United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

L.M., Appellant

and

DEPARTMENT OF THE TREASURY, 

INTERNAL REVENUE SERVICE, 

Richmond, VA, Employer

__________________________________________

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Docket No. 22-0342

Issued: August 25, 2023

Appearances: Case Submitted on the Record

Aaron Aumiller, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On January 6, 2022 appellant, through counsel, filed a timely appeal from a July 27, 2021 

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

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. 

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

5 U.S.C. § 8101 et seq.
2

ISSUES

The issues are: (1) whether OWCP met its burden of proof to terminate appellant’s wageloss compensation and medical benefits effective January 8, 2021 as she no longer had disability 

or residuals causally related to her accepted September 11, 1995 employment injury; and 

(2) whether appellant has met her burden of proof to establish continuing employment-related 

disability or residuals on or after January 8, 2021 due to her accepted September 11, 1995 

employment injury.

FACTUAL HISTORY

This case has previously been before the Board on a different issue. 3 The facts and 

circumstances as set forth in the Board’s prior decision are incorporated herein by reference. The 

relevant facts are as follows.

On September 11, 1995 appellant, then a 37-year-old tax examiner, filed a traumatic injury 

claim (Form CA-1) alleging that on that date she experienced a headache, blurred vision, and pain 

across her upper back, shoulder and neck area when she fell from a chair while in the performance 

of duty. She stopped work on September 11, 1995. OWCP accepted the claim for lumbosacral 

sprain, a contusion of the face, scalp, and neck except eyes, occipital scalp hematoma, herniated 

lumbar discs at L4-5 and L5-S1, and herniated cervical discs at C4-5, C5-6 and C6-7. It paid 

appellant wage-loss compensation for total disability on the periodic rolls beginning 

November 17, 1995. 

A November 28, 2016 magnetic resonance imaging (MRI) scan of the cervical spine 

showed disc degeneration with a disc herniation at C5-6 on the left impinging on the cervical cord 

with broad reversal of normal cervical lordosis, disc degeneration with diffuse disc herniations at 

C4-5 and on the left at C6-7, disc degeneration with a broad disc protrusion at C7-T1, upper 

thoracic disc degeneration, central disc protrusion at C3-4, and disc bulging at C2-3.

A January 28, 2020 lumbar MRI scan revealed a congenitally small spinal canal, disc 

bulging at L1-2, a disc herniation toward the left neural foramen at L2-3, disc degeneration with a 

broad disc herniation and left more than right neural foraminal narrowing at L3-4, disc 

degeneration with multifactorial segmental stenosis, degenerative offset, and right more than left 

neural foraminal narrowing at L4-5, and disc degeneration with a broad disc herniation, marginal 

osteophytosis and left significantly more than right neural foraminal narrowing at L5 -S1.

On March 5, 2020 OWCP referred appellant to Dr. Noubar A. Didizian, a Board-certified 

orthopedic surgeon, for a second opinion examination. It provided a statement of accepted facts 

(SOAF) that indicated that it had accepted the claim for lumbosacral sprain, a contusion of the 

face, scalp, and neck except eyes, and displacement of lumbar and cervical intervertebral discs 

without myelopathy.

In a progress report dated March 23, 2020, Dr. Lance Yarus, an osteopath, indicated that 

he was evaluating appellant for a workers’ compensation injury. He noted that she was not 

3 Docket No. 97-962 (issued November 3, 1998). 
3

working, that she had not resumed work after the injury, and was unable to work due to pain. 

Dr. Yarus diagnosed cervicalgia, lumbar radiculopathy, and lumbar facet syndrome.

On May 19, 2020 Dr. Didizian reviewed appellant’s history of injury and current 

complaints of neck and left leg pain. On examination he observed no spasm of the paraspinal, full 

motor strength of the upper and lower extremities, and a negative straight leg raise. Dr. Didizian 

observed that appellant’s contusions of the face, scalp and neck had resolved, that there was no 

evidence of cervical intervertebral disc displacement with or without myelopathy, and that the 

lumbar intervertebral disc displacement and lumbosacral sprain had resolved. He advised that 

some of her subjective complaints corresponded with the objective findings, noting that the most 

recent lumbar MRI scan showed disc bulging at L1-2, a disc herniation toward the left L2-3 neural 

foramina, an L3-4 broad disc herniation with left more than right neural foraminal narrowing, disc 

degeneration, stenosis, and right more than left neuroforaminal narrowing at L4 -5, and disc 

degeneration, marginal osteophytosis, and left more than right L5-S1 neural foraminal narrowing.

Dr. Didizian found that appellant’s opioid usage was consistent with medical guidelines but 

recommended weaning her off narcotics.

In a June 19, 2020 attending physician’s report (Form CA-20), Dr. Yarus diagnosed disc 

bulges and prolapses at C3-4, C4-5, C5-6, and C6-7, problems with the left shoulder at the rotator 

cuff, and chronic pain. He checked a box marked “Yes” that the condition was caused or 

aggravated by appellant falling off an office chair on September 11, 1995. Dr. Yarus advised that 

she could not currently work.

In a May 28, 2020 telehealth report, Dr. Yarus discussed appellant’s complaints of 

continued pain and noted that she was disabled due to pain. 4 He diagnosed cervicalgia, lumbar 

radiculopathy, and lumbar facet joint syndrome.

In a supplemental report dated July 21, 2020, Dr. Didizian advised that the objective 

findings failed to support appellant’s subjective complaints. He provided his review of the 

diagnostic studies. Dr. Didizian diagnosed lumbosacral joint sprain, a contusion of the face, scalp, 

and neck, and displacement of cervical intervertebral and lumbar disc without myelopathy and 

found that these conditions were employment related. He related, “In addition, another accepted 

injury was aggravation of spondylolysis, spondylosis without myelopathy or radiculopathy, 

lumbosacral spine.” Dr. Didizian advised that there was no evidence that appellant’s continued 

pathology was causally related to the accepted employment injury. He related that the accepted 

conditions were “not active and there were no objective findings to support it.” Dr. Didizian 

indicated that appellant had narcotic dependency. He found that she could return to sedentary 

employment and found that as her date-of-injury job was sedentary she had no restrictions.

On August 14, 2020 OWCP prepared a new SOAF advising that it had accepted appellant’s

claim for lumbosacral sprain, a contusion of the face, scalp and neck except eyes, occipital scalp 

hematoma, cervical disc herniations at C4-5, C5-6, and C6-7, and lumbar disc herniations at L4-5 

and L5-S1. It requested that Dr. Didizian review the updated SOAF and discuss whether it 

changed his opinion. OWCP further asked that he advise whether appellant had sustained an 

employment-related aggravation of spondylosis and, if so, whether it had resolved. It additionally 

4 The record contains progress reports from Dr. Yarus dated July 30, August 31, and October 1, 2020.
4

requested that Dr. Didizian address whether her dependency on narcotics arose because of 

treatment for her employment injury and whether she could perform her usual employment taking 

her current narcotic dose.

In an addendum dated August 24, 2020, Dr. Didizian reviewed the updated SOAF and 

accepted conditions and reported that his opinion remained unchanged. He advised that if 

appellant sustained an aggravation of spondylosis as indicated in the original SOAF, it had 

resolved as of the date of his examination. Dr. Didizian indicated that appellant had become

dependent on narcotics originally taken for her employment injury. He advised that he was not in 

a position “to decide as to how much the narcotic is going to affect her work capacity.”

Dr. Didizian related, “Normally, if one has dependency and [is] able to function with the proper 

narcotic dose as in this case, there is no reason why she cannot go back on sedentary job. On the 

other hand, if she has full dependency and it does affect her sensorium, then any k ind of 

employment would not be appropriate.” 

On November 20, 2020 OWCP notified appellant of its proposed termination of her wageloss compensation and medical benefits as the weight of the evidence established that she no longer 

had any employment-related residuals or disability due to her accepted September 11, 1995 

employment injury. It afforded her 30 days to submit additional evidence or argument if she 

disagreed with the proposed termination. 

In reports dated November 2 and December 3, 2020, Dr. Yarus diagnosed cervicalgia, 

lumbar radiculopathy, and lumbar facet syndrome. He noted that appellant had not resumed work 

following her injury and was currently disabled due to pain.

By decision dated January 8, 2021, OWCP terminated appellant’s wage-loss compensation 

and medical benefits effective that date. It found that Dr. Didizian’s opinion represented the 

weight of the evidence and established that she had no further disability or residuals of her accepted 

September 11, 1995 employment injury. 

On January 28, 2021 appellant, through counsel, requested a telephonic hearing before a 

representative of OWCP’s Branch of Hearings and Review. 

Thereafter, OWCP received a July 16, 2020 report from Dr. Yarus.

5

 Dr. Yarus advised 

that he had reviewed Dr. Didizian’s May 19, 2020 report. He related that appellant had persistence 

disc pathology and radiculopathy, noting that the most recent MRI scan showed lumbar herniation

causing her continued complaints and cervical MRI scans that also reflected “the pathologic injury 

that occurred in the subject incident.” Dr. Yarus asserted that she tolerated her opioids well and 

was at the appropriate dosing. He opined that taking the medication away would “cause side 

effects that are dangerous and detrimental to her health.” Dr. Yarus recommended no change in 

regard to appellant’s care.

A telephonic hearing was held on May 12, 2021.

5 Appellant further submitted a progress report dated January 4, 201 from Dr.Yarus which was similar to his prior 

reports of record.
5

By decision dated July 27, 2021, OWCP’s hearing representative affirmed the January 8, 

2021 decision.

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.6 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.7 Its burden of proof includes the necessity of furnishing rationalized medical 

opinion evidence based on a proper factual and medical background.8

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

entitlement for disability.9 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.10

ANALYSIS -- ISSUE 1

The Board finds that OWCP did not meet its burden of proof to terminate appellant’s wageloss compensation and medical benefits effective January 8, 2021.

OWCP based its termination of appellant’s wage-loss compensation and medical benefits 

on the opinion of Dr. Didizian, OWCP’s referral physician. However, the Board finds that his 

opinion does not contain adequate medical rationale sufficient to establish that she ceased to have 

disability or residuals of her accepted employment conditions and, therefore, is insufficient to serve 

as a basis for OWCP’s termination action.11 

OWCP referred appellant to Dr. Didizian on March 5, 2020. It provided a SOAF that 

specified that it had accepted the claim for lumbosacral sprain, a contusion of the face, scalp, and 

neck, and displacement of lumbar and cervical intervertebral discs without myelopathy.

In a report dated May 19, 2020, Dr. Didizian found that appellant had no evidence of 

cervical intervertebral disc displacement and that her face, scalp, and neck contusions, lumbosacral 

sprain, and lumbar intervertebral disc disease had resolved. He discussed her complaints of neck 

and left leg pain. Dr. Didizian indicated that some of appellant’s subjective complaints correlated 

with the objective findings, noting that her most recent lumbar MRI scan revealed disc bulging, 

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

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

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

9 E.J., Docket No. 20-0013 (issued November 19, 2020); L.W., Docket No. 18-1372 (issued February 27, 2019).

10 A.J., Docket No. 18-1230 (issued June 8, 20200; R.P., Docket No. 18-0900 (issued February 5, 2019).

11 J.D., Docket No. 20-1167 (issued January 26, 2021); Del K. Rykert, 40 ECAB 284 (1988).
6

disc degeneration and disc herniations at various levels. On July 21, 2020 he advised that an 

additional accepted condition was an aggravation of spondylolysis of the lumbar spine. 

Dr. Didizian opined that the accepted conditions had resolved without further objective findings

and that appellant could resume her date-of-injury job without restrictions. OWCP subsequently 

updated its SOAF to reflect that it had accepted appellant’s claim for lumbosacral sprain, a 

contusion of the face, scalp and neck except eyes, occipital scalp hematoma, cervical disc 

herniations at C4-5, C5-6, and C6-7, and lumbar disc herniations at L4-5 and L5-S1.12 In a 

supplemental report dated August 24, 2020, Dr. Didizian opined that his opinion had not changed 

and that any aggravation of spondylosis had resolved as of the date of his examination. He asserted 

that appellant was dependent on narcotics which she had begun taking due to her employment 

injury. Dr. Didizian advised that he was not able to render an opinion on whether her narcotic use 

would affect her ability to function.

The Board finds that Dr. Didizian failed to provide adequate medical rationale for his 

finding that appellant had no residuals of her accepted employment injury. In his May 19, 2020 

report, Dr. Didizian opined that the objective findings supported some of her subjective complaints 

and referred to a lumbar MRI scan showing disc herniations, bulges, and degeneration. While he

concluded that the objective conditions had resolved, he did not provide any explanation for his 

findings or explain why he had found that appellant’s disc herniations had resolved in light of the 

findings on the diagnostic studies. The Board has held that a medical opinion is of limited 

probative value if it contains a conclusion regarding a given medical matter which is unsupported 

by medical rationale.13 Dr. Didizian failed to explain medically how the findings on physical 

examination, diagnostic studies, and history supported his conclusion. 14 He did not refer to 

specific objective medical findings to substantiate that appellant’s accepted conditions had 

resolved such that she was no longer disabled.15 Consequently, Dr. Didizian’s opinion is 

insufficient to meet OWCP’s burden of proof.

Additionally, Dr. Didizian did not address how appellant’s dependency on opioids affected 

her ability to work.

16

 He further found that she may have sustained an aggravation of spondylolysis 

of the lumbar spine.

For these reasons, OWCP improperly terminated appellant’s wage-loss compensation and 

medical benefits effective January 8, 2021.17

12 The International Classification of Diseases (ICD) provides the conditions of herniated discs as a synonym for 

intervertebral disc displacement.

13 See M.G., Docket No. 20-0867 (issued October 13, 2021); P.C., Docket No. 20-0371 (issued January 26, 2021).

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

15 See R.B., Docket No .19-1501(issued February 23, 2021).

16 See A.A., Docket No. 15-0937 (issued August 17, 2015).

17 In light of the Board’s disposition of Issue 1, Issue 2 is rendered moot.
7

CONCLUSION

The Board finds that OWCP did not meet its burden of proof to terminate appellant’s wageloss compensation and medical benefits effective January 8, 2021.

ORDER

IT IS HEREBY ORDERED THAT the July 27, 2021 decision of the Office of Workers’

Compensation Programs is reversed.

Issued: August 25, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board