United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

B.T., Appellant

and

U.S. POSTAL SERVICE, MIDTOWN BRANCH 

POST OFFICE, Atlanta, GA, Employer

__________________________________________

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Docket No. 19-0531

Issued: August 19, 2019

Appearances: Case Submitted on the Record

Appellant, pro se

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 January 2, 2019 appellant filed a timely appeal from a November 30, 2018 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 this case.2

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that, following the November 30, 2018 decision, OWCP received additional evidence. However, 

the Board’s Rules of Procedure provides: “The Board’s review of a case is limited to the evidence in the case record 

that was before OWCP at the time of its final decision. Evidence not before OWCP will not be considered by the 

Board for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this 

additional evidence for the first time on appeal. Id.
2

ISSUE

The issue is whether appellant has met her burden of proof to establish more than one 

percent permanent impairment of the right lower extremity and one percent permanent impairment 

of the left lower extremity, for which she previously received schedule award compensation. 

FACTUAL HISTORY

On June 8, 1995 appellant, then a 36-year-old letter carrier, filed an occupational disease 

claim (Form CA-2) alleging that she developed bilateral plantar fasciitis due to factors of her 

federal employment, including constant standing. 

By decision dated September 29, 1995, OWCP accepted appellant’s claim for the condition 

of bilateral plantar fasciitis. 

On August 8, 2001 appellant filed a claim for a schedule award (Form CA-7). 

In development letters dated September 17, 2001, April 1, 2002, and October 6, 2003,

OWCP requested that Dr. Anthony J. Gatti, a podiatrist, provide an impairment rating pursuant to 

the fifth edition of the American Medical Association, Guides to the Evaluation of Permanent 

Impairment (A.M.A., Guides).3 

On October 17, 2003 appellant was evaluated by Dr. Charles Haendel, a podiatrist, who 

opined that appellant had reached maximum medical improvement (MMI) on October 17, 2003.

Dr. Haendel noted dorsiflexion of 10 degrees, plantar flexion of 45 degrees, inversion of 25 

degrees, eversion to 25 degrees, and ankyloses of 10 degrees. He opined that appellant sustained 

zero percent impairment of the bilateral lower extremities.

By decision dated November 7, 2003, OWCP denied appellant’s schedule award claim, 

finding that the medical evidence of record was insufficient to establish permanent impairment of 

a scheduled member or function of the body. On May 19, 2004 an OWCP hearing representative 

affirmed the November 7, 2003 decision.

On April 20, 2018 appellant filed a claim for a schedule award (Form CA-7). 

In a development letter dated May 4, 2018, OWCP requested that Dr. Jennifer Price, a 

podiatrist, submit an impairment rating in accordance with the sixth edition of the A.M.A., 

Guides.

4

In an April 30, 2018 report, Dr. Price treated appellant in follow up for chronic bilateral 

heel pain. Appellant reported that the heel pain developed gradually over several years and pain 

was worse with weight bearing and alleviated by orthotics. Findings on examination of the 

bilateral lower extremities revealed mild pain to the sub-metatarsal of the forefoot, mild pain to 

palpation of the plantar fascia medial band insertion into the calcaneus, and pain along the dorsal 

 

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

4 A.M.A., Guides (6th ed. 2009). 
3

aspect of the fifth toe which was contracted. X-rays of appellant’s feet revealed inferior calcaneal 

spurs. Dr. Price diagnosed plantar fasciitis, metatarsalgia of both feet, and bilateral calcaneal 

spurs. 

On May 9, 2018 Dr. Price indicated that appellant’s injury resulted in permanent 

impairment. She diagnosed plantar fasciitis, bilateral calcaneal spurs, and bilateral metatarsalgia. 

Dr. Price noted that appellant had a history of chronic plantar fasciitis as she stood and walked on 

her feet all day. Objective findings were bilateral pain to palpation of the plantar fascia medial 

band, and inferior calcaneal spurring, bilaterally. Appellant complained of bilateral foot pain and 

pain on the left outer side of the foot. Dr. Price determined appellant had 25 percent impairment 

of the left and right feet. 

On August 24, 2018 OWCP referred appellant’s case to a district medical adviser (DMA) 

to determine whether the medical evidence of record established permanent impairment of a 

scheduled member or function of the body causally related to appellant’s accepted condition. 

On September 5, 2018 the DMA reviewed the medical evidence of record and determined 

that appellant’s date of MMI was May 9, 2018, the date of Dr. Price’s impairment examination.

Utilizing the diagnosis-based impairment (DBI) methodology as set forth in Table 16-2, page 501-

08, of the A.M.A., Guides, he found that her most impairing diagnosis was plantar fasciitis. The 

DMA placed appellant into a class 1 diagnosis and assigned a grade modifier of 1 for functional 

history (GMFH) because she still had symptoms in her foot joint. He assigned a grade modifier 

of 1 for physical examination (GMPE) because she had an antalgic limp. The DMA found that a 

grade modifier for clinical studies (GMCS) was inapplicable in this case. Using the net adjustment 

formula (GMFH - CDX) + (GMPE - CDX) + (GMCS - CDX), he calculated that appellant had a 

net adjustment of (1-1) + (1-1) + (n/a) = zero, equaling a default grade C. Based on these 

calculations, the DMA concluded that she had one percent permanent impairment of the right 

lower extremity and one percent permanent impairment left lower extremity. He disagreed with

Dr. Price’s schedule award determination of 25 percent of the bilateral lower extremities and noted 

that she provided no methodology to show how she reached that figure. The DMA advised that 

with a diagnosis of plantar fasciitis the highest rated impairment was two percent of the lower 

extremities. 

On September 7, 2018 OWCP requested that Dr. Price review the impairment rating from 

the DMA and respond by opining whether she disagreed with his calculations and providing her 

rationale based on the provisions set forth in the sixth edition of the A.M.A., Guides. 

Dr. Price resubmitted her May 9, 2018 impairment rating. 

By decision dated November 30, 2018, OWCP granted appellant a schedule award for one 

percent permanent impairment of the right lower extremity and one percent permanent impairment 

of the left lower extremity. The award ran for 4.1 weeks for the period from May 9 to June 6, 2018. 

OWCP afforded the weight of the medical evidence to the DMA’s September 5, 2018 report. 
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LEGAL PRECEDENT

The schedule award provisions of FECA and its implementing regulations provide for 

compensation to employees sustaining impairment from loss or loss of use of specified members 

of the body.5 FECA, however, does not specify the manner in which the percentage loss of a 

member shall be determined. The method used in making such determination is a matter which 

rests in the sound discretion of OWCP. For consistent results and to ensure equal justice, the Board 

has authorized the use of a single set of tables so that there may be uniform standards applicable 

to all claimants. The A.M.A., Guides has been adopted by OWCP as a standard for evaluation of 

schedule losses and the Board has concurred in such adoption.6 For schedule awards after May 1, 

2009, the impairment is evaluated under the sixth edition of the A.M.A., Guides, published in 

2009.7

The sixth edition of the A.M.A., Guides provides a DBI method of evaluation utilizing the 

World Health Organization’s International Classification of Functioning, Disability and Health 

(ICF).8 Under the sixth edition, the evaluator identifies the impairment class of diagnosis (CDX) 

condition, which is then adjusted by grade modifiers based on GMFH, GMPE, and GMCS.9 The 

net adjustment formula is (GMFH - CDX) + (GMPE - CDX) + (GMCS - CDX). Evaluators are 

directed to provide reasons for their impairment rating choices, including the choices of diagnoses 

from regional grids and calculations of modifier scores.10

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish more than one 

percent permanent impairment of the right lower extremity and one percent permanent impairment 

of the left lower extremity, for which she previously received schedule award compensation. 

In her May 9, 2018 report, Dr. Price opined that appellant had 25 percent permanent 

impairment of the bilateral lower extremities based on his diagnosis of plantar fasciitis. However,

she did not provide a detailed citation to the A.M.A., Guides and her rating was therefore 

insufficient to establish permanent impairment for purposes of a schedule award. 

In accordance with its procedures, OWCP properly referred the evidence of record to a 

DMA, who, in a September 5, 2018 report, reviewed the medical record and determined that 

 

5 5 U.S.C. § 8107; 20 C.F.R. § 10.404.

6 See Bernard A. Babcock, Jr., 52 ECAB 143 (2000). See also id. at § 8107. 

7 See D.T., Docket No. 12-0503 (issued August 21, 2012); Federal (FECA) Procedure Manual, Part 2 -- Claims, 

Schedule Awards and Permanent Disability Claims, Chapter 2.808.6.6a (March 2017); see also Federal (FECA) 

Procedure Manual Part 3 -- Medical, Schedule Awards, Chapter 3.700.2 and Exhibit 1 (January 2010). 

8 A.M.A., Guides (6th ed. 2009), page 3, section 1.3, International Classification of Functioning, Disability and 

Health (ICF): A Contemporary Model of Disablement. 

9

Id. at 494-531.

10 See R.V., Docket No. 10-1827 (issued April 1, 2011). 
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appellant’s date of MMI was May 9, 2018, the date of Dr. Price’s impairment examination. 

Utilizing Table 16-2, page 501-08, of the sixth edition of the A.M.A., Guides, the DMA found that 

appellant’s most impairing diagnosis was plantar fasciitis. He placed her into a CDX of 1 and 

assigned a GMFH of 1 because she still had symptoms in her foot joint. The DMA calculated that 

appellant had a net adjustment of (1-1) + (1-1) + (n/a) = zero, equaling a default grade C. Based 

on these calculations, he concluded that she had one percent permanent impairment of the right 

lower extremity and one percent permanent impairment of the left lower extremity. 

The Board finds that the DMA applied the appropriate tables and grading schemes of the 

sixth edition of the A.M.A., Guides to Dr. Price’s clinical findings. The DMA’s calculations were 

mathematically accurate. There is no medical evidence of record utilizing the appropriate tables 

of the sixth edition of the A.M.A., Guides demonstrating a greater percentage of permanent 

impairment. The DMA explained that Dr. Price’s rating of 25 percent permanent impairment of 

the bilateral lower extremities was erroneous under the A.M.A., Guides because she failed to

provide her methodology as to how she reached that figure and because the highest available rating 

for the diagnosis of plantar fasciitis was two percent of the lower extremity. The Board has held 

that when the attending physician fails to provide an estimate of impairment conforming to the 

A.M.A., Guides, or does not discuss how he or she arrives at the degree of impairment based on 

physical findings, the opinion is of diminished probative value in establishing the degree of 

impairment and OWCP may rely on the opinion of its medical adviser to apply the A.M.A., Guides

to the findings reported by the attending physician.11 The Board finds that the DMA properly 

applied the standards of the A.M.A., Guides to the physical findings of Dr. Price. The DMA’s

opinion represents the weight of medical evidence and OWCP properly relied on his assessment 

of one percent permanent impairment of the right lower extremity and one percent permanent 

impairment of the left lower extremity.12

There is no probative medical evidence of record, in conformance with the sixth edition of 

the A.M.A., Guides, establishing that appellant has a higher rating of permanent impairment. 

Accordingly, appellant has not established that she is entitled to schedule award compensation 

greater than that previously received. 

Appellant may request a schedule award or increased schedule award, at any time, based 

on evidence of a new exposure or medical evidence showing progression of an employment-related 

condition resulting in permanent impairment or increased impairment. 

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish more than one 

percent permanent impairment of the right lower extremity and one percent permanent impairment 

of the left lower extremity, for which she previously received schedule award compensation. 

 

11 See L.M., Docket No. 12-0868 (issued September 4, 2012); John L. McClanic, 48 ECAB 552 (1997).

12 See M.T., Docket No. 11-1244 (issued January 3, 2012). 
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ORDER

IT IS HEREBY ORDERED THAT the November 30, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: August 19, 2019

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