United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
R.D., Appellant
and
U.S. POSTAL SERVICE, MID-ISLAND
PROCESSING & DISTRIBUTION, Melville, NY,
Employer
__________________________________________

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Appearances:
Paul Kalker, Esq., for the appellant
Office of Solicitor, for the Director

Docket No. 10-235
Issued: October 4, 2010

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 November 3, 2009 appellant, through counsel, filed a timely appeal from a
September 25, 2009 decision of the Office of Workers’ Compensation Programs that denied
authorization for surgery. The Office also denied modification of a September 8, 2008 decision
which terminated appellant’s compensation benefits. Pursuant to 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 the Office properly terminated appellant’s compensation
benefits effective September 27, 2008; (2) whether appellant had any residuals or disability after
September 27, 2008; and (3) whether the Office properly denied authorization for a thoracic
laminectomy decompression and fusion surgery.
FACTUAL HISTORY
On December 12, 2003 appellant, then a 39-year-old mail processor, sustained injury to
his low back. The Office accepted the claim for lumbosacral sprain and placed appellant on the
periodic rolls for temporary total disability effective March 21, 2004.

In an August 11, 2006 report, Dr. Yan Q. Sun, a second opinion Board-certified
orthopedic surgeon, reviewed the medical and employment injury histories and performed a
physical examination. A magnetic resonance imaging (MRI) scan of the lumbar spine was
reviewed and showed bulging discs. Dr. Sun advised that the accepted lumbar condition had
resolved as there were no objective findings. In an attached work capacity evaluation (Form
OWCP-5c), he found that appellant was capable of working eight hours with restrictions. In a
September 25, 2006 addendum, Dr. Sun reiterated that appellant’s lumbar sprain was resolved.
He related that, while appellant continued to be symptomatic, there were no objective findings.
Dr. Sun also opined that appellant’s cervical and thoracic conditions were not due to the
December 12, 2003 employment injury.
In progress notes date October 9, 2006, Dr. Victor Katz, a treating Board-certified
orthopedic surgeon, diagnosed an L5-S1 herniated disc and associated lumbar radiculopathy. In
a work capacity evaluation form of that date (OWCP-5c), he found that appellant was totally
disabled due to chronic pain and noted diagnoses of herniated lumbar disc with radiculopathy
and bilateral foot numbness. In a December 6, 2006 progress note, Dr. Katz diagnosed thoracic
cord compression at T10-11 due to facet hypertrophy and central disc bulge. He recommended
surgery for laminectomy, decompression and possible fusion.
On February 12, 2007 the Office received reports dated May 26 to November 8, 2006
from Dr. Poonam S. Dulai, an examining Board-certified psychiatrist and neurologist, who noted
that appellant injured his neck, back and low back on December 12, 2003. On neurological
examination appellant had lumbar and cervical spine tenderness and lumbar/paraspinal muscle
spasm.
On March 21, 2007 Dr. Katz diagnosed T10-11 central disc herniation with central disc
herniation secondary to facet hypertrophy and disc herniation, degenerative disc disease,
discogenic back pain and L5-S1 central disc herniation. He reported that appellant’s physical
examination was essentially unchanged and that he continued to have paraspinal muscle spasms
and tenderness. Dr. Katz recommended thoracic laminectomy, decompression and fusion
surgery.
On April 11, 2007 the Office received an undated progress note from Dr. Katz, who
attributed appellant’s T10-11 herniated disc to the accepted employment injury. Dr. Katz again
requested authorization for surgery.
In an April 25, 2007 report, Dr. Katz diagnosed degenerative disc disease at L5-S1, L5S1 central herniation, T10-11 cord compression, T10-11 central herniated disc with fact
hypertrophy and myelomalacia of the cord at that level. He reiterated his request for surgery.
The Office found a conflict in the medical opinion between Dr. Katz and Dr. Sun on the
issue of whether appellant had any residuals or disability as a result of his accepted lumbar strain
and on whether his thoracic condition was due to the December 12, 2003 employment injury
necessitating surgery. On June 22, 2007 it referred appellant to Dr. Mitchell Goldstein, a Boardcertified orthopedic, to resolve the conflict.
In a July 11, 2007 report, Dr. Goldstein reviewed the medical record, history of injury, a
statement of accepted facts and set out findings on physical examination. He concluded that

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appellant’s employment-related lumbar strain had resolved. On physical examination, there was
tenderness over the lumbar, paraspinal and thoracic areas. Dr. Goldstein related that an
electromyography showed mild lumbar radiculopathy and an MRI scan showed thoracic
compression at T10 and T11, mild cervical spine discogenic changes and a bulging lumbar disc.
He stated:
“[T]hough he had [an] injury date of [December] 12, [20]03, what he was
describing is he was describing minimal activity at that time that I would not
expect that to cause his clinical problems though at the same time he gives no
other history of precipitating trauma and stress to the spine and the symptoms can
be due to chronic lifting and bending that are work related. Due to his continued
clinical symptoms and compression noted at T10 and T11 surgical and failure to
respond to the current treatment to this date, surgery is reasonable and
appropriate.”
In an August 29, 2007 supplemental report, Dr. Goldstein opined that appellant’s
December 12, 2003 work injury did not cause his thoracic condition. He stated that, while the
surgical procedure recommended by Dr. Katz was reasonable, it was not related to a condition
caused by appellant’s accepted employment injury. Based on appellant’s description of how the
injury occurred on December 12, 2003, Dr. Goldstein did not believe that appellant’s current
orthopedic condition was causally related.
On October 15, 2007 the Office received progress notes from Dr. Katz dated October 9,
2006 to May 12, 2008 and a September 27, 2007 report from Dr. Dulai. Dr. Katz again
requested authorization to perform surgery and reiterated his opinion that appellant’s thoracic
condition was a result of the December 12, 2003 employment injury.
On June 30, 2008 Dr. Dulai diagnosed thoracic and lumbar injuries as a result of
appellant’s December 12, 2003 employment injury. He noted that appellant continued to have
low back pain complaints, intermittent lower extremity spasms and numbness in his feet. A
neurological examination revealed muscle spasm and tenderness of the lumbar paraspinal and
lower thoracic areas.
By decision dated July 31, 2008, the Office denied authorization for the thoracic
laminectomy, decompression and fusion surgery, finding that Dr. Goldstein’s impartial medical
opinion represented the weight of the medical evidence. It determined that the recommended
surgical intervention was not related to the work-related condition.
Thereafter, the Office received a July 21, 2008 progress note from Dr. Katz who noted
appellant’s condition was unchanged. Dr. Katz again requested authorization for surgery.
On August 4, 2008 the Office proposed to terminate appellant’s compensation. It found
that the weight of the medical evidence was represented by the opinion of Dr. Goldstein, the
impartial medical examiner, and established that the accepted lumbosacral strain had resolved
and that he had no residuals or disability due to his accepted condition. The Office also found
that Dr. Goldstein determined that appellant did not require further medical treatment. It allowed
appellant 30 days to submit additional evidence.

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In response, appellant noted that he continued to have residuals and disability due to his
accepted employment injury. He also contended that his thoracic and cervical conditions were
due to his December 12, 2003 employment injury.
By decision dated September 8, 2008, the Office terminated appellant’s compensation
benefits effective September 27, 2008 finding that his accepted lumbosacral sprain had resolved.
It found that Dr. Goldstein’s opinion constituted the weight of the medical evidence.
By decision dated May 20, 2009, the Office denied authorization for surgery. It relied
upon Dr. Goldstein’s impartial opinion that appellant’s thoracic condition was not employment
related.
In a letter dated June 24, 2009, appellant’s counsel requested reconsideration of both
decisions.
By decision dated September 25, 2009, the Office denied modification of the
September 8, 2008 and May 20, 2009 decisions.
LEGAL PRECEDENT -- ISSUE 1
Once the Office accepts a claim and pays compensation, it has the burden of justifying
modification or termination of an employee’s benefits.1 After it has determined that an
employee has disability causally related to his federal employment, the Office may not terminate
compensation without establishing that the disability has ceased or that it is no longer related to
the employment.2 The Office’s burden of proof includes the necessity of furnishing rationalized
medical opinion evidence based on a proper factual and medical background.3
The right to medical benefits for an accepted condition is not limited to the period of
entitlement for disability.4 To terminate authorization for medical treatment, the Office must
establish that appellant no longer has residuals of an employment-related condition, which would
require further medical treatment.5
Section 8123(a) of the Federal Employees’ Compensation Act provides in pertinent part:
“If there is disagreement between the physician making the examination for the United States
and the physician of the employee, the Secretary shall appoint a third physician who shall make
an examination.”6 Where a case is referred to an impartial medical specialist for the purpose of
1

S.F., 59 ECAB ___ (Docket No. 08-426, issued July 16, 2008); Kelly Y. Simpson, 57 ECAB 197 (2005); Paul L.
Stewart, 54 ECAB 824 (2003).
2

I.J., 59 ECAB 524 (Docket No. 07-2362, issued March 11, 2008); Elsie L. Price, 54 ECAB 734 (2003).

3

See J.M., 58 ECAB 478 (2007); Del K. Rykert, 40 ECAB 284 (1988).

4

T.P., 58 ECAB 524 (2007); Kathryn E. Demarsh, 56 ECAB 677 (2005).

5

Kathryn E. Demarsh, id.; James F. Weikel, 54 ECAB 660 (2003).

6

5 U.S.C. § 8123(a); see also R.H., 59 ECAB ___ (Docket No. 07-2124, issued March 7, 2008); Raymond A.
Fondots, 53 ECAB 637 (2002); Rita Lusignan (Henry Lusignan), 45 ECAB 207 (1993).

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resolving a conflict, the opinion of such specialist, if sufficiently well rationalized and based on a
proper factual and medical background must be given special weight.7
ANALYSIS -- ISSUE 1
The Office accepted appellant’s claim for lumbosacral sprain and placed him on the
periodic rolls in receipt of temporary total disability as of March 21, 2004. The burden is on the
Office to support the termination of appellant’s compensation. The Office found that termination
of appellant’s compensation was justified based on the impartial medical opinion of
Dr. Goldstein.
Appellant’s attending Board-certified orthopedic surgeon, Dr. Katz, opined that appellant
had residuals of his accepted lumbosacral sprain and attributed appellant’s T10-11 central disc
herniation to the December 12, 2003 employment injury. Dr. Sun, a second opinion Boardcertified orthopedic surgeon, concluded that appellant’s lumbar sprain had resolved and that
there were continuing disability or residuals due to the December 12, 2003 employment injury.
Dr. Sun found that the T10-11 central disc herniation condition was unrelated to the accepted
employment injury. The Office determined there was a conflict in the medical opinion evidence
as to whether appellant had any continuing residuals or disability due to his accepted
lumbosacral sprain and whether the December 12, 2003 employment injury caused appellant’s
thoracic condition. It referred appellant to Dr. Goldstein, a Board-certified orthopedic surgeon,
to serve as the impartial medical examiner.
The Board finds that Dr. Goldstein’s opinion is not entitled to the special weight
accorded an impartial medical examiner as his opinion is not well rationalized. On July 11, 2007
Dr. Goldstein conducted a physical examination of appellant and reviewed the medical records.
He noted an MRI scan which found a bulging lumbar disc and an EMG report showed mild
lumbar radiculopathy. However, Dr. Goldstein stated that the findings were mostly subjective
and that he saw no specific problems which would hinder appellant’s recovery. When asked to
clarify his opinion regarding appellant’s thoracic condition, in an August 29, 2007 supplemental
report, he noted that the MRI scan he reviewed did show a L4-S1 small central herniation which
he did not comment on in his report. Dr. Goldstein stated that he did not believe appellant’s
orthopedic problems were due to the December 12, 2003 employment injury based on
appellant’s description of the events that day. He did not provide any further explanation or
rationale for his conclusion. The Board has held that medical opinion that is not fortified by
rationale is of diminished probative value.8 Dr. Goldstein’s supplemental report addressed the
issue of whether appellant’s thoracic condition was employment related and noted that he did not
mention an L5-S1 small central disc herniation seen in an MRI scan he reviewed. His report is
not sufficient to establish that all residuals of the accepted condition ceased. In neither report did
Dr. Goldstein provide sufficient medical explanation to support his conclusion that appellant’s
accepted condition had fully resolved. Therefore, Dr. Goldstein’s opinion is of diminished
probative value as it contains insufficient medical rationale to support that appellant no longer
has residuals of his work injury or that his thoracic condition is not employment related.
7

V.G., 59 ECAB ___ (Docket No. 07-2179, issued July 14, 2008); Sharyn D. Bannick, 54 ECAB 537 (2003);
Gary R. Sieber, 46 ECAB 215 (1994).
8

Cecilia M. Corley, 56 ECAB 662 (2005).

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For these reasons, the Board finds that the opinion of Dr. Goldstein is not sufficient to
establish that appellant was no longer disabled or residuals from his accepted employment injury.
The Board finds that the Office did not meet its burden of proof to terminate his compensation
benefits as there remains an unresolved conflict in the medical evidence.
CONCLUSION
The Board finds that the Office failed to meet its burden of proof to terminate appellant’s
compensation benefits as of September 27, 2008.9
ORDER
IT IS HEREBY ORDERED THAT the decision of the Office of Workers’
Compensation Programs dated September 25, 2009 is reversed with respect to the termination of
appellant’s compensation benefits and set aside and remanded on the issue of the denial of
authorization for surgery.
Issued: October 4, 2010
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

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In light of the Board s disposition on the first issue, the second and third issues are moot.

6


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
N.S., Appellant
and
U.S. POSTAL SERVICE, MAIN POST OFFICE,
Lexington, SC, Employer
__________________________________________

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Appearances:
David Proffitt, Esq., for the appellant
Office of Solicitor, for the Director

Docket No. 10-1239
Issued: January 3, 2011

Case Submitted on the Record

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

JURISDICTION
On March 5, 2010 appellant, through her attorney, filed a timely appeal of the
February 1, 2010 nonmerit decision of the Office of Workers’ Compensation Programs finding
that she abandoned her hearing request. Pursuant to 20 C.F.R. §§ 501.2(c) and 501.3, the Board
has jurisdiction over the nonmerit issue in this case.1
ISSUE
The issue is whether appellant abandoned her request for a hearing.

1

The Board notes that appellant, through her attorney, is only appealing from the Office’s February 1, 2010
nonmerit decision. Although the Board has jurisdiction over the Office’s September 14, October 26 and
November 4, 2009 merit decisions, appellant has not appealed these decisions which denied her claim for
compensation and request for psychiatric treatment and terminated her medical benefits, respectively. Therefore, the
Board has not addressed them on this appeal. See 20 C.F.R. § 501.3(a)(c).

On appeal, counsel contends that, neither he nor appellant received notice of the
scheduled hearing. He requests that the Board remand the case to the Office for a hearing to
determine her entitlement to compensation.
FACTUAL HISTORY
The Office accepted that on July 26, 2004 appellant, then a 33-year-old rural carrier
associate, sustained cervical and lumbar strains, post-traumatic headaches and lumbar
radiculopathy in the performance of duty.2 On July 21, 2007 she returned to work as a modified
rural carrier associate.3 Appellant stopped work on October 2, 2008 and filed a claim for
compensation (Form CA-7) for the period commencing that date.
In a September 14, 2009 decision, the Office denied appellant’s claim for compensation
for the period commencing October 2, 20084 finding medical evidence insufficient to establish
that she was totally disabled during the claimed period due to the July 26, 2004 employment
injuries.
By decision dated October 26, 2009, the Office denied appellant’s request for psychiatric
treatment. The medical evidence was insufficient to establish that she sustained an emotional
condition as a consequence of the July 26, 2004 employment injuries.
In a November 4, 2009 decision, the Office terminated appellant’s medical benefits with
regard to her accepted employment injuries, effective that date as she failed to establish any
continuing residuals causally related to the July 26, 2004 employment injuries.
On October 9, 2009 appellant, through her attorney, requested a telephone hearing with
an Office hearing representative regarding the Office’s September 14, 2009 decision. On
December 1, 2009 counsel requested a telephone hearing regarding the Office’s October 26 and
November 4, 2009 decisions.
By letter dated December 15, 2009, the Office’s Branch of Hearings and Review notified
appellant that the hearing was scheduled for January 15, 2010 at 11:45 a.m. Eastern Time. It
instructed her to call the provided toll-free number a few minutes before the hearing time and
enter the passcode to gain access to the conference call. The notice was mailed to appellant’s
address of record. A copy of the notice was also mailed to her attorney’s address of record.
Appellant did not participate in the telephonic hearing.
2

The record reflects that appellant was involved in a work-related motor vehicle accident.

3

In an October 1, 2007 decision, the Office reduced appellant’s compensation to zero as her actual earnings as a
modified rural carrier associate fairly and reasonably represented her wage-earning capacity.
4

On September 14, 2009 the Office advised appellant that her Form CA-7 for the period commencing October 2,
2008 had been filed under the wrong claim number as it related to an accepted October 2, 2008 leg and knee
condition under File No. xxxxxx557. It advised her to file a Form CA-7 under File No. xxxxxx557. The Office
further advised appellant that doubling of the claims under File Nos. xxxxxx557 and xxxxxxx011 was not
warranted. The Board notes that appellant filed a Form CA-7 for the period commencing October 2, 2008 under
File No. xxxxxx557. Her claim was denied by the Office on November 16, 2009.

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In a February 1, 2010 decision, the Branch of Hearings and Review found that appellant
abandoned her requested hearing. The decision noted that the telephone hearing was scheduled
for January 15, 2010, but she failed to appear as instructed. The decision also found that there
was no indication that appellant contacted the Office either prior or subsequent to the scheduled
hearing to explain her failure to participate. Based on these factors, the Office concluded that
appellant abandoned her oral hearing request.
LEGAL PRECEDENT
Under the Federal Employees’ Compensation Act and its implementing regulations, a
claimant who has received a final adverse decision by the Office is entitled to receive a hearing
upon writing to the address specified in the decision within 30 days of the date of the decision for
which a hearing is sought.5 Unless otherwise directed in writing by the claim, the Office hearing
representative will mail a notice of the time and place of the hearing to the claimant and any
representative at least 30 days before the scheduled date.6 The Office has the burden of proving
that it mailed notice of a scheduled hearing to a claimant.7
The authority governing the abandonment of hearings rests with the Office’s procedure
manual, which provides that a hearing can be abandoned only under very limited circumstances.
All three of the following conditions must be present: the claimant has not requested a
postponement; the claimant has failed to appear at a scheduled hearing; and the claimant has
failed to provide any notification for such failure within 10 days of the scheduled date of the
hearing. Under these circumstances, the Branch of Hearings and Review will issue a formal
decision finding that the claimant has abandoned her request for a hearing and return the case to
the district Office.8
ANALYSIS
The record establishes that on December 15, 2009 in response to appellant’s timely
request for an oral hearing, the Branch of Hearings and Review mailed an appropriate notice of
the scheduled telephonic hearing on January 15, 2010 at 11:45 a.m. Eastern Time. The hearing
notice was mailed to appellant’s and her attorney’s address of record. The Board notes that the
notice was sent more than 30 days prior to the scheduled hearing date of January 15, 2010. The
record establishes that appellant did not call at the appointed time. Further, appellant did not
request a postponement of the hearing or explain her failure to appear at the hearing within 10
days of the scheduled hearing. Therefore, the Board finds that she abandoned her request for a
hearing.9
5

5 U.S.C. § 8124(b)(1); 20 C.F.R. § 10.616(a).

6

20 C.F.R. § 10.617(b).

7

See Michelle R. Littlejohn, 42 ECAB 463 (1991).

8

Federal (FECA) Procedure Manual, Part 2 -- Claims, Hearings and Reviews of the Written Record, Chapter
2.1601.6(e) (January 1999). See also G.J., 58 ECAB 651 (2007).
9

See C.T., 60 ECAB ___ (Docket No. 08-2160, issued May 7, 2009).

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On appeal, counsel contends that neither he nor appellant received notice of the
scheduled hearing. The record reflects that the December 15, 2009 hearing notice was mailed to
counsel’s and appellant’s address of record and was not returned as undeliverable. The Board
has found that, in the absence of evidence to the contrary, a letter properly addressed and mailed
in the due course of business, such as in the course of the Office’s daily activities, is presumed
received at the mailing address in due course. This is known as the mailbox rule.10 As the
Office properly mailed a hearing notice to appellant and her attorney, it is presumed that they
received the notice of hearing.
CONCLUSION
The Board finds that appellant abandoned her request for an oral hearing.
ORDER
IT IS HEREBY ORDERED THAT the February 1, 2010 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: January 3, 2011
Washington, DC

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

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

10

Jeffrey M. Sagrecy, 55 ECAB 724 (2004); James A. Gray, 54 ECAB 277 (2002).

4


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

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Appearances:
Thomas R. Uliase, Esq., for the appellant1
Office of Solicitor, for the Director

Docket No. 16-1480
Issued: March 22, 2017

Case Submitted on the Record

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

JURISDICTION
On July 11, 2016 appellant, through counsel, filed a timely appeal from a March 23, 2016
merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the
Federal Employees’ Compensation Act2 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board
has jurisdiction to consider the merits of this case.

1

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

5 U.S.C. § 8101 et seq.

ISSUE
The issue is whether appellant met her burden of proof to establish a recurrence of
disability on August 24, 2015 causally related to the accepted January 26, 2009 employment
injury.
On appeal, counsel contends that appellant has provided sufficient evidence to establish a
recurrence of disability within 90 days of her return to work. He asserts that OWCP’s decision
should be reversed and the matter remanded for approval of the recurrence of injury. In the
alternative, counsel suggests that the factual and medical evidence are sufficient to require
further development and therefore OWCP’s decision must be vacated and the matter remanded
for such additional development.
FACTUAL HISTORY
On January 26, 2009 appellant, then a 57-year-old lead contact representative, filed a
traumatic injury claim (Form CA-1) alleging that on that date she tripped ascending stairs and
injured her right leg, knee, and wrist. She stopped work on the date of the injury. On March 29,
2009 OWCP accepted appellant’s claim for closed dislocation subluxation at L5. Appellant
received compensation benefits on the periodic rolls as of July 5, 2009. On June 1, 2011 OWCP
also accepted her claim for sprain of the lumbar region of the back, closed dislocation lumbar
vertebra, and aggravation of lumbar degenerative disc at L4-L5. OWCP later accepted
appellant’s claim for chronic pain syndrome.
In a medical report dated July 17, 2015, Dr. Laura E. Ross, a Board-certified orthopedic
surgeon, indicated that appellant had spinal restriction/subluxation at T5, T6, T7, T8, L3, L4, L5,
and the sacrum; thoracolumbar, lumbosacral and sacral pain; moderate muscle spasms mid
thoracic, lower thoracic, left lumbar, lumbar, right lumbar, sacral, left buttock and right buttock;
and that the entire spine had moderately reduced range of motion. She noted that appellant was
improving because she was reporting less discomfort. Dr. Ross indicated that appellant could
return to work four hours a day, that she had permanent restrictions including sitting, walking,
standing, and reaching limited to four hours a day, and pushing, pulling and lifting limited to five
pounds. Dr. Ross indicated that appellant would have these restrictions for eight weeks, after
which time she would be able to work an eight-hour workday.
Appellant returned to work on July 17, 2015 at the employing establishment for four
hours a day working under the restrictions assigned by Dr. Ross.
Appellant saw her chiropractor, Dr. Saute K. Dean, on July 21, 2015. Dr. Dean
continued to diagnose subluxations of T1-3, L3-5, as well as shoulder subluxation. At that time,
appellant complained of aching, numbness, tightness, throbbing, and tingling discomfort in the
low back, at a level of 8 on a 1 to 10 scale, with 10 being the most severe. She noted that the
discomfort increased with movement and prolonged sitting, and decreased with rest, ice, and
heat. On July 28, 2015 Dr. Dean indicated that appellant rated her discomfort as level 8 at rest
which may increase to a level 10, and that she was able with much difficulty to perform her
normal job duties. He assessed her as better and with modest improvement.

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On September 1, 2015 appellant filed a recurrence of disability (Form Ca-2A) alleging a
recurrence of her January 28, 2009 injury as of August 24, 2015. She noted that she had been
released to limited duty for four hours a day for eight weeks, having returned to work on
July 27, 2015. Appellant alleged that her back pain, numbness, and tingling from her original
injury never stopped, that she missed work on August 12, 2015 due to work injury pain, and that
as she was getting dressed on August 24, 2015 for work when she noticed that her pain was
worse than usual, but that she went to work and was given heat treatment by the employing
establishment nurse.
In a September 4, 2015 report, Dr. Ross found limited range of motion of the left hip with
tenderness to palpitation on the left lateral aspect, spasms in her lumbar spine with tenderness to
palpitation, and with no new neurovascular findings bilateral lower extremities. She
recommended a magnetic resonance imaging (MRI) scan of the left hip, and further consultations
with specialists.
In a letter dated September 17, 2015, OWCP indicated that appellant’s claim had
previously been accepted for sprain of the lumbar region of the back, closed dislocation of the
lumbar vertebra, degeneration of lumbar or lumbosacral intervertebral disc, and chronic pain
syndrome. It described for appellant the additional evidence that was necessary to support her
claim for a recurrence of disability.
A September 17, 2015 MRI scan report was interpreted by Dr. Scott G. Mattox, a Boardcertified radiologist, as evincing no specific findings to suggest femoral acetabular impingement.
Appellant submitted notes from her August 24, 2015 hospital visit including notes of
Dr. Ramrakshah Tiwari, an emergency room physician. The notes indicate that appellant’s pain
level was 10, but that she ambulated slowly with assistance. The diagnoses were sciatica and
acute exacerbation of chronic back pain. Appellant was instructed to follow up with her
physician.
In a statement dated October 6, 2015, appellant alleged that on August 12, 2015 she
awoke with increased pain in her lower back that was intolerable, and she called her supervisor
to report her back pain. She indicated that she visited her chiropractor, who treated her with heat
and stimulation treatment that temporarily lessened her pain and allowed her to return to work
until August 24, 2015. Appellant alleged that after August 12, 2015 her condition worsened
daily even though she was working a light-duty schedule. She alleged that, on August 24, 2015,
she could no longer tolerate the pain, she went to the nurses’ office at the employing
establishment where she received treatment, and later that day she went to the emergency room
for pain treatment. Appellant stated that she called her supervisor the next day and told her that
she was no longer physically able to continue working. She contended that this was not a new
occupational disease, but rather a recurrence of the pain she had reported on August 12 and 24,
2015 related to her accepted work injury. Appellant noted that her accepted injury left her with
constant low back pain that radiated down to her buttocks and both legs with numbness and
tingling in both legs. She alleged that she never recovered from her original work injury and had
received treatment from several doctors. Appellant noted that, although Dr. Ross released her to
work light-duty employment four hours a day for eight weeks, before the eight weeks were

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completed the pain from her original injury elevated to the point where she could no longer
work.
In an August 26, 2015 note, Dr. Dean indicated that appellant had been under his care
since January 26, 2009 for work-related injuries. He noted that appellant had been receiving care
one to two times per week on a consistent basis to manage her chronic low back pain. Dr. Dean
opined that appellant suffered an exacerbation of her existing lower back condition which led to
her going to the emergency room to manage the pain on August 24, 2015. He indicated that
appellant came to his office on August 26, 2015 for further evaluation and treatment. Dr. Dean
noted an exacerbation of the injuries for which he had been treating her.
In an August 31, 2015 report, Dr. Susan E. Rowling, a Board-certified radiologist,
interpreted x-rays of appellant’s left hip as showing no fracture or misalignment. She noted that
the left hip joint spaces were preserved without significant degenerative changes, but there was a
persistent accessory ossification center lateral to the acetabulum. Dr. Rowling also noted a
transition vertebra partially visualized at the lumbosacral junction, similar to previously.
In an October 7, 2015 report, Dr. Dean noted that appellant ranked her pain at a level 8
that may increase to a level 10. He opined that she was unable to perform her normal job duties,
and was currently unable to work. Dr. Dean noted that appellant was approaching maximum
medical improvement because she was reporting more discomfort. He did note that she had
modest improvement as indicated in her subjective findings.
In an October 8, 2015 note, Dr. Ross indicated that appellant was seen in the emergency
room on August 24, 2015 for an exacerbation of her previous disc problem of her lower back,
which was a work-related injury that occurred on January 26, 2009. She opined that appellant
was unable to work in any capacity due to an acute exacerbation of chronic pain syndrome.
Dr. Ross also noted that appellant had a sprain of the lumbar region, closed dislocation of lumbar
vertebra, and with degeneration of her lumbosacral intervertebral disc.
In an October 14, 2015 note, Dr. Stephen Boyajian, an osteopath specializing in pain
management, noted that appellant had been under his care dating back to April 2009 for a work
injury that occurred in January 2009. He noted that he had last evaluated appellant in May 2015
and that she had undergone treatment that only provided her with temporary relief. Dr. Boyajian
concluded that appellant had since returned to the care of Dr. Ross for further evaluation and
treatment.
By decision dated October 28, 2015, OWCP denied appellant’s claim for a recurrence of
disability. It determined that the evidence of record did not establish that appellant had a return
of or increase in her disability due to a change or a material worsening of the accepted
employment-related condition.
On November 4, 2015 appellant, through counsel, requested a hearing before an OWCP
hearing representative.
Appellant continued to submit multiple reports with regard to her chiropractic
appointments with Dr. Dean, dated from September 9, 2015 through February 11, 2016. In these
reports Dr. Dean continued to opine that appellant was unable to work.
4

In a December 11, 2015 report, Dr. Ross noted that appellant was currently out of work
and that treatment with Dr. Dean was medically necessary and causally related to the accepted
employment injury of January 26, 2009. In a January 21, 2016 report, she noted that she had
been treating appellant for several years for an injury to her low back that occurred on
January 26, 2009. Dr. Ross noted that appellant’s diagnoses were low back injury in the L4-L5
lumbar region, closed dislocation of lumbar vertebra, degeneration of lumbar/ lumbosacral
intervertebral discs, and chronic pain syndrome. She opined that all of these conditions related
to the original injury of January 26, 2009. Dr. Ross discussed her treatment of appellant. She
noted that appellant went to the emergency room on August 24, 2015 due to an exacerbation of
her previous, accepted low back work injury and there had been no new injury diagnosed.
Dr. Ross opined that appellant was unable to work in any capacity at that time due to the
exacerbation of her chronic pain syndrome and because she also had a sprain in her lumbar
region, closed dislocation of the lumbar vertebrae, and degeneration of the lumbosacral
intervertebral discs. She opined that this was not a new occupational disease, but rather the pain
from her original work injury never stopped and began to increase from August 12 through 24,
2015 while she continued to try to work in the light-duty employment position at the employing
establishment.
Dr. Ross noted that on August 24, 2015 appellant’s pain became intolerable and she
required further medical treatment at an emergency room. She opined, as appellant’s treating
medical provider, that her work-related medical condition worsened to a point where she was
unable to do the modified work and that the worsening of the condition, without a doubt, was
related to the initial injury. Dr. Ross noted that appellant had the same physical examination
after August 24, 2015 as she did prior to August 24, 2015, noting that the examination was
unchanged and was clearly consistent with her previous work-related injury that had occurred on
January 26, 2009. She reported that no new findings were noted upon examination. Dr. Ross
explained that the recurrence of appellant’s injury occurred while she was doing her light work
on August 12, 2015, and that she had been treated by her chiropractor whose treatment helped
her to return back to work on August 24, 2015, until the pain reached an intolerant level and she
went to the hospital. In a January 22, 2016 report, she indicated that appellant continued to have
low back pain with unchanged neurologic findings in her lower extremities.
At the hearing held on February 17, 2016, appellant testified that she started work for the
employing establishment on October 11, 1988. She described her employment and noted a prior
employment injury that occurred in July 1997. Appellant noted that it had been raining and on
the way back to her office she slipped on the stairs and fell about 15 stairs. She described her
treatment, and noted that she was able to go back to full-duty work after this accident. Appellant
noted that on January 26, 2009 she fell on some stairs entering work and hurt her knee, wrist and
back. She stated that she returned to work in January 2010, but was unable to return to work full
time, and ceased working on May 25, 2010. Appellant noted that she was under medical care at
that time which included injections, therapy, chiropractic treatment, acupuncture, and aqua
therapy. She returned to work in July 2015, when Dr. Ross agreed to allow her to work part
time. Appellant noted that her doctor had initially placed restrictions on her commute so she did
not go back, but that she received a letter from the employing establishment indicating that they
were going to terminate her if she did not return to work immediately. She noted that for the first
week of work she was getting trained while sitting and that the sitting exceeded her restrictions.

5

Appellant noted that she missed work on August 12, 2015 because of back numbness. She also
alleged that the commute to her job exceeded her restrictions.
By decision dated March 23, 2016, the hearing representative affirmed the October 28,
2015 decision. He determined that appellant had not met her burden of proof to establish
recurrent disability as of August 24, 2015.
LEGAL PRECEDENT
A recurrence of disability means an inability to work after an employee has returned to
work, caused by a spontaneous change in a medical condition which had resulted from a
previous injury or illness without at intervening injury or new exposure to the work environment
that caused the illness.3 The term also means an inability to work that takes place when a lightduty assignment made specifically to accommodate an employee’s physical limitations due to his
or her work-related injury or illness is withdrawn (except when such withdrawal occurs for
reasons of misconduct, nonperformance of job duties, or a reduction in force), or when the
physical requirements of such an assignment are altered so that they exceed his or her established
physical limitations.4
When an employee who is disabled from the job he or she held when injured on account
of employment-related residuals returns to a limited duty position or the medical evidence of
record establishes that he or she can perform the limited-duty position, the employee has the
burden to establish by the weight of the reliable, probative and substantial evidence a recurrence
of total disability and to show that he or she cannot perform such limited-duty work.5 To show a
change in the degree of the work-related injury or condition, the claimant must submit
rationalized medical evidence documenting such change and explaining how or why the accepted
injury or condition disabled the claimant from work on and after the date of the alleged
recurrence of disability.6
OWCP procedures recognize that if an alleged recurrence occurs less than 90 days after a
return to light or full duty, the claimant is not required to produce the same evidence as for a
recurrence claimed long after apparent recovery and return to work. Therefore, in cases where
recurring disability for work is claimed within 90 days or less from the first return to duty, the
focus is on disability rather than causal relationship.7 The attending physician should describe

3

20 C.F.R. § 10.5(x).

4

Id.

5

Albert C. Brown, 52 ECAB 152, 154-55 (2000); Barry C. Petterson, 52 ECAB 120 (2000); Terry R. Hedman,
38 ECAB 222, 227 (1986).
6

James H. Botts, 50 ECAB 265 (1999).

7

Federal (FECA) Procedure Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.5(a) (June 2013). See also
J.S., Docket No. 16-0922 (issued September 22, 2016).

6

the duties which the employee cannot perform and the demonstrated objective medical findings
that form the basis for the renewed disability for work.8
ANALYSIS
OWCP accepted appellant’s claim for a sprain of the lumbar region of the back, closed
dislocation of lumbar vertebra, aggravation of lumbar degenerative disc at L4-L5, and chronic
pain syndrome causally related to appellant’s January 26, 2009 employment-related injury.
Appellant returned to work at the employing establishment for four hours a day on July 17, 2015.
She alleged that she suffered a recurrence of her accepted employment injury on
August 24, 2015. Appellant denies that she suffered a new injury.
The Board finds that appellant has failed to establish a recurrence of disability. OWCP
procedures provide if a claim for recurrence of disability is made within 90 days or less
following the first return to duty, the focus is on disability rather than causal relationship.9 The
Board finds that there is no objective rationalized medical evidence establishing recurrence of
disability on August 24, 2015.10
In support of her recurrence claim, appellant submitted medical reports by Dr. Ross, her
treating orthopedic surgeon. On July 17, 2015 Dr. Ross released appellant to return to work for
four hours a day with limitations including pushing, pulling, and lifting limited to five pounds.
She continued to treat appellant after she released her to return to work. In a January 21, 2016
report, Dr. Ross indicated that appellant was out of work due to the injuries she sustained as a
result of the employment incident of January 26, 2009. She noted that these diagnoses included
low back injury in the L4-L5 lumbar region, closed dislocation of the lumbar vertebrae, and
degeneration of the lumbosacral intervertebral discs. Dr. Ross opined that this was not a new
injury, but rather that appellant worked until her pain became intolerable on August 24, 2015 and
she was treated at the emergency room. She opined that the medical reason for this conclusion
was that appellant’s examination was unchanged, that she had the same physical examination
after August 24, 2015 as she did before August 24, 2015, and no new findings were noted. This
report does not, however, demonstrate a recurrence of disability as Dr. Ross did not provide a
rationalized medical opinion supporting an increase in disability after August 24, 2015. Dr. Ross
indicated that appellant could return to work on July 17, 2015. Despite the fact that she opined
that appellant was totally disabled as of August 24, 2015, she provided no objective evidence of
worsening symptoms. Furthermore, Dr. Ross noted that appellant had the same physical
examination findings before August 24, 2015 as she did after. Therefore, her report does not
show that appellant had an onset of disability that prevented her from performing her limitedduty position.11 Rather, Dr. Ross’ report appears to indicate that there was no change in
appellant’s level of disability before and after the alleged date of recurrence other than subjective
complaints of pain.
8

D.K., Docket No. 15-665 (issued August 10, 2015).

9

Supra note 7; see also A.P., Docket No. 14-1409 (issued June 17, 2015).

10

Supra note 8.

11

Supra note 9.

7

Appellant received chiropractic treatment from Dr. Dean.12 In a report dated August 26,
2015, Dr. Dean indicated that appellant had been under his care since January 26, 2009 for workrelated injuries. He opined that she suffered an exacerbation of her existing lower back condition
which led to her going to the emergency room to manage the pain on August 24, 2015. Dr. Dean
indicated that appellant came to his office on August 26, 2015 for further evaluation and
treatment at which time he determined that she suffered an exacerbation of the injuries for which
he had been treating her. However, his reports also show similar physical findings prior to the
August 24, 2015 alleged recurrence. For example, in an August 17, 2015 report, Dr. Dean
indicated that appellant rated her discomfort at a level 8 with rest and that it increased to a level
10 pain with 10 being the most severe. He noted that appellant was able, with much difficulty, to
perform her normal job duties. Dr. Dean noted that appellant was physically limited while
lifting, bending, stooping, walking, prolonged sitting, pulling, pushing, and twisting. In his
August 26, 2015 report, he noted that appellant had a discomfort level of 10 at rest and was
unable to perform her normal job duties. By the time of his September 2, 2015 report, Dr. Dean
noted that appellant’s discomfort level was level 8 at rest which may increase to level 10, and
that she was currently unable to work. He never explained how appellant’s condition had been
exacerbated on August 24, 2015 such that she sustained recurrent disability. As Dr. Dean’s
findings before and after August 24, 2015 are similar, and he referenced no objective findings
showing an increased level of disability it is found that he failed to provide a rationalized
explanation as to why appellant could perform her job duties, albeit with difficulty, before
August 24, 2016, but at the time of his August 26, 2015 examination she was no longer able to
do so. Dr. Dean appears to base appellant’s inability to work solely on her subjective complaints
of pain. A complaint of too much pain to work, without more, support does not establish
disability for work.13
The remaining medical evidence does not provide a rationalized medical opinion
establishing a recurrence of disability. Dr. Mattox merely interpreted a September 17, 2015 MRI
scan report as evincing no specific MRI scan findings to suggest femoral acetabular
impingement, his report does not address disability. Dr. Rowling interpreted x-rays of
August 31, 2015 as evincing no fracture or misalignment of appellant’s hip, and persistent
accessory ossification center lateral to the acetabulum, and a transition vertebra partially
visualized at the lumbosacral junction, similar to previously. Her report also does not address
disability. The hospital report from August 24, 2015 that was signed by Dr. Tiwari indicates that
appellant suffered from sciatica and an acute exacerbation of chronic back pain. This report does
not address disability or explain why there was a recurrence of the initial disability. Dr. Boyajian
noted that he provided treatment for pain relief, but also did not discuss any recurrence on
August 24, 2015. These medical reports failed to contain rationalized medical opinion, with
objective findings, explaining why appellant was unable to work her part-time light-duty job

12

Under FECA a chiropractor is considered a “physician” only to the extent that the reimbursable services are
limited to treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by
x-ray to exist. See Jay K. Tomokiyo, 51 ECAB 361 (2000).
13

See K.A., Docket No. 15-0665 (issued August 10, 2015).

8

beginning August 24, 2015. As such these reports lack probative value and are therefore
insufficient to establish appellant’s claim.14
Accordingly, appellant has submitted no probative medical opinion evidence to support
her recurrence claim. The medical evidence of record is unsupported by rationalized medical
evidence to demonstrate a claimed recurrence of total disability on August 24, 2015.
Appellant may submit new evidence or argument with a written request for
reconsideration to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a)
and 20 C.F.R. §§ 10.605 through 10.607.
CONCLUSION
The Board finds that appellant failed to meet her burden of proof to establish a recurrence
of disability on August 24, 2015 due to the accepted January 26, 2009 employment injury.
ORDER
IT IS HEREBY ORDERED THAT the decision of the Office of Workers’
Compensation Programs dated March 23, 2016 is affirmed.
Issued: March 22, 2017
Washington, DC

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

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

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

14

See supra note 8.

9


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
W.R., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Chicago, IL, Employer
__________________________________________

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

Docket No. 09-1107
Issued: January 8, 2010

Case Submitted on the Record

DECISION AND ORDER
Before:
DAVID S. GERSON, Judge
COLLEEN DUFFY KIKO, Judge
MICHAEL E. GROOM, Alternate Judge

JURISDICTION
On March 18, 2009 appellant filed a timely appeal from the November 18, 2008 merit
decision of the Office of Workers’ Compensation Programs, which denied his claim of disability
for a particular period. Pursuant to 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction
to review the merits of the case. The Board also has jurisdiction to review the Office’s
January 30, 2009 nonmerit decision denying his request for reconsideration.1
ISSUES
The issues are: (1) whether appellant sustained a recurrence of disability from
September 17 to 23, 2007 as a result of his accepted employment injury; and (2) whether the
Office properly denied his January 12, 2009 request for reconsideration.

1

The Board’s jurisdiction is limited to reviewing the evidence that was before the Office at the time of its final
decision. 20 C.F.R. § 501.2(c). The Board, therefore, has no jurisdiction to review any evidence appellant submitted
on appeal that was not before the Office when it issued its decisions on November 18, 2008 and January 30, 2009.

FACTUAL HISTORY
On August 4, 1989 appellant, then a 37-year-old supervisor of mails, filed an
occupational disease claim alleging that his back condition, which he first became aware of in
March 1987, was a result of his federal employment. The Office accepted his claim for
aggravation of preexisting spondylolisthesis at L5-S1 with L5 spondylosis and spina bifida
occulta. Appellant received compensation for wage loss.
On June 14, 2007 appellant accepted a rehabilitation assignment offer as a mail handler
effective June 23, 2007. Physical restrictions included no continuous standing or walking and no
lifting over 10 pounds.
On January 11, 2007 appellant filed a claim for compensation for total disability from
September 17 to 23, 2007. He sought medical attention on September 18, 2007 for numbness in
his toes: “States that not all of them are numb and his big toes are numb only when he puts
weight on them and it feels as though he is walking on something.” Dr. Thelma Evans, an
internist, diagnosed tenia pedis (athlete’s foot), onychomycosis (a fungal infection), hypertension
and chronic low back pain due to old work injury. She prescribed an antifungal cream to be
applied at bedtime to the nail beds and around the toenails. Dr. Evans advised appellant not to
soak his feet in bleach water but to use Epsom salt if he preferred to use something other than
plain water. She gave him a note to be off work from September 17 to 23, 2007, returning to
work on September 24, 2007 with restrictions on walking, standing and lifting.
On November 30, 2007 the Office informed appellant that the report of Dr. Evans did not
explain any material change in his employment-related condition. It asked him to submit a
narrative report with a well-rationalized statement from his physician showing that he was
disabled due to his work injury. “Your doctor should also explain why you were unable to work
limited duty.”
Appellant responded that his limited duty was not consistent with his work restrictions.
On May 9, 2008 Dr. Thierry Dubois, his family physician, wrote the following:
“[Appellant] is a patient here at Advocate Beverly. Patient was seen by
Dr. Thelma Evans September 7, 2007 thru September 9, 2007. Patient was
diagnosed with an [a]cute [e]xacerbation of his [c]hronic [l]ow [b]ack [p]ain. His
low back pain is work related. Patient was given work statement September 7,
2007 work statement has the patient returning to work September 10, 2007 with
limitations. September 18, 2007 statement has the patient return to work
[September 29, 2007] [sic] with limitations.”
In a decision dated November 18, 2008, the Office denied appellant’s claim for wage loss
from September 17 to 23, 2007. It found that the medical evidence did not establish workrelated disability for the period claimed.
On January 12, 2009 appellant requested reconsideration. He explained that Dr. Evans
was on extended leave and could not be contacted to secure the requested medical narrative prior

2

to the Office decision denying his claim. Appellant stated that he had examined the record,
which “revealed such a narrative in support of my claim.”
In a decision dated January 30, 2009, the Office denied appellant’s request for
reconsideration. It found that he failed to identify the medical narrative to which he referred.
The Office listed Dr. Evans’ return to work slip and Dr. Dubois’ May 9, 2008 report, and that no
new medical evidence pertaining to his claim of disability from September 17 to 23, 2007 had
been submitted following the November 18, 2008 decision. Because appellant’s request for
reconsideration neither raised substantive legal questions nor included new and relevant
evidence, it found it insufficient to warrant a review of its prior decision.
On appeal, appellant repeated that Dr. Evans was on an extended leave of absence. He
stated that he filed a Form CA-2 through his agency but that the Office did not receive it.
Appellant attached a copy of the claim form. He also stated that additional medical evidence
was submitted but never sent to the Office. Appellant enclosed copies of medical records he
maintained to substantiate his claim, including Dr. Evans’ notes and a response from Dr. Dubois.
LEGAL PRECEDENT -- ISSUE 1
The Federal Employees’ Compensation Act provides compensation for the disability of
an employee resulting from personal injury sustained while in the performance of his duty.2
“Disability” means the incapacity, because of an employment injury, to earn the wages the
employee was receiving at the time of injury. It may be partial or total.3
When an employee who is disabled from the job he held when injured on account of
employment-related residuals returns to a limited-duty position, or the medical evidence of
record establishes that he can perform the limited-duty position, the employee has the burden to
establish by the weight of the reliable, probative and substantial evidence a recurrence of total
disability and to show that he cannot perform such limited-duty work. As part of this burden, the
employee must show a change in the nature and extent of the injury-related condition or a change
in the nature and extent of the limited-duty job requirements.4
ANALYSIS -- ISSUE 1
Appellant has the burden of proof to establish his entitlement to compensation for wage
loss for the period claimed. In June 2007 he returned to limited duty as a mail handler in a
rehabilitation assignment. Appellant filed a claim for total wage loss from September 17
to 23, 2007. He has to show either a change in the nature and extent of his injury-related
condition or a change in the nature and extent of his limited-duty job requirements.

2

5 U.S.C. § 8102(a).

3

20 C.F.R. § 10.5(f).

4

See Terry R. Hedman, 38 ECAB 222, 227 (1986).

3

The medical evidence does not establish any change in the nature and extent of his
injury-related condition. Indeed, it appears that appellant was off work due to a fungal infection,
not because of the low back injury he sustained in the late 1980s. When he sought medical
attention on September 18, 2007, his complaint was numbness in his toes. In addition to
hypertension and chronic low back pain, appellant’s treating internist, Dr. Evans, diagnosed
athlete’s foot and a fungal infection. After prescribing an antifungal cream and offering advice
on soaking his feet, she took him off work from September 17 to 23, 2007. Dr. Evans made no
mention of appellant’s spondylolisthesis at L5-S1, his L5 spondylosis or his spina bifida occulta
as being a cause of his disability for work.
On May 9, 2008 Dr. Dubois, appellant’s family physician, did little more than review the
notes of Dr. Evans. He offered no opinion on whether appellant needed to miss work from
September 17 to 23, 2007 because of a worsening of his accepted employment injuries.
The medical evidence of record does not show a change in the nature and extent of
appellant’s injury-related condition. Neither does the factual evidence show a change in the
nature and extent of appellant’s limited-duty job requirements. Appellant stated that his limited
duty was not consistent with his work restrictions, but he offered no evidence to establish that
this was the reason he had to stop work for a week beginning September 17, 2007. He made no
mention of this to Dr. Evans when he sought medical attention on September 18, 2007.
Appellant complained instead about his toes.
Because the evidence fails to establish that appellant sustained a recurrence of disability
from September 17 to 23, 2007 as a result of his accepted employment injury, the Board finds
that appellant has not met his burden of proof. The Board will affirm the Office’s November 18,
2008 decision denying compensation for wage loss from September 17 to 23, 2007.
On appeal, appellant asserts that he filed additional documents, including a Form CA-2
and unspecified medical evidence, but the employing establishment never sent it along to the
Office. It makes no difference to this appeal. The Board’s review of the case is strictly limited
to the evidence that was, in fact, before the Office at the time of its final decision. The Board
cannot consider evidence that does not so appear in the case record.
LEGAL PRECEDENT -- ISSUE 2
The Office may review an award for or against payment of compensation at any time on
its own motion or upon application.5 The employee shall exercise this right through a request to
the district Office.6
An employee (or representative) seeking reconsideration should send the request for
reconsideration to the address as instructed by the Office in the final decision. The request for
reconsideration, including all supporting documents, must be in writing and must set forth
arguments and contain evidence that either: (1) shows that the Office erroneously applied or
5

5 U.S.C. § 8128(a).

6

20 C.F.R. § 10.605.

4

interpreted a specific point of law; (2) advances a relevant legal argument not previously
considered by the Office; or (3) constitutes relevant and pertinent new evidence not previously
considered by the Office.7
A request for reconsideration must be sent within one year of the date of the Office
decision for which review is sought.8 A timely request for reconsideration may be granted if the
Office determines that the employee has presented evidence or argument that meets at least one
of these standards. If reconsideration is granted, the case is reopened and the case is reviewed on
its merits. Where the request is timely but fails to meet at least one of these standards, the Office
will deny the request for reconsideration without reopening the case for a review on the merits.9
ANALYSIS -- ISSUE 2
Appellant made his January 12, 2009 request for reconsideration within one year of the
Office’s November 18, 2008 merit decision denying his recurrence claim. His request was
therefore timely. The request did not show that the Office erroneously applied or interpreted a
specific point of law. It did not advance a relevant legal argument not previously considered by
the Office, nor did it include evidence that constituted relevant and pertinent new evidence not
previously considered by the Office.
Appellant explained that Dr. Evans was on extended leave and could not be contacted to
secure the requested medical narrative. That is not relevant to the issue of his entitlement to the
compensation claimed. It merely accounts for his failure to submit the necessary medical
evidence. Appellant added that his own examination of the record revealed a narrative in support
of his claim. However, he did not specifically identify which medical narrative of record.
Appellant’s January 12, 2009 request for reconsideration does not meet any of the
standards for obtaining a merit review of his case. The Board finds that the Office properly
denied his request. The Board will affirm the Office’s January 30, 2009 decision denying a
reopening of his case.
CONCLUSION
The Board finds that the evidence fails to establish that appellant sustained a recurrence
of disability from September 17 to 23, 2007 as a result of his accepted employment injury. The
Board further finds that the Office properly denied appellant’s January 12, 2009 request for
reconsideration.

7

Id. at § 10.606.

8

Id. at § 10.607(a).

9

Id. at § 10.608.

5

ORDER
IT IS HEREBY ORDERED THAT the January 30, 2009 and November 18, 2008
decisions of the Office of Workers’ Compensation Programs are affirmed.
Issued: January 8, 2010
Washington, DC

David S. Gerson, Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

6


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
D.B., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Detroit, MI, Employer
__________________________________________

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

Docket No. 10-238
Issued: October 8, 2010

Case Submitted on the Record

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

JURISDICTION
On November 2, 2009 appellant filed a timely appeal from a September 25, 2009 merit
decision of the Office of Workers’ Compensation Programs, which affirmed the February 24,
2009 denial of the claim. Pursuant to 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction
over the merits of this case.
ISSUE
The issue is whether appellant established that her bilateral knee degenerative joint
disease is causally related to her federal employment duties.

FACTUAL HISTORY
On November 24, 2008 appellant, a 55-year-old mail processor, filed an occupational
disease claim (Form CA-2) for “post[-]traumatic degenerative arthritis” in her knees.1 She
attributed her condition to employment tasks involving bending, walking, stooping, pushing
heavy equipment and working on “hard” concrete floors, after a November 7, 1996 left knee
injury. Appellant noted that she first became aware of her bilateral knee condition and that it
was caused by her federal employment on June 1, 1999.
Appellant submitted notes bearing illegible signatures, a collection of unsigned treatment
notes and notes signed by a physical therapist.
In a January 9, 1997 note, Dr. Walter L. Everett, Jr., a Board-certified orthopedic
surgeon, diagnosed patellar tendinitis of the left knee.
On June 3, 2003 Dr. Nasser Barkhordari, a radiologist, reported that x-rays of appellant’s
right knee, were essentially a normal study, but revealed “early changes of arthritis.”
On January 11, 2006 Dr. Victor C. Gordon, an orthopedist, carefully reviewed appellant’s
employment history, presented findings on examination and, relative to appellant’s alleged lower
extremity conditions, diagnosed degenerative joint disease in appellant’s knees, chondromalacia
patellae, gait dysfunction with chronic pain syndrome and “reactive depression.” He opined:
“there appears to be a causal relationship between the vocational activities and the current
findings of multiple areas of physical impairment.”
Appellant submitted a January 19, 2006 note in which Dr. Steven Lewin, an orthopedist,
diagnosed “degenerative changes” of the left knee, based upon x-ray studies.
On February 9, 2006 Dr. David H. Berns, a Board-certified diagnostic radiologist,
reported that a magnetic resonance imaging (MRI) scan of appellant’s left knee revealed tricompartmental “arthritic disease” associated with “a small to moderate” sized joint effusion. In
a subsequent report, dated February 13, 2006, Dr. Berns reported that an MRI scan of appellant’s
right knee revealed tricompartmental arthritic changes, small joint effusion with a popliteal cyst
and degenerative changes of the menisci without a definitive tear.
Appellant submitted an October 2, 2006 report in which Dr. Gordon noted that
appellant’s knee arthralgia had increased, with episodic swelling, buckling and occasional
locking. He diagnosed degenerative joint disease of the knees, chondromalacia patellae and gait
dysfunction with chronic pain syndrome.

1

Appellant has additional workers’ compensation claims. Claim file number xxxxxx957 was accepted for a left
knee contusion. Claim file number xxxxxx749 was accepted for left knee strain. Under claim file number
xxxxxx059 appellant claimed work-related stress and anxiety. This claim was denied. Claim file number
xxxxxx055 was accepted for lumbar strain, though later denied. Claim file number xxxxxx085 concerned a
traumatic left shoulder injury. Claim file number xxxxxx698 concerned a traumatic injury claim for bilateral
chronic arm pain, for which she was placed on the periodic rolls. Claim file number xxxxxx463 concerned a left
arm condition.

2

In an October 17, 2007 note, Dr. Thomas Bryan, a Board-certified internist, related that
he had examined appellant on that day for left-knee osteoarthritis. He states that employment
tasks involving bending caused appellant’s knee to “pop out of place.” Dr. Bryan noted that
appellant had osteoarthritis, but that this condition “did not come naturally [but] was initiated by
a work injury.” He did not relate knowledge of appellant’s employment history.
Appellant thereafter submitted a series of reports from Dr. Jeffery J. Carroll, an
orthopedist, dated January 28, February 7 and 21, March 6, May 19 and 30, and October 6, 2008
wherein he diagnosed right-knee degenerative joint disease, bilateral degenerative joint disease
and obesity. Dr. Caroll opined that it is “certainly possible that post[-]traumatic degenerative
disc disease could have occurred because of her injury described in 1996.”
In a June 17, 2008 note, Dr. Thomas Mays, Board-certified in family medicine,
diagnosed knee pain. On September 18, 2008 he diagnosed degenerative joint disease and gait
disease.
On November 6, 2008 Dr. Carroll stated that appellant’s left knee condition was “a direct
result of a previous knee injury, which occurred at work described in 1996.” In a subsequent
note, dated November 24, 2008, he reviewed appellant’s history of injury and course of
treatment. Dr. Carroll stated that appellant’s left knee pain began 12 years ago after a work
injury when she “apparently” strained the knee during a twisting type episode. He noted that
appellant had progressively worsening knee pain since the injury. Dr. Carroll also opined that
her left knee problems have increased due to heavy lifting, pushing, pulling, kneeling and
squatting. Regarding appellant’s right knee, he stated that the right knee was injured at work on
June 1, 1999. Dr. Carroll noted that prior evaluation reveals she does have significant knee
degenerative joint disease, as documented by both physical examination and x-ray evaluation.
Appellant recently had a right total knee arthroplasty and is doing quite well postoperatively
regarding her right knee. However, right knee symptoms have been aggravated by left knee
problems. Finally Dr. Carroll explained that appellant’s left knee was now significantly
symptomatic and she would require left knee arthroplasty as well. He concluded: “It is
reasonable to assume that her left knee arthritis is directly related to her knee injury
approximately 12 years ago, as well as the right knee injury in 1999. [Appellant’s] left knee
symptoms are getting worse due to recent right total knee.”
Appellant submitted a narrative report, dated January 5, 2009, in which Dr. Mays noted
that appellant’s records had been lost, but that he would summarize appellant’s past medical
history based upon his recollection. Dr. Mays stated that she was first seen for left knee pain in
March 1997 and that her work duties were the cause of her knee pain. He stated that appellant’s
knee pain was initially diagnosed as patellar tendinitis, but over the course of years developed
into degenerative joint disease. In 2006, appellant’s right knee condition worsened and she
underwent right knee replacement.
Seeking a supplemental opinion concerning appellant’s condition, by letter dated
January 21, 2009, the Office forwarded a statement of accepted facts and a list of questions to
Dr. Carroll. The Office advised Dr. Carroll that his November 24, 2008 note was insufficient
because its factual history and underlying medical rational were unclear.

3

The statement of accepted facts noted that appellant was employed as a mail processor
beginning in 1985 performing duties including lifting up to 70 pounds a day, pushing/
walking/standing eight hours per day and repeat bending four hours a day. On January 4, 1995 a
mail tray fell on appellant’s left leg/knee. This claim was accepted for left knee contusion. On
November 17, 1996 appellant bent down to retrieve mail from a low shelf and felt a “pop” in her
left knee. This claim was accepted for left knee strain. In July 1999 appellant sustained upper
extremity injuries. She returned to restricted duty on July 20, 1999 and last worked on
August 4, 2000. Appellant sustained two nonwork-related right knee injuries in March and
July 2003, getting off a bus and walking down stairs.
In a February 9, 2009 narrative report, Dr. Carroll states that his records regarding
appellant began on February 7, 2008. Regarding the left knee, he stated that appellant’s
condition, namely arthritis of the left knee:
“[W]as significantly aggravated by the work-related injury but was not caused
by the injury. Also because of the physical nature of [appellant’s] work, it is
likely that the degenerative condition was accelerated. Her arthritis symptoms
were likely precipitated by the work-related injury. It is difficult to discern
whether this was a temporary aggravation or permanent aggravation because I
did not evaluate her at the time of her initial injury. However, it is reasonable
to assume that the left knee injury was permanently aggravated by the injury in
light of [appellant’s] condition and her medical history. I believe that the two
left knee injuries and the general job duties could be reasonably assumed to
significantly aggravate her left knee. That is, there is a causal relationship
between the injury and the job[-]related duties. There was also a precipitation
component and a likely permanent aggravation component. These opinions are
based on your definitions regarding causal relationship and permanent
aggravations.”
Regarding her right knee, Dr. Carroll stated that appellant had related that there was an
injury that occurred at work. He thereafter concluded: “my opinion regarding her right knee is
the same as that of her left knee regarding causal relationship, accelerations, precipitation,
aggravations, temporary aggravations and permanent aggravation.” “In summary, regarding
your questions … regarding injuries of [January 4, 1995] and [November 7, 1996,] the injuries
likely aggravated her possibly preexisting knee degenerative disease. Again with an
acceleration, precipitation and permanent aggravation component per your definition.”
By decision dated February 24, 2009, the Office accepted the employment factors
appellant deemed responsible for her condition, but denied the claim because the evidence of
record did not demonstrate that the established employment factors caused the diagnosed
bilateral degenerative knee conditions.
Appellant disagreed and on March 2, 2009, through her attorney, requested an oral
hearing.

4

At a hearing, conducted July 21, 2009, at which appellant and her attorney were present,
appellant offered testimony concerning her condition, history of injury, course of treatment, her
work duties and the other workers’ compensation claims she has filed.
By decision dated September 25, 2009, the Office denied the claim because the evidence
of record did not demonstrate that appellant’s degenerative joint disease of the knees was
causally related to factors of her federal employment.
LEGAL PRECEDENT
An employee seeking benefits under the Federal Employees’ Compensation Act2 has the
burden of proof to establish the essential elements of her claim by the weight of the evidence,3
including that she sustained an injury in the performance of duty and that any specific condition
or disability for work for which she claims compensation is causally related to that employment
injury.4 As part of her burden, the employee must submit rationalized medical opinion evidence
based on a complete factual and medical background showing causal relationship.5 The weight
of medical evidence is determined by its reliability, its probative value, its convincing quality,
the care of the analysis manifested and the medical rationale expressed in support of the
physician’s opinion.6
To establish that an injury was sustained in the performance of duty in a claim for
occupational disease, an employee must submit: (1) a factual statement identifying employment
factors alleged to have caused or contributed to the presence or occurrence of the disease or
condition; (2) medical evidence establishing the presence or existence of the disease or condition
for which compensation is claimed; and (3) medical evidence establishing that the diagnosed
condition is causally related to the employment factors identified by the employee.7
Causal relationship is a medical issue and the medical evidence generally required to
establish causal relationship is rationalized medical opinion evidence. Rationalized medical
opinion evidence is medical evidence which includes a physician’s rationalized opinion on
whether there is a causal relationship between the employee’s diagnosed condition and the
compensable employment factors. The opinion of the physician must be based on a complete
factual and medical background of the employee, must be one of reasonable medical certainty,

2

5 U.S.C. §§ 8101-8193.

3

J.P., 59 ECAB ___ (Docket No. 07-1159, issued November 15, 2007); Joseph M. Whelan, 20 ECAB 55,
58 (1968).
4

G.T., 59 ECAB ___ (Docket No. 07-1345, issued April 11, 2008); Elaine Pendleton, 40 ECAB 1143,
1145 (1989).
5

Id.; Nancy G. O’Meara, 12 ECAB 67, 71 (1960).

6

Jennifer Atkerson, 55 ECAB 317, 319 (2004); Naomi A. Lilly, 10 ECAB 560, 573 (1959).

7

See Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. Fish, 46 ECAB 276, 279 (1994).

5

and must be supported by medical rationale explaining the nature of the relationship between the
diagnosed condition and the specific employment factors identified by the employee.8
ANALYSIS
The Office accepted the employment factors appellant deemed responsible for her
condition. Appellant was employed as a mail processor as of 1985 performing duties requires
lifting up to 70 pounds a day, pushing/walking/standing eight hours a day, and repeat bending
four hours a day. On January 3, 1995 appellant sustained a left knee contusion when a mail tray
fell on her left knee, and on November 17, 1996 appellant’s left knee “popped” while she was
retrieving mail from a low shelf, causing a left knee strain. Appellant stopped work on August 4,
2000 due to upper extremity injuries. Appellant’s burden is to demonstrate that these established
employment factors caused the alleged bilateral degenerative arthritis of the knees. Causal
relationship is a medical issue that can only be proven by probative medical opinion evidence.
The medical evidence of record lacks the requisite reasoning to establish causal relationship and,
consequently, the Board finds appellant has not established that her currently diagnosed bilateral
knee conditions were causally related to her federal employment.
The Board notes initially that the report and notes bearing illegible signatures, the
collection of unsigned treatment notes, and the notes signed by a physical therapist are not
competent medical evidence and have no evidentiary value because they cannot be identified as
having been prepared by a “physician” as defined by the Act.9 Furthermore, because healthcare
providers such as nurses, acupuncturists, physician assistants and physical therapists are not
considered “physicians” under the Act, their reports and opinions do not constitute competent
medical evidence.10 Thus, this evidence does not establish a causal relationship between the
established employment factors and appellant’s alleged condition.
The reports and notes signed by Drs. Barkhordari, Berns, Everett and Lewin, have
diminished probative value on the issue of causal relationship because they provide diagnoses of
appellant’s bilateral degenerative knee conditions, based upon x-ray and MRI scan studies, but
lack any opinion regarding the cause of the diagnosed conditions. Their reports do indicate,
however, that appellant’s condition worsened based upon radiologic studies between 2003 and
2006.
While Dr. Gordon did provide a detailed report of appellant’s employment history,
diagnosed bilateral degenerative joint disease of the knees, chondromalacia patellae, gait
dysfunction, and concluded that “there appears to be a causal relationship between the vocation
activities and the current findings of multiple areas of physical impairment,” he offered no
medical rationale in support of his conclusion. He offered medical explanation of how the
8

I.J., 59 ECAB ___ (Docket No. 07-2362, issued March 11, 2008); Victor J. Woodhams, 41 ECAB 345,
352 (1989).
9

Vickey C. Randall, 51 ECAB 357 (2000); Merton J. Sills, 39 ECAB 572 (1988) (reports not signed by a
physician lack probative value)
10

5 U.S.C. § 8101(2); see also G.G., 58 ECAB 389 (2007); Jerre R. Rinehart, 45 ECAB 518 (1994); Barbara J.
Williams, 40 ECAB 649 (1989); Jan A. White, 34 ECAB 515 (1983).

6

employment activities appellant had not performed since at least August 2000, would have
physiologically caused the conditions he diagnosed in 2006. Dr. Gordon’s opinion is speculative
at best and does not constitute rationalized medical evidence.
Dr. Bryan stated that employment tasks involving bending caused appellant’s left knee to
“pop out of place” and that appellant’s osteoarthritis “did not come naturally and was initiated by
a work injury.” While it is accepted that appellant sustained a knee strain when her left knee
popped out of place due to a work injury in 1997, Dr. Bryan’s report did not explain how
appellant’s bilateral degenerative knee conditions for which he treated appellant in 2007 would
in fact have been caused by the 1996 left knee strain. He proffered no explanation substantiating
his conclusion and, consequently, his opinion is not sufficiently rationalized. Thus, this evidence
does not establish the requisite causal relationship required to accept appellant’s claim.
Dr. Mays diagnosed degenerative joint and gait disease in 2008, and he explained that
appellant had been first examined in 1997 for left knee pain and that her work duties were the
cause of her knee pain. However, he offered no medical rationale explaining the relationship
between appellant’s earlier left knee injuries and her subsequent bilateral degenerative knee
conditions.
Dr. Carroll initially stated that appellant’s knee condition was “a direct result of a
previous knee injury, which occurred at work described in 1996.” He did not explain the basis of
this conclusion or support it with medical rationale.
Furthermore, Dr. Carroll’s subsequent reasoning is not sufficiently rationalized.
He
stated that it is “certainly possible that posttraumatic degenerative disease could have occurred
because of her injury described in 1996.” (Emphasis added.) Dr. Carroll also stated that it is
“reasonable to assume” that appellant’s left knee arthritis is “directly related to her knee injury
approximately twelve years ago, as well as the right knee injury in 1999.” (Emphasis added.)
However, absent from this evidence is any semblance of rationale substantiating these
conclusions. Additionally, use of the words “could have,” “certainly possible,” and “reasonable
to assume” indicate that Dr. Carroll’s opinion is, at best, speculative.11 (Emphasis added.) His
early reports and notes have little probative value,12 and do not establish the required causal
relationship.
Pursuant to requirements prescribed by its procedural manual,13 the Office notified
appellant that additional evidence was required to accept her claim for compensation. Further,
consistent with the responsibilities defined in its procedural manual, the Office sought a
supplemental opinion from Dr. Carroll.14
11

Ricky S. Storms, 52 ECAB 349 (2001); Leslie C. Moore, 52 ECAB 132 (2000).

12

See Leonard J. O Keefe, 14 ECAB 42, 48 (1962) (where the Board held that medical opinions which are
speculative or equivocal in character have little probative value).
13

See, Federal (FECA) Procedure Manual, Part 2 -- Claims, Development of Claims, Chapter 2.800
(March 2005).
14

Id. at Chapter 2.805.5 (March 2005).

7

Responding to the Office’s January 21, 2009 letter, Dr. Carroll furnished a supplemental
report, dated February 9, 2009. In lieu of sound medical rational and certainty, Dr. Carroll again
shrouded his opinion in a speculative stream of “likely’s,” “possibly’s,” and “reasonably
assume.” Thus, for example, while Dr. Carroll states that it is “likely” that the “physical nature
of appellant’s work” “accelerated” appellant’s “degenerative condition” and that appellant’s
duties “could be reasonably assumed to significantly aggravate her left knee,” (Emphasis added)
such speculative statements lack the requisite medical rational to establish appellant’s claim.15
Even when directly responding to specific issues the Office raised in its January 21, 2009
letter, Dr. Carroll chose speculation over sound medical reasoning, stating, for example, that
appellant’s January 4, 1995 and November 7, 1996 injuries “likely aggravated her possibly
preexisting knee degenerative disease.” (Emphasis added.) Long on speculation, his reports
lacked actual medical rational explaining the relationship of appellant’s employment duties, prior
to August 2000, to her conditions which he diagnosed in 2008.
Because appellant has not submitted medical opinion evidence containing a reasoned
discussion of causal relationship, one that soundly explains how the established employment
factors caused or aggravated a firmly diagnosed medical condition, the Board finds appellant has
not established the essential element of causal relationship.
CONCLUSION
The Board finds appellant has not established she sustained bilateral degenerative knee
conditions causally related to factors of her federal employment.

15

See Leonard J. O Keefe, supra note 12.

8

ORDER
IT IS HEREBY ORDERED THAT the September 25, 2009 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: October 8, 2010
Washington, DC

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

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

9