United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

V.R., Appellant

and

DEPARTMENT OF HOMELAND SECURITY, 

IMMIGRATION & CUSTOMS 

ENFORCEMENT, Laguna Niguel, CA, Employer

__________________________________________

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Docket No. 19-1754

Issued: March 2, 2021

Appearances: Case Submitted on the Record

Toby Rubenstein, 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 August 19, 2019 appellant, through his representative, filed a timely appeal from a 

March 18, 2019 merit decision of the Office of Workers’ Compensation Programs (OWCP).2 

 

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 The Board notes that following the March 18, 2019 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

Pursuant to the Federal Employees’ Compensation Act3(FECA) and 20 C.F.R. §§ 501.2(c) and 

501.3, the Board has jurisdiction over the merits of this case. 

ISSUES

The issues are: (1) whether OWCP properly terminated appellant’s wage-loss 

compensation and medical benefits effective January 30, 2018 as he no longer had residuals or 

disability causally related to his March 18, 2010 employment injury; (2) whether appellant has met 

his burden of proof to establish continuing employment-related disability or residuals on or after 

March 18, 2010 due to his accepted employment injury; and (3) whether appellant has met his 

burden of proof to establish that the acceptance of his claim should be expanded to include prostate 

cancer as a consequence of his March 18, 2020 employment injury. 

FACTUAL HISTORY

On March 19, 2010 appellant, then a 47-year-old special agent/criminal investigator, filed 

a traumatic injury claim (Form CA-1) alleging that on March 18, 2010 he sustained injuries while 

in the performance of duty after his vehicle was struck from behind by another vehicle. OWCP 

accepted the claim, assigned OWCP File No. xxxxxx295, for cervical and lumbar strains. It 

subsequently expanded acceptance of appellant’s claim to include a depressive disorder not 

otherwise specified secondary to his physical injury. OWCP additionally indicated that it had 

accepted an anxiety disorder. It paid appellant wage-loss compensation for total disability on the 

supplemental rolls beginning July 14, 2011 and on the periodic rolls effective February 12, 2012.4

In a report dated March 27, 2013, Dr. Frederick G. Nicola, a Board-certified orthopedic 

surgeon and OWCP referral physician, discussed appellant’s history of employment injuries 

beginning in September 2004. He diagnosed cervical and lumbar degenerative disc disease with 

no evidence of radiculopathy. Dr. Nicola opined that appellant had sustained cervical and lumbar 

sprain superimposed on preexisting degenerative disc disease of the cervical and lumbar spine that 

had resolved. In a May 17, 2013 addendum, he opined that appellant could perform light-duty

employment. On September 30, 2013 Dr. Nicola attributed his work restrictions to his cervical 

degenerative disc disease, noting that the injuries from his March 18, 2010 MVA had resolved no 

later than October 20, 2010, when he was released to his regular employment. 

In a state workers’ compensation form report dated October 13, 2015, Dr. John B. Dorsey, 

a Board-certified orthopedic surgeon, diagnosed lumbar strain, strain of the muscle, fascia, and 

tendon, and an adjustment disorder with depressed mood. He found that appellant should remain 

off work and noted that he had retired from employment.

 

3 5 U.S.C. § 8101 et seq.

4 OWCP previously accepted that appellant sustained strains of the lumbar spine, cervical spine, and left shoulder 

due to a September 24, 2004 employment-related motor vehicle accident (MVA), assigned OWCP File No. 

xxxxxx875. It additionally accepted that he sustained lumbar sprain, thoracic sprain, right ankle sprain, and thoracic 

or lumbosacral neuritis or radiculitis due to an August 28, 2006 injury, assigned OWCP File No. xxxxxx931, and 

lumbar and cervical strain due to a June 23, 2008 employment-related MVA, assigned OWCP File No. xxxxxx529. 

OWCP administratively combined the cases with the current claim as the master file. 
3

On November 13, 2015 OWCP referred appellant to Dr. Jacob Rabinovich, a Boardcertified orthopedic surgeon, for a second opinion examination. In another letter of the same date, 

it referred him to Dr. Gregory M. Nicholson, a Board-certified psychiatrist, for a second opinion 

examination.

In a report dated December 7, 2015, Dr. Rabinovich provided his review of appellant’s 

history of work injuries and the evidence of record. He diagnosed improved cervical and lumbar 

sprain causally related to the accepted employment injury and mild cervical and lumbar 

degenerative disc disease unrelated to the March 18, 2010 work injury. Dr. Rabinovich noted that 

appellant’s MVA on March 18, 2010 had occurred in a parking lot with minor vehicle damage. 

He found that appellant had no residuals of his employment injury, noting that his physical 

examination was within normal limits and as objective studies showed no traumatic changes. 

Dr. Rabinovich opined that he required no further medical treatment for his lumbar and cervical 

sprain.

In a December 16, 2015 report, Dr. Nicholson diagnosed an unspecified depressive 

disorder and unspecified anxiety disorder causally related to appellant’s employment injuries. He 

found that appellant required continued treatment, but that it was reasonable for him to attempt to 

resume work. In a December 24, 2015 work capacity evaluation-psychiatric/psychological 

conditions (Form OWCP-5a), Dr. Nicholson found that he could work in a suitable environment 

with minimal stress and no racial discrimination. 

In a January 27, 2016 state workers’ compensation form report, Dr. John Dorsey diagnosed 

lumbar sprain, a strain of the muscle, fascia, and tendon, and an adjustment disorder with depressed 

mood. He indicated that appellant could not work until February 27, 2016. In a February 17, 2016 

form report, Dr. John Dorsey found that he was disabled until March 17, 2017. 

In a February 18, 2016 report, Dr. E. Richard Dorsey, a Board-certified psychiatrist,

advised that Dr. Nicholson had agreed that appellant had depressive disorder and anxiety disorder 

due to his employment and required continued treatment. He related that appellant’s symptoms 

would worsen causing disability if he resumed his regular employment.

Dr. John Dorsey, in a February 26, 2016 report, concurred with Dr. Nicola’s finding that 

appellant had sustained cervical and lumbar sprains superimposed on preexisting degenerative disc 

disease. He disagreed with Dr. Rabinovich’s opinion that appellant had not sustained an 

aggravation of preexisting cervical and lumbar degenerative disc disease due to his employment 

injury. Dr. John Dorsey asserted that appellant had continuing residuals of his neck and low back 

pain and required periodic medication and therapy.

OWCP determined that a conflict in opinion existed between Dr. John Dorsey and

Dr. Rabinovich regarding whether appellant had continued residuals or disability due to his 

accepted cervical and lumbar strains. It referred him to Dr. Nicholas C. Yaru, a Board-certified 

orthopedic surgeon, for an impartial medical examination. In the accompanying statement of 

accepted facts (SOAF), OWCP provided a history of appellant’s employment injuries and listed 

the accepted conditions resulting from the March 18, 2010 employment injury as lumbar and 

cervical strain, and anxiety disorder. It further provided a history of the subsidiary claims.
4

In a report dated January 11, 2017, Dr. Yaru discussed appellant’s history of a March 18, 

2010 employment-related MVA and reviewed the evidence of record. On examination he found 

decreased range of motion of the cervical and lumbar thigh and right thigh atrophy. Dr. Yaru 

related, “I believe that [appellant] sustained an exacerbation of preexisting lumbar and cervical 

degenerative disc disease, which is related to the cumulative effects of his injuries prior to 

March 2010. Those as previously stated, were in 2004, 2006, and 2008.” He advised, “In 

reviewing his psychological profile it is clear that [appellant] does suffer from insomnia, anxiety, 

and depression. These symptoms can be exacerbated by chronic pain as well.” Dr. Yaru diagnosed 

lumbar and cervical degenerative disc disease. He opined that appellant’s March 2010 

employment injury had temporarily aggravated preexisting disease but that he had no residuals of 

his March 18, 2010 employment injury. Dr. Yaru asserted that he might experience future 

exacerbation of pain in the neck and back unrelated to the March 18, 2010 employment injury but 

instead due to “chronic and preexisting degenerative cervical spine and lumbar spine degenerative 

disc disease.”

On March 15, 2017 OWCP requested that Dr. Yaru clarify whether appellant had 

recovered from his March 18, 2010 employment injury, whether his degenerative back and 

cervical condition were related to cumulative injuries from 2004, 2006, and 2008, and whether he 

had continued disability. 

In a supplemental report dated April 12, 2017, Dr. Yaru related:

“It is my opinion that [appellant] has recovered from his 2010 injury. I agree with

Dr. Rabinovich that the current condition and/or residuals are related to cumulative 

back and cervical injuries of 2004, 2006, and 2008. It is my opinion that [appellant] 

had an exacerbation of his degenerative disc disease of his cervical spine and 

lumbar spine. It is also my opinion that he is fully recovered from this exacerbation 

and there is no increased disability as a result of this exacerbated preexisting 

disease.”

On March 27, 2017 OWCP referred appellant to Dr. Ashraf Elmashat, a Board-certified 

psychiatrist, for a second opinion examination.

In a report dated April 29, 2017, Dr. Elmashat provided his review of the SOAF and 

discussed appellant’s history of injuries in 2004, 2006, 2008 and 2010. He diagnosed an 

adjustment disorder with mixed anxiety and depressed mood. Dr. Elmashat attributed appellant’s 

history of an adjustment disorder to “his physical condition and harassment at work.” He found 

that he would benefit from continued psychiatric care. Dr. Elmashat noted that the impartial 

medical examiner (IME) had found that appellant’s cervical and lumbar degenerative disc disease 

had been exacerbated from employment injuries in 2004, 2006, and 2008 and that he had reached 

his pre-2010 injury status. He advised that from a psychiatric view, he could “resume his usual 

duties in a non-discriminatory environment.” In a Form OWCP-5a dated May 7, 2019,

Dr. Elmashat opined that appellant could perform his regular employment in a safe environment 

without discrimination.

On May 11, 2017 Dr. John Dorsey agreed with Dr. Yaru’s finding that appellant had 

sustained an aggravation of preexisting degenerative disc disease, but opined that the aggravation 
5

was permanent. He found that appellant could perform light work lifting up to 20 pounds 

occasionally and 10 pounds frequently.

In an August 9, 2017 letter, OWCP informed Dr. Elmashat that the IME had found that 

appellant had no employment-related residuals of his back condition. It requested that he explain 

whether appellant had continued residuals or the need for treatment due to his accepted back injury. 

OWCP indicated that it had not accepted harassment as a compensable factor of employment.

In a supplemental report dated August 19, 2017, Dr. Elmashat noted that the IME had 

determined that appellant’s employment-related back pain had resolved. He related, “Therefore, 

[appellant] is no longer suffering continued residuals of his adjustment disorder related to the 

factors of employment and has been considered resolved. He is able to return back to his usual 

work from a psychiatric point of view.”

In a state workers’ compensation form report dated August 30, 2017, Dr. John Dorsey 

diagnosed lumbar sprain, sprain of the muscle, fascia, and tendon of the neck, and a single episode 

of major depressive disorder.5 In a September 27, 2017 report, he also diagnosed an unspecified 

anxiety disorder.6

On November 21, 2017 OWCP advised appellant of its proposed termination of his wageloss compensation and medical benefits as the weight of the evidence established that he no longer 

had any employment-related residuals or disability due to his accepted employment injury. It

afforded him 30 day to submit additional evidence or argument if he disagreed with the proposed 

termination.

On December 1, 2017 Dr. E. Dorsey noted that OWCP proposed to terminate appellant’s 

wage-loss compensation based on Dr. Yaru’s evaluation. He indicated that Dr. Elmashat’s opinion 

was only valid if Dr. Yaru’s conclusions were accurate. Dr. E. Dorsey diagnosed depressive 

disorder, not otherwise specified, with anxiety and rated appellant’s global assessment of function 

(GAF) score as 65 showing mild-to-moderate impairment.

In a report dated December 6, 2017, Dr. John Dorsey advised that he had treated appellant 

since March 24, 2010. He noted his history of work injuries in 2004, 2006, 2008, and 2010. 

Dr. John Dorsey found that he had sustained a permanent aggravation of his preexisting disc 

herniation. He diagnosed lumbar sprain/strain with radiculopathy, a herniated nucleus pulposus, 

cervical sprain/strain, and cervical disc disorder with radiculopathy. Dr. John Dorsey found that 

appellant could perform semi-sedentary work and attributed his disability to his March 18, 2010 

employment injury.

On December 15, 2017 appellant’s then-counsel asserted that OWCP should expand 

acceptance of the claim to include cervical disc disorder with radiculopathy based on Dr. John 

Dorsey’s opinion. 

 

5 On September 22, 2017 Dr. Stephen H. Barkow, a Board-certified anesthesiologist, provided pain management.

6 Dr. John Dorsey continued to provide progress reports describing his treatment of appellant.
6

By decision dated January 30, 2018, OWCP terminated appellant’s wage-loss 

compensation and medical benefits, effective that date. It found that the opinion of Dr. Yaru

represented the special weight of the evidence and established that appellant had no further 

residuals or disability due to his accepted employment-related orthopedic condition. OWCP found 

that appellant had no residuals of his adjustment disorder with depressed mood based on the 

opinion of Dr. Elmashat. It noted that appellant could file an occupational disease claim if he 

believed that he had sustained a stress-related condition due to employment factors unrelated to 

his physical injury.

An electromyogram and nerve conduction velocity (EMG/NCV) study performed on 

February 9, 2018 yielded normal findings. 

On July 17, 2018 Dr. Susan Himelstein, a psychologist, performed psychological testing 

and diagnosed late-onset moderate-to-severe persistent depressive disorder. She noted that 

appellant’s history was positive for multiple traumatic work injuries and racial discrimination 

complaints.

In a report dated October 18, 2018, Dr. Sara A. Epstein, a Board-certified psychiatrist, 

provided her review of appellant’s employment injuries, his Equal Employment Opportunity 

(EEO) claims, and the medical evidence of record pertaining to his psychological condition. She 

diagnosed major depression, generalized anxiety disorder, and chronic stress disorder and 

explained the findings supporting the diagnoses. Dr. Epstein opined that appellant did not meet 

the criteria for an adjustment disorder. She found that his psychiatric diagnoses were “largely 

caused by work injuries” and pain causing reduced function. 

On August 30, 2018 Dr. Franklin Caldera, an osteopath, indicated that he had reviewed the 

medical evidence, including appellant’s history of four employment injuries, and the SOAF. He 

provided examination findings and diagnosed an aggravation of cervical degenerative disc disease, 

cervical and lumbar strain/sprain, and cervical and lumbar radiculitis. Dr. Caldera explained how 

the diagnosed conditions resulted from the March 18, 2010 employment injury. He opined that 

appellant had sustained an aggravation of preexisting cervical and lumbar disc disease due to the 

accepted employment injury. In a work capacity evaluation-musculoskeletal conditions form

(OWCP-5c) dated August 27, 2018, Dr. Caldera provided work restrictions. 

An October 26, 2018 biopsy report indicated that appellant had adenocarcinoma of the 

prostate.

In a November 9, 2018 addendum, Dr. Caldera provided the same diagnoses. He noted 

that appellant had prostate cancer.

In a supplemental report dated November 12, 2018, Dr. Epstein opined that there was 

“evidence to suggest that [appellant’s] work injury contributed to precipitating prostate cancer.” 

She asserted that his prostate cancer was “directly influenced by his work injury, a surfeit of stress 

and depression.” Dr. Epstein referenced medical literature supporting that stress increased the 

incidence of prostate cancer.

On December 19, 2018 appellant’s representative requested reconsideration. She 

maintained that OWCP had not considered that the cumulative effect of appellant’s four injuries 
7

on his underlying degenerative disc disease. The representative also noted that OWCP, in its 

September 17, 2013 decision, indicated that it had accepted depressive disorder, not otherwise 

specified. She asserted that OWCP should expand acceptance of the claim to include cervical and 

lumbar radiculitis and an aggravation of cervical and lumbar degenerative disc disease. The 

representative summarized the newly submitted medical evidence. She asserted that the SOAF 

had failed to set forth the physical requirements of his position and noted that a functional capacity 

evaluation showed that he could not sit more than 25 minutes before experiencing pain. The 

representative further summarized the decisions by the Equal Employment Opportunity 

Commission (EEOC) supporting that appellant had experienced radical discrimination at work. 

She submitted a transcript from a vocational expert from a November 2018 Social Security 

Administration (SSA) hearing and a July 31, 2017 vocational evaluation report. 

By decision dated March 18, 2019, OWCP denied modification of its January 30, 2018 

termination decision. It additionally found that appellant had not established prostate cancer as a 

compensable consequential injury.

LEGAL PRECEDENT -- ISSUE 1

Once OWCP accepts a claim and pays compensation, it has the burden of justifying 

modification or termination of an employee’s benefits.7 After it has determined that an employee 

has disability causally related to his or her federal employment, OWCP may not terminate 

compensation without establishing that the disability has ceased or that it is no longer related to 

the employment.8 Its burden of proof includes the necessity of furnishing rationalized medical 

opinion evidence based on a proper factual and medical background.9

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

entitlement for disability.10 To terminate authorization for medical treatment, OWCP must 

establish that appellant no longer has residuals of an employment-related condition, which would 

require further medical treatment.11

Section 8123(a) provides that, if there is disagreement between the physician making the 

examination for the United States and the physician of the employee, the Secretary shall appoint a 

third physician who shall make an examination.12 When there are opposing reports of virtually 

 

7 R.H., Docket No. 19-1064 (issued October 9, 2020); M.M., Docket No. 17-1264 (issued December 3, 2018).

8 A.T., Docket No. 20-0334 (issued October 8, 2020); E.B., Docket No. 18-1060 (issued November 1, 2018).

9 C.R., Docket No. 19-1132 (issued October 1, 2020); G.H., Docket No. 18-0414 (issued November 14, 2018).

10 L.W., Docket No. 18-1372 (issued February 27, 2019).

11 R.P., Docket No. 18-0900 (issued February 5, 2019).

12 5 U.S.C. § 8123(a); L.T., Docket No. 18-0797 (issued March 14, 2019); Shirley L. Steib, 46 ECAB 309, 

317 (1994).
8

equal weight and rationale, the case must be referred to an IME, pursuant to section 8123(a) of 

FECA, to resolve the conflict in the medical evidence.13

ANALYSIS -- ISSUE 1

The Board finds that OWCP improperly terminated appellant’s wage-loss compensation 

and medical benefits, effective January 30, 2018.

OWCP accepted that appellant sustained cervical and lumbar strains due to his March 18, 

2010 employment injury under OWCP File No. xxxxxx295. It further indicated that it had 

accepted a depressive disorder and an anxiety disorder as a result of his physical injuries. 

Additionally, OWCP accepted that appellant sustained lumbar, cervical, and left shoulder strain 

due to a September 24, 2004 MVA under OWCP File No. xxxxxx875, lumbar sprain, thoracic 

sprain, right ankle sprain, and thoracic or lumbosacral neuritis or radiculitis due to an August 28, 

2006 injury under OWCP File No. xxxxxx931, and lumbar and cervical strain due to a June 23, 

2008 MVA under OWCP File No. xxxxxx529. OWCP administratively combined the files into 

OWCP File No. xxxxxx295. It paid appellant wage-loss compensation for total disability on the 

periodic rolls effective February 12, 2012.

Regarding whether appellant had residuals of his accepted orthopedic conditions, OWCP 

properly determined that a conflict existed between appellant’s physician, Dr. John Dorsey, and

Dr. Rabinovich, a second opinion physician, regarding whether appellant had continued residuals 

due to his accepted cervical and lumbar strains. It referred him to Dr. Yaru for an impartial medical 

examination in order to resolve the conflict, pursuant to 5 U.S.C. § 8123(a). OWCP provided

Dr. Yaru with a SOAF containing a history of all of appellant’s accepted conditions.

Where a case is referred to an IME for the purpose of resolving a conflict, the opinion of 

such specialist, if sufficiently well rationalized and based on a proper factual and medical 

background, must be given special weight.14

The Board finds that Dr. Yaru’s opinion fails to support that appellant no longer had 

residuals or disability due to an employment-related orthopedic condition. In a report dated 

January 11, 2017, Dr. Yaru discussed his history of employment injuries in 2004, 2006, 2008, and 

March 2010. He opined that appellant had experienced an exacerbation of preexisting lumbar and 

cervical disc disease as a result of the employment injuries that had occurred prior to 2010. 

Dr. Yaru diagnosed lumbar and cervical degenerative disc disease and found that the March 2010 

employment injury had temporarily aggravated his preexisting condition. He asserted that 

appellant had no residuals of his March 2010 employment injury but might experience future 

aggravations due to his preexisting degenerative disc disease of the cervical and lumbar spine. In 

an April 12, 2017 supplemental report, Dr. Yaru found that appellant’s current residuals were 

related to the cumulative effect of injuries in 2004, 2006, and 2008 and that the 2010 injury had 

caused an exacerbation of cervical and lumbar degenerative disc disease from which he had 

recovered without increased disability. He did not address whether appellant had continued 

 

13 D.B., Docket No. 19-0663 (issued August 27, 2020).

14 R.O., Docket No. 19-0885 (issued November 4, 2019); Roger Dingess, 47 ECAB 123 (1995).
9

disability due to his preexisting cervical and lumbar degenerative disc disease, which he found 

related to prior employment injuries. As Dr. Yaru determined that appellant had continued 

residuals of his prior employment injuries, which were combined into this claim, his opinion is 

insufficient to support that appellant has no further employment-related disability.15 The Board 

thus finds that OWCP erred in relying on the opinion of Dr. Yaru to terminate appellant’s wageloss compensation and medical benefits for his accepted employment-related orthopedic 

conditions.

Regarding appellant’s psychological condition, Dr. Elmashat based his opinion that 

appellant had no further employment-related psychological condition on the finding by the IME 

that he had no residuals of his accepted orthopedic condition. As discussed, however, Dr. Yaru’s 

opinion is insufficient to establish that appellant has no residuals of his orthopedic conditions; 

consequently, Dr. Elmashat’s opinion is insufficient to show that he has no further psychological 

condition due to his accepted work injury.16 

As OWCP has not established that appellant no longer has continuing residuals or disability 

due to either his employment-related orthopedic or psychiatric conditions, it has failed to meet its 

burden of proof to terminate appellant’s wage-loss compensation and medical benefits.17

LEGAL PRECEDENT -- ISSUE 3

Causal relationship is a medical issue and the medical evidence required to establish causal 

relationship is rationalized medical evidence.18 Neither the mere fact that a disease or condition 

manifests itself during a period of employment, nor the belief that the disease or condition was 

caused or aggravated by employment factors or incidents is sufficient to establish causal 

relationship.19

In discussing the range of compensable consequences, once the primary injury is causally 

connected with the employment, the question is whether compensability should be extended to a 

subsequent injury or aggravation related in some way to the primary injury. The rules that come 

into play are essentially based upon the concepts of direct and natural results and of the claimant’s 

own conduct as an independent intervening cause. The basic rule is that a subsequent injury, 

 

15 See D.F., Docket No. 19-1257 (issued July 14, 2020).

16 Additionally, the Board notes that the SOAF provided to Dr. Elmashat provided that OWCP had accepted an 

adjustment disorder with depressed mood. Prior OWCP decisions indicated that it had also accepted an anxiety 

disorder and depressive disorder.

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

18 G.R., Docket No. 18-0735 (issued November 15, 2018).

19 Id.
10

whether an aggravation of the original injury or a new and distinct injury, is compensable if it is 

the direct and natural result of a compensable primary injury.20

ANALYSIS -- ISSUE 3

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

acceptance of his claim should be expanded to include prostate cancer as a consequence of his 

March 18, 2020 employment injury.

On November 12, 2018 Dr. Epstein advised that evidence suggested that appellant’s 

employment injury contributed to his prostate cancer. She found that stress and depression from 

his injury “directly influenced” his prostate cancer. Dr. Epstein, however, failed to provide any 

rationale for her opinion. A medical report is of limited probative value when the opinion on 

causal relationship lacks medical rationale.21 While Dr. Epstein referenced medical literature 

supporting that stress increased the occurrence of prostate cancer, the Board has held that medical 

texts and excerpts from publications are of no evidentiary value in establishing causal relationship 

as such materials are of general application and are not determinative of whether the specific 

condition claimed is related to the particular employment factors alleged by the employee.22 

The Board finds that the medical evidence is insufficient to establish that appellant 

sustained prostate cancer as a consequential injury. Appellant therefore has not met his burden of 

proof.23

Regarding the issue of a consequential injury, 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 OWCP improperly terminated appellant’s wage-loss compensation 

and medical benefits effective January 30, 2018. The Board further finds that appellant has not 

met his burden of proof to establish that the acceptance of his claim should be expanded to include 

prostate cancer as a consequence of his March 18, 2010 employment injury. 

 

20 K.S., Docket No. 17-1583 (issued May 10, 2018); Arthur Larson & Lex K. Larson, The Law of Workers’ 

Compensation § 3.05 (2014).

21 See C.R., Docket No. 18-1285 (issued February 12, 2019); Debra L. Dillworth, 57 ECAB 516 (2006).

22 L.C., Docket No. 17-1811 (issued March 23, 2018); J.F., Docket No. 17-0458 (issued October 2, 2017).

23 See R.V., Docket No. 18-0552 (issued November 5, 2018).
11

ORDER

IT IS HEREBY ORDERED THAT the March 18, 2019 decision of the Office of 

Workers’ Compensation Programs is reversed in part and affirmed in part.

Issued: March 2, 2021

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