United States Department of Labor

Employees’ Compensation Appeals Board

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R.R., Appellant

and

GOVERNMENT PRINTING OFFICE, 

Washington, DC, Employer

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Docket No. 22-1046

Issued: May 5, 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

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On July 7, 2022 appellant filed a timely appeal from a May 2, 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.

ISSUE

The issue is whether OWCP met its burden of proof to terminate appellant’s wage-loss 

compensation, effective May 2, 2022, as he no longer had disability causally related to his accepted 

July 9, 1987 employment injury.

FACTUAL HISTORY

On July 16, 1987 appellant, then a 39-year-old clerk, filed a traumatic injury claim (Form 

CA-1) alleging that on July 9, 1987 he injured his lower back when lifting a bundle of books while 

1

5 U.S.C. § 8101 et seq.
2

in the performance of duty. He stopped work on July 10, 1987. OWCP accepted the claim for 

lumbosacral strain and cervical intervertebral disc displacement without myelopathy. On

December 26, 1993 appellant returned to light-duty work as a clerk. OWCP accepted multiple 

recurrence claims and paid him wage-loss compensation on the periodic rolls, effective 

October 6, 2002.2

On November 29, 2021 OWCP referred appellant, together with a statement of accepted 

facts (SOAF), a series of questions, and the medical record to Dr. Rafael Lopez, a Board-certified

orthopedic surgeon, for a second opinion evaluation regarding the status of appellant’s accepted 

conditions, extent of disability, and appropriate treatment. In an attachment to the referral letter, 

it noted that appellant’s accepted conditions were sprain of lumbosacral (joint) (ligament), and 

displacement of cervical intervertebral disc without myelopathy. The enclosed August 21, 2019 

SOAF noted that appellant’s claim was accepted for back sprain and bulging disc. It also noted 

that appellant had not undergone surgery under this claim, but that there were indications of record 

that he had also undergone back surgery prior to his employment injury.

In a report dated December 18, 2021, Dr. Lopez noted the SOAF, appellant’s history of 

injury, and medical treatment. He reported that appellant’s claim had been accepted for 

lumbosacral joint/ligament sprain and cervical intervertebral disc displacement without 

myelopathy. Physical examination findings included a normal gait, and no evidence of significant 

swelling, erythema, crepitation, spasm, atrophy or deformity in the cervical, thorax, and sacroiliac. 

Dr. Lopez reported 45 degrees bilateral rotation, extension, and flexion, 10 degrees right lateral 

flexion, and 30 degrees left lateral flexion of the neck and 80 degrees flexion, 90 degrees sitting 

flexion, 20 degrees extension, and 30 degrees bilateral lateral bending of the lower back/sacroiliac. 

A neurological examination revealed normal results. Dr. Lopez noted his review of an October 8, 

2015 lumbar magnetic resonance imaging (MRI) scan, which demonstrated degenerative changes, 

and a March 28, 2016 cervical MRIscan, which demonstrated degenerative stenosis, and indicated

that he had not requested any additional diagnostic studies. In concluding he opined that 

appellant’s work-related conditions had resolved as contusions, strains, and sprains were minor 

self-limiting conditions that, spontaneously healed within days or weeks, there were no objective 

findings or medical evidence that supported appellant’s subjective complaints, and surgery had 

resolved his accepted conditions. Dr. Lopez opined that appellant was capable of performing his 

date-of-injury job without restrictions.

On March 31, 2022 OWCP advised appellant of its proposed termination of his wage-loss 

compensation as he no longer had disability causally related to his accepted employment injury. 

It indicated that the weight of the medical opinion evidence regarding employment-related 

disability rested with the December 18, 2021 report of Dr. Lopez. OWCP afforded appellant 30 

days to present evidence or argument challenging the proposed termination action. No response 

was received.

By decision dated May 2, 2022, OWCP terminated appellant’s wage-loss compensation 

effective that date, finding that he no longer had disability causally related to his accepted July 9, 

2 Appellant retired from the employing establishment effective December 3, 2003. 
3

1987 employment injury. It accorded the weight of the medical evidence to the opinion of

Dr. Lopez.

LEGAL PRECEDENT

Once OWCP accepts a claim and pays compensation, it has the burden of proof to justify 

termination or modification of an employee’s benefits.3 After it has determined that, an employee 

has disability causally related to his or her federal employment, OWCP may not terminate 

compensation without establishing that the disability has ceased or that it is no longer related to 

the employment.

4

 Its burden of proof includes the necessity of furnishing rationalized medical 

opinion evidence based on a proper factual and medical background.

5

ANALYSIS

The Board finds that OWCP failed to meet its burden of proof to terminate appellant’s 

wage-loss compensation, effective May 2, 2022.

The Board finds that the December 18, 2021 report from Dr. Lopez lacks sufficient medical 

reasoning to establish that appellant no longer had any disability due to the accepted lumbosacral 

strain and cervical intervertebral disc displacement without myelopathy. Dr. Lopez opined that 

appellant could return to his date-of-injury job with no restrictions. He based this opinion in part 

on his examination and observation that appellant’s 2015 and 2016 MRI scans showed 

degenerative changes and that new diagnostic testing was unnecessary to evaluate the current 

status of appellant’s accepted conditions. Dr. Lopez concluded in general terms that sprains and 

strains usually resolved within days or weeks, but he did not explain when appellant’s accepted 

lumbosacral strain no longer caused appellant disability, and he did not specifically address how 

he concluded that appellant accepted cervical disc displacement no longer caused disability. 

OWCP’s procedures dictate that, when an OWCP medical adviser, second opinion 

specialist, or impartial medical examiner renders a medical opinion based on a SOAF, which is 

incomplete or inaccurate, or does not use the SOAFas the framework in forming his or her opinion, 

the probative value of the opinion is seriously diminished or negated altogether. 6 The Board finds 

that Dr. Lopez failed to explain with medical rationale why appellant no longer had any disability 

3

See P.T., Docket No. 21-0328 (issued May 2, 2022); T.C., Docket No. 20-1163 (issued July 13, 2021); A.T., 

Docket No. 20-0334 (issued October 8, 2020); S.F., 59 ECAB 642 (2008); KellyY. Simpson, 57 ECAB 197 (2005);

Paul L. Stewart, 54 ECAB 824 (2003).

4

See P.T., id.; T.C., id.; Jason C. Armstrong, 40 ECAB 907 (1989); Charles E. Minnis, 40 ECAB 708 (1989);

Vivien L. Minor, 37 ECAB 541 (1986).

5 P.T., id.; K.W., Docket No. 19-1224 (issued November 15, 2019);see M.C., Docket No. 18-1374 (issued April23, 

2019); Del K. Rykert, 40 ECAB 284, 295-96 (1988).

6 Federal (FECA) Procedure Manual, Part 3 -- Medical, Requirements for Medical Reports, Chapter 3.600.3 

(October 1990); see K.L., Docket No. 21-0104 (issued February 24, 2022); S.C., Docket No. 18-1011 (issued 

March 23, 2020).
4

due to the accepted conditions. Rationalized medical evidence must explain how the physician

reached the conclusion he or she is supporting and must be based on a proper review of the SOAF.

7

Once OWCP undertook development of the record, it was required to complete 

development of the record by procuring medical evidence that would resolve the relevant issue in 

the case.8 As it did not obtain a rationalized medical opinion from the second opinion physician, 

the Board finds that it failed to meet its burden of proof in terminating appellant’s wage-loss 

compensation. 

CONCLUSION

The Board finds that OWCP failed to meet its burden of proof to terminate appellant’s 

wage-loss compensation, effective May 2, 2022.

ORDER

IT IS HEREBY ORDERED THAT the May 2, 2022 decision of the Office of Workers’

Compensation Programs is reversed.

Issued: May 5, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

7 C.G., Docket No. 21-0171 (issued November 29, 2021); B.B., Docket No. 19-1102 (issued November 7, 2019);

Beverly A. Spencer, 55 ECAB 501 (2004).

8 C.B., Docket No. 20-0629 (issued May 26, 2021); J.F., Docket No. 17-1716 (issued March 1, 2018).