United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
E.D., Appellant
and
ADMINISTRATIVE OFFICE OF THE U.S.
COURTS, U.S. DISTRICT COURT,
Santa Fe, NM, Employer
__________________________________________

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

Docket No. 17-1442
Issued: October 17, 2017

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
ALEC J. KOROMILAS, Alternate Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION
On June 19, 2017 appellant filed a timely appeal from a December 21, 2016 nonmerit
decision of the Office of Workers’ Compensation Program (OWCP). As more than 180 days
elapsed from OWCP’s last merit decision, dated September 30, 2015, to 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 the claim.2
ISSUE
The issue is whether OWCP properly denied appellant’s request for reconsideration of
the merits of her claim pursuant to 5 U.S.C. § 8128(a).
1
2

5 U.S.C. § 8101 et seq.

The Board notes that appellant submitted additional evidence to OWCP after the December 21, 2016 decision
was issued. The Board’s jurisdiction is limited to reviewing the evidence that was before OWCP at the time of its
final decision. Therefore, the Board lacks jurisdiction to review this additional evidence. 20 C.F.R. § 501.2(c)(1).

FACTUAL HISTORY
On May 24, 2005 appellant, then a 42-year-old courtroom deputy, filed a traumatic injury
claim (Form CA-1) alleging an injury on May 23, 2005 due to a slip and fall at work. She
stopped work the day of her injury and received continuation of pay. OWCP initially accepted
appellant’s claim for right foot/ankle sprain and right metatarsal fracture. Appellant underwent
right ankle surgery in August 2005. OWCP paid appellant for intermittent wage-loss
compensation for the period July 21, 2005 through January 5, 2006. It subsequently expanded
appellant’s claim to include right foot reflex sympathetic dystrophy.
In a November 20, 2005 attending physician’s report (Form CA-20), Dr. Nathan D. Ivey,
a podiatrist, advised that appellant was capable of light-duty work effective September 2005 with
the following restrictions: weight-bearing as tolerated.
Appellant resigned from federal service effective January 25, 2006.
From 2006 through 2012 appellant continued to receive treatment for her right lower
extremity pain disorder.
On April 18, 2013 OWCP awarded appellant a schedule award for 10 percent permanent
impairment of the right lower extremity. The award covered a 28.8-week period from
November 30, 2012 through June 19, 2013.
In August 2013, OWCP expanded appellant’s claim to include complex regional pain
syndrome (CRPS) or right foot causalgia.
On August 8, 2013 appellant filed a claim for wage-loss compensation (CA-7 and CA-7a
forms) for the period November 6, 2006 through November 29, 2012 and June 20, 2013 and
continuing. In support of her claim, she submitted an employment history indicating that she had
worked as a legal assistant for a law firm from April 2006 to 2009 and then as a self-employed
contractor from 2010 to the present. Appellant also submitted a worksheet indicating her hours
of disability for the period July 21, 2005 through January 5, 2006.3
In a September 26, 2013 letter, OWCP advised appellant of the need to submit medical
evidence in support her claimed period(s) of disability. It afforded her 30 days to submit
additional evidence.
In a second letter dated September 26, 2013, OWCP requested additional information
from the employing establishment regarding appellant’s work or any job offers made to appellant
during the period claimed.
Appellant submitted progress notes from Dr. Craig S. Nairn, a Board-certified
anesthesiologist and pain medicine specialist, covering the period May 21, 2013 through
April 11, 2014. Dr. Nairn’s diagnoses included lower extremity CRPS, with associated chronic
pain syndrome and classical migraine.
3

OWCP previously paid appellant for the claimed period in June 2006.

2

Subsequently, the employing establishment submitted a Notification of Personnel Action
(SF-50) indicating that appellant had resigned from federal employment effective
January 25, 2006.
In a May 5, 2014 letter, the employing establishment noted that there was no additional
job offered to appellant after she resigned on January 25, 2006.
On June 30, 2014 appellant indicated that she was forced to resign her position as
courtroom deputy and basically had no choice but to resign and/or get fired from her position at
the time of her meeting with the Clerk of the Court and the Chief Deputy Clerk. She further
indicated that it was unclear to her at the time whether she would require any special
accommodations and/or physical requirements for work because she was still going through
physical therapy for her foot, so neither she nor the employing establishment knew that she
would require work accommodations.
Appellant continued to submit monthly progress notes from Dr. Nairn. In a June 18,
2015 report, Dr. Nairn indicated that appellant was under his care for CRPS of the lower
extremity and she had tried numerous modalities of treatment. He advised that appellant’s pain
limited her ability to function and would be expected to interfere with her ability to work.
By decision dated September 30, 2015, OWCP denied appellant’s claim for disability for
the period November 6, 2006 to November 29, 2012 and from June 20, 2013 continuing because
the medical evidence of record failed to establish total disability due to the accepted employment
injuries. It found that there was no evidence of record to support that the employing
establishment was not accommodating appellant’s weight-bearing restrictions when she resigned
on January 25, 2006.
On March 14, 2016 appellant requested an expansion of her accepted conditions to
include depressive disorder, anxiety disorder, and agoraphobia and submitted medical evidence
regarding her psychiatric conditions in support of her claim.
On September 30, 2016 appellant requested reconsideration of the September 30, 2015
decision and submitted reports dated September 8 and October 7, 2016 from Dr. Nairn who
continued to diagnose CRPS of the right lower limb and chronic pain syndrome.
OWCP referred appellant for a second opinion psychiatric evaluation. In an October 26,
2016 report, Dr. Lori A. Willinghurst, a Board-certified psychiatrist, diagnosed major depressive
disorder, single, moderate and opined that appellant’s condition was causally related to her
accepted work injury.
In an October 26, 2016 report, Dr. Nairn reiterated his diagnoses and indicated that
appellant continued to complain of pain in her right foot with radiation up the leg above the knee.
In a decision dated December 21, 2016, OWCP expanded appellant’s claim to include
major depressive disorder, single moderate.
By decision dated December 21, 2016, OWCP denied appellant’s request for
reconsideration without a merit review because she failed to advance a relevant legal argument
3

or submit any relevant and pertinent new evidence. It found that the medical evidence appellant
submitted was irrelevant because it failed to establish that the employing establishment was not
accommodating her work restrictions when she resigned on January 25, 2006.
LEGAL PRECEDENT
Section 8128(a) of FECA does not entitle a claimant to review of an OWCP decision as a
matter of right.4 OWCP has discretionary authority in this regard and has imposed certain
limitations in exercising its authority.5 One such limitation is that the request for reconsideration
must be received by OWCP within one year of the date of the decision for which review is
sought.6 A timely application for reconsideration, including all supporting documents, must set
forth arguments and contain evidence that either: (i) shows that OWCP erroneously applied or
interpreted a specific point of law; (ii) advances a relevant legal argument not previously
considered by OWCP; or (iii) constitutes relevant and pertinent new evidence not previously
considered by OWCP.7 When a timely application for reconsideration does not meet at least one
of the above-noted requirements, OWCP will deny the request for reconsideration without
reopening the case for a review on the merits.8
ANALYSIS
The Board finds that appellant’s request for reconsideration neither alleged nor
demonstrated that OWCP erroneously applied or interpreted a specific point of law.
Additionally, the Board finds that she did not advance a relevant legal argument not previously
considered by OWCP. Consequently, appellant is not entitled to further review of the merits of
her claim based on the first and second above-noted requirements under section 10.606(b)(3).
In support of her reconsideration request, appellant submitted reports from Dr. Nairn who
continued to diagnose CRPS of the right lower limb. The Board finds that submission of this
evidence did not require reopening appellant’s case for merit review because it failed to address
the point at issue before OWCP. As OWCP denied the claim based on the lack of supportive
evidence establishing that the employing establishment was not accommodating appellant’s
weight-bearing work restrictions when she resigned on January 25, 2006, the Board finds that
these additional medical reports do not constitute pertinent new and relevant evidence. The
reports further failed to address appellant’s disability for the periods claimed due to her accepted
This section provides in pertinent part: “[t]he Secretary of Labor may review an award for or against payment
of compensation at any time on his own motion or on application.” 5 U.S.C. § 8128(a).
4

5

20 C.F.R. § 10.607.

6

Id. § 10.607(a). For merit decisions issued on or after August 29, 2011, a request for reconsideration must be
“received” by OWCP within one year of OWCP’s decision for which review is sought. Federal (FECA) Procedure
Manual, Part 2 -- Claims, Reconsiderations, Chapter 2.1602.4 (February 2016). Timeliness is determined by the
document receipt date of the request for reconsideration as indicated by the “received date” in the Integrated Federal
Employees’ Compensation System (iFECS). Id. at Chapter 2.1602.4b.
7

20 C.F.R. § 10.606(b)(3).

8

Id. at § 10.608(a), (b).

4

right lower extremity conditions.9 Therefore, they are insufficient to require OWCP to reopen
appellant’s claim for consideration of the merits. Appellant also submitted medical evidence
regarding her psychiatric condition, which was subsequently accepted by OWCP as a workrelated injury.
The Board finds that OWCP properly determined that appellant was not entitled to
further review of the merits of her claim pursuant to any of the three requirements under section
10.606(b)(3) and properly denied her request for reconsideration.
CONCLUSION
The Board finds that OWCP properly denied appellant’s request for reconsideration of
the merits of her claim pursuant to 5 U.S.C. § 8128(a).
ORDER
IT IS HEREBY ORDERED THAT the December 21, 2016 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: October 17, 2017
Washington, DC

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

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

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

9

The submission of evidence or argument which does not address the particular issue involved does not
constitute a basis for reopening a case. See C.H., Docket No. 16-0171 (issued September 5, 2017); Edward Matthew
Diekemper, 31 ECAB 224, 225 (1979).

5


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
E.M., Appellant
and
U.S. POSTAL SERVICE, KILMER
PROCESSING & DISTRIBUTION CENTER,
Edison, NJ, Employer
__________________________________________

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

Docket No. 19-0664
Issued: November 19, 2019

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
PATRICIA H. FITZGERALD, Deputy Chief Judge
JANICE B. ASKIN, Judge

JURISDICTION
On February 4, 2019 appellant filed a timely appeal from a December 20, 2018 merit
decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal
Employees’ Compensation Act1 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has
jurisdiction over the merits of this case.
ISSUE
The issue is whether appellant has greater than 37 percent permanent impairment of his
right lower extremity, for which he previously received schedule award compensation.
FACTUAL HISTORY
On April 18, 2007 appellant filed a notice of recurrence (Form CA-2a) alleging that on
March 2, 2007 he sustained a recurrence of a medical condition causally related to his July 22,
1

5 U.S.C. § 8101 et seq.

1992 employment injury.2 He noted that he stopped work on March 6, 2007 due to right knee pain
and loss of range of motion (ROM). On July 17, 2007 OWCP accepted appellant’s claim for
recurrence of a medical condition, post-traumatic arthropathy right lower extremity.
On December 3, 2007 Dr. James M. Lee, an orthopedic surgeon and appellant’s attending
physician, performed a second right knee arthroscopy.3
In a March 22, 2008 letter, OWCP informed appellant that his April 18, 2007 claim should
have been developed as a new traumatic injury claim, and that he was entitled to 45 days of
continuation of pay.
On November 19, 2010 Dr. Lee performed an additional right knee arthroscopy.
On February 2, 2011 appellant filed a schedule award claim (Form CA-7). By decision
dated December 28, 2012, OWCP granted him a schedule award for 30 percent permanent
impairment of the right lower extremity due to his accepted right knee conditions. The period of
the award was from September 30, 2011 through May 26, 2013.
On November 1, 2013 Dr. Lee recommended a total right knee replacement, which was
performed on May 14, 2014 by Dr. Louis C. Almekinders, a Board-certified orthopedic surgeon.
In a report dated October 20, 2014, he found that appellant had reached maximum medical
improvement (MMI). On October 27, 2014 appellant filed an additional schedule award claim
(Form CA-7).4
In a report dated March 29, 2016, Dr. Almekinders found that as a result of the total knee
replacement appellant had 31 percent permanent impairment of the right lower extremity. On
June 6, 2017 OWCP referred Dr. Almekinders’ March 29, 2016 report to the district medical
adviser (DMA), Dr. Michael M. Katz, a Board-certified orthopedic surgeon, for review and
application of the sixth edition of the American Medical Association, Guides to the Evaluation of
Permanent Impairment (A.M.A., Guides).5 In a June 6, 2017 report, Dr. Almekinder determined
that appellant had 25 percent permanent impairment of his right lower extremity due to his total
knee replacement and therefore was not entitled to an additional schedule award.

2

Appellant has a previously accepted claim under OWCP File No. xxxxxx054 for right knee contusion, left wrist
and hand contusion, and right leg traumatic arthropathy sustained when he tripped over a coworker while in the
performance of duty on July 22, 1992.
3

Appellant first underwent right knee arthroscopy on January 4, 1993.

4

On October 3, 2015 appellant filed a notice of recurrence (Form CA-2a) alleging that on March 3, 2015 he
sustained a recurrence of disability causally related to his March 2, 2017 employment injury. He alleged that the
employing establishment failed to provide him with modified duty in keeping with his employment-related work
restrictions. On November 27, 2015 appellant accepted a modified-duty position at the employing establishment. By
decision dated February 23, 2016, OWCP determined that appellant’s modified-duty position as a manager of
distribution operations fairly and reasonably represented his wage-earning capacity. It reduced his wage-loss
compensation benefits to zero based on his actual earnings in this position.
5

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

2

By decision dated September 21, 2017, OWCP denied appellant’s claim for an additional
schedule award finding that he had no more than 30 percent permanent impairment of his right
knee for which he had previously received a schedule award.
On August 15, 2018 appellant requested reconsideration of the September 21, 2017
schedule award denial.
On September 26, 2018 OWCP referred appellant for a second opinion evaluation with
Dr. Lawrence N. Larabee, Jr., a Board-certified orthopedic surgeon, and requested that he evaluate
appellant’s permanent impairment for schedule award purposes in accordance with the A.M.A.,
Guides. In his October 24, 2018 report, Dr. Larabee described appellant’s history of injury and
listed his right knee surgeries. He described appellant’s findings on physical examination
including an audible “pop” of the iliotibial (IT) band as it rubbed across the prosthesis. Appellant
reported that this was painful and caused him to stop walking after 200 yards. He was unable to
fully extend his right knee by 10 degrees and exhibited flexion of 110 degrees, internal rotation 5
degrees, and external rotation 5 degrees based on three ROM tests. In his left, unaffected knee,
appellant had full extension as well as hyperextension of 5 degrees and flexion of 130 to 135
degrees. Dr. Larabee diagnosed status post right knee arthroplasty and multiple knee surgeries
with loss of ROM of the right knee. He reported that appellant’s date of MMI was
October 20, 2014.
Dr. Larabee provided a November 20, 2018 addendum report utilizing the diagnosis-based
impairment (DBI) method to determine impairment and found that appellant had 37 percent
permanent impairment of the right lower extremity pursuant to the A.M.A., Guides. Under Table
16-3, Knee Regional Grid, page 511 of the A.M.A., Guides, Dr. Larabee identified the diagnosis
of fair result of the total knee replacement a class 3 impairment with a default rating of 37 percent.
He assigned grade modifier of 3 for functional history (GMFH) under Table 16-6, page 516 due
to appellant’s difficulty walking. Under Table 16-7, page 517, Dr. Larabee assigned a grade
modifier 3 for physical examination (GMPE) based on appellant’s loss of range of motion. He
assigned grade modifier 3 for clinical studies (GMCS) in accordance with Table 16-8, page 591 as
the clinical studies confirmed the diagnosis of severe pathology. Using the net adjustment formula
of (GMFH-CDX) + (GMPE-CDX) + (GMCS-CDX), he calculated that appellant had a net
adjustment of 0, which equaled a grade C or 37 percent impairment rating.
On November 27, 2018 OWCP referred Dr. Larabee’s report to the DMA. In a report dated
November 27, 2018, the DMA agreed with Dr. Larabee’s impairment rating for total knee
replacement with a fair result and a default value of 37 percent permanent impairment.6 He found
that Dr. Larabee accurately determined appellant’s GMFH7 and GMCS at 3.8 The DMA further
noted that the GMPE was not applicable as it was used to rate the class of the total knee
replacement.9 After applying the net adjustment formula, he determined that appellant had 37
6

A.M.A., Guides 511, Table 16-3.

7

Id. at 516, Table 16-6.

8

Id. at 519, Table 16-8.

9

Id. at 521.

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percent permanent impairment of his right lower extremity entitling him to a schedule award. As
appellant had previously received schedule awards totaling 30 percent of the right lower extremity
due to his right knee conditions, the DMA found that appellant was entitled to an additional award
of 7 percent permanent impairment of the right lower extremity. He determined that the date of
MMI was October 24, 2018 the date of Dr. Larabee’s examination upon which impairment was
based.
By decision dated December 20, 2018, OWCP granted appellant a schedule award for a
total of 37 percent impairment of his right lower extremity which constituted an additional 7
percent increase to his previous schedule awards of 30 percent permanent impairment of the right
lower extremity.
LEGAL PRECEDENT
The schedule award provisions of FECA10 and its implementing federal regulations11 set
forth the number of weeks of compensation payable to employees sustaining permanent
impairment from loss or loss of use, of scheduled members, functions, and organs of the body.
FECA, however, does not specify the manner by which the percentage loss of a member, function,
or organ shall be determined. To ensure consistent results and equal justice for all claimants under
the law, good administrative practice requires the use of uniform standards applicable to all
claimants.12 The A.M.A., Guides has been adopted by the implementing regulations as the
appropriate standard for evaluating schedule losses.13 As of May 1, 2009, schedule awards are
determined in accordance with the sixth edition of the A.M.A., Guides (2009).14 The Board has
approved the use by OWCP of the A.M.A., Guides for the purpose of determining the percentage
loss of use of a member of the body for schedule award purposes.15
In determining impairment for the lower extremities under the sixth edition of the A.M.A.,
Guides, an evaluator must establish the appropriate diagnosis for each part of the lower extremity
to be rated. With respect to the knee, the relevant portion of the leg for the present case, reference
is made to Table 16-3 (Knee Regional Grid) beginning on page 509.16 After the class of diagnosis
(CDX) is determined from the Knee Regional Grid (including identification of a default grade
value), the net adjustment formula is applied using the GMFH, GMPE, and GMCS. The net
10

5 U.S.C. § 8107.

11

20 C.F.R. § 10.404.

12

J.H., Docket No. 18-1207 (issued June 20, 2019); K.P., Docket No. 18-0777 (issued November 13, 2018);
Ausbon N. Johnson, 50 ECAB 304, 311 (1999).
13

Id.

14

Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, Chapter
2.808.6 (March 2017); Federal (FECA) Procedure Manual, Part 3 -- Medical, Schedule Awards, Chapter 3.700,
Exhibit 1 (January 2010).
15

Id.; Isidoro Rivera, 12 ECAB 348 (1961).

16

A.M.A., Guides 509-11 (6th ed. 2009).

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adjustment formula is (GMFH-CDX) + (GMPE-CDX) + (GMCS-CDX).17 Under Chapter 2.3,
evaluators are directed to provide reasons for their impairment rating choices, including choices
of diagnoses from regional grids and calculations of modifier scores.18
ANALYSIS
The Board finds that appellant has not met his burden of proof to establish greater than 37
percent permanent impairment of his right lower extremity, for which he previously received
schedule award compensation.
In a November 20, 2018 report, Dr. Larabee, OWCP’s second opinion physician, found
that appellant had 37 percent impairment of his right lower extremity due to a fair result of his
total knee replacement. He utilized the DBI method for rating appellant’s permanent impairment.
Under Table 16-3, Knee Regional Grid, page 511 of the A.M.A., Guides, Dr. Larabee identified
the diagnosis of total knee replacement as a class 3 impairment with default rating of 37 percent.
He applied GMFH, GMPE, and GMCS of 3 to the net adjustment formula, which resulted in a net
adjustment of 0, which equaled 37 percent permanent impairment of the right lower extremity.
On November 27, 2018 Dr. Katz, a DMA, noted appellant’s accepted conditions and
reviewed the medical record, including the clinical findings of Dr. Larabee. He agreed with
Dr. Larabee’s 37 percent right lower extremity impairment rating, but noted an error in the
application of the net adjustment formula in that GMPE should not have been included as it was
used to rate the class of the total knee replacement.19 This error did not impact the final grade of
the impairment.
The DMA determined that MMI was October 24, 2018 the date of Dr. Larabee’s
examination upon which the impairment rating was based. On appeal appellant contested the date
of MMI asserting that it should be October 20, 2014 and that compensation be recalculated to
reflect the period of award from October 20, 2014. It is well settled that MMI arises at the point
at which an injury has stabilized and will not improve further.20 The Board has also noted a
reluctance to find a date of MMI which is retroactive to the award, as retroactive awards often
result in a payment of less compensation benefits.21 The determination of whether MMI has been
reached is based on the probative medical evidence of record and is usually considered to be the
date of the medical evaluation which is accepted as definitive by OWCP.22 Payment of an
increased award based on additional impairment may be considered at a later date.23 Dr. Larabee’s
17

Id. at 515-22.

18

Id. at 23-28.

19

Id. at 521.

20

Supra note 13 at Chapter 3.700.3.1.a(1)(b).

21

R.M., Docket No. 18-1313 (issued April 11, 2019); Mark A. Halloway, 55 ECAB 321, 325 (2004).

22

Id.; supra note 13 at Chapter 2.808.7.b.

23

Supra note 19.

5

report formed the basis of the most recent definitive permanent impairment rating. The Board
therefore finds that appellant reached MMI for the calculation of this award on October 24, 2018
and that he has not met his burden of proof to establish entitlement to an increased schedule
award.24
Appellant may request a schedule award or increased schedule award at any time based on
evidence of a new exposure or medical evidence showing progression of an employment-related
condition resulting in permanent impairment or increased impairment.
CONCLUSION
The Board finds that appellant has not met his burden of proof to establish greater than 37
percent permanent impairment of his right lower extremity, for which he previously received
schedule award compensation.
ORDER
IT IS HEREBY ORDERED THAT the December 20, 2018 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: November 19, 2019
Washington, DC

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

Patricia H. Fitzgerald, Deputy Chief Judge
Employees’ Compensation Appeals Board

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

24

Supra note 20.

6


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
S.H., Appellant
and
DEPARTMENT OF TRANSPORTATION,
FEDERAL AVIATION ADMINISTRATION,
Oklahoma City, OK, Employer
__________________________________________

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

Docket No. 19-0631
Issued: September 5, 2019

Case Submitted on the Record

DECISION AND ORDER
Before:
JANICE B. ASKIN, Judge
ALEC J. KOROMILAS, Alternate Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION
On January 22, 2019 appellant filed a timely appeal from a December 26, 2018 merit
decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal
Employees’ Compensation Act1 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has
jurisdiction over the merits of this case.
ISSUE
The issue is whether appellant has met her burden of proof to establish that her lumbar
condition and bilateral lower extremity vascular disorder are causally related to the accepted
factors of her federal employment.

1

5 U.S.C. § 8101 et seq.

FACTUAL HISTORY
On October 18, 2017 appellant, then a 60-year-old management and program assistant,
filed an occupational disease claim (Form CA-2) alleging injuries to her lower back and both lower
extremities, which she attributed to sitting for long periods, lifting, walking on concrete, and
opening and closing heavy doors while in the performance of duty. She identified July 1, 2006 as
the date that she first became aware of her conditions and October 2, 2017 as the date she realized
that the conditions were caused or aggravated by her federal employment. On the reverse side of
appellant’s CA-2 form, the employing establishment indicated that she stopped work on
October 2, 2017.
In an October 2, 2017 initial examination report, Dr. David Dawson, a family practitioner,
noted that appellant worked as an office manager for approximately 12 years, and that “[appellant]
has put in for the leave program as she is unable to go back to work on a daily basis.” By way of
appellant’s history, he noted anxiety, osteoarthritis, an aneurysm, and aneurysm repair graft.
Dr. Dawson reported that she currently complained of back pain and neuropathy, an inability to
feel her toes or walk for long periods, and that she indicated that she could not perform any lifting,
although she did experience relief with rest. Upon physical examination, he diagnosed arterial
deficiencies to the lower extremities and lumbar strain without evidence of radiculopathy.
Dr. Dawson opined that “these injuries arose out of and are causally related to [appellant’s]
required work[-]related physical activities.” He recommended occupational therapy to treat
appellant’s conditions, twice per week for four weeks.
By development letter dated October 25, 2017, OWCP notified appellant of the type of
additional evidence needed to establish her occupational disease claim, including factual evidence
documenting any hazardous exposures at work, and a statement from her physician explaining the
causal relationship between those exposures and the claimed conditions. It also provided an
attached questionnaire for her completion. OWCP afforded appellant 30 days to respond.
In a follow-up report of November 28, 2017, Dr. Dawson further noted that appellant had
a history of multiple surgeries for blocked arteries. Since the last appointment, he noted that she
could work for short periods, but required frequent breaks. Dr. Dawson recommended that
appellant be placed on temporary total disability.
In a January 9, 2018 response to OWCP’s questionnaire, appellant explained that her
medical conditions had worsened in her lower back and both lower extremities which necessitated
three surgeries in her lower extremities. She stated that her full-time job duties included:
pushing/pulling mail carts weighing approximately 40 pounds; storing, lifting, and retrieving
boxes of files, occasionally via step ladder; and picking up daily supplies and equipment from
other locations. Appellant further related that she complained of having job duties which required
her to remain sedentary for over six hours, such as answering telephones and performing data
entry. She also attributed her injuries to walking on concrete between buildings, and opening and
closing doors. Appellant denied the ability to perform any activities outside of her employment
that required extended sitting, walking, lifting, bending, or any other repetitious activity.

2

By decision dated January 19, 2018, OWCP denied appellant’s occupational disease claim.
It explained that the medical evidence of record did not establish a causal relationship between the
diagnosed conditions and the accepted factors of her federal employment.
On January 23, 2018 appellant requested reconsideration and submitted additional
evidence in support of her claim.
In a January 15, 2018 report, Dr. John Hughes, a Board-certified orthopedic surgeon, noted
that appellant had experienced significant difficulties with her vascular status, “especially as far as
[appellant’s] legs [were] concerned.” He noted that appellant had undergone femoral bypass, and
that she had stents placed. Dr. Hughes diagnosed vascular insufficiency of the lower extremities,
status post femoral bypass operation; and, lumbar strain without evidence of radiculopathy. He
recommended against further surgical intervention and to continue occupational therapy.
By decision dated February 16, 2018, OWCP denied modification of its January 19, 2018
decision.
In a follow-up report dated February 12, 2018, Dr. Hughes reported little change since the
previous report. He noted that appellant ambulated, and that she related that she must wear slippers
because the outside of her feet are undergoing vascular changes. Dr. Hughes repeated his
diagnoses, and his recommendation against surgery and in favor of occupational therapy.
In a March 26, 2018 follow-up report, Dr. Hughes explained that it was “an overuse
situation that occurred as a result of appellant’s occupational activities and that this condition
resulted from repetitive trauma “as far as her low back was concerned.” He diagnosed a lumbar
strain without evidence of radiculopathy and reiterated his position favoring conservative
treatment.
In an April 3, 2018 follow-up report, Dr. Dawson noted that, with regard to appellant’s
ability to return to work, he did not believe that she could do so in any capacity as she has severe
peripheral arterial disease, which had already resulted in aortic surgeries, and numerous stents
placed in her lower extremities. He noted that, while she had a lumbar strain, this condition was
not what was preventing her from returning to work. Dr. Hughes ordered a functional capacity
evaluation and indicated that occupational therapy would continue as planned.
In a May 15, 2018 follow-up report, Dr. Dawson noted that appellant had pain in her lower
extremities and lumbar spine, which was aggravated by work duties of lifting or walking. He
diagnosed lumbar strain and arterial deficiencies of the lower extremities and reiterated his opinion
on causal relationship. Dr. Dawson further advised that appellant was temporary totally disabled
and recommended additional occupational therapy.
In a June 11, 2018 follow-up report, Dr. Hughes noted that appellant had always had
restriction of motion in her lumbar spine and that she had a computerized tomography (CT) scan
that revealed an old compressive fracture, which did not occur on the job. He explained that
generally compressive fractures tend to be aggravated over time and will go from a mild
compression to a moderate/severe compression as a natural result of the aging and work-related
process that appellant experienced. Dr. Hughes also noted that appellant had additional disc
protrusion problems that may or may not require future surgical intervention. He diagnosed
3

arterial insufficiency of the lower extremities and a lumbar strain/sprain with old compressive
problems as well as degenerative disc disease. Dr. Hughes recommended disability retirement.
In a June 19, 2018 follow-up report, Dr. Dawson relayed that appellant provided a
magnetic resonance imaging (MRI) scan report that was taken on her lumbar spine in 2010, which
revealed numerous levels of degenerative disc disease and a bulging disc. He related that
“[appellant’s] disorder is related to and has worsened” from her job duties, and that she already
had degenerative disc disease and a bulging and herniated disc in her lumbar spine, which he was
sure had worsened since 2010, as “[appellant] did work doing her job since then[.]” Dr. Dawson
opined that she should be medically retired. He concluded, “[a] lot of [appellant’s] disorder is
related to her repetitive motion and repetitive motion injury from her job with a causal
relationship.”
In a July 31, 2018 follow-up report, Dr. Dawson reported that, “many years ago,” appellant
fell off of a horse, fracturing her first lumbar vertebra. He stated that this injury has since healed,
“but it was seen on an MRI [scan] of her back that was done in 2011.” Dr. Dawson noted that,
since appellant started working for the employing establishment, she had to lift palettes, load files,
move paper, ascend and descend ladders with loads of paper and files, with some items weighing
over 20 pounds each, and “some of them 11 on a cart.” He related that she had to walk from
building to building and push carts around, some weighing 50 pounds each. Dr. Dawson explained
that, over time, this had aggravated appellant’s previous back injury with a fractured lumbar
vertebra, causing her back issues from “previous pain that … sometimes radiated down to
[appellant’s] lower limbs.” He repeated the diagnoses of arterial insufficiency of the lower
extremities and a lumbar strain and sprain with old compressive problems as well as degenerative
disc disease. Dr. Dawson opined that the repetitive job duties aggravated and/or caused appellant’s
back injury, “with causative MRI [scan] findings.” He also noted that appellant sustained a
fracture of the lumbar vertebra before she started working for the employing establishment, and
“it [had] clearly been aggravated by [appellant’s] physical activities … during her job duties.”
Dr. Dawson noted that occupational therapy had been of some utility.
In an August 28, 2018 follow-up report, Dr. Dawson reiterated his opinion that repetitive
lifting, climbing and pushing “aggravated and/or caused the back injury, with the MRI [scan]
findings.”
On October 5, 2018 appellant requested reconsideration. With her request, she submitted
a follow-up report from Dr. Dawson dated November 6, 2017. In this report, Dr. Dawson noted
his opinion that, in the course of her employment, appellant’s lower extremities and lumbar spine
were aggravated with constant walking, standing, carrying boxes and other items, bending, and
kneeling. He stated that these injuries were constantly aggravated by work activities and physical
activities.
In an October 2, 2018 follow-up report, Dr. Dawson noted that, even though appellant had
atherosclerotic artery disease, she also had degenerative disc disease and a history of fractured
vertebra in her back. He stated that “[t]his [had] been aggravated over time” from walking on
concrete, moving heavy boxes, lifting, twisting, and filing. Dr. Dawson continued, “[t]his clearly,
over time … aggravated [appellant’s] previous back injury in a causal relationship and [was] thus
clearly shown to be a cause from an aggravation by her employment[.]” He recommended

4

continuing therapy and diagnosed lumbar strain/sprain with degenerative disc disease of the
lumbar spine.
In October 25 and November 29, 2018 follow-up reports, Dr. Dawson opined that the
initial injury stemmed from a horse-riding accident, which he believed that had since been
aggravated by appellant’s job duties.
In a decision dated December 26, 2018, OWCP denied modification. It again found that
the medical evidence submitted was insufficient to establish causal relationship.
LEGAL PRECEDENT
An employee seeking benefits under FECA2 has the burden of proof to establish the
essential elements of his or her claim, including the fact that the individual is an employee of the
United States within the meaning of FECA, that the claim was timely filed within the applicable
time limitation of FECA,3 that an injury was sustained in the performance of duty as alleged, and
that any disability or medical condition for which compensation is claimed is causally related to
the employment injury.4 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.5
To establish that an injury was sustained in the performance of duty in an occupational
disease claim, a claimant must submit: (1) medical evidence establishing the presence or existence
of the disease or condition for which compensation is claimed; (2) a factual statement identifying
employment factors alleged to have caused or contributed to the presence or occurrence of the
disease or condition; and (3) medical evidence establishing that the diagnosed condition is causally
related to the identified employment factors.6
Causal relationship is a medical question that generally requires rationalized medical
opinion evidence to resolve the issue.7 A physician’s opinion on whether there is causal
relationship between the diagnosed condition and the implicated employment factor(s) must be
based on a complete factual and medical background.8 Additionally, the physician’s opinion must
be expressed in terms of a reasonable degree of medical certainty, and must be supported by

2

Id.

3

J.P., Docket No. 19-0129 (issued April 26, 2019); Joe D. Cameron, 41 ECAB 153 (1989).

4

A.C., Docket No. 19-0266 (issued May 28, 2019); James E. Chadden, Sr., 40 ECAB 312 (1988).

5

J.P., supra note 3; Delores C. Ellyett, 41 ECAB 992 (1990).

6

R.R., Docket No. 19-0048 (issued April 25, 2019); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

7

T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 238 (1996).

8

M.V., Docket No. 18-0884 (issued December 28, 2018); Victor J. Woodhams, supra note 6.

5

medical rationale, explaining the nature of the relationship between the diagnosed condition and
appellant’s specific employment factor(s).9
In any case where a preexisting condition involving the same part of the body is present
and the issue of causal relationship therefore involves aggravation, acceleration or precipitation,
the physician must provide a rationalized medical opinion that differentiates between the effects
of the work-related injury or disease and the preexisting condition.10
ANALYSIS
The Board finds that appellant has not met her burden of proof to establish that her lumbar
condition and bilateral lower extremity vascular disorder are causally related to the accepted
factors of her federal employment.
In an October 2, 2017 report, Dr. Dawson diagnosed arterial deficiency to the lower
extremities and a lumbar strain/sprain without radiculopathy, and opined that “these injuries arose
out of and are causally related to [appellant’s] required work[-]related physical activities.” While
the report opines on causal relationship, it is of limited probative value because of its conclusory
nature.11
In November 6 and 28, 2017 follow-up reports, Dr. Dawson related his opinion that
appellant’s lower extremities and lumbar spine were aggravated by her job duties of constant
walking, standing, carrying items, bending, and kneeling. He stated that these injuries were
constantly aggravated by work activities and physical activities. While Dr. Dawson described
appellant’s work activities, he did not offer an explanation as to how the implicated employment
factors physiologically caused, contributed to, or aggravated the specific diagnosed conditions.12
As such, his opinion is of no probative value.13
The January 15 and February 12, 2018 reports of Dr. Hughes and the April 3, 2018 report
of Dr. Dawson are also insufficient to establish causal relationship. While Dr. Hughes provided
diagnoses and a very general medical history of a femoral bypass and stent placement, he offered
no opinion on what might have caused the diagnosed conditions. Similarly, while Dr. Dawson
notes his belief that appellant is unable to return to work, he did not offer an opinion on causal
relationship in his April 3, 2018 report. Medical evidence which does not offer an opinion on
causal relationship is of no probative value to the issue of causal relationship.14

9

Id.

10

Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013);
P.S., Docket No. 19-0459 (issued July 26, 2019); N.S., Docket No. 19-0167 (issued June 21, 2019).
11

M.S., Docket No. 19-0189 (issued May 14, 2019).

12

Id.

13

See Y.D., Docket No. 16-1896 (issued February 10, 2017).

14

See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

6

In Dr. Hughes’ March 26, 2018 follow-up report, he noted that appellant worked as an
office manager for 12 years, and that her job duties required her to go from building to building
and carry supplies. He noted that she “did a lot of up and down work as far as [appellant’s] desk
was concerned.” Dr. Hughes indicated that it was “an overuse situation that occurred as a result
of these occupational activities. [Appellant] did not have a formal on-the-job injury” and that this
condition resulted from repetitive trauma “as far as [appellant’s] low back was concerned.” He
diagnosed a lumbar strain without evidence of radiculopathy. While Dr. Hughes’ March 26, 2018
report offers an opinion on causal relationship, the report is of reduced probative value because it
contains no physiological explanation as to how appellant’s job duties caused the lumbar
condition.15 The Board also notes that his report is expressly limited to her lumbar condition, and
makes no suggestion that the vascular issues in her lower extremities are related to her
employment.
In his May 15, 2018 follow-up report, Dr. Dawson noted that appellant experienced pain
in her lower extremities and lumbar spine while working, which he opined was aggravated by
work activities of lifting or walking, and reiterated his conclusion that there was a causal
relationship between her conditions and her work. While this report describes appellant’s job
duties and states that her duties aggravated her conditions, the report offers no medical rationale
as to how these activities would aggravate each condition. The conclusory nature of this report
renders it of little probative value.16
In a June 11, 2018 follow-up report, Dr. Hughes noted that appellant always had restricted
motion in her lumbar spine and that a CT scan revealed an old nonwork-related compressive
fracture. He explained that, generally, compressive fractures tend to be aggravated over time and
will worsen as a natural result of aging and work-related processes. Dr. Hughes also noted that
appellant had additional disc protrusion problems, and “things in her lumbar spine” that may or
may not require future surgical intervention. He diagnosed arterial insufficiency of the lower
extremities and a lumbar strain/sprain with old compressive problems, as well as degenerative disc
disease. As it relates to appellant’s lumbar conditions, Dr. Hughes identified a preexisting,
nonwork-related injury that generally has a tendency to worsen partially due to the natural aging
process, but does not distinguish the effects of the aggravation due to age from the aggravation, if
any, due to her federal employment. The Board has consistently held that complete medical
rationalization is particularly necessary when there are preexisting conditions involving the same
body part and has required medical rationale differentiating between the effects of the work-related
injury and the preexisting condition in such cases.17
In a June 19, 2018 follow-up report, Dr. Dawson indicated that appellant provided a lumbar
MRI scan report from 2010, which revealed numerous levels of degenerative disc disease and a
bulging disc. He related that “[appellant’s] disorder is related to and has worsened” from her job
duties, and that she already had degenerative disc disease and a bulging and herniated disc in her
lumbar spine, which he was sure had worsened since 2010, as “[appellant] did work doing her job
15

Supra note 13.

16

Id.; supra note 11.

17

R.R., Docket No. 19-0048 (issued April 25, 2019); see supra note 10.

7

since then[.]” Dr. Dawson stated his opinion that appellant should be medically retired. He
concluded, “[a] lot of her disorder is related to her repetitive motion and repetitive motion injury
from her job with a causal relationship.” The Board finds that this opinion is conclusory in nature
and therefore is of limited probative value and insufficient to establish the claim.18
In his report of July 31, 2018, Dr. Dawson reported that “many, many years ago,” appellant
fell off of a horse, fracturing her first lumbar vertebra. He stated that this injury has since healed,
“but it was seen on an MRI [scan] of [appellant’s] back that was done in 2011.” Dr. Dawson
described appellant’s job duties and explained that, over time, these duties aggravated her previous
back injury and a fractured lumbar vertebra, causing her back issues from “previous pain that has
sometimes radiated down to [appellant’s] lower limbs.” He repeated the diagnoses of arterial
insufficiency of the lower extremities and a lumbar strain/sprain with old compressive problems,
as well as degenerative disc disease. Dr. Dawson opined that the repetitive motion aggravated
and/or caused her back injury, “with causative MRI [scan] findings.” He also noted that appellant
sustained a fracture of the lumbar vertebra before she started her federal employment, and stated
“it has clearly been aggravated by [appellant’s] physical activities that were done during her job
duties.” This report is both internally inconsistent and inconsistent with prior reports. In his prior
reports, Dr. Dawson repeatedly diagnosed a lumbar strain without evidence radiculopathy, but
later indicated that there had been evidence of radiculopathy. Within the report, he offered
inconsistent statements as to whether the previous horse-riding injury had healed, or whether
appellant had continuing residuals and in a constant state of aggravation. The Board has held that
medical reports are of limited probative value if they are internally inconsistent.19 Both reports
also lack any sort of physiological, medical explanation of cause and effect are conclusory in
nature, and are therefore are of limited probative value.20
In his October 2, 2018 follow-up report, Dr. Dawson noted that, even though appellant has
atherosclerotic artery disease, she also has degenerative disc disease and a history of fractured
vertebra in her back. He stated that “[t]his has been aggravated over time” from walking on
concrete, moving heavy boxes, lifting, twisting, and filing. Dr. Dawson continued, “[t]his clearly,
over time, has aggravated [appellant’s] previous back injury in a causal relationship and is thus
clearly shown to be a cause from an aggravation by her employment[.]” The report is of limited
value because it is conclusory,21 as it offers no physiological explanation of how these job duties
caused or aggravated the diagnosed lumbar strain/sprain and the degenerative disc disease.22 A
physician’s opinion on causal relationship must be supported by medical rationale, explaining the
nature of the relationship between the diagnosed condition and appellant’s specific employment
factor(s).23
18

Supra note 16.

19

L.L., Docket No. 18-0861 (issued April 5, 2019).

20

J.P., Docket No. 19-0129 (issued April 26, 2019).

21

Supra note 11.

22

Supra note 20.

23

Id.

8

Dr. Dawson’s October 25 and November 29, 2018 follow-up reports suffer from similar
defects, and the November 29, 2018 report indicates the initial injury was caused by a horse-riding
accident. As noted above, in cases involving a preexisting injury or condition, the Board has
placed special emphasis on the need for particularized and complete medical rationale with specific
physiological explanations that distinguish the effects of the natural progression of the preexisting
condition, any effects caused by aging or nonwork-related injuries and the employment factors.24
This report contains no such rationale, and is thus insufficient to establish causal relationship.
As appellant has not submitted rationalized medical evidence establishing that her lumbar
conditions and bilateral lower extremity vascular disorder are causally related to the accepted
factors of her federal employment, she has not met her burden of proof.
Appellant may submit new evidence or argument with a written request for reconsideration
to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R.
§§ 10.605 through 10.607.
CONCLUSION
The Board finds that appellant has not met her burden of proof to establish that her lumbar
condition and bilateral lower extremity vascular disorder are causally related to the accepted
factors of her federal employment.

24

See D.F., Docket No. 19-0067 (issued May 3, 2019); R.R., supra note 17.

9

ORDER
IT IS HEREBY ORDERED THAT the December 26, 2018 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: September 5, 2019
Washington, DC

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

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

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

10


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
P.C., Appellant
and
U.S. POSTAL SERVICE, GARLAND MAIN
POST OFFICE, Garland, TX, Employer
__________________________________________

)
)
)
)
)
)
)
)

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

Docket No. 18-1527
Issued: February 8, 2019

Case Submitted on the Record

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

JURISDICTION
On August 7, 2018 appellant filed a timely appeal from a March 19, 2018 merit decision
and May 10, 2018 nonmerit decision of the Office of Workers’ Compensation Programs (OWCP).
Pursuant to the Federal Employees’ Compensation Act1 (FECA) and 20 C.F.R. §§ 501.2(c) and
501.3, the Board has jurisdiction over the merits of this case.
ISSUES
The issues are: (1) whether appellant has met her burden of proof to establish a bilateral
trigger finger injury causally related to the accepted factors of her federal employment; and
(2) whether OWCP properly denied appellant’s request for reconsideration of the merits of her
claim under 5 U.S.C. § 8128(a).

1

5 U.S.C. § 8101 et seq.

FACTUAL HISTORY
On February 11, 2018 appellant, then a 62-year-old secretary, filed an occupational disease
claim (Form CA-2) alleging that she developed trigger finger of the middle fingers on both hands
due to keyboarding during a majority of her workday while at the employing establishment. She
claimed that keyboarding caused her middle fingers to lock and resulted in severe pain in her finger
joints. Appellant noted that she previously had an occupational disease that consisted of carpal
tunnel syndrome and trigger finger. She noted that she first became aware of her claimed condition
and its relationship to her federal employment on December 3, 2017.
In an accompanying narrative statement dated February 11, 2018, appellant again
attributed her trigger finger condition to keyboarding while at work. She related that she had
worked at the employing establishment for 31 years. Appellant was originally hired as a computer
forwarding system clerk and held this position for 20 years. She worked in her current secretary
position for eight and one-half years. Appellant typed at a computer workstation six-to-seven
hours a day, five days a week. She noted that, in 2014, she was diagnosed as having carpal tunnel
syndrome and trigger thumb. Appellant underwent carpal tunnel release and release of the tendon
that aggravated her trigger thumb.
OWCP, by development letter dated February 14, 2018, advised appellant of the factual
and medical deficiencies of her claim. It provided a questionnaire for her completion regarding
the circumstances of the injury. Appellant was also asked to provide a narrative medical report
from her physician which contained a detailed description of findings and diagnoses, explaining
how the claimed work activities caused, contributed to, or aggravated her medical condition. By
separate letter of the same date, OWCP requested that the employing establishment provide
additional factual information concerning her alleged injury, to include comments from a
knowledgeable supervisor on the accuracy of appellant’s statements. It afforded appellant and the
employing establishment 30 days to submit the requested evidence. No further evidence was
received.
By decision dated March 19, 2018, OWCP denied appellant’s occupational disease claim,
finding that the evidence of record was insufficient to establish a diagnosed medical condition in
connection with the accepted employment factors. It noted that she had not submitted any medical
evidence in response to its February 14, 2018 development letter.
On April 23, 2018 appellant requested reconsideration.
argument in support of her reconsideration request was received.

No additional evidence or

By decision dated May 10, 2018, OWCP denied appellant’s request for reconsideration of
the merits of her claim, finding that she had neither raised substantive legal questions nor submitted
new and relevant evidence sufficient to require further merit review. It noted that no additional
evidence was received as part of the reconsideration request.

2

LEGAL PRECEDENT -- ISSUE 1
An employee seeking benefits under FECA2 has the burden of proof to establish the
essential elements of his or her claim by the weight of the reliable, probative, and substantial
evidence, including that he or she sustained an injury in the performance of duty, and that any
specific condition or disability from work for which he or she claims compensation is causally
related to that employment injury.3
In an occupational disease claim, a claimant must submit the following: (1) medical
evidence establishing the presence or existence of the disease or condition for which compensation
is claimed; (2) a factual statement identifying employment factors alleged to have caused or
contributed to the presence or occurrence of the disease or condition; and (3) medical evidence
establishing that the diagnosed condition is causally related to the employment factors identified
by the claimant.4
Causal relationship is a medical issue, and the medical evidence required to establish causal
relationship is rationalized medical evidence.5 The opinion of the physician must be based on a
complete factual and medical background of the claimant, must be one of reasonable medical
certainty, and must be supported by medical rationale explaining the nature of the relationship
between the diagnosed condition and the specific employment factors identified by the employee.6
Neither the fact that the condition became apparent during a period of employment, nor the belief
that the condition was caused or aggravated by employment factors or incidents is sufficient to
establish causal relationship.7
ANALYSIS -- ISSUE 1
The Board finds that appellant has not met her burden of proof to establish a bilateral trigger
finger injury causally related to the accepted factors of her federal employment.
OWCP accepted as factual that appellant engaged in repetitive keyboarding in her
employment duties as a secretary. The issue, therefore, is whether appellant submitted sufficient
medical evidence to establish that the employment exposure caused or aggravated a bilateral
trigger finger condition.
By development letter dated February 14, 2018, OWCP requested that appellant submit
additional evidence in support of her claim, including a comprehensive medical report from her
treating physician which included a reasoned explanation as to how the work activities identified
2

Id.

3

M.S., Docket No. 17-0980 (issued June 19, 2018).

4

I.D., Docket No. 18-1118 (issued December 31, 2018); R.B., Docket No. 18-0720 (issued November 13, 2018).

5

K.L., Docket No. 18-0937 (issued December 28, 2018).

6

See supra notes 4 and 5.

7

See supra note 5; Dennis M. Mascarenas, 49 ECAB 215 (1997).

3

by her had caused, contributed to, or aggravated her claimed medical condition. It afforded her 30
days to respond. Appellant did not submit the requested evidence prior to the issuance of OWCP’s
March 19, 2018 merit decision.
Appellant’s burden of proof includes the submission of rationalized medical opinion
evidence, based on a complete factual and medical background, establishing causal relationship
between the accepted employment factors and the diagnosed condition.8 The record in this case
contains no medical evidence. Because appellant has not submitted reasoned medical evidence
explaining how and why her claimed bilateral trigger finger condition was employment related,
she has not met her burden of proof.9
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.
LEGAL PRECEDENT -- ISSUE 2
Section 8128(a) of FECA vests OWCP with a 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.10 Section 10.608(a) of OWCP’s regulations provide that a timely request for
reconsideration may be granted if OWCP determines that the claimant has presented evidence
and/or argument that meet at least one of the standards described in section 10.606(b)(3).11 This
section provides that the application for reconsideration must be submitted in writing and set forth
arguments and contain evidence that either: (1) shows that OWCP erroneously applied or
interpreted a specific point of law; (2) advances a relevant legal argument not previously
considered by OWCP; or (3) constitutes relevant and pertinent new evidence not previously
considered by OWCP.12 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.13
ANALYSIS -- ISSUE 2
The Board finds that OWCP properly denied appellant’s request for reconsideration of the
merits of her claim.

8

See supra notes 4 and 5.

9

R.C., Docket No. 17-1294 (issued December 20, 2018).

10

5 U.S.C. § 8128(a).

11

20 C.F.R. § 10.608(a).

12

Id. at § 10.606(b)(3).

13

Id. at § 10.608(b).

4

OWCP denied appellant’s occupational disease claim for a bilateral trigger finger condition
causally related to the accepted factors of her employment. Thereafter, it denied her timely
reconsideration request without reviewing the merits of her claim.
The Board finds that appellant did not show that OWCP erroneously applied or interpreted
a specific point of law, nor did she advance a relevant legal argument not previously considered
by OWCP, or provide relevant and pertinent new evidence not previously considered by OWCP.
Appellant’s April 23, 2018 reconsideration request consisted only of a checkmark on an
appeal request form indicating that she wanted reconsideration. She did not offer any argument or
submit any evidence in support of her request. Appellant suggested no reason for OWCP to
reconsider the denial of her occupational disease claim. Such a bare request is insufficient to
warrant a reopening of her case.14 Accordingly, appellant did not meet any of the requirements of
20 C.F.R. § 10.606(b)(3). Pursuant to 20 C.F.R. § 10.608, OWCP properly denied merit review.
On appeal appellant contends that she submitted medical evidence together with her
request for reconsideration. As found above, however, the record does not show that any evidence
accompanied her April 23, 2018 reconsideration request. As the record does not contain any new
evidence submitted prior to the issuance of OWCP’s May 10, 2018 nonmerit decision, the Board
finds that OWCP properly declined to reopen her claim for a merit review.
CONCLUSION
The Board finds that appellant has not met her burden of proof to establish a bilateral trigger
finger injury causally related to the accepted factors of her federal employment. The Board further
finds that OWCP properly denied her request for reconsideration of the merits of her claim under
5 U.S.C. § 8128(a).

14

See J.H., Docket No. 18-0875 (issued October 11, 2018); J.R., Docket No. 17-1312 (issued September 20, 2017).

5

ORDER
IT IS HEREBY ORDERED THAT the May 10 and March 19, 2018 decisions of the
Office of Workers’ Compensation Programs are affirmed.
Issued: February 8, 2019
Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge
Employees’ Compensation Appeals Board

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

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

6


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
P.S., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Indianapolis, IN, Employer
__________________________________________

)
)
)
)
)
)
)
)

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

Docket No. 15-0942
Issued: October 9, 2015

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
PATRICIA H. FITZGERALD, Deputy Chief Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On March 25, 2015 appellant filed a timely appeal from February 6 and March 24, 2015
merit decisions 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.2
ISSUE
The issue is whether appellant met her burden of proof to establish disability for the
periods March 10 through April 16, 2014, June 14 through July 25, 2014, and January 14
through March 17, 2015 causally related to her federal employment.

1
2

5 U.S.C. § 8101 et seq.

The Board notes that, following the issuance of the March 24, 2015 OWCP decision, appellant submitted new
evidence. The Board is precluded from reviewing evidence which was not before OWCP at the time it issued its
final decision. See 20 C.F.R. § 501.2(c)(1).

FACTUAL HISTORY
By notice provided May 20, 2014, OWCP accepted that appellant, a 28-year-old city
carrier assistant, sustained a traumatic sprain of the left shoulder and upper arm and a contusion
of the left shoulder region. Appellant was informed that if she lost time from work due to her
work-related condition she could claim compensation using a Form CA-7.
Appellant filed claims for compensation (Form CA-7) for the periods March 10 through
April 16, 2014, June 14 through July 25, 2014, and January 14 through March 17, 2015.3
In letters dated June 9, 2014 and February 2, 2015, OWCP requested additional medical
evidence to establish appellant’s disability from work during the periods claimed and afforded
her 30 days to respond.
Appellant submitted reports dated March 31 and April 15, 2014 from Dr. Kara Davis, an
internist, who diagnosed backache, shoulder pain, and depressive disorder.
By decision dated September 12, 2014, OWCP denied appellant’s claim for disability for
the periods March 10 through April 16, 2014 and June 14 through July 25, 2014 on the basis that
the medical evidence submitted was insufficient to support disability causally connected to the
employment injuries.
On October 29, 2014 appellant requested reconsideration. She submitted a November 4,
2014 narrative statement and physical therapy notes in support of her claim. Appellant also
submitted a January 19, 2015 duty status report from Dr. Prasant Atluri, a Board-certified
orthopedic hand surgeon, who indicated that appellant fell down stairs with a mailbag and
diagnosed pain in her left shoulder joint. Dr. Atluri opined that appellant was disabled for work
and advised that she had no use of her left upper extremity.
In reports dated June 16, 2014 through January 5, 2015, Dr. Osama Ramsey, an
occupational medicine specialist, diagnosed contusion of the left shoulder, left shoulder sprain,
and shoulder region joint pain. He opined that appellant had no work capacity and instructed her
to remain off work.
By decision dated February 6, 2015, OWCP denied modification of its prior decision.
In a January 19, 2015 report, Dr. Atluri reiterated his diagnosis and indicated that since
cessation of medication, appellant’s pain had returned. He noted that her significant pain was
too severe to make progress in therapy and restricted her to no use of the affected hand/arm.

3

Appellant also filed a claim for compensation (Form CA-7) for the period October 29, 2014 through
January 13, 2015. By decision dated April 8, 2015, OWCP denied appellant’s claim for disability for the period
claimed on the basis that the medical evidence submitted was insufficient to support disability due to the accepted
employment injuries. As appellant has not appealed from this decision it is not before the Board on this appeal. See
20 C.F.R. § 501.3(a).

2

By decision dated March 24, 2015, OWCP denied appellant’s claim for disability for the
period January 14 through March 17, 2015 because the medical evidence submitted was
insufficient to support disability due to the employment injuries.
LEGAL PRECEDENT
Section 8102(a) of FECA4 sets forth the basis upon which an employee is eligible for
compensation benefits. That section provides: “The United States shall pay compensation as
specified by this subchapter for the disability or death of an employee resulting from personal
injury sustained while in the performance of his duty....” In general the term “disability” under
FECA means “incapacity, because of an employment injury, to earn the wages the employee was
receiving at the time of injury.”5 This meaning, for brevity, is expressed as disability for work.6
For each period of disability claimed, the employee has the burden of proving that she was
disabled for work as a result of the accepted employment injury.7 Whether a particular injury
caused an employee to be disabled for employment and the duration of that disability are medical
issues which must be proven by the preponderance of the reliable probative and substantial
medical evidence.8
Disability is not synonymous with physical impairment, which may or may not result in
an incapacity to earn wages. An employee who has a physical impairment causally related to her
federal employment, but who nonetheless has the capacity to earn the wages she was receiving at
the time of injury, has no disability as that term is used under FECA and is not entitled to
compensation for loss of wage-earning capacity. The Board will not require OWCP to pay
compensation for disability in the absence of any medical evidence directly addressing the
particular period of disability for which compensation is claimed. To do so would essentially
allow employees to self-certify their disability and entitlement to compensation.9
ANALYSIS
The Board finds that appellant has not established that she was disabled due to her
employment injuries for the periods March 10 through April 16, 2014, June 14 through July 25,
2014, and January 14 through March 17, 2015.
While OWCP accepted that appellant sustained a sprain of the left shoulder and upper
arm, and a contusion of the left shoulder region, appellant bears the burden of proof to establish
through medical evidence both that she was disabled for the claimed periods and that her
4

5 U.S.C. § 8102(a).

5

20 C.F.R. § 10.5(f). See also William H. Kong, 53 ECAB 394 (2002); Donald Johnson, 44 ECAB 540,
548 (1993); John W. Normand, 39 ECAB 1378 (1988); Gene Collins, 35 ECAB 544 (1984).
6

See Roberta L. Kaaumoana, 54 ECAB 150 (2002).

7

See William A. Archer, 55 ECAB 674 (2004).

8

See Fereidoon Kharabi, 52 ECAB 291, 292 (2001).

9

Id.

3

disability was causally related to her accepted injuries.10 The Board finds that appellant
submitted no rationalized medical evidence explaining how the employment injuries materially
worsened or aggravated her medical conditions and caused her to be disabled for work for the
periods March 10 through April 16, 2014, June 14 through July 25, 2014, and January 14
through March 17, 2015.
In his reports, Dr. Ramsey diagnosed contusion of left shoulder, left shoulder sprain, and
shoulder region joint pain. He opined that appellant had no work capacity and instructed her to
remain off work. The Board finds that Dr. Ramsey failed to provide a probative medical opinion
on whether and how appellant was disabled on the dates at issue due to her accepted conditions.
Therefore, Dr. Ramsey’s reports are insufficient to establish that she was disabled for work due
to the employment injuries for the period claimed.
In his reports, Dr. Atluri diagnosed pain in the left shoulder joint and also opined that
appellant was disabled for work. He advised that she had no use of the left extremity. Dr. Atluri
noted that her pain was too severe to make progress in therapy and restricted her to no use of the
affected hand/arm. The Board finds that Dr. Atluri failed to provide a medical opinion
explaining how appellant’s accepted conditions caused her to be disabled for employment on the
dates at issue. The Board finds that the reports from Dr. Atluri are insufficient to establish
appellant’s claim for compensation.
Appellant submitted reports from Dr. Davis who diagnosed backache, shoulder pain, and
depressive disorder. Dr. Davis also failed to offer a probative medical opinion that appellant was
disabled for the periods at issue due to her accepted conditions. Thus, the Board finds her
reports are insufficient to establish appellant’s claim for compensation.11
The physical therapy notes submitted do not constitute competent medical evidence as
they do not contain rationale by a physician relating appellant’s disability to her employment.12
Appellant has not submitted any rationalized medical evidence establishing that she was
disabled for the periods March 10 through April 16, 2014, June 14 through July 25, 2014, and
January 14 through March 17, 2015 causally related to the accepted employment injuries. Thus,
appellant has not met her burden of proof to establish that she is entitled to compensation for any
disability for these time periods.
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.

10

See supra notes 7 and 8. See also V.P., Docket No. 09-337 (issued August 4, 2009).

11

Id.

12

See 5 U.S.C. § 8101(2). Section 8101(2) of FECA provides as follows: “(2) ‘physician’ includes surgeons,
podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and osteopathic practitioners within the
scope of their practice as defined by State law.” See also Paul Foster, 56 ECAB 208, 212 n.12 (2004); Joseph N.
Fassi, 42 ECAB 677 (1991); Barbara J. Williams, 40 ECAB 649 (1989).

4

CONCLUSION
The Board finds that appellant has not met her burden of proof to establish disability for
the periods March 10 through April 16, 2014, June 14 through July 25, 2014, and January 14
through March 17, 2015 causally related to her federal employment.
ORDER
IT IS HEREBY ORDERED THAT the March 24 and February 6, 2015 decisions of the
Office of Workers’ Compensation Programs are affirmed.
Issued: October 9, 2015
Washington, DC

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

Patricia H. Fitzgerald, Deputy Chief Judge
Employees’ Compensation Appeals Board

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

5


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
B.M., Appellant
and
DEPARTMENT OF VETERANS AFFAIRS,
ALEXANDRIA VETERANS
ADMINISTRATION MEDICAL CENTER,
Pineville, LA, Employer
__________________________________________

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

Docket No. 11-1693
Issued: February 6, 2012

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Judge
COLLEEN DUFFY KIKO, Judge
MICHAEL E. GROOM, Alternate Judge

JURISDICTION
On July 15, 2011 appellant filed a timely appeal from a June 14, 2011 decision of the
Office of Workers’ Compensation Programs (OWCP) that denied her 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 met his burden of proof to establish that she sustained a
stress-related condition in the performance of duty causally related to factors of his federal
employment.
On appeal appellant generally asserts that her condition is employment related.

1

5 U.S.C. §§ 8101-8193.

FACTUAL HISTORY
On April 28, 2011 appellant, then a 58-year-old supply clerk, filed a traumatic injury
claim. On April 27, 2011 she was working in a very stressful environment in the canteen which
caused anxiety, a panic attack and right arm pain. Appellant stopped work that day. By letter
dated May 11, 2011, OWCP advised her of the evidence needed to support her claim, and to
submit a description of the employment-related conditions or incidents she believed contributed
to her condition together with a narrative medical report. It also requested that the employing
establishment respond to the claim. Appellant returned to regular duty on May 13, 2011.
In an April 27, 2011 report, Dr. Jose F. Andino, Board-certified in family medicine, noted
that appellant was brought from employee health after developing visual acuity problems,
headaches and dizziness. Appellant stated that she worked in a difficult and probably hostile
environment due to staffing shortages and the demands of the job. Dr. Andino diagnosed an
anxiety attack. In an April 28, 2011 treatment note, Dr. Brian C. Jobe, a Board-certified family
physician, reported a history that appellant was working in a very psychologically stressful
environment in the canteen that caused anxiety and physical symptoms of right arm pain.
Appellant appeared anxious and tearful. Dr. Jobe diagnosed psychological stress and anxiety.
Appellant was to follow-up with her primary care doctor for a cardiac evaluation. Dr. Jobe
found that appellant could not work. On a form report, he checked that the illness was work
related. Dr. Rajinder Verma, Board-certified in family medicine, provided reports dated
May 9, 2011. He noted a history of stress at work. Dr. Verma provided physical examination
findings, diagnosed acute anxiety and advised that appellant could return to full-time work on
May 13, 2011. On May 13, 2011 Dr. Jobe noted appellant’s report that her anxiety level had
improved and she wanted to return to work. He diagnosed psychological stress secondary to
work environment, and anxiety and advised that she could return to work with no restrictions.
By decision dated June 14, 2011, OWCP denied the claim. It found that, while appellant
submitted medical evidence, she did not complete a statement describing the events that occurred
on April 27, 2011 that caused her stress. Therefore, appellant failed to substantiate any
compensable employment factors.
LEGAL PRECEDENT
To establish her claim that she sustained a stress-related condition in the performance of
duty, a claimant must submit the following: (1) medical evidence establishing that she has an
emotional or stress-related disorder; (2) factual evidence identifying employment factors or
incidents alleged to have caused or contributed to her condition; and (3) rationalized medical
opinion evidence establishing that the identified compensable employment factors are causally
related to her stress-related condition.2 If a claimant does implicate a factor of employment,
OWCP should then determine whether the evidence of record substantiates that factor.3 When
the matter asserted is a compensable factor of employment and the evidence of record establishes

2

Leslie C. Moore, 52 ECAB 132 (2000).

3

Dennis J. Balogh, 52 ECAB 232 (2001).

2

the truth of the matter asserted, OWCP must base its decision on an analysis of the medical
evidence.4
Workers’ compensation law does not apply to each and every injury or illness that is
somehow related to an employee’s employment. In the case of Lillian Cutler,5 the Board
explained that there are distinctions as to the type of employment situations giving rise to a
compensable emotional condition arising under FECA. There are situations where an injury or
illness has some connection with the employment but nevertheless does not come within
coverage under FECA.6 When an employee experiences emotional stress in carrying out his or
her employment duties and the medical evidence establishes that the disability resulted from an
emotional reaction to such situation, the disability is generally regarded as due to an injury
arising out of and in the course of employment. This is true when the employee’s disability
results from his or her emotional reaction to a special assignment or other requirement imposed
by the employing establishment or by the nature of the work.7 Allegations alone by a claimant
are insufficient to establish a factual basis for an emotional condition claim.8 Where the claimant
alleges compensable factors of employment, he or she must substantiate such allegations with
probative and reliable evidence.9 Personal perceptions alone are insufficient to establish an
employment-related emotional condition.10
ANALYSIS
The Board finds that appellant did not meet her burden of proof to establish that she
sustained an emotional condition in the performance of duty causally related to factors of her
federal employment on April 27, 2011. The evidence of record does not substantiate any
compensable employment factors.
Appellant submitted medical evidence in which Drs. Andino, Jobe and Verma diagnosed
anxiety, and Dr. Jobe related the condition to work stress. She was advised by OWCP on
May 11, 2011 to submit a further description of the employment incidents and/or conditions that
contributed to her stress. Appellant did not do so. Rather, she generally alleged stress due to her
work environment in the canteen and possible staff shortages. The general assertion on
appellant’s claim form that she worked in a stressful environment is insufficient to substantiate
any work factor as factual. In order to establish her claim, she must submit factual evidence
identifying specific employment factors or incidents as having caused or contributed to her
condition.11 Appellant’s allegation is nonspecific and there are no statements by any coworkers
4

Id.

5

28 ECAB 125 (1976).

6

See Robert W. Johns, 51 ECAB 137 (1999).

7

Lillian Cutler, supra note 5.

8

J.F., 59 ECAB 331 (2008).

9

M.D., 59 ECAB 211 (2007).

10

Roger Williams, 52 ECAB 468 (2001).

11

Leslie C. Moore, supra note 2.

3

or managers to substantiate any staffing shortages or the value of the work she performed. As
she did not submit the requested information, she did not establish that she sustained a stressrelated condition in the performance of duty. OWCP properly denied her 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. §§ 10.605 through 10.607.12
CONCLUSION
The Board finds that appellant failed to meet her burden of proof to establish that she
sustained a stress-related condition in the performance of duty on April 27, 2011.
ORDER
IT IS HEREBY ORDERED THAT the June 14, 2011 decision of the Office of
Workers’ Compensation Programs be affirmed.
Issued: February 6, 2012
Washington, DC

Alec J. Koromilas, Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

12

The Board notes that simultaneous with her appeal to the Board, appellant requested a review of the written
record with OWCP. As noted by OWCP in an October 5, 2011 letter, the Board and OWCP may not have
simultaneous jurisdiction over the same issues. Following the docketing of an appeal before the Board, OWCP does
not retain jurisdiction to render a further decision regarding the issue on appeal until after the Board relinquishes
jurisdiction. A.J., Docket No. 10-619 (issued June 29, 2010). Appellant also submitted evidence with her appeal to
the Board. The Board may not consider this evidence as its review of the record is limited to reviewing the evidence
that was before OWCP at the time of its final decision. 20 C.F.R. § 501.2(c); J.T., 59 ECAB 293 (2008).

4


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
B.W., Appellant
and
DEPARTMENT OF THE NAVY, NAVAL
FACILITIES ENGINEERING COMMAND
MID-ATLANTIC, Norfolk, VA, Employer
__________________________________________

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

Docket No. 17-1929
Issued: February 13, 2018

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
ALEC J. KOROMILAS, Alternate Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION
On September 12, 2017 appellant filed a timely appeal from an August 16, 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.2
ISSUE
The issue is whether appellant met his burden of proof to establish an injury in the
performance of duty on June 27, 2017, as alleged.

1

5 U.S.C. § 8101 et seq.

2
The record provided the Board includes evidence received after OWCP issued its August 16, 2017 decision.
The Board’s review of a case is limited to the evidence in the case record that was before OWCP at the time of its
final decision. 20 C.F.R. § 501.2(c)(1). Therefore, evidence not before OWCP at the time of the August 16, 2017
decision will not be considered by the Board for the first time on appeal. Id.

FACTUAL HISTORY
On July 10, 2017 appellant, then a 45-year-old rigger, filed a traumatic injury claim
(Form CA-1) alleging that he injured his mid-back in the performance of duty on June 27, 2017.
The injury reportedly occurred at 9:00 a.m. on Pier 12 while he was attempting to untie a line to
a yard (“YD”) crane.3 The cause of injury was described as “trying to untie [yard] crane to move
from Pier 12 ... felt I pulled a muscle in back.” V.C., an agency reviewer, signed the Form CA-1
on appellant’s behalf.4 She also acknowledged that he was in the performance of duty at the
time, and that the injury was not the result of appellant’s willful misconduct. Additionally, V.C.
indicated that her knowledge regarding the facts about the injury was in agreement with
statements of the employee and/or witnesses. Appellant first received medical care on June 27,
2017 but, according to V.C., the medical reports did not show that appellant was disabled for
work. Lastly, she challenged appellant’s entitlement to continuation of pay (COP), noting that
the condition may not have been the result of a work-related incident. V.C. further noted that no
supporting medical documentation had been provided.
On June 27, 2017 appellant received treatment at the employing establishment’s health
clinic. Dr. Laura C. Kellogg, a Board-certified family practitioner, checked a box marked “Yes”
indicating an occupational injury related to federal employment. She noted that appellant could
return to his permanent job on July 1, 2017 and indicated, in the “remarks/diagnosis” portion of
the report, “Back strain -- no work until Saturday July 1, 2017. Rest, ice, heat, [prescription]
medications as directed.”5
In a June 30, 2017 report, Dr. Roderick R. MacKinnon, an attending Board-certified
internist, noted that appellant had been under his care beginning June 30, 2017. He further
advised that appellant would be able to return to work on July 10, 2017.
In a July 11, 2017 development letter, OWCP indicated that the documentation received
to date had been reviewed, and noted that it was insufficient to support appellant’s claim. First,
it explained that the evidence was insufficient to establish that appellant actually experienced the
incident or employment factor alleged to have caused injury. Additionally, OWCP explained
that no diagnosis of any condition resulting from his injury had been provided. Lastly, it noted
that the record was devoid of a physician’s opinion as to how appellant’s injury resulted in the
condition which had been diagnosed. OWCP requested that appellant submit additional
evidence in support of his claim, including a physician’s opinion supported by a medical
explanation as to how the reported work incident caused or aggravated a medical condition. It
also requested that, within 30 days, appellant complete and return an attached questionnaire,
which posed various questions regarding the circumstances of the claimed June 27, 2017
employment incident, and whether appellant had any similar disability or symptoms before the
alleged injury. OWCP also advised that the employing establishment was controverting the
claim, asserting that the condition may not be related to appellant’s work duties and that he did
3

Appellant’s regular work hours were 7:00 a.m. to 3:30 p.m., Monday through Friday.

4

Appellant’s immediate supervisor was identified as R.S. However, V.C. signed the Form CA-1 on behalf of
both appellant and his immediate supervisor.
5
On the same dispensary permit form report, appellant’s supervisor, R.S., listed the date of injury as June 27,
2017 and checked a box marked “Yes” indicating an occupational injury.

2

not have supporting medical documentation. It specifically requested that appellant respond to
the employing establishment’s remarks.
The record does not indicate that OWCP received a response to its July 11, 2017
development letter.
In an August 16, 2017 decision, OWCP denied appellant’s claim for a June 27, 2017
employment-related back injury. It noted that appellant had established that he was a federal
civilian employee who filed a timely claim, that the injury, accident, or employment factor
occurred, and that a medical condition had been diagnosed in connection with the injury or
event. OWCP further found, however, that appellant’s claim for a June 27, 2017 employment
injury was denied because he failed to establish that his claimed injury occurred in the
performance of duty.6 It noted that appellant had not responded to its development letter.
LEGAL PRECEDENT
An employee seeking benefits under FECA7 has the burden of proof to establish the
essential elements of his or her claim including the fact that the individual is an employee of the
United States within the meaning of FECA, that the claim was timely filed within the applicable
time limitation period of FECA, that an injury was sustained in the performance of duty as
alleged, and that any disability and/or specific condition for which compensation is claimed are
causally related to the employment injury.8 These are the essential elements of each
compensation claim regardless of whether the claim is predicated upon a traumatic injury or an
occupational disease.9
To determine whether a federal employee has sustained a traumatic injury in the
performance of duty, it first must be determined whether fact of injury has been established.
There are two components involved in establishing fact of injury. First, the employee must
submit sufficient evidence to establish that he or she actually experienced the employment
incident at the time, place, and in the manner alleged.10 Second, the employee must submit
evidence, in the form of medical evidence, to establish that the employment incident caused a
personal injury.11

6

OWCP noted that the evidence was insufficient to establish that the injury and/or medical condition arose during
the course of employment and within the scope of compensable work factors. In addition, it also determined that
appellant did not submit medical evidence establishing a medical condition causally related to the work injury or
event.
7

See supra note 2.

8

C.S., Docket No. 08-1585 (issued March 3, 2009); Elaine Pendleton, 40 ECAB 1143 (1989).

9

S.P., 59 ECAB 184 (2007); Victor J. Woodhams, 41 ECAB 345 (1989). A traumatic injury refers to an injury
caused by a specific event or incident or series of incidents occurring within a single workday or work shift whereas an
occupational disease refers to an injury produced by employment factors which occur or are present over a period
longer than a single workday or work shift. 20 C.F.R. §§ 10.5 (q), (ee); Brady L. Fowler, 44 ECAB 343, 351 (1992).
10

Julie B. Hawkins, 38 ECAB 393 (1987).

11

John J. Carlone, 41 ECAB 354 (1989).

3

Causal relationship is a medical issue and the medical evidence generally required to
establish causal relationship is rationalized medical opinion evidence. The opinion of the
physician must be based on a complete factual and medical background of the claimant, must be
one of reasonable medical certainty, and must be supported by medical rationale explaining the
nature of the relationship between the diagnosed condition and the specific employment factors
identified by the claimant.12
ANALYSIS
On July 10, 2017 appellant filed a traumatic injury claim alleging a work-related injury to
his mid-back on June 27, 2017. The incident reportedly occurred on premises at Pier 12 at 9:00
a.m. The Form CA-1 described the cause of injury as “trying to untie [yard] crane to move from
Pier 12 ... felt I pulled a muscle in back.” The employing establishment did not question the
circumstances of the claimed June 27, 2017 employment incident, nor did it dispute that
appellant was in the performance of duty at the time of his alleged injury. However, it
challenged entitlement to COP, noting that the condition may not be the result of a work-related
incident because no supporting medical documentation had been provided.
In an August 16, 2017 decision, OWCP found that appellant established both components
of fact of injury, but it denied his traumatic injury claim because he failed to establish that his
injury occurred in the performance of duty.13 As noted, the employing establishment did not
challenge whether appellant was in the performance of duty at the time of his alleged injury, and
there is nothing in the record to suggest otherwise.
OWCP accepted that appellant established the factual component of fact of injury with
respect to his claim for a mid-back injury on June 27, 2017.14 The Board finds that he
established the occurrence of an employment incident on June 27, 2017 in the form of attempting
to untie a yard crane. However, appellant’s claim for injury is denied because he failed to
establish the medical component of fact of injury. He did not submit any medical evidence
establishing that the employment incident caused a personal injury.15
In a June 27, 2017 dispensary permit report, Dr. Kellogg noted that appellant could return
to his permanent job on July 1, 2017 and indicated, in the “remarks/diagnosis” portion of the
report, “Back strain -- no work until Saturday July 1, 2017….” Although Dr. Kellogg diagnosed
12

See I.J., 59 ECAB 408 (2008); Donna Faye Cardwell, 41 ECAB 730 (1990).

13
FECA provides for the payment of compensation for the disability or death of an employee resulting from
personal injury sustained “while in the performance of his duty.” 5 U.S.C. § 8102(a). In order to be covered, an
injury must occur at a time when the employee may reasonably be said to be engaged in his master’s business, at a
place when he may reasonably be expected to be in connection with his employment, and while he was reasonably
fulfilling the duties of his employment or engaged in doing something incidental thereto. Roma A. MortensonKindschi, 57 ECAB 418 (2006).
14

See supra note 10.

15
See supra note 11. The Board notes that its basis for denying appellant’s claimed June 27, 2017 employment
injury differs from that of OWCP. The Board is denying appellant’s claim because he failed to establish the medical
component of fact of injury, whereas OWCP denied his claim for failure to establish that the claimed injury occurred
in the performance of duty. See supra note 8.

4

back strain, she did not relate this specific diagnosis to the employment factor established by
appellant, i.e., attempting to untie a crane and falling on June 27, 2017.16
In a June 30, 2017 report, Dr. MacKinnon noted that appellant had been under his care
since June 30, 2017, and indicated that he could return to work on July 10, 2017. He did not
describe the June 27, 2017 employment incident, but diagnosed a back strain.
OWCP previously advised appellant of the deficiencies in the above-noted evidence and
afforded him an opportunity to submit additional medical evidence to support his claim for an
employment-related back condition. However, appellant did not avail himself of that
opportunity in a timely fashion. For these reasons, he has not met his burden of proof to
establish an injury causally related to the accepted June 27, 2017 employment incident.
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 met his burden of proof to establish that he was in the
performance of duty as alleged, but has not established an injury causally related to the accepted
June 27, 2017 employment incident.

16
On the same report appellant’s supervisor listed the date of injury as June 27, 2017. However, Dr. Kellogg did
not list a date of injury or provide any description of the June 27, 2017 employment incident.

5

ORDER
IT IS HEREBY ORDERED THAT the August 16, 2017 decision of the Office of
Workers’ Compensation Programs is affirmed as modified.
Issued: February 13, 2018
Washington, DC

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

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

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

6