United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

Q.M., Appellant

and

U.S. POSTAL SERVICE, PROCESSING & 

DISTRIBUTION CENTER, Inglewood, CA, 

Employer

__________________________________________

)

)

)

)

)

)

)

)

)

Docket No. 20-1614

Issued: November 25, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On March 2, 2020 appellant filed a timely appeal from a January 15, 2020 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 terminated appellant’s compensation, effective 

March 10, 2015, finding that she forfeited her entitlement to compensation pursuant to 5 U.S.C. 

§ 8148(a).

 

1 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

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

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

follows.

On September 21, 2002 appellant, then a 28-year-old mail processor, filed a traumatic 

injury claim (Form CA-1) alleging that on September 1, 2000 she sustained bilateral carpal tunnel 

syndrome as a result of her repetitive employment duties. She stopped work and returned to 

modified duty as a casual clerk on September 12, 2002. OWCP assigned OWCP File No. 

xxxxxx098 and converted appellant’s traumatic injury claim to an occupational disease claim.3 It 

subsequently accepted the claim for bilateral carpal tunnel syndrome, bilateral shoulder strain, 

bilateral de Quervain’s syndrome, and bilateral lateral epicondylitis. Appellant was terminated 

from federal employment, effective December 27, 2002.

OWCP began paying wage-loss compensation benefits on the daily rolls beginning 

September 24, 2002, and placed appellant on the periodic rolls, effective March 23, 2003. 

In March 2015, OWCP received evidence that appellant was indicted in the County of Los 

Angeles for the crime of insurance fraud in violation of Section 550(B) of the California Penal 

Code. “A FELONY COMPLAINT FOR AN ARREST WARRANT” revealed that, on or between 

January 1, 2012 and December 31, 2013, appellant committed the crime of insurance fraud when 

she “assisted, conspired with another to[,] and presented and caused to be presented a written and 

oral statement as part of, ... a claim for payment and other benefit to an insurance policy, knowing 

that the statement contained false and misleading information concerning a material fact.” 

Appellant was charged with one count under Section 550(b)(1) of the California Penal Code.

OWCP also received a “DECLARATION IN SUPPORT OF AN ARREST WARRANT”

signed by A.R., who reported that she was employed as a Peace Officer for the California 

Department of Insurance and that she had obtained information and investigated allegations that 

appellant had committed insurance fraud in violation of California Penal Code 550(B)(1). 

A printout of a court docket revealed that on March 10, 2015 the Superior Court of 

California, County of Los Angeles accepted appellant’s guilty plea to one count of insurance fraud 

under Section 550(B)(3) of the California Penal Code. Appellant was sentenced to three years of 

summary probation and ordered to pay restitution to the employing establishment and a fine to the 

court. The printout was signed by a Deputy of the Superior Court of the County of Los Angeles 

and contained a court stamp. 

By decision dated April 27, 2015, OWCP found that appellant had forfeited her entitlement 

to compensation, effective March 10, 2015, the date of her conviction, as she pled guilty to one 

 

2 Q.M., Docket No. 18-0345 (issued May 17, 2019).

3 OWCP administratively combined this case with a previous claim, under OWCP File No. xxxxxx399, with the 

present case as the master file. Under OWCP File No. xxxxx399, it accepted that appellant sustained cervical and 

lumbosacral strains, cervical radiculopathy, and lumbosacral radiculopathy as a result of her employment duties. 
3

count of insurance fraud in violation of California Penal Code 550(B)(3) in connection with an 

application for, or receipt of, benefits under FECA. It determined that, as a result of her conviction 

and in accordance with 5 U.S.C. § 8148(a) and 20 C.F.R. § 10.17, she was not entitled to receive 

further benefits under FECA under OWCP File Nos.xxxxxx098 and xxxxxx399. OWCP further 

advised that any authorized medical treatment received prior to April 27, 2015 would be paid, but 

no further medical treatment would be paid beyond that date.

On February 23, 2016 appellant requested reconsideration of the April 27, 2015 decision. 

In a February 18, 2016 statement, she requested that OWCP reinstate her wage-loss compensation 

and medical benefits since her conviction and guilty plea were dismissed. Appellant argued that 

since the termination of benefits was based upon a conviction that, no longer stood, her benefits 

should be reinstated. 

OWCP received a printout of the docket for the Superior Court of Los Angeles County, 

which demonstrated that appellant had fulfilled 100 hours of community service and had paid her 

criminal restitution and fine in full. It also revealed that on August 4, 2015 her plea, verdict, or 

finding of guilt regarding count 2 was set aside and vacated and a plea of not guilty was entered. 

OWCP noted that an expungement order was signed and filed. 

Appellant submitted an August 4, 2015 Order For Dismissal from the Superior Court of 

Los Angeles County, which granted appellant’s petition for dismissal regarding appellant’s 

conviction under Section 1203.4 of the California Penal Code. The order was signed by Judge 

David M. Horwitz and was stamped by the Superior Court of Los Angeles County. 

By decision dated May 23, 2016, OWCP vacated the April 27, 2015 termination decision,

and reinstated appellant’s wage-loss compensation and medical benefits. It noted that the 

California Superior Court had dismissed the conviction of insurance fraud against her, and thus, 

OWCP had no basis to terminate her wage-loss compensation and medical benefits pursuant to 5 

U.S.C. § 8148(a).

In an August 15, 2016 decision, OWCP rescinded the May 23, 2016 decision and reinstated 

the April 27, 2015 decision, which terminated appellant’s benefits under Section 8148(a). It noted 

that an Order of Dismissal under California Penal Code § 1203.4 did not nullify or expunge her

criminal conviction of fraud, but was an acknowledgement by the court that she had successfully 

completed her probation and was releasing her from all penalties and disabilities resulting from 

the offense. OWCP cited to various state court decisions in interpreting Section 1203.4 of the 

California Penal Code. 

On August 4, 2017 appellant requested reconsideration. In a June 23, 2017 statement, she 

explained that she pled guilty for insurance fraud pursuant to California Penal Code 550(B)(3)

because at the time of the conviction, she did not have evidence to prove her innocence so she 

accepted a plea bargain to enter a plea of nolo contendere in order to avoid jail time. Appellant 

noted that she later filed a petition for expungement, which was granted on August 4, 2015. She 

initially asserted that OWCP violated the Full Faith and Credit clause of the U.S. Constitution by 

ignoring the clear language of the August 4, 2015 Order for Dismissal, which explicitly noted that 

“the plea, verdict, or finding of guilt be set aside and vacated.” Second, appellant argued that the 

purpose of the California Penal Code Section 1203.4 was to release convicted persons from all 
4

penalties and disabilities from the offense of which he or she had been convicted and that OWCP 

had not shown the existence of a specifically enumerated exception to Section 1203.4 that would 

preclude receipt of workers’ compensation benefits. She also cited to various state cases that 

OWCP had quoted in its decision and explained how her case was different from the cases cited. 

Lastly, appellant alleged that OWCP did not cite to any Board cases to support its arguments in its 

August 15, 2016 decision.

Appellant resubmitted the August 4, 2015 Order For Dismissal, and copies of court records 

dated November 2014 to August 2015, including a notice of scheduling of an August 4, 2015 

hearing on motion for modification of sentence/early termination. 

OWCP received a September 6, 2016 report by Dr. Christopher P. DeCarlo, a physical 

medicine and rehabilitation specialist, who related appellant’s complaints of continuing relenting 

pain in the bilateral biceps area, right elbow, both wrists, and both thumbs. He provided 

examination findings and indicated that she could return to modified work. 

By decision dated November 1, 2017, OWCP denied appellant’s request for 

reconsideration of the merits of the claim, pursuant to 5 U.S.C. § 8128(a). It found that her

reconsideration request neither raised substantive legal questions nor included new and relevant 

evidence sufficient to warrant further merit review of her claim.

Appellant filed an appeal before the Board. In a May 17, 2019 decision, the Board set 

aside the November 1, 2017 decision and remanded her claim to OWCP for review and 

reconsideration on the merits.

By decision dated January 15, 2020, OWCP denied modification of the August 15, 2016 

decision reinstating the termination of appellant’s compensation benefits in accordance with 5 

U.S.C. § 8148(a).

LEGAL PRECEDENT

Public Law No. 103-333, enacted on September 30, 1994, amended FECA by adding 5 

U.S.C. § 8148, which provides for the termination of benefits payable to beneficiaries who have 

been convicted of defrauding FECA program. Section 8148(a) specifically provides that an 

individual convicted of a violation of 18 U.S.C. § 1920 or any other federal or state criminal statute 

relating to fraud in the application for or receipt of a benefit under FECA, shall forfeit, as of the 

date of such conviction, entitlement to any benefit to which such individual would otherwise be 

entitled under FECA for an injury occurring on or before the date of such conviction. Such 

forfeiture shall be in addition to any action the Secretary may take under section 81064(forfeiture) 

or section 81295(recovery of overpayments) of FECA.6

 

4 5 U.S.C. § 8106.

5

Id. at § 8129.

6

Id. at § 8148; see L.C., Docket No. 19-1094 (issued February 25, 2020); D.S., Docket No. 18-1173 (issued June 13, 

2019); F.C., 59 ECAB 666 (2007).
5

Section 10.17 of OWCP’s implementing regulations provides that, when a claimant pleads 

guilty to federal or state criminal charges of fraud in connection with receipt of Federal 

Government benefits, the claimant’s entitlement to further compensation benefits will terminate 

effective the date the guilty plea is accepted. Termination of entitlement under this section is not 

affected by any subsequent change in or recurrence of the beneficiary’s medical condition.7

OWCP’s procedures provide that in support of termination or suspension of compensation 

the record must contain evidence establishing that the person convicted of fraud and the conviction 

was related to the claim for, or receipt of, benefits under FECA.8 Such evidence includes a copy 

of the indictment or formal accusation that the person has committed the crime and a copy of the 

plea agreement with an indication that it was accepted by the court, or a copy of the guilty verdict.9 

The termination is effective on the date of the verdict or on the date the guilty plea is accepted and 

guilt adjudicated.10 Because of the criminal basis for the termination, no pretermination notice is 

required before a final decision is issued.11

ANALYSIS

The Board finds that OWCP improperly terminated appellant’s compensation benefits, 

effective March 10, 2015.

OWCP found that appellant had forfeited her entitlement to compensation, effective 

March 10, 2015, pursuant to 5 U.S.C. § 8148 because she pled guilty to one count of insurance 

fraud in connection with an application for, or receipt of, benefits under FECA in violation of 

California Penal Code 550(B)(3). 

As noted above, OWCP’s procedures provide that, to support the termination of 

compensation under 5 U.S.C. § 8148, the evidence of record must contain a copy of the indictment 

or formal accusation and a copy of the plea agreement with an indication that it was accepted by 

the court, or a copy of the guilty verdict.12 The Board has reviewed the evidence of record and 

notes that it does not contain copies of the indictment, plea agreement, or court judgment related 

to appellant’s guilty verdict. In this case, the evidence of record contains a felony complaint for a 

warrant indicating that she was charged with insurance fraud under Section 550(b)(1) of the 

California Penal Code, a Declaration in support of the arrest warrant, and a printout of the court 

docket. Because the evidence of record does not contain the evidence needed to support the 

termination of appellant’s wage-loss compensation benefits under 5 U.S.C. § 8148, the Board 

 

7 20 C.F.R. § 10.17.

8 Federal (FECA) Procedure Manual, Part 2 -- Claims, Disallowances, Chapter 2.1400.17(c)(2) (September 2020).

9

Id. 

10 Id. at Chapter 2.1400.17(d) (February 2013).

11 Id. at Chapter 2.1400.4(a)(6) (February 2013).

12 Supra notes 7 and 8.
6

therefore finds that OWCP did not properly terminate her compensation benefits, effective 

March 10, 2015.

13

Furthermore, the Board notes that the evidence of record must establish that the individual 

was convicted of a crime related to the claim for or receipt of the compensation benefits under 

FECA.14 In this case, the evidence of record does not establish that appellant’s guilty plea to one 

count of insurance fraud under Section 550(b)(3) of the California Penal Code was related to her 

FECA benefits. Section 550(b)(3) notes that it was unlawful to do or knowingly assist or conspire, 

with any person, to: “(3) [c]onceal, or knowingly fail to disclose the occurrence of, an event that 

affects any person’s initial or continued right or entitlement to any insurance benefit or payment, 

or the amount of any benefit or payment to which the person is entitled.”

15

 According to OWCP’s 

April 27, 2015 and January 15, 2020 decisions, appellant pled guilty in the Superior Court of 

California to insurance fraud in relation to her receipt of FECA benefits. However, there is no 

evidence in the case record to demonstrate that her guilty plea was in connection to the receipt of 

her FECA benefits. Accordingly, the Board finds that the January 15, 2020 decision terminating

appellant’s wage-loss compensation benefits, effective March 10, 2015, shall therefore be 

reversed.

CONCLUSION

The Board finds that OWCP improperly terminated appellant’s compensation benefits, 

effective March 10, 2015.

 

13 C.G., Docket No. 17-1142 (issued January 25, 2018); Lorenzo P. Garcia, Docket No. 99-1665 (issued 

July 12, 2001).

14 Supra note 7.

15 Cal. Penal Code § 550(B)(3). 
7

ORDER

IT IS HEREBY ORDERED THAT the January 15, 2020 decision of the Office of

Workers’ Compensation Programs is reversed.

Issued: November 25, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board