United States Department of Labor

Employees’ Compensation Appeals Board

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P.F., Appellant

and

DEPARTMENT OF HOMELAND SECURITY, 

U.S. CUSTOMS & BORDER PROTECTION, 

U.S. BORDER PATROL, Nogales, AZ, Employer

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Docket No. 23-0831

Issued: October 23, 2023

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On May 25, 2023 appellant filed a timely appeal from an April 13, 2023 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.

ISSUE

The issue is whether appellant has met his burden of proof to establish permanent 

impairment of his right upper extremity, warranting a schedule award.

FACTUAL HISTORY

On October 29, 2019 appellant, then a 44-year-old federal officer,filed a traumatic injury 

claim (Form CA-1) alleging that on October 23, 2019 he injured his right upper arm and shoulder 

1

5 U.S.C. § 8101 et seq.
2

during a training exercise while in the performance of duty. He explained that he was attempting 

to perform a takedown technique shown by the instructor when his right shoulder and upper arm 

bent awkwardly. OWCP accepted the claim for right shoulder joint sprain, unspecified right 

shoulder rotator cuff muscle/tendon injury, and right shoulder lesion. 

On October 9, 2020 Dr. Ty Endean, an osteopath Board-certified in orthopedic surgery, 

performed an authorized right arthroscopic-assisted labral reconstruction based on a diagnosis of 

right labral tear. 

In a January 5, 2021 progress report, Dr. Endean reported that appellant had exceptional 

success regarding his right shoulder status following labral reconstruction in October 2020. 

Appellant was currently asymptomatic, and his right shoulder physical examination revealed no

wing, asymmetry, or crepitus; nontender to palpation; no erythema, ecchymosis, or lesions; 

essentially full range of motion (ROM); and negative Neer and Hawkins sign.

In a report dated September 1, 2021, Dr. Endean advised that appellant had reached 

maximum medical improvement (MMI) for his right shoulder. He noted that appellant had 

undergone right shoulder surgery on October 9, 2020 had been rehabilitated, and was now 

permanent and stationary. Dr. Endean concluded that, pursuant to the sixth edition of the 

American Medical Association, Guides to the Evaluation of Permanent Impairment (A.M.A., 

Guides),

2 appellant had six percent permanent impairment of the right shoulder using Table 15-5.

On September 23, 2021 appellant filed a claim for compensation (Form CA-7) for a 

schedule award.

In an October 21, 2021 report, Dr. Nathan Hammel, a Board-certified orthopedic surgeon 

serving as an OWCP district medical adviser (DMA), reviewed appellant’s medical records and 

statement of accepted facts. He determined that appellant had no permanent impairment using 

either the diagnosis-based impairment (DBI) method or the ROM method. In support of this 

conclusion, Dr. Hammel reported that appellant had undergone labral tear surgery and exhibited 

normal ROM. He explained that Dr. Endean provided no permanent impairment rating 

calculations, and that in his September 1, 2021 report, as well as in a prior clinical visit note he

had related that appellant was completely asymptomatic with a normal physical examination.

By decision dated February 11, 2022, OWCP denied appellant’s schedule award claim, 

finding that the evidence of record was insufficient to establish that he had permanent impairment 

of a scheduled member or function of the body due to his accepted employment injury. 

In an October 27, 2022 report, Dr. John R. Klein, a Board-certified orthopedic surgeon, 

related that on physical examination appellant had no bilateral upper extremity ROM impairment,

some deltoid atrophy, intact bilateral motor strength, and negative apprehension sign with right 

shoulder ROM, especially with external rotation in abduction. Using the sixth edition of the 

A.M.A., Guides, he determined that the class of diagnosis (CDX) for unidirectional shoulder 

instability resulted in a Class 1, grade C permanent impairment, with a default value of six percent. 

Dr. Klein assigned a grade modifier for physical examination (GMPE) of 1 for deltoid atrophy, a

2 A.M.A., Guides (6th ed. 2009).
3

grade modifier for clinical studies (GMCS) of 1, and a grade modifier for functional history 

(GMFH) of 2. He noted that appellant had a QuickDASH score of 41. Using the net adjustment 

formula, Dr. Klein found that appellant had seven percent permanent impairment as the 

impairment rating for the right shoulder had shifted one place to the right, grade D. He found that 

the ROM method was inapplicable as appellant had full ROM.

On February 17, 2023 appellant filed a claim for a schedule award. 

In a report dated March 17, 2023, Dr. Hammel reviewed Dr. Klein’s report and related that 

appellant had zero percent permanent impairment using the sixth edition of the A.M.A., Guides.

He explained that, pursuant to the DBI methodology, in applying Table 15-5 of the A.M.A., 

Guides, appellant should be placed in Class 0 for unidirectional shoulder instability without 

residual instability. Dr. Hammel explained that a Class 1 impairment required objective 

instability, and that Dr. Klein’s report contained no evidence of instability or apprehension on 

examination, and no subjective occurrences of stability. He also noted that appellant had no 

permanent impairment under the ROM methodology as his ROM “is full.” Dr. Hammel

concluded, “[b]oth methods agree no impairment.”

By decision dated April 13, 2023, OWCP denied appellant’s schedule award claim, finding 

that the evidence of record was insufficient to establish permanent impairment of a scheduled 

member or function of the body due to his accepted employment injury. 

LEGAL PRECEDENT

The schedule award provisions of FECA,

3 and its implementing federal regulations,4 set 

forth the number of weeks of compensation payable to employees sustaining permanent 

impairment from loss, or loss of use, of scheduled members or functions of the body. FECA, 

however, does not specify the manner in which the percentage loss of a member shall be 

determined. For consistent results and to ensure equal justice, OWCP has adopted the use of a 

single set of tables so that there may be uniform standards applicable to all claimants. OWCP 

evaluates the degree of permanent impairment according to the standards set forth in the specified 

edition of the A.M.A., Guides, published in 2009.

5

 The Board has approved the use by OWCP of 

the A.M.A., Guides for the purpose of determining the percentage loss of use of a member of the 

body for schedule award purposes.

6

In determining impairment for the upper extremities under the sixth edition of the A.M.A., 

Guides, an evaluator must establish the appropriate diagnosis for each part of the upper extremity 

3

Supra note 1.

4

20 C.F.R. § 10.404.

5 For decisions issued after May 1, 2009, the sixth edition of the A.M.A., Guidesis used. A.M.A., Guides(6th ed. 

2009); Federal FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, 

Chapter 2.808.5a (March 2017); see also id. at Chapter 3.700, Exhibit 1 (January 2010).

6 A.W., Docket No.22-1075 (issued April10, 2023); P.R., Docket No. 19-0022 (issued April9, 2018); Isidor Rivera, 

12 ECAB 348 (1961).
4

to be rated. With respect to the shoulders, the relevant portions of the arm for the present case, 

reference is made to Table 15-5 (Shoulder Regional Grid) beginning on page 401. After the CDX 

is determined from the Shoulder Regional Grid (including identification of a default grade value), 

the net adjustment formula is applied using the GMFH, GMPE, and GMCS. The net adjustment 

formula is (GMFH - CDX) + (GMPE - CDX) + (GMCS - CDX).7 Under Chapter 2.3, evaluators 

are directed to provide reasons for their impairment rating choices, including choices of diagnoses 

from regional grids, and calculations of modifier scores.8

OWCP issued FECA Bulletin No. 17-06 to explain the use of the DBI methodology versus 

the ROM methodology for rating of upper extremity impairments.9 Regarding the application of 

ROM or DBI impairment methodologies in rating permanent impairment of the upper extremities, 

FECA Bulletin No. 17-06 provides in pertinent part:

“Upon initial review of a referral for upper extremity impairment evaluation, the 

DMA should identify (1) the methodology used by the rating physician (i.e., DBI 

or ROM) and (2) whether the applicable tables in Chapter 15 of the [A.M.A., 

Guides] identify a diagnosis that can alternatively be rated by ROM. If the [A.M.A., 

Guides] allow for the use of both the DBI and ROM methods to calculate an 

impairment rating for the diagnosis in question, the method producing the higher 

rating should be used.” (Emphasis in the original.)10

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish permanent 

impairment of the right upper extremity, warranting a schedule award.

In support of his claim for a schedule award, appellant submitted a September 1, 2021 

report from Dr. Endean. Dr. Endean concluded that appellant had a six percent right shoulder 

permanent impairment using Table 15-5 of the A.M.A., Guides. 

The record also contains October 27, 2022 report from Dr. Klein who utilized the DBI 

method, and identified the CDX forthe diagnosis of unidirectional shoulder instability under Table 

15-5 resulted in a Class 1 impairment. Dr. Klein assigned a GMFH of 2, a GMPE of 1, and a 

GMCS of 1 in accordance with Table 15-6. He applied the net adjustment formula, resulting in 

movement from the default grade of C to D and corresponding to seven percent impairment of the 

right upper extremity. Dr. Klein advised the ROM method was not applicable because appellant 

had full ROM. 

OWCP properly routed appellant’s case, including the reports from Dr. Endean and

Dr. Klein to its DMA, Dr. Hammel. The DMA, in an October 21, 2021 report, found that appellant 

7

See A.M.A., Guides (6th ed. 2009). 

8

Id.

9 FECA Bulletin No. 17-06 (issued May 8, 2017).

10 Id.
5

had no permanent right upper extremity permanent impairment. In support of this conclusion, he 

noted that appellant had undergone labral tear surgery. The DMA properly explained that

Dr. Endean had provided no calculations in his September 1, 2021 report, and had related that 

appellant had normal physical examination findings. In a March 17, 2023 report, he reviewed

Dr. Klein’s report and utilized the DBI method. The DMA identified the CDX for the diagnosis 

of unilateral shoulder instability, without residual instability under Table 15-5 as Class 0 

impairment. He explained that a Class 1 impairment required objective instability, and that

Dr. Klein’s report contained no evidence of objective instability. The DMA found no permanent 

impairment under the ROM methodology as his ROM “is full.” He concluded, “[b]oth methods 

agree no impairment.” The DMA opined that appellant had reached MMI on October 27, 2022.

The Board finds that the opinions of the DMA, Dr. Hammelwere based on a proper factual 

and medical history, and on the appropriate tables and grading schemes of the A.M.A., Guides. 

The DMA accurately applied the standards of the A.M.A., Guides to the physical examination 

findings of record. He provided rationale for his impairment rating for the class of impairment for 

the diagnosis from the regional grid. Consequently, the Board finds that the weight of the medical 

evidence is accorded to the DMA’s finding of zero percent permanent impairment of appellant’s 

right upper extremity.

11

Appellant may request a schedule award or increased schedule award at any time based on 

evidence of a new exposure or medical evidence showing progression of an employment-related 

condition resulting in permanent impairment or increased permanent impairment.

CONCLUSION

The Board finds that appellant has not met his burden of proof to establish permanent 

impairment of the right upper extremity, warranting a schedule award.

11 See V.G., Docket No. 19-1728 (issued September 2, 2020).
6

ORDER

IT IS HEREBY ORDERED THAT the April 13, 2023 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: October 23, 2023

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board