United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.C., Appellant 

and 

DEPARTMENT OF THE NAVY, MEDICAL 

COMMAND, Fort Campbell, KY, Employer 

__________________________________________ 

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Docket No. 16-1267 

Issued: February 24, 2017 

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 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On June 6, 2016 appellant filed a timely appeal from a February 22, 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 the claim. 

ISSUE 

The issue is whether appellant met her burden of proof to establish a recurrence of her 

medical condition causally related to her March 17, 2006 employment injury. 

FACTUAL HISTORY 

On March 22, 2006 appellant, then a 40-year-old food service worker, filed a traumatic 

injury claim (Form CA-1) alleging that on March 17, 2006 she broke two front teeth when she 

slipped and fell, striking a gallon jar she was carrying. Evidence received with the claim 

indicated that the teeth were not appellant’s natural teeth, but were part of a 14 unit bridge of 

 1

 5 U.S.C. § 8101 et seq.
2

artificial teeth. The medical evidence also indicated that the bridge needed to be replaced as it 

could not be repaired. Appellant was noted to have had a partial denture for her lower teeth, in 

addition to lower jaw problems due to missing lower back teeth. These were not reported as 

being related to the instant claim, though the dentist indicated that treatment was necessary for 

the lower jaw. OWCP accepted the claim for broken upper front teeth and lower back teeth and 

paid wage-loss compensation benefits, including authorization of the requested bridge 

replacement. 

In January 2015, appellant contacted OWCP by telephone. She indicated that due to her 

husband’s military service her family had been transferred to Japan in 2006 and that they were 

now stationed in Belgium. Appellant stated that she needed her claim reopened for a medical 

appointment. She subsequently provided a new mailing address in writing. 

On May 19, 2015 OWCP received appellant’s claim for a recurrence (Form CA-2a) 

requesting follow-up care for appellant’s denture. Appellant indicated that every six months her 

prosthetic denture needed adjustment and replacement of the rubber and that her prosthetic 

dentures were getting loose. She indicated that she was unable to see her doctor every six 

months as her family was stationed overseas. 

In a January 20, 2015 letter, Dr. Joseph C. Steele, a prosthodontist, indicated that 

appellant’s denture had been replaced due to an injury on March 17, 2006 and that annual 

examinations were needed to maintain oral health along with proper fit of partial dentures. He 

noted that his original treatment included: upper metal partial denture, porcelain fused to high 

noble crown on teeth numbers 2, 6, 11, 13, and 14, and precision attachments for teeth numbers 

2, 6, and 11. 

In a June 2, 2015 letter, OWCP advised appellant of the evidence needed to establish her 

claimed recurrence. It advised that for her to be entitled to additional medical treatment for her 

work injury after being released from care, or not receiving care for a significant period of time, 

she must provide evidence to support that her need for treatment was due to a worsening of the 

accepted work-related conditions(s) without intervening cause. OWCP noted that the evidence 

received was insufficient to establish her claim for recurrence because she was claiming that she 

needed to follow up for adjustment and replacement of the rubber every six months. It requested 

that she provide additional factual evidence along with copies of all medical records for the 

work-related condition and a comprehensive, narrative medical report from her treating 

physician which established the relationship between her current medical condition and the 

original injury. Appellant was afforded 30 days to submit the requested evidence. 

In a July 15, 2015 statement, appellant related that before she left for Japan in 2006, her 

dentist, Dr. Steele, had told her that the replacement rubber for her dentures needed to be 

replaced two to three times a year. She did nothing about it for the first year because she did not 

note any problem. Appellant ultimately returned to the United States and saw Dr. Steele, who 

changed the replacement rubber for her, but she ended up paying the bill on her own as her 

workers’ compensation claim had been closed. She indicated that she had trouble getting the 

rubber replaced as needed because she could not find any dentists to do it. Appellant saw 

Dr. Steele again in 2011, but he recommended that, since she lived in Belgium, she should get 

the work done there. She indicated that she was still trying to get her dentures repaired in 

Belgium. 
3

Medical treatment notes from 2015 indicated that some of the attachments in appellant’s 

upper prosthesis and crowns were broken. The dentist performed the repair, but indicated that 

this was not a good solution. The dentist recommended an extraction of teeth of upper jaw and a 

fixed temporary bridge for six months, after which a fixed bridge would be in upper jaw. 

Handwritten treatment records from 2015, mostly illegible, bills and a claim for medical 

reimbursement were provided. 

By decision dated July 28, 2015, OWCP denied the recurrence claim as the medical 

evidence of record failed to establish that the requested treatment was due to the accepted injury. 

On August 27, 2015 OWCP received appellant’s August 13, 2015 request for review of 

the written record before OWCP’s Branch of Hearings and Review. Appellant provided 

duplicative evidence already of record. 

Medical evidence from 2006 indicated a bridge had been made in April 2004 with five 

teeth supporting that bridge and that appellant’s upper jaw was missing multiple teeth. The 

lower jaw was also missing back teeth, the lower right first molar and the lower left first molar 

and second premolar. Appellant broke the upper front teeth off her bridge due to her accident at 

work on March 17, 2006 and the dentists of record all indicated that her bridge had to be 

replaced. The treatment plan indicated that teeth numbers 2, 6, 11, 13, 14, and 15 were involved. 

By decision dated February 22, 2016, an OWCP hearing representative affirmed the 

July 28, 2015 decision, finding that the medical evidence of record failed to explain how 

appellant’s current need for dental work was due to the accepted March 17, 2006 work injury. 

LEGAL PRECEDENT 

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 that the Secretary of Labor considers likely to cure, give relief, reduce the degree or 

the period of any disability, or aid in lessening the amount of any monthly compensation.2

 

Recurrence of medical condition means a documented need for further medical treatment 

after release from treatment for the accepted condition or injury when there is no accompanying 

work stoppage. Continuous treatment for the original condition or injury is not considered a 

need for further medical treatment after release from treatment, nor is an examination without 

treatment.3 

If a claim for recurrence of medical condition is made more than 90 days after release 

from medical care, a claimant is responsible for submitting a medical report supporting a causal 

relationship between the employee’s current condition and the original injury in order to meet 

her burden.4

 2

 5 U.S.C. § 8103(a). 

3

 20 C.F.R. § 10.5(y). 

4

 Federal (FECA) Procedure Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.4(b) (June 2013); see also 

J.M., Docket No. 09-2041 (issued May 6, 2010). 
4

An employee has the burden of proof to establish that he or she sustained a recurrence of 

a medical condition that is causally related to his or her accepted employment injury. To meet 

this burden, the employee must submit medical evidence from a physician who, on the basis of a 

complete and accurate factual and medical history, supports that the condition is causally related 

to and supports appellant’s conclusion with sound medical rationale.5

ANALYSIS 

OWCP accepted that appellant’s March 17, 2006 employment injury resulted in broken 

upper front teeth and lower back teeth. It authorized an upper bridge replacement due to two 

broken artificial teeth on a bridge that could not be repaired. In 2015, appellant filed a claim for 

recurrence of medical condition, which OWCP denied as the medical evidence of record failed to 

establish that the requested treatments were due to the accepted injury. 

Appellant requested medical care for replacement rubber for her dentures. The medical 

records from 2015 also indicated that some attachments in appellant’s upper prosthesis and 

crowns were broken. 

In a January 20, 2015 letter, Dr. Steele indicated that appellant’s denture had been 

replaced due to an injury on March 17, 2006 and that annual examinations were needed to 

maintain oral health along with proper fit of partial dentures. Dr. Steele, however, did not 

mention any of the above medical care claimed. Medical evidence that does not offer any 

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

of causal relationship.6 

The dental records provided from 2015 also fail to mention that the necessary treatment is 

due to the accepted work injury of 2006. Moreover, there are no dental records from 2006 to 

2015 to substantiate that the claimed recurrence of medical care is due to the work injury of 

2006. 

In order for a medical condition to be covered under FECA, medical evidence must 

demonstrate that it is related to the accepted injury. Appellant’s physician must explain how the 

work injury of 2006 caused or affected her current dental condition, based upon an accurate 

factual and medical history, citing objective findings in support of the opinion. As noted, no 

dentist has explained how appellant’s current need for dental work continued to be related to the 

work injury of 2006. In short, appellant bears the burden of establishing a recurrence of medical 

condition. 

The Board finds that the evidence submitted by appellant lacks adequate rationale to 

establish causal relationship between the alleged recurrence of her medical conditions and the 

accepted employment injury. Appellant has the burden of submitting sufficient medical 

evidence to document the need for further medical treatment. She did not submit such evidence 

as required and failed to establish a need for continuing medical treatment.7

 5 O.H., Docket No. 15-0778 (issued June 25, 2015), K.T., Docket No. 15-1758 (issued May 24, 2016). 

6 Jaja K. Asaramo, 55 ECAB 200 (2004). 

7 See P.Q., Docket No. 14-1905 (issued May 26, 2015); J.F., 58 ECAB 331 (2006). 
5

On appeal, appellant contends that the medical evidence of record supports that her whole 

bridge needed to be replaced to restore her mouth back to the way it was prior to the accident. 

As noted, OWCP authorized the replacement of appellant’s upper bridge and all necessary work, 

which appellant had done. The current issue, however, involves appellant’s claim for medical 

treatment. As noted, the evidence submitted by appellant lacks adequate rationale to establish 

causal relationship between the alleged recurrence of her medical conditions and the accepted 

employment injury. 

Appellant may submit new evidence or argument as part of a formal 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 appellant has not met her burden of proof to establish a recurrence 

of her medical condition causally related to her March 17, 2006 employment injury. 

ORDER 

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

decision dated February 22, 2016 is affirmed. 

Issued: February 24, 2017 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board