for a compound 

medication. 

 

1 Appellant asserts on appeal that he cannot afford to repay the full amount of an overpayment of compensation in 

the amount of $2,738.39 as set forth in an overpayment decision dated June 6, 2017. Appellant specifically appealed 

the decision dated August 1, 2017 which denied compounded medication. He did not file a timely appeal from the 

June 6, 2017 decision within 180 days of issuance and, therefore, the Board lacks jurisdiction over the overpayment 

decision and recovery plan ordered by OWCP. See 20 C.F.R. § 501.3(e).

2 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On February 2, 2010 appellant, then a 50-year-old city carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on January 20, 2010 he slipped on ice and injured his left knee, 

while performing his federal employment duties. On February 25, 2010 OWCP accepted 

appellant’s claim for a left knee sprain and contusion. It subsequently expanded acceptance of the 

claim on May 31, 2011 to include effusion of the left lower leg joint; aggravation of left knee 

osteoarthritis; and unspecified mechanical complication of internal orthopedic device, implant, and 

graft. OWCP paid appellant intermittent wage-loss compensation on the supplemental rolls as of 

March 9, 2010 and on the periodic rolls as of December 18, 2011. On April 2, 2013 appellant

underwent a left knee revision arthroplasty. 

On June 1, 2017 OWCP received an Authorization Request form and Certification/Letter 

of Medical Necessity for Compounded Drugs (OMB No. 1240-0055) for appellant. In this form,

Dr. Mark Stacherski, a Board-certified family practitioner, indicated that he last examined 

appellant on May 30, 2017. He requested authorization for a compound medication identified as

“5F-DlCL03-GABA6-LIDO2-Prilo2%.” Dr. Stacherski noted that this medication was necessary 

to treat appellant’s left knee. He indicated that appellant had tried and failed to obtain relief 

through other products, and that there were no commercially available Federal Drug 

Administration (FDA) drugs appropriate for the diagnosis. Dr. Stacherski indicated that appellant 

had knee surgery in the past and still had chronic pain. He noted that appellant could not be 

prescribed oral nonsteroidal anti-inflammatory drugs (NSAIDS) due to his gastroesophageal reflux 

disease (GERD) for which he takes omeprazole. Dr. Stacherski noted that appellant was 

prescribed oral hydrocodone for his chronic back pain.

On June 9, 2017 OWCP referred the matter to an OWCP medical adviser, Dr. William 

Tontz, Jr., a Board-certified orthopedic surgeon. It noted that OWCP’ s procedures require that 

consideration be given to whether there is justification for a prescription for a compounded 

medication and that its use is consistent with the medical evidence of record. OWCP’s medical 

adviser determined that the proposed compounded medication was not medically necessary. He 

indicated that there were no recent medical reports documenting objective or diagnostic findings. 

Dr. Tontz concluded that there was no need for compounded medication as there were no recent 

medical reports documenting objective or diagnostic findings. Further, guidelines did not support 

compound medications and there was no indication that appellant could not be prescribed oral 

medication, therefore, the compound medication was unnecessary.

By letter dated June 20, 2017, OWCP informed appellant that the evidence of record was 

insufficient to establish that the compounded medication was necessary to treat the effects of his

accepted employment conditions. It requested appellant to provide a narrative explanation from

his physician explaining why the compounded medication was medically necessary, including an 

explanation as to why a commercially available drug was insufficient. OWCP afforded him 30 

days to submit the requested information. Appellant did not respond. 

By decision dated August 1, 2017, OWCP denied authorization for a compounded 

medication as it determined that the evidence of record did not support that this medication was 

medically necessary to treat the effects of appellant’s work-related injury. 
3

LEGAL PRECEDENT

Section 8103(a) of FECA states in pertinent part: 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 the Secretary of Labor considers likely 

to cure, give relief, reduce the degree or the period of disability, or aid in lessening the amount of 

monthly compensation.3 In general, drugs and medications which are necessary to treat an injury 

or occupational disease may be purchased at OWCP’s expense on the recommendation of the 

attending physician. These include prescription as well as nonprescription medications.

4

The Board has found that OWCP has great discretion in determining whether a particular 

type of treatment is likely to cure or give relief.5 The only limitation on OWCP’s authority is that 

of reasonableness.6 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.7

ANALYSIS

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

a compound medication. 

OWCP accepted appellant’s claim for left knee sprain and contusion, effusion of the left 

lower leg, aggravation of left knee osteoarthritis, and unspecified mechanical complication of 

internal orthopedic device, implant, and graft. 

On June 1, 2017 Dr. Stacherski requested approval for a compounded drug, specifically 

“5F-D1CLO3-GABA6-LIDO2-Prilo2%.” He noted that this was a topical drug for treatment of 

appellant’s left knee arthropathy. Dr. Stacherski noted that the drug was necessary because 

appellant had chronic pain, cannot take oral NSAIDS due to his GERD, and that he was still in 

pain despite the fact that he was taking oral hydrocodone for his chronic back pain. However, 

OWCP’s medical adviser, Dr. Tontz, opined that this compound drug was unnecessary. After 

review of criteria for determining whether a compound drug was necessary, he concluded that 

there was no need for compounded medication as there were no recent medical reports 

documenting objective or diagnostic findings. The medical adviser also noted that guidelines did

not support compound medications, and there was no indication that the individual could not take 

oral medications. OWCP advised appellant that a narrative report from his physician was 

 

3 5 U.S.C. § 8103(a).

4 Federal (FECA) Procedure Manual, Part 3 -- Medical, Medical Services and Supplies, Prescription and NonPrescription Drugs, Chapter 3.400.3(a) (October 1995).

5 See M.B., Docket No. 17-1389 (issued April 6, 2018); see also Vicky C. Randall, 51 ECAB 357 (2000). 

6 See Lecil E. Stevens, 49 ECAB 673, 675 (1998). 

7 Rosa Lee Jones, 36 ECAB 679 (1985).
4

necessary to justify the use of a compound drug, but no narrative explaining the rationale for this 

drug was provided. 

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.8 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.9 

The Board finds that OWCP properly relied upon the well-rationalized opinion of OWCP’s

medical adviser, Dr. Tontz. Dr. Stacherski did not provide a well-rationalized opinion explaining 

the necessity of the compounded drug. OWCP asked appellant to submit a well-rationalized 

medical report from Dr. Stacherski to support his request, but he failed to do so. Accordingly, 

OWCP acted within its discretion in denying appellant’s request for compounded medication.

CONCLUSION

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

compounded medication. 

 

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

9 See M.G., Docket No. 18-0099 (issued April 26, 2018). 
5

ORDER

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

Programs dated August 1, 2017 is affirmed. 

Issued: October 19, 2018

Washington, DC

Christopher J. Godfrey, 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