United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
M.G., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Seaford, NY, Employer
__________________________________________

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

Docket No. 18-1616
Issued: April 9, 2020

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Chief Judge
CHRISTOPHER J. GODFREY, Deputy Chief Judge
PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION
On August 21, 2018 appellant filed a timely appeal from a May 8, 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. 2
ISSUE
The issue is whether appellant has met her burden of proof to establish a right wrist
condition causally related to the accepted March 11, 2017 employment incident.

1
2

5 U.S.C. § 8101 et seq.

The Board notes that, following the May 8, 2018 decision, OWCP received additional evidence. However, the
Board’s Rules of Procedure provides: “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. Evidence not before OWCP will not be considered by the Board
for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this evidence for
the first time on appeal. Id.

FACTUAL HISTORY
On March 13, 2017 appellant, then a 42-year-old sales, services, and distribution associate,
filed a traumatic injury claim (Form CA-1) alleging that she injured her right wrist on March 11,
2017 when pulling a “beamer” with mail while in the performance of duty. She did not stop work.
The record contains the first page of an authorization for examination and/or treatment
(Form CA-16) completed by the employing establishment on March 13, 2017 indicating that
appellant was authorized to seek medical treatment.
In a report dated March 13, 2017, Dr. Scott Flashner, an emergency medicine specialist,
examined appellant for complaints of wrist pain that had begun two days earlier at work when she
“pushed” a heavy object. On examination he noted swelling, tenderness, and pain with extension,
flexion, and radial bending of the right wrist. Dr. Flashner diagnosed wrist sprain and strain and
prescribed medication. 3
In a report dated March 15, 2017, Dr. Ronald Light, a Board-certified orthopedic surgeon,
evaluated appellant for right wrist pain after “pulling” a heavy machine at work a few days earlier.
On examination he found tenderness to palpation over the first dorsal extensor compartment and
a positive Finkelstein’s test. Dr. Light diagnosed right wrist de Quervain’s tendinitis and
administered a cortisone injection.
In a duty status report (Form CA-17) dated March 22, 2017, Dr. Light diagnosed
de Quervain’s tendinitis of the right wrist and found that appellant was unable to work. In an
accompanying work exemption request of even date, he found that she should not return to work
until April 5, 2017.
In a follow-up report dated March 22, 2017, Dr. Light noted that appellant had reported
improvement after the injection. On examination of the right wrist he noted tenderness to palpation
over the first dorsal extensor compartment with a positive Finkelstein’s test. Dr. Light
recommended continued observation and physical therapy.
In a Form CA-17 report dated April 5, 2017, Dr. Light diagnosed tendinitis of the right
wrist and found that appellant was totally disabled from work. In an accompanying work
exemption request of even date, he advised that she should not return to work until April 27, 2017.
In a development letter dated April 11, 2017, OWCP informed appellant that the evidence
submitted was insufficient to establish her claim. It advised her of the type of factual and medical
evidence necessary to establish her claim. OWCP afforded appellant 30 days to submit additional
evidence and respond to its inquiries.
In a Form CA-17 report dated April 26, 2017, Dr. Light diagnosed de Quervain’s tendinitis
of the right wrist and found that appellant was totally disabled. In an accompanying work

3

X-rays of appellant’s right wrist taken on March 13, 2017 were unremarkable.

2

exemption request of even date, he advised that she not return to work until May 10, 2017. On
May 2, 2017 Dr. Light extended the work exemption request to May 24, 2017.
In an attending physician’s report (Form CA-20) dated May 3, 2017, Dr. Light diagnosed
tendinitis and noted a history of appellant injuring her right hand pushing a bulk mail carrier
through double doors. He checked a box marked “yes” indicating that her condition was caused
or aggravated by an employment activity, noting that she had severe pain, swelling, stiffness, and
inability to lift.
Appellant submitted reports from physical therapists dated from March 27 through
May 3, 2017.
By decision dated May 12, 2017, OWCP denied appellant’s traumatic injury claim finding
that the medical evidence of record was insufficient to establish a right wrist condition causally
related to the accepted March 11, 2017 employment incident as she had not submitted a
physician’s well-reasoned opinion supported by objective findings explaining how the work
incident of March 11, 2017 caused or aggravated her diagnosed right wrist conditions.
On May 24, 2017 appellant requested a review of the written record before a representative
of OWCP’s Branch of Hearings and Review.
In a Form CA-17 report dated May 24, 2017, Dr. Light diagnosed de Quervain’s tendinitis
of the right wrist and found that appellant was disabled from employment. In an accompanying
work exemption request of even date, he advised that she should not return to work until
June 27, 2017. In a follow-up report dated May 24, 2017, Dr. Light noted that appellant had
experienced relief from her right wrist de Quervain’s tendinitis for one week after her injection.
On examination he noted tenderness to palpation along the first dorsal extensor compartment and
a positive Finkelstein’s test. Dr. Light opined, “Since [appellant] works at a job where there is
repetitive motions involving her right wrist, she was told that this condition is causally related to
her work activity and will not likely improve, without further therapeutic intervention.” He noted
that, as her condition was employment related, he would seek authorization from OWCP for a
de Quervain’s release of the right wrist’s first extensor compartment, which he considered a
medical necessity.
Appellant submitted reports from physical therapists dated from May 22 through
June 23, 2017.
In a Form CA-17 report dated June 26, 2017, Dr. Vincent Leddy, a Board-certified
internist, diagnosed tendinitis of the right wrist and found that appellant could not return to work.
A magnetic resonance imaging (MRI) scan of appellant’s right wrist dated August 10, 2017
demonstrated a prominent bifid median nerve within the carpal tunnel, to be correlated clinically
for carpal tunnel syndrome.
In a Form CA-17 report dated August 28, 2017, Dr. Light diagnosed right carpal tunnel
syndrome and advised that appellant was disabled from employment.

3

By decision dated September 5, 2017, the hearing representative affirmed OWCP’s
May 12, 2017 decision finding that appellant had not submitted medical evidence addressing
causal relationship between the accepted March 11, 2017 employment incident and the diagnosed
condition.
On October 2, 2017 appellant requested reconsideration of OWCP’s September 5, 2017
decision.
Appellant submitted a July 7, 2017 report from Dr. Joseph Stubel, a Board-certified
orthopedic surgeon. Dr. Stubel noted that she complained of right wrist pain. He obtained a
history of appellant injuring her wrist at work on March 11, 2017 while “pushing” a “beamer”
through double doors that rolled back. On examination of the right wrist, Dr. Stubel noted
tenderness to palpation and a positive Finkelstein’s test at the first dorsal compartment, reduced
dorsiflexion strength, reduced volar flexion strength, a weak pinch, and a weak grip. He diagnosed
wrist pain and recommended a right wrist MRI scan.4 In an accompanying Form CA-17 report of
even date, Dr. Stubel diagnosed carpal tunnel syndrome and found appellant disabled from
employment. He reiterated this diagnosis and disability determination in Form CA-17 reports
dated August 22 and September 26, 2017.
In an August 22, 2017 report, Dr. Stubel noted his findings on examination of the right
wrist, including tenderness to palpation at the volar aspect of the wrist, a positive Tinel’s test, and
a positive Phalen’s sign. He noted that the MRI scan suggested possible carpal tunnel syndrome.
In a report dated September 26, 2017, Dr. Stubel provided a history of appellant
experiencing a right wrist injury at work in March 2017 that continued to cause pain and numbness.
He noted the examination findings and diagnosed carpal tunnel syndrome and wrist pain.
Dr. Stubel opined that appellant’s accident in March 2017 caused her carpal tunnel syndrome.
In a Form CA-17 reports dated September 4 and 26, 2017, Dr. Stubel diagnosed carpal
tunnel syndrome and found that appellant was unable to work.
In a report dated October 4, 2017, Dr. Farshad D. Hannanian, a neurologist, discussed
appellant’s complaints of increased right wrist pain, weakness, and numbness radiating into the
fingers of her right hand. He noted that she attributed her symptoms to a March 13, 2017 injury
at work. Dr. Hannanian diagnosed carpal tunnel syndrome and wrist pain. He opined that
appellant’s symptoms were causally related to the March 13, 2017 employment incident.
Appellant submitted a Form CA-17 report signed by a physician assistant dated
October 19, 2017.
In a report dated October 20, 2017, Dr. Stubel examined appellant and noted that she could
resume her usual work. In an accompanying Form CA-17 report of even date, he found that she
could resume work at full duty on October 23, 2017.

4
The Board notes that this MRI scan report had been included as a part of the case record prior to the September 5,
2017 decision.

4

By decision dated January 11, 2018, OWCP denied modification of its September 5,
2017decision.
On February 13, 2018 appellant requested reconsideration of OWCP’s January 11, 2018
decision.
Thereafter, OWCP received a January 30, 2018 report by Dr. Stubel, who noted that the
right wrist pain and carpal tunnel syndrome were “secondary to [appellant’s] work at the
[employing establishment], which included repetitive moving of packages, and then it [was]
aggravated by an injury in which her right hand and wrist were hit with a beam at work.”
In a report dated January 31, 2018, Dr. Hannanian opined that appellant’s diagnosed carpal
tunnel syndrome resulted from repetitive use of her upper extremity at the employing
establishment, but had been exacerbated when her wrist was struck by a beam.
By decision dated May 8, 2018, OWCP denied modification of its January 11, 2018
decision.
LEGAL PRECEDENT
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 timely filed within the applicable
time limitation period of FECA,5 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.6 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. 7
To determine if an employee has sustained a traumatic injury in the performance of duty,
OWCP begins with an analysis of whether fact of injury has been established. Fact of injury
consists of two components that must be considered in conjunction with one another. The first
component is whether the employee actually experienced the employment incident that allegedly
occurred.8 The second component is whether the employment incident caused a personal injury. 9
Rationalized medical opinion evidence is required to establish causal relationship. The
opinion of the physician must be based on a complete factual and medical background, must be
5

S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB
153 (1989).
6
J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40
ECAB 312 (1988).
7

K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014);
Delores C. Ellyett, 41 ECAB 992 (1990).
8

B.P., Docket No. 16-1549 (issued January 18, 2017); Elaine Pendleton, 40 ECAB 1143 (1989).

9

M.H., Docket No. 18-1737 (issued March 13, 2019); John J. Carlone, 41 ECAB 354 (1989).

5

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 incident. 10
Neither the mere fact that, a disease or condition manifests itself during a period of employment,
nor the belief that the disease or condition was caused or aggravated by employment factors or
incidents is sufficient to establish causal relationship. 11
ANALYSIS
The Board finds that appellant has not met her burden of proof to establish a right wrist
condition causally related to the accepted March 11, 2017 employment incident.
In reports dated October 4, 2017 and January 31, 2018, Dr. Hannanian noted that he had
evaluated appellant for continued right carpal tunnel syndrome and pain and weakness in the right
hand. He attributed the carpal tunnel syndrome to her repetitive work activities at the employing
establishment and indicated that her condition had been exacerbated when a beam had struck her
wrist. While Dr. Hannanian provided an opinion as to causal relationship in his reports, he failed
to provide rationale for his conclusion that being struck by a beam aggravated appellant’s carpal
tunnel syndrome.12 The Board has held that a report is of limited probative value regarding causal
relationship if it does not contain medical rationale explaining how a given medical condition is
causally related to an employment incident.13 This report is therefore insufficient to establish
appellant’s claim.
In support of her claim appellant also submitted a series of medical reports by Dr. Stubel.
Dr. Stubel consistently noted examination findings and diagnosed right wrist pain and carpal
tunnel syndrome. He opined that appellant’s conditions were causally related to performing
repetitive employment duties, including moving packages, and that the conditions were aggravated
at work when a beam struck her right hand and wrist. In his September 26, 2017 report, Dr. Stubel
concluded that the diagnosed conditions were due to her “employment incident.” He did not,
however, explain in any of his reports how the accepted employment incident was sufficient to
have caused or aggravated the diagnosed conditions. As noted above, a medical opinion lacking
medical rationale is of limited probative value on the issue of causal relationship and is insufficient
to establish appellant’s claim.14
In a series of medical reports on May 24, 2017, Dr. Light diagnosed right wrist
de Quervain’s tendinitis and related appellant’s condition to repetitive motion at work. He
indicated that he would request authorization from OWCP for a de Quervain’s release of the first
10

S.S., Docket No. 18-1488 (issued March 11, 2019).

11

J.L., Docket No. 18-1804 (issued April 12, 2019).

The Board notes that the accepted mechanism of injury is that appellant was “pulling a beamer with mail.” The
Board has held that medical opinions based on an incomplete or inaccurate history are of limited probative value. See
G.E., Docket No. 19-1190 (issued November 26, 2019); T.O., Docket No. 17-0093 (issued March 22, 2018).
12

13

D.L., Docket No. 19-0900 (issued October 28, 2019); Y.D., Docket No. 16-1896 (issued February 10, 2017);
C.M., Docket No. 14-0088 (issued April 18, 2014).
14

Id.

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extensor compartment of the right wrist. Dr. Light failed to attribute the diagnosed condition of
de Quervain’s tendinitis to the accepted employment incident. Instead, he attributed it to the
repetitive nature of appellant’s federal employment which is not the accepted incident in this
claim.15 Therefore, these May 24, 2017 reports are of diminished probative value on the issue of
causal relationship and are insufficient to establish her claim.
In a report dated March 15, 2017, Dr. Light examined appellant for complaints of pain in
the right wrist after she had injured her right wrist a work a few days earlier pulling a heavy
machine. He diagnosed right wrist de Quervain’s tendinitis. On March 13, 2017 Dr. Flashner
examined appellant for complaints of wrist pain that had begun two days earlier at work when she
had “pushed” a “beamer” of mail at work. He diagnosed right wrist sprain and strain. In a report
dated July 7, 2017, Dr. Stubel examined appellant for complaints of right wrist pain and obtained
a history of her injury of her right wrist at work on March 11, 2017 when a “beamer” that she was
pushing through double doors at work had rolled back. He diagnosed right wrist pain. These
reports are found to contain an incorrect history of injury and thus are of limited probative value. 16
Moreover, without explaining physiologically how the accepted employment incident caused or
contributed to the diagnosed condition, these reports are of limited probative value.17
In a Form CA-20 report dated May 3, 2017, Dr. Light diagnosed de Quervain’s tendinitis
of the right wrist, noting that the injury occurred on March 11, 2017 when appellant was pushing
a “bulk mail carrier” through double doors, which pushed her right hand back. He checked a box
marked “yes” indicating that her condition was caused or aggravated by an employment activity,
noting that she had severe pain, swelling, stiffness, and inability to lift. The Board has held that
when a physician’s opinion on causal relationship consists only of checking “yes” to a form
question, without explanation or rationale, that opinion is of diminished probative value. 18
Consequently, the report of May 3, 2017 is insufficient to establish appellant’s claim.
In a March 22, 2017 progress report, Dr. Light provided examination findings and noted
that appellant’s condition had improved following an injection. He recommended continued
observation and physical therapy. In a report dated August 22, 2017, Dr. Stubel reviewed the
results of an MRI scan which he advised showed possible carpal tunnel syndrome. In a report
dated October 20, 2017, he found a positive Tinel’s sign of the right wrist. Dr. Stubel diagnosed
carpal tunnel syndrome and opined that appellant could return to her usual work. Neither
physician, however, addressed causation. The Board has held that medical evidence that does not

15

See J.M., Docket No. 17-1002 (issued August 22, 2017) (a medical opinion must reflect a correct history and
offer a medically sound explanation by the physician of how the specific employment incident physiologically caused
or aggravated the diagnosed conditions).
16

Id.

17

Supra note 13.

18
See D.P., Docket No. 19-1716 (issued March 11, 2020); M.O., Docket No. 18-1056 (issued November 6, 2018);
Deborah L. Beatty, 54 ECAB 3234 (2003).

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include an opinion regarding the cause of a diagnosed condition is of limited probative value on
the issue of causal relationship.19
Appellant submitted Form CA-17 reports and work exemption requests dated from
March 22 through October 20, 2017 from Dr. Light, Dr. Stubel, Dr. Leddy, and Dr. Hannanian.
She also submitted diagnostic reports dated March 13 and August 10, 2017. These reports did not
provide an opinion regarding the cause of her diagnosed right wrist conditions. As noted, medical
evidence offering no opinion about the cause of an employee’s condition is of limited probative
value on the issue of causal relationship.20 These reports do not contain opinions regarding the
cause of appellant’s carpal tunnel syndrome and thus are insufficient to meet her burden of proof.
The record contains reports authored by physical therapists and physician assistants. The
Board has held that medical reports signed solely by a physical therapist or a physician assistant
are of no probative value as such health care providers are not considered “physician[s]” as defined
under FECA and are therefore not competent to provide medical opinions.21 Consequently, this
evidence is also insufficient to establish appellant’s claim.
The Board finds that appellant has not submitted rationalized medical evidence establishing
a right wrist condition causally related to the accepted March 11, 2017 employment incident and
therefore has not met her burden of proof to establish 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 10.607.22
CONCLUSION
The Board finds that appellant has not met her burden of proof to establish a right wrist
condition causally related to the accepted March 11, 2017 employment incident.

19
See J.H., Docket No. 19-0838 (issued October 1, 2019); L.B., Docket No. 18-0533 (issued August 27, 2018);
D.K., Docket No. 17-1549 (issued July 6, 2018); S.G., Docket No. 19-0041 (issued May 2, 2019).
20

Id.

21

See T.T., Docket No. 19-1121 (issued November 29, 2019); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006)
(lay individuals such as physician assistants, nurses, and physical therapists are not competent to render a medical
opinion under FECA); 5 U.S.C. § 8101(2) (this subsection defines a physician as surgeons, podiatrists, dentists,
clinical psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as
defined by state law). E.T., Docket No. 17-0265 (issued May 25, 2018) (physician assistants are not considered
physicians under FECA); J.M., 58 ECAB 448 (2007) (physical therapists are not considered physicians under FECA).
22

The Board notes that the employing establishment issued a Form CA -16. A properly completed CA-16 form
authorization may constitute a contract for payment of medical expenses to a medical facility or physician, when
properly executed. The form creates a contractual obligation, which does not involve the employee directly, to pay
for the cost of the examination or treatment regardless of the action taken on the claim. See 20 C.F.R.
§ 10.300(c); M.C., Docket No. 18-0951, n.20 (issued January 7, 2019); Tracy P. Spillane, 54 ECAB 608 (2003).

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ORDER
IT IS HEREBY ORDERED THAT the May 8, 2018 decision of the Office of Workers’
Compensation Programs is affirmed.
Issued: April 9, 2020
Washington, DC

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

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

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

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
S.N., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Santa Clarita, CA, Employer
__________________________________________

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

Docket No. 13-2069
Issued: February 21, 2014

Case Submitted on the Record

DECISION AND ORDER
Before:
RICHARD J. DASCHBACH, Chief Judge
COLLEEN DUFFY KIKO, Judge
PATRICIA HOWARD FITZGERALD, Judge

JURISDICTION
On September 9, 2013 appellant filed a timely appeal from a July 8, 2013 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.
ISSUES
The issues are: (1) whether appellant is entitled to compensation for disability from
November 5, 2012 through March 1, 2013 causally related to her accepted employment injuries;
and (2) whether OWCP met its burden of proof to terminate appellant’s medical benefits.
FACTUAL HISTORY
On September 10, 2012 appellant, then a 31-year-old mail carrier, filed a traumatic injury
claim alleging overexposure to the sun on September 4, 2012 caused second degree burns to her
1

5 U.S.C. § 8101-8193.

hands and arms. OWCP accepted the claim for resolved bilateral second-degree sunburn and
subsequently expanded the claim to include temporary aggravation of other dermatitis due to
solar radiations (photodermatitis). It paid medical benefits.
On November 20, 2012 appellant filed a claim (Form CA-7) for compensation for the
period commencing November 5, 2012. Subsequent forms indicated compensation was being
claimed through March 1, 2013.
In a September 24, 2012 report, Dr. Taha M. Ahmad, a Board-certified internist,
discharged appellant from care and released her to full unrestricted work with no need for further
medical care and no ratable impairment. Hyperpigmentation was noted in region of previous
skin sunburn.
In a November 5, 2012 report, Dr. Kristine M. Hirschfield, a Board-certified internist,
diagnosed photodermatitis and opined that the rash on appellant’s arms with mild
hyperpigmentation had resolved. She opined that no further medical treatment was needed and
provided restrictions of working indoors. In a November 12, 2012 report, Dr. Hirschfield noted
a clearing rash on the hyperpigmented area on appellant’s arms with no other lesions or
suspicious lesions noted. She recommended that appellant work in shade/indoors.
In a December 4, 2012 letter, OWCP requested that Dr. Hirschfield provide a complete
narrative report describing appellant’s current medical condition and disability status, including
whether the work restriction of limiting appellant to shade/indoor work has been lifted. In a
December 6, 2012 letter, it informed appellant of the information required to establish a
recurrence of disability claim. Appellant was provided 30 days in which to submit the requested
factual and medical evidence.
On December 6, 2012 OWCP received a factual statement from appellant.
In an October 22, 2012 report, received on December 18, 2012, Dr. Jennifer J. Choi, a
Board-certified family practitioner and an osteopath, stated that appellant suffered from
photosensitivity due to sunlight and is allergic to sunscreen. She advised that working outdoors
puts appellant at risk for sunburn and other potential complications and recommended that
appellant work in an indoor environment.
OWCP referred appellant to Dr. Bernard I. Raskin, a Board-certified dermatologist, for a
second opinion examination to determine the nature and extent of the work-related injury. In a
February 21, 2013 report, Dr. Raskin noted the history of injury, reviewed the statement of
accepted facts and medical record, and provided examination findings. He confirmed that the
aggravation of photodermatitis had resolved and the only residual was mild hyperpigmentation
of the skin, which he stated would gradually resolve with continued sun avoidance. Dr. Raskin
opined that appellant was totally disabled through the date of his examination. He further opined
that she should be returned to an indoor occupation and would then no longer be disabled.
Dr. Raskin recommended that appellant avoid sun exposure.
In an April 3, 2013 letter, OWCP provided Dr. Hirschfield a copy of the second opinion
report and requested that she provide clarification regarding the continued disability even after
resolution of the accepted photodermatitis. In an April 9, 2013 letter, Dr. Hirschfield stated that
2

she concurred completely with all the findings regarding appellant. She indicated that it was a
temporary rash and if appellant was placed in indoor work, she would not be disabled.
On April 10, 2013 OWCP requested that Dr. Raskin clarify the opinion he provided in his
February 21, 2013 report regarding when the aggravation had resolved and clarify if the
restriction of working indoors was prophylactic in nature or based on objective findings or
residuals of the accepted work exposure of September 4, 2012. In a May 15, 2013 addendum
report, Dr. Raskin advised that the date for total resolution of the aggravation of photodermatitis
had resolved on November 15, 2012 and, subsequent to that date, appellant was released by her
treating physician. He further clarified that the restriction that appellant only work indoors was
prophylactic in nature and was given to avoid further recurrence of her underlying
photodermatitis.
In a June 5, 2013 report, Dr. Hirschfield indicated that appellant was seen for an ongoing
recurrent rash with sunlight exposure. She noted that on the initial visit appellant’s rash was
improving with residual scarring and hyperpigmentation since she had been off work.
Dr. Hirschfield noted that appellant was advised to avoid prolonged exposure to sunlight to avoid
further rash and scarring.
By decision dated July 8, 2013, OWCP denied appellant’s claim for compensation for
disability for work during the period November 5, 2012 through March 1, 2013 due to the
September 4, 2012 work injury. This decision also terminated appellant’s medical benefits.
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 by the weight of the evidence.2 For each period of
disability claimed, the employee has the burden of establishing that he or she was disabled for
work as a result of the accepted employment injury.3 Whether a particular injury causes an
employee to become disabled for work, and the duration of that disability, are medical issues that
must be proved by a preponderance of probative and reliable medical opinion evidence.4 To
meet his or her burden, a claimant must submit rationalized medical opinion evidence, based on
a complete factual and medical background, supporting a causal relationship between the alleged
disabling condition and the accepted injury.5
Under FECA the term disability means incapacity, because of an employment injury, to
earn the wages that the employee was receiving at the time of injury.6 Disability is, thus, not
2

See Amelia S. Jefferson, 57 ECAB 183 (2005); see also Nathaniel Milton, 37 ECAB 712 (1986); Joseph M.
Whelan, 20 ECAB 55 (1968).
3

See Amelia S. Jefferson, id.; see also David H. Goss, 32 ECAB 24 (1980).

4

See Edward H. Horton, 41 ECAB 301 (1989).

5

A.D., 58 ECAB 166 (2006); Sandra D. Pruitt, 57 ECAB 126 (2005).

6

S.M., 58 ECAB 166 (2006); Bobbie F. Cowart, 55 ECAB 746 (2004); Conard Hightower, 54 ECAB 796
(2003); 20 C.F.R. § 10.5(f).

3

synonymous with physical impairment which may or may not result in an incapacity to earn
wages.7 An employee who has a physical impairment causally related to his or her federal
employment, but who nonetheless has the capacity to earn the wages he or she was receiving at
the time of injury, has no disability and is not entitled to compensation for loss of wage-earning
capacity.8 When, however, the medical evidence establishes that the residuals or sequelae of an
employment injury are such that, from a medical standpoint, they prevent the employee from
continuing in his or her employment, he or she is entitled to compensation for any loss of wages.
The Board will not require OWCP to pay compensation for disability in the absence of medical
evidence directly addressing the specific dates of disability for which compensation is claimed.
To do so, would essentially allow an employee to self-certify their disability and entitlement to
compensation.9
The Board has held that whether a particular injury causes an employee to be disabled for
work is a medical question that must be resolved by competent and probative medical
evidence.10 The weight of medical opinion is determined on the report of a physician, who
provides a complete and accurate factual and medical history, explains how the claimed
disability is related to the employee’s work and supports that conclusion with sound medical
reasoning.11
ANALYSIS -- ISSUE 1
Appellant claimed that she was totally disabled for work during the period November 5,
2012 through March 1, 2013. The medical evidence of record, as noted by Dr. Hirschfield in her
November 5, 2012 report and Dr. Raskin in his May 15, 2013 report, confirm that the temporary
aggravation of photodermatitis resolved on November 5, 2012 with residual scarring only.
Appellant has the burden of establishing by the weight of the substantial, reliable and probative
evidence, a causal relationship between her claimed total disability commencing November 5,
2012 and the accepted conditions of resolved second-degree burn and temporary aggravation of
other dermatitis due to solar radiation (photodermatitis).12
Both Dr. Hirschfield and Dr. Raskin provided restrictions that appellant only work
indoors. However subsequent reports from the physicians indicate that the restriction was
prophylactic in nature to avoid future injury. Dr. Raskin, in his report of May 15, 2013, clarified
that the restriction that appellant only work indoors was prophylactic in nature and was given to
avoid further recurrence of her underlying photodermatitis. In her June 5, 2013 report,
Dr. Hirschfield stated that appellant was advised to avoid prolonged exposure to sunlight to
7

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

8

Merle J. Marceau, 53 ECAB 197 (2001).

9

See William A. Archer, 55 ECAB 674 (2004); Fereidoon Kharabi, 52 ECAB 291 (2001).

10

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

11

See T.E., Docket No. 09-2040 (issued July 27, 2010); Sedi L. Graham, 57 ECAB 494 (2006).

12

Alfredo Rodriguez, 47 ECAB 437 (1996).

4

avoid further rash and scarring. The Board has held that restrictions which are prophylactic in
nature and based on fear of future injury are not compensable under FECA.13
Appellant did not submit rationalized medical opinion from her physicians finding her
disabled for work on or after November 5, 2012 due to the accepted injuries. In her June 5, 2013
report, Dr. Hirschfield noted prophylactic restrictions against prolonged sunlight exposure, but
did not find appellant disabled for work commencing November 5, 2012. Thus, the medical
evidence submitted in support of her claim for wage-loss compensation for that period is
insufficient to meet appellant’s burden of proof.14 The Board notes that OWCP advised
appellant by May 28, 2013 letter of the necessity of submitting rationalized medical evidence
explaining how the accepted conditions caused the claimed period of disability. Appellant did
not submit such evidence. Therefore, OWCP’s July 8, 2013 decision denying the claimed period
of disability is proper under the law and facts of the case.
On appeal, appellant asserts that the employing establishment could not accommodate her
restrictions and she should be compensated for all or part of the time she was off work. These
contentions are not relevant to the issue of whether the medical evidence established that
appellant was disabled for work on or after November 5, 2012 due to the accepted employment
injuries as her restrictions were prophylactic in nature. 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
The right to medical benefits for an accepted condition is not limited to the period of
entitlement for disability. To terminate authorization for medical treatment OWCP must
establish that a claimant no longer has residuals of an employment-related condition that require
further medical treatment.15
ANALYSIS -- ISSUE 2
OWCP accepted appellant’s claim for resolved bilateral second degree sunburn and
temporary aggravation of photodermatitis. As appellant’s second-degree sunburn had already
resolved at the time the claim was accepted, appellant was no longer entitled to medical
treatment for this condition. In a September 24, 2012 report, Dr. Ahmad reported that appellant
no longer required medical care, as did Dr. Hirschfield in her November 5, 2012 report. Both
physicians noted hyperpigmentation but did not recommend medical treatment for this condition,
which was not accepted as related to the employment injury. OWCP’s second opinion physician,
Dr. Raskin, concurred with appellant’s treating physicians in his February 21 and April 10, 2013
reports. He found that appellant’s accepted aggravation of photodermatis had resolved. The
13

Carlos A Marrero, 50 ECAB 117 (1998); Mary A. Geary, 43 ECAB 300 (1991) (fear or possibility of further
injury is not compensable).
14

Alfredo Rodriguez, supra note 12.

15

T.P., 58 ECAB 524 (2007).

5

Board therefore finds that OWCP met its burden of proof to terminate authorization of medical
benefits for appellant’s accepted medical conditions.
CONCLUSION
The Board finds that appellant has failed to establish that she was totally disabled from
November 5, 2012 through March 1, 2013 due to her September 4, 2012 employment injury.
The Board also finds that OWCP met its burden of proof to terminate authorization of medical
benefits.
ORDER
IT IS HEREBY ORDERED THAT the July 8, 2013 decision of the Office of Workers’
Compensation Programs is affirmed.
Issued: February 21, 2014
Washington, DC

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

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

Patricia Howard Fitzgerald, Judge
Employees’ Compensation Appeals Board

6


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
R.G., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Capitol Heights, MD, Employer
__________________________________________

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

Docket No. 18-1251
Issued: November 26, 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 June 6, 2018 appellant filed a timely appeal from a December 8, 2017 merit decision
of the Office of Workers’ Compensation Programs (OWCP).1 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.3

1
Together with his appeal request, appellant submitted a timely request for oral argument pursuant to 20 C.F.R.
§ 501.5(b). By order dated April 19, 2019, the Board exercised its discretion and denied the request as appellant’s
arguments on appeal could be adequately addressed in a decision based on a review of the case as submitted on the
record. Order Denying Request for Oral Argument, Docket No. 18-1251 (issued April 19, 2019).
2
3

5 U.S.C. § 8101 et seq.

The Board notes that following the December 8, 2017 decision, OWCP received additional evidence. However,
the Board’s Rules of Procedure provides: “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. Evidence not before OWCP will not be considered by the
Board for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this
additional evidence for the first time on appeal. Id.

ISSUES
The issues are: (1) whether OWCP properly determined that appellant received an
overpayment of compensation in the amount of $43,633.21 for the period May 24, 2007 through
January 7, 2017 because he improperly received wage-loss compensation at an augmented
compensation rate; (2) whether it properly found appellant at fault in the creation of the
overpayment, thereby precluding waiver of recovery of the overpayment; and (3) whether OWCP
properly required recovery of the overpayment by withholding $200.00 every 28 days from
appellant’s continuing compensation payments.
FACTUAL HISTORY
On July 19, 2000 appellant, then a 46-year-old Express Mail driver, filed a traumatic injury
claim (Form CA-1) alleging that he sustained an injury to his head and neck on September 6, 1998
when attempting to avoid a motor vehicle accident while driving in the performance of duty.
OWCP initially accepted the claim for cervical strain and later expanded the acceptance of the
claim to include aggravation of cervical myofasciitis.4 Appellant returned to part-time work on
January 6, 1998. In 2001, he underwent a regimen of Botulinum treatments and has not returned
to work. OWCP placed him on the periodic compensation rolls effective December 2, 2001.
In a letter dated September 17, 2002, OWCP requested that appellant complete an EN1032
form, which included questions regarding such matters as his employment activities, earnings and
dependency in order to verify that the appropriate compensations were made. It specifically
indicated that compensation at the augmented rate of 75 percent of the applicable pay rate may be
paid for “an unmarried child between 18 and 23 who is a full-time student even if that person does
not live with you, as long as you make regular direct payments for his or her support.” OWCP
also advised that if he had no eligible dependents he would be paid at 66 2/3 percent of the
applicable pay rate. Appellant completed this form on September 18, 2002 and advised OWCP
that he had a dependent daughter who was born on October 7, 1982 and a dependent son born on
July 5, 1983.
Appellant continued to submit completed and signed EN1032 forms through October 10,
2008, indicating that he had at least one eligible dependent, and as such, was entitled to receive
wage-loss compensation at the augmented rate.
Beginning October 7, 2009, appellant submitted annual EN1032 forms indicating that he
no longer had any eligible dependents and, therefore, was no longer entitled to receive
compensation at the augmented rate.
In a January 17, 2017 development letter, OWCP advised that it had received appellant’s
EN1032 form dated September 20, 2016 where he indicated that he had no dependents. It
explained that he had been paid at the augmented rate of 75 percent rather than at the basic
4

Appellant had a previously accepted claim for a December 20, 1997 cervical sprain and multiple injuries to his
head, right shoulder, cervical spine, lumbosacral spine, and right leg on August 25, 1992. OWCP assigned File No.
xxxxxx568. It has administratively combined File Nos. xxxxxx568 and xxxxxx087 with the latter serving as the
master file.

2

compensation rate of 66 2/3 percent. OWCP enclosed an EN1032 form for completion and
afforded appellant 30 days to submit additional evidence and respond to its inquiries.
Appellant subsequently submitted Part A of a Student Dependency form dated January 26,
2017 indicating that he was not claiming any dependents.
In a February 10, 2017 development letter, OWCP advised appellant that he had not
completed Part B of the Student Dependency form and afforded him 30 days to complete it.
On February 27, 2017 appellant completed Part B of the Student Dependency form
indicating that his daughter had attended Bowie State University in Bowie, Maryland from June 2,
2003 to May 23, 2007.
By letter dated March 21, 2017, OWCP advised appellant that it had made a preliminary
determination that he received an overpayment of compensation in the amount of $43,633.21 for
the period May 24, 2007 through January 7, 2017 because he received compensation at the
augmented three-fourths rate instead of the two-thirds rate when he had no dependents. Its payroll
records established that it continued to pay him compensation at the augmented rate from May 24,
2007 to January 7, 2017, which amounted to a total of $391,186.75. Appellant, however, was only
entitled to receive $347,553.54 in compensation at the basic two-thirds rate, resulting in a
$43,633.21 overpayment.5 OWCP found that he was with fault in the creation of the overpayment
because he knew or reasonably should have known that there was no entitlement to compensation
at the augmented rate after his daughter graduated from college on May 23, 2007. It further found
that appellant continued to accept compensation payments at the augmented rate despite such
knowledge.
The record contains appellant’s pay rate history and a memorandum regarding the dates
and calculations of the overpayment of compensation.
On April 10, 2017 appellant requested a prerecoupment hearing with a representative of
OWCP’s Branch of Hearings and Review on the issues of fault and a possible waiver of this
overpayment.
A prerecoupment hearing was held before an OWCP hearing representative on
August 30, 2017. The hearing representative advised appellant that it would review his financial
records prior to issuing its final overpayment decision.
In an overpayment recovery questionnaire (Form OWCP-20) dated September 20, 2017,
appellant reported a total monthly income of $2,592.12. He indicated that he did not support,
either fully or in part, anyone other than himself. Appellant reported approximately $2,210.00 in
monthly household expenses ($300.00 for rent, $300.00 for food, $100.00 for clothing, $185.00
for utilities, and $400.00 other miscellaneous expenses) and $925.00 in monthly credit card debts.
5

OWCP indicated that, during the period May 24, 2007 through January 7, 2017, it paid appellant at a weekly pay
of $763.92 at three-fourths of the pay rate, effective September 6, 1998, totaling $391,186.75. However, it indicated
that for the same period it should have paid him at two-thirds of his weekly pay $763.92 for a total of $347,553.54.
OWCP concluded that the difference between $391,186.75 and $347,553.53 = $43,633.21, the amount of the
overpayment.

3

He reported the following assets: $0.00 cash on hand, $250.00 in a checking account, $36.15 in a
savings account, $6,290.15 in stocks and bonds, and a $53.32 value of other personal
property/funds totaling $6,629.62. Appellant submitted a number of financial documents in
support of his claim.
By decision dated December 8, 2017, OWCP’s hearing representative finalized OWCP’s
preliminary overpayment determination, finding that appellant had received an overpayment of
compensation in the amount of $43,633.21 for the period May 24, 2007 through January 7, 2017
because he had improperly received augmented compensation without having any dependents. It
adjusted appellant’s compensation payments to the basic compensation rate and found that he was
overpaid $43,633.21 for the period May 24, 2007 through January 7, 2017. OWCP found him at
fault in the creation of the overpayment and, therefore, not entitled to waiver of recovery. It further
found that appellant’s monthly income exceeded his monthly expenses by $382.12 per month
($2,592.12 monthly income - $2,210.00 in monthly expenses). OWCP required recovery of the
overpayment by withholding $200.00 every 28 days from his continuing compensation payments.
LEGAL PRECEDENT -- ISSUE 1
FECA provides that the United States shall pay compensation for the disability or death of
an employee resulting from a personal injury sustained while in the performance of duty.6 If the
disability is total, the United States shall pay the employee during the period of total disability the
basic compensation rate of 66 2/3 percent of his monthly pay. A disabled employee is entitled to
an augmented compensation rate of 75 percent if he has one or more dependents.7
A dependent includes an unmarried child who, while living with the employee or receiving
regular contributions from the employee toward his or her support, is either under 18 years of age
or over 18 years of age and incapable of self-support due to physical or mental disability.8 A child
is also considered a dependent if he or she is an unmarried student under 23 years of age who has
not completed four years of education beyond the high school level and is currently pursuing a
full-time course of study at a qualifying college, university, or training program.9
If a claimant received compensation at the augmented rate during a period when he or she
did not have an eligible dependent, the difference between the compensation that was disbursed at
the 75 percent augmented rate and the compensation that should have been disbursed at the 66 2/3
percent basic rate constitutes an overpayment of compensation.10

6

5 U.S.C. § 8102(a).

7

O.R., 59 ECAB 432, 436 (2008); id. at §§ 8105(a) and 8110(b).

8

Id. at § 8110(a).

9

E.G., 59 ECAB 599, 603 n.10 (2008).

10

Ralph P. Beachum, Sr., 55 ECAB 442, 445 (2004).

4

ANALYSIS -- ISSUE 1
The Board finds that OWCP properly determined that appellant received an overpayment
of compensation in the amount of $43,633.21 for the period May 24, 2007 through January 7, 2017
because he received wage-loss compensation at the augmented rate even though he did not have
an eligible dependent under FECA.
The evidence of record reflects that appellant continued to receive compensation at the
augmented rate from May 24, 2007 through January 7, 2017, despite the fact that his daughter,
who was initially claimed as a dependent, had graduated from college on May 23, 2007 and,
therefore, was no longer a qualifying dependent under FECA.
In a January 17, 2017 development letter, OWCP notified appellant that it received his
Form EN1032 dated September 20, 2016 where he reported that he had no qualifying dependents,
although it had been paying him at the augmented rate. It included an EN1032 form for his
completion and requested that he provide a statement and certification of school enrollment for
any dependents using the attached forms. On February 27, 2017 appellant completed a Student
Dependency form indicating that his daughter had attended Bowie State University in Bowie,
Maryland from June 2, 2003 through May 23, 2007.
Payroll records also confirm that OWCP continued to pay appellant compensation at the
augmented rate from May 24, 2007 to January 7, 2017, which amounted to a total of $391,186.75.
Appellant, however, was only entitled to receive $347,553.54 in compensation at the basic rate,
resulting in an overpayment in the amount of $43,633.21. Accordingly, the Board finds that
OWCP properly determined that he received an overpayment of compensation in the amount of
$43,633.21for the period May 24, 2007 through January 7, 2017.
LEGAL PRECEDENT -- ISSUE 2
5 U.S.C. § 8129(b) provides: “Adjustment or recovery by the United States may not be
made when incorrect payment has been made to an individual who is without fault and when
adjustment or recovery would defeat the purpose of FECA or would be against equity and good
conscience.”11 A claimant who is at fault in the creation of the overpayment is not entitled to
waiver.12 On the issue of fault 20 C.F.R. § 10.433(a) provides that an individual will be found at
fault if he or she has done any of the following: (1) made an incorrect statement as to a material
fact which he or she knew or should have known to be incorrect; (2) failed to provide information
which he or she knew or should have known to be material; or (3) accepted a payment which he
or she knew or should have known was incorrect.13
With respect to whether an individual is without fault, section 10.433(b) of OWCP’s
regulations provide that whether or not OWCP determines that an individual was at fault with
11

5 U.S.C. § 8129(b).

12

See C.Y., Docket No. 18-0263 (issued September 14, 2018).

13

20 C.F.R. § 10.433(a).

5

respect to the creation of an overpayment depends on the circumstances surrounding the
overpayment. The degree of care expected may vary with the complexity of those circumstances
and the individual’s capacity to realize that he or she is being overpaid.14
ANALYSIS -- ISSUE 2
The Board finds that OWCP properly found appellant at fault in the creation of the
overpayment and therefore not entitled to waiver of recovery.
OWCP found that appellant was at fault in the creation of the overpayment because he
accepted payments he knew or should have known to be incorrect as he was aware that he was not
entitled to augmented compensation when he no longer had an eligible dependent.
Appellant acknowledges that his daughter graduated from college on May 23, 2007 and
thereafter was no longer a qualified dependent and as such, he was no longer entitled to augmented
compensation at the three-fourths rate beginning May 24, 2007. Moreover, beginning October 7,
2009, he reported on annually submitted EN1032 forms that he did not have an eligible dependent,
further demonstrating that he was aware that he was no longer entitled to the augmented
compensation rate.
On appeal appellant contends that he was not at fault in the creation of the overpayment of
compensation because he had completed the required report advising OWCP that his dependents
had reached the age of maturity. However, even if the overpayment resulted from negligence on
the part of OWCP, this does not excuse the employee from accepting payment which he knew or
should have known he was not entitled to.15
Accordingly, the Board finds that OWCP properly found appellant at fault in the creation
of the overpayment, as he reasonably knew or should have known that the payments he received
from OWCP for the period May 24, 2007 through January 7, 2017, which contained an
overpayment in the amount of $43,633.21, were in error.
As appellant was at fault under the third standard outlined above,16 recovery of the
overpayment of compensation in the amount of $43,633.21 may not be waived.
LEGAL PRECEDENT -- ISSUE 3
When an overpayment has been made to an individual because of an error of fact or law,
adjustment shall be made under regulations prescribed by the Secretary of Labor by decreasing
later payments to which the individual is entitled.17 When an overpayment of compensation has
been made to an individual who is entitled to further payments, the individual shall refund to
14

Id. at § 10.433(b); see also D.M., Docket No. 17-0983 (issued August 3, 2018).

15

Russell E. Wageneck, 46 ECAB 653 (1995).

16

See supra note 13.

17

5 U.S.C. § 8129(a).

6

OWCP the amount of the overpayment as soon as the error is discovered or his attention is called
to the same. If no refund is made, OWCP shall decrease later payments of compensation, taking
into account the probable extent of future payments, the rate of compensation, the financial
circumstances of the individual, and any other relevant factors, so as to minimize any hardship.18
The individual who received the overpayment is responsible for providing information
about income, expenses, and assets as specified by OWCP. This information will be used to
determine the repayment schedule, if necessary.19
The analysis that determines the amount of adjustment is substantially the same as that
used to determine waiver.20
ANALYSIS -- ISSUE 3
The Board finds that OWCP properly required recovery of the overpayment by withholding
$200.00 every 28 days from appellant’s continuing compensation payments.
In an overpayment recovery questionnaire (Form OWCP-20) dated September 20, 2017,
appellant reported a total monthly income of $2,592.12. He indicated that he did not support,
either fully or in part, anyone other than himself. Appellant also reported approximately $2,210.00
in monthly household expenses ($300.00 for rent, $300.00 for food, $100.00 for clothing, $185.00
for utilities, and $400.00 other miscellaneous expenses) and $925.00 in monthly credit card debts.
Moreover, he reported at total of $6,629.62 in additional assets. Thus, the Board finds that
appellant did not need substantially all of his income to cover ordinary and necessary living
expenses as his discretionary income exceeded $50.00 a month. Appellant’s total monthly income
was $2,592.12, with $2,210.00 in allowable monthly ordinary and necessary living expenses,
leaving $382.12 in discretionary income per month,21 well above the $50.00 amount used to
determine this criterion.22
OWCP’s procedures provide that, if a claimant is being paid compensation or is due
accrued benefits, the debt should be recovered from such benefits as quickly as possible.23
Accordingly, the Board finds that OWCP reasonably concluded that a repayment schedule of

18

20 C.F.R. § 10.441.

19

Id. at § 10.438(a).

20

See J.B. (J.B.), Docket No. 16-0707 (issued November 1, 206); Howard R. Nahikian, 53 ECAB 406 (2002).

21

$2,592.12 - $2,210.00 = $382.12.

22

See N.S., Docket No. 14-2081 (issued February 12, 2015); Federal (FECA) Procedure Manual, Part 6 -- Debt
Management, Initial Overpayment Actions, Chapter 6.200.6a(1)(b) (June 2009) provides that “[a]n individual is
deemed to need substantially all of his or her current income to meet current ordinary and necessary living expenses
if monthly income does not exceed monthly expenses by more than $50[.00]. In other words, the amount of monthly
funds available for debt repayment is the difference between current income and adjusted living expenses (i.e.,
ordinary and necessary living expenses plus $50[.00]).”
23

See A.S., Docket No. 19-0171 (issued June 12, 2019); Frederick Arters, 53 ECAB 397 (2002).

7

$200.00 every 28 days would minimize any resulting hardship while effecting recovery of the
overpayment.
CONCLUSION
The Board finds that OWCP properly determined that appellant received an overpayment
of compensation in the amount of $43,633.21 for the period May 24, 2007 through January 7, 2017
because he improperly received augmented compensation. The Board also finds that OWCP
properly found him at fault in the creation of the overpayment and, therefore, not entitled to waiver
of recovery of the overpayment. The Board further finds that OWCP properly required recovery
of the overpayment by withholding $200.00 every 28 days from appellant’s continuing
compensation payments.
ORDER
IT IS HEREBY ORDERED THAT the December 8, 2017 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: November 26, 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

8


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

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

Docket No. 07-2245
Issued: April 9, 2008

Case Submitted on the Record

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

JURISDICTION
On September 4, 2007 appellant filed a timely appeal from March 12 and June 29, 2007
merit decisions of the Office of Workers’ Compensation Programs denying his claim for
compensation. Under 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 his right shoulder
condition was sustained in the performance of duty.
FACTUAL HISTORY
On December 8, 2006 appellant, then a 47-year-old mailhandler, filed an occupational
disease claim (Form CA-2) alleging that his right shoulder condition was caused by factors of his
federal employment. Appellant indicated that his job involved continuous loading, lifting and
moving trays, tubs and other objects. He first became aware of his condition and realized that it

was caused or aggravated by his employment in August 2005. He submitted a December 6, 2006
medical slip indicating that he was seen that day by Dr. Manohar P. Rao, a plastic surgeon.
By letter dated January 8, 2007, the Office advised appellant that it required additional
evidence to determine whether he was eligible for compensation benefits. The Office asked
appellant to provide additional factual information as well as submit a comprehensive medical
report from his treating physician describing his symptoms and medical reasons for his
condition, with an opinion as to whether his claimed condition was causally related to his federal
employment.
In response, appellant submitted a January 17, 2006 statement; a December 8, 2006
physician written order/fax form from Dr. James T. McGlowan, a Board-certified orthopedic
surgeon and a February 10, 2007 magnetic resonance imaging (MRI) scan report, noting
degenerative changes at the acromial joint and a full-thickness, partial-width tear of the focal
distal anterior supraspinatus. In a January 23, 2007 medical report, Dr. McGlowan noted that
appellant originally injured his right shoulder in 1990 and had ongoing pain and discomfort over
the years. Appellant advised that this was a work-related injury. Examination of the right
shoulder revealed painful range of motion with positive impingement signs. A diagnosis of
internal derangement right shoulder was provided.
By decision dated March 12, 2007, the Office denied appellant’s claim. It found that the
medical evidence did not establish that appellant’s right shoulder condition was related to
established work-related events.
On March 29, 2007 appellant requested reconsideration of the Office’s March 12, 2007
decision. He submitted evidence previously of record and a September 21, 2006 operative report
for a left carpal tunnel syndrome.
In a March 16, 2007 report, Dr. McGlowan noted findings on examination. He diagnosed
a full-thickness rotator cuff tear with impingement. Mr. McGlowan noted that appellant
sustained an injury to his shoulder while working and stated that this was a work-related injury.
By decision dated June 29, 2007, the Office reviewed the case on its merits and denied
modification of the March 12, 2007 decision.
LEGAL PRECEDENT
An employee seeking benefits under the Federal Employees’ Compensation Act1 has the
burden of establishing 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 the Act, that the claim was
timely filed within the applicable time limitation period of the Act, that an injury was sustained
in the performance of duty as alleged and that any disabilities and/or specific conditions for
which compensation is claimed are causally related to the employment injury.2 These are the

1

5 U.S.C. §§ 8101-8193.

2

Elaine Pendleton, 40 ECAB 1143 (1989).

2

essential elements of each and every compensation claim regardless of whether the claim is
predicated upon a traumatic injury or an occupational disease.3
An occupational disease or injury is one caused by specified employment factors
occurring over a longer period than a single shift or workday.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 the factors
alleged to have caused or contributed to the presence or occurrence of the disease or condition;
and (3) medical evidence establishing that the 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 factors
identified by the claimant.5
An award of compensation may not be based on surmise, conjecture, speculation or upon
appellant’s own belief that there is a causal relationship between his or her claimed injury and his
or her employment.6 To establish a causal relationship, appellant must submit a physician’s
report, in which the physician reviews the employment factors identified by appellant as causing
his condition and, taking these factors into consideration as well as findings upon examination of
appellant and his medical history, states whether the employment injury caused or aggravated
appellant’s diagnosed conditions and presents medical rationale in support of the opinion.7
The medical evidence required to establish causal relationship generally is rationalized
medical opinion evidence. Rationalized medical opinion evidence is medical evidence which
includes a physician’s rationalized opinion on the issue of whether there is a causal relationship
between the claimant’s diagnosed condition and the implicated employment factors.8 The
opinion of the physician must be based on a complete factual and medical background of the
claimant9 and must be one of reasonable medical certainty10 explaining the nature of the
relationship between the diagnosed condition and the specific employment factors identified by
the claimant.11

3

Victor J. Woodhams, 41 ECAB 345 (1989).

4

D.D., 57 ECAB ___ (Docket No. 06-1315, issued September 14, 2006).

5

Michael R. Shaffer, 55 ECAB 386, 389 (2004), citing Lourdes Harris, 45 ECAB 545 (1994); Victor J.
Woodhams, supra note 3.
6

Donald W. Long, 41 ECAB 142 (1989).

7

Id.

8

Conard Hightower, 54 ECAB 796 (2003); Leslie C. Moore, 52 ECAB 132 (2000).

9

Tomas Martinez, 54 ECAB 623 (2003); Gary J. Watling, 52 ECAB 278 (2001).

10

John W. Montoya, 54 ECAB 306 (2003).

11

Judy C. Rogers, 54 ECAB 693 (2003).

3

ANALYSIS
Appellant alleged that his job duties as a mail handler involved continuous loading,
lifting and moving trays, tubs and other objects and caused or contributed to his right shoulder
condition. The employing establishment did not contest that appellant engaged in these work
activities during his federal employment and the Office accepted them as established. However,
the Board finds that the medical evidence is insufficient to establish that appellant’s diagnosed
right shoulder condition is causally related to his work duties as a mail handler.
Appellant submitted medical reports dated January 23 and March 16, 2007 from
Dr. McGlowan, who diagnosed internal derangement of the right shoulder. However,
Dr. McGlowan did not specifically address whether any factors of appellant’s employment
caused or contributed to this condition. He merely related that appellant advised him that this
was a work-related injury.12 On March 16, 2007 Dr. McGlowan diagnosed a full-thickness
rotator cuff tear with impingement. He noted that appellant sustained an injury to his shoulder
while working and opined that this was a work-related injury. The Board notes that
Dr. McGlowan did not specifically address what factors of appellant’s employment caused or
contributed to his right shoulder condition. He did not provide any medical rationale to explain
his conclusion on causal relationship. Medical conclusions unsupported by medical rationale are
of diminished probative value and are insufficient to establish causal relation.13 Consequently,
the medical evidence from Dr. McGlowan is insufficient to establish appellant’s claim.
The record contains an MRI scan report pertaining to appellant’s right shoulder.
However, this report does not address the causal relationship of appellant’s diagnosed conditions
and the factors of his employment. This evidence is not probative on that issue. The medical
evidence and reports pertaining to appellant’s left carpal tunnel syndrome condition are not
relevant to the current claim, which pertains to a right shoulder condition.
The Board has held that the mere fact that a condition manifests itself during a period of
employment does not raise an inference that there is a causal relationship between the two.14
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.15 Causal relationship must be substantiated by reasoned medical
opinion evidence, which is appellant’s responsibility to submit.
There is no reasoned medical evidence addressing how appellant’s employment duties
caused or aggravated a right shoulder condition. He has not met his burden of proof in
establishing that he sustained a medical condition in the performance of duty causally related to
factors of his employment.
12

See Linda I. Sprague, 48 ECAB 386 (1997) (medical evidence that does not offer any opinion regarding the
cause of an employee’s condition is of diminished probative value on the issue of causal relationship).
13

Albert C. Brown, 52 ECAB 152 (2000).

14

See Joe T. Williams, 44 ECAB 518, 521 (1993).

15

Id.

4

CONCLUSION
The Board finds that appellant has failed to meet his burden of proof in establishing that
his right shoulder condition was sustained in the performance of duty.
ORDER
IT IS HEREBY ORDERED THAT the decisions of the Office of Workers’
Compensation Programs dated June 29 and March 12, 2007 are affirmed.
Issued: April 9, 2008
Washington, DC

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

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

5


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
R.L., Appellant
and
PEACE CORPS, VOLUNTEER SERVICES,
Lusaka, Zambia, Employer
__________________________________________

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

Docket No. 07-1851
Issued: February 7, 2008

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Chief Judge
MICHAEL E. GROOM, Alternate Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On June 25, 2007 appellant filed a timely appeal from the June 20, 2007 merit decision of
the Office of Workers’ Compensation Programs, which denied modification of a wage-earning
capacity determination. Pursuant to 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction
to review the merits of appellant’s claim.
ISSUE
The issue is whether appellant has met his burden to warrant modification of the Office’s
2002 wage-earning determination.
FACTUAL HISTORY
On July 6, 1995 appellant, then a 55-year-old volunteer, injured his right hip and leg in
the performance of duty when he was thrown during a motorcycle training class. The Office
accepted his claim for hip contusion and right buttocks inflammation and, later, sciatica.
Appellant received compensation for wage loss and permanent impairment.

Appellant returned to work in the private sector. In 2002 the Office determined that he
had a capacity to earn wages, based on his average actual earnings from 1996 to 2001. The
Office paid compensation for appellant’s partial loss of wage-earning capacity.
In December 2004 appellant filed a claim alleging that he sustained a recurrence of total
disability on February 13, 2004. Asked to explain how the recurrence happened, he stated: “I
did not re-currence, I has [been] the same damaged leg, getting more debilitating over the last
[nine] years. My doctor t[o]ld me to move t[o] a warmer climate, so I would have less pain. I
moved to [Texas].”
Appellant’s former employer advised as follows: “[Appellant] was employed at
Blackstone Valley Vocational Regional School District from September 17, 2001 [to]
February 13, 2004. His ending salary was $615.08/week. [Appellant] resigned his position as a
Computer Support Technician to relocate to Florida.” On June 24, 2004 Dr. Alan J. Bell, a
neurologist, reported: “Please be advised that [appellant] was a patient of mine. It was told to
him that by moving to a warmer climate for health reasons his quality of life could improve.”
In a decision dated July 20, 2005, the Office denied appellant’s recurrence claim. The
Office found that the evidence failed to establish that his claimed disability for work beginning
February 13, 2004 was due to the accepted work injury. The Office noted that, while the medical
evidence indicated partial disability, no physician had provided a well-reasoned opinion
explaining that appellant was unable to work due to his accepted condition or that there was a
material worsening of the accepted conditions with no intervening cause resulting in appellant’s
inability to work.
The Office received medical evidence diagnosing mild right-sided S1 radiculopathy with
severe lumbar spasm and additional evidence finding his neurological status stable. On April 27,
2006 Dr. Jim C. Whitley, a clinical psychologist, reported that he knew appellant for
approximately one month and that appellant’s depression was a direct result of an injury he
experienced while serving in the Peace Corps. The psychologist reported that appellant was no
longer employable; he was unable to work, and his constant and debilitating pain precluded him
from participating in any type of retraining or employment. The psychologist concluded that
appellant was physically and psychologically disabled on a permanent basis.
In a decision dated June 8, 2006, the Office reviewed the merits of appellant’s case and
denied modification of the 2002 loss of wage-earning determination. The Office found that
appellant submitted no documents establishing that he suffered a recurrence of disability or that
his work-related conditions had materially worsened to such a degree that he could no longer
perform his light-duty job duties.
On July 19, 2006 Dr. Whitley reported that appellant displayed symptoms consistent with
chronic post-traumatic stress disorder. He stated that appellant’s sense of betrayal by the Peace
Corps and the Office had exacerbated his condition. The Office received additional evidence of
appellant’s functional capacity. On June 24, 2005 Dr. James G. Boyd, Jr., an orthopedist,
diagnosed right shoulder arthritis, rule out right rotator cuff tear, right greater trochanteric
bursitis and mild degenerative joint disease of the hips. He stated that appellant would be very
limited in the amount of lifting or reaching that he could do with the right arm and that repetitive

2

tasks would be difficult for him. He did not feel that any changes seen on x-rays of pelvis and
knee would account for any significant disability but would limit prolonged walking or standing.
In a decision dated June 20, 2007, the Office denied modification of the wage-earning
capacity determination. It found no evidence to establish that the original rating was in error or
that appellant’s compensable medical condition had changed for the worse or that he had been
vocationally rehabilitated. The Office stated: “You have failed to submit any rationalized,
probative and objective medical evidence to support the claim of total disability.”
LEGAL PRECEDENT
Section 8102(a) of the Federal Employees’ Compensation Act provides that 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.”1
In determining compensation for partial disability, the wage-earning capacity of an
employee is determined by the employee’s actual earnings if the employee’s actual earnings
fairly and reasonably represent his wage-earning capacity.”2 Generally, wages actually earned
are the best measure of a wage-earning capacity and in the absence of evidence showing that
they do not fairly and reasonably represent the injured employee’s wage-earning capacity must
be accepted as such measure.3
Once the loss of wage-earning capacity is determined, a modification of such
determination is not warranted unless there is a material change in the nature and extent of the
injury-related condition, the employee has been retrained or otherwise vocationally rehabilitated,
or the original determination was, in fact, erroneous. The burden of proof is on the party
attempting to show modification of the award.4
ANALYSIS
After his July 6, 1995 employment injury, which the Office accepted for hip contusion,
right buttocks inflammation and sciatica, appellant returned to work in the private sector. His
actual earnings from this employment over a period of time demonstrated his capacity to earn a
certain level of wages. Appellant’s employment injury had left him only partially disabled, and
the Office paid compensation for his partial loss of wage-earning capacity.
On February 13, 2004, however, appellant stopped work and claimed compensation for
total disability. He has the burden of proof to submit evidence sufficient to establish a material

1

5 U.S.C. § 8102(a).

2

Id. at § 8115(a).

3

Don J. Mazurek, 46 ECAB 447 (1995).

4

Daniel J. Boesen, 38 ECAB 556 (1987).

3

change in the nature and extent of his injury-related condition.5 Appellant has not met that
burden.
None of the submitted medical reports explains that appellant had to stop work on
February 13, 2004 because his hip contusion had materially worsened, or because his right
buttocks inflammation had materially worsened, or because his sciatica had materially worsened
to the point that he could no longer earn wages. Dr. Whitley, the clinical psychologist, reported
that appellant was totally disabled by constant and debilitating pain. He diagnosed depression
which he attributed to the employment injury. Dr. Whitley added that appellant was
psychologically disabled on a permanent basis, but the Office has not accepted that the
motorcycle incident on July 6, 1995 caused depression or post-traumatic stress disorder. His
reports do not establish a material change in the nature and extent of an injury-related condition.
The contemporaneous evidence indicates that appellant stopped work on February 13,
2004 because Dr. Bell, his neurologist, told him that he could improve the quality of his life by
moving to a warmer climate for health reasons. This is not a recognized basis for modifying a
determination of wage-earning capacity. A working claimant may relocate to a warmer climate
to improve the quality of his life, but that, in itself, does not mean he has lost his capacity to earn
wages. In the absence of a well-reasoned medical opinion showing a material worsening of one
of appellant’s accepted conditions, the Board will affirm the Office’s decision denying
modification of its 2002 determination of wage-earning capacity.
CONCLUSION
The Board finds that appellant has not met his burden to show a modification of the
Office’s 2002 determination of wage-earning capacity.

5

Appellant is not claiming that he has been retrained or vocationally rehabilitated, and he does not seek
reconsideration of the 2002 determination of wage-earning capacity on the grounds that it was in error.

4

ORDER
IT IS HEREBY ORDERED THAT the June 20, 2007 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: February 7, 2008
Washington, DC

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

Michael E. Groom, Alternate 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.W., Appellant
and
DEPARTMENT OF THE TREASURY,
INTERNAL REVENUE SERVICE,
Los Angeles, CA, Employer
__________________________________________

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

Docket No. 18-0949
Issued: July 23, 2019

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 April 4, 2018 appellant filed a timely appeal from a December 18, 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.
ISSUES
The issues are: (1) whether OWCP has met its burden of proof to terminate appellant’s
wage-loss compensation and medical benefits effective January 10, 2017 as she no longer had
residuals or disability casually related to her accepted employment injury; and (2) whether
appellant has met her burden of proof to establish residuals or continuing disability due to her
accepted employment injury on or after January 10, 2017.

1

5 U.S.C. § 8101 et seq.

FACTUAL HISTORY
On September 1, 1988 appellant, then a 48-year-old secretary, filed an occupational disease
claim (Form CA-2) alleging that she sustained a stress-related condition due to factors of her
federal employment including hearing male coworkers making comments of a sexual and sexist
nature. She indicated that she first became aware of her claimed condition on May 15, 1988 and
first became aware of its relation to her federal employment on June 20, 1988. Appellant stopped
work on June 8, 1988.
OWCP accepted appellant’s claim for depressive reaction.2 In reaching its determination,
it accepted several compensable employment factors including that some of the men in appellant’s
work group and a nearby group (including appellant’s manager) made remarks and jokes that were
of a sexual nature or were demeaning to women.3
The case record contains a limited amount of medical records from the late 1980s through
the early 2000s regarding the treatment of appellant’s psychiatric condition. In the early 1990s,
appellant began to treat with Dr. Irvin D. Godofsky, a Board-certified psychiatrist. In an
October 15, 1991 report, Dr. Godofsky indicated that appellant’s employment-related depressive
condition had been compounded by nonwork-related conditions, including bipolar disorder,
alcoholism (now in remission), and personality disorder (mixed) with schizotypal and narcissistic
features.
Dr. Godofsky continued to treat appellant throughout the 1990s and into the early 2000s.
In a report dated November 22, 2004, he noted that appellant was suffering from depressive
disorder with atypical features, alcohol abuse (in remission), personality disorder (not otherwise
specified), and post-traumatic stress disorder (PTSD). Dr. Godofsky noted that appellant’s
condition was chronic and recurring with periods of relative remission and periods of signiﬁcant
relapse and dysfunction. He discussed appellant’s difficulties with tolerating relationships with
supervisors or “authority.” Dr. Godofsky indicated that he did not believe that appellant or anyone
could return to the premorbid state after suffering from a severe depressive disorder complicated
by a serious personality disorder for over 16 years. He opined that appellant would not be
psychologically capable of functioning in a work or vocational rehabilitation setting.
Dr. Godofsky indicated that appellant had tried and failed to function in at least three nonstressful
volunteer jobs over the years.
In a November 11, 2008 report, Dr. Godofsky noted that appellant was suffering from
depressive disorder with atypical features, alcohol abuse (in remission), personality disorder (not
otherwise specified), and PTSD. He explained that the PTSD condition was related to childhood
trauma which was compounded by a physically and emotionally abusive marriage and which was
“magnified and made chronic by the trauma the patient experienced while working for the
[employing establishment].” Dr. Godofsky continued to find that appellant was disabled from all
work.

2

OWCP began to pay appellant appropriate wage-loss compensation on the periodic rolls.

3
OWCP also accepted employment factors with respect to appellant’s seeking of medical treatment in
February 1988 and a May 16, 1988 meeting regarding complaints of sexual harassment in the workplace.

2

In an August 25, 2008 report, Dr. Godofsky reported that appellant was suffering from
recurrent major depressive disorder of moderate severity, PTSD, alcohol abuse (in remission), and
personality disorder (not otherwise specified). He indicated that appellant’s PTSD was magnified
and made chronic by “trauma” she experienced while working for the employing establishment.
Dr. Godofsky continued to find that appellant was totally disabled.
In August 2016 OWCP referred appellant for a second opinion examination to
Dr. Edward R. Ritvo, a Board-certified psychiatrist. It requested that he provide an opinion
regarding whether appellant continued to have residuals or disability causally related to her
accepted employment condition of depressive reaction.
In a September 28, 2016 report, Dr. Ritvo detailed appellant’s factual and medical history.
He provided summaries of reports which described the treatment of her multiple psychiatric
problems over the years. Dr. Ritvo detailed the findings of the evaluation he conducted noting
appellant reported that sometimes she became depressed, but that she was currently taking the
medication Duloxetine which she felt was helpful. Appellant indicated that she had her own
apartment and was able to take care of all her basic needs. Dr. Ritvo noted that appellant drove
her own car and had friends with whom she attended movies and plays. He advised that appellant
denied delusions, hallucinations, morbid mood changes, suicidal ideation, and any evidence of
psychosis. During the evaluation, appellant made good eye contact and exhibited coherent thought
processes. Dr. Ritvo felt that appellant was pleasant and friendly during the evaluation and he
observed that she showed no signs of anxiety or depression.
Dr. Ritvo provided a diagnosis of major depressive order, resolved. He noted that appellant
had been in psychiatric treatment for many years, but apparently had responded well to such
treatment. In response to a question regarding whether appellant continued to suffer from the
depressive reaction as a result of the compensable factors of her former federal employment,
Dr. Ritvo responded, “The claimant has minimal if any residual symptoms of depression at this
time.” He indicated that appellant was capable of working and noted that, given her apparent
ability to function appropriately in her daily activities, she did not presently appear to be disabled.
Dr. Ritvo advised that appellant did not appear to have any work-related limitations at that time.
In an attached work capacity evaluation psychiatric/psychological conditions (Form OWCP-5a)
dated October 5, 2016, he noted that appellant could perform her usual job on a full-time basis.
In a letter dated October 18, 2016, OWCP advised appellant of its proposed termination of
her wage-loss compensation and medical benefits because she ceased to have residuals or disability
causally related to her accepted employment injury. It informed her that the proposed termination
action was based on the September 28, 2016 report of Dr. Ritvo, OWCP’s referral physician.
OWCP afforded appellant 30 days to submit evidence or argument to challenge the proposed
action. Appellant did not submit any evidence or argument within the allotted period.
By decision dated January 10, 2017, OWCP terminated appellant’s wage-loss
compensation and medical benefits effective January 10, 2017 as she no longer had residuals or
disability causally related to her accepted employment injury. It found that the weight of the
medical evidence with respect to employment-related residuals/disability rested with the
September 28, 2016 report of the referral physician, Dr. Ritvo.

3

On December 8, 2017 appellant requested reconsideration of the January 10, 2017
decision.
Appellant submitted a November 17, 2017 report from Dr. Godofsky who advised that it
remained his opinion that appellant continued to suffer from major depressive disorder, PTSD, and
personality disorder (unspecified). He indicated that the major depressive disorder was a chronic,
recurrent condition of “exacerbation and remission over a lifetime.” Dr. Godofsky noted that
Dr. Ritvo’s September 28, 2016 report was based on the day he spent with appellant in
September 2016 while she was in a period of remission. He believed that Dr. Ritvo disregarded
the years of ongoing experience he had with appellant throughout which he documented
appellant’s recurrent exacerbations of depression, somatization, anxiety, and detachment.
Dr. Godofsky posited that these recurrences were triggered by stressors that often replicated the
trauma she experienced at the employing establishment of not being “heard” and being treated in
ways that left her feeling helpless and demeaned.
By decision dated December 18, 2017, OWCP denied modification of its January 10, 2017
decision, noting that appellant had not submitted medical evidence after the January 10, 2017
termination action establishing that she had continuing residuals/disability of her accepted
employment injury on or after January 10, 2017.
LEGAL PRECEDENT -- ISSUE 1
Under FECA, once OWCP has accepted a claim it has the burden of justifying termination
or modification of compensation benefits.4 OWCP may not terminate compensation without
establishing that the disability ceased or that it was no longer related to the employment.5 Its
burden of proof includes the necessity of furnishing rationalized medical opinion evidence based
on a proper factual and medical background.6
ANALYSIS -- ISSUE 1
The Board finds that OWCP met its burden of proof to terminate appellant’s wage-loss
compensation benefits effective January 10, 2017, but it has not met its burden of proof to
terminate her medical benefits effective January 10, 2017.
The Board finds that the weight of the medical evidence with respect to whether appellant
has employment-related disability is represented by the opinion of Dr. Ritvo, OWCP’s referral
physician. The September 28, 2016 report of Dr. Ritvo establishes that appellant had no disability
due to her accepted employment injury, depressive reaction, after January 10, 2017.

4

L.L., Docket No. 18-1426 (issued April 5, 2019); C.C., Docket No. 17-1158 (issued November 20, 2018); I.J., 59
ECAB 408 (2008); Vivien L. Minor, 37 ECAB 541 (1986).
5

A.D., Docket No. 18-0497 (issued July 25, 2018). In general the term disability under FECA means incapacity
because of injury in employment to earn the wages which the employee was receiving at the time of such injury. See
20 C.F.R. § 10.5(f).
6

See R.P., Docket No. 17-1133 (issued January 18, 2018).

4

In his September 28, 2016 report, Dr. Ritvo advised that appellant denied delusions,
hallucinations, morbid mood changes, suicidal ideation, and any evidence of psychosis. During
the evaluation, appellant made good eye contact and exhibited coherent thought processes.
Dr. Ritvo felt that appellant was pleasant and friendly during the evaluation and he observed that
she showed no signs of anxiety or depression. He provided a diagnosis of major depressive order,
resolved. In response to a question regarding whether appellant continued to suffer from the
depressive reaction as a result of the compensable factors of her former federal employment,
Dr. Ritvo responded, “The claimant has minimal if any residual symptoms of depression at this
time.” He indicated that appellant was capable of working and noted that, given her apparent
ability to function appropriately in her daily activities, she did not presently appear to be disabled.
Dr. Ritvo advised that appellant did not appear to have any work-related limitations at the present
time and, in an attached October 5, 2016 form report, he noted that appellant could perform her
usual job on a full-time basis.
The Board has reviewed the opinion of Dr. Ritvo and notes that it has reliability, probative
value, and convincing quality with respect to its conclusions regarding appellant’s employmentrelated disability. Dr. Ritvo provided a thorough factual and medical history and accurately
summarized the relevant medical evidence. He provided medical rationale for his opinion
regarding appellant’s employment-related disability by explaining that he saw nothing in the
medical history or his direct evaluation of appellant to show that she had continuing disability due
to the accepted employment injury.7
For these reasons, OWCP has met its burden of proof to terminate appellant’s wage-loss
compensation effective January 10, 2017.
The Board further finds that Dr. Ritvo’s September 28, 2016 report does not contain a clear
opinion that appellant ceased to have residuals of her accepted employment injury as he advised
that appellant had some, albeit minor, residuals of this employment injury.
Appellant relied upon the medical opinions of Dr. Godofsky. However, the case record
does not contain a medical evaluation of appellant’s psychiatric condition which is
contemporaneous with the September 28, 2016 evaluation by Dr. Ritvo. The last prior evaluation
occurred more than two years prior, i.e., the August 25, 2014 evaluation of Dr. Godofsky. In
addition, although Dr. Godofsky referenced “trauma” at the employing establishment in his
August 25, 2014 report, he did not provide a clear opinion that appellant continued to have
residuals/disability causally related to the accepted condition of depressive reaction.8
Therefore, the Board finds that OWCP has not met its burden of proof to terminate
appellant’s medical benefits effective January 10, 2017.

7

See W.C., Docket No. 18-1386 (issued January 22, 2019); Melvina Jackson, 38 ECAB 443 (1987) (regarding the
importance, when assessing medical evidence, of such factors as a physician’s knowledge of the facts and medical
history, and the care of analysis manifested and the medical rationale expressed in support of the physician’s opinion).
8
See L.B., Docket No. 18-0533 (issued August 27, 2018) (finding that medical evidence which does not offer an
opinion regarding the cause of an employee’s condition/disability is of no probative value on the issue of causal
relationship).

5

LEGAL PRECEDENT -- ISSUE 2
After termination or modification of compensation benefits, clearly warranted on the basis
of the evidence, the burden for reinstating compensation benefits shifts to the claimant.9 In order
to prevail, the claimant must establish by the weight of the reliable, probative, and substantial
evidence that he or she had an employment-related disability which continued after termination of
compensation benefits.10
ANALYSIS -- ISSUE 2
The Board finds that appellant has not met her burden of proof to establish residuals or
continuing disability due to her accepted employment injury on or after January 10, 2017.11
After OWCP’s January 10, 2017 decision terminating appellant’s compensation effective
the same date, appellant submitted additional medical evidence to show she was entitled to wageloss compensation after January 10, 2017 due to her accepted employment injury. Given that the
Board has found that OWCP properly relied on the opinion of Dr. Ritvo in terminating appellant’s
wage-loss compensation effective January 10, 2017, the burden shifts to appellant to establish that
she is entitled to wage-loss compensation after that date. The Board has reviewed the additional
evidence submitted by appellant and notes that it is not of sufficient probative value to establish
that she had disability due to her accepted employment injury after January 10, 2017.
Appellant submitted a November 17, 2017 report from Dr. Godofsky who advised that it
remained his opinion that appellant continued to suffer from major depressive disorder, PTSD, and
personality disorder (unspecified). He noted that Dr. Ritvo’s September 28, 2016 report was based
on the day he spent with appellant in September 2016, while she was in a period of remission, and
he believed that the report disregarded the years that appellant had recurrent exacerbations of
depression, somatization, anxiety, and detachment. Dr. Godofsky posited that these recurrences
were triggered by stressors that often replicated the trauma she experienced at the employing
establishment of not being “heard” and being treated in ways that left her feeling helpless and
demeaned.
The Board finds that Dr. Godofsky’s November 17, 2017 report is of limited probative
value on the underlying issue of this case because he failed to provide adequate medical rationale
in support of his opinion on causal relationship. Dr. Godofsky did not provide any discussion of
the specific condition for which appellant’s claim was accepted, i.e., depressive reaction which
was caused by several factors including exposure to sexual and sexist comments in the workplace.
He made general references to “trauma” from her experience in the workplace, but he did not
discuss specific findings on examination or diagnostic testing which supported his ostensible
opinion that appellant had continuing residuals or disability from a condition which was suffered
almost 30 years prior. The Board has held that a medical report is of limited probative value on the
9

C.V., Docket No. 17-1159 (issued April 6, 2018); Wentworth M. Murray, 7 ECAB 570, 572 (1955).

10

Id.

11
For the reasons described above, OWCP did not meet its burden of proof to terminate appellant’s medical benefits
effective January 10, 2017. Therefore, it is not necessary to discuss appellant’s entitlement to medical benefits when
addressing the second issue of the case.

6

issue of causal relationship if it contains a conclusion regarding causal relationship which is
unsupported by medical rationale.12 Therefore, Dr. Godofsky’s November 17, 2017 report is
insufficient to establish appellant’s 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.
CONCLUSION
The Board finds that OWCP has met its burden of proof to terminate appellant’s wage-loss
compensation effective January 10, 2017, but it has not met its burden of proof to terminate her
medical benefits effective January 10, 2017. The Board further finds that she has not met her
burden of proof to establish residuals or continuing disability due to her accepted employment
injury on or after January 10, 2017.
ORDER
IT IS HEREBY ORDERED THAT the December 18, 2017 decision of the Office of
Workers’ Compensation Programs is affirmed as modified to reflect that OWCP did not meet its
burden of proof to terminate appellant’s medical benefits effective January 10, 2017.
Issued: July 23, 2019
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

12

Y.D., Docket No. 16-1896 (issued February 10, 2017); C.M., Docket No. 14-0088 (issued April 18, 2014).

7