United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

E.T., Appellant

and

U.S. POSTAL SERVICE, BLOOMFIELD HILLS 

POST OFFICE, Bloomfield Hills, MI, Employer

__________________________________________

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Docket No. 23-0001

Issued: July 12, 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On October 2, 2022 appellant filed a timely appeal from July 28 and September 27, 2022 

merit decisions of the Office of Workers’ Compensation Programs (OWCP).1 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.3

1 The Board notes that, during the pendency of this appeal, OWCP issued February 13 and 22, and June13, 2023 

merit decisions which denied appellant’s request for authorization of left shoulder surgery. The Board and OWCP 

may not simultaneously exercise jurisdiction over the same issue(s). Consequently, the February 13 and 22, and 

June 13, 2023 decisions are set aside as null and void. 20 C.F.R. §§ 501.2(c)(3), 10.626; see J.W., Docket No. 

19-1688, n.1 (issued March 18, 2020); J.A., Docket No. 19-0981, n.2 (issued December 30, 2019); Russell E. 

Lerman, 43 ECAB 770 (1992); Douglas E. Billings, 41 ECAB 880 (1990).

2

5 U.S.C. § 8101 et seq.

3 The Board notes that following the September 27, 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

ISSUES

The issues are: (1) whether appellant has met her burden of proof to establish disability 

from work on May 28, 2022 causally related to the accepted January 5, 2020 employment injury; 

and (2) whether OWCP abused its discretion in denying appellant’s request for authorization of 

left shoulder surgery.

FACTUAL HISTORY

On January 7, 2020 appellant, then a 50-year-old city carrier associate, filed a traumatic 

injury claim (Form CA-1) alleging that on January 5, 2020 she injured her left shoulder when she 

slipped on black ice walking to her car while in the performance of duty. She did not stop work. 

OWCP accepted appellant’s claim for left shoulder contusion and left shoulder sprain. By 

decision dated March 13, 2020, it expanded the acceptance of her claim to include left shoulder 

tendinitis, and partial rotator cuff tear. On July 22, 2020 appellant underwent left shoulder 

arthroscopic rotator cuff repair, decompression, and distal clavicle resection. On July 23, 2020 

she stopped work. OWCP paid appellant wage-loss compensation on the supplemental rolls, 

effective July 23, 2020. 

On May 18, 2021 appellant underwent OWCP-authorized left shoulder rotator cuff 

revision. 

On February 23, 2022 appellant returned to full-time, modified-duty work. 

Appellant continued to receive medical treatment. In a report dated May 2, 2022,

Dr. Vinay Pampati, a Board-certified orthopedic surgeon, indicated that appellant was evaluated 

for status-post left shoulder revision arthroscopic rotator cuff repair. He noted appellant’s 

complaints that her shoulder was still very stiff and painful. On physical examination,

Dr. Pampati observed no tenderness to palpation about the left shoulder incisions and painful 

range of motion. He reported that appellant was not making any progress and indicated that “she 

will need a scope, debridement, new cultures, and capsular release/lysis of adhesions.”

Dr. Pampati recommended that appellant be “off work tomorrow and then after procedures.”

On June 3, 2022 appellant filed a claim for compensation (Form CA-7) for disability 

from work on May 28, 2022. On the reverse side of the claim form, the employing establishment 

indicated that appellant was on leave without pay (LWOP) status on May 28, 2022 and returned 

to work on May 31, 2022. 

On June 13, 2022 OWCP referred appellant, along with a statement of accepted facts 

(SOAF), a copy of the case record, and a series of questions, to Dr. Emmanuel Obianwu, a 

Board-certified orthopedic surgeon, for a second-opinion evaluation regarding the status of her 

employment-related injuries. 

Appellant submitted progress reports and work status notes dated January 19, March 2, 

April 8, and May 2, 2022 by Dr. Pampati who noted appellant’s complaints of worsening left 

shoulder pain. Dr. Pampati reviewed appellant’s history and provided examination findings. He

diagnosed left shoulder rotator cuff tear and provided work restrictions. 
3

In a letter dated June 15, 2022, Dr. Pampati opined that appellant should remain off work 

June 14 and 15, 2022. In a separate letter of even date, he indicated that she was scheduled for 

surgery on June 21, 2022 and that her last day of work should be June 17, 2022. Dr. Pampati

recommended that appellant remain off work until June 27, 2022. 

In a June 20, 2022 note, Dr. Pampati reported that appellant should remain out of work. 

In a June 23, 2022 development letter, OWCP informed appellant of the deficiencies of 

her claim for compensation. It advised her of the type of factual and medical evidence required 

and afforded her 30 days to respond.

In a June 24, 2022 note, Dr. Pampati recommended that appellant remain out of work 

until her next appointment on July 20, 2022. 

In a report dated July 15, 2022, Dr. Obianwu reviewed appellant’s history and described 

the January 5, 2020 employment injury. He noted that appellant’s claim was accepted for left 

shoulder contusion, left shoulder sprain, left shoulder rotator cuff tear or rupture, left shoulder 

calcified tendinitis, left shoulder capsulitis, and left shoulder arthritis. Dr. Obianwu indicated 

that appellant complained of pain in her left shoulder radiating all the way to her left hand. On 

examination of appellant’s left shoulder, he observed tenderness elicited in the area of insertion 

of the rotator cuff into the left proximal bilaterally. Range of motion testing revealed abduction 

to 70 degrees, forward flexion to 80 degrees, internal rotation to 30 degrees, external rotation to 

30 to 40 degrees, extension to 40 degrees, and adduction to 40 degrees. Dr. Obianwu diagnosed 

traumatic incomplete tear of the left rotator cuff, left shoulder arthroscopy, rotator cuff repair, 

decompression and distal clavicle resection, postoperative adhesive capsulitis of the left 

shoulder, manipulation under anesthesia with corticosteroid injection, left shoulder failed rotator 

cuff repair, bicipital tenosynovitis, and bursitis, left shoulder revision arthroscopic rotator cuff 

repair, biceps tenotomy, and removal of deep orthopedic implant, and persistent left shoulder 

adhesive capsulitis. He opined that appellant’s work-related condition of adhesive capsulitis had 

not yet resolved. Dr. Obianwu also reported that there were no imaging studies to verify if the 

second left shoulder surgery was successful. He recommended that appellant go through with 

the second manipulation under anesthesia, to be followed by an intra-articular injection. 

Dr. Obianwu completed a work capacity evaluation form (Form OWCP-5c), which indicated that 

appellant could work with restrictions. 

In a July 20, 2022 report, Dr. Pampati conducted an examination and diagnosed adhesive 

capsulitis of the left shoulder and status-post left shoulder rotator cuff repair. He reported that 

appellant continued to have “issues and had a relatively complex course.” Dr. Pampati indicated 

that appellant was not making any progress and had failed all conservative treatment options. He 

explained that appellant was a good candidate for surgery due to the nature, activity level, acuity, 

and functional disability. Dr. Pampati noted that appellant would be scheduled for a left 

shoulder arthroscopy and lysis of adhesions/capsular release. 

By decision dated July 28, 2022, OWCP denied appellant’s claim for compensation for 

disability from work on May 28, 2022. It found that the medical evidence of record was 

insufficient to establish disability from work on the claimed date due to her employment-related 

injuries or to establish time lost from work to obtain medical treatment for her employmentrelated injuries. 
4

In a letter dated August 4, 2022, OWCP requested that Dr. Obianwu provided a 

supplemental report and opine as to the necessity of the requested left shoulder arthroscopic 

surgery to treat appellant’s January 5, 2020 employment injury. 

In an August 12, 2022 report, Dr. Pampati conducted an examination and diagnosed 

adhesive capsulitis of the left shoulder and status-post left shoulder rotator cuff repair. He 

reported that appellant continued to have issues and noted that she would be scheduled for a left 

shoulder arthroscopy and lysis of adhesions/capsular release. 

In an August 30, 2022 report, Dr. Obianwu indicated that he had reviewed Dr. Pampati’s 

recent medical reports and discussed appellant’s previous examination findings following her 

multiple left shoulder surgeries. He opined that appellant did not need another arthroscopy of the 

left shoulder. Dr. Obianwu explained that she already had two arthroscopies, but on his July 15, 

2022 examination appellant could only raise her arm through 70 to 80 degrees. He further noted 

that the absence of intraarticular pathology in the left shoulder in the April 29, 2022 

ultrasonography scan made him feel that invasion of the joint with arthroscopy would not be 

beneficial. Dr. Obianwu also reported that he would recommend manipulation under anesthesia.

In a September 14, 2022 note, Dr. Pampati indicated that appellant could return to work 

on September 19, 2022 with restrictions of lifting up to five pounds per day and no more than 

nine hours daily.

By decision dated September 27, 2022, OWCP denied appellant’s request for 

authorization of left shoulder arthroscopic surgery and included a copy of Dr. Obianwu’s July 15 

and August 30, 2022 reports. It referred to an “enclosed Notice of Decision” explaining its 

denial of medical authorization. However, there was no formal notice of decision attached to the 

September 27, 2022 decision. 

LEGAL PRECEDENT -- ISSUE 1

An employee seeking benefits under FECA4 has the burden of proof to establish the 

essential elements of his or her claim, including that any disability or specific condition for 

which compensation is claimed is causally related to the employment injury. 5 The term 

disability is defined as the incapacity, because of an employment injury, to earn the wages the 

employee was receiving at the time of the injury.6 For each period of disability claimed, the 

employee has the burden of proof to establish that he or she was disabled from work as a result 

of the accepted employment injury.7 Whether a particular injury causes an employee to become 

4

Supra note 1.

5 C.B., Docket No. 20-0629 (issued May 26, 2021); D.S., Docket No. 20-0638 (issued November 17, 2020); S.W., 

Docket No. 18-1529 (issued April19, 2019); Kathryn Haggerty, 45 ECAB 383 (1994); Elaine Pendleton, 40 ECAB 

1143 (1989); see also Nathaniel Milton, 37 ECAB 712 (1986).

6

20 C.F.R. § 10.5(f); S.T., Docket No. 18-412 (issued October 22, 2018); Cheryl L. Decavitch, 50 ECAB 

397 (1999).

7 K.C., Docket No. 17-1612 (issued October 16, 2018); William A. Archer, 55 ECAB 674 (2004).
5

disabled from work, and the duration of that disability, are medical issues that must be proven by 

a preponderance of the reliable, probative, and substantial medical evidence.8 

The medical evidence required to establish causal relationship between a claimed period 

of disability and an employment injury is rationalized medical opinion evidence. The opinion of 

the physician must be based on a complete factual and medical background of the claimant, must 

be one of reasonable medical certainty, and must be supported by medical rationale explaining 

the nature of the relationship between the claimed disability and the specific employment factors 

identified by the claimant.9

The Board will not require OWCP to pay compensation for disability in the absence of 

medical evidence directly addressing the specific dates of disability for which compensation is 

claimed. To do so would essentially allow an employee to self-certify his or her disability and 

entitlement to compensation.10

OWCP’s procedures provide that wages lost for compensable medical examination or 

treatment may be reimbursed.11 A claimant who has returned to work following an accepted 

injury or illness may need to undergo examination, testing, or treatment and such employee may 

be paid compensation for wage loss while obtaining medical services or treatment, including a 

reasonable time spent traveling to and from the medical provider’s location.12 

ANALYSIS -- ISSUE 1

The Board finds that appellant has not met her burden of proof to establish disability 

from work on May 28, 2022 causally related to the accepted January 5, 2020 employment injury.

Appellant submitted a series of progress reports and letters by Dr. Pampati dated May 2

through September 14, 2022. In a May 2, 2022 report and letter, Dr. Pampati noted appellant’s 

complaints of left shoulder pain and stiffness. He conducted an examination and recommended a 

“scope.” Dr. Pampati also noted that appellant should be off work on May 3 and then after 

procedures. While he provided a general opinion that appellant should be off work after medical 

procedures, he did not specifically address the claimed date of disability on May 28, 2022 nor 

attribute appellant’s inability to work to her accepted January 5, 2020 employment injury. The 

Board has held that medical evidence that does not offer an opinion regarding the cause of an 

employee’s condition or disability is of no probative value on the issue of causal relationship. 13 

8

S.G., Docket No. 18-1076 (issued April 11, 2019); Fereidoon Kharabi, 52 ECAB 291, 292 (2001).

9 K.H., Docket No. 19-1635 (issued March 5, 2020); V.A., Docket No. 19-1123 (issued October 29, 2019).

10 K.A., Docket No. 19-1564 (issued June 3, 2020); J.B., Docket No. 19-0715 (issued September 12, 2019); 

William A. Archer, 55 ECAB 674 (2004).

11 Federal (FECA) Procedure Manual, Part 2 -- Claims, Wages Lost for Medical Examination or Treatment, 

Chapter 2.901.19 (February 2013).

12 Id. at Chapter 2.901.19a; M.B., Docket No. 19-1049 (issued October 21, 2019).

13 L.S., Docket No. 19-1231 (issued March 30, 2021); L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., 

Docket No. 17-1549 (issued July 6, 2018).
6

Accordingly, Dr. Pampati’s report is of no probative value and is insufficient to establish the 

claim.

Dr. Pampati’s additional reports postdate the claimed date of disability and did not 

otherwise address the relevant issue of whether appellant was disabled from employment on 

May 28, 2022 due to her accepted January 5, 2020 employment injury.14 Furthermore, the 

evidence of record does not contain any medical reports which establish that appellant received 

medical treatment on May 28, 2022 due to her accepted left shoulder injury. 

As the medical evidence or record is insufficient to establish disability from work on 

May 28, 2022 causally related to the accepted January 5, 2020 employment injury, the Board 

finds that she has not met her burden of proof to establish her claim.

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 and 

20 C.F.R. §§ 10.605 through 10.607. 

LEGAL PRECEDENT -- ISSUE 2

Section 8124(a) of FECA provides that OWCP shall determine and make a finding of fact 

and make an award for or against payment of compensation.15 Section 10.126 of Title 20 of the 

Code of Federal Regulations provides that the decision of the Director of OWCP shall contain 

findings of fact and a statement of reasons.16 OWCP’s procedures provide that the reasoning 

behind OWCP’s evaluation should be clear enough for the reader to understand the precise 

defect of the claim and the kind of evidence which would overcome it. 17 

ANALYSIS -- ISSUE 2

The Board finds that the case is not in posture for decision.

As noted above, section 8124(a) of FECA18 and section 10.12619 of its implementing 

regulations require that final decisions of OWCP contain findings of fact and a statement of 

reasons. As well, OWCP’s procedures provide that the reasoning behind OWCP’s evaluation 

should be clear enough for the reader to understand the precise defect of the claim and the kind 

of evidence which would overcome it.20 The Board finds that OWCP’s September 27, 2022 

decision did not provide a statement of reasons as to why it determined that the evidence of 

14 See K.E., Docket No. 19-1922 (issued July 10, 2020); F.S., Docket No. 18-0098 (issued August 13, 2018); 

P.W., Docket No. 17-0514 (issued June 9, 2017).

15 5 U.S.C. § 8124(a).

16 20 C.F.R. § 10.126.

17 Federal (FECA) Procedure Manual, Part 2 -- Claims, Disallowances, Chapter 2.1400.5 (February 2013).

18 Supra note 3.

19 Supra note 4.

20 Supra note 5.
7

record was insufficient to support authorization for left shoulder arthroscopic surgery as a formal 

decision was not attached. The Board has found that a decision denying a claim should contain a 

correct description of the basis for the denial in order that the parties of interest have a clear 

understanding of the precise defect and the kind of evidence which would overcome it.

21

 For 

this reason, the case must be remanded to OWCP for a proper formal decision, which includes 

findings of fact and a clear and precise statement regarding appellant’s request for authorization 

for left shoulder arthroscopic surgery. Following further development as OWCP deems 

necessary, it shall issue a de novo decision.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish disability 

from work on May 28, 2022 causally related to the accepted January 5, 2020 employment injury. 

The Board further finds that the case is not in posture for decision regarding whether OWCP 

abused its discretion in denying appellant’s request for authorization of left shoulder surgery.

ORDER

IT IS HEREBY ORDERED THAT the July 28, 2022 merit decision of the Office of 

Workers’ Compensation Programs is affirmed. The September 27, 2022 decision of the Office 

of Workers’ Compensation Programs is set aside and the case is remanded for further 

proceedings consistent with this decision of the Board.

Issued: July 12, 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

21 J.W., Docket No. 19-1547 (issued October 26, 2020); R.M., Docket No. 19-0163 (issued July 17, 2019).