United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

H.W., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Burnsville, MN, Employer

__________________________________________

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Docket No. 23-0284

Issued: March 30, 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 December 16, 2022 appellant filed a timely appeal from a September 27, 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

1

5 U.S.C. § 8101 et seq.

2 The Board notes that,following the September 27, 2022 decision, OWCP received additional evidence. 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

ISSUE

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

benefits, effective September 27, 2022, due to her failure to submit a properly completed Form 

EN-1032, as requested.

FACTUAL HISTORY

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

circumstances of the case as set forth in the Board’s prior decisions and orders are incorporated 

herein by reference. The relevant facts are as follows.

On May 26, 1999 appellant, then a 49-year-old postmaster, filed an occupational disease 

claim (Form CA-2) alleging that she sustained a psychological condition causally related to factors 

of her federal employment. OWCP accepted the claim for a prolonged depressive reaction. 

Appellant stopped work on February 10, 1998 and did not return. OWCP paid her wage-loss 

compensation for total disability on the periodic rolls.

OWCP periodically requested that appellant complete and submit financial disclosure 

statements (Form EN-1032) which solicited information regarding her employment, volunteer 

work, dependent(s) status, receipt of other federal benefits and/or payments, and third-party 

settlements.

In a December 2, 2021 letter, OWCP notified appellant that federal regulations required 

her to execute an affidavit relative to any earnings or employment during the previous 15 months 

and that an EN-1032 form was enclosed for that purpose. It advised that she must fully answer all 

questions on the enclosed EN-1032 form and return it within 30 days or her benefits would be 

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

On January 5, 2022 OWCP received a partially completed EN-1032 form. Appellant did 

not submit the first page of the form, responded to the question of whether she performed volunteer 

work with an “X” rather than a “Yes” or “No” as requested, and indicated that she had been 

assigned a CSA number from the Office of Personnel Management, but did not provide the number 

as requested. She signed the form on an unspecified day in December 2021. 

In correspondence dated May 31, 2022, OWCP advised appellant of the deficiencies in the 

Form EN-1032 that she had submitted on January 5, 2022. It requested that she submit a new EN1032 form and enclosed a form for that purpose. OWCP afforded appellant 30 days to submit the 

new form.

Appellant submitted a Form EN-1032 signed June 13, 2022. In response to the questions 

of whether she worked for an employer or was self-employed during the past 15 months, she placed 

3 Docket No. 08-0009 (issued July 10, 2008); Order Remanding Case, H.W., Docket No. 10-0404 (issued 

September 28, 2011); order denying petition for recon., Docket No. 15-1126 (issued August 15, 2016); Docket No. 

10-040 (issued April25, 2012).
3

an “X” rather than responding “Yes” or “No” as requested on the form. Appellant further did not 

provide her CSA number. 

By decision dated September 27, 2022, OWCP suspended appellant’s wage-loss 

compensation benefits effective that date, due to her failure to submit a properly completed 

EN-1032 form, as requested. It noted that, if she completed and returned the enclosed copy of the 

EN-1032 form, her compensation benefits would be restored retroactively to the date they were 

suspended.

LEGAL PRECEDENT

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.4

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. 5 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.6

ANALYSIS

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

benefits, effective September 27, 2022, due to her failure to submit a properly completed EN-1032 

form, as requested.

On December 2, 2021 OWCP provided appellant with an EN-1032 form. It properly 

advised her that, if she did not fully complete and return the form within 30 days, her benefits 

would be suspended. In response, on January 5, 2022, OWCP received a partially completed 

EN-1032 form. Appellant did not include the initial page of the form, failed to properly respond 

to the question of whether she performed volunteer work, failed to provide her CSA number, and 

failed to specify the exact date that she had signed the form. 

OWCP advised appellant of the deficiencies of the form on May 31, 2022 and provided 

her a new EN-1032 form for completion. It requested that she complete, sign, and return the form 

within 30 days. On June 22, 2022 OWCP received an EN-1032 form signed by appellant on 

June 13, 2022. Appellant did not provide her CSA number and placed an “X” in response to the 

4

5 U.S.C. § 8106(b).

5

20 C.F.R. § 10.528; see also L.M., Docket No. 22-0387 (issued August2, 2022); R.B., Docket No. 20-0176 (issued 

June 25, 2020); A.H., Docket No. 15-0241 (issued April3, 2015).

6

Id.;see also id. at § 10.525.
4

questions of whether she worked for an employer or was self-employed during the past 15 months

even though the EN-1032 form requested a “Yes” or “No” response. 

As appellant received wage-loss compensation from OWCP on the periodic rolls, she was 

required to complete an EN-1032 form. She failed to submit a fully and properly completed EN1032 form within 30 days of OWCP’s request.7

 Thus, the Board finds that OWCP properly 

suspended appellant’s compensation benefits, effective September 27, 2022, pursuant to 20 C.F.R. 

§ 10.528.8

CONCLUSION

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

benefits, effective September 27, 2022, due to her failure to submit a properly completed EN-1032 

form, as requested.

ORDER

IT IS HEREBY ORDERED THAT the September 27, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: March 30, 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

7

J.B., Docket No. 22-0162 (issued May 24, 2022).

8

See B.F., Docket No. 22-0585 (issued October 20, 2022); R.B., Docket No. 22-0578 (issued September 13, 2022); 

W.L., Docket No. 18-1051 (issued March 24, 2021);see also James A. Igo, 49 ECAB 189 (1997).