United States Department of Labor

Employees’ Compensation Appeals Board

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M.W., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

JOSEPH MAXWELL CLELAND ATLANTA 

VA MEDICAL CENTER, Decatur, GA, 

Employer

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Docket No. 23-0832

Issued: December 27, 2023

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 March 13, 2023 appellant, through counsel, filed a timely appeal from a February 23, 

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 her burden of proof to establish greater than one 

percent permanent impairment of her right upper extremity (right arm), for which she previously 

received a schedule award.

1

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On December 7, 2020 appellant, then a 62-year-old nurse, filed a traumatic injury claim 

(Form CA-1) alleging that on November 3, 2020 she sustained injuries to her right shoulder and 

arm when a coworker suddenly opened a door and hit her as she was leaving an office. OWCP 

accepted her claim for right shoulder contusion and cervical contusion. It subsequently expanded 

the acceptance of appellant’s claim to include right shoulder incomplete rotator cuff tear and 

cervicalgia. 

In a report dated June 2, 2022, Dr. Scott Gillogly, a Board-certified orthopedic surgeon, 

indicated that appellant sought treatment for complaints of periscapular paracervical myofascial 

pain, and intermittent numbness that went down to her elbows medially. On physical examination, 

he observed pain to palpation, with trigger points and spasm within the trapezius, rhomboids, and 

paracervical musculature. Examination of appellant’s cervical spine demonstrated limited range 

of motion (ROM), particularly with lateral bend to the left and rotation. Dr. Gillogly reported 

good shoulder ROM. He diagnosed myofascial pain syndrome of the neck and thorax, partial 

thickness right rotator cuff tear, and shoulder pain. Dr. Gillogly opined that appellant had five

percent whole person permanent impairment for the cervical spine, pursuant to the fifth edition of 

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

Guides).

2

On June 22, 2022 appellant filed a claim for compensation (Form CA-7) for a schedule 

award. 

On September 23, 2022 OWCP referred appellant’s case to Dr. Herbert White, Jr., a 

physician Board-certified in occupational medicine serving as an OWCP district medical adviser 

(DMA). In a September 30, 2022 report, Dr. White advised that the case record did not contain 

adequate physical examination findings upon which to base a permanent impairment rating. 

On November 4, 2022 OWCP referred appellant, along with the case record, a statement 

of accepted facts (SOAF) and a series of questions, to Dr. Alexander Doman, a Board-certified 

orthopedic surgeon, for a second opinion examination and evaluation. It requested that he provide 

an opinion on her upper extremity permanent impairment under the standards of the sixth edition 

of the A.M.A., Guides3 and The Guides Newsletter, Rating Spinal Nerve Extremity Impairment 

Using the Sixth Edition (July/August 2009) (The Guides Newsletter). 

In a November 22, 2022 report, Dr. Doman described the November 3, 2020 employment 

injury and noted that appellant’s claim was accepted for right shoulder contusion, cervical 

contusion, and incomplete right shoulder rotator cuff tear. On physical examination of appellant’s 

cervical spine, he observed excellent ROM. ROM examination of her right shoulder, taken on 

three separate occasions, revealed forward flexion of 180 degrees, abduction of 180 degrees, and 

extension of 60 degrees. Dr. Doman reported normal muscle strength and no swelling. He 

2 A.M.A., Guides (5th ed. 2001).

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

diagnosed right shoulder contusion with minimal interstitial partial tear of the rotator cuff, and 

opined that appellant’s cervical contusion had resolved. 

Dr. Doman referred to the sixth edition of the A.M.A., Guides and utilized the diagnosisbased impairment (DBI) rating method to find that, under Table 15-5 (Shoulder Regional Grid),

page 402, the class of diagnosis (CDX) for right shoulder rotator cuff partial thickness tear resulted 

in a Class 1 impairment with a default value of one percent. He assigned a grade modifier for 

functional history (GMFH) of 1; a grade modifier for physical examination (GMPE) of 1; and a 

grade modifier for clinical studies (GMCS) of 1. Dr. Doman utilized the net adjustment formula, 

(GMFH – CDX) + (GMPE – CDX) + (GMCS – CDX) = (1 – 1) + (1 – 1) + (1 – 1) = 0, which 

resulted in no net adjustment. Regarding the ROM rating method, he performed three 

measurements and explained that it was not applicable as there was no loss of ROM of the right 

upper extremity. Dr. Doman also reported that there was no permanent impairment with respect 

to contusion of the cervical spine because there were no neurologic deficits. He reported that 

appellant reached maximum medical improvement (MMI) on November 22, 2022. 

OWCP again referred appellant’s case to Dr. White in his role as DMA and requested that 

he review Dr. Doman’s November 22, 2022 report, and provide an opinion on the permanent 

impairment of her right upper extremity. In a December 11, 2022 report, Dr.White referenced the 

sixth edition of the A.M.A., Guides and utilized the DBI rating method to find that, under Table 

15-5 (Shoulder Regional Grid), page 402, the CDX for right shoulder rotator cuff, partial thickness 

tear resulted in a Class 1 impairment with a default value of one percent. He assigned a GMFH of 

1 and a GMPE of 0 due to normal examination. Dr. White indicated that a GMCS was not 

applicable. He utilized the net adjustment formula, (GMFH – CDX) + (GMPE – CDX) = (1 – 1) 

+ (0 – 1) = -1, which resulted in a grade B or one percent permanent impairment of the right upper 

extremity. Under the ROM rating method, Dr. White referred to Table 15-34 (Shoulder Range of 

Motion) on page 475 and found zero percent permanent impairment for flexion of 180 degrees, 

extension of 60 degrees, abduction of 180 degrees, adduction of 40 degrees, internal rotation of 80 

degrees, and external rotation of 60 degrees. As the DBI-rating method produced the higher 

impairment rating, he concluded that appellant had one percent permanent impairment of the right 

upper extremity. Regarding upper extremity impairment for the cervical nerve root, Dr. White 

indicated that she had zero percent permanent impairment for normal sensory and motor findings. 

He reported that appellant reached MMI on November 22, 2022.

By decision dated February 23, 2023, OWCP granted appellant a schedule award for one 

percent permanent impairment of the right upper extremity (right arm). The award ran for 3.12

weeks from November 22 through December 13, 2022 and was based on the November 22, 2022

report of Dr. Doman and the December 11, 2022 report of Dr. White. 

LEGAL PRECEDENT

The schedule award provisions of FECA4 and its implementing regulations5 set forth the 

number of weeks of compensation payable to employees sustaining permanent impairment from 

4

5 U.S.C. § 8107.

5

20 C.F.R. § 10.404.
4

loss or loss of use, of scheduled members or functions of the body. FECA, however, does not 

specify the manner in which the percentage of loss of a member shall be determined. For consistent 

results and to ensure equal justice under the law for all claimants, OWCP has adopted the A.M.A., 

Guides as the uniform standard applicable to all claimants and the Board has concurred in such 

adoption.6 As of May 1, 2009, the sixth edition of the A.M.A., Guides, published in 2009, is used 

to calculate schedule awards.7 

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 

to be rated.8 With respect to the shoulder, the relevant portion 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 the default grade 

value), the net adjustment formula is applied using GMFH, GMPE, and GMCS. 9 The net 

adjustment formula is (GMFH – CDX) + (GMPE – CDX) + (GMCS – CDX).10 Under Chapter 

2.3, 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 provide that the ROM impairment is to be used as a stand-alone 

rating for upper extremity impairments when other grids direct its use, or when no other diagnosisbased 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 impairment methodologies in rating permanent 

impairment of the upper extremities, FECA Bulletin No. 17-06 provides: 

“As the [A.M.A.,] Guides caution that, if it is clear to the evaluator evaluating loss 

of ROM that a restricted ROM has an organic basis, three independent 

6

Id. at § 10.404 (a); see also T.T., Docket No. 18-1622 (issued May 14, 2019); Jacqueline S. Harris, 54 ECAB 

139 (2002). 

7 Federal (FECA) Procedure Manual, Part 2 --Claims, Schedule Awards and Permanent Disability Claims, Chapter 

2.808.5a (March 2017); see also id. at Chapter 3.700.2 and Exhibit 1 (January 2010).

8 K.R., Docket No. 20-1675 (issued August 19, 2022); M.P., Docket No. 13-2087 (issued April 8, 2014).

9 A.M.A., Guides 405-12; see M.P., id.; Docket No. 13-2087 (issued April 8, 2014).

10 Id. at 411.

11 R.R., Docket No. 17-1947 (issued December 19, 2018); R.V., Docket No. 10-1827 (issued April 1, 2011).

12 A.M.A., Guides 461.

13 Id. at 473.

14 Id. at 474.
5

measurements should be obtained and the greatest ROM should be used for the 

determination of impairment, the CE [claims examiner] should provide this 

information (via the updated instructions noted above) to the rating physician(s).

“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

The Bulletin further advises:

“If the rating physician provided an assessment using the ROM method and the 

[A.M.A.,] Guides allows for use of ROM for the diagnosis in question, the DMA 

should independently calculate impairment using both the ROM and DBI methods 

and identify the higher rating for the CE.”

16

ANALYSIS

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

percent permanent impairment of her right upper extremity (right arm), for which she previously 

received a schedule award.

Appellant submitted a June 2, 2022 report from Dr. Gillogly, an attending physician, who 

indicated that right shoulder ROM examination findings were good, and cervical spine ROM 

findings were limited. Without explanation, Dr. Gillogly opined that she had five percent whole 

person permanent impairment for the cervical spine, pursuant to the fifth edition of the A.M.A., 

Guides. However, the Board finds that this report is of limited probative value because he did not 

provide a rating that conformed to the sixth edition of the A.M.A., Guides and The Guides 

Newsletter.

17

 Moreover, FECA does not allow schedule awards for impairment of the body as a 

whole.

18

 Accordingly, Dr. Gillogly’s opinion is insufficient to show that appellant is entitled to 

an additional schedule award. 

In a November 22, 2022 report, Dr. Doman, serving as an OWCP second-opinion 

examiner, noted right shoulder physical examination findings of normal muscle strength and no 

swelling. He initially utilized DBI method and found a net adjustment formula of zero. Dr. Doman

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

16 Id. 

17 L.J., Docket No. 20-1044 (issued July 9, 2021); S.R., Docket No. 18-1307 (issued March 27, 2019); J.G., Docket 

No. 09-1128 (issued December 7, 2009).

18 J.U., Docket No. 21-1298 (issued February 16, 2023); N.D., 59 ECAB 344 (2008); Tania R. Keka, 55 ECAB 

354 (2004).
6

then reported that ROM examination of appellant’s right shoulder, having taken three separate 

measurements, revealed forward flexion of 180 degrees, abduction of 180 degrees, and extension 

of 60 degrees. He indicated that examination of her cervical spine demonstrated excellent ROM,

and opined that her cervical contusion had resolved. Dr. Doman diagnosed right shoulder 

contusion with minimal interstitial partial tear of the rotator cuff.

In accordance with its procedures, OWCP properly routed the case record back to

Dr. White in his role as DMA, who indicated in a December 11, 2022 report that he had reviewed

Dr. Doman’s November 22, 2022 report. Dr. White referenced the sixth edition of the A.M.A., 

Guides and utilized the DBI rating method to find that, under Table 15-5 (Shoulder Regional Grid), 

the CDX for right shoulder rotator cuff, partial thickness tear resulted in a Class 1 impairment with 

a default value of one percent. He assigned a GMFH of 1 and a GMPE of 0 due to normal 

examination. Dr. White indicated that a GMCS was not applicable. He utilized the net adjustment 

formula, (GMFH – CDX) + (GMPE – CDX) = (1 – 1) + (0 – 1) = -1, which resulted in a grade B 

or one percent permanent impairment of the right upper extremity. Under the ROM rating method,

Dr. White referred to Table 15-34 (Shoulder Range of Motion) and determined that appellant had 

zero percent permanent impairment for flexion of 180 degrees, extension of 60 degrees, abduction 

of 180 degrees, adduction of 40 degrees, internal rotation of 80 degrees, and external rotation of 

60 degrees. As the DBI-rating method produced the higher impairment rating, he concluded that 

she had one percent permanent impairment of the right upper extremity. Regarding upper 

extremity impairment for the cervical nerve root, Dr. White determined that appellant had zero 

percent permanent impairment for normal sensory and motor findings. 

The Board finds that OWCP properly relied on the opinion of Dr. White, the DMA, to find 

that appellant had no greater than one percent permanent impairment of her right upper extremity. 

Dr. White properly applied the standards of the A.M.A., Guides to the physical examination 

findings of Dr. Doman, and properly referred to the A.M.A., Guides in calculating appellant’s 

percentage of permanent impairment of the right upper extremity.19 The Board finds that, in the 

above-described calculations, Dr. White reached conclusions regarding her permanent impairment 

that are in accordance with the standards of the sixth edition of the A.M.A., Guides.20 There is no 

medical evidence of record utilizing the appropriate tables of the sixth edition of the A.M.A., 

Guides, demonstrating a greater percentage of permanent impairment of the right upper extremity. 

Accordingly, the Board finds that, as appellant has not submitted medical evidence establishing 

more than one percent permanent impairment of the right upper extremity (right arm), she has not 

met her burden of proof.

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.

19 See R.G., Docket No. 21-0491 (issued March 23, 2023).

20 See T.S., Docket No. 22-0924 (issued April 27, 2023).
7

CONCLUSION

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

percent permanent impairment of her right upper extremity (right arm), for which she previously 

received a schedule award.

ORDER

IT IS HEREBY ORDERED THAT the February 23, 2023 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: December 27, 2023

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