United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

L.M., Appellant

and

U.S. POSTAL SERVICE, PROCESSING &

DISTRIBUTION CENTER, Honolulu, HI, 

Employer

__________________________________________

)

)

)

)

)

)

)

)

)

Docket No. 20-1240

Issued: January 28, 2022

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 3, 2020 appellant, through counsel, filed a timely appeal from a May 4, 2020 merit 

decision of the Office of Workers’ Compensation Programs (OWCP). 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

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

5 U.S.C. § 8101 et seq.

3 The Board notes that, following the May 4, 2020 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

ISSUES

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

wage-loss compensation and medical benefits, effective October 29, 2019; and (2) whether 

appellant has met his burden of proof to establish continuing employment-related disability or 

residuals on or after October 29, 2019 due to his accepted employment injury.

FACTUAL HISTORY

This case has previously been before the Board on a different issue.

4

 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 August 14, 2012 appellant, then a 58-year-old group leader custodian, filed a traumatic 

injury claim (Form CA-1) alleging that on August 13, 2012 he injured his left arm when 

holding/pushing a battery to prevent it from falling while in the performance of duty. OWCP 

accepted the claim for left elbow and forearm sprain, left radial collateral ligament and sprain of 

shoulder, left rotator cuff, superior labrum anterior and posterior (SLAP) lesion of the left shoulder 

and left shoulder biceps tendinitis. It paid appellant wage-loss compensation on the supplemental 

rolls, commencing January 11, 2013 and on the periodic rolls commencing March 6, 2016.

On March 14, 2019 OWCP referred appellant to Dr. WeiChin Chen, a Board-certified 

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

appellant continued to have residuals and/or disability causally related to appellant’s accepted 

August 13, 2012 employment injury.

In a May 16, 2019 report, Dr. Chen indicated that he had reviewed a statement of accepted 

facts and appellant’s medical records, including diagnostic studies. He reported physical 

examination findings and assessed left upper extremity ulnar nerve lesion consistent with clinical 

signs of cubital tunnel syndrome, nonindustrial related. Dr. Chen opined that the accepted left 

elbow sprain, which included radial collateral ligament, had resolved as there was no objective 

evidence that it was still active or causing symptoms. He indicated that the left elbow had stable 

examination with varus and valgus stress at 0 to 30 degrees with no pain with extensor indicis 

proprius testing or resisted wrist extension. There were also no residuals of a radial collateral 

ligament sprain causing instability. Regarding the left shoulder strain, Dr. Chen noted that on 

May 13, 2015 appellant underwent a surgical procedure by Dr. Gary Okamura, a Board-certified 

orthopedic surgeon, who found anterior capsular tearing that was subsequently debridged. 

Appellant’s July 9, 2015 repeat magnetic resonance imaging (MRI) scan did not show any 

persistent sprain of the anterior capsule. Thus, Dr. Chen opined that this and the fact that there 

was no anterior instability of the left shoulder on clinical examination indicated that the condition 

had resolved. Regarding appellant’s left shoulder rotator cuff tear and biceps tendinitis, he found 

that appellant had undergone an open biceps tenodesis by Dr. Okamura on May 13, 2015, which 

addressed and resolved both the superior labral tear and the long head of biceps tendinitis. 

Dr. Chen noted thatDr. Okamura indicated in his May 13, 2015 report that the anteriorrotator cuff 

had some undersurface tear of rotator cuff tendon, but overall it looked normal. He reported that 

a July 9, 2016 repeat MRI scan did not find any rotator cuff tears, only tendinosis, for which no 

treatment was recommended. Thus, Dr. Chen found that the rotator cuff torn tendon was 

4 Docket No. 19-1197 (issued January 8, 2020).
3

debridged and had resolved with findings of degenerative changes that were not employment 

related. 

Dr. Chen also noted that a September 29, 2015 report from Dr. Richard Kimura, a Boardcertified orthopedic surgeon and OWCP second opinion physician, indicated findings of partial 

tear of common flexor tendon, tendinopathy of extensor tendon of the left elbow. He indicated, 

however, that during his examination of the left elbow, appellant’s complaints were along the 

cubital tunnel region and not the lateral epicondylar region, which was consistent with resolution 

of that complaint. In addition, Dr. Chen indicated that appellant did not have any pain with resisted 

distal interphalangeal predominant (DIP) or wrist extension on the left wrist to indicate active 

lateral epicondylitis. He further opined, based on a review of the medical records and appellant’s 

examination, that appellant’s accepted left shoulder and left elbow conditions had resolved and 

appellant was able to return to full duty as a Group Leader Custodian without restrictions. 

An August 5, 2019 x-ray of appellant’s left shoulder revealed mild glenohumeral joint 

osteoarthritis. 

On August 20, 2019 OWCPissued a notice advisingappellant that it proposed to terminate 

his wage-loss compensation and medical benefits because he ceased to have residuals/disability 

causally related to his accepted August 13, 2012 employment injury. It advised appellant that the 

proposed action was based on the opinion of Dr. Chen and afforded appellant’s 30 days to submit 

additional evidence or argument challenging the proposed action.

OWCP received a duplicate copy of the August 5, 2019 left shoulder x-ray and several 

progress reports from Dr. Okamura, dated October 5, 2018 and May 20, and August 5, 2019, 

which noted, in addition to appellant’s left shoulder complaints, that appellant had undergone right 

shoulder arthroscopy, SLAP repair and capsulorrhaphy repair on February 8, 2018.5

In an October 5, 2018 report, Dr. Okamura reported slightly positive impingement signs 

and Hawkins and Neer’s tests for both shoulders. Left shoulder assessments were other specific 

postprocedural states and other shoulder lesions. 

In his May 20, 2019 report, Dr. Okamura noted that appellant reported that his left shoulder 

bothered him more than the right shoulder and that he was in physical therapy for both shoulders. 

With regard to the left shoulder, he assessed pain in the left shoulder and postprocedural state. 

Dr. Okamura recommended that physical therapy be continued and requested an x-ray of the left 

shoulder. Appellant underwent a left shoulder x-ray on August 5, 2019. 

In an August 5, 2019 report, Dr. Okamura indicated that left shoulder x-ray revealed 

arthritis. He provided an assessment of left shoulder pain and left elbow pain and recommended 

injections due to appellant’s persistent symptoms of pain in both shoulders and left elbow. 

Dr. Okamura opined that appellant could not work at medium level, but probably could work more 

of a sedentary or desk work level. 

In a September 23, 2019 report, Dr. Okamura reported that appellant was seen for left 

shoulder pain and numbness status post left shoulder surgery of May 13, 2015. Examination 

findings revealed pain with impingement signs, positive Hawkins and Neer’s tests, and pain in the 

5 The record reflects appellant was seen for right shoulder symptoms in 2017 and 2019. 
4

supraspinatus tendon. Dr. Okamura provided an assessment of left shoulder pain, other specified 

postprocedural states, superior glenoid labrum lesion of left shoulder, and strain of muscle, fascia 

and tendon of long head of left arm biceps. He disagreed that appellant could work full duty 

without restrictions as appellant’s job required a lot of overhead work and appellant had stiffness 

in overhead position and pain reproduced with his shoulder. Dr. Okamura requested that appellant 

undergo a functional capacity evaluation.

On September 23, 2019 OWCP requested that Dr. Chen review Dr. Okamura’s reports and 

provide a supplemental report clarifying whether the accepted left shoulder SLAP tear and 

tendinitis were resolved and whether any further medical treatment is required. 

In a September 27, 2019 supplemental report, Dr. Chen noted that the August 5, 2019 left 

shoulder x-ray revealed mild glenohumeral joint osteoarthritis. He indicated that osteoarthritis 

was a degenerative process not part of the accepted condition. Dr. Chen further noted that 

appellant has mild-to-moderate acromioclavicular (AC) joint arthropathy, which was arthritis of 

the AC joint and not industrial related. He opined that, although appellant’s accepted conditions 

had resolved, appellant’s subjective pain may be medical sequela of his surgical management, but 

did not require further medical curative treatment. Dr. Chen reiterated his opinion that appellant’s 

accepted conditions had resolved based on the May 13, 2015 surgical procedure.

By decision dated October 29, 2019, OWCP terminated appellant’s wage-loss 

compensation and medical benefits, effective that date. It found that the weight of the medical 

evidence was represented by Dr. Chen’s reports.

On November 5, 2019 appellant, through counsel, requested a telephonic hearing before a 

representative of OWCP’s Branch of Hearings and Review. A hearing was held on 

February 20, 2020. 

In a February 27, 2020 report, Dr. Okamura noted evidence of ACjoint arthritis and rotator 

cuff tendinitis. He recommended further x-rays and an MRI scan. 

OWCP subsequently received additional evidence. In a February 12, 2020 letter, Dr. Wray 

Tsuzai, a Board-certified internist, indicated that he was appellant’s treating physician for the 

bilateral shoulder conditions. He opined that appellant reached maximum medical improvement 

(MMI) and that appellant’s current physical abilities prevented him from ever returning to work. 

In a February 3, 2020 report, Dr. Tsuzai indicated that appellant had reached MMI on 

October 11, 2019.

By decision dated May 4, 2020, OWCP’s hearing representative affirmed the October 29, 

2019 decision.

LEGAL PRECEDENT -- ISSUE 1

Once OWCP accepts a claim and pays compensation, it has the burden of proof to justify 

modification or termination of an employee’s benefits.6 It may not terminate compensation 

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

6

S.P., Docket No. 19-0196 (issued June 24, 2020); D.G., Docket No. 19-1259 (issued January 29, 2020); S.F., 59 

ECAB 642 (2008); Kelly Y. Simpson, 57 ECAB 197 (2005); PaulL. Stewart, 54 ECAB 824 (2003).
5

injury.7 OWCP’s burden of proof in terminating compensation includes the necessity of furnishing 

rationalized medical opinion evidence based on a proper factual and medical background. 8

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

entitlement to compensation for disability.9 To terminate authorization for medical treatment, 

OWCP must establish that the employee no longer has residuals of an employment-related 

condition that require further medical treatment.10

ANALYSIS -- ISSUE 1

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

compensation and medical benefits, effective October 29, 2019.

In a May 16, 2019 report, Dr. Chen, an OWCP second opinion physician, opined that 

appellant’s accepted left elbow and left shoulder strains had resolved. He found no evidence of a 

rotator cuff tendon tear, noting that the July 9, 2016 repeat MRI scan did not show any persistent 

sprain of the anterior capsule and did not show any rotator cuff tears, only tendinosis. Dr. Chen 

indicated that his physical evaluation revealed no anterior instability, which confirmed that the 

condition was resolved. He also noted that appellant’s open biceps tendinosis surgery on May 13, 

2015 had resolved the SLAP tear and biceps tendinitis. Dr. Chen further noted that Dr. Okamura 

had indicated, in his May 13, 2015 report, that the anterior rotator cuff had some undersurface tear 

of rotator cuff tendon, but overall it looked normal. Based on these findings, Dr. Chen, thus,

opined that the rotator cuff torn tendon was debridged and had resolved with findings of 

degenerative changes that were not employment related. He also indicated that, during his 

examination of the left elbow, there were no findings to indicate any active lateral epicondylitis 

and appellant’s complaints were along the cubital tunnel region and not the lateral epicondylar 

region, which was consistent with resolution of that complaint. Dr. Chen further opined, based on 

a review of the medical records and appellant’s examination, that appellant was able to perform 

the regular duties of a Group Leader Custodian without restrictions. 

In a supplemental report dated September 27, 2019, Dr. Chen reviewed Dr. Okamura’s 

reports and reiterated his opinion that appellant’s accepted conditions had resolved based on the 

May 13, 2015 surgical procedure. He opined that appellant’s mild glenohumeral joint 

osteoarthritis was a degenerative process not part of the accepted condition and the mild-tomoderate AC joint arthropathy, which was arthritis of the AC joint, was not industrial related. 

The Board finds that Dr. Chen’s reports, when read together, represent the weight of the 

medical evidence at the time OWCP terminated appellant’s wage-loss and medical benefits,

effective October 29, 2019, and that OWCP properly relied on his reports in carrying out its 

7

See S.P., id.; R.P., Docket No. 17-1133 (issued January 18, 2018); Jason C. Armstrong, 40 ECAB 907 (1989); 

Charles E. Minnis, 40 ECAB 708 (1989); Vivien L. Minor, 37 ECAB 541 (1986).

8 D.G., supra note 6; M.C., Docket No. 18-1374 (issued April 23, 2019); Del K. Rykert, 40 ECAB 284, 

29596(1988).

9

S.P., supra note 6; J.W., Docket No. 19-1014 (issued October 24, 2019); L.W., Docket No. 18-1372 (issued 

February27, 2019).

10 D.G., supra note 6; L.S., Docket No. 19-0959 (issued September 24, 2019); R.P., Docket No. 18-0900 (issued 

February5, 2019).
6

termination action. The Board finds that he had full knowledge of the relevant facts and evaluated 

the course of appellant’s accepted work-related left shoulder conditions. Dr. Chen’s opinion is 

based on proper factual and medical history and his report contained a detailed summary of this 

history. He addressed the medical records to make his own examination findings to reach a 

reasoned conclusion regarding appellant’s conditions.11 Dr. Chen found no basis on which to 

attribute any residuals or continued disability to appellant’s accepted conditions. His opinion is 

found to be probative evidence and reliable. The Board finds that Dr. Chen’s opinion constitutes 

the weight of the medical evidence and is sufficient to justify OWCP’s termination of benefits for 

the accepted conditions of left elbow and forearm sprain, left radial collateral ligament and sprain 

of shoulder, left rotator cuff, slap lesion of the left shoulder, and left shoulder biceps tendinitis.12

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

compensation and medical benefits is insufficient to overcome the weight afforded to Dr. Chen as 

the second opinion physician. Appellant submitted reports from Dr. Okamura dated October 5, 

2018 through September 23, 2019. Dr. Okamura indicated that appellant still had left shoulder 

pain. In his August 5, 2019 report, he reported that left shoulder x-ray revealed arthritis. 

Dr. Okamura provided an assessment of left shoulder pain and left elbow pain and indicated that 

appellant was a candidate for injections due to his persistent symptoms of pain in both shoulders 

and left elbow. He also opined that appellant could not work at medium level, but probably could 

work more of a sedentary or desk work level. Dr. Okamura, however, did not explain with 

rationale how/why appellant continued to have residuals/disability causally related to the accepted 

August 13, 2012 employment injury. In his other reports, Dr. Okamura assessed left shoulder pain, 

other specified post procedural states, superior glenoid labrum lesion of left shoulder, and strain 

of muscle, fascia and tendon of long head of left arm biceps and noted positive impingement signs 

and positive Hawkins and Neer’s tests. However, Dr. Okamura did not offer a rationalized opinion

as to whether appellant’s conditions were causally related to the accepted employment injury. The 

Board has held that a medical report is of limited probative value on a given medical issue if it 

contains a medical opinion which is unsupported by medical rationale.13 As noted, Dr. Chen 

reviewed Dr. Okamura’s reports and provided a well-rationalized opinion in his September 27, 

2019 supplemental report as to why appellant no longer had residuals or disability causally related 

to the accepted conditions. 

As Dr. Chen’s opinion constitutes the weight of the medical evidence, the Board finds that 

OWCP met its burden of proof.

LEGAL PRECEDENT -- ISSUE 2

Once OWCP properly terminated compensation benefits, the burden shifts to appellant to 

establish continuing disability after that date causally related to the accepted injury.14 To establish 

causal relationship between the accepted conditions as well as any attendant disability claimed and 

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

12 See B.B., Docket No. 18-0732 (issued March 11, 2020). 

13 See L.S., Docket No. 19-0959 (issued September 24, 2019); M.H., Docket No. 17-0210 (issued June 3, 2018).

14 See J.N., Docket No. 20-1030 (issued November 20, 2020); L.C., Docket No. 18-1759 (issued June 26, 2019);

S.M., Docket No. 18-0673 (issued January 25, 2019).
7

the employment injury, an employee must submit rationalized medical evidence based on a 

complete medical and factual background supporting such causal relationship.15

ANALYSIS -- ISSUE 2

The Board finds that appellant has not met his burden of proof to establish continuing 

employment-related disability or residuals on or after October 29, 2019 due to his accepted 

employment injury. 

In his February 27, 2020 report, Dr. Okamura found evidence of AC joint arthritis and 

rotator cuff tendinitis. However, he did not offer a rationalized opinion as to whether appellant’s

conditions were causally related to the accepted employment injury. The Board has held that a 

medical report is of limited probative value on a given medical issue if it contains a medical 

opinion, which is unsupported by medical rationale.16 Thus, this report is insufficient to cause 

conflict with Dr. Chen’s well-rationalized opinion as to why appellant’s AC joint arthritis was a 

degenerative conditions and not industrial related.

Dr. Tsuzai submitted reports dated February 3 and 12, 2020, which noted that appellant 

reached maximum medical improvement for appellant’s “shoulder” and that his current physical 

abilities prevent him from returning to work. He, however, does not specify which shoulder 

reached maximum medical improvement. Additionally, Dr. Tsuzai fails to offer a rationalized 

opinion as to whether appellant’s inability to work is causally related to the accepted employment 

injury or conditions.17 Thus, his reports are of limited probative value and are of insufficient to 

cause conflict with Dr. Chen’s well-rationalized opinion that the accepted conditions had resolved 

with no residuals or disability.

CONCLUSION

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

compensation and medical benefits, effective October 29, 2019. The Board further finds that he 

15 Id.

16 See L.S., Docket No. 19-0959 (issued September 24, 2019); M.H., Docket No. 17-0210 (issued June 3, 2018).

17 See A.T., Docket No. 20-0334(issued October 8, 2020). 
8

has not met his burden of proof to establish continuing employment-related disability or residuals 

on or after October 29, 2019 due to his accepted employment injury.

ORDER

IT IS HEREBY ORDERED THAT the May 4, 2020 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: January 28, 2022

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board