United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.D., Appellant

and

U.S. POSTAL SERVICE, ANAHEIM 

PROCESSING & DISTRIBUTION CENTER, 

Anaheim, CA, Employer

__________________________________________

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Docket No. 22-1264

Issued: May 15, 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 August 28, 2022 appellant filed a timely appeal from a May 19, 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.

ISSUES

The issues are: (1) whether appellant has met her burden of proof to establish a 

recurrence of total disability commencing October 24, 2018, causally related to her accepted 

employment injury; and (2) whether appellant has met her burden of proof to establish disability 

on June 8 and 9, 2019, causally related to her accepted employment injury.

1

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

This case has been previously before the Board.2 The facts and circumstances as set forth 

in the Board’s prior decision are incorporated herein by reference. The relevant facts are set 

forth below.

On November 18, 2014 appellant, then a 54-year-old clerk, filed an occupational disease

claim (Form CA-2) alleging that she experienced left knee pain due to factors of her federal 

employment which required repetitive bending, reaching, pulling, pushing, grasping and 

standing. OWCP accepted the claim for left knee sprain, left knee meniscal tear, and bilateral 

knee primary osteoarthritis. It paid appellant wage-loss compensation on the supplemental rolls 

from October 9, 2014 and subsequently on the periodic rolls from May 1 through 

October 15, 2016. Appellant again received intermittent wage-loss compensation on the 

supplemental rolls as of October 16, 2016, including June 10 through 22, 2019. OWCP 

thereafter paid wage-loss compensation on the periodic rolls as of June 23, 2019. 

On October 22, 2016 appellant returned to part-time limited-duty work, four hours per

day. On February 20, 2017 she returned to full-time full-duty work. On October 25, 2018

appellant accepted the employing establishment’s offer of a part-time modified assignment as a

parcel post distribution machine clerk scanning small parcel bundles/hanging sacks.

Appellant subsequently filed claims for compensation (Form CA-7) for intermittent

disability from work from October 24, 2018 through January 18, 2019.

In support of her claims, appellant submitted medical evidence.

OWCP, by decision dated January 28, 2019, denied appellant’s claim for a recurrence of 

total disability commencing October 24, 2018, finding that the medical evidence of record was 

insufficient to establish that she was disabled from work due to a material change/worsening of 

her accepted employment-related conditions. 

Thereafter, OWCP received medical evidence.

On May 22, 2019 appellant requested reconsideration of the January 28, 2019 OWCP 

decision and submitted additional medical evidence.

Thereafter, appellant filed additional Form CA-7 claims for compensation for disability

from work including from June 8 through 9, 2019. On a time analysis form (Form CA-7a) dated 

June 24, 2019, she claimed leave without pay (LWOP) used on June 8 and 9, 2019.3

Appellant submitted medical evidence in support of her claims. 

2 Docket No. 20-0179 (issued April 8, 2021).

3 OWCP paid appellant wage-loss compensation on the periodic rolls for the period June 10 through 

July 20, 2019. 
3

In a development letter dated July 1, 2019, OWCP requested that appellant submit 

medical evidence to establish that she was temporarily totally disabled on June 8 and 9, 2019. It 

afforded her 30 days to submit the necessary evidence.

OWCP subsequently received medical evidence.

By decision dated August 1, 2019, OWCP denied appellant’s claim for compensation for 

disability from work on June 8 and 9, 2019, finding that she had not submitted a rationalized 

medical opinion sufficient to establish total disability on the claimed dates due to her accepted 

employment injury.

OWCP received additional medical evidence. 

OWCP, by decision dated August 20, 2019, denied modification of its January 28, 2019 

recurrence decision, finding that the medical evidence submitted did not provide a rationalized 

medical opinion sufficient to establish that appellant’s claimed recurrence of total disability 

commencing October 24, 2018, was causally related to her accepted employment injury.

OWCP continued to receive medical evidence. 

On October 31, 2019 appellant appealed the August 1 and 20, 2019 decisions to the 

Board. By decision dated April 8, 2021, the Board affirmed the August 1 and 20, 2019 

decisions.4 The Board found that appellant had not submitted medical evidence establishing a 

recurrence of total disability commencing October 24, 2018, causally related to her accepted 

employment injury. The Board further found that she had not submitted medical evidence 

establishing employment-related disability on June 8 and 9, 2019. 

Thereafter, OWCP received medical evidence. In x-ray reports dated June 15, 2021,

Dr. Ellen Y. Chang, a Board-certified neurologist, provided an impression of bilateral total knee 

arthroplasties in unchanged, near anatomic alignment and without definite radiographic evidence 

for interval complication.

In a November 13, 2020 office/clinic note and a June 22, 2021 progress note, Dr. Paul K. 

Gilbert, an orthopedic surgeon, indicated that appellant presented for follow-up evaluation of her 

right knee. He noted that she was two years’ status post right total knee arthroplasty and five 

years’ status post left total knee arthroplasty. Dr. Gilbert reported his findings on physical and 

x-ray examination. He provided assessments of foot pain and status post right and left total knee 

arthroplasties. 

OWCP also received hospital records dated May 23, 2019 through November 13, 2020, 

which were previously of record. 

Appellant requested reconsideration before OWCP on October 28, 2021 and continued to 

submit medical evidence. 

4

Supra note 2.
4

Dr. Basimah Khulusi, a Board-certified physiatrist, submitted right knee x-ray reports 

dated June 20, 2017 and June 19, 2018. She also submitted a July 28, 2021 addendum report 

from Dr. Eric Chen, a Board-certified internist, who compared the June 20, 2017 and June 19, 

2018 x-rays on June 30, 2021 and provided his findings. Based on Dr. Chen’s findings,

Dr. Khulusi, in a July 27, 2021 report, determined that appellant had progressive loss of 

thickness of the cartilage in all three compartments of her right knee joint from 2017 until 2018, 

that was significant and measurable on the above-noted x-rays. Thus, she advised that 

appellant’s right knee degeneration was worse on June 19, 2018 than June 20, 2017. Dr. Khulusi 

observed that the right knee degeneration continued to progress spontaneously with continuous 

wearing out of the protective cartilage and thinning of the protective cartilage in all three 

compartments of the knee joint which was an objective finding that undeniably determined that 

appellant’s right knee condition had been deteriorating and explained the progression of her 

symptoms that became severe enough to necessitate right total knee replacement surgery. She 

referenced Chapter 2.1500.3c(5) of OWCP’s procedures,5 and contended that it applied to 

appellant’s case because her diagnosis remained the same, and her disability increased due to 

additional exposure to the same work factors prior to October 24, 2018 with the objective proof 

of worsening based on the above-described x-ray results with progressive wearing out of the 

cartilage in all three compartments of the right knee joint which was supposed to protect her 

knee.

Also submitted were June 20, 2017 and June 19, 2018 bilateral knee x-ray reports 

submitted by Dr. Khulusi which were previously of record. 

X-ray reports dated October 30, 2018, and May 28 and June 19, 2019 from Dr. Jordan 

Gross, a Board-certified diagnostic radiologist, Dr. Dakshesh Patel, a diagnostic radiologist, and

Dr. George Matcuk, a Board-certified diagnostic radiologist, respectively, addressed appellant’s 

bilateral knee conditions and were also previously of record. 

OWCP, by decision dated November 15, 2021, denied modification of its prior August 1, 

2019 disability and August 20, 2019 recurrence decisions.

OWCP received a June 15, 2021 adult ambulatory intake report from Xiomara 

Rodriguez.

6

On February 28, 2022 appellant requested reconsideration of the November 15, 2021 

decision. 

By decision dated May 19, 2022, OWCP denied modification of its November 15, 2021 

decision. 

5

See Federal (FECA) Procedure Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.3c(5) (June 2013).

6 The Board notes that Ms. Rodriguez’s professional qualifications are not contained in the case record.
5

LEGAL PRECEDENT -- ISSUE 1

A recurrence of disability means an inability to work after an employee has returned to 

work, caused by a spontaneous change in a medical condition which resulted from a previous 

compensable injury or illness and without an intervening injury or new exposure in the work 

environment.7 This term also means an inability to work because a light-duty assignment made 

specifically to accommodate an employee’s physical limitations and, which is necessary because 

of a work-related injury or illness, is withdrawn or altered so that the assignment exceeds the 

employee’s physical limitations. A recurrence does not occur when such withdrawal occurs for 

reasons of misconduct, nonperformance of job duties, or a reduction-in-force.8

OWCP’s procedures provide that a recurrence of disability includes a work stoppage 

caused by a spontaneous material change in the medical condition demonstrated by objective 

findings. That change must result from a previous injury or occupational illness rather than an 

intervening injury or new exposure to factors causing the original illness. It does not include a 

condition that results from a new injury, even if it involves the same part of the body previously 

injured.9

An employee who claims a recurrence of disability due to an accepted employmentrelated injury has the burden of proof to establish by the weight of the substantial, reliable, and 

probative evidence that the disability for which he or she claims compensation is causally related 

to the accepted injury. This burden of proof requires that a claimant furnish medical evidence 

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

concludes that, for each period of disability claimed, the disabling condition is causally related to 

the employment injury, and supports that conclusion with medical reasoning. 10 Where no such 

rationale is present, the medical evidence is of diminished probative value. 11

ANALYSIS -- ISSUE 1

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

of total disability, commencing October 24, 2018, causally related to her accepted employment 

injury.

Preliminarily, the Board notes that findings made in prior Board decision are res judicata, 

absent further review by OWCP under section 8128 of FECA. It is, therefore, unnecessary for 

the Board to consider the evidence appellant submitted prior to the issuance of OWCP’s 

7

20 C.F.R. § 10.5(x); see J.D., Docket No. 18-1533 (issued February 27, 2019).

8

Id.

9

Supra note 5 at Chapter 2.1500.2b (June 2013); L.B., Docket No. 18-0533 (issued August 27, 2018).

10 J.D., Docket No. 18-0616 (issued January 11, 2019); C.C., Docket No. 18-0719 (issued November 9, 2018).

11 H.T., Docket No. 17-0209 (issued February 8, 2018).
6

August 1, 2019 recurrence decision as the Board considered that evidence in its April 8, 2021 

decision.12

In support of her claim, appellant submitted Dr. Khulusi’s July 27, 2021 report wherein 

she maintained that Dr. Chen’s July 28, 2021 report, in which he compared x-rays taken on

June 20, 2017 to x-rays taken on June 19, 2018, established that appellant’s right knee condition 

had progressively worsened after June 20, 2017. Dr. Khulusi maintained that Dr. Chen’s 

findings revealed a progressive loss of thickness of the cartilage in all three compartments of the

right knee joint from 2017 until 2018. She further maintained that the right knee degeneration 

continued to progress spontaneously with continuous wearing out of the protective cartilage, and 

thinning of the protective cartilage in all three compartments of the knee joint which was an 

objective finding that undeniably indicated the deterioration and progression of her right knee 

condition that necessitated total right knee replacement. While Dr. Khulusi found that 

appellant’s right knee condition had worsened based on objective evidence, she failed to address 

appellant’s total disability beginning October 24, 2018. The Board has held that medical 

evidence that does not provide an opinion as to whether a condition or period of disability is due 

to an accepted employment-related condition is of no probative value.13 Thus, the Board finds 

that this evidence is insufficient to establish appellant’s recurrence claim. 

Likewise, Dr. Chen’s July 28, 2021 report is also insufficient to establish appellant’s 

recurrence claim. While Dr. Chen compared the June 20, 2017 and June 19, 2018 x-rays, he did 

not provide an opinion addressing appellant’s total disability beginning October 24, 2018.14

Dr. Gilbert’s November 13, 2020 and June 22, 2021 notes provided assessments of foot 

pain and status post right and left total knee arthroplasties. However, he did not provide an 

opinion on causal relationship.

15

Appellant also submitted Dr. Chang’s June 15, 2021 diagnostic test report which 

addressed appellant’s bilateral knee conditions. However, the Board has held that reports of 

diagnostic testing, standing alone, lack probative value as they do not address whether a given 

medical condition or period of disability was caused by the employment. 16

12 M.S.,Docket No. 20-1095 (issued March 29, 2022); C.D., Docket No. 19-1973 (issued May 21, 2020); M.D., 

Docket No. 20-0007 (issued May 13, 2020); Clinton E. Anthony, Jr., 49 ECAB 476 (1998).

13 J.M., Docket No. 22-0280 (issued June 29, 2022); C.M., Docket No. 21-0004 (issued May 24, 2021); R.J., 

Docket No. 19-0179 (issued May 26, 2020); M.A., Docket No. 19-1119 (issued November 25, 2019); S.I., Docket 

No. 18-1582 (issued June 20, 2019); L.B.,Docket No. 18-0533 (issued August 27, 2018);D.K.,Docket No. 17-1549 

(issued July 6, 2018).

14 Id.

15 Id.

16 See J.M., supra note 13;K.W., Docket No. 20-0230 (issued May 21, 2021); M.M.,Docket No. 20-1557 (issued 

November 3, 2021); T.G., Docket No. 20-0032 (issued November 10, 2020); R.N., Docket No. 19-1685 (issued 

February 26, 2020); T.H., Docket No. 18-1736 (issued March 13, 2019).
7

Additionally, appellant submitted the June 15, 2021 adult ambulatory intake report from

Ms. Rodriguez whose professional qualifications are not contained in the case record. The Board 

has held that a medical report may not be considered probative medical evidence if there is no 

indication that the person completing the report qualifies as a physician under FECA. 17 

Therefore, this report is insufficient to establish appellant’s recurrence claim.

As appellant has not submitted medical evidence establishing a recurrence of disability 

commencing October 24, 2018, causally related to her accepted employment injury, the Board 

finds that she has not met her burden of proof.

LEGAL PRECEDENT -- ISSUE 2

For each period of disability claimed, the employee has the burden of proof to establish

that he or she was disabled from work as a result of the accepted employment injury.18 Whether

a particular injury causes an employee to become disabled from work, and the duration of that

disability, are medical issues that must be proven by a preponderance of probative and reliable

medical opinion evidence.19

Under FECA, the term disability means an incapacity because of an employment injury,

to earn the wages the employee was receiving at the time of the injury.20 When, however, the

medical evidence establishes that the residuals or sequelae of an employment injury are such

that, from a medical standpoint, prevent the employee from continuing in his or her employment,

he or she is entitled to compensation for any loss of wages.21

To establish causal relationship between the disability claimed and the employment

injury, an employee mustsubmit rationalized medical evidence, based on a complete factual and

medical background, supporting such causal relationship.22 The opinion of the physician must

be one of reasonable medical certainty and must be supported by medical rationale explaining

the nature of the relationship between the diagnosed condition and the specific employment

factors identified by the employee.23

17 A.D., Docket No. 20-0179 (issued April8, 2021); C.S., Docket No. 19-1377 (issued February 26, 2020); R.M., 

59 ECAB 690 (2008).

18 See L.F., Docket No. 19-0324 (issued January 2, 2020); T.L., Docket No. 18-0934 (issued May 8, 2019); 

Fereidoon Kharabi, 52 ECAB 291, 293 (2001).

19 See 20 C.F.R. § 10.5(f); N.M., Docket No. 18-0939 (issued December 6, 2018).

20 Id. at § 10.5(f); see, e.g.,G.T., 18-1369 (issued March 13, 2019); Cheryl L. Decavitch, 50 ECAB 397 (1999).

21 G.T., id.; Merle J. Marceau, 53 ECAB 197 (2001).

22 See S.J., Docket No. 17-0828 (issued December 20, 2017); Kathryn E. DeMarsh, 56 ECAB 677 (2005).

23 C.B., Docket No. 18-0633 (issued November 16, 2018); Leslie C. Moore, 52 ECAB 132 (2000); Gary L.

Fowler, 45 ECAB 365 (1994).
8

ANALYSIS -- ISSUE 2

The Board finds that appellant has not met her burden of proof to establish disability on 

June 8 and 9, 2019, causally related to her accepted employment injury.

The Board again notes that findings made in prior Board decisions are res judicata, 

absent further review by OWCP under section 8128 of FECA. It is, therefore, unnecessary for 

the Board to consider the evidence appellant submitted prior to the issuance of OWCP’s 

August 20, 2019 disability decision as the Board considered that evidence in its April 8, 2021 

decision.24

For the claimed wage loss on June 8 and 9, 2019, the Board finds that the record is 

devoid of medical evidence supporting that appellant was disabled due to the accepted 

employment injury.25 The Board will not require OWCP to pay compensation for disability in 

the absence of medical evidence directly addressing the specific dates of disability for which 

compensation is claimed. To do so would essentially allow employees to self -certify their 

disability and entitlement to compensation.26

As there is no medical evidence of record establishing employment-related disability on 

June 8 and 9, 2019, appellant has failed to meet her 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 her burden of proof to establish a recurrence 

of total disability, commencing October 24, 2018, causally related to her accepted employment 

injury. The Board further finds that she has not met her burden of proof to establish disability on 

June 8 and 9, 2019, causally related to her accepted employment injury.

24 Supra note 12.

25 See A.B., Docket No. 19-0185 (issued July 24, 2020).

26 Id.; R.A., Docket No. 19-1752 (issued March 25, 2020); Fereidoon Kharabi, supra note 18.
9

ORDER

IT IS HEREBY ORDERED THAT the May 19, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: May 15, 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