United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.B., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

North Metro, GA, Employer

__________________________________________

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Docket No. 18-0040

Issued: May 7, 2019

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On October 5, 2017 appellant filed a timely appeal from a May 31, 2017 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.2

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following the May 31, 2017 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 evidence for 

the first time on appeal. Id. 
2

ISSUE

The issue is whether appellant has met her burden of proof to establish total disability for 

the period September 17 to December 16, 2016 due to her accepted December 6, 2012 

employment injury. 

FACTUAL HISTORY

On December 10, 2012 appellant, then a 56-year-old city letter carrier, filed a traumatic 

injury claim (Form CA-1) alleging that on December 6, 2012 she sprained her left shoulder when 

she tripped over a delivery point sequence while in the performance of duty. The record reveals 

that she was working modified duty due to another work-related injury. 

By decision dated December 18, 2012, OWCP accepted appellant’s claim for right ankle 

contusion, right foot contusion, right hip contusion, and left shoulder contusion. 

On February 3, 2014 appellant underwent authorized lumbar surgery for a previously 

accepted claim and stopped work.3 

Appellant submitted an April 29, 2016 report by Dr. Jon Hyman, a Board-certified 

orthopedic surgeon, specializing in sports medicine. Dr. Hyman indicated that she was employed 

as a mail carrier, but was currently not working. He related appellant’s complaints of discomfort 

and pain with prolonged walking and unbearable pain and weakness in the bilateral hips. 

Dr. Hyman described her December 6, 2012 employment injury and noted that she was also 

receiving medical treatment for her back under a separate claim. He noted that, after appellant

underwent lumbar surgery in February 2014, she experienced more significant bilateral hip pain. 

Upon examination of her bilateral hips, Dr. Hyman observed no tenderness or swelling. Range of 

motion was limited at flexion due to pain. Dr. Hyman diagnosed bilateral hip pain; possible intraarticular synovitis; altered gait, status postsurgery in February 2014; and diminished quad 

strength/decreased motor nerve innervation. He provided a work status form and indicated that 

appellant could work with restrictions of no squatting, kneeling, bending, stooping, use of the 

affected body parts, climbing, running, jumping, pivoting, or twisting and limited lifting, pushing, 

or pulling. 

In a May 10, 2016 work status form, Matthew Guffey, a certified physician assistant, 

indicated that appellant had reached maximum medical improvement for her back, but needed 

treatment for her hip. He noted that she should have “no activity” from May 10 to 

November 8, 2016. 

 

3 Under OWCP File No. xxxxxx907, OWCP accepted that on September 19, 2012 appellant sustained a low back 

strain, left index finger sprain, and aggravation of degenerative disc disease as a result of lifting heavy restoration 

books throughout her route in the performance of duty. Appellant stopped work on September 20, 2012 and returned 

to full-time limited duty on September 21, 2012. She underwent surgery and stopped work on February 3, 2014. 

OWCP paid wage-loss compensation benefits. By decision dated September 17, 2016, it terminated appellant’s wageloss compensation and medical benefits, effective September 13, 2016, because she no longer had residuals or 

disability causally related to her September 19, 2012 employment injury.
3

OWCP received an October 12, 2016 letter from appellant to J.H., her manager. Appellant

informed him that she was appealing her case before OWCP and requesting 320 hours of leave 

with pay. She explained that her physician referred her to Dr. Hyman for evaluation of her hip 

and instructed her to remain on the same work restrictions. Appellant indicated that she was 

enclosing forms requesting leave without pay (LWOP) for the required time including a request 

for or notification of absence forms dated October 12, 2016, which requested LWOP from 

September 19 to December 16, 2016 and several time analysis forms (Forms CA-7a) requesting 

wage-loss compensation for total disability for the period September 19 to December 16, 2016. 

She noted that the reason for using leave was “per [physician’s] orders.” 

In a November 3, 2016 work status form, Dr. Hyman noted a left hip injury. He indicated 

that appellant could work with restrictions of no squatting, kneeling, bending, stooping, climbing, 

running, jumping, pivoting, or twisting and limited use of the affected body part. 

Dr. Plas T. James, a Board-certified orthopedic surgeon specializing in spine surgery, also 

treated appellant. In a November 8, 2016 work status form, he noted a date of injury of 

September 19, 2012 and indicated that she should not work for the period November 8, 2016 until 

her next visit in eight weeks on January 3, 2017. 

On December 6, 2016 appellant filed a claim for wage-loss compensation (Form CA-7) for

LWOP for the period September 17 to November 11, 2016 and for leave buy back for the period 

November 14 to December 16, 2016. On the reverse side of the claim form the employing 

establishment confirmed that she was on LWOP status for the period September 19 to 

November 25, 2016. In an attached Form CA-7a, appellant again indicated that the reason for 

using leave was “per [physician’s] orders” or “per [physician’s] restriction.” 

In a development letter dated December 12, 2016, OWCP informed appellant that it 

received her claim for wage-loss compensation for the period September 17 through 

December 16, 2016. It advised her that the evidence submitted was insufficient to establish her 

claim and requested that she submit additional evidence to establish that she was unable to work 

modified duty during the period claimed as a result of her December 6, 2012 employment injury. 

Appellant was afforded 30 days to provide the requested information. 

In a December 16, 2016 work status form, Dr. Hyman noted an injured body part of left 

hip. He indicated: “no work until next office visit.” 

By decision dated January 24, 2017, OWCP denied appellant’s claim for wage-loss 

compensation benefits for the period September 17 to December 16, 2016. It found that the 

medical evidence of record failed to establish that she was disabled from work or entitled to wageloss compensation during the claimed period as a result of her work injury. OWCP noted that the 

medical records which had been submitted referred to treatment for appellant’s left hip and back, 

which were not accepted conditions under her current claim. 

On March 13, 2017 OWCP received appellant’s request for reconsideration. Appellant

explained that she disagreed with OWCP’s decision that her December 6, 2012 employment injury 

had resolved and that she was no longer disabled. She noted that Dr. Hyman believed that she 

needed further evaluation and should be on “no work” status. Appellant related that she was 
4

currently receiving medical treatment for her feet and shoulder injuries. She noted that she was 

authorized to return to work with restrictions, but the employing establishment could not 

accommodate her restrictions. 

Appellant continued to receive medical treatment from Dr. Hyman. In reports dated 

November 8 and December 16, 2016, Dr. Hyman related that she was two years post status L4-5 

fusion surgery and began to experience back pain, bilateral hip pain, and groin pain approximately 

two months prior. Upon physical examination of appellant’s lumbar spine, he observed 

paraspinous muscle spasm and minimal range of motion of the spine. Straight leg raise testing 

was negative. Dr. Hyman reported that pinprick sensation was normal in the bilateral lower 

extremities. Examination of appellant’s hip also showed positive Patrick test with groin and 

anterior thigh pain. Dr. Hyman indicated that internal and external rotation of her hip caused pain 

in the groin and anterior thigh. He diagnosed status post L4-5 fusion, L3-4 spinal stenosis, and 

bilateral plantar fasciitis. In the December 16, 2016 report, Dr. Hyman noted that no new 

restrictions were made with respect to appellant’s work status. He recommended that she avoid 

actions that caused her pain directly. 

Dr. Hyman continued to treat appellant for her bilateral hip pain. Appellant submitted 

several medical reports and letters dated January 20 to March 1, 2017. She also provided 

diagnostic medical reports dated February 9, 2017 of her pelvis and bilateral hips. 

OWCP received a March 6, 2017 letter by Y.G., a customer services manager at the 

employing establishment. Y.G. informed appellant that the employing establishment did not have 

work available for her within her current work restrictions. 

By decision dated May 31, 2017, OWCP denied modification of the January 24, 2017 

decision. It found that the medical evidence of record was insufficient to establish that appellant 

was unable to work for the period September 17 to December 16, 2016 as a result of her 

December 6, 2012 employment injury. OWCP noted that the evidence submitted indicated that 

her current symptoms and inability to work were related to her nonwork-related left hip and back 

conditions. 

LEGAL PRECEDENT

An employee seeking benefits under FECA4 has the burden of proof to establish the 

essential elements of his or her claim, including that any disability or specific condition for which 

compensation is claimed is causally related to the employment injury.5 The term disability is 

defined as the incapacity because of an employment injury to earn the wages the employee was 

receiving at the time of the injury.6

Whether a particular injury causes an employee to be disabled from employment and the 

duration of that disability are medical issues which must be proved by a preponderance of the 

 

4 Supra note 1.

5 Kathryn Haggerty, 45 ECAB 383 (1994); Elaine Pendleton, 40 ECAB 1143 (1989).

6 20 C.F.R. § 10.5(f); see e.g., Cheryl L. Decavitch, 50 ECAB 397 (1999).
5

reliable, probative, and substantial medical evidence.7 Findings on examination are generally 

needed to support a physician’s opinion that an employee is disabled for work.8 

When an employee, who is disabled from the job he or she held when injured on account 

of employment-related residuals, returns to a light-duty position or the medical evidence 

establishes that light duty can be performed, the employee has the burden of proof to establish by 

the weight of reliable, probative, and substantial evidence a recurrence of total disability. As part 

of this burden of proof, the employee must establish either a change in the nature and extent of the 

injury-related condition, or a change in the nature and extent of the light-duty requirements.9

The Board will not require OWCP to pay compensation for disability in the absence of any 

medical evidence addressing the specific dates of disability for which compensation is claimed. 

To do so would essentially allow an employee to self-certify his or her disability and entitlement 

to compensation.10

ANALYSIS

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

for the period September 17 through December 16, 2016 due to the December 6, 2012 employment 

injury.

During appellant’s claimed period of disability, she received medical treatment from

Dr. Hyman. In a November 3, 2016 work status form, Dr. Hyman noted a left hip injury and 

indicated that she could work with restrictions of no squatting, kneeling, bending, stooping, 

climbing, running, jumping, pivoting, or twisting and limited use of the affected body part. The 

Board finds that this work status form does not establish total disability for the period 

September 17 to December 16, 2016. Rather, Dr. Hyman’s report provided appellant with work 

restrictions and did not indicate that she was totally disabled from work due to her December 6, 

2012 employment injury. Accordingly, his November 3, 2016 work status form fails to establish 

disability from work on the claimed dates due to her accepted injuries.11

In reports dated November 8 and December 16, 2016, Dr. Hyman further related that 

appellant began to experience back pain, bilateral hip pain, and groin pain approximately two 

months prior. He provided physical examination of her lumbar spine and bilateral hips. 

Dr. Hyman diagnosed status post L4-5 fusion, L3-4 spinal stenosis, and bilateral plantar fasciitis. 

He reported that no new restrictions were made with respect to her work status. In a December 16, 

2016 work status form, Dr. Hyman reported: “no work until next office visit.” Although he 

 

7 Amelia S. Jefferson, 57 ECAB 183 (2005); William A. Archer, 55 ECAB 674 (2004).

8 Dean E. Pierce, 40 ECAB 1249 (1989).

9 C.G., Docket No. 16-1503 (issued May 17, 2017).

10 Amelia S. Jefferson, supra note 7.

11 See M.C., Docket No. 16-1238 (issued January 26, 2017). See also Jaja K. Asaramo, 55 ECAB 200 (2004) (the 

Board found that for conditions not accepted or approved by OWCP as due to an employment injury, the claimant 

bears the burden of proof to establish that the condition is causally related to the employment injury).
6

indicated that appellant should remain off work, he did not provide a medical explanation 

explaining why her December 6, 2012 employment injury caused a period of total disability or 

otherwise provide medical rationale why any current condition or disability was due to the 

December 6, 2012 employment injury.12 In addition, Dr. Hyman did not identify the specific dates 

that she was disabled from work nor did he explain how she was no longer able to work due to her 

accepted employment injury. The Board will not require OWCP to pay compensation for 

disability, in the absence of medical evidence directly addressing the specific dates of disability 

for which compensation is claimed.13 To do so would essentially allow an employee to self-certify 

his or her disability and entitlement to compensation.14 Because Dr. Hyman failed to provide 

medical rationale for his conclusion, his opinion is of diminished probative value.15 His additional

reports are of limited probative value on the issue of total disability as they do not address the 

claimed period of disability.

Appellant also submitted a November 8, 2016 work status from by Dr. James. Dr. James 

noted a date of injury of September 19, 2012 and indicated that she should not work for the period 

November 8, 2016 to January 3, 2017. Although he reported that appellant should not work during 

the claimed period, he did not indicate that she was disabled from work due to her accepted 

December 6, 2012 employment injury. Rather, Dr. James noted a date of injury of September 19, 

2012, which was the date of injury under a previously accepted claim. The issue of whether a 

claimant’s disability from work is related to an accepted condition is a medical question, which 

must be established by a physician who, on the basis of a complete and accurate factual and 

medical history, concludes that the disability is causally related to the employment injury and 

supports that conclusion with sound medical reasoning.16 As Dr. James did not attribute 

appellant’s inability to work to her December 6, 2012 employment injury, his opinion is of limited 

probative value.

In addition, the May 10, 2016 work status form by Mr. Guffey, a physician assistant, 

indicating that appellant have “no activity” for the period May 10 to November 8, 2016, is of no 

probative value to establish her disability compensation claim because physician assistants are not 

considered physicians as defined under FECA.17

 

12 See William A. Archer, 55 ECAB 674 (2004).

13 Sandra D. Pruitt, 57ECAB 126 (2005). 

14 J.S., Docket No. 16-1014 (issued October 27, 2014).

15 S.B., Docket No. 13-1162 (issued December 12, 2013).

16 See G.B., Docket No. 16-1003 (issued December 5, 2016).

17 5 U.S.C. § 8101(2) (this subsection defines a physician as surgeons, podiatrists, dentists, clinical psychologists, 

optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by state law); 

20 C.F.R. § 10.5(t). See also David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006) (lay individuals such as physician 

assistants, nurses, and physical therapists are not competent to render a medical opinion under FECA); K.S., Docket 

No. 18-0954 (issued February 26, 2019); K.W., 59 ECAB 271, 279 (2007). 
7

As the medical evidence of record does not contain sufficient rationale to establish disability during the claimed period, the Board finds that appellant has not met her burden of proof.

On appeal, appellant argues that, if she had been allowed to work, she could have reduced 

the amount of debt that she owes. She explained that, beginning in late June 2017, she was not 

receiving financial support and could not pay her debts. As explained above, however, appellant

has not provided rationalized medical evidence to establish her claim for total disability for the 

period September 17 to December 16, 2016 due to her December 6, 2012 employment injury. 

Accordingly, the Board finds that she has not established her claim for wage-loss compensation 

for the claimed period.

The Board further finds, however, that the case is not in posture for decision regarding 

whether appellant is entitled to wage-loss compensation for receiving medical treatment for her

accepted injury on November 3 and 8, and December 16, 2016. 

The record contains evidence that appellant was treated by Dr. Hyman on November 3 and

8, and December 16, 2016. OWCP’s procedures provide that wages lost for compensable medical 

examination or treatment may be reimbursed.18 It notes that a claimant who has returned to work

following an accepted injury or illness may need to undergo examination or treatment and such 

employee may be paid compensation for wage loss while obtaining medical services and for a 

reasonable time spent traveling to and from the medical provider’s location.19 As a rule, no more 

than four hours of compensation or continuation of pay should be allowed for routine medical 

appointments. Longer periods of time may be allowed when required by the nature of the medical 

procedure and/or the need to travel a substantial distance to obtain the medical care.20 The case 

will be remanded for payment of up to four hours of wage-loss compensation for each of these 

medical appointments and travel time.

CONCLUSION

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

for the period September 17 to December 16, 2016 as a result of the December 6, 2012 

employment injury. The Board also finds that this case is not in posture for decision regarding her

reimbursement for medical appointments on November 3 and 8, and December 16, 2016. 

 

18 Federal (FECA) Procedure Manual, Part 2 -- Claims, Computing Compensation, Chapter 2.901.19 

(February 2013).

19 Daniel Hollars, 51 ECAB 355 (2000); Jeffrey R. Davis, 35 ECAB 950 (1984).

20 Supra note 18 at Part 3 -- Medical, Administrative Matters, Chapter 3.900.8 (November 1998).
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ORDER

IT IS HEREBY ORDERED THAT the May 31, 2017 decision of the Office of Workers’

Compensation Programs is affirmed in part and set aside in part. The case is remanded for further 

development consistent with this decision of the Board.21

Issued: May 7, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

 

21 On remand, OWCP should consider combining the case records for OWCP File Nos. xxxxxx242 and xxxxxx907.