United States Department of Labor

Employees Compensation Appeals Board

__________________________________________

Y.J., Appellant

and

U.S. POSTAL SERVICE, CARDISS COLLINS 

PROCESSING & DISTRIBUTION CENTER, 

Chicago, IL, Employer

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Docket No. 20-1337

Issued: February 7, 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 26, 2020 appellant, through counsel, filed a timely appeal from a May 11, 2020 

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

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

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

ISSUES

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

benefits, effective July 2, 2019, finding that she no longer had residuals causally related to her 

accepted bilateral shoulder and hand conditions; and (2) whether appellant has met her burden of 

proof to establish continuing residuals on or after July 2, 2019.

FACTUAL HISTORY

On September 24, 2015 appellant, then a 58-year-old mail handler, filed an occupational 

disease claim (Form CA-2) alleging that she developed intense pain and irritation in her hands, 

wrists, elbows, and shoulders due to factors of her federal employment including repetitively using 

her hands and arms while working on flat machines for four and a half years at work. She noted 

that she first became aware of her claimed condition on September 15, 2015 and realized its 

relationship to her federal employment on September 21, 2015. Appellant stopped work on 

September 28, 2015 and returned on October 3, 2015. OWCP accepted her claim for bilateral 

shoulder articular cartilage disorder and bilateral hand synovitis and tenosynovitis.

On October 7, 2016 appellant underwent OWCP-authorized right shoulder arthroscopy and 

stopped work. OWCP paid appellant wage-loss compensation on the supplemental rolls, effective 

October 5, 2016 and placed her on the periodic rolls, effective March 5, 2017. On August 11, 

2017 appellant returned to full-time, limited-duty work. She continued to receive medical 

treatment and undergo physical therapy treatment for her bilateral shoulder and hand conditions. 

On March 7, 2018 OWCP referred appellant, along with a statement of accepted facts, a 

copy of the case record, and a series of questions, to Dr. Steven Chandler, an osteopathspecializing

in orthopedic surgery, for a second opinion evaluation regarding the status of her employmentrelated conditions. In a June 20, 2018 report, Dr. Chandler reviewed her history of injury and 

noted her current complaints of pain and weakness in her hands. Upon examination of appellant’s 

shoulders, he observed tenderness to the proximal biceps tendon and acromioclavicular (AC) joint. 

Examination of her hands revealed decreased range of motion (ROM) of the wrists. Dr. Chandler 

diagnosed bilateral shoulder bursitis, bilateral shoulder impingement syndrome, bilateral shoulder 

tendinitis and/or tenosynovitis, bilateral carpal tunnel syndrome, and bilateral de Quervain’s

disease/tenosynovitis. 

Dr. Chandler opined that appellant’s right shoulder impingement and rotator cuff tendinitis 

had resolved after her right shoulder arthroscopy and when she was released back to work on 

2

5 U.S.C. § 8101 et seq.

3 The Board notes that, following the May 11, 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.
3

March 10, 2017. He further opined that she still had residuals of her left shoulder condition and 

noted that examination findings had shown positive Neer’s examination and tenderness to 

palpation over the subacromial space. Regarding appellant’s bilateral hand condition,

Dr. Chandler reported that diagnostic testing showed that her bilateral wrist tenosynovitis 

condition had resolved as of February 13, 2017, when appellant was released back to work. 

Dr. Chandler concluded that she no longer needed therapy for her accepted conditions. 

In a July 31, 2018 progress report, Dr. William Payne, a Board-certified orthopedic 

surgeon, reported that appellant was seen for follow-up of right shoulder pain. He noted right 

shoulder examination findings of tenderness in the AC joint and abnormal ROM. Dr. Payne 

diagnosed status post right shoulder subacromial decompression. He recommended work 

conditioning or physical therapy. Dr. Payne also completed occupational health injury notes dated 

July 31 and September 18, 2018, which indicated that appellant could return to work with 

restrictions. 

In a supplemental report dated August 20, 2018, Dr. Chandler clarified that appellant’s 

right shoulder conditions had resolved as of August 11, 2017 when she was released to full duty. 

He also explained that his recommendation that she use splints was more prophylactic so that her 

work duties did not aggravate her bilateral wrist condition. 

In a January 10, 2019 prescription therapy report, Dr. David Barnes, an osteopath who 

specializes in family medicine, noted appellant’s accepted conditions. He explained that she had 

a few “flare-up” episodes since her last evaluation, but continued to show improvement. Upon 

physical examination, Dr. Barnes observed muscle spasm and tenderness in appellant’s bilateral 

thenar pads and hypothenar pads and wrists and restricted ROM. He requested authorization for 

physical and occupational therapy to treat her bilateral hand conditions. Dr. Barnes also completed 

duty status reports (Form CA-17) dated August 16, 2018 through February 7, 2019, wherein he 

opined that appellant could return to work with restrictions. 

OWCP subsequently determined that a conflict in medical opinion existed between

Dr. Barnes, appellant’s treating physician, and Dr. Chandler, OWCP’s second opinion medical 

examiner, with regard to the status of her accepted conditions. As such, it referred her to

Dr. Michael Cohen, a Board-certified orthopedic surgeon, for an impartial medical examination to 

resolve the conflict. 

In a February 28, 2019 report, Dr. Cohen indicated that he reviewed appellant’s records 

and noted that her claim was accepted for bilateral shoulder articular cartilage disorder and bilateral 

hand tenosynovitis and tendinitis. He noted that diagnostic imaging of her right hand in 20164

showed significant carpometacarpal (CMC) arthritis and diagnostic imaging of her left hand in 

20175 showed modest wrist and CMC arthritis. Dr. Cohen reported appellant’s complaints of 

bilateral shoulder pain and pain in the area of the CMC joints of her hands. Upon physical 

4 A December 28, 2016 right hand magnetic resonance imaging (MRI) scan demonstrated severe osteoarthritis of 

the first CMC joint with full-thickness cartilage loss and mild degenerative changes at the metacarpophalangeal and 

interphalangeal joints.

5 A January 30, 2017 left hand MRI scan revealed mild-to-moderate degenerative change in the left wrist, first 

CMC joint, and first metacarpophalangeal joint.
4

examination of her hands and wrists, he observed full ROM, no tenderness, and negative 

Finkelstein’s tests. Examination of appellant’s bilateral shoulders revealed full ROM and rotator 

cuff strength. Dr. Cohen opined that appellant had no residuals of her accepted bilateral shoulder 

conditions. He reported that examination of her shoulders demonstrated full ROM with the only 

positive finding of tenderness over the biceps tendon. Dr. Cohen also opined that appellant’s 

bilateral de Quervain’s tenosynovitis had resolved. He noted that she had negative Finkelstein’s 

test on both wrists and no tenderness over the first dorsal compartment on both wrists. Dr. Cohen 

opined that appellant’s current symptoms were related to her underlying arthritis condition, and 

not related to her employment. He reported that physical therapy would not likely improve her

arthritic symptoms. Dr. Cohen completed a work capacity evaluation (Form OWCP-5c), which 

indicated that appellant could work full time with restrictions. 

On March 19, 2019 OWCP issued a notice proposing to terminate appellant’s medical 

benefits because her accepted bilateral shoulder and hand conditions had resolved. It found that 

the special weight of medical evidence rested with the February 28, 2019 medical report of

Dr. Cohen, OWCP’s impartial medical examiner (IME), who found that she no longer had any 

residuals causally related to her accepted bilateral upper extremity conditions. OWCP afforded 

appellant 30 days to submit additional evidence or argument, in writing, if she disagreed with the 

proposed termination. 

In an April 15, 2019 letter, appellant noted her disagreement with the proposed termination. 

Appellant submitted additional evidence. In progress reports and occupational health 

injury notes dated March 12 and April 9, 2019, Dr. Payne noted that she was seen for follow-up 

evaluation of her right shoulder and complaints of left shoulder pain. Upon examination of the 

right shoulder, he observed abnormal ROM on passive external rotation and normal sensation. 

Examination of appellant’s left shoulder revealed tenderness in the AC joint and abnormal 

abduction and forward flexion. Diagnostic testing, including a Hawkins impingement test, was

positive. Dr. Payne diagnosed status post right shoulder arthroscopy and repair. He indicated that 

appellant could work with restrictions. 

In an April 4, 2019 report, Dr. Barnes noted his disagreement with an OWCP examiner’s 

opinion that appellant only suffered from arthritis in her thumb because arthritis would not present 

with the objective findings that he had seen. He noted diagnoses of bilateral shoulder other 

articular cartilage disorder and bilateral hand synovitis and tenosynovitis. Dr. Barnes indicated 

that it was medically necessary to treat these conditions with continued medical treatment and 

therapy. He also provided a motor grip strength testing report. 

On April 9, 2019 appellant underwent a bilateral shoulder x-ray examination, which 

showed “unremarkable bilateral shoulder x-ray.”

In an April 17, 2019 report, Dr. Barnes agreed that appellant suffered from arthritis, but 

explained that she also continued to have objective findings and symptoms of her accepted bilateral 

hand tenosynovitis condition. He reported that findings from his physical evaluation and 

computerized ROM and grip strength and motor testing revealed that she had limited ROM in her 

wrists, as well as weakness of the wrist and hand muscles. Dr. Barnes indicated that if appellant 

only suffered from arthritis, she would not have those examination findings. He explained that 
5

arthritis was also typically found within synovitis and tenosynovitis patients. Dr. Barnes 

concluded that appellant continued to suffer from her accepted bilateral hand condition. 

In an April 30, 2019 addendum report, Dr. Cohen recounted that he had reviewed

Dr. Barnes’ additional reports, including the motor grip and strength testing report, and noted his 

disagreement with Dr. Barnes’ opinion. He explained that CMC arthritis would also result in 

decreased ROM of the hand, wrist, and thumb, as well as decreased strength and mobility. 

Dr. Cohen reported that physical evaluation of appellant’s hands revealed no findings of 

tenosynovitis, including no tenderness over the first dorsal compartment of both wrists and 

negative Finkelstein’s tests. He confirmed that his opinion from his initial February 28, 2019

impartial medical report remained unchanged. 

A May 3, 2019 left shoulder MRI scan showed partial thickness tear of the distal anterior 

supraspinatus tendon, infraspinatus tendinosis, and mild degenerative changes of the glenohumeral 

and AC joints. 

In a May 9, 2019 letter, appellant contended that the medical evidence of record had 

demonstrated that her pain resulted from a tear in her left shoulder and not from arthritis. She also 

alleged that she continued to experience symptoms in her hands from her a ccepted bilateral 

tenosynovitis condition. Appellant indicated that she needed to undergo left shoulder surgery to 

repair her left shoulder tear and continued physical therapy treatment for her bilateral hand 

condition. 

In a May 21, 2019 occupational health injury report, Dr. Payne noted a diagnosis of left 

shoulder pain and indicated that appellant could return to work with restrictions. 

In a June 6, 2019 Form CA-17 report, Dr. Barnes indicated that appellant could return to 

work with restrictions of no pushing or pulling and taking a 10-minute break every hour. 

OWCP also received physical therapy and chiropractic treatment notes dated from 

August 29, 2018 through May 13, 2019. 

By decision dated July 2, 2019, OWCP finalized the proposed termination of appellant’s 

medical benefits, effective that date. It found that the special weight of medical evidence rested 

with Dr. Cohen, the IME, who had determined in February 28 and April 30, 2019 reports, that she

did not have residuals due to her accepted bilateral shoulder and hand conditions. 

On March 5, 2020 appellant, through counsel, requested reconsideration and submitted 

additional medical evidence.

In reports dated July 2, 2019 through February 18, 2020, Dr. Payne noted diagnoses of left 

shoulder pain, left shoulder partial thickness tear, and status post right shoulder arthroscopy. He

indicated that appellant could work with restrictions. 

OWCP received an August 8, 2019 Form CA-17 report by Dr. Barnes, who indicated that 

appellant could return to work with restrictions. 
6

In an October 8, 2019 progress note, Dr. Payne reported appellant’s complaints of right 

and left shoulder pain aggravated by pushing, pulling, lifting, and repetitive activities at or above 

shoulder height. He noted right shoulder examination findings of tenderness in the AC right joint 

and abnormal abduction, flexion, and external rotation. Examination of appellant’s left shoulder 

revealed normal ROM. Dr. Payne diagnosed status post right shoulder arthroscopy and left 

shoulder partial thickness tear. 

On October 10, 2019 Dr. Payne submitted a request for authorization for left shoulder 

arthroscopy. 

In a November 21, 2019 prescription for therapy note, Dr. Barnes noted that appellant was 

doing well with therapy, but still reported difficulty with strength, grip strength, and ROM. He

reiterated his disagreement with the opinion that hersymptoms were due only to her CMC arthritis 

and explained that CMC arthritis would not present with all the objective findings in his 

examination and computerized testing. Dr. Barnes opined that additional medical treatment was 

needed to treat appellant’s bilateral hand condition and to guarantee that her condition would not 

deteriorate. 

In a January 29, 2020 narrative report, Dr. Payne noted that appellant injured her shoulders 

and hands due to repetitive movement at work. He reported that she currently complained of 

bilateral hand pain, worse on the right, intermittent numbness, tingling, and weakness and bilateral 

shoulder pain. Dr. Payne discussed the medical treatment that appellant had received and noted 

that after several evaluations and diagnostic testing, he assessed that she had right shoulder rotator 

cuff tear, left shoulder impingement with partial tear, bilateral CMC arthritis, bilateral shoulder 

pain, and bilateral de Quervain’stenosynovitis. He opined that the injuries that she sustained were 

a result of repetitive use of the work-related injury while working at the employing establishment. 

Dr. Payne indicated that appellant would need surgery on her left shoulder and additional physical 

therapy.

By decision dated May 11, 2020, OWCP denied modification of the July 2, 2019 decision. 

LEGAL PRECEDENT -- ISSUE 1

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

termination or modification of benefits.6 It may not terminate compensation without establishing 

either that the disability has ceased or that it is no longer related to the employment. 7 OWCP’s 

burden of proof includes the necessity of furnishing rationalized medical opinion evidence based 

on a proper factual and medical background.8 

6 A.D., Docket No. 18-0497 (issued July 25, 2018); S.F., 59 ECAB 642 (2008); KellyY. Simpson, 57 ECAB 197 

(2005); Paul L. Stewart, 54 ECAB 824 (2003).

7 A.G., Docket No. 18-0749 (issued November 7, 2018); see also I.J., 59 ECAB 408 (2008); Elsie L. Price, 54 

ECAB 734 (2003). 

8 R.R., Docket No. 19-0173 (issued May 2, 2019); T.P., 58 ECAB 524 (2007); DelK. Rykert, 40 ECAB 284 (1988).
7

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

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

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

which require further medical treatment.10 

Section 8123(a) of FECA provides that if there is a disagreement between the physician 

making the examination for the United States and the physician of an employee, the Secretary shall 

appoint a third physician (known as a referee physician or IME) who shall make an examination. 11 

For a conflict to arise the opposing physicians’ viewpoints must be of “virtually equal weight and 

rationale.”

12

 When OWCP has referred the case to an IME for the purpose of resolving the conflict, 

the opinion of such specialist, if sufficiently well-rationalized and based upon a proper factual 

background, must be given special weight.13 

ANALYSIS -- ISSUE 1

The Board finds that OWCP did not meet its burden of proof to terminate appellant’s 

medical benefits, effective July 2, 2019.

OWCP improperly determined that a conflict in the medical opinion evidence existed 

between Dr. Barnes, appellant’s treating physician and Dr. Chandler, OWCP’s second opinion 

examiner, regarding whether her accepted bilateral shoulder and hand conditions had resolved. In 

his June 20 and August 20, 2018 reports, Dr. Chandler reported her complaints of pain and 

weakness in her hands. He noted physical examination findings of tenderness to the proximal 

biceps tendon and AC joint of appellant’s shoulders and decreased ROM of her wrists. 

Dr. Chandler diagnosed bilateral shoulder bursitis, bilateral shoulder impingement syndrome, 

bilateral shoulder tendinitis and/or tenosynovitis, bilateral carpal tunnel syndrome, and bilateral 

de Quervain’s disease/tenosynovitis. He opined that appellant’s right shoulder condition had 

resolved after her right shoulder arthroscopy and her release to work on August 11, 2017, but that 

she continued to suffer residuals of her left shoulder condition. Dr. Chandler also indicated that 

her bilateral wrist condition had resolved when she was released back to work on 

February 13, 2017.

As noted above, for a conflict to arise the opposing physicians’ viewpoints must be of 

virtually equal weight and rationale.14 In this case, the Board finds, however, that Dr. Chandler 

9 L.W., Docket No. 18-1372 (issued February 27, 2019); KathrynE. Demarsh, 56 ECAB 677 (2005).

10 R.P., Docket No. 17-1133 (issued January 18, 2018); A.P., Docket No. 08-1822 (issued August 5, 2009).

11 5 U.S.C. § 8123(a); see R.S., Docket No. 10-1704 (issued May 13, 2011); S.T., Docket No. 08-1675 (issued 

May 4, 2009).

12 H.B., Docket No. 19-0926 (issued September 10, 2020); C.H., Docket No. 18-1065 (issued November 29, 2018); 

Darlene R. Kennedy, 57 ECAB 414, 416 (2006).

13 S.S., Docket No. 19-0766 (issued December 13, 2019); W.M., Docket No. 18-0957 (issued October 15, 2018); 

Gloria J. Godfrey, 52 ECAB 486 (2001).

14 Supra note 12.
8

failed to provide sufficient explanation as to why, despite diminished examination findings, 

appellant’s accepted rightshoulder and hand conditions had resolved.15 Dr. Chandler relied on the 

fact that she was released back to work. The Board has held that a report is of limited probative 

value regarding a given medical matter if a physician does not provide medical rationale explaining 

his or her opinion on that matter.16 Therefore, the Board finds that Dr. Chandler’s opinion was not 

of equal weight and was, thus, insufficient to create a conflict with Dr. Barnes.17 Furthermore,

Dr. Chandler determined that appellant still had residuals of her left shoulder condition and, thus, 

there was no conflict in medical evidence regarding her left shoulder condition. As no true conflict 

existed in the medical evidence at the time of the referral to Dr. Cohen, the Board finds that his 

report may not be afforded the special weight of an IME and should be considered for its own 

intrinsic value.18 The referral to Dr. Cohen is therefore considered to be a second opinion 

evaluation.19

In a February 28, 2019 report, Dr. Cohen reviewed appellant’s records and noted that 

appellant’s claim was accepted for bilateral shoulder articular cartilage disorder and bilateral hand 

tenosynovitis and tendinitis. He noted that diagnostic imaging of her bilateral hands had revealed 

wrist and CMC arthritis. Dr. Cohen reported bilateral hand examination findings of full ROM, no 

tenderness, and negative Finkelstein’s tests. Examination of appellant’s bilateral shoulders 

revealed full ROMand rotator cuff strength. Dr. Cohen opined that her accepted bilateral shoulder 

and hand conditions had resolved as she no longer had examination findings to support her 

conditions. He opined that appellant’s current symptoms were related to her underlying arthritis 

condition, and not related to her employment. Dr. Cohen reported that she could continue to work 

full time with restrictions.

Appellant’s treating physician, Dr. Barnes, however, submitted numerous reports wherein 

he noted that appellant continued to suffer residuals of her accepted bilateral shoulder and hand 

conditions that required medical treatment. In a January 10, 2019 report, he indicated that she

continued to show muscle spasm and tenderness in her bilateral thenar pads and hypothenar pads 

and wrists. Dr. Barnes requested authorization for physical and occupational therapy to treat 

appellant’s bilateral hand conditions. In an April 4, 2019 report and April 17, 2019 letter, he 

expressed his disagreement with an OWCP examiner’s opinion that appellant only suffered from 

arthritis. Dr. Barnes noted that examination findings still showed deficits in her hand and 

shoulders. He reported diagnoses of bilateral shoulder other articular cartilage disorder and 

15 See P.E., Docket No. 19-0837 (issued October 20, 2020); see also F.R., Docket No. 17-1711 (issued 

September 6, 2018).

16 L.G., Docket No. 19-0142 (issued August 8, 2019); C.M., Docket No. 14-0088 (issued April18, 2014).

17 Supra note 13; see also R.B., Docket No. 20-0109 (issued June 25, 2020) (the Board found that a second-opinion 

examiner’s report was of limited probative value and insufficient to create a conflict in medical opinion with the 

claimant’s treating physician). 

18 See R.B., id.; see also F.R., supra note 15.

19 See M.G., Docket No. 19-1627 (issued April17, 2020); S.M., Docket No. 19-0397 (issued August 7, 2019) (the 

Board found that at the time of the referral for an impartial medical examination there was no conflict in medical 

opinion evidence; therefore, the referral was for a second opinion examination); Cleopatra McDougal-Saddler, 47 

ECAB 480 (1996).
9

bilateral hand synovitis and tenosynovitis. Dr. Barnes indicated that it was medically necessary to 

treat these conditions with continued medical treatment and therapy.

In an April 30, 2019 addendum report, Dr. Cohen noted that he had reviewed Dr. Barnes’

additional reports, and disagreed with his opinion. He reiterated that physical evaluation of 

appellant’s bilateral hands revealed no findings of tenosynovitis, including no tenderness over the 

first dorsal compartment of both wrists and negative Finkelstein’s tests. Dr. Cohen confirmed that 

his opinion from his initial February 28, 2019 impartial medical report remained unchanged. 

The Board therefore finds that the medical reports of Dr. Cohen and Dr. Barnes are of 

virtually equal weight and rationale, and therefore an unresolved conflict in medical opinion now 

exists between Dr. Barnes and Dr. Cohen regarding whether appellant’s accepted bilateral 

shoulder and hand conditions had resolved. It is well established that when there exist opposing 

medical reports of virtually equal weight and rationale, the case should be referred to an IME for 

the purpose of resolving the conflict.20 As a conflict in medical evidence regarding whether 

appellant’s accepted bilateral shoulder and hand conditions had resolved remains prior to July 2, 

2019, the Board finds that OWCP has not met its burden of proof to terminate hermedical benefits.

CONCLUSION

The Board finds that OWCP did not meet its burden of proof to terminate appellant’s 

medical benefits effective July 2, 2019.21

20 Supra notes 11 and 13.

21 In light of the Board’s disposition of Issue 1, Issue 2 is rendered moot.
10

ORDER

IT IS HEREBY ORDERED THAT the May 11, 2020 decision of the Office of Workers’

Compensation Programs is reversed.

Issued: February 7, 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