United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
B.P., Appellant
and
DEPARTMENT OF VETERANS AFFAIRS,
VETERANS ADMINISTRATION DENTAL
SERVICE, Biloxi, MS, Employer
__________________________________________

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

Docket No. 10-1205
Issued: February 22, 2011

Case Submitted on the Record

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

JURISDICTION
On March 25, 2010 appellant filed a timely appeal from a merit decision of the Office of
Workers’ Compensation Programs dated September 29, 2009. Pursuant to 20 C.F.R. §§ 501.2(c)
and 501.3, the Board has jurisdiction over the merits of this decision.
ISSUE
The issue is whether the Office properly suspended appellant’s compensation pursuant to
5 U.S.C. § 8123(d) on the grounds that she refused to submit to a medical examination.
FACTUAL HISTORY
This case has previously been before the Board. In a July 31, 1995 decision, the Board
found that the denial by the Office of appellant’s request for a lump-sum payment for wage-loss

benefits did not constitute an abuse of discretion.1 The law and facts of the previous Board
decision are incorporated herein by reference. Thereafter, appellant continued to receive
compensation on the periodic rolls.
The Office continued to develop the claim, and by letter dated January 17, 2008, notified
appellant that there was no current medical evidence to establish entitlement to continuing
compensation and asked that she provide a detailed narrative medical report. Appellant did not
submit the requested medical report, and in September 2008, the Office informed her that a
second opinion evaluation was needed to address whether any or all of her accepted employment
injuries had resolved and, if not, whether she could return to work in a limited-duty capacity. On
October 31, 2008 the Office referred her to Dr. Raymond Fletcher, a Board-certified orthopedic
surgeon, for a second opinion evaluation. The appointment was cancelled,2 and on
November 13, 2008, Medical Consultants Network (MCN), the contract medical appointment
scheduler, notified appellant that an appointment had been made for an evaluation by
Dr. Charlton Barnes, also Board-certified in orthopedic surgery, at 4:00 p.m., on December 10,
2008, in Pascagoula, Mississippi.
On December 4, 2008 appellant telephoned the Office, stating that she could not attend
the scheduled appointment because she was physically unable to drive. The Office explained
that transportation could be provided, but she stated that she would not attend the appointment.
It informed her that, if she changed her mind, transportation could be provided. On
December 11, 2008 MCN informed the Office that appellant did not attend the appointment
scheduled for December 10, 2008.
On December 12, 2008 the Office proposed to suspend appellant’s compensation benefits
on the grounds that she failed to appear for the examination scheduled for December 10, 2008
with Dr. Barnes. Appellant was informed of the penalty provision of section 8123(d) of the
Federal Employees’ Compensation Act3 and was given 14 days to provide in writing good cause
for her failure to appear. She did not respond in writing.4
By decision dated December 30, 2008, the Office finalized the proposed termination. It
noted that appellant did not attend the appointment scheduled for December 10, 2008 and did not
provide an explanation for her failure to attend. In a December 31, 2008 letter, appellant
1

Docket No. 92-2283 (issued July 31, 1995). On December 6, 1984 appellant sustained employment-related
neck and back injuries when a chair was pulled out as she was trying to sit. The claim was accepted for contusion to
the lower back, cervical and lumbar sprains and cervical disc syndrome at C4-5 for which she had surgery on
May 7, 1987. Appellant was placed on the periodic compensation rolls in 1985.
2

Appellant had seen Dr. Fletcher for a second opinion evaluation on April 30, 2003. In June 2003 she called both
the Office and the physician’s office, stating that she was not pleased with his report. In November 2008 appellant
called the appointment scheduler, threatening to sue for the referral to Dr. Fletcher. The appointment was then
cancelled.
3

5 U.S.C. §§ 8101-8193.

4

Appellant telephoned the Office on December 19, 2008. The call was returned on three occasions but there was
no answer. Appellant called again on December 29, 2008, stating that she would respond to the December 12, 2008
letter.

2

requested 60 days to provide medical information and stated that she would have had to ride a
bus to the scheduled appointment. She also stated that she had seen physicians on December 20
and 22, 2008 for high blood pressure. Appellant submitted reports dated June 30 and July 26,
2006 from Board-certified internists, Dr. J. Donald Kirby and Dr. Gary M. Rich, respectively,
advising that she had been treated for six years for multiple medical problems and an employing
establishment memorandum dated December 20, 1984 regarding possible exposure to
formaldehyde. On January 20, 2009 she requested a hearing.5 In a February 28, 2009 report,
Dr. Julia Dannelley, a Board-certified internist, advised that appellant was under her care for
complications of cirrhosis of the liver and hypertension. She stated that appellant had not been
able to travel outside of Mobile recently and so could not make it to her workers’ compensation
appointment.
At the hearing, held telephonically on June 10, 2009, appellant testified that she called
MCN on December 5, 2008 to cancel the appointment because she could not travel due to poor
health and talked with MCN again on December 8, 2008. The hearing representative instructed
appellant to provide records regarding the telephone calls to MCN and informed her of her
responsibilities regarding resumption of compensation. The hearing representative also informed
appellant that she needed to provide a medical report explaining why she was so ill in
December 2008 that she could not travel when she would be furnished transportation to the
appointment and why she continued to be medically unable to travel. Appellant stated that she
would rather sue in federal court than comply.
Appellant submitted nothing further, and by decision dated September 29, 2009, the
Office hearing representative affirmed the December 30, 2008 decision.
LEGAL PRECEDENT
Section 8123 of the Act authorizes the Office to require an employee, who claims
disability as a result of federal employment, to undergo a physical examination as it deems
necessary.6 The determination of the need for an examination, the type of examination, the
choice of locale and the choice of medical examiners are matters within the province and
discretion of the Office.7 The Office’s regulations at section 10.320 provide that a claimant must
submit to examination by a qualified physician as often and at such times and places as the
Office considers reasonably necessary.8 Section 8123(d) of the Act and section 10.323 of the
Office’s regulations provide that, if an employee refuses to submit to or obstructs a directed
medical examination, his or her right to compensation is suspended until the refusal or
obstruction ceases.9 Office procedures provide that before the Office may invoke these
5

On February 6 and 10, 2009 appellant telephoned the Office. On each date she was informed that the
suspension would be reversed when she indicated, in writing, a willingness to appear for a second opinion
evaluation. Appellant was also informed that transportation would be provided.
6

5 U.S.C. § 8123.

7

J.T., 59 ECAB 293 (2008).

8

20 C.F.R. § 10.320.

9

5 U.S.C. § 8123(d); 20 C.F.R. § 10.323; Dana D. Hudson, 57 ECAB 298 (2006).

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provisions, the employee is to be provided a period of 14 days within which to present in writing
his or her reasons for the refusal or obstruction.10 If good cause for the refusal or obstruction is
not established, entitlement to compensation is suspended in accordance with section 8123(d) of
the Act.11
ANALYSIS
The Board finds that appellant refused to submit to the scheduled December 10, 2008
second opinion examination with Dr. Barnes within the meaning of section 8123 of the Act. The
Office directed appellant to attend a second opinion evaluation with Dr. Barnes, a Boardcertified orthopedic surgeon.
On November 13, 2008 appellant was referred to Dr. Barnes for a second opinion
evaluation, scheduled at 4:00 p.m. on December 10, 2008.
Appellant did not attend the December 10, 2008 appointment, and in a December 12,
2008 notice, the Office afforded her 14 days to provide good cause in writing for her failure to
attend the scheduled examination. She was advised of the penalty provision of section 8123(d)
of the Act for failure to attend such an examination. Although appellant telephoned the Office,
she did not provide an explanation in writing or submit any evidence addressing why she did not
appear for the scheduled December 10, 2008 examination.
The Board has recognized the Office’s responsibility in developing claims.12 Section
8123 authorizes it to require an employee, who claims disability as a result of federal
employment, to undergo a physical examination as the Office deems necessary. The
determination of the need for an examination, the type of examination, the choice of locale and
the choice of medical examiners are matters within the province and discretion of the Office.
The only limitation on this authority is that of reasonableness.13 The referral to an appropriate
specialist in appellant’s area at the Office’s expense cannot be considered unreasonable. In this
case, the Office clearly acted within its discretion by referring appellant for a second opinion
examination to assess her employment-related condition. When appellant failed to attend, the
Office properly advised her of its intention to suspend compensation benefits. She did not
respond in writing to the notice of proposed suspension or otherwise provide reasons for not
attending the examination.
After the Office’s December 30, 2008 decision suspending appellant’s right to
compensation, she requested 60 days to provide additional medical information and submit
additional evidence. The 1984 employing establishment memorandum and the 2006 medical
reports are irrelevant as to why she failed to appear for the scheduled examination in
10

Federal (FECA) Procedure Manual, Part 2 -- Claims, Developing and Evaluating Medical Evidence, Chapter
2.810.14(d) (July 2000); J.T., supra note 7.
11

Id.

12

Scott R. Walsh, 56 ECAB 353 (2005).

13

20 C.F.R. § 10.320; see J.T., supra note 7.

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December 2008. Dr. Dannelley’s report is also insufficient to establish that appellant was unable
to attend the December 10, 2008 examination. While she generally advised in her February 28,
2009 report that appellant was under her care for complications of cirrhosis of the liver and
hypertension and had not been able to travel outside Mobile recently, she did not provide an
explanation as to why appellant was medically unable to travel on December 10, 2008, when
transportation would have been provided.
Appellant testified at the hearing that she called MCN to cancel the appointment and
could not travel due to poor health. The hearing representative requested that she submit
documentation of the telephone calls and a medical report specifically addressing her condition
at that time. No responsive evidence was received prior to issuance of the hearing
representative’s decision on September 29, 2009. The Board thus finds that the Office properly
suspended benefits for not attending the scheduled medical examination.14
CONCLUSION
The Board finds that the Office properly suspended appellant’s compensation benefits on
December 30, 2008 as she failed to attend a scheduled medical examination without showing
good cause for her refusal.

14

J.T., supra note 7.

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ORDER
IT IS HEREBY ORDERED THAT the September 29, 2009 decision of the Office of
Workers’ Compensation Programs be affirmed.
Issued: February 22, 2011
Washington, DC

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

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
I.L., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Wailuku, HI, Employer
__________________________________________

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

Docket No. 17-0684
Issued: July 18, 2017

Case Submitted on the Record

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

JURISDICTION
On February 3, 2017 appellant filed a timely appeal from an October 14, 2016 merit
decision and a January 13, 2017 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.2
ISSUES
The issues are: (1) whether appellant has met her burden of proof to establish a bilateral
hand condition causally related to factors of her federal employment; and (2) whether OWCP
properly denied appellant’s request for further merit review of her claim pursuant to 5 U.S.C
§ 8128(a).

1
2

5 U.S.C. § 8101 et seq.

Appellant submitted new evidence on appeal. However, the Board is precluded from reviewing evidence which
was not before OWCP at the time of its final decision. See 20 C.F.R. § 501.2(c)(1).

FACTUAL HISTORY
On July 12, 2016 appellant, then a 57-year-old mail carrier, filed an occupational disease
claim (Form CA-2) alleging that she developed pain in her hands and thumbs from her everyday
work duties. She first became aware of her condition in March 2016 and of its relationship to
her employment on April 12, 2016.
The employing establishment provided an employee information form dated July 19,
2016 which noted her job record, accident and injury history, and prior claims.
By letter dated August 5, 2016, OWCP advised appellant of the deficiencies in her claim
and provided her the opportunity to submit additional factual and medical evidence. This
included a detailed narrative medical report from her treating physician which contained a
history of the injury and a medical explanation with objective evidence of how the reported work
exposure contributed to her claimed condition.
In response, appellant submitted an August 20, 2016 narrative statement in which she
described her work duties which mainly required the use of her thumbs and fingers. She held
mail in bundles in one hand and fingered them individually with the other hand to case them into
slots on shelves at work stations. Appellant pulled cased mail down and placed it into work trays
or tubs to load into a mail truck for delivery. She related using a heavy and bulky hand-held
scanner to scan multiple mail pieces, numerous parcels, and multiple managed service point
labels throughout the workday. Appellant fingered through sequenced three-foot long mail trays.
Her route usually had five trays that she worked through using her thumbs and index fingers to
bring up a letter piece for delivery. Once appellant was in her vehicle, she used her hands to turn
the ignition on and off, slide doors to open and close, set a hand brake, roll up the window, and
lock her vehicle. Postal regulations required her to do this every time she exited and walked
away from the vehicle. This was done numerous times as appellant’s route had about 1,000
delivery points. Appellant opened and closed the back hatch of her truck to deliver parcels (she
delivered two or three times more than other carriers). Her route consisted of more than half her
deliveries to cluster box units (CBUs). Appellant constantly used her hands to open and close
these metal units with a key. She noted that heavy latches must be lifted to fully open and close
each unit. Appellant delivered mail to individual standing mailboxes which involved using her
hands and thumbs to open and close the box doors. She used a pen to write notices and
accountable mail, markers to label parcels when delivery could not be made, and rubber bands to
bundle mail. Appellant sought medical treatment on April 12, 2016 after pain in both hands
persisted for over a month. She was advised by two physicians that her pain was due to
repetitive motions and overuse. Appellant asserted that she continued to have pain.
Appellant submitted several reports from Dr. Rebecca A. Romack, a family practitioner.
In progress notes and office visit reports dated August 8 and 23, 2016, Dr. Romack indicated that
appellant was presented with a work-related injury. She noted appellant’s complaints which
included pain due to trigger fingers and employment as a postal carrier. Regarding mechanism
of injury, Dr. Romack noted that appellant informed her that on March 1, 2016 she repeatedly
used her hands throughout the day at work. Appellant grabbed trays of mail with her fingers and
lifted them out with her thumbs. She also opened a latch on CBUs and pulled things out of them.
Appellant then held a bundle of mail in her left hand and lifted with her right hand. She opened

2

and closed the hatch all day long when getting in and out of her truck. Appellant had an “old
column shiftings” to turn the ignition on and off in her truck. Dr. Romack discussed examination
findings and diagnosed bilateral first carpometacarpal (CMC) joint osteoarthritis. She opined
that the underlying cause of appellant’s condition was overuse in the course of employment as a
postal carrier. Dr. Romack related that there were no known preexisting conditions and/or
nonoccupational factors contributing to the development of her injury. She maintained that
medical maximum improvement was anticipated in one to two months and appellant’s prognosis
was fair.
In industrial work status reports dated August 8 and 23 and September 9, 2016,
Dr. Romack restated her diagnosis of bilateral first CMC joint osteoarthritis. She placed
appellant on modified activity at work and home from August 8 through October 7, 2016.
Dr. Romack indicated that appellant could not work more than 8 hours a day or 40 hours a week.
In a September 12, 2016 physician’s form report, she indicated by checking a box marked “yes”
that appellant’s March 1, 2016 accident was the only cause of her condition. Dr. Romack noted
that appellant had resumed light work on August 8, 2016.
In an after-visit summary dated August 31, 2016, Nancy Zionkowski, an occupational
therapist, provided instructions for an arthritis home program.
By decision dated October 14, 2016, OWCP denied appellant’s occupational disease
claim. It found that Dr. Romack had not provided a rationalized opinion, supported by a medical
explanation, as to how the established employment factors caused, contributed to, or aggravated
appellant’s bilateral hand condition.
OWCP received a February 12, 2016 laboratory report which provided blood test results.
In progress notes dated September 9 and October 7, 2016, Dr. Lisa K. Sodetani, a Board-certified
internist, discussed examination findings and assessed appellant with bilateral first CMC joint
osteoarthritis and de Quervain’s tenosynovitis. In an industrial work status report dated
September 9, 2016, she restated her diagnosis and placed appellant off work through
October 7, 2016.
On December 31, 2016 appellant requested reconsideration. She noted that she would
submit additional argument from her physician at a later time. Appellant related that her
physician was on maternity leave.
In a January 13, 2017 decision, OWCP denied appellant’s request for reconsideration. It
found that the evidence of record was insufficient to warrant merit review of the prior decision.
OWCP noted that “[n]o new evidence was presented for review.”
LEGAL PRECEDENT -- ISSUE 1
An employee seeking benefits under FECA 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 filed within the applicable time
limitation, that an injury was sustained while 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

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employment injury.3 These are the essential elements of each and every compensation claim
regardless of whether the claim is predicated on a traumatic injury or an occupational disease.4
To establish that an injury was sustained in the performance of duty 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
employment factors identified by the claimant were the proximate cause of the condition for
which compensation is claimed or, stated differently, medical evidence establishing that the
diagnosed condition is causally related to the employment factors identified by the claimant.
The medical evidence required to establish a causal relationship is rationalized medical opinion
evidence. The opinion of the physician must be based on a complete factual and medical
background of the employee, must be one of reasonable certainty, and must be supported by
medial rationale explaining the nature of the relationship between the diagnosed condition and
the specific employment factors identified by the employee.5
ANALYSIS -- ISSUE 1
There is no dispute that appellant’s employment activities included fingering, pulling,
lifting, turning, sliding, and rolling. The Board finds, however, that the medical evidence of
record is insufficient to establish that these accepted factors of her federal employment caused or
aggravated her bilateral hand conditions.
Appellant submitted medical evidence primarily from her family physician, Dr. Romack.
In progress notes and office visit reports dated August 8 and 23, 2016, Dr. Romack noted
appellant’s history of injury, set forth examination findings, and diagnosed bilateral first CMC
joint osteoarthritis. She opined that the diagnosed condition was caused by overuse at work.
Although Dr. Romack found that appellant was injured at work, she did not provide medical
rationale explaining the basis of her conclusory opinion regarding the causal relationship
between her bilateral hand condition and the established employment factors.6 This is especially
important as she also indicated that appellant had preexisting conditions and/or nonoccupational
factors that contributed to the development of her condition. The Board finds, therefore, that this
evidence is insufficient to meet appellant’s burden of proof.
In a September 12, 2016 physician’s form report, Dr. Romack indicated by checking a
box marked “yes” that appellant’s March 1, 2016 accident was the only cause of her condition.

3

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

4

S.P., 59 ECAB 184 (2007); Victor J. Woodhams, 41 ECAB 345 (1989); Joe D. Cameron, 41 ECAB 153 (1989).

5

I.J., 59 ECAB 408 (2008); Victor J. Woodhams, id.

6

See T.M., Docket No. 08-0975 (issued February 6, 2009) (a medical report is of limited probative value on the
issue of causal relationship if it contains a conclusion regarding causal relationship which is unsupported by medical
rationale).

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However, she did not provide a firm diagnosis of a particular medical condition.7 Moreover, the
Board has held that when a physician’s opinion on causal relationship consists only of checking
“yes” to a form question, without more by way of medical rationale, it is of little probative value
and insufficient to establish appellant’s claim.8 A mere conclusory opinion provided by a
physician without the necessary rationale explaining how and why the incident or work factors
were sufficient to result in the diagnosed medical condition is insufficient to meet a claimant’s
burden of proof.9 Dr. Romack has not offered sufficient explanation to address how the
established work factors caused or aggravated a diagnosed medical condition. For the stated
reasons, her report is insufficient to establish appellant’s claim.
Other reports from Dr. Romack are of limited probative value as she did not offer a
medical opinion on whether the diagnosed conditions were caused or aggravated by the
established employment factors.10 Thus, her reports are insufficient to establish appellant’s
burden of proof.
The August 31, 2016 after-visit summary of Ms. Zionkowski, an occupational therapist,
is insufficient to establish appellant’s claim. This evidence has no probative medical value as an
occupational therapist is not considered a physician as defined under FECA.11
Appellant’s belief that factors of employment caused or aggravated her condition is
insufficient, by itself, to establish causal relationship.12 The issue of causal relationship is a
medical one and must be resolved by probative medical opinion from a physician. The Board
finds that there is insufficient medical evidence of record to establish that appellant’s bilateral
hand condition was caused or aggravated by the established employment factors. Appellant,
therefore, did not meet her burden of proof.
On appeal appellant contends that her claim should not have been denied because her
physician’s notes did not provide sufficient details. She noted that since her insurance provider
did not have a physician specializing in occupational health and safety for federal employees, she
was scheduled for an appointment with a regular physician, Dr. Romack. Appellant has the
burden of proof, however, to establish her claim and OWCP notified her of the type of evidence
7

See Deborah L. Beatty, 54 ECAB 340 (2003) (where the Board found that, in the absence of a medical report
providing a diagnosed condition and a reasoned opinion on causal relationship with the employment incident,
appellant did not meet her burden of proof).
8

See J.T., Docket No. 15-0196 (issued March 23, 2015); Lillian M. Jones, 34 ECAB 379 (1982).

9

J.D., Docket No. 14-2061 (issued February 27, 2015).

10

A.D., 58 ECAB 159 (2006) (medical evidence which does not offer any opinion regarding the cause of an
employee’s condition is of limited probative value on the issue of causal relationship).
11

5 U.S.C. § 8101(2); see R.S., Docket No. 16-1303 (issued December 2, 2016) (occupational therapists are not
considered physicians as defined under FECA); J.J., Docket No. 15-0727 (issued July 16, 2015) (reports from an
occupational therapist have no probative value as an occupational therapist is not a physician as defined under
FECA).
12

20 C.F.R. § 10.115(e); Phillip L. Barnes, 55 ECAB 426, 440 (2004).

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needed to establish her claim. Because she has not provided such medical opinion evidence in
this case, she has failed to meet 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.
LEGAL PRECEDENT -- ISSUE 2
Section 8128 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.13 Section 10.608(b) 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).14 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.15 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.16
ANALYSIS -- ISSUE 2
OWCP issued a decision on October 14, 2016 denying appellant’s occupational disease
claim, finding that the medical evidence did not contain a rationalized medical opinion
explaining the causal relationship between the established employment factors and her diagnosed
medical condition. On December 31, 2016 appellant requested reconsideration of this decision.
Prior to her request for reconsideration on December 31, 2016 and after the issuance of OWCP’s
decision on October 14, 2016, she submitted additional new medical evidence. Appellant
submitted a February 12, 2016 laboratory report, which provided blood test results,
Dr. Sodetani’s September 9 and October 7, 2016 progress notes, and an industrial work status
report addressing appellant’s bilateral hand condition and disability from work. OWCP declined
her request for reconsideration in a January 13, 2017 final nonmerit decision. It noted that no
further evidence had been presented for review.
The issue presented is whether appellant met any of the requirements of 20 C.F.R.
§ 10.606(b)(3), requiring OWCP to reopen the case for review of the merits of the claim.

13

5 U.S.C. § 8128(a).

14

20 C.F.R. § 10.608(a).

15

Id. at § 10.606(b)(3).

16

Id. at § 10.608(b).

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The Board notes that the record is clear that OWCP received the February 12, 2016
laboratory report and Dr. Sodetani’s September 9 and October 7, 2016 progress notes and
industrial work status report prior to the issuance of its January 13, 2017 final nonmerit decision.
OWCP, however, incorrectly determined in its January 13, 2017 decision denying appellant’s
request for reconsideration of the merits of her claim that no new evidence was presented for
review.
FECA provides that OWCP shall determine and make findings of fact in making an
award for or against payment of compensation after considering the claim presented by the
employee and after completing such investigation as OWCP considers necessary with respect to
the claim.17 Since the Board’s jurisdiction of a case is limited to reviewing that evidence which
is before OWCP at the time of its final decision,18 it is necessary that OWCP review all evidence
submitted by a claimant and received by OWCP prior to issuance of its final decision. As the
Board’s decisions are final as to the subject matter appealed,19 it is crucial that all evidence
relevant to that subject matter which was properly submitted to OWCP prior to the time of
issuance of its final decision be addressed by OWCP.20
The Board finds that OWCP improperly failed to consider all the relevant evidence
submitted by appellant in denying her request for reconsideration of the merits of her claim
pursuant to 5 U.S.C. § 8128(a). Therefore, the case is remanded to OWCP for consideration of
the evidence she submitted in connection with her reconsideration request, to be followed by the
issuance of an appropriate decision regarding her reconsideration request.
CONCLUSION
The Board finds that appellant has failed to meet her burden of proof to establish a
bilateral hand condition causally related to factors of her federal employment. The Board further
finds that OWCP did not consider all the evidence submitted by appellant before denying her
request for reconsideration pursuant to 5 U.S.C. § 8128(a). The case is remanded to OWCP for
consideration of the evidence appellant submitted in connection with her reconsideration request.

17

5 U.S.C. § 8124(a)(2).

18

20 C.F.R. § 501.2(c).

19

Id. at § 501.6(d).

20

See E.P., Docket No. 14-0278 (issued February 26, 2014); see also William A. Couch, 41 ECAB 548,
553 (1990).

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ORDER
IT IS HEREBY ORDERED THAT the October 14, 2016 decision of the Office of
Workers’ Compensation Programs is affirmed. The January 13, 2017 decision of OWCP is set
aside, and the case is remanded for further proceedings consistent with this decision of the
Board.
Issued: July 18, 2017
Washington, DC

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

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

8


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
L.C., Appellant
and
DEPARTMENT OF THE TREASURY,
INTERNAL REVENUE SERVICE,
Bensalem, PA, Employer
__________________________________________

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Appearances:
Thomas R. Uliase, Esq., for the appellant
Office of Solicitor, for the Director

Docket No. 15-0903
Issued: August 13, 2015

Case Submitted on the Record

DECISION AND ORDER
Before:
PATRICIA H. FITZGERALD, Deputy Chief Judge
COLLEEN DUFFY KIKO, Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On March 24, 2015 appellant, through counsel, filed a timely appeal from a
November 17, 2014 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.
ISSUES
The issues are: (1) whether it met its burden of proof to terminate appellant’s
compensation benefits effective April 6, 2014 as the accepted conditions had resolved with no
residuals; and (2) whether appellant met her burden of proof to establish continued disability
after April 6, 2014.

1

5 U.S.C. §§ 8101-8193.

On appeal counsel asserts that the impartial medical examiner was not properly selected
and that his opinion is not sufficiently rationalized to meet OWCP’s burden to terminate
appellant’s compensation benefits.
FACTUAL HISTORY
On August 3, 1994 appellant, then a 41-year-old correspondence examination technician,
filed a traumatic injury claim alleging that she injured her right knee when she tripped over a
trash can at work that day. At the time of the injury, she was working three days a week due to a
nonoccupational motor vehicle accident. Appellant stopped work on the date of injury and did
not return. OWCP accepted that she sustained a right knee strain, and she was placed on the
periodic compensation rolls. The claim was expanded to include reflex sympathetic dystrophy
(RSD) of the right knee.2
Appellant began treatment with Dr. Robert Knobler, a Board-certified neurologist, on
March 14, 1996, who diagnosed RSD of both legs and recommended medication and physical
therapy. Dr. Knobler advised that her condition was guarded. Appellant submitted numerous
reports of him describing her care up to August 1, 2007.
OWCP continued to develop the claim, and in September 2011 referred appellant to
Dr. Raoul Biniaurishvili, a Board-certified neurologist, for a second opinion evaluation. In an
October 5, 2011 report, Dr. Biniaurishvili reported physical examination findings, diagnosed
right knee regional pain syndrome, anxiety disorder, and depression, and recommended
additional studies. In an attached work capacity evaluation, he found that appellant could work
eight hours a day with physical restrictions. A November 8, 2011 x-ray of the right knee
demonstrated mild degenerative joint disease. A right knee magnetic resonance imaging (MRI)
scan study that day demonstrated marked degenerative changes and chondromalacia patella and a
possible acute process at the ventral aspect of the tibia.
On December 22, 2011
Dr. Biniaurishvili reported the study findings and recommended additional study regarding the
tibial findings.
In a January 10, 2013 report, Dr. Shailen Jalali, an attending physician who is Boardcertified in anesthesiology and pain medicine, noted appellant’s complaint of wide-spread body
pain. He described the history of injury and provided examination findings. Dr. Jalali diagnosed
complex regional pain syndrome (CRPS), most prominent in the lower extremities, complicated
by a history of seizure disorder, hypothyroidism, and cervical spine pathology that required
surgery.
In April 2013, OWCP again referred appellant to Dr. Biniaurishvili. In an April 1, 2013
report, Dr. Biniaurishvili additionally diagnosed right knee arthritis, cervical, and lumbar spine
degenerative disease and pain, rule-out discogenic lumbar spine disease, psychophysiological
insomnia, organic brain syndrome, and possible fibromyalgia. He recommended additional
studies and advised that appellant had physical limitations related to CRPS. An April 10, 2013
electromyographic study of the lower extremities demonstrated findings consistent with mild
symmetrical distal polyneuropathy. In a work capacity evaluation dated April 17, 2013,
2

RSD is now known as complex regional pain syndrome (CRPS).

2

Dr. Biniaurishvili provided physical restrictions and advised that appellant could work four hours
of restricted-duty daily. On April 25, 2013 he advised that she was capable of performing the
duties of correspondence examination technician for four hours daily.
Dr. Jalali and his associates provided treatment notes dated February 7 to May 22, 2013
in which they described appellant’s condition and treatment.3 In correspondence dated May 31,
2013, he advised that he began treating appellant on January 10, 2013. Dr. Jalali noted his
review of Dr. Biniaurishvili’s report and disagreed with his conclusion that appellant could
return to part-time work, advising that she was not capable of gainful employment due to a
significant pain level and difficulty in concentration. He and his associates continued to submit
treatment notes describing appellant’s condition.
OWCP determined that a conflict in medical evidence had been created between the
opinions of Dr. Jalali and Dr. Biniaurishvili regarding appellant’s work capabilities, and referred
her to Dr. Richard I. Katz, a Board-certified neurologist, for an impartial medical evaluation.
The record contains an OWCP ME023, appointment schedule notification that indicates
that an appointment was made with Dr. Katz after 21 bypasses were made. It also includes an
impartial request form, a referral sheet dated September 26, 2013, and a handwritten request
form.
In a December 2, 2013 report, Dr. Katz noted appellant’s complaints and his review of
the record. He described physical examination findings, advising that she had no objective
reproducible neurologic or neurovascular abnormality and had no restrictions related to the
August 3, 1994 employment injury. In a work capacity evaluation dated December 2, 2013,
Dr. Katz advised that appellant could return to her usual job without restrictions.
On January 16, 2014 OWCP found that the weight of the medical evidence rested with
the opinion of Dr. Katz and proposed to terminate appellant’s compensation benefits because the
medical evidence established that she no longer had residuals or disability due to the
employment injury.
Dr. Jalali submitted a work capacity evaluation dated February 18, 2014 in which he
advised that appellant could work for four hours a day with restrictions to her physical capacity.
By decision dated March 27, 2014, OWCP finalized the termination of appellant’s
wage-loss and medical benefits, effective April 6, 2014, finding that she had no residuals of the
accepted conditions. It found that the weight of the evidence rested with the opinion of Dr. Katz
who performed an impartial medical evaluation.
Appellant timely requested a hearing. She submitted medical evidence previously of
record and treatment notes dated April 15 and May 13, 2014 in which Dr. Purewal and Dr. Jalali
provided physical examination findings, described appellant’s medications, and diagnosed CRPS
3

Dr. Jalali’s associates were Dr. John Park, Dr. Miteswar Purewal, and Dr. Rishin Patel, all Board-certified in
anesthesiology and pain medicine. A treatment note dated March 17, 2014 was completed by Theresa DiJoseph, a
physician assistant.

3

affecting the lower and upper extremities and trunk with associated neuropathic pain.4 In
August 23, 2014 correspondence, Dr. Jalali described appellant’s treatment since
January 20, 2013. He reviewed Dr. Biniaurishvili’s April 1, 2013 report and Dr. Katz’s
December 2, 2013 report and disagreed with their conclusions. Dr. Jalali opined that appellant
suffered from CRPS and had significant functional loss as a result of the pain condition and this
was caused by the August 3, 1994 employment injury. He concluded that she could not return to
any type employment.
On October 3, 2014 counsel forwarded a June 2, 1995 report from Dr. Ronald M.
Fairman, previously of record, and copies of Social Security Administration disability
regulations regarding RSD/CRPS.
At the hearing, held on October 6, 2014, counsel noted that the record did not provide
sufficient evidence to indicate that Dr. Katz was properly selected as the referee physician,
noting that the record contained no required screen shots. Appellant testified that in 1981 she
injured her right knee when she fell at a hotel, and that on May 23, 1992 she was struck by a
truck, hit her head, and suffered a frontal lobe injury. She stated that she did not return to work
until early 1994 and at the time of the August 3, 1994 injury, she was working eight hours a day,
three days a week. Appellant described her job duties and her medical condition and treatment
since the 1994 injury. She testified that she did not have the physical or mental ability to
perform an offered position. Counsel asserted that the claim should be expanded to include
RSD/CRPS of all extremities, a herniated lumbar disc, depression, and anxiety.
Following the hearing, counsel submitted a pleading, maintaining that the termination
should be reversed because Dr. Katz was not properly selected and because appellant continued
to suffer residuals of the accepted conditions. He further maintained that the accepted conditions
should be expanded to include a lumbar herniated disc, depression, anxiety, and the spread of
CRPS to all extremities.
In a statement dated November 4, 2014, appellant described her medical condition and
asserted that the examination by Dr. Katz was brief and incomplete. She further indicated that
she did not receive the proposed termination notice.
By decision dated November 17, 2014, OWCP’s hearing representative affirmed the
March 27, 2014 decision. He found that OWCP followed proper procedures in referring
appellant to Dr. Katz and found the weight of the medical opinion rested with Dr. Katz who
opined that appellant had no work-related residuals.5

4

Appellant also submitted additional treatment notes from physician assistants.

5

The hearing representative also noted that, as Dr. Biniaurishvili opined that right lower extremity CRPS
aggravated anxiety and depression, the claim should be expanded to include these conditions as consequential to the
accepted injury.
Dr. Biniaurishvili concluded, however, that since the record established that the
employment-related CRPS had resolved, it followed that the aggravating effects of the condition had also ceased.

4

LEGAL PRECEDENT -- ISSUE 1
Section 8123(a) provides that, if there is disagreement between the physician making the
examination for the United States and the physician of the employee, the Secretary shall appoint
a third physician who shall make an examination. The implementing regulations state that, if a
conflict exists between the medical opinion of the employee’s physician and the medical opinion
of either a second opinion physician or the medical adviser, OWCP shall appoint a third
physician to make an examination. This is called a referee examination and OWCP will select a
physician who is qualified in the appropriate specialty and who has no prior connection with the
case.6
A physician selected by OWCP to serve as an impartial medical specialist should be one
wholly free to make a completely independent evaluation and judgment. In order to achieve this,
OWCP has developed specific procedures for the selection of the impartial medical specialist
designed to provide adequate safeguards against any possible appearance that the selected
physician’s opinion was biased or prejudiced. The procedures contemplate that the impartial
medical specialist will be selected on a strict rotating basis in order to negate any appearance that
preferential treatment exists between a particular physician and OWCP.7
The Medical Management Application (MMA), which replaced the Physician’s Directory
Service, allows users to access a database of Board-certified specialist physicians and is used to
schedule referee examination. The application contains an automatic and strict rotational
scheduling feature to provide for consistent rotation among physicians and to record the
information needed to document the selection of the physician. If an appointment cannot be
scheduled in a timely manner or cannot be scheduled for some other reason such as a conflict or
the physician is of the wrong specialty, the scheduler will update the application with an
appropriate bypass code. Upon the entering of a bypass code, the MMA will select the next
physician in the rotation.8
Section 3.500.i of OWCP procedure manual provides that, as of December 17, 2012, the
ME023 report must contain the following information:
(1) For the physician selected, the following information will be available on
page 1 of the report: the claimant’s name, case number, and home zip code; the
name, address, phone number, and specialty of the physician selected for the
appointment; the date, time, and type of appointment; and the user ID of the
individual who generated the report.
If physicians were bypassed prior to the selection of this physician, the selected
physician’s information will also be listed at the end of the report in a section that
denotes the physician that was selected for the appointment. The date on which
6

20 C.F.R. § 10.321.

7

Federal (FECA) Procedure Manual, Part 3 -- Medical, OWCP Directed Medical Examinations, Chapter 3.500.5
(May 2013).
8

Id. at 3.500.5.b-e.

5

the appointment was scheduled will also be listed here. (This is not the same as
the date of the actual appointment.)
(2) For each physician bypassed, the report will show the following information
on subsequent pages of the report:
(a) The name, specialty, state, and zip code based upon the information in
the Medical Management application.
(b) A distance based on the approximate number of miles between the
claimant’s home zip code and that physician’s zip code. See 5e(4) for
more detail on the calculation of the distance.
(c) The date on which the last appointment was scheduled with that
physician based upon the information in the Medical Management
application. (This is not the same as the date of the actual appointment.)
If there is no record of any previously scheduled appointment, the report
will list “none.”
(d) The date and time the physician was bypassed, along with the bypass
code (and bypass note, if any). See paragraph 6 of this chapter for a more
detailed discussion of bypass codes.
(3) Every page of the ME023 report (other than the first page) has a certification
statement on the bottom verifying that the report is evidence that the appointment
was scheduled using the Medical Management application in iFECS.
(4) The ME023 report is separated into sections based on the various search
ranges (Initial Zip Cluster Match, 50-Mile Range Outside of Zip Cluster, 75-Mile
Range Outside of Zip Cluster, etc.). If no physicians were found within a
particular range, the report shows this result.9
ANALYSIS -- ISSUE 1
The Board finds that OWCP failed to properly establish that Dr. Katz was properly
selected as the impartial medical specialist.
It is well established that OWCP has an obligation to verify that it selected Dr. Katz in a
fair and unbiased manner. It maintains records for this very purpose. The current record
contains one page of the Form ME023 listing Dr. Katz as the selected physician and that there
had been 21 bypasses before OWCP was able to schedule an appointment with a neurologist.
The ME023 report contains no further information or documentation, such as screen shots or a
bypass log, regarding the 21 bypasses. The record is therefore insufficient for the Board to
verify that Dr. Katz was properly selected.

9

Id. at 3.500.5.i.

6

The Board has placed great importance on the appearance as well as the fact of
impartiality, and only if the selected procedures, which were designed to achieve this result, are
scrupulously followed may the selected physician carry the special weight accorded to an
impartial medical specialist.10 Consequently, the Board finds that Dr. Katz cannot be considered
the impartial medical specialist as OWCP has not met its obligation to establish that he was
properly selected. As the November 17, 2014 decision, that affirmed the termination effective
April 6, 2014, found the weight of the evidence rested with Dr. Katz, it must be reversed.
In light of the Board’s finding regarding Issue 1, Issue 2 is rendered moot.
CONCLUSION
The Board finds that, as OWCP did not properly select Dr. Katz as the referee physician,
the November 17, 2014 decision must be reversed.
ORDER
IT IS HEREBY ORDERED THAT the November 17, 2014 decision of the Office of
Workers’ Compensation Programs is reversed.
Issued: August 13, 2015
Washington, DC

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

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

10

See J.W., Docket No. 12-331 (issued January 14, 2013).

7


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
G.S., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Grand Rapids, MI, Employer
__________________________________________

)
)
)
)
)
)
)
)

Appearances:
Alan J. Shapiro, Esq., for the appellant1
Office of Solicitor, for the Director

Docket No. 19-0277
Issued: August 22, 2019

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
JANICE B. ASKIN, Judge
ALEC J. KOROMILAS, Alternate Judge

JURISDICTION
On November 19, 2018 appellant, through counsel, filed a timely appeal from a
September 27, 2018 merit decision of the Office of Workers’ Compensation Programs (OWCP).
Pursuant to the Federal Employees’ Compensation Act2 (FECA) and 20 C.F.R. §§ 501.2(c) and
501.3, the Board has jurisdiction over the merits of this case.

1

In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for legal
or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. § 501.9(e).
No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An attorney or
representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject to fine or
imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a
representative, prior to approval by the Board, may be reported to appropriate authorities for investigation.
2

5 U.S.C. § 8101 et seq.

ISSUE
The issue is whether appellant has met his burden of proof to establish more than 31 percent
permanent impairment of the left lower extremity, for which he previously received a schedule
award.
FACTUAL HISTORY
On January 6, 2014 appellant, then a 60-year-old city carrier, filed an occupational disease
claim (Form CA-2) alleging that he developed a left knee condition due to factors of his federal
employment including repetitive carrying and delivering mail. He first became aware of his
condition and of its relationship to his employment on September 30, 2013.3 By decision dated
April 1, 2014, OWCP accepted the claim for mechanical loosening of prosthetic knee joint.
On July 18, 2014 appellant underwent an OWCP-approved surgery for revision of left total
knee replacement, both tibial and femoral components for aseptic loosening using cemented and
porous coated implants through medial parapatellar arthrotomy.4 He stopped work on July 18,
2014 and did not return. Appellant received wage-loss compensation on the periodic rolls
beginning October 19, 2014. He subsequently retired from the Postal Service on July 31, 2015.
On May 17, 2016 appellant filed a claim for a schedule award (Form CA-7).
In a development letter dated May 31, 2016, OWCP requested that appellant submit a
permanent impairment evaluation from his attending physician in accordance with the sixth edition
of American Medical Association, Guides to the Evaluation of Permanent Impairment (A.M.A.,
Guides).5 It afforded him 30 days to respond and submit the requested report. No evidence was
received.
By decision dated August 4, 2016, OWCP denied appellant’s claim for a schedule award
finding that the evidence was insufficient to establish that he sustained permanent impairment of
a scheduled member or function of the body. It noted that he failed to provide a permanent
impairment rating from his treating physician.
On August 12, 2016 appellant, through counsel, requested an oral hearing before a
representative of OWCP’s Branch of Hearings and Review. In support of his claim, he submitted
a June 21, 2016 permanent impairment evaluation from Dr. Neil Allen, Board-certified in internal
medicine and neurology.
In his June 21, 2016 report, Dr. Allen provided findings on physical examination, reviewed
diagnostic testing, and determined that appellant had reached maximum medical improvement
3

The record reflects that OWCP File No. xxxxxx411 is the master file and has been combined with OWCP File
No. xxxxxx510. In OWCP File No. xxxxxx510 appellant’s October 20, 2005 occupational injury claim (Form CA-2)
was accepted for temporary aggravation of left knee arthritis.
4

Appellant had a history of total left knee replacement in 2004 and revision of total left knee replacement in 2011.

5

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

2

(MMI). He discussed appellant’s July 18, 2014 left total knee arthroplasty, diagnostic studies, and
noted that an October 21, 2013 bone scan revealed ﬁndings consistent with prosthetic loosening
within the medial and lateral femoral component of the left knee arthroplasty as there was
increased uptake on all three phases at its medial aspect. Dr. Allen reported that x-rays of the left
femur were performed on July 21, 2014 which revealed left knee prosthesis and a nondisplaced
longitudinal fracture extending from the metaphysis of the femur into the diaphysis more than
halfway up the left femur. He further discussed appellant’s November 5, 2014 x-rays of the left
knee which revealed cemented total knee arthroplasty components with long stems and sleeves,
good alignment with no signs of loosening, lysis, or wear, and fracture lines remained well healed.
Utilizing Table 16-3, Knee Regional Grid, of the sixth edition of the A.M.A., Guides, Dr. Allen
assigned a class of diagnosis (CDX) of 4 for the diagnosis of total knee replacement based on the
medical records and the July 18, 2014 operative report, at a grade C default value of 75 percent.6
He discussed findings related to functional history, physical examination, and clinical studies and
assigned grade modifiers of 2, 2, and 4 respectively. Application of the net adjustment formula
warranted movement two places to the left of the default value at class C to class A, totaling 67
percent permanent impairment of the left lower extremity.7
On February 9, 2017 OWCP routed Dr. Allen’s report, a statement of accepted facts
(SOAF), and the case record to Dr. Jovito Estaris, Board-certified in occupational medicine
serving as an OWCP district medical adviser (DMA), for review and evaluation of appellant’s
permanent impairment pursuant to the A.M.A., Guides. Dr. Estaris was also asked to provide a
date of MMI.
In a February 23, 2017 report, the DMA reviewed the case file and determined that
appellant reached MMI on June 21, 2016. He disagreed with Dr. Allen’s left knee permanent
impairment rating and determined that the diagnosis of mechanical loosening of left total knee
replacement amounted to a CDX assignment of 3 at a default value of 37 percent for a fair result
and mild motion deficits.8 The DMA noted that a November 5, 2014 postoperative left knee x-ray
revealed good alignment and no signs of loosening. He assigned a grade modifier of 2 for
functional history (GMFH), a grade modifier of 1 for physical examination (GMPE), and no grade
modifier for clinical studies (GMCS) since it was used for placement of the class. Utilizing the
net adjustment formula warranted movement two places to the left of default grade C to grade A,
totaling 31 percent permanent impairment of the left lower extremity.9
The DMA discussed the differences in his impairment rating from that of Dr. Allen, noting
that they disagreed on values assigned for both the CDX as well as the grade modifiers. He
reported that the criteria for a CDX of 4 for a total knee replacement diagnosis was a poor result
or chronic infection. As such, Dr. Allen’s class 4 assignment was improper as there was no chronic
infection and the diagnosis was aseptic loosening of hardware. The DMA also noted that a class
4 assignment was not appropriate because x-rays of the left knee post second revision showed
6

Id. at 511, Table 16-3.

7

Id. at 521.

8

Supra note 5.

9

Id.

3

good alignment and no signs of loosening. He noted that physical examination findings also failed
to support this class which revealed Lachman grade 1 for minimal instability and mild motion
deficits. The DMA further disagreed with Dr. Allen’s grade modifiers, noting that GMCS could
not be assigned since it was used for placement of the class and that physical examination findings
amounted to a GMPE of 1 rather than 2 as determined by Dr. Allen.
By letter dated March 31, 2017, OWCP provided Dr. Allen with the DMA’s February 23,
2017 report for review and comment. It provided him 30 days to respond. No response was
received.
By decision dated May 31, 2017, OWCP granted appellant a schedule award for 31 percent
permanent impairment of the left lower extremity. The date of MMI was found to be
June 21, 2016. The award covered a period of 89.28 weeks from June 21, 2016 through
March 7, 2018. OWCP noted that the weight of the medical evidence rested with Dr. Estaris,
serving as the DMA, who correctly applied the A.M.A., Guides to Dr. Allen’s June 21, 2016
examination findings.
On June 7, 2017 appellant, through counsel, requested an oral hearing before a
representative of OWCP’s Branch of Hearings and Review. A hearing was held on November 13,
2017 at which appellant testified in support of his claim and described the effects of his
employment injury.
By decision dated January 29, 2018, OWCP’s hearing representative affirmed the May 31,
2017 decision. She noted that the DMA provided sufficient medical rationale in support of his
opinion and properly applied Dr. Allen’s examination findings to establish 31 percent permanent
impairment of the left lower extremity. The hearing representative further noted that Dr. Allen
incorrectly applied the A.M.A., Guides and failed to respond to OWCP’s request for his review
and comment.
On May 21, 2018 appellant, through counsel, requested reconsideration of OWCP’s
decision. Counsel noted submission of a new medical report from Dr. Allen not previously
considered in support of appellant’s schedule award claim.
In an April 12, 2018 medical report, Dr. Allen reevaluated appellant, provided physical
examination findings, and discussed diagnostic studies. Based on medical records and physical
examination ﬁndings of mild motion deﬁcits in ﬂexion and extension, he diagnosed a class 4
impairment at a default value of 67 percent for a left total knee arthroplasty, poor result.10
Dr. Allen noted that appellant underwent a left total knee arthroplasty in 2004 and a second in
2005, followed by two revisions in 2011 and 2014. He explained that when grading outcomes for
a total knee arthroplasty, one is to determine class placement in reference to the primary procedure.
Unlike arthroscopic procedures, the number of joint replacements one may undergo in a lifetime
is limited, especially given the risks. Dr. Allen reported that appellant was unlikely to be eligible
for additional joint replacement procedures and would likely out live his current prosthetic,
severely limiting his function later in life. He explained that appellant’s revision procedure in
2014 was the result of mechanical loosening of his prosthetic. This loosening was the direct result
10

Id.

4

of trauma, rather than the age-related breakdown of his hardware, and was an undesired (poor)
outcome of the primary knee arthroplasty procedure. Dr. Allen noted that GMCS and GMPE were
not considered in the net adjustment as they were used for placement of the class, and GMFH was
also not considered as it varied by two or more from clinical studies and physical examination. 11
Therefore, he determined that the grade C default value remained unchanged and concluded that
appellant sustained 67 percent permanent impairment of the left lower extremity.
On August 15, 2018 OWCP routed a SOAF and Dr. Allen’s June 21, 2016 report and
updated April 12, 2018 report, to Dr. Estaris the DMA, for review and determination regarding
whether his previous 31 percent left lower extremity impairment rating remained unchanged. It
also provided him additional records to assist in his impairment review, including: results of
diagnostic tests performed on October 21 and December 9, 2013, July 18, and 21, and August 1,
2014; a copy of the July 18, 2014 operative report; physical therapy notes dated July 22 to
October 30, 2014; and additional progress notes dated November 5, 2014 from Dr. Bryan Pack, a
Board-certified orthopedic surgeon; and February 22, 2016, from Dr. Sam Ho, a Board-certified
neurologist.
In a supplemental August 20, 2018 medical report, the DMA reported that his prior 31
percent permanent impairment rating for the left lower extremity remained unchanged, referencing
his previous February 23, 2017 report. He argued that Dr. Allen provided an inconsistent
impairment rating as his June 21, 2016 report used class 4 with a 75 percent default value while
his April 12, 2018 report used class 4 with a 67 percent default value. The DMA noted that
Dr. Allen incorrectly utilized mild motion deficits in flexion and extension for a class 4 impairment
when the criteria was poor result (poor position), moderate to severe instability, and/or moderate
to severe motion deficit. He reported that Dr. Allen’s findings correlated with a CDX of 3. The
DMA noted that the last x-ray report of the left knee showed that alignments were good overall,
no loosening, good overall ﬁxation, fracture femur, healed, callus formation, and no radiolucency.
He reported that this x-ray showed that the prosthesis was in a good position, not a poor position,
which was the criteria for a class 4 diagnosis. The DMA further reported that Dr. Allen noted
these findings in his report when stating that x-rays of the left knee performed on November 5,
2014 revealed cemented total knee arthroplasty components with long stems and sleeves, good
alignment with no signs of loosening, lysis, or wear, and fracture lines remained well healed. He
concluded that physical examination and clinical study findings supported a class 3 placement,
amounting to 31 percent permanent impairment of the left lower extremity due to adjustments for
nonkey modifiers.
By decision dated September 27, 2018, OWCP denied modification of its January 29, 2018
decision, finding that appellant was entitled to no more than 31 percent permanent impairment of
the left lower extremity previously received.
LEGAL PRECEDENT
The schedule award provision of FECA and its implementing regulations set forth the
number of weeks of compensation payable to employees sustaining permanent impairment from
11

Id. at 517.

5

loss or loss of use of scheduled members or functions of the body.12 However, FECA does not
specify the manner in which the percentage of loss shall be determined. For consistent results and
to ensure equal justice under the law to all claimants, good administrative practice necessitates the
use of a single set of tables so that there may be uniform standards applicable to all claimants.
Through its implementing regulations, OWCP adopted the A.M.A., Guides 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 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 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
OWCP’s procedures provide that, after obtaining all necessary medical evidence, the file
should be routed to a DMA for an opinion concerning the nature and percentage of impairment in
accordance with the A.M.A., Guides, with the medical adviser providing rationale for the
percentage of impairment specified.19

12

5 U.S.C. § 8107; 20 C.F.R. § 10.404.

13

20 C.F.R. § 10.404. See also Ronald R. Kraynak, 53 ECAB 130 (2001).

14

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

Isidoro Rivera, 12 ECAB 348 (1961).

16

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

17

Id. at 515-22.

18

Id. at 23-28.

19

See supra note 9 at Chapter 2.808.6(e) (March 2017).

6

ANALYSIS
The Board finds that appellant has not met his burden of proof to establish more than 31
percent permanent impairment of the left lower extremity, for which he previously received a
schedule award.
In support of his schedule award claim, appellant submitted medical reports from
Dr. Allen, his attending physician, dated June 21, 2016 and April 12, 2018. In his most recent
April 12, 2018 report, Dr. Allen calculated 67 percent permanent impairment of the left lower
extremity based on a class 4 diagnosis of total knee replacement. In evaluating appellant’s
permanent impairment of the left knee, he placed appellant in a class 4 based upon the poor
outcome of his 2011 revision procedure and because appellant was unlikely to be eligible for
additional joint replacement procedures and would likely out live his current prosthetic. The Board
finds that Dr. Allen’s impairment opinion was not sufficiently rationalized as he did not explain
why appellant’s good result following his 2014 revision procedure, rather than a poor result from
the 2011 procedure, placed appellant in class 4. Furthermore, Dr. Allen’s opinion regarding
appellant’s future condition was speculative in nature, and therefore insufficient to establish
appellant’s current extent of permanent impairment.20 A schedule award is appropriate where the
physical condition of an injured member has stabilized, despite the possibility of an eventual
change in the degree of functional impairment in the member.21
OWCP properly referred Dr. Allen’s report to Dr. Estaris, serving as a DMA for review.22
In his August 20, 2018 report, the DMA related that Dr. Allen had improperly placed appellant’s
total knee replacement in class 4 when it should have been placed in class 3. He explained that a
class 4 placement was improper because appellant’s examination findings revealed mild motion
deficits and mild laxity. The DMA explained that appellant’s last x-ray report of the left knee
showed good overall alignment, no loosening, good overall ﬁxation, fracture femur, healed, callus
formation, and no radiolucency. He reported that this x-ray showed that the prosthesis was in a
good position. The Board finds that pursuant to Table 16-3, a class 4 placement for a total knee
replacement requires poor result (poor position), moderate to severe instability, and or moderate
to severe motion deficit.23 As appellant did not meet this criteria, the DMA properly placed
appellant in class 3 for a fair result (fair position, mild instability and/or mild motion deficit).
While the default rating for total knee replacement class 3 is 37 percent, Dr. Estaris properly
explained that GMFH was 2, GMPE was 1, and no GMCS was assigned since it was used for
placement of the class. Utilizing the net adjustment formula the default rating of 37 percent was
moved two places to the left for a total 31 percent permanent impairment of the left lower
extremity. The DMA also explained that Dr. Allen had improperly assigned GMPE as appellant
only had minimal instability and mild motion deficits. The Board finds that the impairment rating

20

J.A., Docket No. 16-1621, 16-1622 (issued May 12, 2017).

21

See T.C., Docket No. 17-1906 (issued May 25, 2018).

22

Supra note 16.

23

Supra note 6.

7

from the DMA represents the weight of the medical evidence in this case as he properly applied
the appropriate provisions of the A.M.A., Guides to the clinical findings of record.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 more than 31
percent permanent impairment of the left lower extremity, for which he has previously received a
schedule award.
ORDER
IT IS HEREBY ORDERED THAT the September 27, 2018 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: August 22, 2019
Washington, DC

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

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

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

24

J.H., Docket No. 18-1207 (issued June 20, 2019).

8


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
E.M., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Compton, CA, Employer

)
)
)
)
)
)
)
)

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

Docket No. 15-1497
Issued: December 18, 2015

Case Submitted on the Record

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

JURISDICTION
On July 1, 2015 appellant filed a timely appeal from a June 19, 2015 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 the claim.
ISSUE
The issue is whether appellant met his burden of proof to establish a recurrence of a
medical condition causally related to his June 6, 2006 employment injury.
FACTUAL HISTORY
On June 19, 2006 appellant, then a modified letter carrier, filed a traumatic injury (Form
CA-1) alleging that he experienced chest pains, headaches and insomnia on June 6, 2006 due to
ongoing harassment by Postmaster Mike McGee and noncompliance with a May 24, 2006
1

5 U.S.C. § 8101 et seq.

grievance decision. He stopped work on June 9, 2006 and returned to work on July 13, 2006.
OWCP accepted the claim for anxiety disorder, depressive disorder, psychological factors
affecting medical condition and paid appropriate compensation benefits. Appellant stopped
work again on September 19, 2007 and has not returned.
Appellant filed a (Form CA-7) claim for compensation, alleging wage loss since
September 19, 2007. In a November 1, 2007 report, Barbara A. Ammon, Ph.D., a clinical
psychologist related that he alleged unfair treatment on July 12, 2007 when management issued
another job offer which entailed custodial duties outside his medical restrictions and that he also
felt unfairly treated on August 29, 2007 where management issued another job offer requiring
repetitive fingering and grasping of mail. She concluded that appellant’s emotional condition
was employment related.
In a November 30, 2007 decision, OWCP denied his claim of recurrent disability for
work beginning September 19, 2007. It found that the factual and medical evidence of record
indicated that appellant’s current emotional condition was attributed to new allegations and
events or incidents pertaining to light-duty jobs offered in OWCP File No. xxxxxx760.2
Appellant’s case in File No. xxxxxx693 was administratively closed October 1, 2011.
On July 8, 2014 appellant telephoned OWCP and requested his claim OWCP File No.
xxxxxx693 be reopened for psychological treatment. Medical evidence from Dr. Ammon was
received. In a May 8, 2014 report, she noted that appellant had been disabled from his usual
employment since September 19, 2007 due to his accepted conditions of anxiety disorder,
depressive disorder, and psychological factors affecting medical condition. Dr. Ammon opined
that he was not able to participate in vocational rehabilitation. In a June 19, 2014 report, she
noted that appellant recently experienced a worsening of his symptoms with regard to his
accepted conditions under File No. xxxxxx693. Dr. Ammon further noted that he had requested
that she provide individual psychotherapy and indicated that 12 to 15 sessions were necessary. A
June 19, 2014 request for authorization was also received.
By letter dated July 8, 2014, OWCP advised appellant of the definition of a recurrence of
a medical condition for medical treatment only. It went on to explain that to be entitled to
additional medical treatment for his work injury after being released from care or not receiving
care for a significant period of time, the evidence must demonstrate that the claimed recurrent
condition is a spontaneous return or increase of disability of the accepted work-related
condition(s) without intervening cause. It further advised him that the factual evidence must
clarify the issue of intervening facts and that the medical evidence must demonstrate that the
current diagnosed condition was causally related to the original work factor(s). Appellant was
2

In Master OWCP file number xxxxxx760, appellant alleged that on September 3, 1996 he sustained left upper
extremity injury due to repetitive mail handling. This claim was accepted for left thumb metacarpophalangeal
arthralgia, left shoulder strain and impingement syndrome. Appellant received a schedule award for 20 percent
permanent impairment of the left upper extremity on July 14, 1998, and an award for 41 percent permanent left
upper extremity on March 9, 2000. He had alleged that job offers of July and August 2007 violated his medical
restrictions in file number xxxxxx760 and caused emotional distress. Appellant elected to receive wage-loss
benefits in file number xxxxxx760 as of August 6, 2013. He was referred to vocational rehabilitation on
April 16, 2014.

2

requested to respond to a questionnaire to substantiate the factual elements in his claim and to
submit a comprehensive medical narrative report from a qualified physician within 30 days.
In a July 3, 2014 response to OWCP’s questionnaire, appellant stated that his condition
never went away and that he had the same symptoms. He advised that he had been off work
since September 19, 2007. In a September 15, 2014 Form CA-7 appellant claimed compensation
for the period September 19, 2007 through August 6, 2013.3
On August 7, 2014 medical reports from Dr. Ammon were received pertaining to care
appellant received from September 27, 2007 to April 2, 2008. Dr. Ammon reported his
psychological symptoms developed reactive to employment-related stress and reiterated that he
was precluded from returning to the employing establishment. In a July 31, 2014 report, she
advised appellant requested authorization to resume treatment for his emotional condition that
developed reactive to employment-related stress. Dr. Ammon noted his accepted conditions and
indicated that, in her December 13, 2007 report, she had noted that he had experienced
deterioration in his emotional condition reactive to ongoing supervisory maltreatment and denial
of limited duty within his restrictions. Appellant last worked September 19, 2007 and OWCP
denied disability benefits. Dr. Ammon noted that he received individual psychotherapy with her
through September 2009 as he continued to experience psychological symptoms. Appellant
recently resumed treatment as he continued to experience emotional distress reactive to his
treatment by the employing establishment in not honoring his medical restrictions. He realized
the ongoing extent of his distress when he was contacted regarding referral for vocational
rehabilitation. Dr. Ammon opined that appellant continued to experience anxiety disorder,
depressive disorder, and psychological factors with conditions classified elsewhere and required
a regimen of individual psychotherapy.
By decision dated September 22, 2014, OWCP denied appellant’s claim for recurrence of
medical condition as he had not established that he required additional medical treatment due to
a worsening of his accepted work-related condition in OWCP File No. xxxxxx693 without
intervening cause. The decision noted that the earlier report of Dr. Ammon dated November 1,
2007, referenced multiple intervening allegations of harassment from the employing
establishment, and opined that those intervening causes may have been the cause of the material
worsening of appellant’s accepted conditions. OWCP advised that appellant’s claim remained
closed for medical care.
On March 25, 2015 OWCP received appellant’s March 16, 2015 request for
reconsideration.
In a March 26, 2015 work status report, Dr. Joan W. Wright, a Board-certified hand
surgeon, indicated that appellant needed to return to disability retirement status previously
accepted in 2007. She opined that he was restricted from computer use due to his hand and
shoulder conditions and that he was not capable of participating in the rehabilitation program.
Reports from Dr. Ammon were received. In a May 8, 2014 report, Dr. Ammon indicated
that appellant had been disabled from his usual employment since September 19, 2007. She
3

The record does not indicate that OWCP has formally adjudicated this claimed period of disability.

3

opined that he could not work for the employing establishment or any employing establishment
due to his accepted conditions of anxiety disorder, depressive disorder, and psychological factors
affecting his medical condition. Dr. Ammon also opined that appellant was unable to participate
in vocational rehabilitation. Also included was a duplicative copy of her July 31, 2014 report.
In a May 6, 2015 report, Dr. Ammon noted that appellant requested a resumption of
individual psychotherapy with her due to the aggravation of his psychological and
psychophysiological symptoms since participating in vocational rehabilitation beginning midMarch 2015. She indicated that his emotional condition deteriorated reactive to a worsening of
his orthopedic symptoms and the pressures of the program. Dr. Ammon opined that appellant’s
high level of anxiety and depression affected his sleep, he was distracted by his orthopedic pain
and was unable to concentrate and retain new material. She also indicated that he had difficulty
following instructions and comprehending and completing tests. Dr. Ammon noted that she had
previously precluded appellant from returning to any type of work and that he was unable to
participate in vocational rehabilitation. She diagnosed anxiety disorder, depressive disorder, and
psychological factors with conditions classified elsewhere.
By decision dated June 19, 2015, OWCP denied modification of its September 22, 2014
decision. It found that there was insufficient evidence to establish a causal relationship between
appellant’s current condition “to which you require treatment and your June 6, 2006 work-related
injury.”
LEGAL PRECEDENT
A recurrence of a medical condition is defined as a documented need for further medical
treatment after release from treatment for the accepted condition or injury.4 Continuous
treatment for the original condition or injury is not considered a recurrence of a medical
treatment nor is an examination without treatment.5 As distinguished from a recurrence of
disability, a recurrence of a medical condition does not involve an accompanying work
stoppage.6 It is the employee’s burden to establish that the claimed recurrence is causally related
to the original injury.7 Causal relationship is a medical issue that can generally be resolved only
by rationalized medical opinion evidence.8
To establish that a claimant’s alleged recurrence of the condition was caused by the
accepted injury, medical evidence of bridging symptoms between his or her present condition
and the accepted injury must support the physician’s conclusion of a causal relationship.9
4

20 C.F.R. § 10.5(y).

5

Id.

6

Id. at § 10.5(x).

7

Id. at § 10.104. See also Mary A. Ceglia, 55 ECAB 626, 629 (2004).

8

See Jennifer Atkerson, 55 ECAB 317 (2004).

9

Mary A. Ceglia, supra note 7.

4

ANALYSIS
OWCP accepted that appellant’s June 6, 2006 employment injury resulted in anxiety
disorder, depression, and psychological factors affecting his medical condition. The record
indicates that appellant has been off work since September 19, 2007, Dr. Ammon related that he
last received medical care for his accepted emotional conditions in September 2009. Appellant
subsequently filed a claim for medical treatment of his accepted conditions commencing
June 2014 due to the employment-related emotional conditions of June 6, 2006. He, therefore,
has the burden to show that his need for treatment was due to a worsening of the accepted workrelated conditions, without intervening cause.10
There is no indication in the record that appellant’s accepted medical conditions naturally
progressed or spontaneously worsened without intervening cause. There is also no medical
evidence from a physician who, on the basis of a complete and accurate factual and medical
history, concludes that the need for medical treatment for emotional conditions was causally
related to the June 6, 2006 employment injuries, and supports that conclusion with sound
medical reasoning.11
Numerous reports were received from Dr. Ammon, who noted that appellant recently
experienced a worsening of his psychiatric conditions and that he requested authorization of
psychotherapy. However, she failed to offer any medical rationale to establish that his need for
further treatment was in fact related to the accepted June 6, 2006 employment injury.12 In her
July 31, 2014 report, Dr. Ammon referenced multiple intervening allegations of harassment from
appellant’s employing establishment pertaining to his other accepted claim for left upper
extremity injury. While those intervening factors may have caused a worsening of the accepted
conditions, it does not support a natural progression or spontaneous worsening of the accepted
emotional conditions, from this accepted claim.
For example, in her May 6, 2015 medical report, Dr. Ammon indicated that appellant’s
emotional conditions of anxiety disorder, depression, and psychological factors with conditions
classified elsewhere deteriorated as a reaction to a worsening of his orthopedic symptoms and the
pressures of the vocational rehabilitation program, which he began mid-March 2015. However,
she did not opine that his emotional condition for which treatment was required was due to his
June 6, 2006 work injury. Rather, Dr. Ammon attributed appellant’s need for treatment due to
participation in the vocational rehabilitation program under claim number xxxxxx760.
Appellant’s participation in the vocational rehabilitation program constitutes an intervening
factor. Dr. Ammon has not submitted any medical report which explains why his June 6, 2006
accepted injury now requires further medical treatment.

10

Where the treatment for an employment-related condition is continuous, OWCP has the burden of proof to
terminate medical benefits and must establish that there are no residuals of the employment-related condition that
require further treatment. Furman G. Peake, 41 ECAB 361 (1990). Such is not the case here.
11

Ronald A. Eldridge, 53 ECAB 218 (2001); see Nicolea Bruso, 33 ECAB 1138, 1140 (1982).

12

Id.

5

In his March 26, 2015 work status report, Dr. Wright indicated that appellant needed to
return to disability retirement status previously accepted and that he was not capable of
participating in the vocational rehabilitation program. He also restricted appellant from
computer use due to his hand and shoulder conditions. This report was of no probative value
regarding the issue of whether appellant required further medical treatment of his accepted
emotional conditions arising from the June 6, 2006 employment injury.
Appellant’s statements as to why he requires medical treatment for his emotional
conditions are irrelevant. An award of compensation may not be made on the basis of surmise,
conjecture, speculation, or on his unsupported belief of causal relation.13
The Board finds that the evidence submitted by appellant lacks adequate rationale to
establish a causal connection between the alleged recurrent need for treatment and the accepted
June 6, 2006 employment injury. Appellant had the burden of submitting sufficient medical
evidence to document the need for further medical treatment. He did not submit such evidence
as required and failed to establish a need for continuing medical treatment.14 The Board also
notes that while appellant has filed claims for disability benefits, the decision on appeal only
concerns his claim for medical benefits. Accordingly, the Board will affirm OWCP’s June 19,
2015 decision.
Appellant may submit new evidence or argument as part of 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 his burden of proof to establish a recurrence of
his medical conditions causally related to his June 6, 2006 employment injury.

13

Patricia J. Glenn, 53 ECAB 159 (2001); Ausberto Guzman, 25 ECAB 362 (1974).

14

See P.Q., Docket No. 14-1905 (issued May 26, 2015); J.F., 58 ECAB 331 (2006).

6

ORDER
IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs
decision dated June 19, 2015 is affirmed.
Issued: December 18, 2015
Washington, DC

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

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

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

7