United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.T., Appellant

and

U.S. POSTAL SERVICE, CHICAGO BULK 

MAIL CENTER, Chicago, IL Employer

__________________________________________

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Docket No. 20-0370

Issued: September 27, 2021

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

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On December 3, 2019 appellant filed a timely appeal from an October 30, 2019 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 her burden of proof to establish greater than seven 

percent permanent impairment of her left upper extremity for which she previously received a 

schedule award.

FACTUAL HISTORY

On August 22, 2002 appellant, then a 36-year-old clerk, filed a traumatic injury claim 

(Form CA-1) alleging that, on August 21, 2002, she developed severe left elbow pain when

 

1

5 U.S.C. § 8101 et seq.
2

throwing skids of mail while in the performance of duty. She returned to light-duty work on 

August 22, 2002. On August 4, 2003 OWCP accepted appellant’s claim for left arm tendinitis.2

On April 7, 2004 appellant filed a claim for compensation (Form CA-7) for a schedule 

award.

By decision dated September 3, 2004, OWCP granted appellant a schedule award for seven 

percent permanent impairment of the left upper extremity.

On June 13, 2019 appellant filed a claim for an additional schedule award (Form CA-7).

In a June 24, 2019 development letter, OWCP informed appellant that additional evidence 

was needed to establish her additional schedule award claim. It advised her of the type of medical 

evidence necessary and afforded her 30 days to respond.

In a report dated July 22, 2019, Dr. David Barnes, a Board-certified family practitioner, 

diagnosed left medial epicondylitis. He noted appellant’s surgery and reported that she was 

experiencing a loss of function due to muscle atrophy and weakness. Utilizing the sixth edition of 

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

Guides),

3 Dr. Barnes found that, under Table 15-4, page 399, appellant’s diagnosis was consistent 

with status post-surgical release of flexor or extensor origins with residual symptoms, which is a 

class of diagnosis (CDX) of 1, with a default value of 5. He further found: a grade modifier for

functional history (GMFH) of 3 (severe) as defined on page 406, Table 15-7 of the A.M.A., 

Guides; a grade modifier for physical examination (GMPE) of 1 (mild decreased from uninjured 

side) in accordance with page 408, Table 15-8; and a grade modifier for clinical studies (GMCS) 

of 2, moderate pathology as found on page 410, Table 15-9 of that A.M.A., Guides. Dr. Barnes 

applied the net adjustment formula from page 411 of the A.M.A., Guides to reach a final rating of 

seven percent permanent impairment of the left upper extremity.

Dr. Barnes also calculated appellant’s loss of range of motion (ROM) of the left elbow,

finding that she exhibited 2 degrees of elbow extension and 78 degrees of elbow supination by 

averaging three repetitions. He applied page 474, Table 15-33, of the A.M.A., Guides, to 

determine that appellant had no permanent impairment due to loss of extension, no permanent 

impairment due to loss of supination, and no permanent impairment based on loss of ROM.

On September 11, 2019 OWCP referred the medical evidence, including Dr. Barnes’

July 22, 2019 report, and a statement of accepted facts (SOAF) to Dr. Jovito Estaris, a physician 

Board-certified in occupational medicine serving as an OWCP district medical adviser (DMA). In 

a September 29, 2019 report, Dr. Estaris found that the GMFH applied by Dr. Barnes was more 

than two grades higher than that of GMPE, rendering it unreliable and excluding it from the net 

adjustment formula in accordance with page 406 of the A.M.A., Guides. He applied the amended 

net adjustment formula and determined that appellant had no more than five percent permanent 

 

2 On September 24, 2003 appellant underwent a left elbow medial epicondylectomy and debridement of the medial 

epicondyle.

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

impairment of the left upper extremity. The DMA further determined that appellant had no 

permanent impairment due to loss of range of motion and, as such, the diagnosis-based impairment 

rating was appropriate.

By decision dated October 30, 2019, OWCP found that appellant had not met her burden 

of proof to establish greater than seven percent permanent impairment of her right upper extremity 

for which she had previously received a schedule award.

LEGAL PRECEDENT

The schedule award provisions of FECA,4 and its implementing federal regulations,5 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. The method used in making such a determination is a matter which rests in the 

discretion of OWCP. For consistent results and to ensure equal justice, the Board has authorized 

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 

sixth edition of the A.M.A., Guides, published in 2009.6 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.7

The sixth edition of the A.M.A., Guides provides a diagnosis-based method of evaluation 

utilizing the World Health Organization’s International Classification of Functioning Disability 

and Health (ICF).

8

 Under the sixth edition, the evaluator identifies the CDX, which is then 

adjusted by the GMFH, GMPE, and GMCS.9 The net adjustment formula is (GMFH - CDX) + 

(GMPE - CDX) + (GMCS - CDX).10 Evaluators are directed to provide reasons for their 

impairment choices, including the choices of diagnoses from regional grids and calculations of 

modifier scores.11

The A.M.A., Guides also provides that the ROM impairment method is to be used as a 

stand-alone rating for upper extremity impairment when other grids direct its use or when no other 

 

4

Supra note 2 at 8107.

5

20 C.F.R. § 10.404.

6 For decisions issued after May 1, 2009 the sixth edition of the A.M.A., Guides(2009) is used. Federal (FECA) 

Procedure Manual, Part 2 -- Claims, Schedule Award and Permanent Disability Claims, Chapter 2.808.5(a)

(March 2017); see also Part 3 -- Medical, Schedule Awards, Chapter 3.700, Exhibit 1 (January 2010).

7 P.R., Docket No. 19-0022 (issued April9, 2018); Isidoro Rivera, 12 ECAB 348 (1961).

8

See A.M.A., Guides(6th ed. 2009), at 3, section 1.3.

9

Id. at 494-531.

10 Id. at 411.

11 R.R., Docket No. 17-1947 (issued December 19, 2018); R.V., Docket No. 10-1827 (issued April1, 2011).
4

diagnosis-based sections are applicable.12 If ROM is used as a stand-alone approach, the total of 

motion impairment for all units of function must be calculated. All values for the joint are 

measured and added.13 Adjustments for functional history may be made if the evaluator 

determines that the resulting impairment does not adequately reflect functional loss and functional 

reports are determined to be reliable.14

Regarding the application of ROM or DBI methodologies in rating permanent impairment 

of the upper extremities, FECA Bulletin No. 17-06 provides in pertinent part that: “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.)15

OWCP’s procedures provide that, after obtaining all necessary medical evidence, the file 

should be routed through an OWCP medical adviser for an opinion concerning the nature and 

percentage of impairment in accordance with the A.M.A., Guides, with an OWCP medical adviser 

providing rationale for the percentage of impairment specified.16

ANALYSIS

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

seven percent permanent impairment of her left upper extremity for which she previously received 

a schedule award.

In his July 22, 2019 report, Dr. Barnes opined that appellant had seven percent permanent 

impairment of the left upper extremity based on the DBI methodology set forth in the sixth edition 

of the A.M.A., Guides. He also used the ROM methodology of the sixth edition of the A.M.A., 

Guides and found that, in accordance with this methodology, she had no permanent impairment of 

the left upper extremity. Dr. Barnes’ impairment rating did not exceed that previously received 

by appellant on September 3, 2004. Therefore, his July 22, 2019 report does not support that 

appellant is entitled to greater left upper extremity permanent impairment than was previously 

awarded. Furthermore, Dr. Barnes’ DBI evaluation of appellant’s permanent impairment was 

inconsistent with the sixth edition of the A.M.A., Guides as he did not exclude the GMFH, which 

was unreliable in accordance with the A.M.A., Guides, page 406 and, thus, excluded from the net 

 

12 A.M.A., Guides 461.

13 Id. at 473.

14 Id. at 474.

15 FECA Bulletin No. 17-06 (May 8, 2018); V.L., Docket No. 18-0760 (issued November 13, 2018).

16 Id.
5

adjustment formula. The Board, therefore, finds that Dr. Barnes’ report lacks probative value and 

is insufficient to establish appellant’s claim for an additional schedule award.17

The DMA, Dr. Estaris, reviewed Dr. Barnes’ July 22, 2019 report and determined that it 

provided sufficient findings, but an incorrect application of the A.M.A., Guides. He applied the

appropriate tables and pages in the A.M.A., Guides and found that appellant had five percent 

permanent impairment of the left upper extremity based upon the DBI rating method. 

The Board finds that the DMA’s opinion constitutes the weight of the medical evidence. 18 

The Board further finds that there is no current medical evidence of record, in conformance with 

the sixth edition of the A.M.A., Guides, establishing that appellant has greater than seven percent 

permanent impairment of the left upper extremity. Accordingly, appellant has not established 

entitlement to a schedule award greater than that previously awarded.19 

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

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

condition resulting in permanent impairment or increased impairment.

CONCLUSION

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

seven percent permanent impairment of her left upper extremity for which she previously received 

a schedule award.

 

17 L.C., Docket No. 19-0564 (issued September 16, 2019).

18 See K.A., Docket No. 20-1463 (issued March 16, 2021); O.F., Docket No. 19-0986 (issued February 12, 2020); 

M.C.,Docket No. 15-1757 (issued March 17, 2016) (the only medical evidence that demonstrated a proper application 

of the A.M.A., Guides was the report of the DMA).

19 D.L. Docket No. 20-1016 (issued December 8, 2020); J.K., Docket No. 19-1420 & 19-1422 (issued 

August12, 2020).
6

ORDER

IT IS HEREBY ORDERED THAT the October 30, 2019 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: September 27, 2021

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board