United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.A., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Lodi, CA, Employer 

__________________________________________ 

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Docket No. 16-1687 

Issued: January 26, 2017 

Appearances: Case Submitted on the Record

Daniel M. Goodkin, Esq., for the appellant1

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 August 23, 2016 appellant, through counsel, filed a timely appeal from a July 22, 

2016 merit decision of the Office of Workers’ Compensation Programs (OWCP). 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. 

ISSUES 

The issues are: (1) whether OWCP met its burden of proof to terminate appellant’s 

medical and wage-loss compensation benefits on October 23, 2014; and (2) whether appellant 

 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

 5 U.S.C. § 8101 et seq. 
2

met her burden of proof to establish continuing employment-related disability or residuals after 

October 23, 2014. 

On appeal counsel asserts that appellant continues to suffer residuals of the October 28, 

2013 employment injury because, as evidenced by the medical evidence of record, she sustained 

additional injuries that day including bilateral carpal tunnel syndrome, cervical radiculopathy, 

and complex regional pain syndrome (CRPS). 

FACTUAL HISTORY 

On October 29, 2013 appellant, then a 51-year-old city mail carrier, filed a traumatic 

injury claim (Form CA-1) alleging that a fall from a curb while delivering mail on October 28, 

2013 caused a right hand fracture, and injuries to her right knee and left foot. She stopped work 

that day and was seen by Dr. Rami Georgies, a Board-certified family physician, at an urgent 

care facility. Dr. Georgies reported a history that she fell on concrete, hitting her knee and right 

hand and provided examination findings and diagnosed a fifth distal phalange fracture with hand 

pain and right knee pain. A splint was placed that day. Appellant had good capillary refill and 

normal sensation after placement. Right knee and hand x-rays done that day were unremarkable. 

October 29, 2013 left ankle and foot x-rays were also unremarkable. 

OWCP accepted sprains of the right hand and wrist and a sprain of the left ankle on 

November 21, 2013. Appellant received compensation and was later placed on the periodic 

compensation rolls effective March 9, 2014. 

Dr. Kevin Buckman, an emergency medicine specialist and general practitioner, 

examined appellant on October 29, 2013. He noted a history of appellant falling on a curb at 

work, injuring her right hand and knee, and left foot. Dr. Buckman submitted weekly reports in 

which noted complaints of left ankle and right arm pain. He described examination findings 

including negative Tinel’s and Phalen’s signs in the right hand. Dr. Buckman diagnosed injuries 

of the right arm, right knee, and left ankle. He recommended an ace wrap and advised that 

appellant could not work. On December 11, 2013 Dr. Buckman referred appellant for magnetic 

resonance imaging (MRI) scans and to Dr. Vincent Leung, Board-certified in orthopedic and 

hand surgery. 

In a January 2, 2014 report, Dr. Leung noted that appellant fell at work and was seen for 

a complaint of right arm pain. He advised that examination was difficult, noting that her pain 

was not well localized. Dr. Leung indicated that, after examining her “back and forth,” the only 

localization he could pin down was at the base of the right long finger and was suggestive of 

trigger finger. He interpreted MRI scans of the right wrist and right hand as normal and advised 

that right hand and wrist x-rays done in his office that day were also normal.3

 Dr. Leung advised 

that he had no explanation for her multiple areas of pain which were somewhat out of proportion 

to objective findings, and the suspicion of right long trigger finger was the only diagnosis. He 

concluded that appellant could return to regular duty. 

 3

 The record before the Board does not contain MRI scan reports, other than Dr. Leung’s report of his review of 

the scans. 
3

Appellant then began treatment with Dr. Gary R. Wisner, a Board-certified orthopedic 

surgeon, on January 29, 2014. On a State of California workers’ compensation form report, 

Dr. Wisner noted a history that appellant fell on her hand at work and continued to have pain 

with superficial touch. He described examination findings and diagnosed early CRPS of the 

right hand, wrist, and upper extremity, and severe right wrist sprain. Dr. Wisner recommended 

that appellant discontinue use of a splint. He also provided a January 29, 2014 duty status report 

(Form CA-17) in which he advised that appellant could not work. 

In March 2014 OWCP referred appellant to Dr. Ernest B. Miller, a Board-certified 

orthopedic surgeon, for a second opinion evaluation. 

Dr. Wisner continued to submit State of California Workers’ Compensation form reports, 

noting subjective complaints of right hand numbness, tingling, swelling, and pain that radiated 

into the forearm, and right ankle pain that radiated up into the leg. He diagnosed early CRPS of 

the right hand and wrist, severe right wrist sprain, and a painful ganglion seen on MRI scan. 

Dr. Wisner advised that appellant could not work. 

In a May 8, 2014 report, Dr. Miller noted his review of the record and appellant’s report 

that she slipped and fell at work on October 28, 2013, injuring her right hand and wrist and left 

ankle. He described her current complaints of right hand pain, numbness, and tingling radiating 

to the right elbow, and sharp pain in the left foot shooting up from the great toe. Dr. Miller 

advised that right wrist range of motion was limited due to pain, and that she had no right upper 

extremity atrophy. Ankle range of motion was full and symmetric. Dr. Miller indicated that 

skin, temperature, texture, color, and sensation were completely normal in the arms and ankles. 

He diagnosed sprain of the right wrist and right hand with residual symptoms of pain with range 

of motion, and left ankle sprain, resolved, with normal gait. In answer to OWCP questions, 

Dr. Miller advised that appellant continued to have right hand and wrist pain due to the 

October 28, 2013 work injury. He opined that the period of appellant’s total disability was quite 

unnecessary and that she needed no further treatment other than over-the-counter medication for 

the accepted sprains. Dr. Miller opined that a period of total disability for diagnoses of sprain 

and strain should not exceed four to six weeks. He recommended that appellant resume normal 

activity and advised that a rigorous exercise program was the key to recovery. 

Dr. Wisner continued to submit both State of California form reports and duty status 

reports in which he reiterated his findings and conclusion that appellant could not work. 

On August 15, 2014 OWCP proposed to terminate appellant’s medical and wage-loss 

compensation benefits. It found that the weight of the medical opinion evidence rested with the 

opinion of Dr. Miller who advised that she could return to work and that she needed no further 

treatment for the accepted sprains. 

In reports received after the proposed termination dated July 28 to September 8, 2014, 

Dr. Wisner noted appellant’s continued complaint of right wrist and left ankle pain. He 

described decreased range of motion in the right wrist and left ankle and reiterated his diagnoses 

of early CRPS of the right hand and wrist, severe right wrist sprain, and painful ganglion. 

Dr. Wisner continued to advise that appellant could not work. In correspondence dated 

August 19, 2014, he noted that appellant was initially seen on January 29, 2014 with complaints 

of severe right hand and finger pain and severe left foot and ankle pain that she indicated were 
4

caused by a fall at work on October 28, 2013. Dr. Wisner reported that appellant was seen for 

regular follow-up appointments and continued to have pain and symptomatology of the right 

hand, wrist, and left ankle. He diagnosed early CRPS/RSD (reflex sympathetic dystrophy) of the 

right hand, wrist, and right upper extremity, severe right wrist sprain, possible right triquetrum 

fracture, painful ganglion by MRI scan, Dupuytren’s nodules of the right long and ring fingers, 

left foot, ankle sprain with possible internal derangement and metatarsalgia, and osteoarthritis 

left foot/ankle. He concluded that the work injury had not resolved. 

In an October 23, 2014 decision, OWCP terminated appellant’s medical and wage-loss 

compensation benefits, effective that day. It found that the weight of the medical evidence rested 

with the opinion of Dr. Miller. 

On August 7, 2015 appellant, through counsel, requested reconsideration.4

 Counsel 

submitted a July 10, 2015 report in which Dr. Jeffrey R. Levin, a Board-certified neurologist, 

noted a history that appellant tripped and fell while delivering mail on October 28, 2013 and 

sustained trauma to her chest, right arm, and ankle. He related that she had been unable to return 

to work. Dr. Levin described physical examination findings of positive Tinel’s sign at both 

wrists with thenar weakness and atrophy bilaterally, mild weakness of the deltoid and biceps 

bilaterally, more prominent in the right than the left, and pain and tenderness in the right hand. 

He reported that the distal phalanx of the middle finger was somewhat swollen and tender to 

palpation, and that the right hand was colder than the left with decreased capillary refill. 

Dr. Levin noted no other weakness was seen in the arms and legs, and that she ambulated 

without difficulty. Sensory examination was grossly intact to light touch, vibration, and 

pinprick. Dr. Levin diagnosed bilateral carpal tunnel syndrome and C5-6 radiculopathy, as 

confirmed by his electrodiagnostic testing done that day.5 He opined that appellant had RSD 

noting that history suggested that RSD was caused by trauma to the right arm. Dr. Levin 

recommended a bone scan for further confirmation, and a cervical spine MRI scan. He advised 

that the diagnosed carpal tunnel syndrome was partially due to appellant’s repetitive duties of 

lifting and grasping as a mail carrier and that it and the diagnosed radiculopathy were caused or 

aggravated by her fall on October 28, 2013. Dr. Levin concluded that, at that time, appellant had 

work restrictions due to her inability to use her hands appropriately. 

Dr. Wisner continued to submit both State of California workers’ compensation form 

reports and duty status reports in which he reiterated his findings and conclusion that appellant 

could not work. 

In a merit decision dated November 5, 2015, OWCP denied modification of the 

October 23, 2014 decision. It found that Dr. Levin failed to provide a rationalized medical 

opinion which supported that the diagnoses of carpal tunnel syndrome, RSD, or cervical 

radiculopathy were causally related to the October 28, 2013 work injury. 

 4

 Appellant had initially requested a hearing before an OWCP hearing representative. On February 12, 2015 a 

union representative cancelled the request. 

5

 A copy of this report is found in the case record. 
5

On April 26, 2016 appellant, through counsel, requested reconsideration. Counsel 

maintained that appellant sustained additional diagnoses due to the October 28, 2013 

employment injury that rendered her totally disabled. 

In a November 6, 2015 report, Dr. Wisner described findings from an October 7, 2015 

examination. He noted appellant’s complaint of pain and stiffness with weather changes in the 

right hand and left ankle pain with prolonged walking. Dr. Wisner diagnosed right hand sprain, 

right wrist sprain, and left ankle sprain. He prescribed over-the-counter medication and physical 

therapy. 

Dr. Timothy A. Walth, a chiropractor, submitted a February 12, 2016 report, cosigned 

and adopted by Dr. Wisner. In his report, he noted appellant’s work history with the employing 

establishment since 1990. Appellant related that on October 28, 2013 she tripped on a curb, 

falling forward, landing on her outstretched left hand with her right hand curled underneath her 

body, trapping it between her body and the concrete. She felt immediate right hand pain and had 

a left knee contusion. Medical evidence reviewed included a December 17, 2013 right hand 

MRI scan that showed no evidence of abnormality at the third metacarpophalangeal joint, 

although motion limited the evaluation; a November 25, 2014 cervical spine MRI scan that 

showed moderate narrowing of the right C5-6 neural foramen, and newly developed left-side 

neural foraminal stenosis at the C3-4 level potentially compromising the existing nerve root, and 

mild posterior disc bulging from C3 through C6; and a November 26, 2014 lumbar spine MRI 

scan showing a disc bulge at L4-5.6

 Appellant complained of right forearm, wrist, and hand pain 

with numbness and tingling, and occasional swelling. She had cervical spine pain radiating into 

the upper left trapezial area. Appellant noted that when she fell on her left arm in October 2013, 

she felt the impact through her cervical spine which became painful in about April 2014. Right 

wrist findings included mild atrophy, diffuse swelling, and exquisite tenderness of the middle 

and ring finger metacarpophalangeal articular structures. Phalen’s, Reverse Phalen’s, and 

Tinel’s tests were positive on the right. Tinel’s was also positive on the left. Right wrist range 

of motion was diminished. Appellant had paraspinal musculature tenderness from C3 to C6 and 

T1 through T7. Facet Distraction and Spurling’s tests were positive in the cervical spine. Soto 

Hall testing was positive in both the cervical and thoracic spine, and both demonstrated 

decreased range of motion. Appellant had increased exaggerated response to light touch and 

two-point stimuli along the right forearm and hand. 

Dr. Walth diagnosed chronic pain and strain of the right wrist, right forearm, cervical 

spine, and thoracic spine, severe in the right wrist and RSD/CRPS of the right wrist and right 

forearm. Further right wrist diagnoses were carpal tunnel syndrome, post-traumatic cyst, and 

radial and ulnar styloid inflammation. Dr. Walth also diagnosed articular dysfunction of the 

cervical and thoracic spines with cervical radiculopathy at C5-6. He referenced publications that 

supported his conclusions about appellant’s condition, the definition for causation under 

California worker’s compensation law, the fifth edition of the American Medical Association, 

Guides to the Evaluation of Permanent Impairment (hereinafter A.M.A., Guides),7

 and American 

College of Occupational and Environmental Medicine. Dr. Walth concluded that appellant’s 

diagnoses of RSD/CRPS, carpal tunnel syndrome, styloid inflammation, and post-traumatic cyst, 

 6

 Copies of the test reports are not found in the case record. 

7

 A.M.A., Guides (5th ed. 2001). 
6

chronic pain and strain, and the cervical and thoracic articular dysfunction were directly related 

to the October 28, 2013 work injury, and the right arm diagnoses were due to the prolonged use 

of her splint provided at the beginning of her care. He deferred to Dr. Wisner regarding 

appellant’s return to work. On an attached work capacity evaluation (Form OWCP-5c), 

Dr. Walth advised that appellant had right arm limitations on reaching above the shoulder, 

operating a motor vehicle, repetitive wrist and elbow use, pushing, pulling, and lifting. 

Dr. Wisner agreed with these restrictions. 

In a merit decision dated July 22, 2016, OWCP denied modification of the prior 

decisions. It found that the weight of the medical opinion evidence continued to rest with 

Dr. Miller who advised that the accepted conditions had resolved. OWCP also found that there 

was no rationalized medical evidence supporting the connection of CRPS, carpal tunnel 

syndrome, cervical radiculopathy, or thoracic sprain to the October 28, 2013 work injury. 

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. It may not terminate compensation 

without establishing that the disability ceased or that it was no longer related to the employment.8

 

OWCP’s burden of proof in terminating compensation includes the necessity of furnishing 

rationalized medical opinion evidence based on a proper factual and medical background.9

 

ANALYSIS -- ISSUE 1 

OWCP accepted that on October 28, 2013 appellant sustained right hand, right wrist, and 

left ankle sprains. It terminated her wage-loss compensation and medical benefits on 

October 23, 2014, based on the opinion of Dr. Miller, an OWCP referral physician. 

The medical evidence relevant to the October 23, 2014 termination included Dr. Miller’s 

May 8, 2014 report in which he noted his review of the medical record and diagnostic studies, 

and thoroughly described physical examination findings. Dr. Miller noted that appellant reported 

a history that she slipped and fell at work on October 28, 2013, injuring her right hand and wrist 

and left ankle. He described her current complaints of right hand pain, numbness, and tingling 

radiating to the right elbow, and sharp pain in the left foot shooting up from the great toe. 

Dr. Miller advised that right wrist range of motion was limited due to pain and that she had no 

right upper extremity atrophy. Ankle range of motion was full and symmetric. Dr. Miller 

indicated that skin, temperature, texture, color, and sensation were completely normal in the 

upper extremities and ankles. He diagnosed sprain of the right wrist and right hand with residual 

symptoms of pain with range of motion, and left ankle sprain, resolved, with normal gait. 

Dr. Miller advised that, while appellant continued to have right hand and wrist pain due to the 

October 28, 2013 work injury, she had no further disability and needed no further treatment for 

the accepted sprains. He opined that appellant was no longer totally disabled, noting that a 

period of total disability for diagnoses of sprain and strain should not exceed four to six weeks. 

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

9 Id.
7

Dr. Miller recommended that appellant resume normal activity and advised that a rigorous 

exercise program was the key to recovery. 

In response to the pretermination notice, appellant submitted a number of form reports 

from Dr. Wisner who began treating appellant on January 29, 2014. In these reports Dr. Miller 

noted appellant’s continued complaint of right wrist and left ankle pain. He described decreased 

range of motion in the right wrist and left ankle and reiterated his diagnoses of early CRPS of the 

right hand and wrist, severe right wrist sprain, and painful ganglion, and advised that she could 

not work. On August 19, 2014 Dr. Wisner advised that appellant continued to have pain and 

symptomatology of the right hand, wrist, and left ankle. Diagnosis included early CRPS/RSD of 

the right hand, wrist, and arm, severe right wrist sprain, left ankle sprain with possible internal 

derangement and metatarsalgia, and osteoarthritis left foot/ankle. While Dr. Wisner opined that 

appellant’s October 28, 2013 employment injury had not resolved, he did not offer any 

explanation of the mechanics of how the October 28, 2013 employment injury caused appellant’s 

current diagnoses and continued disability.10 

Moreover, shortly before Dr. Wisner began treating appellant, in a January 2, 2014 

report, Dr. Leung had noted the history of injury and advised that physical examination was 

difficult, noting that her pain was not well localized. He advised that he had no explanation for 

her multiple areas of pain which were somewhat out of proportion to objective findings, and the 

suspicion of right long trigger finger was the only diagnosis. Dr. Leung concluded that appellant 

could return to regular-duty work. 

The Board finds that Dr. Wisner’s opinion is insufficient to establish a conflict in medical 

evidence with the well-rationalized opinion of Dr. Miller whose opinion represents the weight of 

the medical evidence at the time OWCP terminated appellant’s wage-loss compensation and 

medical benefits. Dr. Miller had full knowledge of the relevant facts and evaluated the course of 

appellant’s accepted conditions. His opinion was based on proper factual and medical history 

and his report contained a detailed summary of this history. Dr. Miller addressed the medical 

records to make his own examination findings to reach a reasoned conclusion regarding 

appellant’s conditions.11 At the time benefits were terminated, he found no basis on which to 

attribute any residuals or continued disability to appellant’s accepted conditions. Dr. Miller’s 

opinion is found to be probative evidence and reliable, and sufficient to justify OWCP’s 

termination of benefits for the accepted conditions. 

OWCP therefore met its burden of proof to terminate appellant’s wage-loss compensation 

and medical benefits on October 23, 2014.12

 10 See S.S., Docket No. 15-1422 (issued October 28, 2015). 

11 See Michael S. Mina, 57 ECAB 379 (2006) (the opportunity for and thoroughness of examination, the accuracy 

and completeness of the physician’s knowledge of the facts and medical history, the care of analysis manifested, and 

the medical rationale expressed in support of the physician’s opinion are facts, which determine the weight to be 

given to each individual report). 

12 Supra note 8. 
8

LEGAL PRECEDENT -- ISSUE 2 

As OWCP met its burden of proof to terminate appellant’s medical and wage-loss 

compensation benefits on October 23, 2014, the burden shifted to her to establish that she had 

any disability causally related to the accepted knee conditions.13 Causal relationship is a medical 

issue. The opinion of the physician must be based on a complete factual and medical 

background of the claimant, must be one of reasonable medical certainty and must be supported 

by medical rationale explaining the nature of the relationship between the diagnosed condition 

and the specific employment factors identified by the claimant.14

ANALYSIS -- ISSUE 2 

The Board finds that appellant did not establish that she had continuing residuals or 

disability relating to the accepted right hand, right wrist, and left ankle sprains after 

October 23, 2014. 

Subsequent to the termination of benefits appellant submitted a July 10, 2015 report from 

Dr. Levin, who did not examine appellant until more than 20 months after the employment 

injury. Dr. Levin did not discuss the accepted conditions. Rather, he diagnosed bilateral carpal 

tunnel syndrome and C5-6 radiculopathy, conditions not accepted as employment related.15 

While Dr. Levin found positive Tinel’s tests bilaterally, Dr. Buckman, who treated appellant 

from October 29 to December 11, 2013, noted negative Tinel’s and Phalen’s tests in appellant’s 

right hand. Dr. Levin provided no real explanation of how the October 28, 2013 work injury 

caused the diagnosed carpal tunnel syndrome and cervical radiculopathy or why appellant could 

not use her hands. Furthermore, his opinion that RSD could be caused by trauma was 

speculative. The Board has long held that medical opinions that are speculative or equivocal in 

character are of diminished probative value.16

Dr. Wisner continued to submit form reports and duty status reports after the October 23, 

2014 termination. In each of these reports he provided similar findings and conclusions to those 

he reported prior to the termination. They alone are therefore insufficient to meet appellant’s 

burden of proof that she continued to be disabled.17 

Dr. Wisner also cosigned Dr. Walth’s February 12, 2016 report which was rendered more 

than 27 months after the October 28, 2013 work injury and included the first report that on 

October 28, 2013 appellant did not land on her right hand but on the left, and that her right hand 

was trapped underneath her. While he reported his review of diagnostic testing, none of these 

reports are found in the case record. In regard to cervical radiculopathy, Dr. Walth reported that 

 13 See Daniel F. O’Donnell, Jr., 54 ECAB 456 (2003). 

14 Leslie C. Moore, 52 ECAB 132 (2000); Gary L. Fowler, 45 ECAB 365 (1994). 

15 T.M., Docket No. 08-975 (issued February 6, 2009) (where a claimant claims that a condition not accepted or 

approved by OWCP was due to an employment injury, the claimant bears the burden of proof to establish that the 

condition is causally related to the employment injury through the submission of rationalized medical evidence). 

16 D.D., 57 ECAB 734 (2006). 

17 Supra note 14. 
9

appellant felt that her fall on October 28, 2013 impacted her cervical spine, but that she had no 

cervical complaints until April 2014. He also noted positive finding on examination of both 

hands and in the cervical spine. Dr. Walth concluded that appellant’s diagnoses of RSD/CRPS, 

carpal tunnel syndrome, styloid inflammation, and post-traumatic cyst, chronic pain and strain, 

and the cervical and thoracic articular dysfunction were directly related to the October 28, 2013 

employment injury, and the right upper extremity diagnoses were also due to the prolonged use 

of her splint provided at the beginning of her care. Other than generally opining that use of the 

splint contributed to the RSD/CRPS diagnosis, Dr. Walth provided no additional explanation. 

While he referenced some publications, he did not provide a sufficient explanation of the 

applicability of the general medical principles discussed in the articles to the specific factual 

situation at issue in the case.18 

The Board finds that Dr. Walth did not explain with sufficient rationale how and why the 

conditions of chronic pain and strain of the right wrist, right forearm, cervical spine, and thoracic 

spine, severe in the right wrist; RSD/CRPS of the right wrist and right forearm; carpal tunnel 

syndrome; post-traumatic cyst; radial and ulnar styloid inflammation; and articular dysfunction 

of the cervical and thoracic spines with cervical radiculopathy at C5-6 were caused by the 

October 28, 2013 employment injury. The Board has long held that to support causal 

relationship, the opinion of the physician must be based on a complete factual and medical 

background of the claimant, must be one of reasonable medical certainty, and must be supported 

by medical rationale explaining the nature of the relationship between the diagnosed condition 

and the specific employment factors identified by the employee.19 

The opinion of a physician supporting causal relationship must be one of reasonable 

medical certainty that the condition for which compensation is claimed is causally related to a 

claimant’s federal employment and such relationship must be supported with affirmative 

evidence, explained by medical rationale and be based upon a complete and accurate medical 

and factual background of the claimant.20 The Board has long held that medical opinions not 

containing rationale on causal relation are of diminished probative value and are generally 

insufficient to meet appellant’s burden of proof.21 The Board finds that Dr. Walth’s February 12, 

2016 report as cosigned by Dr. Wisner is of limited probative value on the issue of whether 

appellant had any continuing disability or condition due to the October 28, 2013 employment 

injury. Dr. Walth did not discuss the accepted conditions, and the history of injury provided by 

him was not in accordance with those more contemporaneous with the employment injury.22 His 

opinion is insufficient to establish that the October 28, 2013 employment injury caused 

additional conditions or that appellant continued to be disabled due to the accepted right hand, 

right wrist, and left ankle sprains. 

 18 See Roger G. Payne, 55 ECAB 535 (2004). 

19 Supra note 14. 

20 A.D., 58 ECAB 149 (2006). 

21 Carolyn F. Allen, 47 ECAB 240 (1995). 

22 The Board has held that contemporaneous evidence is entitled to greater probative value than later evidence. 

S.S., 59 ECAB 315 (2008). 
10

The factors that comprise the evaluation of medical evidence include the opportunity for 

and the thoroughness of physical examination, the accuracy and completeness of the physician’s 

knowledge of the facts and medical history, the care of analysis manifested and the medical 

rationale expressed in support of the physician’s opinion.23 As there is no medical evidence of 

record of sufficient rationale to establish that appellant continued to be disabled due to the 

October 28, 2013 employment injury, she did not meet her burden of proof to establish that she 

continued to be disabled due to the accepted right hand, right wrist, and left ankle sprains after 

October 23, 2014. 

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 met its burden of proof to terminate appellant’s 

compensation on October 23, 2014 and that she did not establish that she had a continuing 

employment-related condition or disability after October 23, 2014. 

ORDER 

IT IS HEREBY ORDERED THAT the July 22, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: January 26, 2017 

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 

 23 Nicolette R. Kelstrom, 54 ECAB 570 (2003).