United States Department of Labor

Employees’ Compensation Appeals Board

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W.R., Appellant

and

DEPARTMENT OF THE NAVY, NAVAL 

MEDICAL COMMAND, San Diego, CA, 

Employer

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Docket No. 18-0133

Issued: May 21, 2018

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 October 24, 2017 appellant filed a timely appeal from a September 27, 2017 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. 

ISSUE

The issue is whether OWCP properly suspended appellant’s compensation benefits,

effective June 24, 2017, due to his failure to submit a completed EN1032 form as requested.

 

1 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

This case has previously been before the Board.2 The facts and circumstances set forth in 

the Board’s prior decision are incorporated herein by reference. The relevant facts are as follows.

OWCP accepted that, on February 8, 1984, appellant, then a 51-year-old ambulance driver, 

sustained low back strain and an L3-4 disc protrusion. He stopped work in February 1984 and 

received wage-loss compensation from OWCP for total disability. By decision dated March 27, 

2000, OWCP reduced appellant’s compensation after finding that he had the capacity to earn 

wages as a security guard.

In a July 22, 2010 decision, the Board set aside a September 15, 2009 OWCP decision,

finding that appellant was not entitled to premium pay for holidays in his pay rate for compensation 

purposes.3 The Board remanded the case for OWCP to further develop the factual evidence to 

determine whether he was entitled to premium pay for holiday work. 

OWCP periodically sent appellant letters (Form CA-1032) requesting that he complete an 

enclosed form (Form EN1032) with regard to his earnings and employment activity, if any, within 

the past 15 months.4 

On April 19, 2017 OWCP informed appellant that federal regulations required him to make 

an affidavit regarding any earnings received or employment performed during the previous 15 

months and that an EN1032 form was enclosed for that purpose.5 It advised that he had to 

completely answer all questions on the form and that his benefits would be suspended pursuant to 

20 C.F.R. § 10.528 if a completed form was not received by OWCP within 30 days. OWCP mailed 

the letter to appellant’s address of record. Appellant did not respond to OWCP’s request.

By decision dated June 7, 2017, OWCP suspended appellant’s wage-loss compensation,

effective June 24, 2017, for failing to submit the EN1032 form as requested. It advised that if he 

completed and returned an enclosed copy of the EN1032 form, it would restore his wage-loss 

compensation retroactive to the date of suspension.

Appellant, by letter dated June 26, 2017, requested a review of the written record before 

an OWCP hearing representative. He related that he did not complete the form because he was 

awarded compensation which he maintained did not qualify as income. Appellant contended that 

OWCP failed to properly include holiday pay, cost-of-living adjustments, and night differential in 

his compensation. He questioned OWCP’s authority to stop paying him wage-loss compensation. 

 

2 Docket No. 10-0147 (issued July 22, 2010). 

3

Id. 

4 The EN1032 also requests information with respect to dependents, receipt of other federal benefits, third-party 

settlements, and fraud offenses.

5 By decision dated May 31, 2016, OWCP had previously suspended appellant’s wage-loss compensation benefits

for failure to submit an April 14, 2016 EN1032 form. He submitted the EN1032 form on June 20, 2016 and OWCP 

reinstated his wage-loss compensation.
3

Appellant submitted an excerpt from a form indicating that compensation payments were not 

subject to federal income tax.

By decision dated September 27, 2017, an OWCP hearing representative affirmed the 

June 7, 2017 decision. She noted that matters regarding appellant’s pay rate for compensation 

purposes were not currently at issue and that OWCP complied with its procedures in suspending 

his wage-loss compensation under section 10.528 for failing to submit a completed EN1032 form.

LEGAL PRECEDENT

Section 8106(b) of FECA authorizes the Secretary of Labor to require a partially disabled 

employee to report his or her earnings from employment or self-employment, by affidavit or 

otherwise, in the manner and at the times the Secretary specifies.6

Under section 10.528 of OWCP’s implementing federal regulations, an employee in receipt 

of compensation benefits must complete an affidavit as to any work or activity indicating an ability 

to work which the employee has performed for the prior 15 months.7 If an employee who is 

required to file such a report fails to do so within 30 days of the date of the request, his or her right 

to compensation for wage loss is suspended until OWCP receives the requested report. At that 

time, OWCP will reinstate compensation retroactive to the date of suspension if the employee 

remains entitled to compensation.8

ANALYSIS

The Board finds that OWCP properly suspended appellant’s compensation benefits 

effective June 24, 2017 due to his failure to complete the EN1032 form as requested. 

On April 19, 2017 OWCP provided appellant with the EN1032 form. It notified him that 

federal regulations required him to complete the form and answer all questions concerning his 

employment or earnings. OWCP properly notified appellant that, if he did not completely answer 

all questions and return the statement within 30 days, his benefits would be suspended. 

Appellant failed to timely submit the EN1032 form within 30 days. OWCP paid him wageloss compensation and thus he was required to complete the EN1032 form.9

 The failure to file an 

EN1032 form within 30 days of the request results in the suspension of compensation.10 The Board 

 

6 5 U.S.C. § 8106(b).

7 20 CFR § 10.528; see also A.H., Docket No. 15-0241 (issued April 3, 2015).

8

Id.; see also 20 CFR § 10.525.

9 See A.S., Docket No. 17-1530 (issued November 7, 2017).

10 See supra note 6.
4

thus finds that OWCP properly suspended appellant’s wage-loss compensation benefits effective 

June 24, 2017 pursuant to 20 C.F.R. § 10.528.11 

Following OWCP’s suspension of his compensation, appellant requested a review of the 

written record, arguing that his compensation from OWCP did not constitute income. He also 

raises this argument on appeal. As noted, however, appellant is required to submit the EN1032 

form regarding any earnings or employment during the previous 15 months or have his benefits 

suspended under section 10.528.12 His benefits may be retroactively reinstated once he submits 

the EN1032 form to OWCP.

CONCLUSION

The Board finds that OWCP properly suspended appellant’s compensation benefits,

effective June 24, 2017, due to his failure to submit a completed EN1032 form as requested.

ORDER

IT IS HEREBY ORDERED THAT the September 27, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: May 21, 2018

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

 

11 See P.M., Docket No. 16-0382 (issued May 19, 2016); M.W., Docket No. 15-0507 (issued June 18, 2015).

12 Id.