United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

L.G., Appellant

and

DEPARTMENT OF DEFENSE, NATIONAL 

SECURITY AGENCY, Fort Meade, MD, 

Employer

__________________________________________

)

)

)

)

)

)

)

)

)

Docket No. 19-0142

Issued: August 8, 2019

Appearances: Case Submitted on the Record

Analese B. Dunn, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On October 24, 2018 appellant filed a timely appeal from a May 3, 20182 merit decision of 

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

 

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 The appeal request claims to appeal from a May 22, 2018 decision. However, there is no such decision of record. 

The only decision within the jurisdiction of the Board is dated May 3, 2018.

3 5 U.S.C. § 8101 et seq.
2

ISSUES 

The issues are: (1) whether OWCP has met its burden of proof to terminate appellant’s 

wage-loss compensation and medical benefits, effective August 31, 2015, as she no longer had

residuals or disability causally related to her accepted October 1, 2014 employment injury; and 

(2) whether appellant has met her burden of proof to establish employment-related continuing 

residuals or disability on or after August 31, 2015.

FACTUAL HISTORY

On October 6, 2014 appellant, then a 49-year-old country desk officer, filed a traumatic 

injury claim (Form CA-1) alleging that on October 1, 2014 she sustained injury due to falling and 

landing on her right hip while in the performance of duty.

4

 She stopped work on October 2, 2014. 

OWCP accepted appellant’s claim for sprains of her neck, right shoulder/upper arm, right 

hip/thigh, and lumbar region, and contusions of multiple sites.

5

 It paid appellant wage-loss 

compensation benefits.

On October 15, 2014 Dr. James York, a Board-certified orthopedic surgeon, diagnosed 

cervical, left hip, and lumbar sprains and opined that appellant could return to her full-duty work 

on October 20, 2014. Appellant did not return to any form of work.

6

On February 23, 2015 appellant underwent a functional capacity evaluation (FCE) which 

assessed her ability to perform various physical activities. Due to consistency of effort 

discrepancies, self-limiting behaviors, and sub-maximal efforts, the results of the evaluation 

represented a minimal level of functioning for appellant. The FCE revealed that appellant had fair 

lifting/carrying mechanics and was at least capable of lifting 20 pounds (from floor to waist) and 

pushing 30 pounds. It also showed inconsistent results upon some muscle and hand grip/pinch 

testing.

In early April 2015, OWCP referred appellant for a second opinion examination to

Dr. Stuart J. Gordon, a Board-certified orthopedic surgeon. It requested that he provide an opinion 

regarding whether she continued to have residuals or disability due to her accepted October 1, 

2014 employment injury. 

In an April 21, 2015 report, Dr. Gordon detailed appellant’s factual and medical history 

and described her current complaints, including neck, back, and right hip pain. He reported the 

findings of the physical examination he conducted on that date, noting that no paraspinal muscle 

spasms were observed in her cervical spine. Appellant voluntarily restricted her cervical motion 

 

4 The traumatic injury claim was filed on appellant’s behalf by her immediate supervisor. 

5 Appellant visited an emergency room on October 3, 2014 and x-rays taken at that time showed degenerative disc 

disease at the C6-7 level with loss of disc space. A November 24, 2014 magnetic resonance imaging scan of 

appellant’s lumbar spine showed a disc bulging and facet arthropathy at L5-S1. 

6 On March 4, 2015 Dr. York indicated that appellant had been capable of returning to her full-duty work since 

October 20, 2014. 
3

on direct examination in contrast to her easy change of head position when she provided her 

history. Dr. Gordon advised that, with respect to her lumbar spine, she complained of lumbar pain

without appreciable spasms. Appellant only allowed a few degrees of lumbar motion on direct 

examination when standing, but she tolerated full lumbar flexion when seated. Dr. Gordon noted 

that straight leg raising was negative bilaterally and that strength and sensation were intact in the 

lower extremities.7 He diagnosed obesity, concern for abnormal illness behavior, symptom 

magnification, volitional restriction, prior cervical/lumbar trauma (private motor vehicle accident 

six years prior), and preexisting degenerative disease of both hips and the cervical and lumbar

areas of the spine.8 Dr. Gordon indicated that the following diagnosed conditions related to the 

October 1, 2014 fall had resolved: cervical strain, right shoulder contusion/strain, right hip 

contusion/strain, and lumbar strain. 

Dr. Gordon advised that appellant’s subjective complaints did not comport with her 

objective findings, noting that the only objective findings were degenerative in nature. He agreed 

with the findings of the February 23, 2015 FCE showing multiple inconsistencies and subjective 

reporting which far outweighed the expected effects of “[appellant’s] mechanism of injury and 

event.” Dr. Gordon noted that appellant’s nonindustrial/preexisting disability included 

degenerative disease of her cervical and lumbar spine, cervical stenosis, obesity, and degenerative 

disease of her hips. He posited that her preexisting conditions were not aggravated on October 1, 

2014 and maintained that she presently ceased to have residuals of the accepted October 1, 2014 

injury. Dr. Gordon found that appellant’s current complaints were related to obesity and 

degenerative disease. He indicated that she required no additional treatment and he determined 

that she could return to work in a full-duty capacity. Dr. Gordon attached an April 21, 2015 work 

capacity evaluation form (OWCP-5c) in which he opined that appellant could perform her usual 

job on a full-time basis without restrictions. 

In a June 3, 2015 letter, OWCP advised appellant of its proposed termination of her wageloss compensation and medical benefits commencing August 31, 2015, because she ceased to have 

residuals of her October 1, 2014 employment injury. It informed her that the termination was 

justified by the opinion of Dr. Gordon. OWCP afforded appellant 30 days to submit evidence and 

argument challenging the proposed action. 

Appellant submitted a July 4, 2015 statement in which she asserted that she continued to 

have disabling neck, shoulder, hip, and back conditions due to her October 1, 2014 fall. 

Appellant submitted several medical reports, including a May 22, 2015 report from

Dr. Patricia P. Jett, a Board-certified family practitioner, who diagnosed shoulder pain, lumbago, 

cervicalgia, and pelvic/thigh pain. Dr. Jett found that appellant’s physical condition and chronic 

pain prevented her from returning to work.9 On June 18, 2015 Dr. William Tham, a Board-

 

7 Appellant had no irritability with full motion of her right shoulder. She complained of bilateral inguinal discomfort 

upon range of motion of the hips, but no palpable mass was found in the inguinal region.

8 Dr. Gordon indicated that the diagnoses of symptom magnification, concern for abnormal illness behavior, and 

volitional restriction were corroborated during the February 23, 2015 FCE. 

9

In several reports from March 2015, Dr. Thomas Hyland-Robertson, a chiropractor, diagnosed degeneration of 

cervical and lumbar discs. 
4

certified physical medicine and rehabilitation physician, noted that his physical examination 

showed no weakness in appellant’s trunk and extremities. He diagnosed muscle spasm and 

fibromyalgia and reported that the diagnostic testing did not show any significant pathology which 

would explain all of her symptoms. Dr. Tham indicated that appellant had widespread myofascial 

pain from her October 1, 2014 injury and noted, “[Appellant] has fibromyalgia which can be 

triggered by an injury.” 

In a June 26, 2015 report, Dr. Vincent Ng, a Board-certified orthopedic surgeon, diagnosed 

bilateral hip trochanteric bursitis. In July 29 and August 19, 2017 reports, Dr. Claudia Dal-Molin, 

a Board-certified internist, diagnosed bilateral hip trochanteric bursitis, adductor tendinitis, and 

“[question] of fibromyalgia].”

In July 2017 OWCP requested that Dr. Gordon review the additional medical evidence

submitted by appellant and provide a supplemental report indicating whether the additional 

evidence changed the opinion he provided in his April 21, 2015 report. 

In an August 24, 2015 report, Dr. Gordon summarized the newly submitted medical 

evidence and noted, “I have no change in my previously stated opinions regarding [appellant] with

respect to my report of [April 21, 2015].”

By decision dated August 31, 2015, OWCP terminated appellant’s wage-loss 

compensation and medical benefits, effective that same date, because she no longer had disability 

or residuals causally related to her October 1, 2014 employment injury. It determined that its 

termination action was justified by the opinion of Dr. Gordon. 

On September 25, 2015 appellant, through counsel, requested a hearing with a 

representative of OWCP’s Branch of Hearings and Review. During the hearing, held on May 16, 

2016, counsel argued that the medical evidence of record showed that appellant continued to have 

employment-related disability/residuals.

Appellant subsequently submitted a March 21, 2016 report from Dr. Ralph Salvagno, a 

Board-certified orthopedic surgeon, who described her factual and medical history, including the 

circumstances of the October 1, 2014 employment injury.10 Dr. Salvagno reported the findings of 

the physical examination he conducted on March 21, 2016 and diagnosed bilateral hip contusions 

and cervical, lumbar, and right shoulder sprains due to the October 1, 2014 fall. He also indicated 

that appellant had preexisting degenerative disc disease at C6-7 and L5-S1 and that a right 

hip/thigh sprain related to the October 1, 2014 fall had resolved. Dr. Salvagno referenced

Dr. Gordon’s comments regarding the February 23, 2015 FCE and indicated that the 

inconsistencies observed during the FCE were limited to appellant’s hand grip/pinch testing and 

did not concern the regions affected by her employment injury, i.e., her neck, right shoulder, right 

hip, and low back. He further indicated that she “did appear to demonstrate reasonable effort”

during the FCE. Dr. Salvagno recommended various work restrictions, including lifting no more 

than 10 pounds. 

 

10 Dr. Salvagno also noted that appellant reported being involved in a motor vehicle accident six years prior without 

“any significant residuals.”
5

By decision dated August 1, 2016, OWCP’s hearing representative affirmed the August 31, 

2015 decision. She determined that the August 31, 2015 termination action was proper and found 

that, since the time of termination, appellant had not established continuing residuals or disability 

causally related to her accepted employment injury. The hearing representative determined that

Dr. Salvagno’s March 21, 2016 report was of limited probative value with respect to continuing 

employment-related disability/residuals.

On January 25, 2017 appellant, through counsel, requested reconsideration of the August 1, 

2016 decision. Appellant submitted a November 11, 2016 report from Dr. Robert W. Macht, a 

Board-certified surgeon, who discussed her October 1, 2014 injury and reported the findings of 

the physical examination he carried out on November 7, 2016. Dr. Macht indicated that she

exhibited consistent range of motion losses in her neck, left shoulder, and back. He found that 

appellant still had residuals of her October 1, 2014 employment injury, noting that the current 

diagnoses of sprains of her neck, shoulders, back, and hips were causally related to the October 1, 

2014 injury. Dr. Macht indicated that she had been totally disabled from her regular work since 

October 1, 2014. He referenced appellant’s neck and low back regions and noted, “It is a soft 

tissue muscle ligament injury to those regions which is causing [appellant’s] disability, therefore, 

citing the preexisting degenerative disc disease as the [October 1, 2014] source of her disability is 

erroneous.” Dr. Macht further found that she had “a 25 percent permanent partial impairment 

[rating] of [appellant’s] neck and right shoulder region and a 25 percent permanent partial 

impairment [rating] of her back and right hip region” due to the October 1, 2014 injury.

11

In a February 5, 2018 report, Dr. Salvagno noted that the inconsistencies in appellant’s 

February 23, 2015 FCE were only noted with respect to hand testing and that the evaluation of the 

body parts injured on October 1, 2014 showed no inconsistencies. He indicated that the observed 

difference between seated flexion and standing flexion would not be an indicator of symptom 

magnification as seated flexion is passive and standing flexion is active.12 Dr. Salvagno indicated 

that a positive Waddell’s test indicating evidence of symptom magnification or malingering

required three out of five signs to be positive, but appellant only exhibited two out of five positive 

signs. He maintained that attending physician reports from 2015 through 2017 did not document 

evidence of symptom magnification or an etiology for her continued symptoms other than the work 

injury. Dr. Salvagno noted that Dr. Tham had found that appellant had fibromyalgia as a 

consequence of the October 1, 2014 injury. He found that she had demonstrated consistent and 

persistent symptoms/impairment since October 1, 2014 and noted that all providers had related her

symptoms/impairment to the October 1, 2014 employment injury. Dr. Salvagno noted, “It is for 

these reasons that I believe [appellant] continues to suffer from cervical sprain, lumbar sprain, left 

 

11 Dr. Macht actually referenced a March 20, 2012 accident as the cause of the permanent impairment, but this 

appears to have been an inadvertent error as he correctly referenced appellant’s October 1, 2014 injury throughout the 

rest of the report.

12 Dr. Salvagno indicated that a positive Waddell’s test indicating evidence of semantic magnification or 

malingering required three out of five signs to be positive, but appellant only exhibited two out of five positive signs.
6

shoulder sprain and bilateral hip contusions as documented in my physical examination results on 

March 21, 2016.”

13

By decision dated February 9, 2017, OWCP denied modification of its August 1, 2016 

decision. 

On February 8, 2018 appellant, through counsel, requested reconsideration of the 

February 9, 2017 decision. In a March 10, 2017 report, Dr. Jett indicated that, after her October 1, 

2014 injury, appellant continued to have “chronic pain in [appellant’s] cervicalgia [sic], groin, 

clavicle, throat, shoulder, back, and lumbar spine.” She opined that appellant’s “traumatic fall has 

aggravated, exacerbated, or accelerated [appellant’s] medical condition premorbid.” In another 

March 10, 2017 report, Dr. Jett diagnosed chronic pain syndrome, dysphagia, acute stress reaction, 

and “other injury of muscle, fascia, and tendon of other parts of biceps, left arm, sequela.”

By decision dated May 3, 2018, OWCP denied modification of its February 9, 2017 

decision. 

LEGAL PRECEDENT -- ISSUE 1

Under FECA, once OWCP has accepted a claim it has the burden of proof to justify

termination or modification of compensation benefits.14 OWCP may not terminate compensation 

without establishing that the disability ceased or that it was no longer related to the employment.15 

OWCP’s burden of proof includes the necessity of furnishing rationalized medical opinion 

evidence based on a proper factual and medical background.16

ANALYSIS -- ISSUE 1

The Board finds that OWCP has met its burden of proof to terminate appellant’s wage-loss 

compensation and medical benefits effective August 31, 2015 as she no longer had residuals or 

disability causally related to her accepted October 1, 2014 employment injury. 

 

13 Appellant also submitted a December 2, 2015 report from Dr. David M. Ibrahimi, a Board-certified 

neurosurgeon, who advised that her radiating symptoms in her arms and legs, last observed in June 2015, had all 

resolved. Dr. Ibrahimi opined that there was no need for neurological intervention with respect to her neck and back. 

In a January 13, 2016 report, Dr. Ghislaine Fougy, a Board-certified psychiatrist, diagnosed appellant with depression 

and anxiety reactive to her October 1, 2014 fall at work. She advised that appellant also developed fibromyalgia and 

indicated that appellant could not return to work due to the severity of her injuries. 

14 C.C., Docket No. 17-1158 (issued November 20, 2018); I.J., 59 ECAB 408 (2008); Vivien L. Minor, 37 ECAB 

541 (1986).

15 A.D., Docket No. 18-0497 (issued July 25, 2018). In general the term disability under FECA means incapacity 

because of injury in employment to earn the wages which the employee was receiving at the time of such injury. See 

20 C.F.R. § 10.5(f).

16 R.P., Docket No. 17-1133 (issued January 18, 2018).
7

The Board finds that the thorough, well-rationalized April 21 and August 19, 2015 reports

of Dr. Gordon, an OWCP referral physician, establish that appellant had no disability/residuals 

causally related to her October 1, 2014 employment injury after August 31, 2015.

In his April 21, 2015 report, Dr. Gordon noted that appellant voluntarily restricted her 

cervical motion on direct examination in contrast to her easy change of head position when she 

provided her history.17 He diagnosed obesity, concern for normal illness behavior, symptom 

magnification, volitional restriction, prior cervical/lumbar trauma (private motor vehicle accident 

six years prior), and preexisting degenerative disease of both hips and the cervical and lumbar 

areas of the spine. Dr. Gordon opined that the diagnosed conditions related to the October 1, 2014 

fall had resolved, including contusions of multiple sites and sprains of appellant’s neck, right 

shoulder, right hip, and lumbar region. He posited that her preexisting conditions were not 

aggravated on October 1, 2014 and maintained that she presently ceased to have residuals of the

October 1, 2014 injury. Dr. Gordon determined that appellant could return to work in a full-duty 

capacity. In his August 24, 2015 report, he summarized the medical evidence appellant submitted 

after OWCP sent her a June 3, 2015 notice of proposed termination and he noted that these 

documents did not change his April 21, 2015 opinion.

The Board has carefully reviewed the opinion of Dr. Gordon and notes that it has reliability, 

probative value, and convincing quality with respect to its conclusions regarding the relevant issue 

of the present case. Dr. Gordon’s opinion provided a thorough factual and medical history and 

accurately summarized the relevant medical evidence. Moreover, he provided a proper analysis 

of the factual and medical history and the findings on examination, including the results of 

diagnostic testing, and reached conclusions regarding appellant’s condition which comported with 

this analysis.18 Dr. Gordon provided medical rationale for his opinion by explaining that her

subjective complaints did not comport with her objective findings. He noted that appellant ceased 

to have objective findings of her accepted soft-tissue injuries related to the October 1, 2014 

injury.

19

 Dr. Gordon further explained that her continuing medical problems were related to 

nonwork-related conditions, including obesity and degenerative disease in both hips and the 

cervical and lumbar areas of the spine.

After OWCP sent appellant a June 3, 2015 notice of proposed termination, she submitted 

additional medical evidence, including a May 22, 2015 report from Dr. Jett who diagnosed 

shoulder pain, lumbago, cervicalgia, and pelvic/thigh pain which caused total disability. In a 

June 18, 2015 report, Dr. Tham indicated that appellant had widespread myofascial pain from her 

October 1, 2014 injury and noted, “[Appellant] has fibromyalgia which can be triggered by an 

injury.” In a June 26, 2015 report, Dr. Ng diagnosed appellant with bilateral hip trochanteric 

 

17 Moreover, appellant only allowed a few degrees of lumbar motion on direct examination when standing, but she 

tolerated full lumbar flexion when seated.

18 See W.C., Docket No. 18-1386 (issued January 22, 2019); Melvina Jackson, 38 ECAB 443 (1987) (regarding the 

importance, when assessing medical evidence, of such factors as a physician’s knowledge of the facts and medical 

history, and the care of analysis manifested and the medical rationale expressed in support of the physician’s opinion).

19 Dr. Gordon opined that the findings of the February 23, 2015 FCE showed multiple inconsistencies and 

subjective reporting which far outweighed the expected effects of the employment injury.
8

bursitis and, in July 29 and August 19, 2017 reports, Dr. Dal-Molin diagnosed bilateral hip 

trochanteric bursitis, adductor tendinitis, and “[question] of fibromyalgia].”

20

The Board finds that these reports are of limited probative value regarding the termination 

of appellant’s wage-loss compensation and medical benefits because they do not contain a 

rationalized medical opinion relating disability or residuals to the accepted October 1, 2014 

employment injury. Although Dr. Tham indicated that she had widespread myofascial pain from 

her October 1, 2014 injury, he did not explain how this pain could have been related to the accepted 

employment conditions.21 With particular respect to Dr. Jett’s diagnosis of pain, it should be noted 

that the Board has held that pain alone is a symptom, not a medical diagnosis, and Dr. Jett did not 

relate any condition to the October 1, 2014 employment injury.22 Dr. Ng and Dr. Dal-Molin also 

failed to relate any condition to the October 1, 2014 employment injury.23 The Board has held that 

a report is of limited probative value regarding causal relationship if it does not contain medical 

rationale explaining how an employment activity could have caused or aggravated a medical 

condition.24 For these reasons, the above-noted reports are insufficient to show that OWCP’s 

termination action was improper.

The Board therefore finds that OWCP has met its burden of proof to terminate appellant’s 

wage-loss compensation and medical benefits, effective August 31, 2015, as she no longer had 

residuals or disability causally related to her accepted October 1, 2014 employment injury.

LEGAL PRECEDENT -- ISSUE 2

When OWCP properly terminates compensation benefits, the burden shifts to appellant to 

establish continuing residuals or disability after that date, causally related to the accepted 

employment injury.25 To establish causal relationship between the condition as well as any 

attendant disability claimed and the employment injury, an employee must submit rationalized 

 

20 Appellant also submitted several reports from March 2015 in which Dr. Hyland-Robertson, a chiropractor, 

diagnosed degeneration of cervical and lumbar discs.

21 Dr. Tham did not provide a clear opinion that appellant’s fibromyalgia was related to her October 1, 2014 

employment injury and OWCP has not accepted fibromyalgia as an employment-related condition.

22 See F.U., Docket No. 18-0078 (issued June 6, 2018).

23 With respect to Dr. Hyland-Robertson’s reports, chiropractors are only considered physicians under FECA, and 

their reports considered medical evidence, to the extent that they treat spinal subluxations as demonstrated by x-ray to 

exist. 5 U.S.C. § 8101(2). See A.M., Docket No. 16-1875 (issued August 23, 2017); Jack B. Wood, 40 ECAB 95, 

109 (1988). These submitted reports are not considered to be probative medical evidence because Dr. HylandRobertson did not treat spinal subluxations as demonstrated by x-ray to exist.

24 See Y.D., Docket No. 16-1896 (issued February 10, 2017).

25 See S.M., Docket No. 18-0673 (issued January 25, 2019); C.S., Docket No. 18-0952 (issued October 23, 2018); 

Manuel Gill, 52 ECAB 282 (2001).
9

medical evidence based on a complete medical and factual background, supporting such causal 

relationship.26 

ANALYSIS -- ISSUE 2

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

continuing employment-related residuals or disability on or after August 31, 2015.

After OWCP’s August 31, 2015 decision terminating appellant’s wage-loss compensation 

and medical benefits effective that day, she submitted additional medical evidence which she felt 

showed that she was entitled to continued compensation after August 31, 2015. Given that the 

Board has found that OWCP properly relied on the opinion of Dr. Gordon in terminating her wageloss compensation and medical benefits effective August 31, 2015, the burden shifts to her to 

establish that she is entitled to such compensation after that date. The Board has reviewed the 

additional evidence submitted by appellant and finds that it is of insufficient probative value to 

establish that she had residuals or disability causally related to her accepted October 1, 2014 

employment injury on or after August 31, 2015.

Appellant submitted a March 21, 2016 report from Dr. Salvagno, who diagnosed bilateral 

hip contusions and cervical, lumbar, and right shoulder sprains due to the October 1, 2014 injury. 

Dr. Salvagno referenced Dr. Gordon’s comments regarding the February 23, 2015 FCE and noted 

that the inconsistencies observed during the FCE were limited to her hand grip/pinch testing and 

did not concern the regions affected by her employment injury, i.e., her neck, right shoulder, right 

hip, and low back. He indicated that appellant had appeared to demonstrate reasonable effort

during the FCE and he recommended various work restrictions. Dr. Salvagno produced a similar 

report on February 2, 2018 in which he again noted that she demonstrated reasonable effort during 

the February 23, 2015 FCE. He found that appellant had demonstrated consistent and persistent 

symptoms/impairment since her employment injury on October 1, 2014 and opined that, therefore, 

she continued to suffer from cervical sprain, lumbar sprain, left shoulder sprain, and bilateral hip 

contusions as documented in the March 21, 2016 physical examination.27

The Board notes that Dr. Salvagno’s March 21, 2016 and February 2, 2018 reports do not 

contain sufficient medical rationale to establish that appellant had continuing residuals or disability 

causally related to her accepted October 1, 2014 employment injury on or after August 31, 2015. 

Dr. Salvagno placed great emphasis on his belief that she demonstrated reasonable effort during 

the February 23, 2015 FCE. However, this discussion does not obviate the need for a detailed 

explanation of how appellant could have continued to have residuals of the October 1, 2014 softtissue injury on or after August 31, 2015 or related disability. In essence, Dr. Salvagno only 

provided a conclusory opinion in which he opined that she continued to have such employmentrelated residuals/disability. He failed to explain how this opinion was supported by objective 

 

26 Id.

27 Dr. Salvagno acknowledged that he had not examined appellant since March 21, 2016.
10

findings of record.28 The Board has held that a medical report is of limited probative value on the 

issue of causal relationship if it contains a conclusion regarding causal relationship which is 

unsupported by medical rationale.29 

In a November 11, 2016 report, Dr. Macht found that appellant still had residuals of her 

October 1, 2014 injury, noting that the current diagnoses of sprains of her neck, shoulders, back, 

and hips were causally related to the October 1, 2014 accident. He indicated that she had been 

totally disabled from her regular work since October 1, 2014. The Board notes that Dr. Macht’s 

report is of limited probative value because it contains a mere conclusory opinion without explaining 

how and why the October 1, 2014 soft-tissue injury caused residuals or disability on or after 

August 31, 2015. Such an opinion is insufficient to meet appellant’s burden of proof.30 Moreover,

Dr. Macht opined that appellant had employment-related residuals of conditions which have not 

been accepted as causally related to the October 1, 2014 injury, including left shoulder and left hip 

sprains. He maintained that her preexisting degenerative conditions played no role in her current 

symptoms, but he did not provide any reasoning for this opinion.

31

In a March 10, 2017 report, Dr. Jett indicated that, after her October 1, 2014 injury, 

appellant continued to have “chronic pain in her cervicalgia [sic], groin, clavicle, throat, shoulder, 

back, and lumbar spine.” She noted that appellant’s “traumatic fall has aggravated, exacerbated, 

or accelerated [appellant’s] medical condition premorbid.” The Board finds that Dr. Jett’s report 

is of limited probative value because she did not provide medical rationale in support of her opinion 

that an accepted condition related to the October 1, 2014 employment injury caused residuals or 

disability on or after August 31, 2015.32 In addition, Dr. Jett suggested that appellant had 

employment-related residuals of conditions which have not been accepted as causally related to the 

October 1, 2014 injury, including throat and groin conditions.33

 

28 In addition, Dr. Salvagno asserted that appellant had employment-related residuals in the form of a left shoulder 

sprain, but no such condition has been accepted in connection with the October 1, 2014 injury.

29 C.M., Docket No. 14-0088 (issued April 18, 2014). Dr. Salvagno also indicated in his February 2, 2018 report that

Dr. Tham had found that appellant had fibromyalgia as a consequence of the October 1, 2014 injury. However,

Dr. Tham did not provide a clear opinion that appellant’s fibromyalgia was related to her October 1, 2014 employment 

injury and OWCP has not accepted fibromyalgia as an employment-related condition. The record also contains a 

January 13, 2016 report from Dr. Fougy who diagnosed appellant with depression and anxiety reactive to her 

October 1, 2014 fall. However, these conditions also have not been accepted as related to the October 1, 2014 injury 

and the record does not contain a rationalized medical opinion establishing such causal relationship.

30 See id.; see also J.D., Docket No. 14-2061 (issued February 27, 2015).

31 Dr. Macht also found that appellant had permanent impairment of her neck, right shoulder, back, and right hip 

region due to the October 1, 2014 accident, but this opinion is of limited probative value because he provided no 

supporting rationale. See D.R., Docket No. 16-0528 (issued August 24, 2016).

32 See supra note 24.

33 In another March 10, 2017 report, Dr. Jett diagnosed chronic pain syndrome, dysphagia, acute stress reaction, 

and “other injury of muscle, fascia, and tendon of other parts of biceps, left arm, sequela.” However, she did not 

provide an opinion regarding the cause of these conditions.
11

On appeal counsel argues the above-described reports of attending physicians establish that 

appellant had continuing residuals and disability causally related to her accepted employment 

injury on and after August 31, 2015. However, as explained above, the Board finds that those 

reports are of limited probative value regarding this matter.

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(a) and 20 C.F.R. 

§§ 10.605 through 10.607.

CONCLUSION

The Board finds that OWCP has met its burden of proof to terminate appellant’s wage-loss 

compensation and medical benefits effective August 31, 2015 as she no longer had residuals or 

disability causally related to her accepted October 1, 2014 employment injury. The Board further 

finds that she has not met her burden of proof to establish continuing employment-related residuals 

or disability on or after August 31, 2015.

ORDER

IT IS HEREBY ORDERED THAT the May 3, 2018 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: August 8, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board