United States Department of Labor

Employees’ Compensation Appeals Board

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Y.B., Appellant

and

DEPARTMENT OF THE AIR FORCE, 

HICKAM AIR FORCE BASE, HI, Employer

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Docket No. 23-0838

Issued: December 20, 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

JANICE B. ASKIN, Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On April 26, 2023 appellant filed a timely appeal from a December 5, 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.2

ISSUE

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

benefits, effective December 5, 2022, for failure to submit a Form CA-1032, as requested.

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the December 5, 2022 decision, appellant submitted additional evidence to 

OWCP. 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

FACTUAL HISTORY

On July 11, 2005 appellant, then a 54-year-old supervisory general supply specialist, filed 

a traumatic injury claim (Form CA-1) alleging that on July 8, 2005 she sustained injuries to the 

right side of her head and neck, right lower extremity, right knee, hands, and shoulders when she 

caught her left shoe on a boilerplate, tripped, and fell onto the right side of her body. She stopped 

work on the date of injury. OWCP accepted the claim for contusions of multiple sites;sprain of 

right shoulder, upper arm, and rotator cuff; contusion of the face, scalp, and neck; bilateral carpal 

tunnel syndrome; contusions of the bilateral hands; and tenosynovitis of the bilateral hands and 

wrists.3 It paid appellant wage-loss compensation on the supplemental rolls, effective 

September 12, 2005. Appellant returned to part-time modified-duty work on September 29, 2006. 

OWCP paid her wage-loss compensation on the periodic rolls, effective September 28, 2008.4

Appellant retired from the employing establishment effective October 2, 2008. 

On October 18, 2022 OWCP informed appellant that federal regulations required her to 

execute an affidavit relative to any earnings or employment during the previous year and that a 

Form CA-1032 was enclosed for that purpose. It advised her that she must fully answer all 

questions on the enclosed Form CA-1032, and return it within 30 days or her benefits would be 

suspended. OWCP mailed the letter to appellant’s last known address of record. 

On December 5, 2022 OWCP received a completed Form CA-1032, signed by appellant 

on November 9, 2022. 

By decision dated December 5, 2022, OWCP suspended appellant’s wage-loss 

compensation benefits, effective that day, due to her failure to submit the Form CA-1032, as 

requested.5 It advised that, if she were to complete and return the form, her compensation benefits

would be restored retroactively to the date they were suspended. 

3 On February 2, 2006 appellant underwent an OWCP-authorized right carpal tunnel release and on May11, 2006

she underwent OWCP-authorized left carpal tunnel release. On December 8, 2005 she underwent OWCP-authorized 

right shoulder arthroscopy. On January6, 2015 appellant underwent OWCP-authorized right shoulder arthroscopy 

with debridement and right biceps tenotomy. 

4

In a preliminary notice dated November 9, 2017 and finalized December 11, 2017, OWCP determined that 

appellant received an overpayment of compensation in the amount of $43,034.00 for the period September 8, 2008 

through November 11, 2017 as she had received wage-loss compensation at an incorrect pay rate. It directed recovery 

of the overpayment by withholding $250.00 from her continuing compensation payments. In a preliminary notice 

dated April 20, 2018 and finalized August 3, 2018, OWCP found that appellant received an overpayment of 

compensation in the amount of $2,926.19 for the period February 3 through March 3, 2018, for which she was at fault, 

as she concurrently received FECAwage-loss compensation benefits and Office of Personnel Management retirement 

benefits. It directed recovery of the overpayment by a single payment of the entire amount. In a preliminary notice 

dated March 28, 2022 and finalized May 3, 2022, OWCP determined that appellant received an overpayment of 

compensation in the amount of $64,610.90 for the period December 1, 2015 through January 2, 2021, for which she 

was not at fault, as she concurrently received FECA wage-loss compensation benefits and Social Security 

Administration age-related retirement benefits without an appropriate offset. It directed recovery of the overpayment 

by deducting $450.00 from her continuing compensation payments every 28 days.

5 On its face, OWCP’s December 5, 2022 decision foundthat appellant failed to respond to the October 18, 2022 

request. The Board notes that,while shedid respond, she did not do so in a timely manner. Under the circumstances 

of the case, OWCP’s finding that appellant failed to respond is harmless error. 
3

LEGAL PRECEDENT

Section 8106(b) of FECA authorizes the Secretary of Labor to require a partially disabled 

employee to report his or her earnings from employment or self-employment, by affidavit or 

otherwise, in the manner and at the times the Secretary specifies. 6

Under section 10.528 of OWCP’s implementing federal regulations, an employee in receipt 

of compensation benefits must complete an affidavit as to any work or activity indicating an ability 

to work, which the employee has performed for the prior 15 months. 7 If an employee who is 

required to file such a report fails to do so within 30 days of the date of the request, his or her right 

to compensation for wage loss is suspended until OWCP receives the requested report. At that 

time, OWCP will reinstate compensation retroactive to the date of suspension if the employee 

remains entitled to compensation.8

ANALYSIS

The Board finds that OWCP has met its burden of proof to suspend appellant’s wage-loss 

compensation benefits, effective December 5, 2022, for failure to submit a Form CA-1032, as 

requested.

On October 18, 2022 OWCP provided appellant with a Form CA-1032 and notified her 

that federal regulations required her to complete the form and answer all questions concerning her 

employment or earnings. It properly notified her that, if she did not completely answe r all 

questions and return the statement within 30 days, her benefits would be suspended. The record 

reflects that OWCP’s letter was properly mailed to appellant’s last known address of record and 

there is no indication that it was returned as undeliverable.9 Under the mailbox rule, a document 

mailed in the ordinary course of the sender’s business practices to the addresseelast known address 

of record is presumed to be received by the addressee. 10

The record indicates that appellant failed to timely submit the Form CA-1032 within 30 

days of OWCP’s request. She was receiving wage-loss compensation benefits and she was, 

therefore, required to complete the Form CA-1032. Appellant’s failure to file a Form CA-1032 

within 30 days supports the suspension of compensation. Thus, the Board finds that OWCP 

properly suspended her compensation benefits, effective December 5, 2022, pursuant to 20 C.F.R. 

§ 10.528.

6

5 U.S.C. § 8106(b).

7

20 C.F.R. § 10.528.

8

Id.; see also id. at § 10.525.

9 E.M., Docket No. 21-1231 (issued April 19, 2023); C.C., Docket No. 17-0043 (issued June 15, 2018);A.H., 

Docket No. 15-0241 (issued April3, 2015) (Under the mailbox rule, a document mailed in the ordinary course of the 

sender’s business practices to the addressee’s last known address is presumed to be received by the addressee).

10 Id. 
4

CONCLUSION

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

benefits for failure to submit a Form CA-1032, as requested.

ORDER

IT IS HEREBY ORDERED THAT the December 5, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: December 20, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board