United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.L., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Washington, DC, Employer

__________________________________________

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Docket No. 20-1010

Issued: April 8, 2022

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On April 6, 2020 appellant filed a timely appeal from an October 11, 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 to 

consider the merits of this case.

ISSUE

The issue is whether OWCP has met its burden of proof to terminate appellant’s wage-loss 

compensation and medical benefits, effective October 13, 2019, as she no longer had residuals or 

disability causally related to her accepted employment condition.

FACTUAL HISTORY

On February 7, 2001 appellant, then a 48-year-old city carrier, filed an occupational disease 

claim (Form CA-2) alleging that she sustained wrist and hand injuries due to factors of her federal 

1

5 U.S.C. § 8101 et seq.
2

employment, including casing mail and placing it in mailboxes/slots. She noted that she first 

became aware of her conditions on January 10, 2001 and realized their relationship to her federal 

employment on January 29, 2001. OWCP accepted the claim for bilateral carpal tunnel syndrome. 

Appellant underwent carpal tunnel release on March 20, 2001. OWCP paid her wage-loss 

compensation on the periodic rolls as of June 16, 2002.

In a letter to appellant dated August 14, 2017, OWCP informed her that periodic medical 

reports were required for all cases for which compensation is paid. It requested that she have her 

physician respond to a series of questions and provide a detailed report to OWCP within 30 days 

of the date of the letter. OWCP sent the same letter to appellant on August 6, 2018. It subsequently 

received a September 14, 2017 medical report by Dr. Jacob Cherian, an attending internist, who 

noted that appellant presented for her annual workers’ compensation evaluation. Dr. Cherian 

reported examination findings and listed current chronic diagnoses of benign essential 

hypertension, pure hypercholesterolemia, reflex sympathetic dystrophy (RSD) of the upper limb, 

disturbance of skin sensation, joint pain, chronic pain syndrome, esophageal reflux, fibromyalgia, 

bilateral carpal tunnel syndrome, and adhesive capsulitis of the shoulder. He provided an 

assessment that appellant had chronic pain syndrome due to her work-related injury.

In a letter dated August 21, 2018, OWCP informed appellant that there was no current 

medical evidence in the case file to establish her entitlement to continuing compensation benefits. 

It requested that she submit a current detailed medical report from an attending physician

addressing her employment-related residuals and disability. OWCP also requested that the 

physician complete an accompanying work capacity evaluation (Form OWCP-5c), indicating 

whether appellant was able to return to work. Appellant was afforded 30 days to submit the 

requested information.

On January 31, 2019 OWCP referred appellant, together with a statement of accepted facts 

(SOAF), the medical record, and a series of questions, to Dr. Rafael A. Lopez Steuart, a Boardcertified orthopedic surgeon, for a second opinion to determine whether she continued to suffer 

from residuals and/or disability causally related to her accepted work-related injury.

Dr. Steuart, in a February 27, 2019 letter, noted his review of the SOAF and appellant’s 

medical records. He also noted her current complaint of intermittent numbness in her thumb, 

fingers, hands, and elbow. On physical examination Dr. Steuart reported full motion of both wrists 

in pronation, supination, flexion, and extension. He also found normal symmetric sensation of 

both hands and fingers, a bilaterally negative Phalen’s test, and all tendons and ligaments intact.

Dr. Steuart advised that there were no objective findings on physical examination and there were 

no diagnostic tests available for his review. He recounted that appellant reported that she had 

undergone left carpal tunnel release without improvement of her symptomatology. Dr. Steuart 

found that the accepted work-related bilateral carpal tunnel syndrome condition had resolved based 

on the objective evidence, although appellantremained symptomatic. He concluded that there was 

no need for further medical treatment. Dr. Steuart opined that appellant was capable of returning 

to her date-of-injury city carrier job. In an accompanying Form OWCP-5c, he found that she could 

perform her usual job with no restrictions.

By notice dated April 4, 2019, OWCP advised appellant that it proposed to terminate her 

wage-loss compensation and medical benefits based on Dr. Steuart’s opinion that the accepted 
3

employment-related condition had ceased without residuals or disability. It afforded her 30 days 

to submit additional evidence or argument challenging the proposed termination.

OWCP subsequently received additional medical evidence from Dr. Cherian. In a

September 20, 2018 report, Dr. Cherian noted that appellant presented for her annual workers’

compensation evaluation. He noted her continuing complaints of chronic pain in her back, 

shoulders, and arms. Dr. Cherian discussed examination findings and reiterated his prior chronic 

diagnoses of benign essential hypertension, pure hypercholesterolemia, RSD of the upper limb, 

disturbance of skin sensation, joint pain, chronic pain syndrome, esophageal reflux, fibromyalgia, 

bilateral carpal tunnel syndrome, and adhesive capsulitis of the shoulder. He provided an 

assessment that appellant still had chronic pain and was unable to perform strenuous or repetitive 

work.

In an undated attending physician’s report (Form CA-20), Dr. Cherian noted a history of

the October 10, 2001 employment injury after which appellant experienced chronic pain in her 

back, shoulders, and arm. He reiterated his prior diagnoses of bilateral carpal tunnel syndrome 

and RSD. Dr. Cherian checked a box marked “Yes” indicating that the diagnosed conditions were 

caused or aggravated by the described employment activity. He opined that appellant was totally 

disabled from 2002 to the present.

By decision dated October 11, 2019, OWCP terminated appellant’s wage-loss and medical 

compensation benefits, effective October 13, 2019, finding that the medical evidence submitted 

was insufficient to outweigh Dr. Steuart’s opinion.

LEGAL PRECEDENT

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

termination or modification of an employee’s benefits.2 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.3 Its burden of proof includes the necessity of furnishing rationalized medical 

opinion evidence based on a proper factual and medical background.4

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

entitlement for disability compensation.5 To terminate authorization for medical treatment, OWCP 

2

See R.P., Docket No. 17-1133 (issued January 18, 2018); S.F., 59 ECAB 642 (2008);Kelly Y. Simpson, 57 ECAB 

197 (2005); Paul L. Stewart, 54 ECAB 824 (2003).

3

See R.P., id.; Jason C. Armstrong, 40 ECAB 907 (1989); Charles E. Minnis, 40 ECAB 708 (1989); VivienL. 

Minor, 37 ECAB 541 (1986).

4 K.W., Docket No. 19-1224 (issued November 15, 2019); see M.C., Docket No. 18-1374 (issued April23, 2019); 

Del K. Rykert, 40 ECAB 284, 295-96(1988).

5 A.G., Docket No. 19-0220 (issued August1, 2019); A.P.,Docket No. 08-1822 (issued August 5, 2009); T.P., 58 

ECAB 524 (2007); KathrynE. Demarsh, 56 ECAB 677 (2005); Furman G. Peake, 41 ECAB 361, 364 (1990).
4

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

require further medical treatment.6

ANALYSIS

The Board finds that OWCP failed to meet its burden of proof to terminate appellant’s 

wage-loss compensation and medical benefits, effective October 13, 2019, as she no longer had 

residuals or disability causally related to her accepted employment condition.

OWCP terminated appellant’s wage-loss compensation and medical benefits based on the 

February 27, 2019 report of Dr. Steuart, the second opinion physician. The Board finds, however, 

that OWCP improperly accorded the weight of medical evidence to his second opinion report. 

Dr. Steuart noted his review of the SOAF, indicating his understanding that appellant’s 

claim was accepted for bilateral carpal tunnel syndrome. He related her account of experiencing 

no improvement of her symptomatology following her 2001 left carpal tunnel release. Dr. Steuart 

indicated that appellant’s physical examination revealed no objective findings of the bilateral 

carpal tunnel syndrome resulting from her employment. He noted, however, that there were no 

diagnostic tests available for his review. Dr. Steuart opined that the accepted work-related

condition had resolved, that appellant could return to her date-of-injury city carrier position with 

no restrictions, and that there was no need for further medical treatment.

The Board finds, however, that Dr. Steuart’s opinion was conclusory in nature and did not 

contain sufficient medical reasoning to establish that appellant no longer had residuals or disability 

due to her accepted employment injury.7 In assessing medical evidence, the number of physicians 

supporting one position or another is not controlling, the weight of such evidence is determined 

by its reliability, its probative value, and its convincing quality. 8 The factors that determine the 

probative medical evidence include the opportunity for and thoroughness of examination 

performed by the physician, the accuracy or completeness of the physician’s knowledge of the 

facts and medical history, the care of analysis manifested, and the medical rationale expressed by 

the physician on the issue addressed to him by OWCP.9 Once OWCP undertook development of 

the record, it was required to complete development of the record by procuring medical evidence 

that would resolve the relevant issue in the case.10

6 K.W., supra note 4; see A.G., id.; James F. Weikel, 54 ECAB 660 (2003); Pamela K. Guesford, 53 ECAB 

727 (2002); FurmanG. Peake, id.

 

7 C.B., Docket No. 20-0629 (issued May 26, 2021); A.G., Docket No. 20-0187 (issued December 31, 2020); see 

J.W., 19-1014 (issued October 24, 2019); S.W., Docket No. 18-0005 (issued May 24, 2018).

 

8 D.W., Docket No. 18-0123 (issued October 4, 2018);Nicolette R. Kelstrom, 54 ECAB 570 (2003).

 

9 A.G., supra note 5; James T. Johnson, 39 ECAB 1252 (1988).

 

10 See J.F., Docket No. 17-1716 (issued March 1, 2018).
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The Board finds that Dr. Steuart’s report lacks sufficient medical reasoning to establish 

that appellant’s accepted bilateral carpal tunnel syndrome had resolved without residuals. While

Dr. Steuart opined that her accepted condition had resolved and that she could return to her dateof-injury position with no restrictions based on the objective evidence, he noted that there were no 

diagnostic studies available for his review. Moreover, he failed to explain why appellant no longer 

had employment-related residuals although she remained symptomatic. Rationalized medical 

evidence must include rationale explaining how the physician reached the conclusion he or she is 

supporting.11 Accordingly, the Board finds that Dr. Steuart did not provide an opinion with 

sufficient medical reasoning to establish that appellant no longer had residuals or disability due to 

her accepted employment injury.12 Dr. Steuart’s second opinion report is therefore of diminished 

probative value.

The Board thus finds that OWCP failed to meet its burden of proof. 

CONCLUSION

The Board finds that OWCP failed to meet its burden of proof to terminate appellant’s 

wage-loss compensation and medical benefits, effective October 13, 2019.

ORDER

IT IS HEREBY ORDERED THAT the October 11, 2019 decision of the Office of 

Workers’ Compensation Programs is reversed.

Issued: April 8, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

 

11 B.B., Docket No. 19-1102 (issued November 7, 2019); Beverly A. Spencer, 55 ECAB 501 (2004).

 

12 Supra note 7.