United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

M.G., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

OAKLAND REGIONAL OFFICE, Oakland, CA, 

Employer

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Docket No. 23-0136

Issued: June 13, 2023

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On November 9, 2022 appellant filed a timely appeal from an October 17, 2022 merit 

decision 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.

1 On his application for review (AB-1), appellant indicated that he was appealing from a May10, 2022 merit 

decision of OWCP. The Board’s review authority, however, is limited to appeals which are filed within 180 days 

from the date of issuance of OWCP’s decision. 20 C.F.R. § 501.3(e). The 180th day following OWCP’s May10, 

2022 decision was November 6, 2022. As that,fell on a Sunday, appellant had until the next business day, Monday, 

November 7, 2022, to file the appeal. As appellant did not file this appeal until November 9, 2022, more than 180 

days after the May 10, 2022 decision, the Board lacksjurisdiction to review that decision. The only decision within 

the Board’s jurisdiction is the October 17, 2022 merit decision.

2

5 U.S.C. § 8101 et seq.
2

ISSUE

The issue is whether OWCP abused its discretion in denying appellant’s request for 

authorization for a magnetic resonance imaging (MRI) scan of the brain.

FACTUAL HISTORY

On January 27, 2022 appellant, then a 62-year-old agronomist, filed a traumatic injury 

claim (Form CA-1) alleging that on October 22, 2021 he sustained an adverse reaction to a 

COVID-19 vaccination. OWCP accepted the claim for adverse effect of other viral vaccines. 

In a report dated March 21, 2022, Dr. Allen D. Bott, a Board-certified neurologist, 

discussed appellant’s complaints of aching joints, cough, fatigue, headache, and muscle pain after 

receiving a COVID-19 vaccination. Appellant subsequently experienced wheezing and pain in his 

groin. Dr. Bott noted that appellant currently complained of problems with memory and balance. 

He diagnosed severe, recurrent major depressive disorder with anxious distress. Dr. Bott opined 

that appellant’s headaches were compatible with tension headaches, likely due to his major 

depressive disorder. He acknowledged that it was controversial whether a vaccination could cause 

mood changes, but that the “clear temporal relationship of [appellant’s] apparent mood disorder to 

the vaccine suggests it was likely etiological.” 

On June 3, 2022 Dr. Bott diagnosed complications following an immunization. He advised 

that appellant had complained of a difficulty with cognition since a COVID-19 infection. Dr. Bott 

indicated that he had prescribed an antidepressant that also helped with cognition. He related that 

appellant had symptoms of a severe major depressive disorder and complaints of headaches. 

Dr. Bott advised that the headaches were “most compatible with chronic tension-type headaches 

and intimately associated with [appellant’s major depressive disorder].” He noted that appellant 

was anxious about his headaches and requested authorization for an MRI scan of the brain to rule 

out anatomic damage from COVID-19.

In a development letter dated June 10, 2022, OWCP advised Dr. Bott that it was currently 

unable to authorize an MRI scan of the brain and informed him of the deficiencies in the evidence. 

It requested that he provide a medical report explaining why an MRI scan of the brain was 

medically necessary due to the accepted condition. OWCP sent a copy of the letter to appellant.

In a progress report dated July 13, 2022, Dr. Bott discussed appellant’s complaints of 

headaches and physical symptoms supporting the diagnosis of major depressive disorder with 

anxiety. He noted that the condition was “apparently precipitated by a presumed inflammatory 

reaction following his COVID-19 vaccine.” Dr. Bott requested an MRI scan of the brain to 

eliminate other causes for the headaches and to determine whether the vaccine had caused a more 

significant adverse reaction. He maintained that an MRI scan was “warranted in view of how long 

[appellant’s] symptoms have been ongoing.” 

On August 12, 2022 Dr. Bott discussed appellant’s treatment with medications and noted 

that he would try to appeal the denial of the MRI scan of the brain. On September 14, 2022 he

indicated that appellant had been scheduled for a sleep study and discussed his treatment.
3

On October 17, 2022 Dr. David I. Krohn, a Board-certified internist serving as a district 

medical adviser (DMA), opined that it was unlikely that appellant’s major depression was related 

to the COVID-19 vaccination. He discussed appellant’s continued symptoms of confusion, 

hopelessness, and difficulty concentrating. Dr. Krohn opined that “psychiatric side effects of the 

vaccine are extremely rare” and that only one case had been reported. He further found that

Dr. Bott had not sufficiently explained the relationship between the COVID-19 vaccination and 

appellant’s headaches. Dr. Krohn advised that the only adequately documented cause of 

headaches due to a COVID-19 vaccination was cerebral venous thrombosis, but that Dr. Bott had 

not diagnosed this condition and no findings raised suspicion of such a diagnosis. He opined that,

absent suspicion of cerebral venous thrombosis or a statement from Dr. Bott explaining how the 

headaches were related to the COVID-19 vaccination, there was insufficient support for approval 

of an MRI scan of the brain. 

By decision dated October 17, 2022, OWCP denied appellant’s request for authorization 

for an MRI scan of the brain. 

LEGAL PRECEDENT

Section 8103(a) of FECA3 provides that the United States shall furnish to an employee who 

is injured while in the performance of duty, the services, appliances, and supplies prescribed or 

recommended by a qualified physician, which OWCP considers likely to cure, give relief, reduce 

the degree or the period of disability, or aid in lessening in the amount of monthly compensation.4 

The Board has found that OWCP has great discretion in determining whether a particular 

type of treatment is likely to cure or give relief.5 The only limitation on OWCP’s authority is that 

of reasonableness.6 Abuse of discretion is generally shown through proof of manifest error, clearly 

unreasonable exercise of judgment, or actions taken which are contrary to both logic and probable 

deductions from established facts. It is not enough to merely show that the evidence could be 

construed to produce a contrary factual conclusion.7 In order to be entitled to reimbursement of 

medical expenses, it must be shown that the expenditures were incurred for treatment of the effects 

3

Id.

4

Id. at § 8103;see L.W., Docket No. 21-0607 (issued October 18, 2022); N.G.,Docket No. 18-1340 (issued 

March 6, 2019).

5 C.Y., Docket No. 21-0335 (issued November 7, 2022); R.C.,Docket No. 18-0612 (issued October 19, 2018);

Vicky C. Randall, 51 ECAB 357 (2000).

6 M.S., Docket No. 22-0113 (issued June 7, 2022); B.L.,Docket No. 17-1813 (issued May 23, 2018); Lecil E. 

Stevens, 49 ECAB 673, 675 (1998).

7 D.H., Docket No. 22-0533 (issued August4, 2022); S.W.,Docket No. 18-1529 (issued April19, 2019);Rosa Lee 

Jones, 36 ECAB 679 (1985).
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of an employment-related injury or condition.8 Proof of causal relationship in a case such as this 

must include supporting rationalized medical evidence.9

ANALYSIS

The Board finds that OWCP did not abuse its discretion in denying appellant’s request for 

authorization for an MRI scan of the brain.

In a report dated March 21, 2022, Dr. Bott diagnosed severe, recurrent major depressive 

disorder with anxious distress. He found that appellant’s symptoms were compatible with tension 

headaches likely due to his depressive disorder. Dr. Bott acknowledged that it was controversial 

whether a vaccine could cause mood changes, but found that the temporal relationship suggested 

causation. 

On June 2, 2022 Dr. Bott indicated that appellant complained of cognitive difficulties 

following a COVID-19 infection. He diagnosed major depressive disorder and headaches most 

likely due to tension and the depressive disorder. Dr. Bott recommended an MRI scan of the brain 

to rule out anxiety about headaches or damage from COVID-19. He did not, however, explain 

why appellant’s headaches resulted from the accepted condition of a vaccine reaction. As Dr. Bott 

did not provide medical rationale explaining why the MRI scan of the brain was necessary to treat 

appellant’s accepted condition, his opinion is of limited probative value.10

In a report dated July 13, 2022, Dr. Bott advised that appellant’s major depressive disorder 

with headaches was apparently caused by an inflammatory reaction after a vaccination for 

COVID-19. He related that he had requested an MRI scan of the brain to rule out other causes of 

the headaches and to determine whether the vaccination had caused any significant issues. Dr. Bott 

asserted that the MRI scan was warranted due to the duration of appellant’s symptoms. He did 

not, however, identify what conditions caused by vaccination could result in headaches or provide 

any rationale for his opinion. As discussed, a report is of limited probative value if it does not 

contain medical rationale which explains a physician’s opinion.11 Dr. Bott’s report is therefore 

insufficient to establish an abuse of discretion.12

On October 17, 2022 Dr. Krohn advised that it was unlikely that the diagnosis of major 

depression was not related to the COVID-19 vaccination, noting that only one such case had been 

reported. He opined that Dr. Bott had insufficiently explained the relationship between the 

COVID-19 vaccination and appellant’s headaches. Dr. Krohn indicated that cerebral venous 

thrombosis could cause vaccination-related headaches, but noted that Dr. Bott had not rendered 

8

J.R., Docket No. 17-1523 (issued April 3, 2018); Bertha L. Arnold, 38 ECAB 282, 284 (1986).

9 L.W., Docket No. 21-0607 (issued October 18, 2022); Zane H. Cassell, 32 ECAB 1537, 1540-41 (1981); John E. 

Benton, 15 ECAB 48, 49 (1963).

10 See C.Y., Docket No. 21-0335 (issued November 7, 2022); Y.D.,Docket No. 16-1896 (issued February 10, 2017).

11 See D.K., Docket No. 20-0002 (issued August25, 2020); D.L.,Docket No. 19-0900 (issued October 28, 2019);

Y.D., id.; C.M., Docket No. 14-0088 (issued April 18, 2014).

12 D.K., id.
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that diagnosis. He opined that, without suspicion of cerebral venous thrombosis or rationale from

Dr. Bott explaining the relationship of the headaches and the COVID-19 vaccination, there was 

insufficient evidence to authorize approval from an MRI scan of the brain. 

The only limitation on OWCP’s authority is approving or disapproving service under 

FECA is one of reasonableness.13 OWCP referred the case record to Dr. Krohn for review. 

Dr. Krohn found that appellant did not require an MRI scan of the brain due to his accepted 

employment injury. He provided a well-reasoned opinion explaining why the proposed MRI scan 

of the brain was unrelated to the accepted employment injury.14 Thus, the Board finds that OWCP 

did not abuse its discretion in denying authorization for the requested procedure.

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(a) and 20 C.F.R. 

§§ 10.605 through 10.607.

CONCLUSION

The Board finds that OWCP did not abuse its discretion in denying appellant’s request for 

authorization for an MRI scan of the brain.

13 See B.I., Docket No. 22-0090 (issued July 19, 2022); W.M., Docket No. 18-0957 (issued October 15, 2018).

14 See M.S., supra note 6; A.S., Docket No. 19-0745 (issued October 10, 2019);M.M.,Docket No. 19-0491 (issued 

August 14, 2019); N.M., Docket No. 18-1584 (issued March 15, 2019).
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ORDER

IT IS HEREBY ORDERED THAT the October 17, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: June 13, 2023

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board