United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

M.S., Appellant

and

U.S. POSTAL SERVICE, PROCESSING & 

DISTRIBUTION CENTER, Redding, CA, 

Employer

__________________________________________

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Docket No. 19-1011

Issued: October 29, 2019

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On April 2, 2019 appellant filed a timely appeal from an October 5, 2018 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 this case.3

 

1 Under the Board’s Rules of Procedure, an appeal must be filed within 180 days from the date of issuance of an 

OWCP decision. An appeal is considered filed upon receipt by the Clerk of the Appellate Boards. See 20 C.F.R. 

§ 501.3(e)-(f). One hundred and eighty days from October 5, 2018, the date of OWCP’s last decision, was 

April 3, 2019. Because using April8, 2019, the date the appeal was received by the Clerk of the Appellate Boards 

would result in the loss of appeal rights, the date of the postmark is considered the date of filing. The date of the U.S. 

Postal Service postmark is April2, 2019, rendering the appeal timely filed. See 20 C.F.R. § 501.3(f)(1).

2

5 U.S.C. § 8101 et seq.

3 The Board notes that following the October 5, 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 greater than 10

percent permanent impairment of the right upper extremity and greater than 3 percent permanent 

impairment of the left upper extremity, for which she previously received schedule award

compensation. 

FACTUAL HISTORY

On November 16, 2015 appellant, then a 37-year-old mail processing clerk, filed an 

occupational disease claim (Form CA-2) alleging that she developed injuries to both shoulders as 

a result of her routine, everyday employment duties. She first became aware of her condition on 

September 3, 2015 and realized it resulted from factors of her federal employment on 

November 12, 2015. Appellant did not stop work. OWCP accepted her claim for bilateral rotator 

cuff strains and bilateral rotator cuff bursitis/tendinitis.

On January 4, 2017 appellant underwent OWCP-approved right shoulder arthroscopic 

surgery and stopped work. OWCP paid wage-loss compensation on the supplemental rolls, 

effective January 4, 2017. On December 4, 2017 appellant returned to full-time, modified-duty 

employment. 

On January 16, 2018 appellant filed a claim for a schedule award (Form CA-7). 

In a development letter dated January 18, 2018, OWCP advised appellant that no medical 

evidence was submitted to establish her schedule award claim. It requested that she provide a 

medical report from her attending physician, which included a statement that the accepted 

condition had reached maximum medical improvement (MMI) and an impairment rating utilizing 

the appropriate portions of the sixth edition of the American Medical Association, Guides to the 

Evaluation of Permanent Impairment (A.M.A., Guides).4 OWCP afforded appellant 30 days to 

submit the necessary evidence. 

Appellant submitted a series of reports dated October 5, 2017 to January 3, 2018 by

Dr. Richard P. Musselman, a family practitioner. Dr. Musselman recounted appellant’s 

complaints of bilateral shoulder pain and described her employment duties as a mail processing 

clerk. He provided examination findings and diagnosed right rotator cuff tear, bilateral shoulder 

rotator cuff strain, rotator cuff disorder, and bilateral shoulder pain.

OWCP referred appellant, along with a statement of accepted facts (SOAF) and a copy of 

the record, to Dr. Charles F. Xeller, a Board-certified orthopedic surgeon, serving as a secondopinion examiner, to provide an assessment of appellant’s work-related bilateral shoulder 

conditions and any resulting permanent impairment. 

In a May 14, 2018 report, Dr. Xeller indicated that he had reviewed the SOAF and noted 

appellant’s accepted conditions for bilateral shoulder rotator cuff strains and bilateral shoulder 

bursitis. He recounted appellant’s complaints of pain with fast movements in the right shoulder 

and with overhead movement in both shoulders. Upon examination of both shoulders, Dr. Xeller 

 

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

observed slight impingement on the right and left and some pain with supraspinatus resistant 

motion, bilaterally. He evaluated appellant’s shoulder range of motion (ROM) and noted three 

measurements for each motion. Dr. Xeller diagnosed status post right shoulder surgery and slight 

impingement on the left, but normal range of motion. 

Referring to Table 15-5, Shoulder Regional Grid, A.M.A., Guides, Dr. Xeller assigned 

class 1, default three percent, for diagnosis-based impairment (DBI) for left tendinitis, residual 

loss of function. He assigned a grade modifier of 1 for history (GMFH) due to pain overhead and 

a grade modifier of 1 for physical examination (GMPE) due to positive impingement signs. 

Dr. Xeller reported that there was no grade modifier for clinical studies as imaging was not 

available. He applied the net adjustment formula, which resulted in no change, for a total of three 

percent left upper extremity impairment. Dr. Xeller pointed out that appellant had normal ROM 

testing on the left. For appellant’s right shoulder, he reported that appellant was also class 1, 

default three percent for right tendinitis, residual loss. Dr. Xeller indicated that the grades on the 

right were the same as the left and calculated that appellant had three percent right upper extremity 

permanent impairment under the DBI method. He explained that, in the alternative, right upper 

extremity impairment could also be rated under the ROM method and calculated that appellant 

had nine percent right upper extremity permanent impairment under the ROM method. Dr. Xeller

reported a date of MMI of May 11, 2018. 

In a May 23, 2018 addendum report, Dr. Xeller indicated that according to Table 15-34, 

Shoulder Range of Motion, for appellant’s right shoulder, she had three percent impairment for 

150 degrees flexion, 0 percent impairment for 50 degrees extension, 3 percent impairment for 142 

degrees abduction, 0 percent impairment for 50 degrees adduction, 4 percent impairment for 42 

degrees internal rotation, and 0 percent impairment for 64 degrees external rotation for a total of 

10 percent right upper extremity impairment under the ROM method. He assigned a GMFH of 1, 

which resulted in no net modifier and a final impairment rating of 10 percent right upper extremity 

permanent impairment. 

In an August 27, 2018 report, Dr. Herbert White, an OWCP district medical adviser 

(DMA) and Board-certified in occupational and preventive medicine, reviewed appellant’s history, 

including the SOAF and medical record, and noted that her claim was accepted for bilateral 

shoulder rotator cuff strain and bilateral shoulder bursitis. Utilizing the DBI method, he referenced 

Table 15-5, Shoulder Regional Grid, and assigned class 1, tier 2 for right tendinitis. Dr. White 

assigned GMFH of 1 due to pain/symptoms with strenuous activity, GMPE of 1 for mild motion 

deficits, and no grade modifier for clinical studies. After applying the net adjustment formula, 

which yielded no change, he determined that appellant had three percent right upper extremity 

impairment. Dr. White indicated for appellant’s right shoulder that under the ROM methodology 

and Table 15-34, Shoulder Range of Motion, appellant had 3 percent impairment for flexion, 0

percent impairment for extension, 3 percent impairment for abduction, 0 percent impairment for 

adduction, 4 percent impairment for internal rotation, and 0 percent impairment for external 

rotation for a total of 10 percent right upper extremity impairment. He explained that, pursuant to 

the A.M.A., Guides, because the ROM method resulted in the greater impairment, appellant had 

10 percent permanent impairment of the right upper extremity. 

For appellant’s left shoulder, Dr. White referenced Table 15-5 and assigned class 1, tier 2 

for left tendinitis under the DBI method. He assigned GMFH of 1 due to pain/symptoms with 

strenuous activity, GMPE of 1 for mild tenderness, and no grade modifiers for clinical studies. 
4

After applying the net adjustment formula, which resulted in no change, Dr. White determined that 

appellant had default value of three percent left upper extremity impairment. Under the ROM 

methodology, he indicated that appellant had zero percent impairment for normal range of motion 

according to Table 15-34, Shoulder Range of Motion. Thus, Dr. White concluded that appellant 

had three percent permanent impairment of the left upper extremity. He assigned an MMI date of 

December 6, 2017, the date that Dr. Musselman indicated that appellant reached MMI.

By decision dated October 5, 2018, OWCP granted appellant schedule award 

compensation for 10 percent permanent impairment of the right upper extremity and 3 percent 

permanent impairment of the left upper extremity. The award ran for 40.56 weeks from May 11, 

2018 to February 18, 2019. 

LEGAL PRECEDENT

The schedule award provisions of FECA5 and its implementing regulations6 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. FECA, however, does not 

specify the manner in which the percentage of loss of a member shall be determined. For consistent 

results and to ensure equal justice under the law for all claimants, OWCP has adopted the A.M.A., 

Guides as the uniform standard applicable to all claimants and the Board has concurred in such 

adoption.7 As of May 1, 2009, the sixth edition of the A.M.A., Guides, published in 2009, is used 

to calculate schedule awards.8

In addressing impairment for the upper extremities under the sixth edition of the A.M.A., 

Guides, an evaluator must establish the appropriate diagnosis for each part of the upper extremity 

to be rated.9 After a class of diagnosis (CDX) is determined (including identification of a default 

grade value), the impairment class is then adjusted by grade modifiers based on functional history 

(GMFH), physical examination (GMPE), and clinical studies (GMCS).10 The net adjustment 

formula is (GMFH – CDX) + (GMPE – CDX) + (GMCS – CDX).11 

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

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

 

5

5 U.S.C. § 8107.

6

20 C.F.R. § 10.404.

7

Id. at 10.404(a); see also Jacqueline S. Harris, 54 ECAB 139 (2002). 

8 Federal (FECA) Procedure Manual, Part 2 --Claims, Schedule Awards and Permanent Disability Claims, Chapter 

2.808.5(a) (March 2017); see also Part 3 --Medical, Schedule Awards, Chapter 3.700.2 and Exhibit 1 (January 2010).

9 T.T., Docket No. 18-1622 (issued May 14, 2019).

10 A.M.A., Guides 383-492; see M.P., Docket No. 13-2087 (issued April8, 2014).

11 Id. at 411.
5

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

percentage of impairment specified.12

Regarding the application of ROM or DBI impairment methodologies in rating permanent 

impairment of the upper extremities, FECA Bulletin No 17-06 provides: “As the [A.M.A.,] Guides 

caution that if it is clear to the evaluator evaluating loss of ROM that a restricted ROM has an 

organic basis, three independent measurements should be obtained and the greatest ROM should 

be used for the determination of impairment, the CE [claims examiner] should provide this 

information (via the updated instructions noted above) to the rating physician(s).”

Upon initial review of a referral for upper extremity impairment evaluation, the DMA 

should identify: “(1) the methodology used by the rating physician (i.e., DBI or ROM); and 

(2) whether the applicable tables in Chapter 15 of the [A.M.A.,] Guides identify a diagnosis that 

can alternatively be rated by ROM. If the [A.M.A.,] Guides allow for the use of both the DBI and 

ROM methods to calculate an impairment rating for the diagnosis in question, the method 

producing the higher rating should be used.”

13

The Bulletin further advises:

“If the rating physician provided an assessment using the ROM method and the 

[A.M.A.,] Guides allow for use of ROM for the diagnosis in question, the DMA 

should independently calculate impairment using both the ROM and DBI methods 

and identify the higher rating for the CE.”

14

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish greater than 10

percent permanent impairment of the right upper extremity and greater than 3 percent permanent 

impairment of the left upper extremity, for which she previously received schedule award

compensation. 

Dr. Xeller, the second opinion examiner, noted appellant’s accepted conditions for bilateral 

shoulder rotator cuff strains and bilateral shoulder bursitis. Upon examination of appellant’s 

shoulders, he observed slight impingement on the right and left and some pain with supraspinatus 

resistant motion, bilaterally. For appellant’s right shoulder, Dr. Xeller provided three ROM 

measurements and noted the highest measurements to be 150 degrees flexion, 50 degrees 

extension, 142 degrees abduction, 50 degrees adduction, 42 degrees internal rotation, and 64 

degrees external rotation. He indicated that ROM for appellant’s left shoulder was normal. Based 

on the DBI method, Dr. Xeller found three percent permanent impairment of the right and left 

 

12 See Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, 

Chapter 2.808.6 (March 2017). R.M., Docket No. 18-1313 (issued April11, 2019); C.K., Docket No. 09-2371 (issued 

August18, 2010).

13 FECA Bulletin No. 17-06 (May 8, 2017); V.L., Docket No. 18-0760 (issued November 13, 2018); A.G., Docket 

No. 18-0329 (issued July 26, 2018).

14 FECA Bulletin No. 17-06 (May 8, 2017).
6

upper extremities. Applying the ROM method, he found 10 percent permanent impairment of the 

right upper extremity and normal range of motion of the left upper extremity -- no impairment. 

In an August 27, 2018 report, Dr. White, the DMA, noted that he had reviewed appellant’s 

history, including the SOAF and Dr. Xeller’s May 11, 2018 second-opinion report. For appellant’s 

right shoulder, he utilized Table 15-5, Shoulder Regional Grid, and assigned class 1, tier 2 for right 

tendinitis. Dr. White reported GMFH of 1 and GMPE of 1. After applying the net adjustment 

formula, which resulted in no change, he determined that appellant had three percent right upper 

extremity impairment under the DBI method. Dr. White indicated that the ROM method could 

also be utilized to determine permanent impairment of appellant’s right shoulder. Utilizing Table 

15-34, Shoulder Range of Motion, he reported that appellant had 3 percent impairment for flexion, 

0 percent impairment for extension, 3 percent impairment for abduction, 0 percent impairment for 

adduction, 4 percent impairment for internal rotation, and 0 percent impairment for external 

rotation for a total of 10 percent right upper extremity impairment. Dr. White explained that,

pursuant to the A.M.A., Guides, because the ROM method resulted in the greater impairment, 

appellant had 10 percent permanent impairment of the right upper extremity. 

For appellant’s left shoulder, Dr. White referenced Table 15-5 and assigned class 1, tier 2 

for left tendinitis under the DBI method. He assigned GMFH of 1 and GMPE of 1. After applying 

the net adjustment formula, which resulted in no change, Dr. White determined that appellant had 

default value of three percent left upper extremity impairment. Under the ROM methodology, he 

indicated that appellant had zero percent impairment for normal range of motion according to 

Table 15-34, Shoulder Range of Motion. Dr. White concluded that, since the DBI method 

provided the higher rating, appellant had three percent permanent impairment of the left upper 

extremity. 

The Board finds that the DMA properly discussed how he arrived at his conclusion by 

listing appropriate tables and pages in the A.M.A., Guides and established that appellant sustained 

10 percent right upper extremity permanent impairment and 3 percent left upper extremity 

permanent impairment. Dr. White accurately summarized the relevant medical evidence, provided 

detailed findings on examination, and reached conclusions about appellant’s condition which 

comported with his findings.15 In addition, he properly utilized the DBI method and ROM method 

to rate appellant’s bilateral shoulder condition pursuant to FECA Bulletin No. 17-06. As

Dr. White’s report is detailed, well rationalized, and based on a proper factual background, his 

opinion represents the weight of the medical evidence.16 Thus, the Board finds that appellant has 

not met her burden of proof to establish that she is entitled to a greater bilateral upper extremity 

permanent impairment than previously awarded.

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.

 

15 J.M., Docket No. 18-1387 (issued February 1, 2019); W.H., Docket No. 19-0102 (issued June21, 2019).

16 See D.S., Docket No. 18-1816 (issued June20, 2019).
7

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish more than 10

percent permanent impairment of the right upper extremity and more than 3 percent permanent 

impairment of the left upper extremity, for which she previously received schedule award

compensation. 

ORDER

IT IS HEREBY ORDERED THAT the October 5, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: October 29, 2019

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board