United States Department of Labor

Employees’ Compensation Appeals Board

T.K., Appellant

and

DEPARTMENT OF JUSTICE, FEDERAL 

BUREAU OF INVESTIGATION, Quantico, VA, 

Employer

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Docket No. 23-1003

Issued: January 30, 2024

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On July 24, 2023 appellant filed a timely appeal from a May 8, 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.2

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the May8, 2023 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

ISSUE

The issue is whether appellant has met his burden of proof to establish a recurrence of the 

need for medical treatment, commencing March 1, 2023, causally related to his accepted right 

shoulder injury.

FACTUAL HISTORY

On January 23, 2012 appellant, then a 36-year-old special agent, filed an occupational 

disease claim (Form CA-2) alleging that he developed right shoulder rotator cuff impingement and 

tendinitis due to factors of his federal employment. He related that as a law enforcement officer, 

he was required to exercise regularly, which included weight training and cardiovascular exercises, 

and practice defensive tactics drills. Appellant noted that he first became aware of his condition 

on January 9, 2007, and realized its relationship to his federal employment on August 17, 2011. 

He did not stop work. OWCP assigned the claim OWCP File No. xxxxxx222 and accepted it for 

right shoulder rotator cuff impingement. It paid appellant wage-loss compensation on the 

supplemental rolls for loss of time from work to attend medical appointments.

Under OWCP File No. xxxxxx633, appellant has a previously accepted traumatic injury 

claim (Form CA-1) for other injuries of the right shoulder causally related to a January 9, 2007 

employment injury when he slipped while descending steps on a bus while holding a guide rail 

with his right hand, thereby hyperextending his right shoulder. OWCP has administratively 

combined the current case, under OWCP File No. xxxxxx222, and OWCP File No. xxxxxx633, 

with the latter serving as the master file. 

On September 11, 2012 appellant underwent OWCP-approved arthroscopic subacromial 

decompression, arthroscopic distal clavicle resection, and debridement of the glenohumeral joint 

of the right shoulder.

On March 29, 2023 appellant filed a notice of recurrence (Form CA-2a) alleging the 

recurrent need for additional medical treatment for his right shoulder conditions beginning

March 1, 2023. He indicated that after he returned to work, he experienced recurring shoulder 

pain and was unable to lift weight overhead. 

In a report dated March 22, 2023, Dr. Eric Padegimas, an orthopedic surgeon, indicated 

that he evaluated appellant for complaints of right shoulder pain. He noted that appellant sustained 

an injury in 2007 at work when he caught himself while falling out of a vehicle and heard a pop in 

his right shoulder. Dr. Padegimas reported that appellant had two surgeries, but did not have any 

reparative surgeries. On examination of the right shoulder, he observed pain with combined 

abduction/external rotation without apprehension and positive O’Brien’s test. Sensation was intact 

to light touch distally. Dr. Padegimas indicated that a right shoulder x-ray scan revealed moderate 

degenerative changes with a large inferior humeral head osteophyte. He diagnosed right shoulder 

primary osteoarthritis. Dr. Padegimas reported that appellant had a work injury in 2007 where he 

had a “near dislocation event.” He noted that appellant underwent two surgeries and subsequently 

developed arthritis. Dr. Padegimas opined that “this is an extractable [appellant] linked to his prior 

work injury.” He recommended that appellant’s treatment for arthritis be considered a part of his 

original injury.
3

In a development letter dated March 31, 2023, OWCP informed appellant of the 

deficiencies of his recurrence claim. It advised him of the type of medical evidence required to 

establish his claim and provided him with a questionnaire to complete. OWCP afforded appellant 

30 days to provide the requested evidence. 

In an April 23, 2023 response to OWCP’s development letter, appellant explained that the 

recurrence occurred as a normal deterioration of the right shoulder and subsequent arthritic buildup inside the shoulder since the original 2007 employment injury. He indicated that his work 

activities involved desk work, physical activity when arresting and apprehending subjects, and 

annual physical fitness testing. Appellant alleged that his current claim for recurrence was directly 

related to his employment injury in 2007, because he had no additional traumatic event involving

his shoulder. He indicated that his current pain and discomfort were identical in nature and 

location to the pain and discomfort experienced after his original injury. Appellant further noted

that he did not have any injuries since the 2007 employment injury, and had not engaged in any 

hobbies or activities that would have caused damage to his shoulder. 

By decision dated May 8, 2023, OWCP denied appellant’s claim for a recurrence of the 

need for medical treatment, finding that the medical evidence of record was insufficient to establish 

that he required additional medical treatment due to a worsening of his accepted work-related 

conditions without intervening cause.

LEGAL PRECEDENT

A recurrence of a medical condition means a documented need for further medical 

treatment after release from treatment for the accepted condition or injury when there is no 

accompanying work stoppage.3 An employee has the burden of proof to establish that he or she 

sustained a recurrence of a medical condition that is causally related to his or her accepted 

employment injury without intervening cause.4 

If a claim for recurrence of a medical condition is made more than 90 days after release 

from medical care, a claimant is responsible for submitting a medical report establishing causal 

relationship between the employee’s current condition and the original injury in order to meet his 

or her burden of proof.5 To meet this burden the employee must submit medical evidence from a 

physician who, on the basis of a complete and accurate factual and medical history, supports that 

3

20 C.F.R. § 10.5(y).

4

See S.P., Docket No. 19-0573 (issued May 6, 2021); M.P.,Docket No. 19-0161 (issued August 16, 2019); E.R., 

Docket No. 18-0202 (issued June 5, 2018).

5 Federal (FECA) Procedure Manual, Part 2 --Claims, Recurrences, Chapter 2.1500.4b (June 2013); see also J.M., 

Docket No. 09-2041 (issued May 6, 2010).
4

the condition is causally related and supports his or her conclusion with sound medical rationale. 6 

Where no such rationale is present, medical evidence is of diminished probative value. 7 

ANALYSIS

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

the need for medical treatment, commencing March 1, 2023, causally related to his accepted right 

shoulder injury.

Appellant submitted a March 22, 2023 report by Dr. Padegimas who noted that appellant 

sustained an injury in 2007 at work when he caught himself while falling out of a vehicle and heard 

a pop in his right shoulder. Dr. Padegimas provided examination findings and diagnosed right 

shoulder primary osteoarthritis. He indicated that appellant underwent two surgeries after the 2007 

employment injury and subsequently developed arthritis. Dr. Padegimas opined that “this is an 

extractable [appellant] linked to his prior work injury.” While he provided an opinion supportive 

of causal relationship between appellant’s current right shoulder symptoms and appellant’s

original right shoulder injury, Dr. Padegimas failed to provide medical rationale in support of his 

opinion. The Board has held that a report is of limited probative value regarding causal 

relationship if it does not contain medical rationale explaining how a given medical condition or 

disability has an employment-related cause.8 Accordingly, this report is insufficient to establish 

appellant’s recurrence claim.

As the medical evidence of record does not contain a rationalized medical opinion 

establishing that appellant required further medical care on or after March 1, 2023 causally related 

to his accepted right shoulder injury, the Board finds that he has not met his burden of proof.

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 appellant has not met his burden of proof to establish a recurrence of 

the need for medical treatment, commencing March 1, 2023, causally related to his accepted right 

shoulder injury.

6 T.B., Docket No. 18-0672 (issued November 2, 2018); O.H., Docket No. 15-0778 (issued June 25, 2015).

7 A.M., Docket No. 22-0322 (issued November 17, 2022); R.C., Docket No. 20-1321 (issued July 7, 2021); R.S., 

Docket No. 19-1774 (issued April 3, 2020).

8 W.M., Docket No. 21-1217 (issued October 11, 2022); T.T., Docket No. 18-1054 (issued April8, 2020); Y.D., 

Docket No. 16-1896 (issued February 10, 2017).
5

ORDER

IT IS HEREBY ORDERED THAT the May 8, 2023 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: January 30, 2024

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board