United States Department of Labor

Employees’ Compensation Appeals Board

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M.G., Appellant

and

DEPARTMENT OF JUSTICE, U.S. MARSHALS

SERVICE, Pierre, SD, Employer

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Docket No. 21-0427

Issued: January 6, 2022

Appearances: Case Submitted on the Record

Appellant, pro se

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 January 14, 2021 appellant filed a timely appeal from an October 21, 2020 merit 

decision of the Office of Workers’ Compensation Programs (OWCP).1 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. 

1 The Board notesthat,following the October 21, 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

5 U.S.C. § 8101 et seq.
2

ISSUE

The issue is whether appellant has met his burden of proof to establish a recurrence of the 

need for medical treatment commencing January 16, 2020 causally related to his accepted 

April 10, 2008 employment injury.

FACTUAL HISTORY

On April 10, 2008 appellant, then a 32-year-old marshal in training, filed a second Form 

CA-1 alleging that on April 10, 2008 his left shoulder became dislocated during defensive training 

while in the performance of duty. He did not stop work. On May 7, 2009 OWCP accepted this 

claim for closed anterior dislocation of the left shoulder under OWCP File No. xxxxxx507.

3

On September 5, 2008 appellant underwent a diagnostic arthroscopy with Bankart repair, 

left shoulder.

By decision dated July 8, 2010, OWCPgranted appellant a schedule award for four percent 

permanent impairment of his left upper extremity.

On February 6, 2020 appellant filed a notice of recurrence (Form CA-2a) alleging that on 

January 16, 2020 he noticed pain emanating from his left shoulder due to his April 10, 2008 

employment injury. He asserted that his recurrence occurred during normal everyday use and that 

he had noticed reduced strength and mobility. Appellant did not stop work.

In a February 6, 2020 development letter, OWCP requested additional medical evidence in 

support of appellant’s claimed recurrence of a medical condition. It afforded him 30 days to 

response. No response was received.

By decision dated April 29, 2020, OWCP denied appellant’s recurrence claim.

On May 4, 2020 Dr. MichaelJ. Lillestol, a Board-certified internist, examined appellant 

due to left shoulder pain. He noted that appellant denied any recent history of trauma, but 

described his April 10, 2008 employment injury. Dr. Lillestol noted that since April 10, 2008

appellant had previously experienced occasional episodes with left shoulder pain which lasted a 

few days to a week, but usually receded. He noted that appellant’s current left shoulder pain had 

persisted for two to three weeks and reported that his left arm strength was decreased. Dr. Lillestol 

found limited range of motion in the left shoulder and some tenderness in the medial aspect of the 

shoulder. He diagnosed recurrent shoulder dislocation and opined that appellant had a left shoulder 

strain pattern with possible internal derangement.

On May 11, 2020 appellant requested an oral hearing from a representative of OWCP’s 

Branch of Hearings and Review. During the hearing held on September 8, 2020, appellant testified

3 Appellant has a prior claim under OWCP File No. xxxxxx633, which OWCP accepted for closed dislocation of 

the left shoulder. OWCP authorized wage-loss compensation beginning September 14, 2008. Appellant returned to 

full-duty work on December 18, 2008. OWCP has administratively combined appellant’s claims with OWCP File 

No. xxxxxx633 serving as the master file.
3

that he had no intervening injury and that his shoulder condition occasionally caused him pain and 

stiffness.

By decision dated October 21, 2020, OWCP’s hearing representative affirmed the

April 29, 2020 OWCP decision.

LEGAL PRECEDENT

A recurrence of a medical condition means a documented need for further medical 

treatment after release from treatment for the accepted condition or injury when there is no 

accompanying work stoppage.4 An employee has the burden of proof to establish that he or she 

sustained a recurrence of a medical condition that is causally related to his or her accepted 

employment injury without intervening cause.5

If a claim for recurrence of a medical condition is made more than 90 days after release 

from medical care, a claimant is responsible for submitting a medical report supporting a causal 

relationship between the employee’s current condition and the original injury in order to meet his 

or her burden.6 To meet this burden, the employee must submit medical evidence from a physician 

who, on the basis of a complete and accurate factual and medical history, supports that the 

condition is causally related and supports his or her conclusion with sound medical ratio nale.7 

Where no such rationale is present, medical evidence is of diminished probative value. 8

ANALYSIS

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

the need for medical treatment commencing January 16, 2020 causally related to his accepted 

April 10, 2008 employment injury.

In a May 4, 2020 note, Dr. Lillestol noted that appellant denied any recent history of left 

shoulder trauma and described appellant’s April 10, 2008 employment injury. He also noted that 

appellant’s current left shoulder pain had persisted for two to three weeks and that appellant’s left 

arm strength was decreased. Dr. Lillestol found limited range of motion in the left shoulder and 

some tenderness in the medial aspect of the shoulder. He diagnosed recurrent shoulder dislocation 

and opined that appellant had a left shoulder strain pattern with possible internal derangement.

4

20 C.F.R. § 10.5(y).

5

S.P., Docket No. 19-0573 (issued May 6, 2021); M.P., Docket No. 19-0161 (issued August 16, 2019); E.R., 

Docket No. 18-0202 (issued June 5, 2018).

6 Federal (FECA) Procedural Manual, Part 2 --Claims, Recurrences, Chapter 2.1500.4b (June 2013); see also J.M.,

Docket No. 09-2041 (issued May 6, 2010).

7

S.P., supra note 5; A.C., Docket No. 17-0521 (issued April24, 2018); O.H., Docket No. 15-0778 (issued 

June 25, 2015).

8

S.P., supra note 5; Michael Stockert, 39 ECAB 1186 (1988).
4

Although Dr. Lillestol related appellant’s current left shoulder condition to his accepted 

employment injury, his report is of limited probative value on the underlying issue of this case 

because he did not provide a rationalized opinion explaining the causal relationship between 

appellant’s recurrent need for medical treatment and the accepted employment injury. He did not 

describe appellant’s accepted employment conditions in any detail or explain the 

pathophysiological process through which such conditions, sustained in approximately April 10, 

2008, would require medical treatment in 2020. Dr. Lillestol did not adequately explain how 

appellant sustained a spontaneous recurrence of the accepted employment conditions, without an 

intervening cause, such that appellant needed medical treatment for that condition. The Board has 

held that a report is of limited probative value if it does not contain medical rationale explaining 

causal relationship between the recurrent need for medical treatment and the accepted 

employment-related injury. Therefore, hisMay 4, 2020 note is insufficient to establish appellant’s 

claim.

As the medical evidence of record does not contain a rationalized medical opinion 

establishing a recurrent need for medical treatment commencing January 16, 2020 causally related 

to his accepted employment injury, the Board finds that appellant has not met his burden of proof.

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 appellant has not met his burden of proof to establish a recurrence of 

the need for medical treatment commencing January 16, 2020 causally related to his accepted 

April 10, 2008 employment injury.
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ORDER

IT IS HEREBY ORDERED THAT the October 21, 2020 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: January 6, 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