United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
G.S., Appellant
and
DEPARTMENT OF THE ARMY, ANNISTON
ARMY DEPOT, Anniston, AL, Employer
__________________________________________

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Appearances:
Alan J. Shapiro, Esq., for the appellant
Office of Solicitor, for the Director

Docket No. 11-949
Issued: November 14, 2011

Case Submitted on the Record

DECISION AND ORDER
Before:
RICHARD J. DASCHBACH, Chief Judge
ALEC J. KOROMILAS, Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On March 7, 2011 appellant filed a timely appeal from a February 2, 2011 decision of the
Office of Workers’ Compensation Programs which affirmed an OWCP decision denying his
claim for compensation. Pursuant to the Federal Employees’ Compensation Act1 and 20 C.F.R.
§§ 501.2(c) and 501.3, the Board has jurisdiction over the merits of the case.
ISSUE
The issue is whether appellant met his burden of proof in establishing that he had more
than four hours of disability on April 29, 2010 causally related to his accepted employment
condition.
FACTUAL HISTORY
On March 10, 2003 appellant, then a 32-year-old temporary heavy mobile equipment
repairer, filed a traumatic injury claim alleging that on March 6, 2003 he slipped and fell injuring
1

5 U.S.C. §§ 8101-8193.

his back while tightening a bolt with a wrench. OWCP accepted his claim for sciatica.
Appellant stopped work on March 6, 2003 and worked intermittently thereafter.
Appellant was treated by Dr. K.L. Vandervoort, a Board-certified orthopedist, from
March 12 to June 13, 2003 for low back pain which developed after a work incident. He
diagnosed left sciatica. Dr. Vandervoort managed appellant through a conservative regimen
including anti-inflammatory medications, rest, time off work, physical therapy, epidural steroid
injections and light-duty work. Appellant was treated by Dr. R. Barry Stuman, a Board-certified
anesthesiologist, who performed lumbar epidural steroid injections on April 10 and
May 16, 2003. A March 28, 2003 magnetic resonance imaging (MRI) scan of the lumbar spine
revealed degenerative disc changes at L4-5, L5-S1 and central and right paracentral disc bulge at
L4-5 with a central disc protrusion at L5-S1 level.
On May 22, 2003 appellant was referred for vocational rehabilitation. On March 21,
2004 he returned to work as a modified mobile heavy equipment repairer, earning $713.19 per
week. In a July 7, 2004 decision, OWCP found that appellant’s actual earnings as a modified
mobile heavy equipment repairer represented his wage-earning capacity and that his earnings in
that position was equivalent to the pay rate for the position he held at the time of his injury.
Appellant was treated by Dr. Hisham Hakim, a Board-certified orthopedist, beginning
August 19, 2004, for back pain with radiculopathy. Dr. Hakim noted muscle tightness and
spasm in the paraspinous region bilaterally and tenderness in the lumbar areas at the L1 joint. He
diagnosed back pain with muscle spasm and continued appellant’s work restrictions. From
January 13 to November 24, 2009, Dr. Hakim diagnosed back pain with increasing muscle
spasm and recommended trigger point injections. On November 24, 2009 he noted appellant’s
complaints of chronic low back pain and shoulder pain. Appellant reported injuring his shoulder
on September 11, 2008 and undergoing surgery. Dr. Hakim diagnosed back pain with
radiculopathy and shoulder pain postsurgery and continued work restrictions. He noted a
functional capacity evaluation recommended full-time light-duty work. Dr. Hakim continued to
treat appellant from January 5 to March 4, 2010, for radiating low back pain. On March 4, 2010
he diagnosed chronic back pain noted that appellant was working full-time, light duty and
continued his work restrictions.
On April 29, 2010 Dr. Hakim treated appellant that date for worsening low back pain.
Appellant reported driving a street sweeper which vibrated and aggravated his symptomology.
Dr. Hakim noted objective findings of tenderness across the back in the lumbar area with muscle
tightening. He diagnosed back pain and recommended stretching exercises and use of a back
support. In an April 29, 2010 return to work slip, Dr. Hakim continued appellant’s current work
status through July 29, 2010.
On April 29, 2010 appellant submitted a Form CA-7, claiming compensation for total
disability for nine hours on April 29, 2010. In a CA-7a form time analysis, he requested nine
hours of leave without pay on April 29, 2010, for a physician’s appointment.
In a letter dated May 10, 2010, OWCP requested that appellant submit additional
information with regard to his claim for compensation on April 29, 2010. It requested that he

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submit medical evidence establishing that he was totally disabled due to the accepted condition
for the period claimed.
Appellant submitted a July 22, 2010 return to work slip from Dr. Hakim who continued
appellant’s work restrictions.
In a July 30, 2010 decision, OWCP found that appellant was entitled to four hours of
compensation on April 29, 2010 but that he provided insufficient documentation to support
disability for the other five hours claimed. It noted that normally four hours of compensation are
allowed for medical appointment.
On August 20, 2010 appellant through his attorney requested a telephonic hearing. He
submitted an August 19, 2010 return to work slip from Dr. Hakim, which continued his work
restrictions until October 14, 2010. In a September 9, 2010 return to work slip, Dr. Hakim noted
treating appellant on that date. Also submitted was a September 9, 2010 functional capacity
evaluation which noted that appellant could work full sedentary duty. In an October 21, 2010
return to work slip, Dr. Hakim continued appellants current work status until
December 16, 2010.
In a decision dated February 2, 2011, the hearing representative affirmed OWCP’s
decision dated July 30, 2010.
LEGAL PRECEDENT
A claimant has the burden of proving by a preponderance of the evidence that he or she is
disabled for work as a result of an accepted employment injury and submit medical evidence for
each period of disability claimed.2 Whether a particular injury causes an employee to be
disabled for employment and the duration of that disability are medical issues.3 The issue of
whether a particular injury causes disability for work must be resolved by competent medical
evidence.4 To meet this burden, a claimant must submit rationalized medical opinion evidence,
based on a complete factual and medical background, supporting a causal relationship between
the alleged disabling condition and the accepted injury.5
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 an employee to self-certify his or her disability and
entitlement to compensation. For each period of disability claimed, the employee has the burden

2

See Fereidoon Kharabi, 52 ECAB 291 (2001).

3

Id.

4

See Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

5

C.S., Docket No. 08-2218 (issued August 7, 2009).

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of establishing that he or she was disabled for work as a result of the accepted employment
injury.6
OWCP’s procedure manual provides that wages lost for compensable medical
examination or treatment may be reimbursed.7 It notes that a claimant who has returned to work
following an accepted injury or illness may need to undergo examination or treatment and such
employee may be paid compensation for wage loss while obtaining medical services and for a
reasonable time spent traveling to and from the medical provider’s location.8 As a rule, no more
than four hours of compensation or continuation of pay should be allowed for routine medical
appointments. Longer periods of time may be allowed when required by the nature of the
medical procedure and/or the need to travel a substantial distance to obtain the medical care.9
ANALYSIS
OWCP accepted appellant’s claim for sciatica. Appellant filed a claim for wage-loss
compensation for nine hours of leave without pay on April 29, 2010 to attend a physician’s
appointment. The Board notes that OWCP authorized payment for four hours on April 29, 2010
but found insufficient evidence to support any greater entitlement on that date. The Board notes
that the record supports that appellant was attending a physician’s appointment for his workrelated injury on this date and was properly granted compensation for four hours on that date
consistent with OWCP procedures.10
The Board finds that the medical evidence submitted in support of the wage-loss
compensation claim for five additional hours of total disability for April 29, 2010 is insufficient
to establish that the claimed period of disability was caused or aggravated by the accepted
employment injury.
On April 29, 2010 Dr. Hakim treated appellant for worsening low back pain which
developed after driving a street sweeper which vibrated and aggravated his symptoms. He noted
objective findings of tenderness across the back in the lumbar area with muscle tightening.
Dr. Hakim diagnosed back pain and continued appellant’s restrictions. Similarly, in an April 29,
2010 return to work slip, he continued appellant’s current work status through July 29, 2010.
Although these notes indicated that appellant had a physician’s appointment on April 29, 2010,
the physician failed to provide a reasoned opinion explaining why he was disabled for nine hours
on that particular day. As noted, OWCP procedures provide for payment of compensation for
6

Sandra D. Pruitt, 57 ECAB 126 (2005).

7

See Federal (FECA) Procedure Manual, Part 2 -- Claims, Computing Compensation, Chapter 2.901.16
(December 1995).
8

See also Daniel Hollars, 51 ECAB 355 (2000); Jeffrey R. Davis, 35 ECAB 950 (1984).

9

See supra note 7, Part 3 -- Medical, Administrative Matters, Chapter 3.900.8 (November 1998).

10

The Board notes that, while a July 7, 2004 wage-earning capacity determination is in place, OWCP is not
precluded from considering a limited period of disability without establishing that modification of the wage-earning
capacity determination is warranted. See Sharon C. Clement, 55 ECAB 552 (2004); K.R., Docket No. 09-415
(issued February 24, 2010).

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wages lost for compensable medical examination or treatment for up to four hours.11 However,
Dr. Hakim did not explain why four hours was insufficient to allow for his appointment or the
reasons why appellant was otherwise totally disabled for more than four hours on April 29, 2010
due to the accepted sciatica sustained on March 6, 2003. Other reports from him do not
specifically address whether appellant was totally disabled for more than four hours on
April 29, 2010. Thus, Dr. Hakim’s reports are insufficient to establish that appellant had
additional compensable wage loss on April 29, 2010. As noted, part of appellant’s burden of
proof includes submitting rationalized medical evidence which supports a causal relationship
between the alleged disabling condition and the accepted injury.
Likewise, no other medical evidence of records addresses whether appellant had more
than four hours of disability on April 29, 2010 causally related to his accepted sciatica sustained
on March 6, 2003. Consequently, the medical evidence did not establish that the claimed period
of disability was due to appellant’s employment injury of March 6, 2003.
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 failed to establish that he had more than four hours of
disability on April 29, 2010 was causally related to the accepted employment injury.

11

See id. See also supra note 7.

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ORDER
IT IS HEREBY ORDERED THAT the decision of the Office of Workers’
Compensation Programs dated February 2, 2011 is affirmed.
Issued: November 14, 2011
Washington, DC

Richard J. Daschbach, Chief Judge
Employees’ Compensation Appeals Board

Alec J. Koromilas, Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
Y.G., Appellant
and
DEPARTMENT OF VETERANS AFFAIRS, VA
PACIFIC ISLANDS HEALTHCARE SYSTEM,
SPARK A. MATSUNAGA VA MEDICAL
CENTER, Honolulu, HI, Employer
__________________________________________

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Appearances:
Appellant, pro se
Office of Solicitor, for the Director

Docket No. 20-0688
Issued: November 13, 2020

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Chief Judge
PATRICIA H. FITZGERALD, Alternate Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION
On February 10, 2020 appellant filed a timely appeal from a January 10, 2020 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 to consider the merits of this case.
ISSUE
The issue is whether appellant has met her burden of proof to establish exposure to
norovirus in the performance of duty, as alleged.
FACTUAL HISTORY
On July 18, 2019 appellant, then a 59-year-old advanced practice registered float nurse
(APRN), filed an occupational disease claim (Form CA-2) alleging that she contracted a viral
1

5 U.S.C. § 8101 et seq.

infection while treating patients due to factors of her federal employment. She noted that she first
became aware of the condition on July 12, 2019 and related it to factors of her federal employment
on July 13, 2019. Appellant stopped work on July 15, 2019.
In a July 18, 2019 statement, K.S., appellant’s supervisor, noted that appellant reported a
viral respiratory illness on July 15, 2019 which she attributed to exposure to ill patients in the
ambulatory care center on July 12, 2019. In a development letter dated July 22, 2019, OWCP
notified appellant of the factual and medical deficiencies of her claim. It advised her of the type
of evidence required and provided a questionnaire for her completion. OWCP afforded appellant
30 days to submit additional medical evidence.
In response, appellant provided a completed questionnaire dated July 31, 2019. She
asserted that she was exposed to a virus on or before July 12, 2019, in the employing
establishment’s ambulatory care center. Appellant noted that a viral infection affected 8 of 10 unit
employees.
By decision dated August 22, 2019, OWCP denied appellant’s occupational disease claim,
finding that the evidence of record was insufficient to establish that the identified exposure
occurred as alleged. It concluded, therefore, that the requirements had not been met to establish
an injury as defined by FECA.
On November 12, 2019 appellant requested reconsideration and submitted additional
evidence.2 In a July 18, 2019 e-mail, she notified supervisor, K.S. that she believed that she had
contracted “the virus that is going around in module 2.” On Friday July 12, 2019 appellant
experienced fatigue, a sore throat, and a chest rash. She then experienced the onset of nausea,
vomiting, and headache.
Dr. Steven M. Sovich, an osteopathic physician Board-certified in family practice, noted
in a July 18, 2019 report that appellant experienced an illness during an outbreak from July 10 to
12, 2019 among ambulatory care center staff. He diagnosed “most likely nonspecific viral illness.”
Dr. Sovich noted that an employing establishment infectious disease physician had been notified
of appellant’s illness during the previous week. He provided an updated report to an employing
establishment infection control nurse.
In a report dated August 2, 2019, Dr. Blake A. Smith, Board-certified in emergency
medicine, observed right upper quadrant tenderness and mild diffuse abdominal tenderness. He
obtained abdominal imaging studies indicative of a bowel ileus. Dr. Smith offered several
differential diagnoses.
On August 5, 2019 Dr. Geoffrey C. Alexander, Board-certified in emergency medicine,
reported a three-week history of diffuse abdominal pain. He diagnosed abdominal pain.

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An August 2, 2019 abdominal imaging record demonstrated common bile duct dilatation to 10 millimeter of
indeterminate significance. September 18, 2019 bilateral hand x-rays were within normal limits. Appellant also
provided serology and stool culture reports dated from July 30 to October 18, 2019, and nurses notes dated August 9,
15, and 30, 2019.

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Dr. David R. Worthen, a Board-certified family practitioner, noted in an August 13, 2019
report appellant’s complaints of weakness, nausea, and abdominal discomfort. He diagnosed
possible irritable bowel syndrome, spasm, or gastroenteritis.
In a report dated August 19, 2019, Dr. James A. Fitch, a physician specializing in
emergency medicine, diagnosed subacute norovirus gastroenteritis.
In a September 17, 2019 report, Dr. Francis D. Pien, Board-certified in internal medicine
and infectious disease, returned appellant to full-duty work effective that day. In a report dated
October 18, 2019, he diagnosed polyarthralgia following onset of norovirus and possible post-viral
syndrome.
Dr. Mary Li, a Board-certified internist, summarized appellant’s history of injury and
treatment in a November 1, 2019 report. She noted that an August 10, 2019 stool sample, was
positive for norovirus. Dr. Li diagnosed gastroenteritis, dilation of the common bile duct,
neuropathy, stool positive for norovirus, post-viral syndrome, and polyarthralgia. She opined that
appellant became ill while at work on July 12, 2019.
By decision dated January 10, 2010, OWCP denied modification, finding that the evidence
of record was insufficient to establish that the occupational exposure occurred, as alleged.
LEGAL PRECEDENT
An employee seeking benefits under FECA3 has the burden of proof to establish the
essential elements of his or her claim, including that the individual is an employee of the United
States within the meaning of FECA, that the claim was filed within the applicable time limitation
period of FECA,4 that an injury was sustained while in the performance of duty as alleged, and
that any disability or specific condition for which compensation is claimed is causally related to
the employment injury.5 These are the essential elements of each and every compensation claim,
regardless of whether the claim is predicated upon a traumatic injury or an occupational disease.6
In an occupational disease claim, appellant’s burden requires submission of the following:
(1) a factual statement identifying employment factors alleged to have caused or contributed to the
presence or occurrence of the disease or condition; (2) medical evidence establishing the presence
or existence of the disease or condition for which compensation is claimed; and (3) medical

3

Supra note 1.

4

S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB
153 (1989).
5

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40
ECAB 312 (1988).
6
K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014);
Delores C. Ellyett, 41 ECAB 992 (1990).

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evidence establishing that the diagnosed condition is causally related to the employment factors
identified by the employee.7
An injury does not have to be confirmed by eyewitnesses in order to establish the fact that
an employee sustained an injury in the performance of duty, but the employee’s statements must
be consistent with the surrounding facts and circumstances and his or her subsequent course of
action.8 The employee has not met his or her burden of proof to establish the occurrence of an
injury when there are inconsistencies in the evidence that cast serious doubt upon the validity of
the claim. Such circumstances as late notification of injury, lack of confirmation of injury,
continuing to work without apparent difficulty following the alleged injury, and failure to obtain
medical treatment may, if otherwise unexplained, cast serious doubt on an employee’s statements
in determining whether a prima facie case has been established.9 An employee’s statements
alleging that an injury occurred at a given time and in a given manner is of great probative value
and will stand unless refuted by strong or persuasive evidence.10
ANALYSIS
The Board finds that appellant has established exposure to norovirus in the performance of
duty, as alleged.
In response to OWCP development questionnaire, appellant asserted that she was exposed
to a virus on or before July 12, 2019, in the employing establishment’s ambulatory care center.
She noted that a viral infection affected 8 of 10 unit employees. The record establishes that
appellant promptly reported the onset of gastric and respiratory symptoms to K.S., her supervisor
on July 15, 2019. She sought treatment on July 18, 2019 from Dr. Sovich, who noted a viral
outbreak in her work area from July 10 to 12, 2019, which resulted in notification of an employing
establishment infectious disease physician. Dr. Pien confirmed the specific diagnosis of norovirus
in September 17 and October 18, 2019 reports. Additionally, Dr. Li related in her November 1,
2019 report that appellant contracted norovirus while at work on July 12, 2019.
As noted above, an employee’s statements alleging that an injury occurred at a given time
and in a given manner is of great probative value and will stand unless refuted by strong or
persuasive evidence.11 The Board thus finds that appellant has established exposure to norovirus
in the performance of duty, as alleged.

7

J.V., Docket No. 18-0177 (issued August 26, 2020); S.C., Docket No. 18-1242 (issued March 13, 2019); R.H., 59
ECAB 382 (2008).
8

M.F., Docket No. 18-1162 (issued April 9, 2019); Charles B. Ward, 38 ECAB 667-71 (1987).

9

L.D., Docket No. 16-0199 (issued March 8, 2016); Betty J. Smith, 54 ECAB 174 (2002).

10

M.H., Docket No. 20-0576 (issued August 6, 2020); see M.C., Docket No. 18-1278 (issued March 7, 2019); D.B.,
58 ECAB 464, 466-67 (2007).
11

Id.

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As appellant has established the claimed occupational exposure, the question becomes
whether this exposure caused an injury.12 As OWCP found that she had not established fact of
injury, it did not evaluate the medical evidence. The Board, therefore, will set aside OWCP’s
January 10, 2020 decision and remand the case for consideration of the medical evidence of
record.13 After any further development as deemed necessary, OWCP shall issue a de novo
decision addressing whether appellant has met her burden of proof to establish a medical condition
causally related to the accepted employment exposure.
CONCLUSION
The Board finds that appellant has met her burden of proof to establish that
occupational exposure to norovirus occurred in the performance of duty, as alleged. The Board
further finds that the case is not in posture for decision regarding whether she has established a
medical condition causally related to the accepted employment exposure.
ORDER
IT IS HEREBY ORDERED THAT the January 10, 2020 decision of the Office of
Workers’ Compensation Programs is reversed and the case is remanded for further proceedings
consistent with this decision of the Board.
Issued: November 13, 2020
Washington, DC

Alec J. Koromilas, Chief Judge
Employees' Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge
Employees' Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge
Employees' Compensation Appeals Board

12

See R.S., 20-0471 (issued October 7, 2020); N.B., Docket No. 13-0513 (issued August 27, 2017).

13

M.H., supra note 10; S.M., Docket No. 16-0875 (issued December 1, 2017).

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
S.G., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
North Metro, GA, Employer
__________________________________________

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Appearances:
Appellant, pro se
Office of Solicitor, for the Director

Docket No. 17-1054
Issued: September 14, 2017

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
COLLEEN DUFFY KIKO, Judge
ALEC J. KOROMILAS, Alternate Judge

JURISDICTION
On April 21, 2017 appellant filed a timely appeal from a February 10, 2017 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 met his burden of proof to establish a bilateral foot
condition causally related to factors of his federal employment.
FACTUAL HISTORY
On November 15, 2016 appellant, then a 54-year-old labor custodian, filed an
occupational disease claim (Form CA-2) alleging that he developed bilateral plantar fasciitis,
peripheral neuropathy, and bilateral ankle pain as a result of standing for prolonged periods of
1

5 U.S.C. § 8101 et seq.

time in the performance of duty. He related that he first became aware of his condition and that
it was causally related to his federal employment on September 3, 2014. Appellant did not stop
work. The employing establishment noted that he was allowed to sit 15 minutes per hour.
By letter dated November 18, 2016, OWCP advised appellant that no evidence had been
submitted to establish his claim. It requested that he respond to the attached questionnaire in
order to substantiate the factual elements of his claim and that he provide additional medical
evidence to establish a diagnosed condition causally related to his federal employment.
Appellant was afforded 30 days to submit additional evidence.
On November 28, 2016 appellant explained that he had been employed for over 20 years
in a position that required him to perform prolonged standing and walking on concrete floors.
He related that his tour was from 7:30 a.m. to 4:00 p.m. Appellant indicated that he was
submitting medical evidence in support of his claim. He provided a position description for a
building maintenance custodian.
Appellant provided various reports from Dr. Jimmy L. Gregory, a podiatrist. In an
April 1, 2015 report, Dr. Gregory related that appellant complained of severe pain in the heel and
arch on both feet, present for quite some time. Appellant claimed that the condition started while
he was in active duty military from 1983 to 2001 when he was on his feet for most of the day.
He currently worked at the employing establishment and stood up for most of the day.
Dr. Gregory noted that appellant complained of pain at work and also described a fall down the
stairs in 1985, which resulted in two broken ankles. Upon physical examination of appellant’s
feet, he reported severe pain with palpation of the plantar fascia from the central portion to the
attachment to the heel. Neurological examination showed diminished vibratory perception.
Dr. Gregory diagnosed bilateral plantar fasciitis, peripheral neuropathy, and bilateral ankle pain.
In April 9 and May 6, 2015 progress notes, Dr. Gregory reported examination findings of
severe pain with palpation of the plantar medial aspect of both heels at the attachment of the
plantar fascia to the calcaneal tubercle. He diagnosed bilateral plantar fasciitis. In an April 9,
2015 prescription note, Dr. Gregory prescribed bilateral foot and ankle orthotics.
Dr. Gregory related in a January 28, 2016 progress note that appellant complained of
severe pain in both heels and some burning pain in his feet. He also indicated that the ankle and
foot orthotics aggravated his feet. Upon physical examination, Dr. Gregory reported palpable
pedal pulse and mildly diminished vibratory perception. He also noted severe pain with
palpation of the plantar medial heel and in the area of the calcaneal nerve. Dr. Gregory
diagnosed bilateral recalcitrant plantar fasciitis, bilateral medial calcaneal neuritis, and possible
neuropathy.
Appellant underwent a right foot x-ray scan by Dr. Johnny Alexander, a Board-certified
radiologist, who indicated in a February 19, 2016 report that appellant had a small plantar
calcaneal spur.
In April 20 and 24, 2016 progress notes, Dr. Gregory noted that appellant complained of
continued heel pain. Upon physical examination, he reported pain with palpation of the bilateral
plantar fascial attachment to the calcaneus. Dr. Gregory indicated that radiographs revealed a

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large calcaneal spur. He diagnosed recalcitrant bilateral plantar fasciitis with calcaneal spur.
Dr. Gregory recommended that appellant continue physical therapy and a bilateral night splint.
Dr. Gregory diagnosed plantar fascial fibromatosis in a May 2, 2016 prescription note
and recommended medical equipment for appellant’s pain.
In a July 7, 2016 note, Dr. Gregory related appellant’s complaints of severe pain of both
heels. He reported palpable pedal pulses and severe pain with palpation of the plantar medial
heel in the area of the distribution of the medial calcaneal nerve. Dr. Gregory diagnosed bilateral
plantar fasciitis and bilateral calcaneal neuritis.
Dr. Gregory indicated in an October 24, 2016 note that appellant received some relief
with injection, but still complained of foot pain, greater on the right than the left. Upon physical
examination, he reported severe pain with palpation of the right heel and moderate pain of the
left heel. Dr. Gregory diagnosed bilateral plantar fasciitis. He recommended that appellant
continue with pain medication, work restrictions, and orthopedic shoes.
OWCP denied appellant’s claim in a decision dated February 10, 2017. It accepted his
employment duties as a labor custodian and that he sustained a bilateral foot condition, but
denied his claim as the medical evidence submitted failed to establish that his condition was
causally related to factors of his federal employment.
LEGAL PRECEDENT
An employee seeking benefits under FECA has the burden of proof to establish the
essential elements of his or her claim by the weight of the reliable, probative, and substantial
evidence2 including that he or she sustained an injury in the performance of duty and that any
specific condition or disability for work for which he or she claims compensation is causally
related to that employment injury.3 In an occupational disease claim, appellant’s burden requires
submission of the following: (1) a factual statement identifying employment factors alleged to
have caused or contributed to the presence or occurrence of the disease or condition; (2) medical
evidence establishing the presence or existence of the disease or condition for which
compensation is claimed; and (3) medical evidence establishing that the diagnosed condition is
causally related to the employment factors identified by the employee.4
Causal relationship is a medical issue and the medical evidence generally required to
establish causal relationship is rationalized medical opinion evidence.5 The opinion of the
physician must be based on a complete factual and medical background of the employee, must be
one of reasonable medical certainty, and must be supported by medical rationale explaining the
2

J.P., 59 ECAB 178 (2007); Joseph M. Whelan, 20 ECAB 55, 58 (1968).

3

M.M., Docket No. 08-1510 (issued November 25, 2010); G.T., 59 ECAB 447 (2008); Elaine Pendleton, 40
ECAB 1143, 1145 (1989).
4

R.H., 59 ECAB 382 (2008); Ernest St. Pierre, 51 ECAB 623 (2000).

5

I.R., Docket No. 09-1229 (issued February 24, 2010); D.I., 59 ECAB 158 (2007).

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nature of the relationship between the diagnosed condition and the specific employment factors
identified by the employee.6
ANALYSIS
Appellant alleges that he developed a bilateral foot condition as a result of standing and
walking for prolonged periods of time in the performance of his duties as a labor custodian.
OWCP accepted the repetitive duties of a labor custodian and that he was diagnosed with
bilateral plantar fasciitis, peripheral neuropathy, and bilateral ankle pain, but denied his claim
because the medical evidence failed to establish that his bilateral foot condition was causally
related to his employment duties.
The Board finds that appellant has not met his burden of proof to establish his
occupational disease claim.
Appellant submitted a series of reports from Dr. Gregory dated April 1, 2015 to
October 24, 2016. In the initial examination report, Dr. Gregory related appellant’s complaints
of severe pain in the heel and arch of both feet. Appellant indicated that the condition started
while he was in active duty military from 1983 to 2001 and persisted to this day. Dr. Gregory
noted that appellant currently worked for the employing establishment and stood up for most of
the day. He also described that appellant fell down the stairs in 1985 and broke both his ankles.
Dr. Gregory reported physical examination findings of severe pain with palpation of the plantar
fascia, palpable pedal pulse, and mildly diminished vibratory perception. In an April 24, 2016
progress note, he indicated that radiographs showed a large calcaneal spur. Dr. Gregory
diagnosed bilateral plantar fasciitis with calcaneal spur of the right foot. He recommended pain
medication, orthotic shoes, and modified duty. Although Dr. Gregory accurately described that
appellant’s employment duties required standing for most of the day, he did not provide any
opinion that the cause of appellant’s bilateral foot condition was his employment. The Board has
held that medical evidence that does not offer any opinion regarding the cause of an employee’s
condition is of limited probative value on the issue of causal relationship.7 Causal relationship is
a medical question that must be established by probative medical opinion from a physician.8 A
probative medical opinion from a physician is particularly warranted in this case since appellant
has related that his bilateral foot condition initially started when he was in active duty military
and that he previously broke both his ankles. Dr. Gregory failed to provide any medical
explanation, based on medical rationale, as to how appellant’s employment duties would have
aggravated or contributed to his current bilateral foot condition.9
The only other medical evidence of record was the February 19, 2016 x-ray report from
Dr. Alexander. This report noted a small plantar calcaneal spur, but offered no opinion regarding
6

I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 465 (2005).

7

C.B., Docket No. 09-2027 (issued May 12, 2010); J.F., Docket No. 09-1061 (issued November 17, 2009); A.D.,
58 ECAB 149 (2006).
8

W.W., Docket No. 09-1619 (issued June 2, 2010); David Apgar, 57 ECAB 137 (2005).

9

See S.E., Docket No. 08-2214 (issued May 6, 2009); T.M., Docket No. 08-0975 (issued February 6, 2009).

4

the cause of this condition. The Board has held that reports of diagnostic tests, are of limited
probative value as they fail to provide an opinion on the causal relationship between appellant’s
employment duties and the diagnosed conditions. For this reason, this evidence is not sufficient
to meet his burden of proof.10
On appeal appellant alleges that he has bilateral plantar fasciitis and pes planus as a result
of prolonged standing and walking on concrete floor for over 20 years as part of his duties as a
labor custodian. He noted that he researched articles, which showed that prolonged standing can
cause pes planus and plantar fasciitis. However, materials from periodicals, journals and
magazines are of no probative value to support a claim for compensation. Medical evidence
must be in the form of rationalized opinion by a qualified physician based on a complete and
accurate medical and factual history.11
Neither the mere fact that a disease or condition manifests itself during a period of
employment nor the belief that the disease or condition was caused or aggravated by
employment factors or incidents is sufficient to establish a causal relationship.12 Such a
relationship must be shown by rationalized medical evidence of a causal relation based upon a
specific and accurate history of employment conditions which are alleged to have caused or
exacerbated a disabling condition.13 Because appellant has not submitted such rationalized
medical evidence in this case, the Board finds that he has not met his burden of proof to establish
his occupational disease claim.
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. §§ 10.606 through 10.607.
CONCLUSION
The Board finds that appellant has not met his burden of proof to establish a bilateral foot
condition causally related to factors of his federal employment.

10

See A.B., Docket No. 17-0301 (issued May 19, 2017).

11

See John D. Baskette, 30 ECAB 761 (1979).

12

E.J., Docket No. 09-1481 (issued February 19, 2010).

13

Patricia J. Bolleter, 40 ECAB 373 (1988).

5

ORDER
IT IS HEREBY ORDERED THAT the February 10, 2017 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: September 14, 2017
Washington, DC

Christopher J. Godfrey, Chief Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge
Employees’ Compensation Appeals Board

6


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
H.P., Appellant
and
DEPARTMENT OF THE INTERIOR,
NATIONAL PARK SERVICE, Brooklyn, NY,
Employer
__________________________________________

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Appearances:
Appellant, pro se
Office of Solicitor, for the Director

Docket No. 08-1773
Issued: April 6, 2009

Case Submitted on the Record

DECISION AND ORDER
Before:
COLLEEN DUFFY KIKO, Judge
MICHAEL E. GROOM, Alternate Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On June 10, 2008 appellant filed a timely appeal of a March 12, 2008 decision of an
Office of Workers’ Compensation Programs’ hearing representative who affirmed the
termination of his compensation benefits. Pursuant to 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 the Office met its burden of proof to terminate appellant’s
compensation benefits effective September 7, 2007.
FACTUAL HISTORY
On September 8, 1989 appellant, then a 37-year-old maintenance mechanic, sustained a
low back strain when he rode a lawnmower over a boardwalk that collapsed, causing him to fall
into a three foot hole. The Office accepted his claim for low back strain. Following his injury,
appellant returned to work with light-duty restrictions on lifting. On April 3, 1990 he injured his

back while moving and carrying boxes at work. Appellant stopped work that day and did not
return. The Office accepted his claim for aggravated low back syndrome and herniated disc at
L5-S1. It paid wage-loss compensation for total disability and placed him on periodic rolls
effective August 22, 1990.
Appellant sought treatment from Dr. Michael Schuman, a Board-certified neurologist,
between 1991 and 1992. On October 21, 1991 Dr. Schuman placed appellant on a “no straining
routine,” which included no lifting over 10 pounds. He concluded that appellant could not work.
In a January 14, 1992 duty status report, Dr. Schuman noted that the duration of appellant’s total
disability was unknown. Subsequently, Dr. Edwin Chang, a Board-certified neurosurgeon and
associate of Dr. Schumann, treated appellant. He diagnosed ventral and left side herniated disc
at L5-S1 and recommended surgery. On January 5, 1999 Dr. Chang noted that appellant
remained totally disabled and that he did not want to have surgery. In a February 3, 2000
progress note, he advised that appellant’s condition remained unchanged. Dr. Chang attributed
appellant’s back condition as a direct result of his 1990 work injury. He advised that, as it had
been 10 years since appellant’s injury and he had not shown any sustained on permanent
improvement, his disability was permanent. Appellant next sought treatment from Dr. Chang on
February 26, 2002, at which time a prescription was refilled and appellant was discharged on an
as-needed basis. On June 18, 2002 Dr. Dr. Chang examined appellant and noted no change in
symptoms. He indicated that appellant’s low back and neck pain were aggravated by any kind of
physical activity or prolonged walking, standing or sitting.
In a November 3, 2004 report, Dr. Germaine Rowe, a Board-certified physiatrist and
associate of Dr. Chang, noted appellant’s history of chronic neck and low back pain from
operating a lawnmower on a boardwalk that collapsed. She advised that the lumbar spine
revealed minimal tenderness to palpation in the paraspinal muscles and there was virtually a full
range of motion in the forward flexion and backward flexion extension. Dr. Rowe concluded
that appellant had normal strength in the lower extremities of all muscle groups tested. She
recommended a conservative pain management approach.
On April 21, 2006 the Office asked appellant to provide a medical report from his
physician regarding the extent of his employment-related condition and disability.
Appellant subsequently submitted a December 15, 2004 report, previously not of record,
from Dr. Rowe, who noted that appellant’s physical examination remained the same. He
ambulated with normal gait and his strength sensation and reflexes were intact. Dr. Rowe
reiterated that appellant was not interested in pursuing any type of interventional treatment and
was treated conservatively. Appellant also submitted medical evidence and physical therapy
records previously of record.
On September 14, 2006 the Office referred appellant and a statement of accepted facts to
Dr. Harold Alexander, a Board-certified orthopedic surgeon, for a second opinion evaluation. In
an October 12, 2006 medical report, Dr. Alexander reviewed appellant’s history and his medical
treatment. On examination, he found that low back flexion, extension and side bending were 10
percent decreased in all ranges and his cervical spine had 20 percent decreased range of motion
in all directions. In reviewing x-rays, Dr. Alexander found degenerative changes at C5-6 and
C6-7 and marked narrowing of L5-S1 disc space with anterior osteophytosis of bony bridging.

2

He diagnosed cervical and lumbosacral degenerative disc disease. In response to the Office’s
questions, Dr. Alexander opined that appellant’s lumbar condition had been aggravated and
precipitated by his work injury but that the aggravation was temporary as he had been
asymptomatic. He found that appellant’s current symptoms would have likely occurred at some
time due to his degenerative disc disease. Dr. Alexander advised that appellant had returned to
his baseline lumbar condition and that his current symptoms were due to the natural progression
of degenerative disc disease. He found that appellant had reached maximum medical
improvement and did not need any other medical treatment. Dr. Alexander noted that appellant
could work an eight-hour day with a 50-pound lifting restriction. He also attached a work
restriction evaluation form setting forth particular work restrictions.
On July 5, 2007 the Office issued a proposed notice of termination of compensation. It
found that the weight of the medical evidence, represented by Dr. Alexander’s report,
demonstrated that appellant no longer had any disability or residuals due to his accepted April 3,
1990 injury. The Office allowed 30 days for appellant to submit additional evidence. In
response, appellant submitted a July 20, 2007 statement explaining that he disagreed with
Dr. Alexander’s report as it only reflected a “snapshot” of his medical condition of 10 years. He
submitted evidence previously of record.
In a decision dated September 7, 2007, the Office terminated appellant’s compensation
benefits effective September 10, 2007, finding that Dr. Alexander’s report established that the
accepted lumbar conditions had resolved.
On October 9, 2007 appellant requested an oral hearing, which was held on
January 10, 2008. In a November 16, 2007 report, Dr. Ralph D’Auria, a Board-certified
physiatrist, received a history of the September 8, 1989 work injury and reported appellant’s
complaint of neck and low back pain. Based on x-rays of appellant’s cervical and lumbar spine
taken that day, he concluded that the cervical spine had diffuse degenerative changes most
pronounced in the C5-6 area and limited range of motion. Dr. D’Auria also concluded that the
lumbosacral spine had anterior and posterior degenerative changes most pronounced in the
L1-S1 region and that the L5-S1 region was going into spontaneous fusion. He noted that
appellant attributed his back pain to the September 8, 1989 work injury and that he should return
for treatment as needed.
In a March 12, 2008 decision, an Office hearing representative affirmed the September 7,
2007 decision.
LEGAL PRECEDENT
Once the Office accepts a claim, it has the burden of justifying termination or
modification of compensation benefits.1 After it has determined that an employee has disability
causally related to his federal employment, the Office may not terminate compensation without
establishing that the disability has ceased or that it is no longer related to the employment.2 The
1

I.J., 59 ECAB ___ (Docket No. 07-2362, issued March 11, 2008); Fermin G. Olascoaga, 13 ECAB 102,
104 (1961).
2

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

3

Office’s burden of proof includes the necessity of furnishing rationalized medical opinion
evidence based on a proper factual and medical background.3 The right to medical benefits for
an accepted condition is not limited to the period of entitlement to compensation for disability.
To terminate authorization for medical treatment, the Office must establish that the claimant no
longer has residuals of an employment-related condition, which requires further medical
treatment.4
ANALYSIS
The Office accepted that appellant sustained an employment-related low back strain,
aggravation of low back syndrome and aggravation of a herniated disc at L5-S1 on April 3, 1990.
It terminated his compensation benefits effective September 10, 2007. The Board finds that the
Office met its burden to establish that appellant’s accepted conditions had resolved.
On April 21, 2006 the Office requested that appellant submit updated medical evidence.
Appellant submitted a December 15, 2004 report of Dr. Rowe and several medical reports and
physical therapy notes already of record. Dr. Rowe noted that appellant had minimal tenderness
in the lumbar spine with virtually a full range of motion. She also found normal strength in the
muscles of the lower extremities. Thereafter, the Office referred him to Dr. Alexander for a
second opinion evaluation.
In an October 12, 2006 report, Dr. Alexander examined appellant and reviewed his
history. He diagnosed cervical and lumbosacral degenerative disc disease and concluded that
appellant’s employment-related condition had resolved. Dr. Alexander explained that the workrelated aggravation of appellant’s lumbar condition was temporary as demonstrated by the fact
that he had been asymptomatic. He attributed appellant’s present symptomatology to the
underlying degenerative disc disease which was not employment related. Dr. Alexander advised
that appellant had returned to a preinjury baseline lumbar condition and that his current
symptoms were due to the natural progression of degenerative disc disease and to the April 3,
1990 work incident. He did not attribute any continuing condition to appellant’s accepted work
injuries. The Board finds that Dr. Alexander’s report represents the weight of the medical
evidence. The Office properly relied on his report in terminating appellant’s benefits.
Dr. Alexander’s opinion is based on proper factual and medical history as he had a statement of
accepted facts and his report contained an accurate summary of the relevant medical evidence.
Furthermore, he analyzed this information in addition to his own findings on examination,
including the results of diagnostic testing, to reach a reasoned conclusion regarding appellant’s
condition.5

3

T.P., 58 ECAB ___ (Docket No. 07-60, issued May 10, 2007); Larry Warner, 43 ECAB 1027 (1992).

4

E.J., 59 ECAB ___ (Docket No. 08-1350, issued September 8, 2008).

5

See Naomi Lilly, 10 ECAB 560 (1959) (the opportunity for and thoroughness of examination, the accuracy and
completeness of the doctor’s knowledge of the facts and medical history, the care of analysis manifested and the
medical rationale expressed in support of the doctor’s opinion are factors which enter into the weight of an
evaluation).

4

Appellant submitted a November 16, 2007 report from Dr. D’Auria, who found that
appellant had lumbar degenerative disc changes and spontaneous fusion at the L5-S1 level.
However, in addressing the cause of appellant’s condition, Dr. D’Auria noted that appellant
attributed his back pain to the 1989 work injury. This does not reflect his own independent
opinion on causal relationship but instead is a reiteration of appellant’s opinion.6 Dr. D’Auria’s
report does not provide a full explanation as to how appellant’s current back condition was
caused or aggravated by either the 1989 or 1990 work injuries. There is no other medical
evidence contemporaneous with the termination of appellant’s benefits which supports that
appellant has any continuing employment-related condition.
Consequently, the weight of the medical evidence rests with Dr. Alexander and
establishes that appellant has no residuals of his accepted lumbar conditions. The Office met its
burden of proof to terminate appellant’s compensation benefits.
CONCLUSION
The Board finds that the Office met its burden of proof to terminate appellant’s
compensation benefits effective September 10, 2007.
ORDER
IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’
decisions dated March 12, 2008 and September 7, 2007 are affirmed.
Issued: April 6, 2009
Washington, DC

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

Michael E. Groom, Alternate Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board
6

See Lois E. Culver (Clair L. Culver), 53 ECAB 412 (2002) (the opinion of a physician must be of reasonable
medical certainty and must be supported by medical rationale explaining causal relationship).

5


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
P.B., Appellant
and
DEPARTMENT OF DEFENSE, DEFENSE
FINANCE & ACCOUNTING SERVICE,
Indianapolis, IN, Employer
__________________________________________

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Appearances:
Alan J. Shapiro, Esq., for the appellant
Office of Solicitor, for the Director

Docket No. 12-483
Issued: June 15, 2012

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Judge
COLLEEN DUFFY KIKO, Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On January 4, 2012 appellant, through her attorney, filed a timely appeal from the
November 30, 2011 merit decision of the Office of Workers’ Compensation Programs (OWCP),
which affirmed the denial of her claim for a recurrence of disability. 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 established that she sustained a recurrence of disability on
October 6, 2009 causally related to her October 14, 2008 employment injury.
On appeal appellant’s attorney contends that OWCP’s decision was contrary to fact and
law.

1

5 U.S.C. § 8101 et seq.

FACTUAL HISTORY
This case was previously before the Board. In a decision dated June 9, 2011, the Board
affirmed OWCP’s July 13, 2010 decision, finding that appellant did not meet her burden of proof
to establish that she sustained a recurrence of disability on October 6, 2009 causally related to
her October 14, 2008 employment injury.2 The facts of the case, as set forth in the prior
decision, are incorporated by reference.
By letter dated September 20, 2011, appellant, through her attorney, requested
reconsideration and submitted additional evidence.
In an April 12, 2010 report, Dr. Thomas Haher, a Board-certified orthopedic surgeon,
diagnosed herniated disc cervical no myelopathy and neck pain. He indicated that the date of
injury was October 14, 2008 and opined that appellant’s percentage of temporary impairment
was 100 percent.
In a March 4, 2011 magnetic resonance imaging (MRI) scan of the cervical spine report,
Dr. Christopher Vaughn, a Board-certified radiologist, diagnosed degenerative changes of the
cervical spine, small right foraminal disc protrusion at C3-4, disc osteophyte complex at C5-6,
three to four millimeter central disc protrusion at C6-7 and mild-to-moderate left-sided neural
foraminal narrowing due to facet arthropathy at C7-T1.
Appellant also resubmitted the following evidence: two x-ray reports dated October 2,
2009; a November 6, 2009 MRI scan of the cervical spine; and a March 7, 2011 report by
Dr. Walter H. Short, a Board-certified orthopedic hand surgeon.
By decision dated November 30, 2011, OWCP denied modification of the prior decision,
finding that the evidence submitted did not establish that appellant sustained a recurrence of
disability on October 6, 2009 causally related to the employment injury.
LEGAL PRECEDENT
A person seeking benefits under FECA3 has the burden of establishing the essential
elements of her claim. 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 has resulted
from a previous injury or illness without an intervening injury or new exposure to the work
environment that caused the illness.4 A person who claims a recurrence of disability due to an
accepted employment-related injury has the burden of establishing by the weight of the
substantial, reliable and probative evidence that the disability for which she claims compensation
is causally related to the accepted injury. This burden of proof requires that an employee furnish
medical evidence from a physician who, on the basis of a complete and accurate factual and
2

Docket No. 10-2175 (issued June 9, 2011). OWCP accepted that on October 14, 2008 appellant, then a 51-yearold accounting technician, sustained right bicipital tenosynovitis and right Gamekeeper’s thumb.
3

5 U.S.C. §§ 8101-8193.

4

See R.S., 58 ECAB 362 (2007); 20 C.F.R. § 10.5(x).

2

medical history, concludes that the disabling condition is causally related to the employment
injury and supports that conclusion with sound medical reasoning.5 Where no such rationale is
present, medical evidence is of diminished probative value.6
ANALYSIS
OWCP accepted appellant’s claim for right bicipital tenosynovitis and right
Gamekeeper’s thumb. The issue is whether appellant established that she was totally disabled
commencing October 6, 2009 due to her October 14, 2008 employment injury.
OWCP did not accept a cervical condition causally related to appellant’s October 14,
2008 employment injury. Although Drs. Haher and Vaughn provided firm diagnoses, they
provided medical reports regarding a cervical condition. The issue here is a recurrence of the
accepted medical conditions. Thus, these medical reports are immaterial in nature.
The two x-ray reports dated October 2, 2009, the November 6, 2009 MRI scan and the
March 7, 2011 report from Dr. Short were previously considered and found insufficient to
establish appellant’s claim.
The Board finds that the evidence submitted by appellant does not provide adequate
rationale to show a spontaneous change in her medical condition which has resulted from the
October 14, 2008 employment injury nor a change in the nature and extent of the injury-related
condition. Therefore, appellant did not meet her burden of proof to establish disability as a result
of a recurrence.
On appeal appellant’s attorney contends that OWCP’s decision was contrary to fact and
law. For the reasons stated above, the Board finds the attorney’s argument is unsubstantiated.
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 did not establish that she sustained a recurrence of
disability on October 6, 2009 causally related to her October 14, 2008 employment injury.

5

See I.J., 59 ECAB 408 (2008); Nicole Bruso, 33 ECAB 1138, 1140 (1982).

6

See Michael Stockert, 39 ECAB 1186, 1187-88 (1988); Ronald C. Hand, 49 ECAB 113 (1997).

3

ORDER
IT IS HEREBY ORDERED THAT the November 30, 2011 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: June 15, 2012
Washington, DC

Alec J. Koromilas, Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board

4


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
K.O., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Honolulu, HI, Employer
__________________________________________

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Appearances:
Appellant, pro se
Office of Solicitor, for the Director

Docket No. 11-1436
Issued: January 10, 2012

Case Submitted on the Record

DECISION AND ORDER
Before:
RICHARD J. DASCHBACH, Chief Judge
ALEC J. KOROMILAS, Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On May 20, 2011 appellant filed a timely appeal from March 25 and April 29, 2011 merit
decisions of the Office of Workers’ Compensation Programs (OWCP) which denied his
recurrence of disability claim. 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 was disabled from September 27, 2010 to February 9,
2011 as a result of a recurrence of his accepted knee condition.
FACTUAL HISTORY
On July 7, 2010 appellant, then a 54-year-old postal worker, filed an occupational disease
claim alleging that he developed a right knee condition as a result of his employment. OWCP
accepted his claim for right knee osteoarthritis, chondromalacia and other internal derangement.
1

5 U.S.C. § 8101 et seq.

On February 24, 2010 appellant underwent right knee arthroplasty.
returned to light duty on April 27, 2010.

He stopped work and

Appellant filed various claims for disability compensation for the period September 27,
2010 to February 9, 2011.2
In a January 25, 2010 report, Dr. Calvin S. Oishi, a Board-certified orthopedic surgeon,
noted appellant’s complaints of persistent right knee pain. The examination revealed antalgic
gait, definite lateral thrust and range of motion of 5 to 85 degrees. Dr. Oishi diagnosed bone-onbone arthritis and scheduled appellant for a knee replacement.
In a February 24, 2010 operative report, Dr. Oishi noted appellant’s diagnosis of severe
osteoarthritis of the right knee and explained his procedure for a right knee arthroplasty.
In a March 4, 2010 physical therapy report, co-signed by Steven Tom, P.T. and Dr. Oishi,
appellant was authorized to undergo physical therapy from March 4 to April 1, 2010. Appellant
also submitted various physical therapy examination records and progress notes dated March 4 to
April 23, 2010.
In March 15, April 26 and May 24 2010 reports, Dr. Oishi stated that appellant had less
pain and was recovering well after surgery. Upon examination, he observed extension to 0
degrees and flexion up to 120 degrees. Appellant’s neurovascular status was intact and
radiographs revealed no migration, fracture and dislocation. Dr. Oishi authorized appellant to
return to light duty with restrictions for four hours a day and recommended that he continue
physical therapy.
In June 21, July 19 and August 16, 2010 reports, Dr. Oishi stated that appellant was
progressing well and related that he had less pain. The examination revealed range of motion of
0 to 130 degrees and no effusion and tenderness. Dr. Oishi concluded that appellant had stable
alignment and had definitely improved, but needed to continue with physical therapy and remain
on light duty.
In a September 13, 2010 report, Dr. Oishi stated that appellant experienced less pain and
requested to return to full duty. The examination revealed no effusion and tenderness and range
of motion was 0 to 130 degrees. Dr. Oishi concluded that appellant had definitely improved and
authorized him to return to full duty.
In a September 17, 2010 report, Dr. Oishi related that appellant reported less pain and
was doing well. He observed that appellant’s range of motion was 0 to 120 degrees and that
radiographs revealed acceptable alignment.
In a September 17, 2010 disability certificate, Dr. Oishi noted that appellant was disabled
from work from September 27 to December 13, 2010 and needed help to complete his route.
2

According to appellant’s time analysis forms, he worked occasional hours on September 29 and November 27
and 29, 2010. He submitted other claims for disability compensation for the period February 19 to April 15, 2011.
Because OWCP did not address these compensation claims, this issue is not before the Board at this time.

2

In a September 27, 2010 report, Dr. Oishi noted appellant’s complaints of knee pain. The
examination revealed range of motion of 0 to 120 degrees and no effusion or tenderness.
Dr. Oishi authorized appellant to return to light duty.
On November 16, 2010 OWCP advised appellant that his disability compensation claim
for September 27 to October 2, 2010 was not payable because according to Dr. Oishi’s
September 27, 2010 report he was released to light duty. It informed him that, if his employing
establishment was unable to accommodate his restrictions, he needed to submit written
documentation in order for compensation to be paid.
In an October 29, 2010 statement, the employing establishment reported that, although
appellant was released to limited duty, management could not provide work that fit within those
restrictions. Accordingly, appellant worked less than four hours when he returned to work on
April 27, 2010.
In a November 22, 2010 statement, appellant explained that two weeks prior to
September 27, 2010 he worked eight hours per day, five days per week. On the week of
September 27, 2010, his knee was painful, swollen and was giving out on him so he called in
sick that week. Appellant’s physical therapist informed him that he was working too much and
needed to rest his knee. He explained that he presently worked half days and was going to
therapy twice a week.
In a December 1, 2010 disability slip, Dr. Oishi stated that appellant was totally
incapacitated from December 1, 2010 to January 26, 2011.
In a December 1, 2010 report, Dr. Oishi related that appellant’s knee was more painful,
stiff and swollen. The examination revealed no effusion and redness. Appellant stated that he
could not handle work and would like eight weeks off work. In a December 10, 2010 addendum,
Dr. Oishi explained that his decision to keep appellant off work for eight weeks was based on his
statement that he physically could not handle his work. He stated that there were limited
physical findings and he had to assume appellant was telling the truth.
In a December 6, 2010 statement, appellant noted that he went to see Dr. Oishi on
December 1, 2010 for pain in his right knee and was ordered to be “totally incapacitated” for
eight weeks. He requested that a nurse be assigned to his case.
In a December 8, 2010 treatment plan certification co-signed by Dr. Oishi and Mr. Tom,
they provided the goals of appellant’s physical therapy and noted his knee symptoms of
restricted range of motion, weakness, functional strength loss, gait deviations and inability to
return to normal work duties. Appellant submitted additional physical therapy reports dated
December 8, 2010 to February 23, 2011.
In a January 26, 2011 report, Dr. Oishi stated that despite ongoing therapy he could not
do his job and was unable to do his work at all.
On January 31, 2011 OWCP advised appellant that his claims for disability compensation
could not be processed because the medical evidence was not sufficient to support complete
disability.
3

In a February 9, 2011 report, Dr. Oishi related that appellant felt like he could do at least
light duty. On examination, his range of motion was 0 to 100 degrees with a 1+ effusion.
Dr. Oishi provided a disability slip authorizing appellant to return to light duty on
February 10, 2011.
In a February 18, 2011 disability slip, Dr. Oishi stated that appellant was partially
incapacitated from February 18 to March 16, 2011.
In a February 18, 2011 duty status report with an unknown signature, appellant was
authorized to work three hours per day, five days a week with certain restrictions.
In a March 25, 2011 decision, OWCP denied appellant’s claim for disability
compensation for the period September 27, 2010 to February 9, 2011 finding that the medical
evidence did not demonstrate that he was disabled from work during the period claimed as a
result of his employment injury. It noted that Dr. Oishi’s medical report merely stated that the
patient stated that he was unable to handle work and did not provide any objective medical
findings to support appellant’s disability.3
On April 1, 2011 appellant submitted a request for reconsideration contending that the
evidence he submitted contained objective medical findings to support his claimed disability. He
resubmitted his treatment plan certificates, various physical therapy treatment plans and duty
status report.
In a December 2010 knee outcome survey, appellant indicated how his daily activities
were affected by various symptoms.
In a March 18, 2011 knee progress note, a physical therapist noted appellant’s complaints
of knee pain, stiffness and weakness. The examination revealed range of motion was 0 degrees
extension and 130 to 143 degrees flexion. It was recommended that appellant continue physical
therapy for four weeks.
In a March 18, 2011 treatment plan, a physical therapist indicated that appellant
underwent physical therapy from March 4 to April 1, 2011.
In an April 13, 2011 disability certificate, Dr. Oishi reported that appellant should
continue light duty three hours per day from April 13 to May 11, 2011.
In an April 13, 2011 report, Dr. Oishi related that appellant felt his knee was still weak
and that he could not handle full duty because his leg got swollen and tired. Examination
revealed range of motion 0 to 140 degrees with minimal effusion and tenderness. Dr. Oishi
recommended that appellant continue therapy and be on light-duty status permanently.

3

Appellant received compensation for the periods June 15 to September 10, 2010; February 19 to March 4, 2011;
and March 5 to 18, 2011; and March 19 to May 13, 2011 for total disability and because the employing
establishment was unable to provide light duty.

4

By decision dated April 29, 2011, OWCP refused to modify its March 25, 2011 denial
decision finding that the evidence did not contain a physician’s rationalized medical opinion
explaining how appellant’s disability resulted from his employment injury.
LEGAL PRECEDENT
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
injury or illness without an intervening injury or new exposure to the work environment that
caused the illness.4 This term also means an inability to work when a light-duty assignment
made specifically to accommodate an employee’s physical limitations due to his work-related
injury or illness is withdrawn (except when such withdrawal occurs for reasons of misconduct,
nonperformance of job duties or a reduction-in-force) or when the physical requirements of such
an assignment are altered so that they exceed his established physical limitations.5 Moreover,
when the claimed recurrence of disability follows a return to light-duty work, the employee may
satisfy his burden of proof by showing a change in the nature and extent of the injury-related
condition such that he is no longer able to perform the light-duty assignment.6
Where an employee claims a recurrence of disability due to an accepted employmentrelated injury, he has the burden of establishing that the recurrence of disability is causally
related to the original injury.7 This burden includes the necessity of furnishing evidence from a
qualified physician who concludes, on the basis of a complete and accurate factual and medical
history, that the condition is causally related to the employment injury.8 The medical evidence
must demonstrate that the claimed recurrence was caused, precipitated, accelerated or aggravated
by the accepted injury.9
ANALYSIS
OWCP accepted that appellant sustained a right knee condition as a result of his federal
employment as a postal worker. Appellant underwent total right knee arthroplasty and stopped
work. On April 27, 2010 he returned to light duty. Appellant filed various compensation claims
for total disability from September 27, 2010 to February 9, 2011. OWCP denied appellant’s
disability compensation claims on the grounds that the medical evidence failed to establish that
he was disabled as a result of his accepted right knee injury. The Board finds that he failed to
meet his burden of proof to establish that his claimed disability was causally related to his
accepted right knee injury.
4

20 C.F.R. § 10.5(x).

5

Id.

6

Theresa L. Andrews, 55 ECAB 719, 722 (2004).

7

20 C.F.R. § 10.104(b); Carmen Gould, 50 ECAB 504 (1999); Robert H. St. Onge, 43 ECAB 1169 (1992).

8

Helen K. Holt, 50 ECAB 279 (1999).

9

Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.2 (March 2011).

5

Appellant submitted various medical reports from Dr. Oishi during the time period in
question. In his September 13, 2010 report, just 14 days before appellant stopped light duty
work, Dr. Oishi noted that appellant was doing well and requested to return to full duty. He also
provided various disability slips. In September 17 and December 1, 2010 disability certificates,
Dr. Oishi noted that appellant was disabled from work from September 27 to January 26, 2011
and needed help to complete his route. In a January 26, 2011 note, he reported that appellant
was unable to do his work at all. Although Dr. Oishi states that appellant was unable to work
during the aforementioned periods, he did not address the cause of appellant’s inability to work
or explain how his claimed disability resulted from his employment injury. Thus, these disability
slips are of little probative value on the issue of causal relationship.10
In his December 1, 2010 narrative report, Dr. Oishi observed no effusion and redness and
stated that appellant requested eight weeks off work because he could not handle it. In a
December 10, 2010 addendum, he explained that he decided to keep appellant off work for eight
weeks based on his statement that he physically could not handle the job. Dr. Oishi noted that
there were limited physical findings. The Board has found that findings on examination are
generally needed to support a physician’s opinion that an employee is disabled for work.11
Dr. Oishi, however, did not provide any objective medical findings to support appellant’s
disability but indicated that he recommended appellant stay off work due to his request. Because
the record fails to contain objective medical findings to support that appellant was disabled from
work due to his employment injury, the Board finds that he did not meet his burden of proof to
establish his claim.
The other evidence of record is likewise insufficient to establish appellant’s claim. The
various physical therapy reports, treatment plans, and progress notes are not sufficient to
demonstrate that appellant was disabled from work as a result of his employment injury because
physical therapists are not “physicians” as defined by FECA.12 Thus, their opinions regarding
diagnosis and causal relationship are of no probative medical value.13 Similarly, the knee
outcome survey is insufficient to establish causal relationship because it was not completed by a
physician. Because the other medical evidence either failed to address appellant’s disability
from work or addressed time periods for disability compensation not before the Board at this
time, the Board finds that the evidence of record is void of probative medical evidence to
establish that appellant was disabled from work from September 27 to February 9, 2011 as a
result of his employment.
On appeal, appellant contends that the evidence submitted was sufficient to establish that
he was unable to work from September 27, 2010 to February 9, 2011. The record in this case,
however, does not contain a well-rationalized medical opinion from a physician demonstrating
that his claimed disability resulted from his right knee employment injury. Causal relationship is
a medical issue and the medical evidence required to establish causal relationship is rationalized
10

S.S., 59 ECAB 315 (2008); Elizabeth H. Kramm, 57 ECAB 117 (2008).

11

See S.F., 59 ECAB 525 (2008); Fereidoon Kharabi, 52 ECAB 291 (2001).

12

5 U.S.C. § 8101(2).

13

See Roy L. Humphrey, 57 ECAB 238 (2005).

6

medical evidence.14 Neither the fact that appellant’s claimed condition became apparent or
worsened during a period of employment nor his belief that his condition was aggravated by his
employment is sufficient to establish causal relationship.15
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 did not meet his burden of proof to establish a recurrence
of disability for the period September 27, 2010 to February 9, 2011.
ORDER
IT IS HEREBY ORDERED THAT the March 25 and April 29, 2011 decisions of the
Office of Workers’ Compensation Programs are affirmed.
Issued: January 10, 2012
Washington, DC

Richard J. Daschbach, Chief Judge
Employees’ Compensation Appeals Board

Alec J. Koromilas, Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board

14

G.T., 59 ECAB 447 (2008); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

15

D.I., 59 ECAB 158 (2007); Ruth R. Price, 16 ECAB 688, 691 (1965).

7


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
L.G., Appellant
and
U.S. POSTAL SERVICE, FORT DEARBORN
STATION, Chicago, IL, Employer
__________________________________________

)
)
)
)
)
)
)
)

Appearances:
Alan J. Shapiro, Esq., for the appellant
Office of Solicitor, for the Director

Docket No. 15-1375
Issued: September 3, 2015

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
COLLEEN DUFFY KIKO, Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On June 8, 2015 appellant, through counsel, filed a timely appeal of an April 16, 2015
nonmerit decision of the Office of Workers’ Compensation Programs (OWCP). As more than
180 days elapsed between November 7, 2013, the date of OWCP’s most recent merit decision,
and the filing of this appeal, pursuant to the Federal Employees’ Compensation Act1 (FECA) and
20 C.F.R. §§ 501.2(c) and 501.3, the Board lacks jurisdiction over the merits of appellant’s
claim.
ISSUE
The issue is whether OWCP properly denied appellant’s request for further merit review
pursuant to 5 U.S.C. § 8128(a).
On appeal counsel asserts that the April 16, 2015 decision was contrary to fact and law.

1

5 U.S.C. §§ 8101-8193.

FACTUAL HISTORY
This case has previously been before the Board. In an order dated July 25, 2013, the
Board found the case not in posture for decision as the record did not contain evidence from the
employing establishment, which had been cited in an OWCP September 16, 2011 decision. The
Board remanded the case to OWCP to obtain the aforementioned evidence.2 In an October 23,
2014 decision, the Board found that appellant had not established an occupational disease in the
performance of duty and affirmed a November 7, 2013 OWCP decision.3 The findings of the
previous Board decisions and orders are incorporated herein by reference.
On February 18, 2015 appellant, through counsel, requested reconsideration and
submitted evidence previously of record including statements by Coworkers Caroline Travis and
Nancy Morrow, and a grievance settlement decision dated September 23, 2010. In an undated
statement, appellant generally alleged that her claim should be accepted. She also submitted a
partial October 11, 2013 nursing triage report completed by Olivia Szymczak, a May 20, 2014
statement from a friend, Aurora Volkmann-Arendt, who advised that appellant had no problems
with irritations since she retired, and the first page of a grievance appeal. In a May 16, 2014
report, Dr. Steven Wolf, an attending Board-certified internist, advised that he had treated
appellant since January 2010 and that it was likely that atmospheric contaminants at work caused
skin rashes on a recurrent and regular basis.
In a nonmerit decision dated April 16, 2015, OWCP denied appellant’s reconsideration
request. It found the evidence submitted was either duplicative or irrelevant and, therefore,
insufficient to warrant merit review.
LEGAL PRECEDENT
Section 8128(a) of FECA vests OWCP with discretionary authority to determine whether
it will review an award for or against compensation, either under its own authority or on
application by a claimant.4 Section 10.608(a) of OWCP’s regulations provide that a timely
request for reconsideration may be granted if OWCP determines that the employee has presented
evidence and/or argument that meets at least one of the standards described in section
10.606(b)(3).5 This section provides that the application for reconsideration must be submitted
in writing and set forth arguments and contain evidence that either: (i) shows that OWCP
2

Docket No. 13-658 (issued July 25, 2013). On December 20, 2010 and January 5, 2011 appellant, then a 53year-old mail processing clerk, filed occupational disease claims alleging that she had been exposed to ongoing
chemical irritants at work that caused face, eye, and neck problems. After an initial denial on April 6, 2011, in a
June 20, 2011 decision, an OWCP hearing representative remanded the case for OWCP to obtain additional
information from the employing establishment regarding testing and investigation of chemical irritants in the
workplace. In a September 16, 2011 decision, OWCP indicated that correspondence regarding alleged chemical
exposure was found in OWCP file number xxxxxx808 which indicated that an investigation had been conducted.
On June 11, 2012 an OWCP hearing representative affirmed the September 16, 2011 decision, and in a merit
decision dated January 3, 2013, OWCP denied modification of the prior decisions.
3

Docket No. 14-1178 (issued October 23, 2014).

4

5 U.S.C. § 8128(a).

5

20 C.F.R. § 10.608(a).

2

erroneously applied or interpreted a specific point of law; or (ii) advances a relevant legal
argument not previously considered by OWCP; or (iii) constitutes relevant and pertinent new
evidence not previously considered by OWCP.6 Section 10.608(b) provides that when a request
for reconsideration is timely but fails to meet at least one of these three requirements, OWCP
will deny the application for reconsideration without reopening the case for a review on the
merits.7
ANALYSIS
The only decision before the Board in this appeal is the nonmerit decision of OWCP
dated April 16, 2015 which denied appellant’s application for review. It follows that because
there is no OWCP merit decision before the Board it lacks jurisdiction to consider the merits of
appellant’s claim.8
The Board finds that, as appellant did not assert that OWCP erroneously applied or
interpreted the law and did not advance a relevant legal argument not previously considered by
OWCP, and that she was not entitled to a merit review of the merits of her claim based on the
first and second requirements under section 10.606(b)(3).9
With respect to the third above-noted requirement under section 10.606(b)(3), appellant
submitted some evidence previously of record that had been reviewed by OWCP and the Board.
This included statements by Coworkers Travis and Morrow, and a grievance settlement decision
dated September 23, 2010. Evidence or argument that repeats or duplicates evidence previously
of record has no evidentiary value and does not constitute a basis for reopening a case.10
Appellant also submitted a partial October 11, 2013 nursing triage report and a May 20,
2014 statement from a friend, who advised that appellant had no problems with irritations since
she retired. A medical report is considered probative evidence if there is a clear indication that
the person completing, signing, and dating the report qualifies as a “physician” as defined in
section 8102(2) of FECA. That provision provides that the term “physician” includes surgeons,
podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and osteopathic
practitioners within the scope of their practice as defined by State law.11 Lay persons such as
Ms. Volkmann-Arendt and nurses like Ms. Szymczak are not physicians. These reports
submitted by appellant are, therefore, not competent medical evidence. Likewise, the first page
of the grievance appeal is not relevant to the merit issue of whether appellant established an
occupational disease causally related to her federal employment. The grievance form is as it is
incomplete and merely demonstrates, at most, that an appeal was filed.

6

Id. at § 10.608(b)(3).

7

Id. at § 10.608(b).

8

Id. at § 501.3(e).

9

Id. at § 10.606(b)(3); see R.M., 59 ECAB 690 (2008).

10

J.P., 58 ECAB 289 (2007).

11

5 U.S.C. § 8102(2); see Roy L. Humphrey, 57 ECAB 238 (2005); Jaja K. Asaramo, 55 ECAB 200 (2004).

3

In his May 16, 2014 report, Dr. Wolf, an attending internist, advised that he had been
treating appellant since January 2010 and that it was likely that atmospheric contaminants at
work caused skin rashes on a recurrent and regular basis. He previously submitted similar
opinions reviewed by both OWCP and the Board.12 Appellant, therefore, has not submitted
relevant and pertinent new evidence not previously considered by OWCP.
As appellant did not show that OWCP erred in applying a point of law, advance a
relevant legal argument not previously considered, or submit relevant and pertinent new
evidence not previously considered by OWCP, OWCP properly denied her reconsideration
request.13
CONCLUSION
The Board finds that OWCP properly refused to reopen appellant’s case for further
consideration of the merits of her claim pursuant to 5 U.S.C. § 8128(a).
ORDER
IT IS HEREBY ORDERED THAT the April 16, 2015 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: September 3, 2015
Washington, DC

Christopher J. Godfrey, Chief Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board

12

Supra notes 2 and 3.

13

Supra note 8.

4