United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.B., Appellant

and

DEPARTMENT OF THE NAVY, NAVAL 

MEDICAL COMMAND, OAK KNOLL NAVAL 

HOSPITAL, Oakland, CA, Employer

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Docket No. 22-1351

Issued: May 5, 2023

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

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On September 19, 2022 appellant filed a timely appeal from a July 13, 2022 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.

ISSUE

The issue is whether OWCP properly suspended appellant’s wage-loss compensation and 

medical benefits pursuant to 5 U.S.C. § 8123(d), effective July 13, 2022, due to herfailure to attend 

a scheduled medical examination. 

1

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On September 21, 1990 appellant, then a 51-year-old nurse, filed a traumatic injury claim 

(Form CA-1) alleging that on September 8, 1990 she sustained a torn meniscus in her right knee 

when she stooped down to bathe a patient while in the performance of duty.2 OWCP accepted her 

claim for right knee meniscus tear and subsequently expanded acceptance of the claim to include 

aggravation of bilateral osteoarthritis of the knees. It paid appellant wage-loss compensation on 

the periodic rolls, effective February 1, 1998. 

In an April 14, 2022 letter, OWCP notified appellant that she was being referred for a 

second opinion examination on May 25, 2022 with Dr. Rafael Lopez, a Board-certified orthopedic 

surgeon, regarding her continuing disability and medical residuals due to the accepted 

September 8, 1990 employment injury. The letter informed appellant of her obligations to attend 

and cooperate with the examination and explained that her compensation benefits would be 

suspended for failure to report to, or for obstruction of, the examination, pursuant to 5 U.S.C. 

§ 8123(d). The letter also contained the date, time, and location of her appointment and was mailed 

to her last known address of record in the ordinary course of business. 

In an April 25, 2022 memorandum of telephone call (Form CA-110), OWCP noted that 

appellant indicated that she could not travel to Jacksonville, Florida for the second opinion 

evaluation. It advised her to contact QTC, the medical scheduler, to see if they could reschedule 

her appointment. Appellant noted that she did not want to reschedule the appointment, but she 

wanted an appointment that was closer to her.

On May 26, 2022 the medical scheduler advised OWCP that appellant did not attend the 

examination scheduled for May 25, 2022.

In a notice dated June 21, 2022, OWCP proposed to suspend appellant’s wage-loss 

compensation and medical benefits as she failed to attend the medical examination scheduled for 

May 25, 2022. It afforded her 14 days to respond in writing with an explanation as to why she did 

not attend the examination with Dr. Lopez. OWCP advised appellant that, if good cause was not 

established, her compensation benefits would be suspended pursuant to 5 U.S.C. § 8123(d) until 

she attended and fully cooperated with the examination. It instructed her to contact OWCP 

immediately if she intended to report to a rescheduled examination with Dr. Lopez. 

In a statement dated June 30, 2022, appellant explained that when she received the 

April 2022 letter regarding an appointment with Dr. Lopez, she was experiencing excruciating 

pain in her knees, lower back, and left hip, and had difficulty moving. She indicated that she called 

the number on the letter and spoke with someone who said that she would try to get appellant a 

closer appointment.

2 OWCP assigned the present claim OWCP File No. xxxxxx121. Appellant subsequently filed a Form CA-1 for a

July 27, 1994 employment injury. It assigned that claim OWCP File No. xxxxxx147 and accepted it for left knee 

meniscus tear. OWCP has administratively combined OWCP File Nos. xxxxxx147 and xxxxxx121, with the latter 

serving as the master file. 
3

By decision dated July 13, 2022, OWCP suspended appellant’s wage-loss compensation 

and medical benefits, effective that date, pursuant to 5 U.S.C. § 8123(d), due to her failure, without 

good cause, to attend the medical examination scheduled for May 25, 2022.

LEGAL PRECEDENT

Section 8123 of FECA authorizes OWCP to require an employee, who claims disability as 

a result of federal employment, to undergo a physical examination as it deems necessary. 3 The 

determination of the need for an examination, the type of examination, the choice of locale, and 

the choice of medical examiners are matters within the province and discretion of OWCP. 4 

OWCP’s regulations provide that a claimant must submit to an examination by a qualified 

physician as often and at such times and places as OWCP considers reasonably necessary.5 Section 

8123(d) of FECA and OWCP regulations provide that, if an employee refuses to submit to or 

obstructs a directed medical examination, his or her right to compensation is suspended until the 

refusal or obstruction ceases.6 OWCP’s procedures provide that, before OWCP may invoke these 

provisions, the employee is to be provided a period of 14 days within which to present in writing 

his or her reasons for the refusal or obstruction.7 If good cause for the refusal or obstruction is not 

established, entitlement to compensation is suspended in accordance with section 8123(d) of 

FECA.8

ANALYSIS

The Board finds that OWCP properly suspended appellant’s wage-loss compensation and 

medical benefits pursuant to 5 U.S.C. § 8123(d), effective July 13, 2022, due to her failure to attend 

a scheduled medical examination. 

In a letter dated April 14, 2022, OWCP notified appellant that she was being referred for a 

second opinion examination on May 25, 2022 with Dr. Lopez to determine the status of her 

employment-related injury. The letter sent to her last known address of record, informed her of 

her obligations to attend and cooperate with the examination, and explained that her compensation 

benefits would be suspended for failure to report to, or for obstruction of, the examination. The 

letter also contained the date, time, and location of appellant’s appointment. 

3

5 U.S.C. § 8123.

4

See Q.V., Docket No. 21-1188 (issued May 26, 2022); R.D., Docket No. 20-1551 (issued November 8, 2021); 

L.B., Docket No. 17-1891 (issued December 11, 2018); J.T., 59 ECAB 293 (2008).

5

20 C.F.R. § 10.320.

6

5 U.S.C. § 8123(d); see also id. at § 10.323; D.K., Docket No. 18-0217 (issued June 27, 2018).

7 Federal (FECA) Procedure Manual, Part 2 -- Claims, Developing and Evaluating Medical Evidence, Chapter 

2.810.13d (September 2010).

8

Id. at Chapter 2.810.13e.
4

Absent evidence to the contrary, a letter properly addressed and mailed in the ordinary 

course of business is presumed to have been received. This is known as the mailbox rule. 9 The 

April 14, 2022 letter was sent to appellant’s last known address of record and is presumed to have 

been received by her absent any notice of nondelivery. She has not submitted evidence to rebut 

this presumption. Appellant did not appear for the May 25, 2022 appointment.10

In its June 21, 2022 notice, OWCP provided appellant 14 days to submit a valid reason for 

her failure to attend the scheduled medical appointment on May 25, 2022. In a June 30, 2022 

response, appellant submitted a statement indicating that she did not attend the appointment 

because she was in excruciating pain, and explained that she contacted the medical scheduler about 

arranging an examination that was closer to her. While these documents were received within 14 

days of the proposed notification of suspension, they do not constitute good cause for refusing to 

attend the scheduled appointment.11 For this reason, the Board finds that she has not established 

good cause for failing to appear for the scheduled examination on May 25, 2022.

As appellant did not attend the second opinion examination as scheduled, and failed to 

provide good cause for failing to appear within 14 days of OWCP’s June 21, 2022 notice of 

proposed suspension, the Board finds that OWCP properly suspended her wage-loss compensation 

and medical benefits in accordance with 5 U.S.C. § 8123(d), effective July 13, 2022.12

CONCLUSION

The Board finds that OWCP properly suspended appellant’s wage-loss compensation and 

medical benefits pursuant to 5 U.S.C. § 8123(d), effective July 13, 2022, due to her failure to attend 

a scheduled medical examination.

9

See James A. Gray, 54 ECAB 277 (2002).

10 See Q.V., Docket No. 21-1188 (issued May 26, 2022).

11 See A.H., Docket No. 21-0688 (issued October 6, 2021); see also R.C., Docket No. 09-2328 (issued 

July 12, 2010).

12 See R.T., Docket No. 20-0933 (issued July 29, 2022); A.H., Docket No. 21-0688 (issued October 6, 2021); G.R., 

Docket No. 20-0915 (issued January 29, 2021).
5

ORDER

IT IS HEREBY ORDERED THAT the July 13, 2022 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: May 5, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board