UNITED STATES OF AMERICA

MERIT SYSTEMS PROTECTION BOARD 

HEATHER TODD,

Appellant,

v.

DEPARTMENT OF VETERANS 

AFFAIRS,

Agency.

DOCKET NUMBER

DE-0752-16-0409-I-1

DATE: February 10, 2023

THIS FINAL ORDER IS NONPRECEDENTIAL1

Peter F. Carroll, Esquire, Kalispell, Montana, for the appellant.

Alexandra M. Felchlin, Denver, Colorado, for the agency.

BEFORE

Cathy A. Harris, Vice Chairman

Raymond A. Limon, Member

Tristan L. Leavitt, Member

FINAL ORDER

¶1 The appellant has filed a petition for review of the initial decision, which 

reversed her removal but denied her affirmative defenses. Generally, we grant 

petitions such as this one only in the following circumstances: the initial decision 

contains erroneous findings of material fact; the initial decision is based on an 

 

1 A nonprecedential order is one that the Board has determined does not add 

significantly to the body of MSPB case law. Parties may cite nonprecedential orders, 

but such orders have no precedential value; the Board and administrative judges are not 

required to follow or distinguish them in any future decisions. In contrast, a 

precedential decision issued as an Opinion and Order has been identified by the Board 

as significantly contributing to the Board’s case law. See 5 C.F.R. § 1201.117(c).
2

erroneous interpretation of statute or regulation or the erroneous application of 

the law to the facts of the case; the administrative judge’s rulings during either 

the course of the appeal or the initial decision were not consistent with required 

procedures or involved an abuse of discretion, and the resulting error affected the 

outcome of the case; or new and material evidence or legal argument is available 

that, despite the petitioner’s due diligence, was not available when the record 

closed. Title 5 of the Code of Federal Regulations, section 1201.115 (5 C.F.R. 

§ 1201.115). After fully considering the filings in this appeal, we conclude that

the appellant has not established any basis under section 1201.115 for granting 

the petition for review. Therefore, we DENY the petition for review and 

AFFIRM the initial decision, which is now the Board’s final decision. 5 C.F.R. 

§ 1201.113(b). 

¶2 The following facts, as further detailed in the initial decision, are not 

disputed. The agency hired the appellant in October 2015, under reinstatement 

authority. Initial Appeal File (IAF), Tab 29, Initial Decision (ID) at 2. The 

agency removed her in June 2016, without due process, under the mistaken belief 

that she was a probationary employee. ID at 2-3. Its cited reasons for the 

removal were (1) excessive leave usage, (2) unauthorized absence, and (3) failure 

to adhere to the sick leave certification requirements that had been imposed by 

the agency. ID at 2. After the appellant filed the instant Board appeal, the 

agency recognized its mistake, rescinded the notice of termination, and instructed 

her to return to duty. Id.

¶3 Because the appellant waived her right to a hearing, the administrative 

judge issued a decision based on the written record. She reversed the appellant’s 

removal based on the agency’s admitted due process violation, but denied the 

appellant’s affirmative defenses of harmful procedural error and disability 

discrimination. ID at 3-4, 6-12. The administrative judge ordered the agency to 

cancel the removal and retroactively restore the appellant, effective June 28,

2016. ID at 12-13.
3

¶4 The appellant has filed a petition for review. Petition for Review (PFR) 

File, Tab 1. The agency has filed a response and the appellant has replied. PFR

File, Tabs 4-5. 

The appellant’s harmful error claim is moot.

¶5 We first note that the agency concedes that its removal action must be 

reversed, based on its admitted due process violation. IAF, Tab 18 at 1, Tab 19 

at 9. Accordingly, while the appellant has reasserted her harmful procedural error 

affirmative defense on review, PFR File, Tab 1 at 4-7, that matter is moot. Even 

if the appellant could prove that the agency committed a harmful error, it would 

not result in any additional relief beyond that which is required for its due process 

violation. See, e.g., Carter v. U.S. Postal Service, 75 M.S.P.R. 51, 55 n.4 (1997) 

(acknowledging but not ruling on an appellant’s harmful error claims because the 

appellant’s removal had to be reversed for other reasons); Hejka v. U.S. Marine 

Corps, 9 M.S.P.R. 137, 140 (1981) (same); see also Goeke v. Department of 

Justice, 122 M.S.P.R. 69, ¶¶ 23-27 (2015) (finding that the appellants proved 

their harmful procedural error claim and, as a result, ordering cancellation of the 

agency’s adverse action). 

¶6 Although the agency’s admission of the due process violation does render 

some issues moot, it does not render the case moot because live issues remain. 

Here, those live issues include the appellant’s restoration to the status quo ante 

and any claim for damages that are within the Board’s jurisdiction. See Hess v. 

U.S. Postal Service, 124 M.S.P.R. 40, ¶¶ 8, 19 (2016) (recognizing that an 

agency’s rescission of an action appealed does not render the appeal moot if that 

rescission fails to afford all relief available before the Board, including status quo 

ante relief and compensatory damages for discrimination claims).

The appellant has failed to prove that the agency engaged in disability 

discrimination.

¶7 The appellant presented general allegations below, which the administrative 

judge construed as an affirmative defense of disability discrimination. IAF,
4

Tab 7 at 1, Tab 18 at 3. She found that while the record supported the existence 

of disabling conditions, post-traumatic stress disorder and gastritis, the appellant 

failed to meet her burden of proving that the agency engaged in disability 

discrimination. ID at 9-12. 

¶8 Most notably, the administrative judge found neither the appellant nor the 

pertinent agency officials were even aware of the appellant’s disabilities until 

after her termination, when she received treatment and diagnoses. ID at 9-10; 

IAF, Tab 19 at 83, 85, 87, Tab 26 at 15, 18. The administrative judge further 

found that the appellant did not request any accommodation and agency officials 

were unaware of any need for one. ID at 9; see Paris v. Department of the 

Treasury, 104 M.S.P.R. 331, ¶ 17 (2006) (recognizing that a disability 

discrimination claim for failure to accommodate will fail if the employee never 

requested accommodation while employed). Although the appellant had taken a 

notable amount of sporadic leave prior to her termination, the administrative 

judge concluded that the timing and reasons given for the leave did not give rise 

to an inference of disability or need for accommodation. ID at 10; IAF, Tab 12 

at 24-25, Tab 19 at 18-21. The administrative judge also concluded that even if 

pertinent agency officials had perceived her as disabled, the appellant did not 

present any evidence that suggested discriminatory animus. ID at 10; see

Gardner v. Department of Veterans Affairs, 123 M.S.P.R. 647, ¶¶ 28-29 (2016) 

(explaining that an appellant may rely on various types of evidence that the Board 

will evaluate as a whole, including direct evidence or any of the three types of 

indirect evidence, i.e., pretext, comparator, or other bits and pieces that present a 

“convincing mosaic” of discrimination), clarified by Pridgen v. Office of 

Management and Budget, 2022 MSPB 31, ¶¶ 23-24. While the appellant argued 

that her supervisor withheld information concerning Family and Medical Leave 

Act (FMLA) leave or other helpful programs, the administrative judge correctly 

concluded that the record reflected the opposite, as those officials repeatedly 

offered the appellant various resources such as the Employee Assistance Program 
5

and a Human Resource Specialist who could provide FMLA assistance. ID

at 10-11; IAF, Tab 12 at 24-25, 29-30, Tab 19 at 14.

¶9 In reasserting her disability discrimination claim on review, the appellant 

has presented a number of conclusory assertions, without identifying any 

supportive evidence. PFR File, Tab 1 at 7-12; see 5 C.F.R. § 1201.115(a)

(requiring that a petition for review identify specific evidence in the record 

demonstrating any alleged erroneous findings of material fact and explain why 

the challenged factual determinations are incorrect); see also Tines v. Department 

of the Air Force, 56 M.S.P.R. 90, 92 (1992) (explaining that a petition for review 

must contain sufficient specificity for the Board to ascertain whether there is a 

serious evidentiary challenge justifying a complete review of the record). 

Moreover, many of the conclusory assertions have little or no bearing on a 

disability discrimination analysis. For example, the appellant argues that the 

agency treated her differently because of the mistaken belief that she was a 

probationary employee. PFR File, Tab 1 at 7-9. Even if true, that has no 

apparent bearing on the limited issue before us – whether the agency was 

improperly motivated by the appellant’s disability when it terminated her or 

failed to provide her with reasonable accommodation.2See Forte v. Department 

of the Navy, 123 M.S.P.R. 124, ¶¶ 27-33 (2016) (discussing a disability 

discrimination claim in the context of disparate treatment allegations); Clemens v. 

Department of the Army, 120 M.S.P.R. 616, ¶¶ 10-17 (2014) (discussing a 

disability discrimination claim in the context of an alleged failure to 

accommodate). 

¶10 The appellant also argues that the agency, particularly her immediate 

supervisor, improperly discriminated against her on the basis of “dislike.” PFR

 

2 Because we affirm the administrative judge’s finding that the appellant failed to show 

that disability discrimination was a motivating factor in her termination, we need not 

resolve the issue of whether the appellant proved that discrimination was a “but-for”

cause of the agency’s decision. See Pridgen, 2022 MSPB 31, ¶¶ 20-22, 40-42.
6

File, Tab 1 at 5, 8. According to the appellant, she was subjected to acts such as 

nasty looks, harassment about her time, loss of responsibilities, and being left out. 

Id. at 9. But again, the limited issue before us is whether the agency engaged in 

disability discrimination. See generally Brown v. U.S. Postal Service, 

115 M.S.P.R. 609, ¶ 15 (2011) (recognizing that an employee is not guaranteed a 

work environment free of stress, criticism, or difficult working conditions), aff’d,

469 F. App’x 852 (Fed. Cir. 2011). Therefore, we have only considered the 

appellant’s allegations in that context and find no basis for determining that these 

conclusory assertions evidence disability discrimination. 

¶11 Similarly, while the appellant appears to suggest that the agency should 

have offered her a reasonable accommodation, PFR File, Tab 1 at 10-12, she has 

failed to identify any evidence showing that agency officials were even aware of 

her disability, much less informed that she required accommodation. As the 

administrative judge recognized, the agency presented evidence to the contrary, 

including sworn statements from the appellant’s supervisor, a Human Resources 

Specialist, and the person who signed the appellant’s mistaken probationary 

termination, all of which indicated that they had no knowledge of the appellant 

having any disability or requiring any accommodation. IAF, Tab 19 at 79‐87. 

Moreover, while the appellant generally alludes to accommodation, she has not 

identified what kind of accommodation she needed. See Gardner, 123 M.S.P.R.

647, ¶ 35 (recognizing that, for a disability discrimination claim based on a 

failure to accommodate, an appellant’s burden includes showing, to the extent 

possible, that there was a reasonable accommodation under which she could 

perform the essential duties of her position or of a vacant position to which she 

could be reassigned). 

¶12 The appellant’s petition for review generally reflects frustration with her 

termination, which the agency acknowledges was improper for other reasons. 

However, the appellant has not shown that her probationary termination was 

improperly motivated by disability discrimination, or that the agency improperly 
7

failed to accommodate her. The record before us suggests that the probationary 

termination was solely motivated by legitimate nondiscriminatory leave issues 

which were both identified in the termination notice and well documented 

throughout the appellant’s limited tenure. IAF, Tab 12 at 13-15. Among other 

things, that evidence includes various contemporaneous documents showing that 

the agency continually expressed concerns with the appellant’s extensive leave 

usage and failure to follow leave procedures, beginning as early as 2 months after 

her hire date. IAF, Tab 12 at 24-26, 29-31, Tab 19 at 12-17. 

If the appellant believes the agency has failed to comply with this Final Order to 

cancel her removal and retroactively restore her, she should file a petition for 

enforcement with the Denver Field Office.

¶13 On review, the appellant presents several other arguments which are 

difficult to follow, but appear to present allegations concerning a possible 

compliance matter. She seems to assert that there has been some problem with 

her reinstatement, which she simultaneously attributes to agency retaliation and 

an inability to return to work due to her ongoing medical limitations. 3 PFR File, 

Tab 1 at 13-15. The appellant also summarily asserts that the agency has 

provided only a quarter of the back pay she is owed. Id. at 15. The agency 

responded with argument and evidence, indicating that it provided back pay for 

the period between her improper termination on June 28, 2016, and September 14, 

2016, when she was instructed to return to duty as the agency attempted to correct 

its improper termination. PFR File, Tab 4 at 6, 10-18; IAF, Tab 12 at 10. 

¶14 The Board’s regulations provide that a “party may petition . . . for 

enforcement of a final decision or order issued under the Board’s appellate 

jurisdiction.” 5 C.F.R. § 1201.182(a) (emphasis added). Because the appellant 

 

3

The record suggests that the appellant at least considered entering into some sort of 

settlement with the agency because she was either unwilling or medically unable to 

return to her former position. IAF, Tab 10 at 3, Tab 14 at 7, Tab 17 at 1. It further 

suggests that the appellant may not have reported to duty, despite the agency’s 

instruction to do so. IAF, Tab 16 at 2.
8

filed a petition for review, the initial decision will not become final until we issue 

the instant order. See 5 C.F.R. §§ 1201.113(a) (explaining that an initial decision 

by an administrative judge will become the Board’s final decision 35 days after 

issuance unless a party files a petition for review), 1201.113(b) (explaining that, 

if a party files a petition for review, the initial decision becomes final when the 

Board issues its last decision denying the petition for review). Therefore, to the 

extent that the appellant’s petition for review contains arguments pertaining to 

compliance, those arguments are premature. See Lucas v. Department of Defense, 

64 M.S.P.R. 172, 177-78 (1994) (explaining that if an appellant had filed a 

petition for enforcement after the agency had notified him that it had canceled his 

removal but before the Board had issued its final order in the associate appeal, the 

petition would have been dismissed as premature), overruled on other grounds by 

Fischer v. Department of the Treasury, 97 M.S.P.R. 546 (2004). 

¶15 If the appellant believes that the agency has failed to comply with this final 

order to cancel her removal and retroactively restore her, she should file a 

petition for enforcement with the Denver Field Office, where that issue must first 

be adjudicated. 5 C.F.R. § 1201.182(a). 

ORDER

¶16 We ORDER the agency to cancel the removal and to retroactively restore 

the appellant effective June 28, 2016. See Kerr v. National Endowment for the 

Arts, 726 F.2d 730 (Fed. Cir. 1984). The agency must complete this action no 

later than 20 days after the date of this decision.

¶17 We also ORDER the agency to pay the appellant the correct amount of back 

pay, interest on back pay, and other benefits under the Office of Personnel 

Management’s regulations, no later than 60 calendar days after the date of this 

decision. We ORDER the appellant to cooperate in good faith in the agency’s 

efforts to calculate the amount of back pay, interest, and benefits due, and to 

provide all necessary information the agency requests to help it carry out the 
9

Board’s Order. If there is a dispute about the amount of back pay, interest due, 

and/or other benefits, we ORDER the agency to pay the appellant the undisputed 

amount no later than 60 calendar days after the date of this decision. 

¶18 We further ORDER the agency to tell the appellant promptly in writing 

when it believes it has fully carried out the Board’s Order and of the actions it has 

taken to carry out the Board’s Order. The appellant, if not notified, should ask 

the agency about its progress. See 5 C.F.R. § 1201.181(b). 

¶19 No later than 30 days after the agency tells the appellant that it has fully 

carried out the Board’s Order, the appellant may file a petition for enforcement 

with the office that issued the initial decision on this appeal if the appellant 

believes that the agency did not fully carry out the Board’s Order. The petition 

should contain specific reasons why the appellant believes that the agency has not 

fully carried out the Board’s Order, and should include the dates and results of 

any communications with the agency. 5 C.F.R. § 1201.182(a).

¶20 For agencies whose payroll is administered by either the National Finance 

Center of the Department of Agriculture (NFC) or the Defense Finance and 

Accounting Service (DFAS), two lists of the information and documentation 

necessary to process payments and adjustments resulting from a Board decision 

are attached. The agency is ORDERED to timely provide DFAS or NFC with all 

documentation necessary to process payments and adjustments resulting from the 

Board’s decision in accordance with the attached lists so that payment can be 

made within the 60‐day period set forth above.

NOTICE OF APPEAL RIGHTS4

You may obtain review of this final decision. 5 U.S.C. § 7703(a)(1). By 

statute, the nature of your claims determines the time limit for seeking such

 

4

Since the issuance of the initial decision in this matter, the Board has updated the 

notice of review rights included in final decisions. As indicated in the notice, the Board 

cannot advise which option is most appropriate in any matter.
10

review and the appropriate forum with which to file. 5 U.S.C. § 7703(b). 

Although we offer the following summary of available appeal rights, the Merit 

Systems Protection Board does not provide legal advice on which option is most 

appropriate for your situation and the rights described below do not represent a 

statement of how courts will rule regarding which cases fall within their 

jurisdiction. If you wish to seek review of this final decision, you should 

immediately review the law applicable to your claims and carefully follow all 

filing time limits and requirements. Failure to file within the applicable time 

limit may result in the dismissal of your case by your chosen forum. 

Please read carefully each of the three main possible choices of review 

below to decide which one applies to your particular case. If you have questions 

about whether a particular forum is the appropriate one to review your case, you 

should contact that forum for more information. 

(1) Judicial review in general. As a general rule, an appellant seeking 

judicial review of a final Board order must file a petition for review with the U.S. 

Court of Appeals for the Federal Circuit, which must be received by the court 

within 60 calendar days of the date of issuance of this decision. 5 U.S.C. 

§ 7703(b)(1)(A). 

If you submit a petition for review to the U.S. Court of Appeals for the 

Federal Circuit, you must submit your petition to the court at the 

following address: 

U.S. Court of Appeals 

for the Federal Circuit 

717 Madison Place, N.W. 

Washington, D.C. 20439 

Additional information about the U.S. Court of Appeals for the Federal 

Circuit is available at the court’s website, www.cafc.uscourts.gov. Of particular 

relevance is the court’s “Guide for Pro Se Petitioners and Appellants,” which is 

contained within the court’s Rules of Practice, and Forms 5, 6, 10, and 11. 
11

If you are interested in securing pro bono representation for an appeal to 

the U.S. Court of Appeals for the Federal Circuit, you may visit our website at 

http://www.mspb.gov/probono for information regarding pro bono representation 

for Merit Systems Protection Board appellants before the Federal Circuit. The 

Board neither endorses the services provided by any attorney nor warrants that 

any attorney will accept representation in a given case. 

(2) Judicial or EEOC review of cases involving a claim of 

discrimination. This option applies to you only if you have claimed that you 

were affected by an action that is appealable to the Board and that such action 

was based, in whole or in part, on unlawful discrimination. If so, you may obtain 

judicial review of this decision—including a disposition of your discrimination 

claims—by filing a civil action with an appropriate U.S. district court (not the 

U.S. Court of Appeals for the Federal Circuit), within 30 calendar days after you 

receive this decision. 5 U.S.C. § 7703(b)(2); see Perry v. Merit Systems 

Protection Board, 582 U.S. ____ , 137 S. Ct. 1975 (2017). If you have a 

representative in this case, and your representative receives this decision before 

you do, then you must file with the district court no later than 30 calendar days

after your representative receives this decision. If the action involves a claim of 

discrimination based on race, color, religion, sex, national origin, or a disabling 

condition, you may be entitled to representation by a court‐appointed lawyer and 

to waiver of any requirement of prepayment of fees, costs, or other security. See

42 U.S.C. § 2000e-5(f) and 29 U.S.C. § 794a. 

Contact information for U.S. district courts can be found at their respective 

websites, which can be accessed through the link below: 

http://www.uscourts.gov/Court_Locator/CourtWebsites.aspx. 

Alternatively, you may request review by the Equal Employment 

Opportunity Commission (EEOC) of your discrimination claims only, excluding 

all other issues. 5 U.S.C. § 7702(b)(1). You must file any such request with the 
12

EEOC’s Office of Federal Operations within 30 calendar days after you receive

this decision. 5 U.S.C. § 7702(b)(1). If you have a representative in this case, 

and your representative receives this decision before you do, then you must file 

with the EEOC no later than 30 calendar days after your representative receives

this decision. 

If you submit a request for review to the EEOC by regular U.S. mail, the 

address of the EEOC is: 

Office of Federal Operations 

Equal Employment Opportunity Commission 

P.O. Box 77960 

Washington, D.C. 20013 

If you submit a request for review to the EEOC via commercial delivery or 

by a method requiring a signature, it must be addressed to: 

Office of Federal Operations 

Equal Employment Opportunity Commission 

131 M Street, N.E. 

Suite 5SW12G 

Washington, D.C. 20507 

(3) Judicial review pursuant to the Whistleblower Protection 

Enhancement Act of 2012. This option applies to you only if you have raised 

claims of reprisal for whistleblowing disclosures under 5 U.S.C. § 2302(b)(8) or 

other protected activities listed in 5 U.S.C. § 2302(b)(9)(A)(i), (B), (C), or (D). 

If so, and your judicial petition for review “raises no challenge to the Board’s 

disposition of allegations of a prohibited personnel practice described in section 

2302(b) other than practices described in section 2302(b)(8), or 2302(b)(9)(A)(i), 

(B), (C), or (D),” then you may file a petition for judicial review either with the 

U.S. Court of Appeals for the Federal Circuit or any court of appeals of 

competent jurisdiction.5The court of appeals must receive your petition for 

 

5

The original statutory provision that provided for judicial review of certain 

whistleblower claims by any court of appeals of competent jurisdiction expired on 

December 27, 2017. The All Circuit Review Act, signed into law by the President on 
13

review within 60 days of the date of issuance of this decision. 5 U.S.C. 

§ 7703(b)(1)(B). 

If you submit a petition for judicial review to the U.S. Court of Appeals for 

the Federal Circuit, you must submit your petition to the court at the 

following address: 

U.S. Court of Appeals 

for the Federal Circuit 

717 Madison Place, N.W. 

Washington, D.C. 20439 

Additional information about the U.S. Court of Appeals for the Federal 

Circuit is available at the court’s website, www.cafc.uscourts.gov. Of particular 

relevance is the court’s “Guide for Pro Se Petitioners and Appellants,” which is 

contained within the court’s Rules of Practice, and Forms 5, 6, 10, and 11. 

If you are interested in securing pro bono representation for an appeal to 

the U.S. Court of Appeals for the Federal Circuit, you may visit our website at 

http://www.mspb.gov/probono for information regarding pro bono representation 

for Merit Systems Protection Board appellants before the Federal Circuit. The 

Board neither endorses the services provided by any attorney nor warrants that 

any attorney will accept representation in a given case. 

 

July 7, 2018, permanently allows appellants to file petitions for judicial review of 

MSPB decisions in certain whistleblower reprisal cases with the U.S. Court of Appeals 

for the Federal Circuit or any other circuit court of appeals of competent jurisdiction. 

The All Circuit Review Act is retroactive to November 26, 2017. Pub. L. No. 115 -195, 

132 Stat. 1510. 
14

Contact information for the courts of appeals can be found at their 

respective websites, which can be accessed through the link below: 

http://www.uscourts.gov/Court_Locator/CourtWebsites.aspx.

FOR THE BOARD:

Washington, D.C.

 /s/ for 

Jennifer Everling

Acting Clerk of the Board
DEFENSE FINANCE AND ACCOUNTING SERVICE

Civilian Pay Operations

DFAS BACK PAY CHECKLIST

The following documentation is required by DFAS Civilian Pay to compute and pay back pay 

pursuant to 5 CFR § 550.805. Human resources/local payroll offices should use the following 

checklist to ensure a request for payment of back pay is complete. Missing documentation may 

substantially delay the processing of a back pay award. More information may be found at: 

https://wss.apan.org/public/DFASPayroll/Back%20Pay%20Process/Forms/AllItems.aspx. 

NOTE: Attorneys’ fees or other non-wage payments (such as damages) are paid by 

vendor pay, not DFAS Civilian Pay. 

☐ 1) Submit a “SETTLEMENT INQUIRY - Submission” Remedy Ticket. Please identify the 

specific dates of the back pay period within the ticket comments. 

Attach the following documentation to the Remedy Ticket, or provide a statement in the ticket 

comments as to why the documentation is not applicable: 

☐ 2) Settlement agreement, administrative determination, arbitrator award, or order. 

☐ 3) Signed and completed “Employee Statement Relative to Back Pay”. 

☐ 4) All required SF50s (new, corrected, or canceled). ***Do not process online SF50s 

until notified to do so by DFAS Civilian Pay.*** 

☐ 5) Certified timecards/corrected timecards. ***Do not process online timecards until 

notified to do so by DFAS Civilian Pay.*** 

☐ 6) All relevant benefit election forms (e.g. TSP, FEHB, etc.). 

☐ 7) Outside earnings documentation. Include record of all amounts earned by the employee 

in a job undertaken during the back pay period to replace federal employment. 

Documentation includes W-2 or 1099 statements, payroll documents/records, etc. Also, 

include record of any unemployment earning statements, workers’ compensation, 

CSRS/FERS retirement annuity payments, refunds of CSRS/FERS employee premiums, 

or severance pay received by the employee upon separation. 

Lump Sum Leave Payment Debts: When a separation is later reversed, there is no authority 

under 5 U.S.C. § 5551 for the reinstated employee to keep the lump sum annual leave payment 

they may have received. The payroll office must collect the debt from the back pay award. The 

annual leave will be restored to the employee. Annual leave that exceeds the annual leave 

ceiling will be restored to a separate leave account pursuant to 5 CFR § 550.805(g).
NATIONAL FINANCE CENTER CHECKLIST FOR BACK PAY CASES

Below is the information/documentation required by National Finance Center to process 

payments/adjustments agreed on in Back Pay Cases (settlements, restorations) or as ordered by 

the Merit Systems Protection Board, EEOC, and courts. 

1. Initiate and submit AD-343 (Payroll/Action Request) with clear and concise information 

describing what to do in accordance with decision. 

2. The following information must be included on AD-343 for Restoration: 

a. Employee name and social security number. 

b. Detailed explanation of request. 

c. Valid agency accounting. 

d. Authorized signature (Table 63). 

e. If interest is to be included. 

f. Check mailing address. 

g. Indicate if case is prior to conversion. Computations must be attached. 

h. Indicate the amount of Severance and Lump Sum Annual Leave Payment to be 

collected (if applicable). 

Attachments to AD-343 

1. Provide pay entitlement to include Overtime, Night Differential, Shift Premium, Sunday 

Premium, etc. with number of hours and dates for each entitlement (if applicable). 

2. Copies of SF-50s (Personnel Actions) or list of salary adjustments/changes and amounts. 

3. Outside earnings documentation statement from agency. 

4. If employee received retirement annuity or unemployment, provide amount and address to 

return monies. 

5. Provide forms for FEGLI, FEHBA, or TSP deductions. (if applicable)

6. If employee was unable to work during any or part of the period involved, certification of the 

type of leave to be charged and number of hours. 

7. If employee retires at end of Restoration Period, provide hours of Lump Sum Annual Leave 

to be paid. 

NOTE: If prior to conversion, agency must attach Computation Worksheet by Pay Period and 

required data in 1‐7 above. 

The following information must be included on AD-343 for Settlement Cases: (Lump Sum 

Payment, Correction to Promotion, Wage Grade Increase, FLSA, etc.) 

a. Must provide same data as in 2, a-g above.

b. Prior to conversion computation must be provided. 

c. Lump Sum amount of Settlement, and if taxable or non-taxable. 

If you have any questions or require clarification on the above, please contact NFC’s 

Payroll/Personnel Operations at 504-255-4630.