United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
L.C., Appellant
and
DEPARTMENT OF DEFENSE, DEFENSE
FINANCING & ACCOUNTING SERVICE,
Columbus, OH, Employer
__________________________________________

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

Docket No. 07-1659
Issued: February 22, 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 6, 2007 appellant filed a timely appeal from a May 3, 2007 merit decision by a
hearing representative of the Office of Workers’ Compensation Programs that affirmed the
denial of her occupational disease claim. Pursuant to 20 C.F.R. §§ 501.2(c) and 501.3, the Board
has jurisdiction over the merits of the claim.
ISSUE
The issue is whether appellant met her burden of proof in establishing that she developed
an occupational disease in the performance of duty.
FACTUAL HISTORY
On March 2, 2006 appellant, then a 38-year-old lead accounting technician, filed an
occupational disease claim alleging that she developed spinal subluxation in the performance of
duty. She first became aware of her condition on February 10, 2006 and related it to her
employment on February 20, 2006. Appellant explained that her job required her to sit at her

desk for long periods of time, leaning forward and straining her neck and spine. She stopped
work on March 10, 2006 and returned about six months later. The employing establishment
controverted appellant’s claim. In an October 25, 2005 e-mail notice, appellant’s supervisor
informed her that she would have new job duties and confirmed that her job entailed keying
throughout the day. She recommended that appellant “plan your work to key part of the day then
do some other duties on your desk in an attempt to avoid the pain in your wrist and arms.”
With her claim, appellant provided an undated report from Dr. Gene S. Harrison, a
chiropractor, who diagnosed spinal subluxation at C5-6 as seen on x-ray, which he explained had
caused forward head posture, a reversed cervical curve, muscle guarding, hypertonicity of the
cervical musculature and nerve interference. In a March 16, 2005 report, Dr. Harrison explained
that appellant first had symptoms, including neck pain, in 2004. He noted treating her on
July 19, 2004 and that x-rays showed multiple subluxations of appellant’s cervical spine.
Dr. Harrison opined that appellant’s job responsibilities, which included sitting at a desk and
looking down at her keyboard while engaged in repetitive stress activities, caused her condition.
He also stated that appellant’s job interfered with her ability to recover fully from her conditions.
In a handwritten report dated May 2005, Dr. Harrison reiterated that appellant’s neck posturing
at work caused a reversed cervical curve, posterior subluxation of C5 on C6, anterior-superior
subluxation and forward head posture, all of which were revealed on x-rays. He explained that
her forward head posture caused a posterior subluxation at C5-6, while overcompensation from
looking upwards in the forward postural position caused anterior and superior subluxations at
C1. Dr. Harrison indicated that appellant’s condition had developed over a period of years,
explaining, “the longer a person is subject to this postural stress, the easier it is for their soft
tissue structures to change by conforming to the altered biomechanics thus giving rise to a
chronic condition that is easily exacerbated.”
In a June 1, 2006 report, he diagnosed carpal tunnel syndrome, shoulder tendinitis, elbow
tendinitis and subluxations at C2 and C5, but noted that appellant had improved since her
May 24, 2006 treatment.
Dr. Harrison noted examination findings and concluded that
appellant’s condition was related to her repetitive duties and head position at her job. In a
June 22, 2006 report, he obtained updated x-ray findings. Dr. Harrison stated that x-rays showed
“complete reversal of the normal lordotic curvature of [appellant’s] cervical spine.” He also
noted moderate subluxations at C5-6 and anterior and superior subluxations at C1. Dr. Harrison
stated that the subluxations had altered appellant’s spinal biomechanics, pressuring her nerves
and causing radicular and upper extremity problems which were related to her employment. He
noted that the x-rays to which he referred had been taken in his office and that he had personally
reviewed them.
By decision dated July 18, 2006, the Office denied the claim, noting that the medical
evidence established that appellant had been treated for the claimed condition since 2004. It
found that she failed to provide sufficient evidence to show that her condition was related to her
work duties and not to prior or external causes.
Appellant requested an oral hearing, which was held on January 9, 2007. In a
November 14, 2006 report, Dr. Harrison noted first examining and treating her for neck
problems in 2004, at which time he recommended that she take leave from work. Dr. Harrison
reported that appellant’s condition improved when she took leave from work and received

2

treatment. Appellant’s symptoms returned in February 2006 and her job duties of “data entering
and constant looking down at the computer with the repetitive motion of her wrist prevented
[him] from being able to correct [appellant’s] symptoms faster than she was irritating them at
work.” Dr. Harrison stated that when appellant returned to work she was required to do more
work than anticipated, which caused continued exacerbation. He concluded that appellant’s
condition was related to the forward posture in which she held her head while working at her
computer. In a February 20, 2007 report, Dr. Harrison reiterated his x-ray findings and opinion
that appellant’s spinal subluxations were caused by altered spinal biomechanics due to repetitive
stress and forward head posturing at work. He explained that he examined appellant on July 19,
2004 and that, after the examination, “x-rays were performed in order to evaluate these
conditions radiographically and determine the presence of subluxation.” Dr. Harrison stated that
he was trained to read and interpret x-rays and that he had personally reviewed appellant’s
x-rays.
By decision dated May 3, 2007, the hearing representative affirmed the denial of
appellant’s occupational disease claim. She found that the evidence established that x-rays were
taken on July 19, 2004 and sometime in May 2005. The hearing representative noted that
Dr. Harrison’s reports did not establish that the x-rays were taken contemporaneously with the
claim in 2006. As there was no evidence that Dr. Harrison obtained x-rays in 2006, he was not a
“physician” as defined under the Federal Employees’ Compensation Act. The claim was denied
based on the insufficiency of the medical evidence.
LEGAL PRECEDENT
An employee seeking benefits under the 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 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 The test for determining whether
appellant sustained a compensable occupational disease or injury is three-pronged. To establish
the factual elements of the claim, appellant must submit: “(1) medical evidence establishing the
presence or existence of the disease or condition for which compensation is claimed; (2) a factual
statement identifying 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
1

5 U.S.C. §§ 8101-8193.

2

Elaine Pendleton, 40 ECAB 1143 (1989).

3

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

4

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

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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
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.6 The
opinion of the physician must be based on a complete factual and medical background of the
claimant7 and must be one of reasonable medical certainty8 explaining the nature of the
relationship between the diagnosed condition and the specific employment factors identified by
the claimant.9
ANALYSIS
The evidence establishes that appellant’s job duties required sitting with her neck in a
forward position. In its initial decision the Office determined that Dr. Harrison’s reports were
insufficiently rationalized to support causal relationship. Appellant requested an oral hearing.
The hearing representative found that there was no evidence that he obtained x-rays
contemporaneously with the onset of appellant’s symptoms in 2006. Therefore, his reports did
not constitute competent medical evidence.
The Act provides that a chiropractor’s reports constitute competent medical evidence in
the limited circumstance involving a chiropractor’s diagnosis of subluxation of the spine, based
on x-ray testing.10 Pursuant to section 10.311(c) of the Act’s implementing regulation: “A
chiropractor may interpret his or her x-rays to the same extent as any other physician. To be
given any weight, the medical report must state that x-rays support the finding of spinal
subluxation. The Office will not necessarily require submittal of the x-ray, or a report of the
x-ray, but the report must be available for submittal on request.”11 The hearing representative
determined that the evidence failed to support a subluxation of the spine as confirmed by x-rays,
because Dr. Harrison did not note the dates on which he performed x-ray testing. The hearing
representative determined that Dr. Harrison was not a physician under the Act. However, the
Board notes that, under section 10.311(c), he was entitled to interpret his own x-rays and is not

5

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

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

7

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

8

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

9

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

10

5 U.S.C. § 8101(2); see also Jay K. Tomokiyo, 51 ECAB 361 (2000).

11

20 C.F.R. § 10.311(c).

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required to submit the x-rays, or reports of the x-rays, unless requested.12 The record does not
reflect that the Office ever requested Dr. Harrison’s x-ray films or otherwise requested
information on the dates on which the x-rays were taken. The Board notes that Dr. Harrison
specifically stated in several reports that his spinal subluxation findings were based on x-ray
testing. Accordingly, the Board finds that Dr. Harrison reviewed x-rays in diagnosing a
subluxation and is a physician as defined under the Act.13 The weight of his medical opinion,
however, is not sufficient to establish appellant’s cervical condition as employment related.
In Linda L. Mendenhall the Board explained the effects of delayed diagnostic testing on
the probative value of medical evidence:
“When the physician conducts diagnostic testing immediately after an alleged
injury, the physician is better able to determine whether that testing documents
the injury described by the employee’s history. It must of course be
acknowledged that even immediate testing carries with it a degree of uncertainty.
Such testing does not by reason of its promptness, necessarily document the
injury claimed by the employee, who might well have sustained the condition
before the date of the alleged injury and under circumstances not covered by the
Act. When the physician delays diagnostic testing, the uncertainty mounts and a
question arises as to whether that testing in fact documents the injury claimed by
the employee. When the delay becomes so significant that it calls into question
the validity of an affirmative opinion based at least in part on that testing, such a
delay diminishes the probative value of the opinion offered.
“The Board does not, however, wish to impose an inflexible time limitation
within which physicians must conduct diagnostic testing. How to examine a
patient and when to conduct diagnostic testing are matters properly left to the
physician in the exercise of his or her professional judgment.… To discharge an
employee’s burden of proof, however, the physician must nevertheless provide
sufficient medical rationale to support the affirmative opinion offered.”14
The record indicates that x-rays were obtained in 2004 and 2005. In a March 16, 2005
report, Dr. Harrison stated that appellant’s job duties, which included sitting at a desk and
looking down at a keyboard while engaged in repetitive activities, caused a C5-6 subluxation and
interfered with her ability to recover. However, he did not adequately explain how appellant’s
job duties would cause or contribute to the diagnosed cervical condition. In a May 2005 report,
Dr. Harrison reiterated that appellant’s condition was the result of her forward neck posturing at
work. He noted that she first had symptoms in 2004 and on July 19, 2004 he reviewed x-rays
showing subluxations of the cervical spine. Dr. Harrison stated that the condition had developed
over a period of years. On June 1, 2006 he again stated that appellant’s conditions were related
to her repetitive activities and head posturing at her job, but did not provide a full explanation of
12

Id.

13

See supra note 10.

14

41 ECAB 532 (1990) (internal citations omitted).

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how her physical condition evolved in relation to her job duties.15 In a June 22, 2006 report,
Dr. Harrison reiterated that appellant’s head posturing had caused subluxations of her cervical
spine, which altered her spinal biomechanics, causing her condition. However, he again did not
explain how head posturing could cause or contribute to a cervical a subluxation. Dr. Harrison
did not provide a full, detailed explanation of how appellant’s spinal biomechanics were altered
by her employment activities.
In a November 14, 2006 report, Dr. Harrison stated that appellant’s symptoms improved
during a leave of absence in 2004 and 2005 and worsened when she returned to work in
February 2006. The Board has held that the mere fact that a condition manifests itself or
worsens during a period of employment16 or that work activities produce symptoms revelatory of
an underlying condition17 does not raise an inference of causal relationship between the
condition and the employment factors. Dr. Harrison stated that when appellant returned to work
she was required to do more work than anticipated, which he believed caused an exacerbation of
her condition. He did not support this statement with further explanation or rationale regarding
how specific work duties would cause an exacerbation of the diagnosed cervical subluxations.
Dr. Harrison merely restated that appellant’s forward head posturing caused her spinal
subluxations.
Accordingly, the Board finds that appellant did not meet her burden of proof to establish
that she developed a cervical condition in the performance of duty. Although Dr. Harrison is a
physician pursuant to the Act, his reports are insufficiently rationalized. He did not provide
adequate rationale for his stated conclusion that appellant’s spinal condition was related to her
employment.
CONCLUSION
The Board finds that appellant did not meet her burden of proof in establishing that she
developed an occupational disease in the performance of duty.

15

The Board notes that Dr. Harrison diagnosed conditions other than cervical subluxations in this report. As a
chiropractor may qualify as a physician in the diagnosis and treatment of spinal subluxations his opinion is not
considered competent medical evidence in the evaluation of other disorders including those of the extremities,
although they originate in the spine. See Pamela K. Guersford, 53 ECAB 726 (2002).
16

William Nimitz, Jr., 30 ECAB 567 (1979).

17

Richard B. Cissel, 32 ECAB 1910 (1981).

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ORDER
IT IS HEREBY ORDERED THAT the May 3, 2007 decision of the Office of Workers’
Compensation Programs is affirmed.
Issued: February 22, 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

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
P.M., Appellant
and
U.S. POSTAL SERVICE, NETWORK
DISTRIBUTION CENTER, Hazelwood, MO,
Employer
__________________________________________

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

Docket No. 12-37
Issued: May 8, 2012

Case Submitted on the Record

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

JURISDICTION
On October 12, 2011 appellant filed a timely appeal from an August 31, 2011 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 case.
ISSUE
The issue is whether appellant met her burden of proof to establish that she sustained an
occupational disease claim in the performance of duty.
FACTUAL HISTORY
On May 22, 2011 appellant, then a 55-year-old clerk, filed an occupational disease claim
alleging that she sustained severe right arm pain due to constant keying and lifting of mail using
1

5 U.S.C. § 8101 et seq.

the right hand. She became aware of her condition and its relationship to her employment on
May 15, 2011. Appellant stopped work on May 26, 2011 and returned on June 3, 2011.
OWCP informed appellant in a June 10, 2011 letter that additional evidence was needed
to establish her claim. It gave her 30 days to submit a factual statement detailing the
contributory employment factors and a medical report from a qualified physician explaining how
a diagnosed condition resulted from these factors.
Appellant specified in a June 13, 2011 statement that she filed a previous claim, which
was accepted for right elbow bursitis.2 Whereas this prior injury was due to repetitive
automation machinery duties, she attributed her new condition to keying mail and picking up
mail sacks weighing up to 70 pounds for alternating two-hour rotations.
In a June 13, 2011 report, Dr. Gena Napier, a Board-certified family practitioner, related
that appellant’s right upper extremity symptoms arose 15 years earlier and before she was
employed as a postal clerk.3 On examination of the right shoulder, she observed asymmetric
posture, abnormal rhythm, winged scapula, diffuse tenderness to palpation, limited active range
of motion (ROM), diminished strength, and positive Neer’s and lift-off tests. Dr. Napier
diagnosed recurrent right arm pain. She opined that repetitive lifting and data entry at work
aggravated the preexisting condition.
In a June 24, 2011 report, Dr. David W. Strege, a Board-certified orthopedic surgeon,
noted that appellant experienced pain in the anterior and lateral aspects of the right shoulder
sometime in May 2011. On examination, he observed diffuse superior and lateral aspect
tenderness, restricted abduction, motion weakness and positive impingement signs. X-rays
exhibited subacromial space narrowing and moderate degenerative changes of the
acromioclavicular joint. Dr. Strege diagnosed rotator cuff tendinitis and possible rotator cuff
tear. He pointed out that appellant worked for the employing establishment.
In a July 12, 2011 status note, Dr. Strege excused appellant from work for the period
June 24 to July 11, 2011. He released her to modified duty effective July 12, 2011.
By decision dated August 31, 2011, OWCP denied appellant’s claim, finding the medical
evidence insufficient to demonstrate that the accepted employment factors caused or aggravated
a right upper extremity condition.
LEGAL PRECEDENT
An employee seeking benefits under FECA 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 FECA, that the claim was timely filed within the applicable time
limitation period, that an injury was sustained in the performance of duty as alleged, and that any
2

OWCP File No. xxxxxx490. This claim is not before the Board on the present appeal.

3

Dr. Napier identified a history of obesity, benign hypertension, left knee osteoarthritis and tobacco use disorder.
None of these conditions are presently before the Board.

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disabilities and/or specific conditions for which compensation is claimed are causally related to
the employment injury.4 These are the essential elements of each and every compensation claim
regardless of whether the claim is predicated upon a traumatic injury or an occupational disease.5
Whether an employee actually sustained an injury in the performance of duty begins with
an analysis of whether fact of injury has been established.6 To establish fact of injury in an
occupational disease claim, 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 evidence generally required to establish
causal relationship is rationalized medical opinion evidence. Rationalized medical opinion
evidence is evidence which includes a physician’s opinion on the issue of whether there is a
causal relationship between the claimant’s diagnosed condition and the implicated employment
factors. The opinion of the physician must be based on a complete factual and medical
background, must be one of reasonable medical certainty, and must be supported by medical
rationale explaining the nature of the relationship between the diagnosed condition and the
specific employment factors identified by the claimant.8
ANALYSIS
While the case record supports that appellant keyed mail and carried sacks weighing up
to 70 pounds for alternating two-hour rotations, the Board finds that she did not establish her
occupational disease claim because the medical evidence did not sufficiently establish that these
accepted employment factors were causally related to a right arm condition.
In a June 13, 2011 report, Dr. Napier indicated that appellant sustained a preexisting right
upper extremity injury before becoming a postal clerk. She diagnosed recurrent right arm pain
and concluded that repetitive lifting and data entry at appellant’s job aggravated the condition.
Dr. Napier, however, failed to establish causal relationship because she did not adequately
explain how repetitive lifting and data entry pathophysiologically caused or aggravated the
injury.9 Medical reports consisting solely of conclusory statements without supporting rationale
are of little probative value.10
4

Elaine Pendleton, 40 ECAB 1143 (1989).

5

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

6

See S.P., 59 ECAB 184, 188 (2007).

7

See R.R., Docket No. 08-2010 (issued April 3, 2009); Roy L. Humphrey, 57 ECAB 238, 241 (2005).

8

I.J., 59 ECAB 408 (2008); Woodhams, supra note 5.

9

Joan R. Donovan, 54 ECAB 615, 621 (2003); Ern Reynolds, 45 ECAB 690, 696 (1994).

10

William C. Thomas, 45 ECAB 591 (1994).

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In a June 24, 2011 report, Dr. Strege diagnosed rotator cuff tendinitis and possible rotator
cuff tear. He then excused appellant from work from June 24 to July 11, 2011 and recommended
modified assignment effective July 12, 2011. Although Dr. Strege briefly noted that she was a
federal employee, he did not opine that her rotator cuff tendinitis resulted from her job duties.11
In the absence of rationalized medical opinion evidence, appellant did not meet her burden of
proof.
Appellant contends on appeal that Drs. Napier and Strege supported causal relationship.
As noted, the medical evidence was insufficient to demonstrate that keying mail and lifting sacks
caused or aggravated a right arm condition. The Board also points out that appellant submitted
new evidence on appeal. The Board lacks jurisdiction to review evidence for the first time on
appeal.12 However, appellant may submit new evidence or argument as part of a formal written
request for reconsideration to OWCP within one year of this merit decision, pursuant to 5 U.S.C.
§ 8128(a) and 20 C.F.R. §§ 10.605 through 10.607.
CONCLUSION
The Board finds that appellant did not establish that she sustained an occupational disease
in the performance of duty.

11

J.F., Docket No. 09-1061 (issued November 17, 2009); S.E., Docket No. 08-2214 (issued May 6, 2009)
(medical evidence that does not offer any opinion regarding the cause of an employee’s condition is of limited
probative value on the issue of causal relationship).
12

20 C.F.R. § 501.2(c).

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ORDER
IT IS HEREBY ORDERED THAT the August 31, 2011 decision of the Office of
Workers’ Compensation Programs be affirmed.
Issued: May 8, 2012
Washington, DC

Alec J. Koromilas, Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
T.B., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Jacksonville, FL, Employer
__________________________________________

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

Docket No. 20-1413
Issued: July 1, 2021

Case Submitted on the Record

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

JURISDICTION
On July 20, 2020 appellant filed a timely appeal from a June 30, 2020 merit decision of the
Office of Workers’ Compensation Programs (OWCP).1 Pursuant to the Federal Employees’

1

Appellant submitted a timely request for oral argument before the Board. 20 C.F.R. § 501.5(b). Pursuant to the
Board’s Rules of Procedure, oral argument may be held in the discretion of the Board. 20 C.F.R. § 501.5(a). In
support of his oral argument request, appellant asserted that oral argument should be granted because he had a greater
permanent impairment of his right knee because he had a full knee replacement, which OWCP did not approve. The
Board, in exercising its discretion, denies appellant’s request for oral argument because the arguments on appeal can
adequately be addressed in a decision based on a review of the case record. Oral argument in this appeal would further
delay issuance of a Board decision and not serve a useful purpose. As such, the oral argument request is denied and
this decision is based on the case record as submitted to the Board.

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
ISSUE
The issue is whether appellant has met his burden of proof to establish more than 25 percent
permanent impairment of his right lower extremity for which he previously received a schedule
award.
FACTUAL HISTORY
This case was previously been before the Board.4 The facts and circumstances set forth in
the Board’s prior decision are incorporated herein by reference. The relevant facts are as follows.
On May 2, 2006 appellant, then a 47-year-old letter carrier, filed a traumatic injury claim
(Form CA-1) alleging that on May 1, 2006 he twisted his right knee when he failed to notice a step
down on the sidewalk while in the performance of duty. OWCP accepted the claim for sprain of
the lateral collateral ligament, right knee medial meniscus tear, and right knee traumatic
arthropathy of the lower leg.
On June 26, 2006 appellant underwent an OWCP-approved partial medial meniscectomy,
right knee, which was performed by Dr. E. Jean Dabezies, Jr., a Board-certified orthopedic
surgeon. On December 21, 2006 he underwent a right knee medial unicompartmental arthroplasty,
also performed by Dr. Dabezies.
On April 5, 2007 appellant filed a claim for a schedule award (Form CA-7). By decision
dated May 29, 2007, OWCP granted appellant a schedule award for 25 percent permanent
impairment of the right lower extremity (leg). The award ran for 72 weeks during the period
April 6, 2007 to August 21, 2008.
On January 10, 2013 appellant underwent a total knee arthroplasty with a postoperative
diagnosis of failed unicompartmental arthroplasty, right knee. This procedure was also performed
by Dr. Dabezies.
On February 22, 2014 appellant filed a Form CA-7 for an increased schedule award. By
decision dated June 3, 2014, OWCP denied appellant’s claim for an additional schedule award.

2

5 U.S.C. § 8101 et seq.

3
The Board notes that, following the June 30, 2020 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.
4

Docket No. 14-1640 (issued December 8, 2014).

2

On July 7, 2014 appellant filed a request for reconsideration. By decision dated July 10, 2014,
OWCP denied appellant’s request for reconsideration.
On July 21, 2014 appellant appealed to the Board. By decision dated December 8, 2014,
the Board affirmed OWCP’s June 3 and July 10, 2014 decisions.5 The Board found that appellant
had not met his burden to establish more than 25 percent impairment of his right lower extremity
for which he previously received a schedule award. The Board further found that OWCP properly
denied appellant’s reconsideration request.
On November 16, 2019 appellant again filed a Form CA-7 for an increased schedule award.
Progress reports from Dr. Dabezies, Jr., dated November 17, 2015, October 4, 2016,
September 27, 2017, September 21, 2018, and September 18, 2019 were received. In the
September 18, 2019 report, Dr. Dabezies indicated that appellant was six years postoperative
unicompartmental to total revision of right knee, and nine months status post left total knee
arthroplasty. Appellant reported pain with the right knee and difficulty ascending stairs. His
physical examination revealed stable posterior total knee arthroplasty in good alignment and
position with no changes from previous x-rays. Mild effusion was noted in both knees, with good
stability bilaterally with some anterior-posterior laxity on the right compared to the left, due to
appellant’s multiple right knee procedures. Dr. Dabezies provided an impression right knee pain.
He opined that appellant had limitation of his right knee, but it was stable. Dr. Dabezies, however,
did not provide a permanent impairment rating, related to appellant’s accepted right knee
condition, in any of his reports.
In a December 9, 2019 developmental letter, OWCP requested that Dr. Dabezies address
whether appellant had additional permanent impairment of his right lower extremity greater than
the 25 percent impairment he was previously awarded, pursuant to the sixth edition of the
American Medical Association, Guides to the Evaluation of Permanent Impairment (A.M.A.,
Guides)6 and whether he had reached maximum medical improvement. Dr. Dabezies was
requested to provide his opinion within 30 days. He did not respond.
By decision dated February 25, 2020, OWCP denied appellant’s claim for an increased
schedule award, finding that appellant was entitled to no more than 25 percent permanent
impairment of the right lower extremity (leg) previously received. It noted that no additional
medical evidence was received.
On March 13, 2020 appellant requested a review of the written record before a
representative of OWCP’s Branch of Hearings and Review. By decision dated June 30, 2020, an
OWCP hearing representative affirmed OWCP’s February 25, 2020 decision as appellant had not
provided evidence from a physician supporting that he sustained greater than the 25 percent
permanent impairment of the right lower extremity previously received.

5

See id.

6

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

3

LEGAL PRECEDENT
The schedule award provisions of FECA and its implementing regulations set forth the
number of weeks of compensation payable to employees sustaining permanent impairment from
loss or loss of use of scheduled members or functions of the body. 7 However, FECA does not
specify the manner in which the percentage of loss shall be determined. For consistent results and
to ensure equal justice under the law to all claimants, good administrative practice necessitates the
use of a single set of tables so that there may be uniform standards applicable to all claimants.
Through its implementing regulations, OWCP adopted the A.M.A., Guides as the appropriate
standard for evaluating schedule losses.8 As of May 1, 2009, schedule awards are determined in
accordance with the sixth edition of the A.M.A., Guides (2009).9
The sixth edition of the A.M.A., Guides provides a diagnosis-based method of evaluation
utilizing the World Health Organization’s International Classification of Functioning, Disability
and Health.10 Under the sixth edition, the evaluator identifies the impairment for the class of
diagnosis (CDX), which is then adjusted by the grade modifier for functional history (GMFH), the
grade modifier for physical examination (GMPE), and the grade modifier for clinical studies
(GMCS).11 The net adjustment formula is (GMFH-CDX) + (GMPE-CDX) + (GMCS-CDX).12
It is the claimant’s burden of proof to establish permanent impairment of a scheduled
member or function of the body as a result of an employment injury. 13 OWCP’s procedures
provide that, to support a schedule award, the file must contain competent medical evidence which
shows that the impairment has reached a permanent and fixed state and indicates the date on which
this occurred, describes the impairment in sufficient detail so that it can be visualized on review,
and computes the percentage of impairment in accordance with the A.M.A., Guides.14

7

5 U.S.C. § 8107; 20 C.F.R. § 10.404.

8

Id. at § 10.404; L.T., Docket No. 18-1031 (issued March 5, 2019); see also Ronald R. Kraynak, 53 ECAB
130 (2001).
9

Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, Chapter
2.808.5(a) (March 2017); see also Chapter 3.700.2 and Exhibit 1 (January 2010).
10

A.M.A., Guides (6th ed. 2009), section 1.3, The International Classification of Functioning, Disability and Health
(ICF): A Contemporary Model of Disablement.
11

Id. at 493-556.

12

Id. at 521.

13

See T.H., Docket No. 19-1066 (issued January 29, 2020); D.F., Docket No. 18-1337 (issued February 11, 2019);
Tammy L. Meehan, 53 ECAB 229 (2001).
14
See J.K., Docket Nos. 19-1420 & 19-1422 (issued August 12, 2020); see also B.J., Docket No. 19-0960 (issued
October 7, 2019).

4

ANALYSIS
The Board finds that appellant has not met his burden of proof to establish more than 25
percent permanent impairment of his right lower extremity for which he previously received a
schedule award.
Preliminary, the Board notes that it is unnecessary for the Board to consider the evidence
that was previously considered in its December 8, 2014 decision, affirming OWCP’s finding that
appellant established no more than 25 percent permanent impairment of the right lower extremity
for which he previously received a schedule award. Findings made in prior Board decisions are
res judicata absent any further review by OWCP under section 8128 of FECA.15
In support of his request for an increased schedule award, appellant submitted progress
reports from Dr. Dabezies dated November 17, 2015, October 4, 2016, September 27, 2017,
September 21, 2018, and September 18, 2019, which only reflected his continuing treatment of
appellant’s right knee conditions. He did not provide any impairment calculations in conformance
with the A.M.A., Guides.
The Board finds that Dr. Dabezies’ September 18, 2019 report did not provide findings
which indicated that appellant may be entitled to an increased award. There is no probative
medical evidence of record, in conformance with the sixth edition of the A.M.A., Guides,
establishing that he has greater permanent impairment of his right lower extremity than that
previously awarded. Accordingly, appellant has not established that he is entitled to an increased
schedule award.
On appeal appellant contends that the severity of his continuing condition entitles him to
an increased schedule award. As noted above, there is no probative medical evidence of record,
in conformance with the sixth edition of the A.M.A., Guides, establishing that he has greater
permanent impairment of his right lower extremity than that previously awarded.
Appellant may request a schedule award or increased schedule award at any time based on
evidence of a new exposure or medical evidence showing progression of an employment-related
condition resulting in permanent impairment or increased impairment.
CONCLUSION
The Board finds that appellant has not met his burden of proof to establish more than 25
percent permanent impairment of his right lower extremity, for which he previously received a
schedule award.

15
M.D., Docket No. 20-0007 (issued May 13, 2020); D.B., Docket No. 17-1444 (issued January 11, 2018);
Clinton E. Anthony, Jr., 49 ECAB 476 (1998).

5

ORDER
IT IS HEREBY ORDERED THAT the June 30, 2020 decision of the Office of Workers’
Compensation Programs is affirmed.
Issued: July 1, 2021
Washington, DC

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

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

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

6


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
I.M., Appellant
and
U.S. POSTAL SERVICE, RALEIGH
PROCESSING & DISTRIBUTION CENTER,
Raleigh, NC, Employer
__________________________________________

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

Docket No. 20-0980
Issued: February 2, 2021

Case Submitted on the Record

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

JURISDICTION
On April 4, 2020 appellant filed a timely appeal from an October 17, 2019 merit decision
and January 22, 2020 nonmerit 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). However, in a letter received by OWCP on July 20, 2020, appellant withdrew his oral argument request.
2
3

5 U.S.C. § 8101 et seq.

The Board notes that, following the January 22, 2020 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 appellant has met his burden of proof to establish a recurrence
of disability for the period July 24, 2018 through April 12, 2019 causally related to his accepted
employment injuries; and (2) whether OWCP properly denied appellant’s request for
reconsideration of the merits of his claim pursuant to 5 U.S.C. § 8128(a).
FACTUAL HISTORY
On November 12, 1997 OWCP accepted that appellant, then a 39-year-old distribution
clerk, sustained a triangular fibrocartilage tear of his right wrist, due to handling mailbags on
June 24, 1996 (OWCP File No. xxxxxx600). The accepted conditions were later expanded to
include closed dislocation of the right wrist, left wrist ganglion, bilateral primary osteoarthritis of
the forearms, tenosynovitis of the right hand/wrist, and right wrist sprain. Appellant stopped work
for various periods and OWCP paid him wage-loss compensation for periods of disability from
work.4
Under OWCP File No. xxxxxx771, OWCP accepted that on May 22, 1997 appellant
sustained temporary aggravation of right wrist triangular fibrocartilage tear. Under OWCP File
No. xxxxxx274, OWCP accepted that on August 5, 1997 he sustained right wrist extensor
tenosynovitis. It administratively combined the files for OWCP File Nos. xxxxxx771, xxxxxx274,
and xxxxxx600, designating the latter as the master file.
On February 2, 2017 appellant began working in a limited-duty position on a full-time
basis for the employing establishment. The position restricted appellant from lifting more than 5
pounds, pushing/pulling more than 10 pounds, and from engaging in climbing. Appellant stopped
work on February 17, 2017 due to a back injury, which has not been accepted as work related.
Appellant later filed claims for compensation (Form CA-7) alleging that he sustained a
recurrence of disability for the period July 24, 2018 through April 12, 2019, causally related to his
accepted employment injuries.
Appellant submitted medical evidence, including a July 3, 2018 duty status report (Form
CA-17), a July 3, 2018 work excuse report, a July 24, 2018 work release report, and an August 3,
2018 work excuse report. Some of the reports delineated short periods of disability and mentioned
appellant’s back complaints.
In a January 31, 2019 development letter, OWCP requested that appellant submit
additional factual and medical evidence in support of his claim.
Appellant submitted additional medical evidence, including an August 16, 2018 Form CA17 report, and February 14 and 21, and March 14, 2018 work excuse reports. Some of the reports
delineated short periods of disability and mentioned appellant’s back complaints.

4
On February 6, 1997 appellant underwent OWCP-authorized debridement surgery for his right wrist triangular
fibrocartilage tear. OWCP placed appellant on the supplemental rolls commencing April 27, 2005.

2

By decision dated April 3, 2019, OWCP denied appellant’s recurrence of disability claim
because he failed to submit sufficient medical evidence in support thereof.
On May 5, 2019 appellant requested reconsideration of the April 3, 2019 decision. In
support of his reconsideration request, appellant submitted time analysis forms (Forms CA-7a) for
the period March 30 through April 11, 2019.
By decision dated June 6, 2019, OWCP denied modification of the April 3, 2019 decision.
On July 19, 2019 appellant requested reconsideration of the June 6, 2019 decision. In a
July 19, 2019 statement, he asserted that OWCP had improperly denied his claim by asserting that
the employing establishment had not rescinded his limited-duty assignment.
By decision dated October 17, 2019, OWCP denied modification of the June 6, 2019
decision.
On October 29, 2019 appellant requested reconsideration of the October 17, 2019 decision.
In an October 29, 2019 statement, he noted that he was presenting arguable error for the denial of
his claim. Appellant indicated, “The evidence I submitted on my last request for reconsideration
was to show that my agency had not rescinded my limited[-]duty assignment, based on the fact
that I worked my assignment in April 2019, and there is no evidence that they ever tried to rescind
my limited[-]duty assignment, which you used as … reasons to deny my claim for compensation.”
By decision dated January 22, 2020, OWCP denied appellant’s request for reconsideration
of the merits of his claim pursuant to 5 U.S.C. § 8128(a).
LEGAL PRECEDENT -- ISSUE 1
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 resulting from a previous
compensable injury or illness without an intervening injury or new exposure in the work
environment.5 This term also means an inability to work because a light-duty assignment made
specifically to accommodate an employee’s physical limitations, and which is necessary because
of a work-related injury or illness, is withdrawn or altered so that the assignment exceeds the
employee’s physical limitations. A recurrence does not occur when such withdrawal occurs for
reasons of misconduct, nonperformance of job duties, or a reduction-in-force.6
OWCP’s procedures provide that a recurrence of disability includes a work stoppage
caused by a spontaneous material change in the medical condition demonstrated by objective
findings. That change must result from a previous injury or occupational illness rather than an
intervening injury or new exposure to factors causing the original illness. It does not include a

5

20 C.F.R. § 10.5(x); see J.D., Docket No. 18-1533 (issued February 27, 2019).

6

Id.

3

condition that results from a new injury, even if it involves the same part of the body previously
injured.7
An employee who claims a recurrence of disability due to an accepted employment-related
injury has the burden of proof to establish by the weight of the substantial, reliable, and probative
evidence that the disability for which he or she claims compensation is causally related to the
accepted injury. This burden of proof requires that a claimant furnish medical evidence from a
physician who, on the basis of a complete and accurate factual and medical history, concludes that,
for each period of disability claimed, the disabling condition is causally related to the employment
injury, and supports that conclusion with medical reasoning.8 Where no such rationale is present,
the medical evidence is of diminished probative value.9
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
of proof 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.10 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.11
ANALYSIS -- ISSUE 1
The Board finds that appellant has not met his burden of proof to establish a recurrence of
disability for the period July 24, 2018 through April 12, 2019 causally related to his accepted
employment injuries.
Appellant submitted a series of medical reports in support of his recurrence of disability,
consisting of a July 3, 2018 Form CA-17, a July 3, 2018 work excuse report, a July 24, 2018 work
release report, an August 3, 2018 work excuse report, an August 16, 2018 Form CA-17, and
February 14 and 21, and March 14, 2018 work excuse reports. However, none of the reports
contains an opinion that he sustained disability for the period July 24, 2018 through April 12, 2019
causally related to his accepted employment injuries sustained on June 24, 1996, May 22 and
August 5, 1997. The Board has held that medical evidence that does not offer an opinion regarding

7

Federal (FECA) Procedure Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.2b (June 2013); L.B., Docket
No. 18-0533 (issued August 27, 2018).
8

J.D., Docket No. 18-0616 (issued January 11, 2019); see C.C., Docket No. 18-0719 (issued November 9, 2018).

9

H.T., Docket No. 17-0209 (issued February 8, 2018).

10

See D.W., Docket No. 19-1584 (issued July 9, 2020); S.D., Docket No. 19-0955 (issued February 3, 2020);
Terry R. Hedman, 38 ECAB 222 (1986).
11
C.B., Docket No. 19-0464 (issued May 22, 2020); see R.N., Docket No. 19-1685 (issued February 26, 2020);
Terry R. Hedman, id.

4

the cause of an employee’s disability is of no probative value on the issue of causal relationship.12
Therefore, these reports are insufficient to establish appellant’s recurrence of disability claim.
As appellant has not submitted any rationalized medical evidence establishing a recurrence
of disability for the period July 24, 2018 through April 12, 2019 causally related to his accepted
employment injuries, he has failed to meet his burden of proof.
Appellant may submit new evidence or argument with a written request for reconsideration
to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R.
§§ 10.605 through 10.607.
LEGAL PRECEDENT -- ISSUE 2
Section 8128(a) of FECA vests OWCP with discretionary authority to determine whether
to review an award for or against compensation. The Secretary of Labor may review an award for
or against compensation at any time on his or her own motion or on application.13
To require OWCP to reopen a case for merit review pursuant to FECA, the claimant must
provide evidence or an argument which: (1) shows that OWCP erroneously applied or interpreted
a specific point of law; (2) advances a relevant legal argument not previously considered by
OWCP; or (3) constitutes relevant and pertinent new evidence not previously considered by
OWCP.14
A request for reconsideration must be received by OWCP within one year of the date of
OWCP’s decision for which review is sought.15 If it chooses to grant reconsideration, it reopens
and reviews the case on its merits.16 If the request is timely, but fails to meet at least one of the
requirements for reconsideration, OWCP will deny the request for reconsideration without
reopening the case for review on the merits.17 The Board has held that the submission of evidence
or argument which repeats or duplicates evidence or argument already in the case record18 and the

12

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

13

5 U.S.C. § 8128(a); see L.D., Docket No. 18-1468 (issued February 11, 2019); V.P., Docket No. 17-1287 (issued
October 10, 2017); D.L., Docket No. 09-1549 (issued February 23, 2010); W.C., 59 ECAB 372 (2008).
14

20 C.F.R. § 10.606(b)(3); see M.S., Docket No. 18-1041 (issued October 25, 2018); L.G., Docket No. 09-1517
(issued March 3, 2010); C.N., Docket No. 08-1569 (issued December 9, 2008).
15

20 C.F.R. § 10.607(a). The one-year period begins on the next day after the date of the original contested
decision. Federal (FECA) Procedure Manual, Part 2 -- Claims, Reconsiderations, Chapter 2.1602.4 (February 2016).
Timeliness is determined by the document receipt date of the request for reconsideration as indicated by the received
date in the Integrated Federal Employees’ Compensation System (iFECS). Id. at Chapter 2.1602.4b.
16

Id. at § 10.608(a); see D.C., Docket No. 19-0873 (issued January 27, 2020); M.S., 59 ECAB 231 (2007).

17

20 C.F.R. § 10.608(b); see T.V., Docket No. 19-1504 (issued January 23, 2020); E.R., Docket No. 09-1655 (issued
March 18, 2010).
18

N.L., Docket No. 18-1575 (issued April 3, 2019); Eugene F. Butler, 36 ECAB 393, 398 (1984).

5

submission of evidence or argument which does not address the particular issue involved does not
constitute a basis for reopening a case.19
ANALYSIS -- ISSUE 2
The Board finds that OWCP properly denied appellant’s request for reconsideration of the
merits of his claim pursuant to 5 U.S.C. § 8128(a).
On October 29, 2019 appellant filed a timely request for reconsideration of an October 17,
2019 decision.20 The Board finds that he did not establish that OWCP erroneously applied or
interpreted a specific point of law, nor did he advance a relevant legal argument not previously
considered by OWCP. In an October 29, 2019 statement, he noted that he was presenting arguable
error for the denial of his claim. Appellant indicated, “The evidence I submitted on my last request
for reconsideration was to show that my agency had not rescinded my limited[-]duty assignment,
based on the fact that I worked my assignment in April 2019, and there is no evidence that they
ever tried to rescind my limited[-]duty assignment, which you used as … reasons to deny my claim
for compensation.” However, OWCP had previously considered and rejected this same argument
when it previously denied appellant’s claim. The Board has held that the resubmission of a
previous argument does not require reopening of claim for merit review.21 Accordingly, the Board
finds that appellant is not entitled to a review of the merits based on either the first or second
requirement under 20 C.F.R. § 10.606(b)(3).
Upon reconsideration, appellant did not submit any evidence in support of his recurrence
of disability claim. Therefore, he also failed to satisfy the third requirement under 20 C.F.R.
§ 10.606(b)(3), i.e., the submission of relevant and pertinent new evidence not previously
considered by OWCP.
The Board accordingly finds that appellant has not met any of the requirements of 20 C.F.R.
§ 10.606(b)(3). Pursuant to 20 C.F.R. § 10.608, OWCP properly denied merit review.
CONCLUSION
The Board finds that appellant has not met his burden of proof to establish a recurrence of
disability for the period July 24, 2018 through April 12, 2019 causally related to his accepted
employment injuries. The Board further finds that OWCP properly denied appellant’s request for
reconsideration of the merits of his claim pursuant to 5 U.S.C. § 8128(a).

19

M.K., Docket No. 18-1623 (issued April 10, 2019); Edward Matthew Diekemper, 31 ECAB 224, 225 (1979).

20

See J.F., Docket No. 16-1233 (issued November 23, 2016).

21

See supra note 18.

6

ORDER
IT IS HEREBY ORDERED THAT the January 22, 2020 and October 17, 2019 decisions
of the Office of Workers’ Compensation Programs are affirmed.
Issued: February 2, 2021
Washington, DC

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

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

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

7


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
N.C., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Manchester, NH, Employer
__________________________________________

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

Docket No. 19-0299
Issued: June 24, 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 November 20, 2018 appellant filed a timely appeal from a September 28, 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 left wrist carpal
tunnel syndrome causally related to the accepted factors of her federal employment.

1
2

5 U.S.C. § 8101 et seq.

The Board notes that, following the September 28, 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
additional evidence for the first time on appeal. Id.

FACTUAL HISTORY
On July 12, 2018 appellant, then a 23-year-old city carrier assistant, filed an occupational
disease claim (Form CA-2) alleging that she sustained carpal tunnel syndrome due to factors of
her federal employment. She noted that she first became aware of her claimed condition on July 2,
2018 and explained that she did not inform the employing establishment within 30 days after she
realized her disease’s relationship to her federal employment because she was initially instructed
by her physician to treat her wrist condition with a brace and ibuprofen, and over the course of
such treatment she realized that her wrist was not healing. On the reverse side of the claim form,
the employing establishment noted that appellant first received medical care and reported her
condition to her supervisor on July 2, 2018 and that she stopped work and was last exposed to
conditions alleged to have caused her disease on July 2, 2018.
In a report dated December 6, 2017, Dr. Ryan Kramer, a Board-certified family
practitioner, diagnosed bilateral carpal tunnel syndrome.
In a report dated July 2, 2018, Elizabeth Nigrello, a physician assistant, examined appellant
and diagnosed acute left wrist pain.
Appellant submitted an unsigned hospital report dated July 2, 2018, received by OWCP on
July 12, 2018, in which the author diagnosed carpal tunnel syndrome and referred her to an
orthopedic surgeon for a follow-up.
In a personal statement dated July 2, 2018, appellant indicated that she was diagnosed with
carpal tunnel syndrome in January 2018 and was asked to sleep with a brace on both wrists. She
noted that on July 1, 2018, while at home, her wrists became swollen and painful. Appellant did
not perform parcel deliveries at work that day.
In a letter dated July 12, 2018, the employing establishment challenged appellant’s claim
contending that she failed to establish fact of injury and causal relationship.
In a development letter dated July 17, 2018, OWCP advised appellant of the factual and
medical deficiencies of her claim. It provided a questionnaire for her completion to establish the
employment factors alleged to have caused or contributed to her medical condition and requested
a medical report from her attending physician explaining how and why her federal work activities
caused, contributed to, or aggravated her medical condition. OWCP afforded appellant 30 days to
submit the necessary evidence.
In a separate development letter dated July 17, 2018, OWCP requested that the employing
establishment submit comments from a knowledgeable supervisor on the accuracy of her
statements, a description of the tasks she performed that involved repetitive hand and wrist
movements, and a description of the specific work area which she indicated led to the development
of her claimed condition.
OWCP continued to receive medical evidence. In a duty status report (Form CA-17) dated
July 6, 2018, Dr. Courtney Arrington, a Board-certified family practitioner, diagnosed carpal
tunnel syndrome and left wrist pain. She indicated that appellant could resume full-time
employment on August 2, 2018 with restrictions.
2

In an attending physician’s report (Form CA-20) dated July 24, 2018, Dr. Arrington
diagnosed carpal tunnel syndrome. She checked a box marked “yes” when asked whether
appellant had any history or evidence of concurrent or preexisting injury or disease. Dr. Arrington
also checked a box marked “yes” when asked if she believed that appellant’s condition was caused
or aggravated by her employment activities, and noted that her condition resulted from repetitive
pushing, pulling, and carrying. She related that she was unsure whether appellant could resume
regular work, and indicated that appellant may only intermittently lift one-pound.
By decision dated September 28, 2018, OWCP denied appellant’s claim, finding that the
evidence submitted was insufficient to establish that her diagnosed medical condition was causally
related to the accepted factors of her federal employment. It concluded, therefore, that she had not
met the requirements to establish an employment-related injury or condition.
LEGAL PRECEDENT
An employee seeking benefits under FECA3 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,4 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.5 These are the essential elements of each and every compensation claim,
regardless of whether the claim is predicated upon a traumatic injury or an occupational disease.6
To establish that an injury was sustained in the performance of duty in an occupational
disease claim, a claimant must submit the following: (1) medical evidence establishing the
presence or existence of the disease or condition for which compensation is claimed; (2) a factual
statement identifying employment factors alleged to have caused or contributed to the presence or
occurrence of the disease or condition; and (3) medical evidence establishing that the employment
factors identified by the claimant were the proximate cause of the condition for which
compensation is claimed or, stated differently, medical evidence establishing that the diagnosed
condition is causally related to the employment factors identified by the claimant.7
The medical evidence required to establish causal relationship is rationalized medical
opinion evidence.8 Rationalized medical opinion evidence is medical evidence which includes a
3

Supra note 1.

4

S.C., Docket No. 18-1242 (issued March 13, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59
ECAB 178 (2007); Joe D. Cameron,41 ECAB 153 (1989).
5
S.C., id.; J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden,
Sr., 40 ECAB 312 (1988).
6

S.C., id.; 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).
7

C.D., Docket No. 17-2011 (issued November 6, 2018); Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996).

8

M.B., Docket No. 17-1999 (issued November 13, 2018).

3

physician’s rationalized opinion on the issue of whether there is causal relationship between the
claimant’s diagnosed condition and the implicated employment factors. The opinion of the
physician must be based on a complete factual and medical background of the claimant, must be
one of reasonable medical certainty, and must be supported by medical rationale explaining the
nature of the relationship between the diagnosed condition and the specific employment factors
identified by the claimant.9
ANALYSIS
The Board finds that appellant has not met her burden of proof to establish left wrist carpal
tunnel syndrome causally related to the accepted factors of her federal employment.
In his December 6, 2017 report, Dr. Kramer simply diagnosed bilateral carpal tunnel
syndrome, however, he did not opine as to the cause of appellant’s condition. The Board has held
that medical evidence that does not offer an opinion regarding the cause of an employee’s
condition is of no probative value on the issue of causal relationship.10
Appellant also submitted a Form CA-17 dated July 6, 2018 and a Form CA-20 dated
July 24, 2018 from Dr. Arrington who diagnosed carpal tunnel syndrome. In the Form CA-17
Dr. Arrington did not address causal relationship between the carpal tunnel syndrome and factors
of appellant’s federal employment. As such, her report is of no probative value on the issue of
causal relationship.11
In the Form CA-20, Dr. Arrington checked a box marked “yes” when asked if she believed
that appellant’s condition was caused or aggravated by her employment activities, and noted that
her condition resulted from repetitive pushing, pulling, and carrying. The Board has checked a
box marked “yes” in a form report, without additional explanation or rationale, is insufficient to
establish causal relationship.12 In addition, while Dr. Arrington opined as to the cause of
appellant’s condition, her conclusory opinion is insufficiently rationalized. 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/disability was related to employment
factors.13 For the foregoing reasons, Dr. Arrington’s reports are insufficient to establish
appellant’s claim.
Appellant submitted a July 2, 2018 report from Ms. Nigrello, a physician assistant, who
diagnosed acute left wrist pain. The Board has held that medical reports signed solely by a
physician assistant are of no probative value as a physician assistant is not considered a physician

9

M.L., Docket No. 18-1605 (issued February 26, 2019).

10

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

11

Id.

12

S.C., supra note 4; see Barbara J. Williams, 40 ECAB 649, 656 (1989).

13

S.C., id.; see Y.D., Docket No. 16-1896 (issued February 10, 2017).

4

as defined under FECA and therefore is not competent to provide a medical opinion.14 Therefore,
Ms. Nigrello’s report has no probative value.
OWCP also received an unsigned hospital report dated July 2, 2018, in which the author
diagnosed carpal tunnel syndrome, and referred appellant to an orthopedic surgeon for a followup. The Board has held that a report that bears an illegible signature cannot be considered
probative medical evidence because it lacks proper identification.15 Thus, this report has no
probative value.
As there is no rationalized medical evidence of record explaining how appellant’s
employment duties caused or aggravated her carpal tunnel syndrome, appellant has not met her
burden of proof to establish that her left wrist carpal tunnel syndrome was causally related to
factors of her federal employment.
Appellant may submit new evidence or argument with a written request for reconsideration
to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R.
§§ 10.605 through 10.607.
CONCLUSION
The Board finds that appellant has not met her burden of proof to establish left wrist carpal
tunnel syndrome causally related to the accepted factors of her federal employment.

14

See 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). T.K., Docket No. 19-0055 (issued
May 2, 2019) (physician assistants are not considered physicians under FECA).
15
K.C., Docket No. 18-1330 (issued March 11, 2019); see R.M., 59 ECAB 690 (2008); D.D., 57 ECAB 734
(2006); Richard J. Charot, 43 ECAB 357 (1991).

5

ORDER
IT IS HEREBY ORDERED THAT the September 28, 2018 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: June 24, 2019
Washington, DC

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

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

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

6


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
M.H., Appellant
and
DEPARTMENT OF HOMELAND SECURITY,
TRANSPORTATION SECURITY
ADMINISTRATION, Colorado Springs, CO,
Employer
__________________________________________

)
)
)
)
)
)
)
)
)
)

Appearances:
Richard Daniels, for the appellant
Office of Solicitor, for the Director

Docket No. 14-591
Issued: June 11, 2014

Case Submitted on the Record

DECISION AND ORDER
Before:
PATRICIA HOWARD FITZGERALD, Acting Chief Judge
MICHAEL E. GROOM, Alternate Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On January 16, 2014 appellant, through her representative, filed a timely appeal from the
October 16 and 22, 2013 merit decisions of the Office of Workers’ Compensation Programs
(OWCP). Pursuant to the Federal Employees’ Compensation Act1 (FECA) and 20 C.F.R.
§§ 501.2(c) and 501.3, the Board has jurisdiction over the merits of the schedule award decision.
ISSUE
The issue is whether appellant whether established permanent impairment due to her
accepted left shoulder and right knee conditions.
On appeal, appellant’s representative asserts that appellant is entitled to schedule awards
for the accepted left shoulder and right knee conditions and that OWCP failed to adequately
examine the medical evidence in three combined files.
1

5 U.S.C. §§ 8101-8193.

FACTUAL HISTORY
On August 10, 2004 OWCP accepted that appellant, then a 49-year-old transportation
security screener, sustained employment-related bilateral carpal tunnel syndrome. The claim
was adjudicated by OWCP under claim file number xxxxxx284. On August 26 and
October 21, 2004 appellant underwent left and right carpal tunnel releases, respectively. She
returned to modified duty.
On April 20, 2007 appellant filed a traumatic injury claim, alleging that on April 19, 2007
she injured her left arm and shoulder while lifting luggage. The claim was adjudicated under
claim file number xxxxxx898.2 Appellant began limited duty and was placed on the periodic
compensation rolls when the employing establishment had no work available within her
restrictions. OWCP accepted left shoulder impingement syndrome and left shoulder sprain. A
September 21, 2007 magnetic resonance imaging (MRI) scan of the left shoulder demonstrated a
rotator cuff tear that was not considered full thickness. Appellant accepted a permanent
modified position on December 3, 2008.
On January 24, 2009 appellant filed an occupational disease claim, alleging that her job
duties caused significant lower extremity pain and swelling.
She stopped work on
January 19, 2009. The claim was adjudicated under file number xxxxxx453 and was accepted
for a right knee meniscus tear. On May 20, 2009 Dr. John H. Pak, a Board-certified orthopedic
surgeon, performed right knee arthroscopy to repair a partial medial meniscal tear. The claim
files were combined with file number xxxxxx284 as the master file. Appellant received
compensation and resigned in July 2009 when her husband was transferred to Delaware.
On September 6, 2012 appellant filed a schedule award claim. In a July 23, 2012 report,
Dr. David Weiss, an osteopath, advised that, under the sixth edition of the American Medical
Association, Guides to the Evaluation of Permanent Impairment (hereinafter A.M.A., Guides),3
she had eight percent impairment of each upper extremity due to entrapment neuropathy. Under
Table 15-5, Shoulder Regional Grid, appellant had a class 1 full-thickness rotator cuff tear with
residual loss for a default impairment of five percent. Dr. Weiss applied the net adjustment
formula, finding a modifier of three for Functional History (GMFH), a grade modifier of one for
Physical Examination (GMPE) and a grade modifier of two for Clinical Studies (GMCS), for a
net adjustment of one, for a total six percent upper extremity impairment due to the accepted left
shoulder condition. He also found that, under Table 16-3, Knee Regional Grid, a right partial
medial meniscectomy yielded a default two percent impairment. Dr. Weiss then applied the net
adjustment formula, finding modifiers of two each for functional history, physical examination
and clinical studies, for a net adjustment of three, yielding a right lower extremity impairment of
three percent.
On October 22, 2012 Dr. Arnold T. Berman, a Board-certified orthopedic surgeon and
OWCP medical adviser, reviewed the statement of accepted facts and medical record. He stated
2

At the time of the 2004 occupational disease claim, appellant worked at Orlando International Airport in
Orlando, Florida. She relocated to Colorado and began work at the Colorado Springs Airport.
3

A.M.A., Guides (6th ed. 2008).

2

that Dr. Weiss erred in assigning an impairment rating for a full-thickness rotator cuff tear when
the MRI scan findings demonstrated no evidence of a full-thickness tear. Dr. Berman advised
that appellant should be rated upon impingement syndrome which, under Table 15-5, yielded a
default value of one percent. He applied the net adjustment formula, finding grade modifiers of
one each for functional history, physical examination and clinical studies, which resulted in a net
adjustment of zero, for a final impairment of one percent due to the accepted left shoulder
conditions.
In a February 17, 2013 report, Dr. Berman advised that he agreed with the rating by
Dr. Weiss that appellant had eight percent impairment to each upper extremity. He stated that
since a left shoulder strain was not an accepted condition, appellant was not entitled to a
schedule award for this condition. Dr. Berman stated that the date of maximum medical
improvement was July 23, 2012, the date of Dr. Weiss’ examination.
By decision dated February 27, 2013, appellant was granted a schedule award for an eight
percent impairment of both the right and left upper extremities. The awards ran from
July 23, 2012 to July 7, 2013. The decision noted that the ratings were based on the medical
findings of Dr. Weiss and Dr. Berman.
On March 7, 2013 appellant, through her representative, requested a hearing that was
held on June 11, 2013. Her representative did not disagree with the schedule award for carpal
tunnel syndrome but noted that Dr. Weiss also provided impairment ratings for appellant’s left
shoulder and right knee conditions. Although these conditions were accepted under separate
claim numbers, the claims had been combined. The representative requested that the case be
remanded for development on whether appellant was entitled to schedule awards for the accepted
left shoulder and right knee conditions.
In a July 31, 2013 decision, an OWCP hearing representative affirmed the
February 27, 2013 decision with regards to appellant’s impairment due to the accepted bilateral
carpal tunnel syndrome condition. Upon return of the case record, OWCP was directed to
determine if appellant was entitled to schedule awards for the left shoulder impingement
syndrome, left shoulder sprain or right knee meniscus tear.
In correspondence to appellant dated September 18, 2013, OWCP noted that a medial
meniscus tear had been accepted and asked her to provide a medical report, in accordance with
the A.M.A., Guides that addressed this impairment.
On September 18, 2013 OWCP asked Dr. Berman to address whether appellant was
entitled to an increased schedule award due to the accepted shoulder condition. In an
October 15, 2013 report, Dr. Berman noted his review of the medical record and referenced his
February 17, 2013 report. He concluded that appellant would not be entitled to an increased
schedule award due to the left shoulder condition.
In a decision dated October 16, 2013, OWCP found the weight of the evidence rested
with the opinion of its medical adviser, who found that appellant did not have a greater
impairment of her left arm. In an October 22, 2013 decision, it found that, as appellant had not

3

responded to the September 18, 2013 letter requesting medical evidence, she was not entitled to a
schedule award for the accepted right knee meniscus tear.
LEGAL PRECEDENT
The schedule award provision of FECA4 and its implementing federal regulations5 set
forth the number of weeks of compensation payable to employees sustaining permanent
impairment from loss or loss of use, of scheduled members or functions of the body. However,
FECA does not specify the manner in which the percentage of loss shall be determined. For
consistent results and to ensure equal justice under the law for all claimants, OWCP has adopted
the A.M.A., Guides as the uniform standard applicable to all claimants.6 For decisions after
February 1, 2001, the fifth edition of the A.M.A., Guides was used to calculate schedule awards.7
For decisions issued after May 1, 2009, the sixth edition is to be used.8
The sixth edition of the A.M.A., Guides provides a diagnosis-based method of evaluation
utilizing the World Health Organization’s International Classification of Functioning, Disability
and Health (ICF).9 Under the sixth edition, for upper extremity impairments the evaluator
identifies the impairment class for the diagnosed condition (CDX), which is then adjusted by
grade modifiers based on functional history, physical examination and clinical studies.10 The
sixth edition of the A.M.A., Guides also provides that, under certain circumstances, range of
motion may be selected as an alternative approach in rating impairment. An impairment rating
that is calculated using range of motion may not be combined with a diagnosis-based impairment
and stands alone as a rating.11 Under the sixth edition, for lower extremity impairments the
evaluator identifies the impairment class for the diagnosed condition, which is then adjusted by
grade modifiers based on functional history, physical examination and clinical studies.12 The net
adjustment formula is (GMFH - CDX) + (GMPE - CDX) + (GMCS - CDX).13 Under Chapter

4

5 U.S.C. § 8107.

5

20 C.F.R. § 10.404.

6

Id. at § 10.404(a).

7

Federal (FECA) Procedure Manual, Part 3 -- Medical, Schedule Awards, Chapter 3.700, Exhibit 4
(January 2010).
8

FECA Bulletin No. 09-03 (issued March 15, 2009).

9

A.M.A., Guides, supra note 3 at 3, section 1.3, “The International Classification of Functioning, Disability and
Health (ICF): A Contemporary Model of Disablement.”
10

Id. at 385-419.

11

Id. at 390. The A.M.A., Guides explains that diagnoses in the grid that may be rated using range of motion are
followed by an asterisk.
12

Id. at 494-531.

13

Id. at 521.

4

2.3, evaluators are directed to provide reasons for their impairment rating choices, including
choices of diagnoses from regional grids and calculations of modifier scores.14
OWCP procedures provide that, after obtaining all necessary medical evidence, the file
should be routed to an OWCP medical adviser for an opinion concerning the nature and
percentage of impairment in accordance with the A.M.A., Guides, with the medical adviser
providing rationale for the percentage of impairment specified.15 In determining entitlement to a
schedule award, preexisting impairment to the scheduled member is to be included.16
ANALYSIS
The Board finds this case is not in posture for decision regarding whether appellant is
entitled to schedule awards for the accepted conditions of left shoulder impingement syndrome
and left shoulder sprain, adjudicated under claim file number xxxxxx898 or right knee meniscus
tear, adjudicated under claim file number xxxxxx453. Appellant’s representative noted at the
June 11, 2013 hearing, that he did not disagree with the schedule award rating for her bilateral
carpal tunnel syndrome.
Regarding the accepted left shoulder condition, Dr. Weiss advised that appellant had six
percent impairment based on a full-thickness rotator cuff tear. As noted by Dr. Berman, the
medical evidence does not support that appellant sustained a full-thickness tear. The
September 21, 2007 MRI scan noted that the rotator cuff tear found was not considered full
thickness. Thus, Dr. Weiss’ report is insufficient to establish entitlement to an additional
schedule award of six percent due to the accepted left shoulder condition. Dr. Berman submitted
three reports in which he addressed appellant’s left shoulder. In an October 22, 2012 report, he
indicated that her shoulder should be rated under Table 15-5 for a diagnosis of impingement
syndrome which yielded one percent impairment. In his February 17, 2013 report, OWCP’s
medical adviser indicated that, since a left shoulder strain was not accepted, appellant was not
entitled to a schedule award for this condition. On October 15, 2013 he indicated that he had
reviewed his February 17, 2013 report and appellant was not entitled to an increased award due
to the left shoulder condition.
In the October 16, 2013 decision, OWCP found the weight of the medical evidence rested
with the opinion of its medical adviser regarding the impairment to appellant’s left shoulder.
Dr. Berman did not acknowledge that a left shoulder condition was accepted under claim file
number xxxxxx898. His reports are contradictory but indicate greater impairment due to
impingement. The Board finds the case is not in posture for decision. The case will be
remanded to OWCP to develop the medical record on appellant’s left shoulder impingement and
left shoulder sprain adjudicated under claim file number xxxxxx898.

14

Id. at 23-28.

15

See Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims,
Chapter 2.808.6(f) (February 2013).
16

Peter C. Belkind, 56 ECAB 580 (2005).

5

The Board will also remand the case with regard to appellant’s right leg impairment. In a
July 23, 2012 report, Dr. Weiss found that, under Table 16-3, a partial medial meniscectomy
yielded a default two percent impairment. He applied the net adjustment formula, finding a
grade modifier of two each for functional history, physical examination and clinical studies, for a
net adjustment of three, yielding a right lower extremity impairment of three percent. Dr. Pak
noted on the May 20, 2009 operative report that a partial medial meniscectomy was performed.
In the October 22, 2013 decision, OWCP denied appellant’s claim finding that the record did not
contain a medical report regarding her right knee. Dr. Weiss, however, clearly provided an
impairment rating for her right knee condition. OWCP did not ask Dr. Berman or another
OWCP medical adviser to review the record with regard to the impairment to appellant’s right
knee.
Proceedings under FECA are not adversarial in nature and OWCP is not a disinterested
arbiter. While the claimant has the burden to establish entitlement to compensation, OWCP
shares responsibility in the development of the evidence. The case will be remanded to OWCP
for further development on the extent of impairment based on the accepted left shoulder and
right knee conditions. On remand OWCP should prepare a statement of accepted facts that
includes the three combined cases and their accepted conditions. Such further development as
deemed necessary, OWCP shall issue an appropriate merit decision on the issue of appellant’s
entitlement to schedule awards for the accepted left shoulder and right knee conditions.17
CONCLUSION
The Board finds this case is not in posture for decision regarding the degree of
appellant’s left upper extremity and right lower extremity impairments.

17

See M.D., Docket No. 13-503 (issued September 19, 2013).

6

ORDER
IT IS HEREBY ORDERED THAT the October 22 and 16, 2013 decisions of the
Office of Workers’ Compensation Programs are set aside and the case is remanded to OWCP for
proceedings consistent with this opinion of the Board.
Issued: June 11, 2014
Washington, DC

Patricia Howard Fitzgerald, Acting Chief Judge
Employees’ Compensation Appeals Board

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

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

7