United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

T.P., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Lancaster, CA, Employer

__________________________________________

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Docket No. 19-0865

Issued: November 14, 2019

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On March 15, 2019 appellant, through counsel, filed a timely appeal from a January 14, 

2019 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 to consider the merits of this case.

 

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

ISSUE

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

impairment of a scheduled member entitling her to a schedule award.

FACTUAL HISTORY

On June 8, 2015 appellant, then a 58-year-old city carrier, filed a traumatic injury claim 

(Form CA-1) alleging that on June 4, 2015 she twisted her left ankle when driving her delivery 

route while in the performance of duty. She stopped work on June 5, 2015. Following a period 

of modified-duty work commencing in mid-August 2015, appellant returned to full-duty work. 

In a report dated June 25, 2015, Dr. Sheryl A. Haggerty, a general practitioner, noted a 

history of a resolved left ankle fracture in 1960, a resolved occupational left ankle sprain in 2001, 

a 2014 dog bite to the left ankle, and the June 4, 2015 employment incident. She diagnosed a left 

ankle strain. 

By decision dated October 28, 2015, OWCP accepted the claim for left ankle sprain. 

In a report dated November 23, 2015, Dr. Haggerty found that appellant had attained 

maximum medical improvement (MMI). In a December 17, 2015 report, she found full range of 

left ankle motion without pain and discharged appellant from care. 

On April 20, 2016 appellant filed a claim for a schedule award (Form CA-7).

In support of her claim, appellant submitted a June 15, 2016 impairment rating from

Dr. Mesfin Seyoum, a family medicine specialist. Dr. Seyoum noted a fracture to the left fourth 

toe in February 2015, with no other left foot or ankle injuries prior to the June 4, 2015 employment 

incident. He provided findings on physical examination, noting a slightly guarded gait, minimal 

tenderness of the lateral aspect of the left ankle, full range of left ankle motion in all planes, and a 

normal sensory examination and reflexes throughout both lower extremities. Appellant scored 28 

on the American Medical Association, Guides to the Evaluation of Permanent Impairment

(A.M.A., Guides) Pain Disability Questionnaire (PDQ),3and obtained a minimal score on the 

American Academy of Orthopedic Surgeons (AAOS) lower limb questionnaire. Dr. Seyoum 

diagnosed left ankle sprain as the accepted condition and opined that based on the information 

available it appeared that her left ankle condition was caused by the accepted employment injury 

of June 4, 2015, which occurred while she was working as a mail carrier. He further opined that 

appellant had reached MMI on November 23, 2015. 

Referring to the Table 16-2 of the A.M.A., Guides, foot and ankle regional grid,

Dr. Seyoum calculated a rating of one percent permanent impairment of the left lower extremity 

for left ankle sprain.4 He determined that this diagnosis resulted in a class 1 impairment with a 

 

3 A.M.A., Guides, (6th ed. 2009) at Appendix 3-1.

4

Id. at 501.
3

default value of grade C, equaling one percent permanent impairment of the left lower extremity.

5

 

Dr. Seyoum assigned a grade modifier of 1 for functional history (GMFH) based on appellant’s

AAOS and PDQ questionnaire scores,

6

a grade modifier of 1 for physical examination (GMPE),7

and no applicable modifier for clinical studies (GMCS).

8

 Applying the net adjustment formula, 

(GMFH - CDX) + (GMPE - CDX), he subtracted 1, the numerical value of the class, from the 

numerical value of the grade modifiers, (1-1) + (1-1), and then combined those values, resulting 

in a net adjustment of zero.

9

 This resulted in a final permanent impairment rating of one percent 

of the left lower extremity.

On April 18, 2017 OWCP routed Dr. Seyoum’s report, a statement of accepted facts, and 

the case record to Dr. Todd Fellars, a Board-certified orthopedic surgeon serving as an OWCP 

district medical adviser (DMA), for review and evaluation of appellant’s permanent impairment 

pursuant to the A.M.A., Guides. It also asked Dr. Fellars to provide a date of MMI. 

In a May 18, 2017 report, the DMA reviewed the case file and determined that appellant 

had reached MMI on December 17, 2015. He disagreed with Dr. Seyoum’s permanent impairment 

rating as she had a completely normal examination at her final medical visit with her treating 

provider on December 17, 2015. The DMA opined that, according to Table 16-2 at page 501 of 

the A.M.A., Guides,

10 appellant had a class 0 impairment resulting in zero percent left lower 

extremity permanent impairment.

By decision dated May 19, 2017, OWCP denied appellant’s claim for a schedule award as 

the evidence of record was insufficient to establish permanent impairment to a member or function 

of the body. 

On May 25, 2017 appellant, through counsel, requested a telephonic oral hearing before a 

representative of OWCP’s Branch of Hearings and Review. 

By decision dated October 5, 2017, an OWCP hearing representative found that the case 

was not in posture for decision. He set aside the May 19, 2017 decision and remanded the case to 

OWCP as further development was warranted. The hearing representative explained that as

Dr. Seyoum was the only physician who provided an impairment rating, a second opinion 

examination was warranted.

 

5 Dr. Seyoum’s June 15, 2016 impairment rating notes a class 2, grade C diagnosis-based impairment (DBI), 

equaling one percent left lower extremity impairment. However, he noted a class of diagnosis (CDX) of 1 in his 

application of the net adjustment formula. Therefore, the Board finds that Dr. Seyoum’s initial reference to a class 2 

CDX was a typographical error. 

6 Supra note 3 at 516, Table 16-6.

7

Id. at 517, Table 16-7.

8

Id. at 519, Table 16-8.

9

Id. at 521.

10 Id. at 501, Table 16-2.
4

On December 6, 2017 OWCP referred appellant for a second opinion examination with

Dr. Mark D. Bernhard, an osteopathic physician Board-certified in physiatry, to determine whether 

her accepted left ankle sprain caused permanent impairment of the left lower extremity. 

In a January 19, 2018 report, Dr. Bernhard noted appellant’s history of injury, medical 

treatment, and physical examination findings, including her complaints of occasional dull aching 

and stiffness of the left ankle. He determined that she reached MMI as of June 15, 2016, the date 

of Dr. Seyoum’s examination. Appellant scored a nine on the AAOS lower limb questionnaire,

indicating a minimal impairment according to Table 16-6.

11

 On examination, Dr. Bernhard 

observed full range of motion (ROM) of both ankles in all planes, with no atrophy in either lower 

extremity. He referred to Table 16-2 of the A.M.A., Guides to diagnose a left ankle strain CDX. 

Dr. Bernhard found a GMFH of zero as appellant had a minimal questionnaire result and no gait 

derangement, a GMPE of zero as she had no consistent findings, no palpatory findings, and normal 

ROM. He applied the net adjustment formula, (GMFH - CDX) + (GMPE - CDX), to calculate 

zero percent permanent impairment of the left lower extremity. Dr. Bernhard noted that utilizing 

the ROM rating method also resulted in zero percent impairment of the left lower extremity. 

On March 7, 2018 the DMA reviewed Dr. Bernhard’s second opinion evaluation and 

concurred with his rating methodology and application of the A.M.A., Guides. He opined that 

appellant had zero percent permanent impairment of the left lower extremity. The DMA confirmed 

that appellant attained MMI on December 17, 2015, the date of Dr. Haggerty’s examination. 

In a March 14, 2018 report, Dr. Seyoum noted his disagreement with Dr. Bernhard’s 

January 19, 2018 impairment rating. He contended that appellant had one percent permanent 

impairment of the left lower extremity according to Table 16-2,12 based on a CDX of 1, grade C 

left ankle sprain, equal to one percent lower extremity impairment. Dr. Seyoum assessed a GMFH 

of one for a PDQ score of 28, and a GMPE of zero according to Table 16-7.13 He noted that there 

was no applicable GMCS as there were no relevant clinical studies of record. Applying the net 

adjustment formula, (GMFH - CDX) + (GMPE - CDX), or (1-1) + (0-1), resulted in a net 

adjustment of negative one, which lowered the default CDX grade of C one position to the left, 

equal to a one percent permanent impairment of the left lower extremity. Dr. Seyoum opined that 

the ROM rating methodology was not applicable as appellant had a full range of left ankle motion 

at the time of his June 15, 2016 examination. 

By decision dated July 25, 2018, OWCP denied appellant’s claim for a schedule award as 

the evidence of record was insufficient to establish permanent impairment to a scheduled member 

or function of the body. 

On July 31, 2018 appellant, through counsel, requested a telephonic oral hearing before a 

representative of OWCP’s Branch of Hearings and Review. At the hearing, held December 11, 

2018, appellant asserted that she had minimal symptoms with weather changes. 

 

11 Id. at 516, Table 16-6.

12 Id. at 501, Table 16-2.

13 Id. at 517, Table 16-7.
5

By decision dated January 14, 2019, an OWCP hearing representative affirmed the July 25, 

2018 decision denying appellant’s schedule award claim. 

LEGAL PRECEDENT

The schedule award provision of FECA and its implementing regulations set forth the 

number of weeks of compensation payable to employees sustaining permanent impairment from 

loss or loss of use of scheduled members or functions of the body.14 However, FECA does not 

specify the manner in which the percentage of loss shall be determined. For consistent results and 

to ensure equal justice under the law to all claimants, good administrative practice necessitates the 

use of a single set of tables so that there may be uniform standards applicable to all claimants. 

Through its implementing regulations, OWCP adopted the A.M.A., Guides as the appropriate 

standard for evaluating schedule losses.15

As of May 1, 2009, schedule awards are determined in accordance with the sixth edition 

of the A.M.A., Guides (2009).16 The Board has approved the use by OWCP of the A.M.A., Guides

for the purpose of determining the percentage loss of use of a member of the body for schedule 

award purposes.17

The A.M.A., Guides provide a DBI method of evaluation utilizing the World Health 

Organization’s International Classification of Functioning, Disability, and Health (ICF). For lower 

extremity impairments, the evaluator identifies the impairment CDX condition, which is then 

adjusted by GMFH, GMPE, and GMCS.18 The net adjustment formula is (GMFH - CDX) + 

(GMPE - CDX) + (GMCS - CDX).19 Evaluators are directed to provide reasons for their 

impairment rating choices, including choices of diagnoses from regional grids and calculations of 

modifier scores.20

 

14 5 U.S.C. § 8107; 20 C.F.R. § 10.404.

15 Id. at § 10.404. See also Ronald R. Kraynak, 53 ECAB 130 (2001).

16 See Federal (FECA) Procedure Manual, Part 3 -- Medical, Schedule Awards, Chapter 3.700, Exhibit 1 

(January 2010); Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability 

Claims, Chapter 2.808.5a (March 2017).

17 L.N., Docket No. 18-0156 (issued August 21, 2019); P.R., Docket No. 19-0022 (issued April 9, 2018); Isidoro 

Rivera, 12 ECAB 348 (1961).

18 A.M.A., Guides (6th ed. 2009) at 493-531.

19 Id. at 521.

20 R.R., Docket No. 17-1947 (issued December 19, 2018); R.V., Docket No. 10-1827 (issued April 1, 2011).
6

A schedule award can be paid only for a condition related to an employment injury. The 

claimant has the burden of proving that the condition for which a schedule award is sought is 

causally related to his or her employment.21

OWCP’s procedures provide that, after obtaining all necessary medical evidence, the file 

should be routed to an OWCP DMA for an opinion concerning the nature and percentage of 

permanent impairment in accordance with the A.M.A., Guides, with the DMA providing rationale 

for the percentage of impairment specified.22

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a permanent 

impairment of a scheduled member entitling her to a schedule award.

Appellant filed a claim for a schedule award and submitted a June 15, 2016 impairment 

rating and March 14, 2018 supplemental report from Dr. Seyoum in support of her claim. 

Dr. Seyoum’s reports are the only evidence of record that she has submitted providing an opinion 

as to her permanent functional impairment. He calculated appellant’s permanent impairment 

rating for the condition of left ankle sprain, the accepted condition, and he opined that she had 

reached MMI on November 23, 2015. Dr. Seyoum discussed his impairment calculations. Citing 

Table 16-2, Foot and Ankle Regional Grid, of the A.M.A., Guides, he calculated one percent 

permanent impairment of the left lower extremity for left ankle sprain with mild pain symptoms.

The Board has previously explained that the medical evidence of record must establish that 

the accepted employment injury contributed to the permanent impairment for which schedule 

award compensation is alleged.23 Although Dr. Seyoum attributed appellant’s subjective 

symptoms to the accepted June 4, 2015 left ankle sprain, he found no objective signs of the 

resolved employment injury.24 Additionally, he did not mention the 1960 right ankle fracture and 

2001 right ankle sprain noted by Dr. Haggerty in her June 25, 2015 report. As such, Dr. Seyoum’s

reports are based on an incomplete history and are insufficient to establish appellant’s claim.25 

Therefore, the Board finds that his opinions are insufficient for her to meet her burden of proof to 

establish that her left ankle permanent impairment is causally related to her accepted July 4, 2015

employment injury.

 

21 See T.O., Docket No. 18-0659 (issued August 8, 2019); Tammy L. Meehan, 53 ECAB 229 (2001).

22 See supra note 16 at Chapter 2.808.6(f) (March 2017). 

23 Supra note 21.

24 See V.S., Docket No. 16-0464 (issued June 1, 2016).

25 The Board has held that medical reports must be based on a complete and accurate factual and medical 

background and medical opinions based on an incomplete or inaccurate history are of limited probative value. H.A., 

Docket No. 18-1466 (issued August 23, 2019); J.R., Docket No. 12-1099 (issued November 7, 2012); Douglas M. 

McQuaid, 52 ECAB 382 (2001).
7

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.26

On appeal counsel contends that OWCP failed to give due deference to the findings of 

appellant’s physicians. As found above, Dr. Seyoum provided insufficient medical rationale to 

meet her burden of proof.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish a permanent 

impairment of a scheduled member entitling her to a schedule award.

ORDER

IT IS HEREBY ORDERED THAT the January 14, 2019 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: November 14, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

 

26 See W.H., Docket No. 19-0102 (issued June 21, 2019); Linda T. Brown, 51 ECAB 115 (1999).