United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

P.J., Appellant

and

DEPARTMENT OF COMMERCE, U.S. 

PATENT & TRADEMARK OFFICE, PATENT 

PUBLICATIONS OFFICE, Arlington, VA, 

Employer

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Docket No. 20-0549

Issued: December 18, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Deputy Chief Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On January 13, 2020 appellant filed a timely appeal from a December 10, 2019 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 appellant has met her burden of proof to establish greater than 35 

percent permanent impairment of her right upper extremity and 37 percent permanent impairment 

of her left upper extremity, for which she previously received schedule award compensation.

 

1 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On March 1, 2001 OWCP accepted under OWCP File No. xxxxxx548 that appellant, then 

a 39-year-old legal instrument examiner, sustained an occupational disease in the form of bilateral 

carpal tunnel syndrome due to performing the repetitious duties of her job.2 Appellant stopped 

work on March 12, 2001 and OWCP paid her disability compensation beginning that day based 

on a pay rate of $691.52 per week. She returned to part-time work (four hours per day) on 

September 4, 2007 and stopped work on September 20, 2007.3

On July 7, 2015 appellant underwent OWCP-authorized cervical surgery, including 

anterior cervical fusion and arthrodesis at C5-6, and partial cervical corpectomy with spinal cord 

and foraminal decompression at C5-6. 

On March 4, 2016 appellant filed a claim for a schedule award (Form CA-7) due to her 

accepted employment injuries. By decision dated December 5, 2016, OWCP granted her a 

schedule award for nine percent permanent impairment of her left upper extremity due to 

impairment stemming from her cervical spine. The award ran for 28.08 weeks from August 16, 

2016 to February 28, 2017. OWCP indicated that appellant had a weekly pay rate of $691.52, 

effective March 12, 2001. The award was based on a September 15, 2016 report of Dr. Michael M. 

Katz, a Board-certified orthopedic surgeon, who served as an OWCP district medical adviser 

(DMA). The DMA had evaluated August 16, 2016 findings of Dr. Burke Haskins, a Boardcertified orthopedic surgeon, who served as an OWCP referral physician. In reaching his 

permanent impairment rating of nine percent of the left upper extremity, he applied The Guides 

Newsletter, Rating Spinal Nerve Extremity Impairment Using the Sixth Edition (July/August 2009) 

(The Guides Newsletter), which is a supplemental publication of the sixth edition of the American 

Medical Association, Guides to the Evaluation of Permanent Impairment (A.M.A., Guides),4and 

found sensory and motor deficits associated with the left C6 nerve distribution. 

In a June 6, 2018 report, Dr. David Dorin, an attending Board-certified orthopedic surgeon, 

noted that appellant presented complaining of numbness, tingling, and pain in both her hands. He 

detailed physical examination findings, noting a mildly positive Tinel’s sign in the right hand. 

Dr. Dorin diagnosed neuralgia of the right upper extremity and right carpal tunnel syndrome. 

On August 5, 2019 appellant filed a claim for an increased schedule award. 

 

2 Appellant underwent several OWCP-authorized upper extremity and cervical surgeries. OWCP previously 

accepted under OWCP File No. xxxxxx385 that, due to an April 19, 1999 reaching incident, she sustained 

intervertebral cervical disc disorder with myelopathy, cervical disc herniation at C6-7, cervical sprain, 

myalgia/myositis, fibromyalgia, brachial neuritis/radiculitis, and right shoulder/arm sprain. It administratively 

combined OWCP File Nos. xxxxxx385 and xxxxxx548, designating the latter file to serve as the master file. 

3 Beginning June 8, 2008, OWCP paid appellant disability compensation based on a weekly pay rate of $868.63. 

However, it later determined in an August 3, 2017 decision that this pay rate was improper because, when she

sustained a recurrence of disability on September 20, 2007, her weekly pay was $434.32 due to the part-time nature 

of her work. Because appellant’s date-of-injury weekly pay rate of $691.52 was higher than the $434.32 figure, she 

effectively had a weekly pay rate of $691.52. 

4 A.M.A., Guides (6th ed. 2009).
3

In an August 22, 2019 report, Dr. Daniel R. Ignacio, Board-certified in physical medicine 

and rehabilitation, discussed appellant’s factual and medical history and reported findings upon 

physical examination. He noted that her physical examination documented decreased sensation in 

the bilateral C5 and C6 nerve distributions, as well as in the right C4 nerve distribution. 

Dr. Ignacio found that the examination also showed weakness in the bilateral C5 and C6 nerve 

distributions, as well as the in the right C4 nerve distribution. He also advised that appellant had 

decreased sensation and weakness in the bilateral median nerve distributions, and limited bilateral 

shoulder motion. Dr. Ignacio provided range of motion (ROM) findings for her shoulders. He

evaluated the permanent impairment of appellant’s right upper extremity noting that, applying The 

Guides Newsletter, the right C4 cervical radiculopathy warranted four percent impairment due to 

sensory defect and six percent impairment due to motor defect. With regard to the right C5 cervical 

radiculopathy, appellant had four percent impairment due to sensory defect and six percent 

impairment due to motor defect. Dr. Ignacio indicated that, with regard to the right C6 cervical 

radiculopathy, she had six percent impairment due to sensory defect and eight percent impairment 

due to motor defect. He advised that these impairment values totaled to 34 percent impairment of

the right upper extremity. Dr. Ignacio noted that appellant had chronic right median neuritis and 

noted “I will give [appellant] a permanent impairment due to the sensory defect, 6 [percent] to 

motor defect, that is 10 [percent] impairment related to the right median neuritis.” He noted that, 

with regard to the limited motion along the right shoulder, he assigned 15 percent impairment. 

Dr. Ignacio opined that appellant had a combined 59 percent permanent impairment of the right 

upper extremity.

With regard to the left upper extremity, Dr. Ignacio indicated that appellant’s left C5 

cervical radiculopathy warranted four percent impairment due to sensory defect and six percent 

impairment due to motor defect. He indicated that, with regard to the left C6 cervical 

radiculopathy, she had six percent impairment due to sensory defect and eight percent impairment 

due to motor defect. Dr. Ignacio advised that these impairment values totaled to 24 percent 

permanent impairment of the left upper extremity. He noted that appellant had chronic left median 

neuritis and noted that she had “[four percent] impairment due to sensory defect, [six percent]

impairment due to motor defect.” Dr. Ignacio noted that, with regard to the limited motion along 

the left shoulder, he assigned a rating of 10 percent permanent impairment. He concluded that

appellant had a combined 44 percent permanent impairment of the left upper extremity. 

OWCP referred appellant’s case to Dr. Arthur S. Harris, a Board-certified orthopedic 

surgeon serving as a DMA. It requested that the DMA review Dr. Ignacio’s August 22, 2019 

report and provide an opinion regarding the nature and extent of permanent impairment of her

upper extremities under the standards in the sixth edition of the A.M.A., Guides.

5

In an October 15, 2019 report, the DMA noted that he had reviewed Dr. Ignacio’s 

August 22, 2019 report and indicated that, utilizing The Guides Newsletter, appellant had four

percent right upper extremity impairment for residual problems with pain/impaired sensation from 

her right C5 cervical radiculopathy, six percent for residual problems with motor weakness from 

her right C5 cervical radiculopathy, six percent for residual problems with pain/impaired sensation 

from her right C6 cervical radiculopathy, and seven percent for residual problems with motor 

weakness from her right C6 cervical radiculopathy. He found that this resulted in a combined 22

 

5

Id.
4

percent permanent impairment of the right upper extremity. The DMA advised that, utilizing 

Table 15-23 on page 449 of the sixth edition of the A.M.A., Guides, appellant also had nine percent

permanent impairment of the right upper extremity for residual problems with right carpal tunnel 

syndrome status post carpal tunnel release. He noted that her condition fell under grade modifier 

3 on Table 15-23. The DMA also indicated that, utilizing the diagnosis-based impairment (DBI) 

rating method under Table 15-5 beginning on page 401, appellant had five percent permanent 

impairment of her right upper extremity impairment for her right partial rotator cuff tear. With 

regard to the ROM impairment rating method for the right shoulder, appellant had, utilizing Table 

15-34 on page 475, three percent right upper extremity impairment for loss of flexion, one percent

for loss of extension, three percent for loss of abduction, and two percent for loss of internal 

rotation. The DMA indicated that this resulted in nine percent impairment based on the ROM 

impairment rating method and resulted in greater impairment than the DBI rating method. He 

advised that, per Table 2-1 on page 20, the A.M.A., Guides noted that “if the [A.M.A., Guides]

provides more than one method to rate a particular impairment condition, the method producing 

the higher rating must be used.” The DMA advised that he utilized the Combined Values Chart 

on page 604 to add the various impairment values for the right upper extremity and concluded that 

appellant had 35 percent permanent impairment of the right upper extremity. 

For the left upper extremity, the DMA again utilized The Guides Newsletter and noted that 

appellant had four percent left upper extremity impairment for residual problems with 

pain/impaired sensation from her left C5 cervical radiculopathy, six percent for residual problems 

with motor weakness from her left C5 cervical radiculopathy, six percent for residual problems 

with pain/impaired sensation from her left C6 cervical radiculopathy, and seven percent for 

residual problems with motor weakness from her left C6 cervical radiculopathy. He found that 

this resulted in 22 percent permanent impairment of the left upper extremity impairment. The 

DMA advised that, utilizing Table 15-23 on page 449 of the sixth edition of the A.M.A., Guides, 

appellant also had nine percent permanent impairment of the left upper extremity for residual 

problems with left carpal tunnel syndrome status post carpal tunnel release. He noted that her

condition fell under grade modifier 3 on Table 15-23. The DMA also indicated that, utilizing the 

DBI rating method under Table 15-5 beginning on page 401, appellant had five percent permanent 

impairment of her left upper extremity impairment for her partial rotator cuff tear. With regard to 

the ROM impairment rating method for the left shoulder, appellant had, utilizing Table 15-34 on 

page 475, three percent right upper extremity impairment for loss of flexion, one percent for loss 

of extension, three percent for loss of abduction, and four percent for loss of internal rotation. The 

DMA indicated that this resulted in 11 percent impairment based on the ROM impairment rating 

method and resulted in greater impairment than the DBI rating method. He advised that he utilized 

the Combined Values Chart on page 604 to add the various impairment values for the left upper 

extremity and concluded that appellant had a combined 37 percent permanent impairment of the 

left upper extremity.

OWCP requested that the DMA provide clarification of the methodology applied in his 

October 15, 2019 report and, in a supplemental November 19, 2019 report, he noted that on 

October 15, 2019 he found that appellant had 22 percent permanent impairment of the right upper 

extremity due to motor and sensory deficits evaluated under The Guides Newsletter. The DMA

clarified that such impairments for nerve radiculopathy are to be combined utilizing the Combined 

Values Chart on page 604 of the sixth edition of the A.M.A., Guides and were not to be 

mathematically added together. He noted that appellant was found to have nine percent upper 

extremity impairment for right carpal tunnel syndrome and nine percent upper extremity 
5

impairment for the right shoulder. The DMA advised that utilizing the Combined Values Chart to 

combine the impairment values due to cervical radiculopathy, carpal tunnel syndrome, and right 

shoulder deficits resulted in 35 percent permanent impairment of the right upper extremity. He

noted that, when patients have multiple impairments in the same extremity, the A.M.A., Guides

directs evaluators to use the Combined Values Chart. The DMA noted that multiple impairments 

in the same extremity were not to be mathematically added together in order to determine the total 

impairment in a given extremity. He provided a similar description of his assessment of the 

permanent impairment of appellant’s left upper extremity. The DMA noted that he used the 

Combined Values Chart to combine the 22 percent permanent impairment of appellant’s left upper 

extremity due to motor and sensory deficits evaluated under The Guides Newsletter, the 9 percent 

permanent impairment due to left carpal tunnel syndrome, and the 11 percent permanent 

impairment due to left shoulder deficits. He concluded that she had a combined 37 permanent 

impairment of her left upper extremity. 

By decision dated December 10, 2019, OWCP granted appellant a schedule award for 35 

percent permanent impairment of her right upper extremity and an additional 28 percent permanent 

impairment of her left upper extremity.6 The award ran for 196.56 weeks from August 22, 2019 

to May 28, 2023 and the amount paid was based on a weekly compensation rate of $691.52. 

LEGAL PRECEDENT

The schedule award provisions of FECA7and its implementing regulations

8

set forth the 

number of weeks of compensation payable to employees sustaining permanent impairment from 

loss, or loss of use, of scheduled members or functions of the body. However, FECA does not 

specify the manner in which the percentage of loss shall be determined. For consistent results and 

to ensure equal justice under the law to all claimants, OWCP has adopted the A.M.A., Guides as 

the uniform standard applicable to all claimants.9 As of May 1, 2009, the sixth edition of the 

A.M.A., Guides is used to calculate schedule awards.10

Neither FECA nor its implementing regulations provide for the payment of a schedule 

award for the permanent loss of use of the back/spine or the body as a whole.11 However, a 

schedule award is permissible where the employment-related spinal condition affects the upper 

and/or lower extremities.12 The sixth edition of the A.M.A., Guides (2009) provides a specific 

 

6 Appellant previously received a schedule award on September 29, 2016 for nine percent permanent impairment 

of her left upper extremity due to impairment stemming from her cervical spine. 

7 5 U.S.C. § 8107.

8 20 C.F.R. § 10.404.

9

Id. See also T.T., Docket No. 18-1622 (issued May 14, 2019).

10 Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, Chapter 

2.808.5(a) (March 2017); id. at Chapter 3.700.2 and Exhibit 1 (January 2010). 

11 5 U.S.C. § 8107(c); 20 C.F.R. § 10.404(a) and (b); see A.G., Docket No. 18-0815 (issued January 24, 2019); 

Jay K. Tomokiyo, 51 ECAB 361, 367 (2000).

12 Supra note 10 at Chapter 2.808.5c(3) (March 2017).
6

methodology for rating spinal nerve extremity impairment in The Guides Newsletter. It was 

designed for situations where a particular jurisdiction, such as FECA, mandated ratings for 

extremities and precluded ratings for the spine. FECA-approved methodology is premised on 

evidence of radiculopathy affecting the upper and/or lower extremities. The appropriate tables for

rating spinal nerve extremity impairment are incorporated in the Federal (FECA) Procedure 

Manual.13

Impairment due to carpal tunnel syndrome is evaluated under the scheme found in Table 

15-23 (Entrapment/Compression Neuropathy Impairment) and accompanying relevant text.14 In 

Table 15-23, grade modifier levels (ranging from 0 to 4) are described for the categories test 

findings, history, and physical findings. The grade modifier levels are averaged to arrive at the 

appropriate overall grade modifier level and to identify a default rating value. The default rating 

value may be modified up or down by one percent based on functional scale, an assessment of 

impact on daily living activities.15

In determining impairment for the upper extremities under the sixth edition of the A.M.A., 

Guides, an evaluator must establish the appropriate diagnosis for each part of the upper extremity 

to be rated. With regard to the shoulder, the relevant portion of the arm for the present case, 

reference is made to Table 15-5 (Shoulder Regional Grid) beginning on page 401. After the class 

of diagnosis (CDX) is determined from the Shoulder Regional Grid (including identification of a 

default grade value), the net adjustment formula is applied using the grade modifier for functional 

history (GMFH), grade modifier for physical examination (GMPE), and grade modifier for clinical 

studies (GMCS). The net adjustment formula is (GMFH - CDX) + (GMPE - CDX) + (GMCS -

CDX).16 

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish greater than 35 

percent permanent impairment of her right upper extremity and 37 percent permanent impairment 

of her left upper extremity, for which she previously received schedule award compensation.

The Board has carefully reviewed the October 15 and November 19, 2019 reports of

Dr. Harris, the DMA, who evaluated the August 22, 2019 examination findings of Dr. Ignacio to 

calculate the permanent impairment of appellant’s upper extremities. The Board finds that the 

DMA properly applied the standards of the sixth edition of the A.M.A., Guides to find that she has 

35 percent permanent impairment of her right upper extremity and 37 percent permanent 

impairment of her left upper extremity.

 

13 Supra note 10 at Chapter 3.700, Exhibit 4 (January 2010).

14 See A.M.A., Guides 449, Table 15-23.

15 A survey completed by a given claimant, known by the name QuickDASH, may be used to determine the Function 

Scale score. Id. at 448-49.

16 See A.M.A., Guides (6th ed. 2009) 405-12. Table 15-5 also provides that, if motion loss is present for a claimant 

with certain diagnosed conditions, permanent impairment may alternatively be assessed using Section 15.7 (ROM 

impairment). Such a ROM assessment stands alone and is not combined with a DBI rating. Id. at 401-05, 475-78.
7

In his October 15, 2019 report, the DMA noted that he had reviewed Dr. Ignacio’s 

August 22, 2019 report and indicated that, utilizing The Guides Newsletter,

17 appellant had four

percent right upper extremity impairment for residual problems with pain/impaired sensation from 

her right C5 cervical radiculopathy, six percent for residual problems with motor weakness from 

her right C5 cervical radiculopathy, six percent for residual problems with pain/impaired sensation 

from her right C6 cervical radiculopathy, and seven percent for residual problems with motor 

weakness from her right C6 cervical radiculopathy. He found that this resulted in 22 percent 

permanent impairment of the right upper extremity impairment. The DMA advised that, utilizing 

Table 15-23 on page 449 of the sixth edition of the A.M.A., Guides, appellant also had nine percent 

permanent impairment of the upper extremity for residual problems with right carpal tunnel 

syndrome status post carpal tunnel release.18 He noted that her condition fell under grade modifier 

3 on Table 15-23. The DMA also noted that, utilizing the DBI method under Table 15-5 beginning 

on page 401, appellant had five percent permanent impairment of her right upper extremity 

impairment for her partial rotator cuff tear.19 With regard to the ROM impairment rating method 

for the right shoulder, appellant had, utilizing Table 15-34 on page 475, three percent right upper 

extremity impairment for loss of flexion, one percent for loss of extension, three percent for loss 

of abduction, and two percent for loss of internal rotation. The DMA indicated that this resulted 

in nine percent impairment based on the ROM impairment rating method and resulted in greater 

impairment than the DBI rating method. He advised that, per Table 2-1 on page 20, the A.M.A., 

Guides noted that “if the [A.M.A., Guides] provides more than one method to rate a particular 

impairment condition, the method producing the higher rating must be used.” The DMA noted

that he utilized the Combined Values Chart on page 604 to combine the various impairment values 

for the right upper extremity and concluded that appellant had 35 percent permanent impairment 

of the right upper extremity. 

For the left upper extremity, the DMA again utilized The Guides Newsletter and noted that 

appellant had four percent left upper extremity impairment for residual problems with 

pain/impaired sensation from her left C5 cervical radiculopathy, six percent for residual problems 

with motor weakness from her left C5 cervical radiculopathy, six percent for residual problems 

with pain/impaired sensation from her left C6 cervical radiculopathy, and seven percent for 

residual problems with motor weakness from her left C6 cervical radiculopathy. He found that 

this resulted in 22 percent permanent impairment of the left upper extremity. The DMA advised 

that, utilizing Table 15-23 on page 449, appellant also had nine percent upper extremity 

impairment for residual problems with left carpal tunnel syndrome status post carpal tunnel 

release. He noted that her condition fell under grade modifier 3 on Table 15-23. The DMA also 

noted that, utilizing the DBI method under Table 15-5 beginning on page 401, appellant had five

percent permanent impairment of her left upper extremity impairment for her partial rotator cuff 

tear. With regard to the ROM impairment rating method for the left shoulder, appellant had, 

utilizing Table 15-34 on page 475, three percent right upper extremity impairment for loss of 

flexion, one percent for loss of extension, three percent for loss of abduction, and four percent for 

loss of internal rotation. The DMA indicated that this resulted in 11 percent impairment based on 

the ROM impairment rating method and resulted in greater impairment than the DBI rating 

 

17 See supra notes 9 through 11.

18 See supra notes 12 and 13.

19 See supra note 14.
8

method. He advised that he utilized the Combined Values Chart on page 604 to add the various 

impairment values for the left upper extremity and concluded that appellant had 37 percent 

permanent impairment of the left upper extremity.20

The Board notes that Dr. Ignacio determined in his August 22, 2019 report that appellant 

had 59 percent permanent impairment of the right upper extremity and 44 percent permanent 

impairment of the left upper extremity. However, this impairment rating is of limited probative 

value because Dr. Ignacio did not adequately explain how it was derived in accordance with the 

standards of the sixth edition of the A.M.A., Guides. Dr. Ignacio’s brief permanent impairment 

evaluation lacks substantial explanation. For example, he provided impairment ratings for bilateral 

median nerve neuritis and unnamed bilateral shoulder deficits, but he did not provide an adequate 

explanation for these ratings, which included specific references to the sixth edition of the A.M.A., 

Guides. The Board has held that an opinion on permanent impairment is of limited probative value 

if it is not derived in accordance with the standards adopted by OWCP and approved by the Board 

as appropriate for evaluating schedule losses.21

On appeal appellant asserts that it was improper for her December 10, 2019 schedule award 

to be based on a weekly pay rate of $691.52 per week. However, she did not provide any support 

for this assertion and has not otherwise shown that she received an incorrect amount of schedule 

award compensation.

Appellant may request a schedule award or increased schedule award at any time based on 

evidence of a new exposure or medical evidence showing progression of an employment-related 

condition resulting in permanent impairment or increased impairment.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish greater than 35 

percent permanent impairment of her right upper extremity and 37 percent permanent impairment 

of her left upper extremity, for which she previously received schedule award compensation.

 

20 In his November 19, 2019 report, the DMA provided further discussion of his impairment rating method with 

emphasis on the manner in which he combined various impairment rating values.

21 See N.A., Docket No. 19-0248 (issued May 17, 2019); James Kennedy, Jr., 40 ECAB 620, 626 (1989) (finding 

that an opinion which is not based upon the standards adopted by OWCP and approved by the Board as appropriate 

for evaluating schedule losses is of little probative value in determining the extent of a claimant’s permanent 

impairment).
9

ORDER

IT IS HEREBY ORDERED THAT the December 10, 2019 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: December 18, 2020

Washington, DC

Christopher J. Godfrey, Deputy 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