United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

L.B., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS ADMINISTRATION MEDICAL 

CENTER, Philadelphia, PA, Employer

__________________________________________

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Docket No. 18-0560

Issued: August 20, 2018

Appearances: Case Submitted on the Record

Aaron B. Aumiller, 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 January 16, 2018 appellant, through counsel, filed a timely appeal from a July 20, 2017 

merit decision of the Office of Workers’ Compensation Programs (OWCP).2 Pursuant to the 

 

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 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 July 20, 2017, the date of OWCP’s last decision was Tuesday, 

January 16, 2018. Since using January 23, 2017, 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 January 16, 2018, rendering the appeal timely filed. See 20 C.F.R. § 501.3(f)(1).
2

Federal Employees’ Compensation Act3(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 properly terminated appellant’s wage-loss 

compensation and authorization for medical benefits effective April 6, 2014 as she had no further 

disability or need for medical treatment causally related to her June 28, 2011 employment injury; 

(2) whether she has established continuing employment-related disability after April 6, 2014; and 

(3) whether appellant has established that the acceptance of her claim should be expanded to 

include additional conditions as a result of her June 28, 2011 employment injury.

FACTUAL HISTORY

On July 1, 2011 appellant, then a 46-year-old medical technician, filed a traumatic injury 

claim (Form CA-1) alleging that on June 28, 2011 she injured her right shoulder and arm when 

she was struck by a patient while in the performance of duty. She stopped work on June 28, 2011. 

OWCP accepted the claim for a right shoulder sprain and paid appellant wage-loss compensation 

for total disability beginning August 18, 2011. 

An August 3, 2011 magnetic resonance imaging (MRI) scan study of the right shoulder 

revealed a partial bursal surface tear and/or intrasubstance degeneration of the supraspinatus 

tendon and findings suggesting a prior repair of the glenoid labrum. A January 10, 2012 right 

shoulder MRI scan study showed mild tendinopathy at the supraspinatus tendon, a prior right 

anterior/superior labral repair, mild osteoarthritis of the acromioclavicular (AC) joint with mild 

associated capsular hypertrophy, and a stable small ossific fragment in the anterior superior labrum 

possibly representing a loose body, fragment of a fracture, heterotopic ossification, or thickened 

glenohumeral middle ligament.

In a June 13, 2012 progress report, Dr. Damon D. Cary, an attending osteopath, discussed 

appellant’s continued complaints of pain in the shoulders bilaterally.4 On examination he found 

right trapezial and deltoid muscle spasms and tenderness and a loss of sensation at the right C4 

dermatome. Dr. Cary diagnosed severe right shoulder sprain and left shoulder sprain and opined 

that appellant was totally disabled. 

OWCP, on July 20, 2012, referred appellant to Dr. Robert Allen Smith, a Board-certified 

orthopedic surgeon, for a second opinion examination. It requested that he address whether she 

continued to have residuals or disability due to her accepted work injury and to provide all 

diagnoses which resulted from the June 28, 2011 employment injury.

In a report dated August 6, 2012, Dr. Smith reviewed appellant’s history of a June 28, 2011 

injury to her right shoulder at work and noted that in 2004 she underwent a right shoulder 

acromioplasty and labral repair. He discussed her current complaints of pain and radiating 

 

3 5 U.S.C. § 8101 et seq.

4 Dr. Cary continued to provide progress reports describing his treatment of appellant. 
3

numbness and tingling of the right shoulder, spasm and swelling, and sensations of hot and cold. 

On examination Dr. Smith found unspecific signs of impingement, a normal neurological 

examination, and full strength and range of motion except for internal rotation. He diagnosed a 

right shoulder soft tissue strain due to employment. Dr. Smith advised that he was uncertain of 

the cause of appellant’s pain, noting that the findings on MRI scan study were “consistent with 

prior surgical artifact with nothing of a posttraumatic nature that could be attributed to the June 28, 

2011 incident.” He opined that her soft tissue sprain had resolved based on the objective findings. 

Dr. Smith related, “It appears that [appellant’s] symptoms represent residual from her prior 

surgery, and any additional treatment or surgery would be related to those preexisting factors and 

not the incident of June 28, 2011.” He found that, considering only the accepted right shoulder 

sprain, she could resume work without restrictions. 

On August 8, 2012 Dr. Cary diagnosed severe right shoulder sprain and a left shoulder 

sprain and found that appellant was totally disabled. In a February 27, 2013 report, he discussed 

her history of a right shoulder injury on June 28, 2011 and subsequent treatment. Dr. Cary related 

that appellant sustained a left shoulder sprain and sprains/strains of the cervical and thoracic spine 

due to the “nature of her type of injury.” He advised, “In particular the cervical and thoracic strain 

and sprain is due to the muscles that make up the area of her right shoulder. They originate in the 

cervical area and they help create the function of the right shoulder.” Dr. Cary recommended right 

shoulder surgery and opined that appellant was totally disabled.5

On June 19, 2013 OWCP found that a conflict in medical opinion existed between

Dr. Smith and Dr. Cary regarding the extent of appellant’s employment-related disability and need 

for medical treatment as a result of the accepted work injury. It referred her to Dr. Andrew 

Gelman, a Board-certified orthopedic surgeon, for an impartial medical examination. OWCP 

requested that he provided the diagnoses due to the June 28, 2011 work injury, whether appellant 

had any further disability due to the injury, whether she had any preexisting or nonemploymentrelated disability, and whether she needed further medical treatment.

In a report dated August 13, 2013, Dr. Gelman reviewed the history of injury and the 

medical reports of record, including the results of diagnostic studies. On examination he measured 

range of motion of the right shoulder and found a “provocative Tinel’s [sign] through the cubital 

tunnel.” Dr. Gelman found a negative Finkelstein’s test, no pain radiating down the arm, but some 

neck pain with Spurling’s maneuver, and a strong radial pulse. He noted that appellant complained 

of upper right trapezius discomfort and a tingling sensation of the right arm with glenohumeral 

rotation and gravity dependent positioning. Dr. Gelman found no edema, redness, or warmth. He 

related, “With regards to the incident of June 28, 2011, the mechanism described appears to be 

consistent with the early impression of right shoulder contusion with an apparent accepted 

diagnosis of right shoulder sprain. Like others have noted, the mechanism described would not 

appear to explain the assorted complaints for which [she] has represented.” Dr. Gelman noted that 

a physician had recommended surgery for subacromial pathology, which was not accepted as

related to the June 28, 2011 work injury and would not “explain the assorted symptomatology for 

which [appellant] has and continues to represent affecting the entirety of her right upper 

 

5

In a May 14, 2013 work capacity evaluation (Form OWCP-5c), Dr. Cary found that appellant was totally disabled 

from employment and indicated that he was awaiting approval for right shoulder surgery. 
4

extremity.” Dr. Gelman found that, considering only the shoulder strain, she could return to her 

usual employment. He related, “Other pathophysiology may preclude rigorous use of the right 

upper extremity, although again, as stated in this narrative, such pathophysiology is not attributable 

to the accepted diagnosis dating back to June 28, 2011.” Dr. Gelman recommended further 

evaluation of appellant’s positive Tinel’s sign at the right elbow, noting that any such treatment

would be unrelated to the June 28, 2011 work injury. He related, “With regards to that which 

occurred on June 28, 2011, it is my opinion that [she] has made a full and complete recovery.”

In a January 15, 2014 progress report, Dr. Cary diagnosed severe right shoulder sprain with 

internal derangement and left shoulder sprain. He opined that appellant was totally disabled.

On February 27, 2014 OWCP advised appellant of its proposed termination of her wageloss compensation and medical benefits. It found that Dr. Smith’s opinion represented the weight 

of the evidence and established that she had no further injury-related condition or disability. 

Dr. Cary, on March 17, 2014, related that he had treated appellant beginning August 17, 

2011 for injuries resulting from her June 28, 2011 work injury. He diagnosed right shoulder sprain 

with internal derangement, left shoulder strain, and noted that she also experienced thoracic and 

cervical pain. Dr. Cary disagreed with Dr. Smith’s finding, noting that appellant continued to

require treatment for both shoulders. He related, “[She] has a permanent and chronic injury with 

regard to her right shoulder and has an ongoing current injury to her left shoulder.” Dr. Cary

attributed the left shoulder condition to her need to compensate for the injured right shoulder and 

recommended right shoulder surgery. He attributed the bilateral shoulder sprain and right shoulder 

internal derangement to the June 28, 2011 work injury and opined that appellant was totally 

disabled.

By decision dated March 31, 2014, OWCP terminated appellant’s wage-loss compensation 

and authorization for medical treatment effective April 6, 2014 finding that she had no further 

disability or condition causally related to her accepted June 28, 2011 employment injury. It found 

that the opinions of Dr. Smith and Dr. Gelman constituted the weight of the evidence and 

established that she had no further residuals of her right shoulder sprain.

Counsel, on April 25, 2014, requested a telephonic hearing before an OWCP hearing 

representative.6 At the telephone hearing, held on November 13, 2014, he asserted that

Dr. Gelman’s report was insufficiently rationalized and failed to address her cervical condition. 

Appellant related that she had undergone shoulder surgery on May 28, 2014. She noted that she 

slipped and fell in February 2014, injuring her left lower back. 

By decision dated January 29, 2015, OWCP’s hearing representative affirmed the 

March 31, 2014 decision. She found that the opinion of Dr. Gelman, as the impartial medical 

examiner (IME), constituted the special weight of the evidence and established that appellant had 

no further residuals of her employment injury.

 

6 Dr. Cary continued to provide progress reports regarding his treatment of appellant’s right and left shoulder 

condition.
5

Subsequent to the hearing representative’s decision, appellant submitted a May 8, 2014 

report from Dr. G. Russell Huffman, a Board-certified orthopedic surgeon. Dr. Huffman discussed 

her history of neck and shoulder pain after a patient “struck her in the shoulder and neck region.” 

He noted that appellant previously underwent a glenoid labrum repair “but had been completely 

asymptomatic and had resumed full work duties.” Dr. Huffman reviewed the MRI scan study 

findings of subacromial space fluid, tearing of the biceps labral complex, and tendinopathy of the 

supraspinatus tendon. He recommended shoulder surgery and rehabilitation for her cervical spine 

problems, noting that he does think that these are related even indirectly to her injury.

On January 29, 2016 counsel requested reconsideration. He asserted that Dr. Gelman

failed to address her surgical condition and did not provide medical reasoning for his conclusions.

OWCP, in an April 25, 2016 decision, denied modification of its January 29, 2015 

decision. It found that appellant had not submitted sufficient evidence to overcome the special 

weight afforded Dr. Gelman as the IME.

Appellant, through counsel, on April 25, 2017 again requested reconsideration. He 

asserted that Dr. Smith’s report was insufficient to create a conflict as he failed to address her 

cervical condition or provide rationale for his opinion. Counsel submitted the June 3, 2014 

operative report, noting that it established that appellant had shoulder pathology.

On June 3, 2014 Dr. Huffman performed a capsular release, extensive debridement, and 

subacromial decompression of appellant’s right shoulder.

By decision dated July 20, 2017, OWCP denied modification of its April 25, 2016 

decision.7 It found that Dr. Smith properly considered the statement of accepted facts in reaching 

his conclusions and found that appellant only sustained a right shoulder strain due to her work 

injury. OWCP further determined that Dr. Gelman found that the June 28, 2011 work injury did 

not cause her current complaints. 

On appeal counsel contends that Dr. Smith’s opinion was insufficient to create a conflict 

in medical opinion as he failed to address her cervical condition or provide any rationale for his 

findings. He asserts that OWCP failed to sufficiently develop whether she experiences neck 

problems due to her work injury. Counsel notes that appellant’s shoulder surgery revealed clear 

findings of pathology. He further alleges that Dr. Gelman failed to provide any rationale for his 

opinion regarding whether the work injury aggravated or accelerated a preexisting condition.

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.8 After it has determined that an employee 

has disability causally related to his or her federal employment, OWCP may not terminate 

 

7 OWCP referred to the IME at one point as Dr. Altman rather than Dr. Gelman, but this appears to be a 

typographical error.

8 See S.F., 59 ECAB 642 (2008); Kelly Y. Simpson, 57 ECAB 197 (2005).
6

compensation without establishing that the disability has ceased or that it is no longer related to 

the employment.9 Its burden of proof includes the necessity of furnishing rationalized medical 

opinion evidence based on a proper factual and medical background.10

The right to medical benefits for an accepted condition is not limited to the period of 

entitlement for disability.11 To terminate authorization for medical treatment, OWCP must 

establish that appellant no longer has residuals of an employment-related condition, which would 

require further medical treatment.12

Section 8123(a) provides that, if there is disagreement between the physician making the 

examination for the United States and the physician of the employee, the Secretary shall appoint a 

third physician who shall make an examination.13 The implementing regulation provides that, if a 

conflict exists between the medical opinion of the employee’s physician and the medical opinion 

of either a second opinion physician or an OWCP medical adviser, OWCP shall appoint a third 

physician to make an examination. This is called a referee examination and OWCP will select a 

physician who is qualified in the appropriate specialty and who has no prior connection with the 

case.14 

In situations where there exist opposing medical reports of virtually equal weight and 

rationale and the case is referred to an IME for the purpose of resolving the conflict, the opinion 

of such specialist, if sufficiently well rationalized and based upon a proper factual background, 

must be given special weight.15

ANALYSIS -- ISSUE 1

OWCP accepted that appellant sustained right shoulder strain due to a June 28, 2011 

employment injury. It paid her wage-loss compensation for total disability beginning 

August 18, 2011. OWCP properly determined that a conflict in medical opinion arose between

Dr. Cary, appellant’s attending physician, and Dr. Smith, an OWCP referral physician, regarding 

the extent of her disability due to her employment injury and need for medical treatment. It 

referred her to Dr. Gelman, a Board-certified orthopedic surgeon, for an impartial medical 

examination.

Where there exist opposing medical reports of virtually equal weight and rationale and the 

case is referred to an impartial medical specialist for the purpose of resolving the conflict, the 

 

9 See I.J., 59 ECAB 408 (2008); Elsie L. Price, 54 ECAB 734 (2003).

10 See J.M., 58 ECAB 478 (2007); Del K. Rykert, 40 ECAB 284 (1988).

11 See T.P., 58 ECAB 524 (2007); Kathryn E. Demarsh, 56 ECAB 677 (2005).

12 See Kathryn E. Demarsh, id.; James F. Weikel, 54 ECAB 660 (2003).

13 5 U.S.C. § 8123(a).

14 20 C.F.R. § 10.321.

15 R.C., 58 ECAB 238 (2006); David W. Pickett, 54 ECAB 272 (2002); Barry Neutuch, 54 ECAB 313 (2003).
7

opinion of such specialist, if sufficiently well rationalized and based upon a proper factual 

background, must be given special weight.16 

The Board finds that the opinion of Dr. Gelman is well rationalized and based on a proper 

factual and medical history. Dr. Gelman accurately summarized the relevant medical evidence, 

provided detailed findings on his examination, and reached conclusions about appellant’s 

condition which comported with his findings.17 In a report dated August 13, 2013, he reviewed 

the medical evidence of record, including the results of diagnostic studies. On examination

Dr. Gelman found a negative Finkelstein’s test, neck pain with Spurling’s maneuver, but no arm 

pain, and a strong radial pulse. He further found a positive Tinel’s sign. Dr. Gelman advised that 

the accepted condition of a right shoulder strain did not explain appellant’s symptoms. He found 

that she had recovered from her shoulder strain and, considering only the shoulder strain, could 

resume her usual employment. Dr. Gelman determined that any other pathology was not related 

to the June 28, 2011 work injury and recommended evaluation of the positive Tinel’s sign at the 

right elbow, noting that any required treatment was not related to employment. He provided 

rationale for his opinion by explaining that the diagnosed condition of right shoulder sprain and 

the mechanism of the June 28, 2011 work injury were not consistent with her current symptoms. 

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

his opinion is entitled to the special weight accorded an IME.

18

 

The remaining evidence submitted prior to OWCP’s termination of appellant’s 

compensation is insufficient to overcome the special weight afforded Dr. Gelman as the IME. On 

January 15, 2014 Dr. Cary diagnosed right shoulder sprain and internal derangement and left 

shoulder sprain and found that she was disabled from employment. In a March 17, 2014 report, 

he related that appellant required additional treatment of both shoulders, and attributed the left 

shoulder condition to overuse of the left arm due to the right shoulder injury. Dr. Cary diagnosed 

bilateral shoulder sprains and right shoulder internal derangement due to the June 28, 2011 

employment injury and opined that she was totally disabled. Dr. Cary, however, was on one side 

of the conflict resolved by Dr. Gelman. A medical report from a physician on one side of a conflict 

resolved by an IME is generally insufficient to overcome the special weight accorded the report of 

an IME or to create a new conflict.19

The Board, therefore, finds that OWCP properly terminated appellant’s wage-loss 

compensation and medical benefits for the accepted condition of right shoulder strain effective 

April 6, 2014.20

 

16 J.M., 58 ECAB 478 (2007); Darlene R. Kennedy, 57 ECAB 414 (2006).

17 Manuel Gill, 52 ECAB 282 (2001).

18 See J.M., supra note 16; Kathryn E. Demarsh, supra note 11.

19 See Jaja K. Asaramo, 55 ECAB 200 (2004); Michael Hughes, 52 ECAB 387 (2001).

20 See D.G., Docket No. 17-0608 (issued March 19, 2018).
8

On appeal counsel asserts that Dr. Smith failed to address her cervical condition. The 

relevant issue, however, is whether appellant experienced any further disability or need for medical 

treatment due to her right shoulder strain. 

Counsel also contends that neither Dr. Smith nor Dr. Gelman provided rationale for their 

opinions. He thus maintains that Dr. Smith’s opinion was insufficient to create a conflict in 

medical evidence and that Dr. Gelman’s opinion does not constitute the special weight of the 

evidence. As discussed, however, OWCP properly found that Dr. Smith’s report was sufficient to 

create a conflict in medical opinion. Dr. Smith based his opinion on an accurate medical history 

and provided rationale for his opinion that appellant’s right shoulder strain had resolved based on 

the objective findings. As noted, Dr. Gelman also provided rationale for his opinion, and thus his 

opinion represents the special weight of the evidence.

LEGAL PRECEDENT -- ISSUE 2

Once OWCP properly terminates a claimant’s compensation benefits, he or she has the 

burden of proof to establish continuing disability after that date causally related to the accepted 

injury.21 To establish a causal relationship between the condition as well as any attendant disability 

claimed and the employment injury, an employee must submit rationalized medical evidence based 

on a complete medical and factual background, supporting such a causal relationship.22 Causal 

relationship is a medical issue and the medical evidence required to establish a causal relationship 

is rationalized medical evidence.23 A claimant must establish by the weight of the reliable, 

probative, and substantial evidence that he or she had an employment-related disability which 

continued after termination of compensation benefits.24

ANALYSIS -- ISSUE 2

The Board finds that the medical evidence is insufficient to establish continuing 

employment-related disability after the March 31, 2014 termination of wage-loss compensation 

and medical benefits. 

Following the termination, appellant submitted a May 8, 2014 report from Dr. Huffman. 

Dr. Huffman reviewed her history of a prior glenoid labrum repair that was subsequently 

asymptomatic such that she resumed her usual work duties. He noted that appellant experienced 

neck and right shoulder pain after a patient struck that area. Dr. Huffman recommended shoulder 

surgery and rehabilitation for her cervical spine issues. On June 3, 2014 he performed a capsular 

release, extensive debridement, and subacromial decompression of appellant’s right shoulder. 

Dr. Huffman did not, however, address the relevant issue of whether appellant was disabled from 

 

21 See T.M., Docket No. 17-0915 (issued August 29, 2017); supra note 17.

22 Id.

23 Paul Foster, 56 ECAB 208 (2004); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

24 See J.A., Docket No. 15-0908 (issued August 6, 2015).
9

employment due to her accepted condition of right shoulder strain, and thus his report is of 

diminished probative value on this issue.25

As there is no medical evidence establishing that appellant continued to be disabled due to 

her accepted right shoulder strain, she did not meet her burden of proof to establish continuing 

employment-related disability after April 6, 2014.26

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 and 20 C.F.R. 

§§ 10.605 through 10.607. 

LEGAL PRECEDENT -- ISSUE 3

An employee has the burden of proof to establish that any specific condition for which 

compensation is claimed is causally related to the employment injury.27 Causal relationship is a 

medical issue, and the medical evidence required to establish causal relationship is rationalized 

medical evidence.28 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.29 Neither the mere fact that a disease 

or condition manifests itself during a period of employment nor the belief that the disease or 

condition was caused or aggravated by employment factors or incidents is sufficient to establish 

causal relationship.30

ANALYSIS -- ISSUE 3

The Board finds that appellant has not met her burden of proof to expand the acceptance 

of her claim to include cervical, thoracic, left shoulder, and additional right shoulder conditions. 

In a February 27, 2013 report, Dr. Cary diagnosed right and left shoulder strains and 

thoracic and cervical sprains/strains which he attributed to the nature of appellant’s injury. He 

advised that she sustained cervical and thoracic sprain and strain from her right shoulder muscles. 

Dr. Cary did not explain how, with reference to the specific mechanism of injury, being struck by 

 

25 See D.S., Docket No. 17-0084 (issued January 23, 2018) (the Board will not require OWCP to pay compensation 

for disability in the absence of medical evidence directly addressing the specific dates of disability for which 

compensation is claimed).

26 See G.H., Docket No. 16-0432 (issued October 12, 2016).

27 Kenneth R. Love, 50 ECAB 276 (1999).

28 See Jacqueline M. Nixon-Steward, supra note 23.

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

30 See Dennis M. Mascarenas, 49 ECAB 215 (1997).
10

a patient on June 28, 2011 resulted in cervical, thoracic, or left shoulder strain other than to note 

involvement of her right shoulder muscles. Consequently, his report is of little probative value.31

On March 17, 2014 Dr. Cary diagnosed a right shoulder sprain with internal derangement, 

left shoulder strain, and thoracic and cervical pain. He found that the left shoulder strain resulted 

from appellant overcompensating due to the right shoulder injury. Dr. Cary did not, however, 

provide any rationale in support of his conclusions. Medical evidence that states a conclusion, but 

does not offer any rationalized medical explanation regarding the cause of an employee’s condition 

is of limited probative value on the issue of causal relationship.

32

 Regarding Dr. Cary’s finding 

that appellant sustained internal derangement of the right shoulder as a result of the June 28, 2011 

employment injury, the Board notes that he did not support his causation finding with medical 

rationale explaining how the work injury caused or aggravated the diagnosed conditions of right 

shoulder derangement.33 Such rationale is particularly important given appellant’s history of 

preexisting right shoulder conditions.34

Dr. Huffman, in a May 8, 2014 report, discussed the findings on MRI scan study of the 

right shoulder and recommended surgery. He did not, however, specifically relate any of the 

findings to the accepted work injury. Medical evidence that does not offer any opinion regarding 

the cause of an employee’s condition is of limited probative value on the issue of causal 

relationship.35

Moreover, Dr. Smith and Dr. Gelman found that appellant had no diagnosed condition due 

to her June 28, 2011 work injury other than a right shoulder sprain. Dr. Smith, in an August 6, 

2012 report, found that she sustained a soft tissue strain of the right shoulder due to her 

employment injury, and that the MRI scan study findings did not reveal anything post-traumatic 

in nature. He attributed appellant’s symptoms to her prior shoulder injury and resulting surgery.

OWCP did not specifically request that Dr. Gelman, the physician selected as the IME, to 

address claim expansion and thus his opinion is that of a second opinion physician on the issue.36 

It did, however, ask that he provide all diagnosed conditions. Dr. Gelman diagnosed only right 

shoulder strain due to the June 28, 2011 work injury.

The Board, therefore, finds that appellant failed to meet her burden of proof to expand 

acceptance of her claim to include conditions other than right shoulder sprain.

37

 

31 See E.D., Docket No. 16-1854 (issued March 3, 2017).

32 See K.A., Docket No. 16-1330 (issued December 28, 2016).

33 See K.W., Docket No. 10-0098 (issued September 10, 2010).

34 See P.H., Docket No. 16-0654 (issued July 21, 2016); S.R., Docket No. 16-0657 (issued July 13, 2016).

35 R.E., Docket No. 10-0679 (issued November 16, 2010); K.W., 59 ECAB 271 (2007).

36 See S.F., Docket No. 17-1427 (issued May 16, 2018).

37 See C.W., Docket No. 16-0858 (issued April 3, 2017).
11

On appeal counsel asserts that OWCP failed to properly develop the issue of whether she 

sustained a cervical condition due to her work injury and notes that surgery on her right shoulder 

showed pathology. As noted, however, appellant did not submit reasoned medical evidence on 

causal relationship sufficient to establish additional employment-related conditions.

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 and 20 C.F.R. 

§§ 10.605 through 10.607. 

CONCLUSION

The Board finds that OWCP properly terminated appellant’s wage-loss compensation and 

authorization for medical benefits effective April 6, 2014 as she had no further disability or need 

for medical treatment causally related to her June 28, 2011 employment injury. The Board further 

finds that she has neither established continuing employment-related disability after April 6, 2014,

nor has she established the expansion of the acceptance of her claim to include additional 

conditions as a result of her June 28, 2011 employment injury.

ORDER

IT IS HEREBY ORDERED THAT the July 20, 2017 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: August 20, 2018

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