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

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

Docket No. 14-1453
Issued: December 3, 2014

Case Submitted on the Record

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

JURISDICTION
On June 9, 2014 appellant, through his attorney, filed a timely appeal from a March 25,
2014 merit decision of an Office of Workers’ Compensation Programs’ (OWCP) hearing
representative. Pursuant to the Federal Employees’ Compensation Act1 (FECA) and 20 C.F.R.
§§ 501.2(c) and 501.3, the Board has jurisdiction over the merits of this case.
ISSUE
The issue is whether appellant has met his burden of proof to establish a traumatic injury
in the performance of duty.
FACTUAL HISTORY
On June 24, 2010 of traumatic injury claim was filed on behalf of appellant, then a 68year-old ramp clerk. The claim asserted that he sustained a contusion when he slipped over a
skid and fell while at work on June 21, 2010. Appellant stopped work on June 21, 2010.
1

5 U.S.C. § 8101 et seq.

A June 21, 2010 fire department incident report noted transporting appellant to a local
emergency room. It advised that he slipped and fell at work resulting in right side rib cage pain
and wrist pain. Responders found appellant lying on the floor when they arrived. Appellant
related to responders that he lost his footing as he was walking on skids/pallets. A June 21, 2010
emergency department record advised that he was admitted into the intensive care unit. It
advised that appellant hit his head as a result of a mechanical fall. Appellant was diagnosed with
hemoperitoneum and right abdominal hemorrhage. He complained of right rib and right wrist
pain. A June 21, 2010 emergency department injury/minor illness history and physical report,
advised that appellant slipped on the floor at work landing on his right wrist, elbow and chest
wall. The report advised that he was experiencing abdominal pain and tenderness of the right
chest wall and wrist. A June 21, 2010 nursing report noted that appellant arrived to the
emergency department via ambulance. It specified that his pain assessment was 9 on a scale of 1
to 10.
In a June 21, 2010 report, Dr. Stephen Doundoulakis, Board-certified in diagnostic
radiology and neuroradiology, advised that computerized tomography (CT) scans revealed high
density fluid in the pelvis and mild fluid seen in the right abdomen. He advised that the high
density fluid was likely hemoperitoneum. Dr. Doundoulakis noted that appellant possibly had an
adrenal hemorrhage. He also noted that there was mild induration seen on the right side of the
abdomen, suggesting injury on the right side.
In a June 22, 2010 report, Dr. Luisa Orrico, Board-certified in internal medicine, noted
that appellant fell on his right side while at work, resulting in right abdominal pain. She advised
that CT scans of the abdomen revealed hemoperitoneum around the right kidney and liver,
extending into the pelvis. Dr. Orrico diagnosed intraabdominal hemorrhage secondary to
trauma. She noted that appellant had a history of coronary artery disease, with stenting in 2009,
and hypertension that were currently stable. In a June 23, 2010 statement, Dr. Orrico noted his
hospitalization on June 21, 2010 for injuries post fall while at work. She advised that appellant
was stabilized and released on June 23, 2010. Dr. Orrico noted that he should not return to work
for two weeks.
In a June 22, 2010 consultation report, Dr. Andrew Sherman, Board-certified in critical
care and pulmonary medicine, noted that appellant suffered a mechanical fall at work striking his
head and the right side of his chest and flank. He advised that the consultation was for
appellant’s anemia secondary to intraabdominal hemorrhage. Dr. Sherman noted that appellant
presented with right side abdominal pain. He further advised that rib x-rays were negative;
however, CT scans revealed intraperitoneal blood. Dr. Sherman noted that appellant was stable
the morning following the incident, yet he complained of pelvis pain on his right side.
On June 7, 2011 and May 29, 2013 appellant’s counsel asked that OWCP develop the
claim as appellant sustained more than a contusion from the June 21, 2010 incident.
In a June 4, 2013 letter, OWCP notified appellant that it initially allowed a limited
amount of medical expenses as the employing establishment did not controvert continuation of
pay or controvert the merits of the claim. It indicated that it would now fully develop the claim.
OWCP advised appellant to submit a medical report that included a diagnosis and a physician’s
opinion on causal relationship supported by medical rationale.

2

In a January 17, 2013 report, Dr. Reji Ninan, a Board-certified family practitioner, noted
first treating appellant on September 15, 2011. She advised that he had a work-related injury on
June 21, 2010 when he fell onto his flank region. Dr. Ninan stated that appellant lost
consciousness and was taken to a hospital. She advised that CT scans revealed hemoperitoneum
and right adrenal gland hemorrhage. Dr. Ninan further advised that a subsequent October 27,
2012 CT scan showed no residual damage to appellant’s adrenal glands or abdominal viscera.
Appellant also resubmitted records of his hospital treatment.
By decision dated August 27, 2013, OWCP denied appellant’s claim because medical
evidence did not establish that the diagnosed condition was causally related to a work-related
incident.
On September 3, 2013 appellant, through his attorney, requested a telephone hearing
which was held on February 3, 2014. During the hearing, he noted that he was off work for four
to five days and returned to a “sit-down” job. Appellant stated that he subsequently retired when
the employing establishment closed the facility where he worked. He further advised that his
medical bills totaled approximately $20,000.00.
By decision dated March 25, 2014, the hearing representative affirmed the denial of
appellant’s claim because the medical evidence did not establish that the diagnosed condition
was causally related to the established work incident.
LEGAL PRECEDENT
An employee seeking compensation under FECA has the burden of establishing the
essential elements of his or her claim by the weight of reliable, probative, and substantial
evidence,2 including that he or she is an “employee” within the meaning of FECA and that he or
she filed his or her claim within the applicable time limitation.3 The employee must also
establish that he or she sustained an injury in the performance of duty as alleged and that his or
her disability for work, if any, was causally related to the employment injury.4
To determine whether a federal employee has sustained a traumatic injury in the
performance of duty, it first must be determined whether fact of injury has been established.
There are two components involved in establishing fact of injury. First, the employee must
submit sufficient evidence to establish that he or she actually experienced the employment
incident at the time, place, and in the manner alleged. Second, the employee must submit
medical evidence to establish that the employing establishment incident caused a personal
injury.5

2

J.P., 59 ECAB 178 (2007); Joseph M. Whelan, 20 ECAB 55, 57 (1968).

3

R.C., 59 ECAB 427 (2008).

4

Id.; Elaine Pendleton, 40 ECAB 1143, 1145 (1989).

5

T.H., 59 ECAB 388 (2008).

3

Rationalized medical opinion evidence is generally required to establish causal
relationship. 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.6
ANALYSIS
The evidence supports that on June 21, 2010 appellant fell while at work. Therefore, the
Board finds that the first component of fact of injury is established. However, the medical
evidence is insufficient to establish that the diagnosed condition of abdominal hemorrhage and
anemia was due to the June 21, 2010 incident.
In her June 22, 2010 report, Dr. Orrico noted that appellant fell on his right side while at
work and advised that CT scans of the abdominal revealed hemoperitoneum around the right
kidney and liver, extending into the pelvis. She diagnosed intraabdominal hemorrhage
secondary to trauma. Although this report identifies the history of appellant’s injury and states
that his hemorrhage was secondary to trauma, Dr. Orrico failed to specifically explain how the
workplace fall on June 21, 2010 caused the diagnosed internal injuries. Likewise, in her June 23,
2010 statement, Dr. Orrico noted his hospitalization for injuries after a workplace fall and
advised that he should not work for two weeks but she did not explain how the workplace fall
caused or aggravated the particular diagnosed conditions. Thus, these reports are insufficient to
establish appellant’s claim.
In a June 22, 2010 consultation report, Dr. Sherman noted appellant’s fall at work and
advised that he was seeing appellant for anemia secondary to intraabdominal hemorrhage. While
he noted the history of the June 21, 2010 fall at work, he did not specifically address how the
diagnosed conditions were caused or aggravated by the workplace fall. In a January 17, 2013
report, Dr. Ninan advised that appellant had a work-related injury when he fell onto his flank
region on June 21 2010. She advised that initial CT scans revealed hemoperitoneum and right
adrenal gland hemorrhage but that a subsequent October 27, 2012 CT scan showed no residual
damage to appellant’s adrenal glands or abdominal viscera. Although Dr. Ninan referenced a
work injury, it appears that she is repeating the history provided by appellant. In any event, she
noted that diagnostic testing showed appellant’s conditions had since resolved and she did not
otherwise provide medical rationale explaining how the workplace fall caused or aggravated the
diagnosed medical conditions for any particular period. Therefore, these reports are not
sufficient to establish the claim.
Dr. Doundoulakis’ June 21, 2010 diagnostic test report is of limited probative value as he
did not indicate that any diagnosed condition was causally related to the June 21, 2010

6

I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345 (1989).

4

workplace fall.7 Furthermore, initial hospital records from nurses and nonphysicians are
insufficient to establish the claim as medical evidence must be provided by a physician.8
As noted, causal relationship is a medical question that must be established by probative
medical opinion from a physician.9 The physician must accurately describe appellant’s work
duties and medically explain the process by which these duties would have caused or aggravated
a diagnosed condition.10 Because appellant has not provided such medical opinion evidence in
this case, he has failed to meet his burden of proof.
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 a traumatic injury in the performance of
duty on June 21, 2010.

7

See Jaja K. Asaramo, 55 ECAB 200 (2004) (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).
8

See 5 U.S.C. § 8101(2). This subsection defines the term “physician.” See also Charley V.B. Harley, 2 ECAB
208, 211 (1949) (where the Board held that medical opinion, in general, can only be given by a qualified physician).
9

See supra note 6.

10

Solomon Polen, 51 ECAB 341 (2000) (rationalized medical evidence must relate specific employment factors
identified by the claimant to the claimant’s condition, with stated reasons by a physician). See also S.T., Docket No.
11-237 (issued September 9, 2011).

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ORDER
IT IS HEREBY ORDERED THAT the March 25, 2014 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: December 3, 2014
Washington, DC

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

Patricia Howard Fitzgerald, Judge
Employees’ Compensation Appeals Board

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

6


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
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and
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U.S. POSTAL SERVICE, AIR MAIL FACILITY, )
Jacksonville, FL, Employer
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__________________________________________ )
A.W., Appellant

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

Docket No. 11-687
Issued: September 29, 2011

Case Submitted on the Record

DECISION AND ORDER
Before:
RICHARD J. DASCHBACH, Chief Judge
ALEC J. KOROMILAS, Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On January 21, 2011 appellant, filed a timely appeal of a December 27, 2010 Office of
Workers’ Compensation Programs’ (OWCP) merit decision denying appellant’s claimed
occupational disease. Pursuant to the Federal Employees’ Compensation Act (FECA)1 and 20
C.F.R. §§ 501.2(c)(1) and 501.3, the Board has jurisdiction to consider the merits of the case
ISSUE
The issue is whether appellant has met his burden of proof in establishing that his back
and knee conditions are due to his federal job duties.
FACTUAL HISTORY
On May 11, 2010 appellant, then a 49-year-old mail handler, filed an occupational
disease claim alleging that he developed degenerative joint disease in his lower back and knees
due to excessive pushing and pulling and heavy lifting required to perform his job duties. He
1

5 U.S.C. § 8101 et seq.

indicated that he first became aware of this condition and related it to his employment on
April 7, 2003. Appellant stated that his neck and back hurt when he was required to look down
for long periods of time. He also stated that his pain increased during the day as he fulfilled his
work duties of throwing mail resulting in lower back, neck and knee pain.
In a report dated April 7, 2003, Dr. John M. Flinchbaugh, an osteopath, noted that
appellant sustained a left knee injury in the performance of duty in 1998 including anterior
cruciate ligament repair. Appellant again injured his left knee in 2001 pushing equipment at
work which required a second anterior cruciate ligament repair. Dr. Flinchbaugh found that
appellant had degenerative changes in the right knee on x-ray. He diagnosed status post left and
right anterior cruciate reconstruction, lumbosacral strain and sprain as well as degenerative joint
disease of the right knee and chondromalacia patella of the left knee. Dr. Flinchbaugh stated,
“As far as his lumbar symptoms are concerned, I would recommend some flexibility exercise to
his hamstrings and some proper utilization of his legs for lifting rather than using his back.
[Appellant’s] symptoms to his back will be intermittent and may cause him to lose two days a
month referable to the low back. Depending on the amount of lifting may require further loss of
work.”
In a report dated April 27, 2010, Dr. Ronald James Stephens, an internist, diagnosed
degenerative joint disease with painful knees and chronic back pain syndrome. He stated, “The
patient’s symptoms are aggravated by excessive pushing or pulling and heavy lifting which is
limited to 25 pounds.” On December 12, 2010 Dr. Stephens recommended that appellant be
reassigned to a position that required less strenuous activity.
OWCP requested additional factual and medical evidence in a letter dated May 28, 2010.
It allowed 30 days for a response. Appellant submitted no additional evidence.
By decision dated July 12, 2010, OWCP denied appellant’s claim on the grounds that he
failed to submit the necessary medical opinion evidence to establish that his neck, back and knee
conditions were related to his employment duties.
Appellant requested an oral hearing. The employing establishment indicated that he had
10 percent armed services-related disability to his right knee. Appellant testified at the oral
hearing on October 20, 2010 reviewing Dr. Flinchbaugh’s report and statement that appellant
should push with his legs properly or his back would begin hurting. He stated that his back
began hurting two years earlier when he changed jobs and began twisting and bending.
Appellant stated that his knees hurt all the time. He submitted an additional medical report and
OWCP’s hearing representative allowed an additional 30 days to submit other reports.
Dr. Patrick J. Burns, an osteopath, completed a report on January 24, 2009 and stated that
appellant had bulges in his neck and lumbar spine. He stated that appellant’s current job
required heavy lifting and twisting. Dr. Burns recommended that appellant transfer to a less
strenuous position with limited heavy lifting. On March 30, 2009 Dr. Vincent Galiano, a Boardcertified family practitioner, noted that appellant wished to return to work and had experienced
neck, low back and right shoulder injuries. He stated that appellant had right shoulder surgery
and could not return to full-duty work which required heavy lifting, twisting and bending.

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By decision dated December 27, 2010, OWCP’s hearing representative denied
appellant’s claim on the grounds that there was no medical evidence opining that his job duties
caused or aggravated his neck and back conditions. OWCP’s hearing representative found that
Dr. Stephens opined that appellant’s symptoms were aggravated by work, but did not provide a
firm diagnosis, objective findings or medical reasoning supporting that the underlying condition
was caused or aggravated by work.
LEGAL PRECEDENT
OWCP’s regulations define an occupational disease as “a condition produced by the work
environment over a period longer than a single workday or shift.”2 To establish that an injury
was sustained in the performance of duty in an occupational disease claim, a claimant must
submit the following: (1) medical evidence establishing the presence or existence of the disease
or condition for which compensation is claimed; (2) a factual statement identifying employment
factors alleged to have caused or contributed to the presence or occurrence of the disease or
condition; and (3) medical evidence establishing that the employment factors identified by the
claimant were the proximate cause of the condition for which compensation is claimed or, stated
differently, medical evidence establishing that the diagnosed condition is causally related to the
employment factors identified by the claimant. The evidence required to establish causal
relationship is rationalized medical opinion evidence, based upon a complete factual and medical
background, showing a causal relationship between the claimed condition and identified factors.
The belief of a claimant that a condition was caused or aggravated by the employment is not
sufficient to establish causal relation.3
ANALYSIS
Appellant has alleged that he developed a back and knee condition due to his federal
employment. He attributed his condition to excessive pushing and pulling and heavy lifting.
Dr. Stephens diagnosed degenerative joint disease with painful knees and chronic back pain
syndrome. The Board finds that, as found by OWCP, appellant had submitted the initial factual
and medical evidence to establish the first two elements of an occupational disease claim.
However, the Board further finds that he has not submitted the necessary rationalized medical
opinion evidence to establish a causal relationship between his diagnosed condition of
degenerative joint disease and chronic back pain syndrome and his accepted employment duties.
Dr. Flinchbaugh examined appellant on April 7, 2003 and provided a medical history
including multiple left knee surgeries and a service-related right knee surgery. He diagnosed left
and right anterior cruciate reconstruction, lumbosacral strain and sprain as well as degenerative
joint disease of the right knee and chondromalacia patella of the left knee. Dr. Flinchbaugh did
not specifically describe appellant’s employment duties of looking down, excessive pushing,
pulling and heavy lifting, but instead recommended that he utilize appropriate lifting protocol.
He indicated that appellant’s back symptoms could be variable and linked with the amount of
lifting he performed. The Board finds that this report is not sufficiently detailed to meet
appellant’s burden of proof. Dr. Flinchbaugh did not attribute appellant’s diagnosed conditions
2

20 C.F.R. § 10.5(q).

3

Lourdes Harris, 45 ECAB 545, 547 (1994).

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to his employment duties and did not clearly opine that his employment duties caused or
aggravated his back and knee symptoms. Instead he suggested that appellant lift with his legs
and that appellant’s symptoms could be linked with the lifting performed. Without a clear
opinion regarding the nature of the relationship between appellant’s diagnosed condition and his
employment, this report is not sufficient to meet his burden of proof.
Dr. Stephens opined that appellant’s symptoms were aggravated by pushing or pulling
and heavy lifting in the performance of his job duties. He did not provide any further
explanation of his opinion. Dr. Stephens did not explain the basis for his opinion that appellant’s
job duties were causing either a temporary or permanent aggravation of appellant’s underlying
degenerative joint condition. Without medical reasoning explaining why and how appellant’s
employment activities resulted in an aggravation of his condition, this report is not sufficient to
establish his claim for an occupational disease.
In a January 24, 2009 report, Dr. Burns diagnosed bulges in the neck and lumbar spine.
He stated that appellant’s current job required heavy lifting and twisting and recommended that
appellant transfer to a less strenuous position with limited heavy lifting. This note is not
sufficient to meet appellant’s burden of proof as Dr. Burns did not provide a clear diagnosis and
did not offer an opinion regarding whether appellant’s current condition was caused or
aggravated by his employment activity. Without a diagnosis, an opinion that this diagnosis was
due to the accepted employment activity and medical rationale explaining that opinion, this
report is not sufficiently detailed and well-reasoned to meet appellant’s burden of proof.
In his March 30, 2009 report, Dr. Galiano stated that appellant had experienced neck, low
back and right shoulder injuries. He did not offer any opinion as to the cause of these conditions.
Dr. Galiano did not indicate that appellant should not work or should have limited duties due to
his back or knee injuries, instead attributing appellant’s disability to right shoulder surgery. The
Board finds that this report does not provide the necessary medical opinion evidence to meet
appellant’s burden of proof. Dr. Galiano did not attribute any of appellant’s diagnosed condition
to specific employment duties. Without any medical opinion evidence, this report is not
sufficient to meet appellant’s burden of proof.
Appellant may submit new evidence or argument with a written request for
reconsideration to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a)
and 20 C.F.R. §§ 10.605 through 10.607.
CONCLUSION
The Board finds that appellant has not submitted the necessary medical opinion evidence
to establish a causal relationship between his employment duties and his diagnosed back, knee,
neck and shoulder conditions.

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ORDER
IT IS HEREBY ORDERED THAT the December 27, 2010 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: September 29, 2011
Washington, DC

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

Alec J. Koromilas, 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
__________________________________________
M.S., Appellant
and
DEPARTMENT OF VETERANS AFFAIRS,
BUFFALO VETERANS ADMINISTRATION
MEDICAL CENTER, Buffalo, NY, Employer
__________________________________________

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

Docket No. 19-1096
Issued: November 12, 2019

Case Submitted on the Record

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

JURISDICTION
On April 19, 2019 appellant filed a timely appeal from a March 18, 2019 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

1
2

5 U.S.C. § 8101 et seq.

The Board notes that following the March 18, 2019 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.

ISSUE
The issue is whether appellant has met her burden of proof to establish a right ankle
condition causally related to the accepted January 29, 2019 employment incident.
FACTUAL HISTORY
On February 5, 2019 appellant, a 52-year-old food service worker, filed a traumatic injury
claim (Form CA-1) alleging that she injured her right ankle on January 29, 2019 when she stepped
into a pothole in the employing establishment parking lot while in the performance of duty. On
the reverse side of the claim form, the employing establishment indicated that she stopped work
on February 1, 2019 and received medical treatment.
A February 5, 2019 right ankle x-ray revealed avulsion fractures by the medial malleolus.
Dr. Jeffrey L. Lieberman, a radiologist, noted that one of the fractures appeared “old” and the other
was of “uncertain age.”
In a progress note dated February 6, 2019, an employee occupational health nurse
practitioner, Chris D. Hull, indicated that on February 1, 2019, appellant presented stating that she
fell on January 29, 2019 at about 2:05 p.m. in the employee parking lot, twisting her right ankle
when leaving for the day. She was off work on January 30 and 31, 2019 resting, using ice, and
elevating her leg. Appellant currently had the same pain level as the initial injury, and she was to
follow up with her own primary care provider as she had a current ankle/foot issue for which she
was already receiving treatment. An examination revealed a full, active range of motion with some
discomfort with lateral and medial motion. Foot flexion and extension was demonstrated without
difficulty or pain. The bilateral malleolus, both medial and lateral, had point tenderness. She was
assessed with avulsion fractures closed/inferior and adjacent to the medial malleolus.
In a chart review note dated February 6, 2019, Brian E. Lucas, a physician assistant,
indicated that his review of the x-rays revealed avulsion fractures, which appeared to be non-acute
in nature. He wrote that it appeared appellant could be treated as an ankle sprain, which could take
8 to 12 weeks to fully improve.
In a February 11, 2019 development letter, OWCP requested that appellant submit
additional evidence in support of her claim. It advised her of the type of factual and medical
evidence needed and provided a questionnaire for her completion, which inquired as to the
circumstances of the injury, including details as to the nature and use of the parking lot. OWCP
also requested that appellant provide a narrative report from her attending physician, to include a
diagnosis and an explanation as to how the reported work incident either caused or aggravated a
medical condition. By separate letter of even date, it also requested additional information from
the employing establishment. OWCP afforded both appellant and the employing establishment 30
days to respond.
In a February 12, 2019 work restriction note, Mr. Hull indicated that appellant could not
stand or walk more than 10 minutes at a time. If the employing establishment was unable to
accommodate this restriction, Mr. Hull advised that she should be sent home.

2

By decision dated March 18, 2019, OWCP denied appellant’s traumatic injury claim.
While it accepted that the January 29, 2019 employment incident occurred as alleged, OWCP
found that no valid diagnosis had been produced in connection with the accepted employment
incident. Thus, appellant had not met the requirements for establishing an injury as defined by
FECA.
LEGAL PRECEDENT
An employee seeking benefits under FECA3 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 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 determine if an employee sustained a traumatic injury in the performance of duty,
OWCP begins with an analysis of whether fact of injury has been established.7 Fact of injury
consists of two components that must be considered in conjunction with one another. The first
component is whether the employee actually experienced the employment incident that allegedly
occurred.8 The second component is whether the employment incident caused a personal injury.9
An employee may establish that an injury occurred in the performance of duty as alleged, but fail
to establish that the disability or specific condition for which compensation is being claimed is
causally related to the injury.10
Causal relationship is a medical question that generally requires rationalized medical
opinion evidence to resolve the issue.11 A physician’s opinion on whether there is a causal
relationship between the diagnosed condition and the implicated employment factor(s) must be
3

Supra note 1.

4

J.P., Docket No. 19-0129 (issued April 26, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); Joe D.
Cameron, 41 ECAB 153 (1989).
5
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

R.R., Docket No. 19-0048 (issued April 25, 2019); L.M., Docket No. 13-1402 (issued February 7, 2014);
Delores C. Ellyett, 41 ECAB 992 (1990).
7

E.M., Docket No. 18-1599 (issued March 7, 2019); T.H., 59 ECAB 388, 393-94 (2008).

8

L.T., Docket No. 18-1603 (issued February 21, 2019); Elaine Pendleton, 40 ECAB 1143 (1989).

9

B.M., Docket No. 17-0796 (issued July 5, 2018); John J. Carlone, 41 ECAB 354 (1989).

10

J.P., Docket No. 19-0129 (issued April 26, 2019); L.T., Docket No. 18-1603 (issued February 21, 2019);
Shirley A. Temple, 48 ECAB 404, 407 (1997).
11

E.M., supra note 7; Robert G. Morris, 48 ECAB 238 (1996).

3

based on a complete factual and medical background.12 Additionally, the physician’s opinion must
be expressed in terms of a reasonable degree of medical certainty, and must be supported by
medical rationale, explaining the nature of the relationship between the diagnosed condition and
appellant’s specific employment factor(s).13
ANALYSIS
The Board finds that appellant has not met her burden of proof to establish an injury
causally related to the accepted January 29, 2019 employment incident.
In his report of February 6, 2019, Brian Lucas, a physician assistant, diagnosed an ankle
sprain. However, the medical component of fact of injury must be established by a medical report
from a qualified physician who provides a valid diagnosis of a medical condition in connection to
the January 29, 2019 employment incident.14 OWCP received various treatment records authored
by physician assistants and nurse practitioner. As these providers are not considered
“physician[s]” as defined by FECA, their respective reports are insufficient for purposes of
establishing entitlement to FECA benefits.15
Dr. Lieberman, did not mention any link whatsoever between the January 29, 2019 incident
and the clinical findings of avulsion fractures that he observed on the x-rays of appellant’s right
ankle.16 Therefore, his report does not establish that appellant sustained a condition connected to
the accepted employment incident.17
Without medical evidence authored or countersigned by a qualified physician linking the
accepted incident to a valid diagnosis,18 the Board finds that appellant has not met her burden of

12

M.V., Docket No. 18-0884 (issued December 28, 2018); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

13

Id.

14

Y.N., Docket No. 14-0705 (issued July 2, 2014).

15
5 U.S.C. § 8101(2) provides that a physician includes surgeons, podiatrists, dentists, clinical psychologists,
optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by state law.
See 5 U.S.C. § 8102(2); M.M., Docket No. 16-1617 (issued January 24, 2017); David P. Sawchuk, 57 ECAB 316, 320
n.11 (2006) (lay individuals such as nurses, physician assistants, and physical therapists are not competent to render
a medical opinion under FECA); M.G., Docket No. 19-0918 (issued September 20, 2019 (nurse practitioners are not
considered physicians under FECA; therefore, their medical findings and/or opinions will not suffice for purposes of
establishing entitlement to FECA benefits). See also Gloria J. McPherson, 51 ECAB 441 (2000); Charley V.B.
Harley, 2 ECAB 208, 211 (1949) (a medical issue such as causal relationship can only be resolved through the
submission of probative medical evidence from a physician).
16

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

17

L.T., Docket No. 18-1603 (issued February 21, 2019).

18

A report from a physician assistant or certified nurse practitioner will be considered medical evidence if
countersigned by a qualified physician. Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship,
Chapter 2.805.3a(1) (January 2013).

4

proof to show that she sustained any medical condition as a result of the accepted January 29, 2019
employment incident.19
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 a right ankle
condition causally related to the accepted January 29, 2019 employment incident.
ORDER
IT IS HEREBY ORDERED THAT the March 18, 2019 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: November 12, 2019
Washington, DC

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

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

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

19

E.M., Docket No. 18-1599 (issued March 7, 2019).

5


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
L.D., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Bedford Park, IL, Employer
__________________________________________
Appearances:
Appellant, pro se
Office of Solicitor, for the Director

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Docket No. 08-2288
Issued: September 11, 2009

Case Submitted on the Record

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

JURISDICTION
On August 19, 2008 appellant filed a timely appeal of the June 9, 2008 decision of the
Office of Workers’ Compensation Programs finding 17 percent impairment of the left upper
extremity and denying him an increased impairment rating of the right upper extremity.
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 has more than a 17 percent permanent impairment of the
left upper extremity and an 11 percent permanent impairment of the right upper extremity for
which he received schedule awards.
FACTUAL HISTORY
On January 30, 2002 appellant, then a 48-year-old letter carrier, filed a traumatic injury
claim alleging that on January 17, 2002 he slipped and fell on ice landing on his left side while
collecting mail from a box on the street. He did not stop work. On March 7, 2002 the Office

accepted appellant’s claim for cervical strain and herniated cervical disc with nerve root
impingement.1
On December 26, 2003 appellant filed a schedule award claim. On September 13, 2005
the Office requested an impairment rating from his treating physician. In reports dated April 8,
2006, Dr. Jacob Salomon, a surgeon, diagnosed poststatus laminectomy at C4-5 and C5-6 with
cervical radiculopathy, left worse than right and cervical spondylosis with cervical arthropathy.
He noted that appellant had completed an outcome assessment form, which he utilized in
conjunction with Tables 16-10, 16-11 and 16-13 on pages 482, 484 and 489 of the American
Medical Association, Guides to the Evaluation of Permanent Impairment (A.M.A., Guides)
(5th ed. 2001) to rate impairment of the upper extremities. In a separate April 8, 2006 report,
Dr. Salomon assessed appellant’s motor and sensory impairments in both arms in the C5-6
distribution pursuant to the A.M.A., Guides. He identified the nerves involved in each arm and
applied the A.M.A., Guides in concluding that appellant had 46 percent impairment of the left
arm and 22 percent impairment of the right arm.
In a May 24, 2006 report, an Office medical adviser reviewed the record and determined
that appellant’s left upper extremity impairment resulted from the accepted conditions. He
advised that the date of maximum medical improvement was June 9, 2004, approximately one
year after appellant’s surgery. The Office medical adviser also found that appellant had a one
percent permanent impairment to his left upper extremity.2
By decision dated September 20, 2006, the Office granted a schedule award for one
percent permanent impairment of the left upper extremity. The period of the award ran for 3.12
weeks from June 9 to 30, 2004.3
On October 5, 2006 appellant requested an oral hearing. By decision dated January 12,
2007, an Office hearing representative remanded the case for further development as the Office
medical adviser had not been provided with Dr. Salomon’s April 8, 2006 report for review.
In a February 3, 2007 report, the Office medical adviser reviewed Dr. Salomon’s April 8,
2006 report and found an 11 percent impairment of each upper extremity. His findings were
based on percentages awarded for Grade 4 pain in the distribution of the C5 and C6 nerve root,
Grade 4 motor deficit distribution in the C5 nerve root and Grade 3 motor deficit distribution at
the C6 nerve root, according to Tables 15-14 through 15-17 on pages 421 and 424 of the A.M.A.,
Guides.
By decision dated February 26, 2007, the Office granted a schedule award for 11 percent
permanent impairment for each the right and left upper extremities. The awards took into

1

On April 15, 2003 the Office accepted a recurrence claim beginning on January 15, 2003. It also accepted
procedures for C4-5 discectomy and decompression, which was performed on June 24, 2003.
2

The Office medical adviser did not review Dr. Salomon’s April 8, 2006 report in assessing impairment.

3

This was an amended schedule award to reflect a 75 percent compensation, which revised the Office’s
September 19, 2006 decision reflecting a 66 2/3 percent compensation rate.

2

account the one percent previously awarded for the left upper extremity. The period of the
awards ran for 65.52 weeks from July 1, 2004 to October 2, 2005.
On March 23, 2007 appellant requested an oral hearing that was held on August 29, 2007.
In an April 11, 2007 report, Dr. Salomon explained why his impairment rating differed
from that of the Office medical adviser. He noted that the medical advisers’ ratings for the
percentages for pain of a nerve root and of a motor deficit of a nerve root were less.
Dr. Salomon explained that the percentages he picked were based on a narrative outcome
assessment form completed by appellant. He advised that he considered his findings valid and
that they were in conformance with the A.M.A., Guides. Based on these findings, Dr. Salomon
found that appellant had a 22 percent permanent impairment of the right upper extremity and a
46 percent impairment of the left upper extremity.
On November 15, 2007 an Office hearing representative vacated the February 26, 2007
decision and remanded the case for further medical development. On December 10, 2007
another Office medical adviser reviewed the reports of Dr. Salomon and the previous medical
adviser and noted that each physician relied on tables in the A.M.A., Guides, that provided for
impairment of affected nerve roots. The Office subsequently determined that there was a
conflict in the medical evidence between the Office medical adviser and Dr. Salomon.
On April 2, 2008 the Office referred appellant, with a statement of accepted facts, to
Dr. Julie Wehner, a Board-certified orthopedic surgeon, for a referee evaluation to determine the
impairment due to his work injury.
In an April 30, 2008 report, Dr. Wehner provided a history of injury and medical
treatment. Upon examination, she found that appellant’s neck range of motion was self-limiting
and there was no atrophy at the elbow, deltoid or supraspinatus area. Dr. Wehner diagnosed
cervicalgia status post C4-5 fusion. She advised that appellant’s left shoulder rotator cuff
problem was not related specifically to the cervical spine. Dr. Wehner found evidence of left
cubital tunnel syndrome with ulnar nerve impingement likely due to some other activities as
C4-5 cervical disc problems would not cause numbness to appellant’s fourth and fifth digits,
while cubital tunnel fit this distribution of nerve impingement. She indicated that examination of
his right upper extremity revealed mild cubital tunnel which was an impingement at the elbow
and, therefore, was not a work-related injury or related to the cervical spine area. Dr. Wehner
determined that the pain in appellant’s left shoulder overlapped what was referred from his neck
and what was inherent to his shoulder. She utilized the A.M.A., Guides and found that he had a
five percent C5 nerve root sensory deficit for left shoulder pain according to Table 16-13 on page
489. Dr. Wehner determined that appellant had a Grade 4 pain deficit at 25 percent according to
Table 16-10 on page 482. She multiplied 5 percent by 25 percent and concluded that he had a
1 percent upper extremity permanent impairment. Dr. Wehner further noted that she did not find
a motor impairment of the cervical spine. She did not include the right upper extremity in the
impairment ratings because her findings were not related to the cervical spine or work injury.
On May 12, 2008 the Office requested that Dr. Wehner clarify her impairment rating of
appellant’s upper extremities and include all work-related and nonwork-related impairments. In
a May 23, 2008 report, Dr. Wehner noted that appellant had an abnormal range of motion of the

3

left shoulder with active abduction of 100 degrees, which was four percent impairment from
Figure 16-43 on page 477. She also noted that there was no loss of adduction. Dr. Wehner
found 120 degrees forward flexion, four percent impairment and full extension, citing Figure
16-40 on page 476. She also found 30 degrees internal rotation or four percent impairment based
on Figure 16-46 on page 479 and 90 degrees of external rotation, a zero percent impairment.
Dr. Wehner added the loss of left shoulder range of motion and to total 12 percent impairment.
Regarding appellant’s left elbow cubital tunnel, she determined a nerve sensory deficit of
Grade 2, based on his abnormal sensations and moderate pain that may prevent activities on the
left side, which she assessed a 70 percent deficit, citing Table 16-10 on page 482. Dr. Wehner
also noted an ulnar nerve lesion at the cubital tunnel and determined a seven percent sensory
deficit for the ulnar nerve above the mid forearm according to Table 16-15 on page 492. She
multiplied 70 percent by the 7 percent sensory deficit and found 4.9 percent impairment rating
for the left elbow cubital tunnel. For appellant’s right elbow cubital tunnel, Dr. Wehner
determined a nerve sensory deficit of Grade 4, for which she assessed 10 percent, per Table
16-10 on page 482 and a 7 percent sensory deficit for an ulnar nerve above the mid forearm
according to Table 16-15 on page 492. She multiplied 10 percent by 7 percent sensory deficit,
which resulted in 0.7 percent impairment rating for the right cubital tunnel. Dr. Wehner found
that, for the cubital tunnel syndrome, appellant had one percent impairment on the right and five
percent impairment on the left. She concluded that he had a total of one percent impairment of
the right upper extremity. Using the Combined Values Chart on page 604, Dr. Wehner
combined 5 percent for left cubital tunnel with 12 percent for rotator cuff disease to derive at
16 percent impairment for the left upper extremity. When combined to the previous 1 percent
impairment rating of the left upper extremity for nerve root pain, it resulted in 17 percent
impairment for the left upper extremity.
By decision dated June 9, 2008, the Office denied appellant’s claim for an increased
schedule award for the right arm finding that there was insufficient evidence to establish
additional permanent impairment to the right arm and that the weight of the medical evidence
rested with Dr. Wehner. It amended appellant’s left arm schedule award with an additional
6 percent impairment or a total award of 17 percent. The period of the award was for 18.72
weeks and ran from October 3, 2005 to February 11, 2006 and took into account appellant’s
previous schedule awards.
Appellant appealed to the Board and requested oral argument, which was scheduled for
May 14, 2009. He did not appear for the scheduled oral argument.
LEGAL PRECEDENT
The schedule award provision of the Federal Employees’ Compensation Act4 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. The Act, however, does not specify the manner in which the percentage loss of a
member shall be determined. The method used in making such determination is a matter which
rests in the sounds discretion of the Office. For consistent results and to ensure equal justice, the
4

5 U.S.C. §§ 8101-8193. See 5 U.S.C. § 8107.

4

Board has authorized the use of a single set of tables so that there may be uniform standards
applicable to all claimants. The A.M.A., Guides has been adopted by the Office for evaluating
schedule losses and the Board has concurred in such adoption.5
Section 8123(a) of the Act provides that when there is a disagreement between the
physician making the examination for the United States and the physician of the employee, a
third physician shall be appointed to make an examination to resolve the conflict. When there
are opposing medical reports of virtually equal weight and rationale, the case must be referred to
an impartial medical specialist, pursuant to section 8123(a), to resolve the conflict in the medical
evidence.6
ANALYSIS
A conflict in medical opinion arose between Dr. Salomon, appellant’s treating physician,
and an Office medical adviser, as to the degree of permanent impairment to his upper
extremities. Dr. Salomon determined that appellant had a 46 percent left upper extremity
impairment and a 22 percent right upper extremity impairment based on the criteria of the
A.M.A., Guides for sensory deficits, loss of sensation, atrophy and weakness of appellant’s C5
and C6 nerve root. An Office medical adviser found an 11 percent permanent impairment for
each upper extremity based on pain and motor deficit distribution in the C5 and C6 nerve root
according to the A.M.A., Guides. The Office properly referred appellant to Dr. Wehner, a
Board-certified orthopedic surgeon, for a referee medical evaluation on the percentage of
permanent impairment.7 It properly requested a supplemental report from Dr. Wehner to provide
a rating of appellant’s upper extremities that included all impairments.8
Dr. Wehner’s reports dated April 30 and May 23, 2008 provided impairment findings for
appellant’s left and right upper extremities and the corresponding calculations. She measured
appellant’s left shoulder range of motion as abduction of 100 degrees for four percent
impairment,9 no loss of adduction, flexion of 120 degrees for four percent impairment,10 full
extension, internal rotation of 30 degrees for four percent impairment and external rotation of

5

See 20 C.F.R. § 10.404; R.D., 59 ECAB ___ (Docket No. 07-379, issued October 2, 2007).

6

Richard R. Lemay, 56 ECAB 341 (2005); see 5 U.S.C. § 8123(a).

7

The Act’s implementing regulations state that, if a conflict exists between the medical opinion of the employee’s
physician and the medical opinion of either a second opinion physician or an Office medical adviser, the Office shall
appoint a third physician to make an examination. This is called a referee examination and the Office will select a
physician who is qualified in the appropriate specialty and who has no prior connection with the case. See 20 C.F.R.
§ 10.321(b); R.H., 59 ECAB ___ (Docket No. 07-2124, issued March 7, 2008).
8

See V.G., 59 ECAB ___ (Docket No. 07-2179, issued July 14, 2008) (when the Office obtains an opinion from
an impartial medical specialist for the purpose of resolving a conflict in the medical evidence and the specialist’s
opinion requires clarification or elaboration, the Office must secure a supplemental report from the specialist to
correct the defect).
9

See A.M.A., Guides 477, Figure 16-43.

10

See id. at 476, Figure 16-40.

5

90 degrees for no impairment.11 Dr. Wehner added the percentages to total 12 percent range of
motion impairment of the left shoulder. For appellant’s left elbow cubital tunnel, she described a
nerve sensory deficit of Grade 2 at 70 percent12 and a sensory maximum impairment of 7 percent
for the ulnar nerve above the mid forearm.13 By multiplying 70 percent by 7 percent,
Dr. Wehner derived 4.9 percent which was rounded to 5 percent impairment.14 She opined that
there were no motor deficits. To determine appellant’s total left upper extremity impairment,
Dr. Wehner utilized the Combined Values Chart15 to combine 12 percent range of motion
impairment, 5 percent cubital tunnel impairment and 1 percent C5 nerve root pain impairment
previously determined in her April 30, 2008 report to a total of 17 percent.
Dr. Wehner also calculated impairment for appellant’s right elbow cubital tunnel. She
described appellant’s nerve sensory deficit as Grade 4 for 10 percent.16 She also noted a
maximum sensory impairment of 7 percent for the ulnar nerve above the mid forearm.17
Dr. Wehner multiplied 10 percent by 7 to derive 0.7 percent impairment, which was rounded to
1 percent impairment of the right elbow cubital tunnel. She noted that this was also the total
impairment for appellant’s right upper extremity.
When a case is referred to a referee medical specialist for the purpose of resolving a
conflict in medical opinion, the opinion of such specialist, if sufficiently well rationalized and
based upon a proper factual background, must be given special weight.18 The Board finds that,
the report of Dr. Wehner, the referee medical specialist, is entitled to such weight. She had the
entire case record and a statement of accepted facts at her disposal, she examined appellant and
related her findings and she offered an opinion that was sufficiently well rationalized to resolve
the conflict that had arisen.19 Dr. Wehner also properly calculated the impairment percentages
for appellant’s upper extremities according to the A.M.A., Guides.
The Board finds that the weight of the medical evidence establishes that appellant has no
more than 17 percent impairment of the left upper extremity or 11 percent impairment of the
right upper extremity.

11

See id. at 479, Figure 16-46.

12

See id. at 482, Table 16-10.

13

See id. at 492, Table 16-15.

14

J.Q., 59 ECAB ___ (Docket No. 06-2152, issued March 5, 2008) (the policy of the Office is to round the
calculated percentage of impairment to the nearest whole number).
15

See A.M.A., Guides 604.

16

See supra note 12.

17

See supra note 13.

18

Y.A., 59 ECAB ___ (Docket No. 08-254, issued September 9, 2008).

19

See Sherry A. Hunt, 49 ECAB 467 (1998).

6

On appeal, appellant asserts that the schedule award for his upper extremities should be
increased as his impairment was due to an accepted work-related injury. He further asserts that
Dr. Salomon’s impairment rating reflects the true state of his condition. As noted, the Office
found that a conflict existed in the medical evidence between Dr. Salomon and an Office medical
adviser and, therefore, appellant was properly referred to Dr. Wehner for a referee evaluation to
resolve the conflict. Dr. Wehner’s opinion was given special weight because it was well
rationalized, had proper calculations and was based on findings from her own independent
examination and the entire case record. As she determined that appellant had a 17 percent left
upper extremity impairment and a 1 percent right upper extremity impairment, appellant is not
entitled to an increased schedule award. Appellant also asserts that his employment injury limits
his activities. However, the Board has held that factors such as limitations on daily activities do
not go into the calculation of a schedule award.20
CONCLUSION
The Board finds that appellant has no more than 17 percent impairment of the left upper
extremity or 11 percent impairment of the right upper extremity, for which he has received a
schedule award.
ORDER
IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’
decision dated June 9, 2008 is affirmed.
Issued: September 11, 2009
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
20

E.L., 59 ECAB ___ (Docket No. 07-2421, issued March 10, 2008).

7


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
S.A., Appellant
and
DEPARTMENT OF THE NAVY, NORFOLK
NAVAL SHIPYARD, Portsmouth, VA, Employer
__________________________________________

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

Docket No. 11-1124
Issued: December 7, 2011

Case Submitted on the Record

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

JURISDICTION
On April 5, 2011 appellant filed a timely appeal from an October 25, 2010 merit decision
of the Office of Workers’ Compensation Programs (OWCP) denying his claim for a schedule
award; and a December 16, 2010 nonmerit decision denying his request for review of the written
record. 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 cases.
ISSUES
The issues are: (1) whether OWCP properly determined that appellant’s hearing
impairment was not ratable; (2) whether OWCP abused its discretion by refusing to authorize
hearing aids; and (3) whether OWCP properly denied appellant’s request for a review of the
written record.

1

5 U.S.C. § 8101 et seq.

FACTUAL HISTORY
On July 14, 2010 appellant, then a 54-year-old administrative support specialist, filed an
occupational disease claim, stating that he sustained hearing loss due to noise exposure in his
federal employment.
In response to a request for further information from OWCP, appellant submitted his
statement of employment history, personnel action forms, position descriptions, as well as
employing establishment audiograms.
Appellant’s employment records indicate that he began working for the Department of
the Navy in 1974 and remained at the employing establishment until the present time. His
assignment was modified several times, but the type of noise he was exposed to remained
identical until 2008, when he was assigned the current position and was no longer subject to
noise. Prior to 2008 appellant was subjected to noise associated with sandblasting, grinding,
needle guns and hammering.
OWCP received audiometric examination reports provided by the employing
establishment from 1974, 1997 and 2010. The unsigned audiogram dated April 6, 2010
indicated that testing at the frequency levels of 500, 1,000, 2,000 and 3,000 cycles per second
revealed decibel losses: right ear 5, 20, 25 and 45 decibels; left ear 15, 20, 20 and 15 decibels.
OWCP referred appellant and a statement of accepted facts to Dr. Eugenia Gray, a Boardcertified otolaryngologist, for audiometric and otologic examination and evaluation.
Audiometric testing of appellant was performed on September 3, 2010. Testing at the frequency
levels of 500, 1,000, 2,000 and 3,000 cycles per second revealed the following: right ear 5, 20,
25 and 50 decibels; left ear 20, 25, 20 and 25 decibels. Dr. Gray concluded that appellant
sustained sensorineural bilateral hearing loss as a result of his employment, but that the hearing
loss was not ratable. She rationalized this conclusion by stating that the sensorineural hearing
loss pattern was consistent with noise exposure, and appellant had a history of being exposed to
noise during his federal employment. Dr. Gray also opined that the hearing loss was not ratable
as the extent of hearing loss was zero percent, after deduction of the 25 decibel fence. However,
she noted that appellant would benefit from hearing aids, stating that he could only hear the
television at a volume level that was intolerable for his family, and that his daily conversations
were also impaired.
By decision dated October 8, 2010, OWCP notified appellant that his claim was accepted
for bilateral sensorineural hearing loss due to workplace exposure to noise. On September 20,
2010 the district medical adviser (DMA) reviewed Dr. Gray’s report and the audiometric test of
September 3, 2010. The DMA concluded that appellant had a noise-induced sensorineural
hearing loss which was not ratable in either ear. In accordance with the sixth edition of the
American Medical Association, Guides to the Evaluation of Permanent Impairment, (A.M.A.,
Guides), appellant had a zero percent binaural sensorineural hearing loss, and that the date of
maximum medical improvement was September 3, 2010. The DMA noted, however, that the
medical evidence “does support OWCP authorization of amplification to treat his conditions,”
and also recommended yearly audiograms and hearing protection for appellant.

2

In an October 25, 2010 decision, OWCP determined that appellant was not entitled to a
schedule award of compensation and that the weight of the medical evidence established that he
would not benefit from hearing aids.
Appellant disagreed with the decision and requested review of the written record on
November 29, 2010.
OWCP denied appellant’s request for a review of the written records, by decision dated
December 16, 2010, on the grounds that the request was not timely filed. Appellant was
informed that his case had been considered in relation to the issues involved, and that the issues
could be addressed by requesting reconsideration before and submitting evidence not previously
considered.
LEGAL PRECEDENT -- ISSUE 1
The schedule award provision of FECA2 and its implementing regulations3 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 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. The A.M.A., Guides has been adopted by the implementing regulations as the
appropriate standard for evaluating schedule losses.4
OWCP evaluates industrial hearing loss in accordance with the standards contained in the
A.M.A., Guides. Using the frequencies of 500, 1,000, 2,000 and 3,000 cycles per second, the
losses at each frequency are added up and averaged. Then, the fence of 25 decibels is deducted
because, as the A.M.A., Guides points out, losses below 25 decibels result in no impairment in
the ability to hear everyday speech under everyday conditions. The remaining amount is
multiplied by a factor of 1.5 to arrive at the percentage of monaural hearing loss. The binaural
loss is determined by calculating the loss in each ear using the formula for monaural loss: the
lesser loss is multiplied by five, then added to the greater loss and the total is divided by six to
arrive at the amount of the binaural hearing loss. The Board has concurred in OWCP’s adoption
of this standard for evaluating hearing loss.5
The requirements of the evidence to be used in evaluating occupational hearing loss
claims are defined by the Federal (FECA) Procedure Manual, which provides that an employee
should undergo audiological evaluation and otological examination; that the audiological testing
precede the otologic examination; that the audiological evaluation and otologic examination be
performed by different individuals as a method of evaluating the reliability of the findings; that
2

5 U.S.C. § 8107.

3

20 C.F.R. § 10.404 (1999).

4

Id. See also Jacqueline S. Harris, 54 ECAB 139 (2002).

5

J.H., Docket No. 08-2432 (issued June 15, 2009); J.B., Docket No. 08-1735 (issued January 27, 2009).

3

the clinical audiologist and otolaryngologist be certified; that all audiological equipment
authorized for testing meet the calibration protocol contained in the accreditation manual of the
American Speech and Hearing Association that the audiometric test results include both bone
conduction and pure-tone air conduction thresholds; speech reception thresholds and monaural
discrimination scores; and that the otolaryngologist’s report include the date and hour of
examination; date and hour of the employee’s last exposure to loud noise; a rationalized medical
opinion regarding the relationship.6
ANALYSIS -- ISSUE 1
The Board finds that OWCP properly relied on the test results of Dr. Gray, the second
opinion physician, as her audiometric study was the only report of record that met all the
calibration protocol requirements required by OWCP.7
An OWCP medical adviser applied OWCP’s standardized procedures to the September 3,
2010 audiogram performed for Dr. Gray. Test results for the right ear at the frequency levels of
500, 1,000, 2,000 and 3,000 cycles per second revealed decibel losses of 5, 20, 25 and 50
decibels, respectively. These decibels were totaled at 100 and were divided by 4 to obtain an
average hearing loss at those cycles of 25 decibels. The average of 25 decibels was then reduced
by 25 decibels (the first 25 decibels were discounted as discussed above) to equal 0, which was
multiplied by the established factor of 1.5 to compute a zero percent monaural loss of hearing for
the right ear.
Testing for the left ear at the frequency levels of 500, 1,000, 2,000 and 3,000 cycles per
second revealed decibel losses of ear 20, 25, 20 and 25, respectively. These decibels were
totaled at 90 and were divided by 4 to obtain the average hearing loss at those cycles of 22.5
decibels. The average of 22.5 decibels was then reduced by 25 decibels (the first 25 decibels
were discounted as discussed above) to equal 0 which was multiplied by the established factor of
1.5 to compute a zero percent hearing monaural loss for the left ear. As such, the binaural loss
also comes out to be zero percent.
The Board finds that OWCP properly concluded that appellant’s binaural hearing loss
was not ratable.
LEGAL PRECEDENT -- ISSUE 2
Section 8103(a) of FECA provides that the United States shall furnish to an employee
who is injured while in the performance of duty, the services, appliances and supplies prescribed
or recommended by a qualified physician, which the Secretary of Labor considers likely to cure,
give relief, reduce the degree or the period of any disability or aid in lessening the amount of any

6

Joshua Holmes, 42 ECAB 231 (1990).

7

The April 6, 2010 employing establishment audiogram was unsigned and did not contain complete calibration
information. It does not comply with OWCP procedures.

4

monthly compensation.8 OWCP must therefore exercise discretion in determining whether the
particular service, appliance or supply is likely to affect the purposes specified in FECA.9
Following medical evaluation of a claim, if the hearing loss is determined to be
nonratable for schedule award purposes, other benefits such as hearing aids may still be payable
if any employment-related loss exists, as supported by medical rationale.10
ANALYSIS -- ISSUE 2
The Board finds that OWCP abused its discretion in denying appellant’s request for
hearing aids. OWCP justified its decision by stating that “the weight of the medical evidence
established that [appellant] would not benefit from hearing aids.” This statement lacks
evidentiary basis, as both medical reports from the DMA and Dr. Gray explicitly recommended
hearing aids for treatment of appellant’s condition. Dr. Gray’s November 8, 2010 wellrationalized report determined that appellant sustained a nonratable, employment-related hearing
loss, but that authorization of hearing aids was appropriate in view of his impairment in daily
conversation and communication. The DMA agreed with Dr. Gray’s conclusion and stated that
the medical evidence supported use of hearing aids. There is no contradicting medical evidence.
The facts of this case are comparable to those presented in A.S.11 In that case, both the
referee physician and the DMA agreed that OWCP should furnish the employee hearing aids,
while OWCP denied the request without providing any factual findings or reasoning in support
of its conclusion. The Board found that the employee was entitled to hearing aids.
The Board concludes that appellant is entitled to hearing aids.
LEGAL PRECEDENT -- ISSUE 3
Section 8124(b)(1) of FECA provides that, before review under section 8128(a) of this
title, a claimant for compensation not satisfied with a decision of the Secretary is entitled, on
request made within 30 days after the date of the issuance of the decision, to a hearing on his
claim before a representative of the Secretary.12 Section 10.616(a) of the federal regulations
implementing this section of FECA provides that a claimant, injured on or after July 4, 1966,
who has received a final adverse decision by OWCP may obtain a hearing by writing to the
address specified in the decision. The hearing request must be sent within 30 days (as
determined by the postmark or other carrier’s date marking) of the date of the decision for which
a hearing is sought.13
8

5 U.S.C. § 8103(a).

9

See Marjorie S. Geer, 39 ECAB 1099 (1988); see also W.S., Docket No. 11-707 (issued September 28, 2011).

10

A.S., Docket No. 10-2048 (issued June 7, 2011); see also F.D., Docket No. 10-1175 (issued January 4, 2011).

11

A.S., supra note 10.

12

5 U.S.C. § 8124(b)(1).

13

N.M., 59 ECAB 511 (2008).

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OWCP, in its broad discretionary authority in the administration of FECA, has the power
to hold hearings in certain circumstances where no legal provision was made for such hearings,
and OWCP must exercise this discretionary authority in deciding whether to grant a hearing.
OWCP’s procedures, which require OWCP to exercise its discretion to grant or deny a hearing
when a hearing request is untimely or made after reconsideration under section 8128(a), are a
proper interpretation of FECA and Board precedent.14
ANALYSIS -- ISSUE 3
Appellant requested a review of the written record before OWCP’s Branch of Hearings
and Review on November 29, 2010. As the request was submitted more than 30 days following
issuance of the October 25, 2010 decision, it was untimely filed.
OWCP considered the matter in relation to the issue involved and found that additional
evidence could be submitted with a request for reconsideration. It has administrative discretion
in determining whether a hearing should be granted even though the request is untimely. An
abuse of discretion is generally shown through proof of manifest error, a clearly unreasonable
exercise of judgment, or actions taken which are contrary to both logic and probable deductions
from established facts.15 Because reconsideration exists as an alternative appeal right to address
the issues raised by OWCP’s October 25, 2010 decision, the Board finds that OWCP did not
abuse its discretion in denying appellant’s untimely request for a review of the written record.
CONCLUSION
The Board finds that appellant did not sustain a ratable hearing loss; that OWCP abused
its discretion in denying appellant’s request for hearing aids, and that OWCP properly denied
appellant’s request for review of the written record as untimely.16
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.

14

Sandra F. Powell, 45 ECAB 877 (1994).

15

Samuel R. Johnson, 51 ECAB 612 (2000).

16

Appellant may request a schedule award or increased schedule award based on evidence of a new exposure or
medical evidence showing progression of an employment-related condition resulting in permanent impairment or
increased impairment.

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ORDER
IT IS HEREBY ORDERED THAT the December 16, 2010 decision of the Office of
Workers’ Compensation Programs is affirmed, and the October 25, 2010 decision is affirmed in
part and reversed regarding the issue of appellant’s entitlement to hearing aids.
Issued: December 7, 2011
Washington, DC

Alec J. Koromilas, Judge
Employees’ Compensation Appeals Board

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

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

7


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
L.W., Appellant
and
DEPARTMENT OF THE ARMY, ARMY
MEDICAL COMMAND, Fort Bragg, NC,
Employer
__________________________________________

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Appearances:
Lucille H. Williams, pro se
Office of Solicitor, for the Director

Docket No. 07-1850
Issued: November 21, 2007

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Chief Judge
DAVID S. GERSON, Judge
MICHAEL E. GROOM, Alternate Judge

JURISDICTION
On August 23, 2006 appellant filed a timely appeal from the September 27, 2006 merit
decision of the Office of Workers’ Compensation Programs denying her traumatic injury claim.
Pursuant to 20 C.F.R. §§ 501.2 and 501.3, the Board has jurisdiction over the merits of this case.
ISSUE
The issue is whether appellant sustained a right knee injury while in the performance of
duty on July 28, 2006.
FACTUAL HISTORY
On July 28, 2006 appellant, a 60-year-old nursing assistant, filed a traumatic injury claim
alleging that she fell on that date on a “shining floor,” while walking down a hall with charts. A
witness, Captain Caulk, confirmed that appellant fell in the clinic’s hallway as she was carrying
charts to the “mod” office on July 28, 2006. In an undated statement, appellant alleged that, a
coworker, Sallie Underwood had falsely indicated that on the date in question, appellant caught

her toe on the floor and fell to her knees. She stated that Ms. Underwood was not present at the
time of the incident and that her shoe never came off.
In a letter dated August 24, 2006, the Office informed appellant that the employing
establishment had controverted her claim on the grounds that appellant fell because she was
wearing oversized shoes. It advised her that the information submitted was insufficient to
establish her claim and allowed her 30 days to submit additional information, including a
detailed account of the alleged injury and a physician’s report with a diagnosis and a rationalized
opinion as to the cause of the diagnosed condition.
Appellant submitted a July 28, 2006 work excuse bearing an illegible signature,
indicating that she could return to work on July 31, 2006. July 28, 2006 emergency room care
discharge instructions, bearing an illegible signature of a physician’s assistant, provided a
diagnosis of right knee contusion. Notes indicated “right knee pain -- hit on floor.”
In an undated statement, appellant indicated that on the date in question, she slipped on a
“slippery and shining floor” as she was heading for “mod.” She noted that Captain Caulk helped
her to a chair and a Mrs. Williams provided her with an ice pack. In a July 28, 2006
authorization for treatment, Sonia Shaw, a registered nurse, related appellant’s account of the
alleged incident. She reported that appellant was walking down C hallway, on her way to the
“mod” office when she caught her toe on the floor and fell to her knees. Appellant was helped to
a chair and an ice pack was applied to her knee.
A July 28, 2006 attending physician’s report, bearing an illegible signature indicated that
appellant “slipped when at work -- fell on right knee.” In response to the question as to whether
the physician believed that appellant’s condition was caused by employment factors, the form
contained a checkmark in the “yes” box.
In an August 23, 2006 report, Dr. S.J. Patel, a treating physician, stated that he had
examined appellant on August 21, 2006 for right leg pain. He related that she was seen at
Womack Clark Clinic on July 28, 2006; that she returned to work on July 31, 2006, but was
unable to remain because appellant was not feeling well; and that she returned to work on
August 1, 2006. The record contains an August 24, 2006 return-to-work slip, signed by Patsy
Willis, a receptionist for Cape Fear Valley Internal Medicine, stating that appellant could return
to work on that date.
By decision dated September 27, 2006, the Office denied appellant’s claim. It accepted
that the work event occurred as alleged but found that the medical evidence did not contain a
diagnosis that could be connected to the accepted event. Therefore, the evidence to establish that
appellant had sustained an injury under the Federal Employees’ Compensation Act on
July 28, 2006.1
1

The Board notes that appellant submitted additional evidence after the Office rendered its September 27, 2006
decision. Its 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); Dennis E. Maddy, 47 ECAB 259 (1995); James C. Campbell, 5 ECAB 35, 36
n.2 (1952). Therefore, this new evidence cannot be considered by the Board on appeal. Appellant may submit this
evidence to the Office, together with a formal request for reconsideration, pursuant to 5 U.S.C. § 8128(a) and
20 C.F.R. § 10.606(b)(2).

2

LEGAL PRECEDENT
The Act provides for payment of compensation for disability or death of an employee
resulting from personal injury sustained while in the performance of duty.2 The phrase
“sustained while in the performance of duty” is regarded as the equivalent of the coverage
formula commonly found in workers’ compensation laws, namely, arising out of and in the
course of employment.3
An employee seeking benefits under the Act has the burden of proof to establish the
essential elements of 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 disability or specific condition for which compensation is claimed is
causally related to the employment injury.4 When an employee claims that she sustained a
traumatic injury in the performance of duty, she must establish the fact of injury, consisting of
two components, which must be considered in conjunction with one another. The first is
whether the employee actually experienced the incident that is alleged to have occurred at the
time, place and in the manner alleged. The second is whether the employment incident caused a
personal injury, and generally this can be established only by medical evidence.5
The claimant has the burden of establishing by the weight of reliable, probative and
substantial evidence that the condition for which compensation is sought is causally related to a
specific employment incident or to specific conditions of employment.6 An award of
compensation may not be based on appellant’s belief of causal relationship.7 Neither the mere
fact that a disease or condition manifests itself during a period of employment nor the belief that
the disease or condition was caused or aggravated by employment factors or incidents is
sufficient to establish a causal relationship.8 Simple exposure to a workplace hazard does not
constitute a work-related injury entitling an employee to medical treatment under the Act.9

2

5 U.S.C. § 8102(a).

3

This construction makes the statute effective in those situations generally recognized as properly within the
scope of workers’ compensation law. Charles E. McAndrews, 55 ECAB 711 (2004); see also Bernard D. Blum, 1
ECAB 1 (1947).
4

Robert Broome, 55 ECAB 339 (2004).

5

Deborah L. Beatty, 54 ECAB 340 (2003). See also Tracey P. Spillane, 54 ECAB 608 (2003); Betty J. Smith, 54
ECAB 174 (2002). The term injury as defined by the Act, refers to a disease proximately caused by the
employment. 5 U.S.C. § 8101(5). See 20 C.F.R. § 10.5(q)(ee).
6

Katherine J. Friday, 47 ECAB 591, 594 (1996).

7

Dennis M. Mascarenas, 49 ECAB 215, 218 (1997).

8

Id.

9

20 C.F.R. § 10.303(a).

3

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 that includes a physician’s rationalized opinion on whether
there is a causal relationship between the claimant’s diagnosed condition and the established
incident or factor of employment. The opinion 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 established incident or factor of employment.10
ANALYSIS
The Office accepted that appellant was a federal employee, that she timely filed her claim
for compensation benefits and that the July 28, 2006 workplace incident occurred as alleged.
The issue, therefore, is whether appellant has submitted sufficient medical evidence to establish
that the employment incident caused an injury. The medical evidence of record does not contain
a rationalized medical opinion establishing that the work-related incident caused or aggravated
her right knee injury or disability. Therefore, appellant has failed to satisfy her burden of proof.
Medical evidence submitted by appellant consists of a July 28, 2006 work excuse bearing
an illegible signature; July 28, 2006 emergency room discharge instructions, bearing an illegible
signature of a physician’s assistant; a July 28, 2006 treatment authorization, signed by a
registered nurse; an August 24, 2006 return-to-work slip, signed by a receptionist; and an
August 23, 2006 report from Dr. Patel. None of these reports constitute probative medical
evidence.
On August 23, 2006 Dr. Patel stated that he had examined appellant on August 21, 2006 for
right leg pain. He related that she was seen at Womack Clark Clinic on July 28, 2006; that she
returned to work on July 31, 2006, but was unable to remain because she was not feeling well;
and that she returned to work on August 1, 2006. Dr. Patel did not provide a definitive diagnosis
or render an opinion as to the cause of appellant’s condition.11 The Board has long held that
medical evidence which does not offer an opinion regarding the cause of an employee’s
condition is of limited probative value on the issue of causal relationship. The record does not
contain an opinion by Dr. Patel or by any other qualified physician, supporting appellant’s
contention that her right knee condition was causally related to the accepted employment
activity. While appellant has submitted chart notes and other medical documents which track her
treatment, she has not provided a narrative report containing a physician’s rationalized opinion
on whether there is a causal relationship between her condition and the established July 28, 2006
work incident. The Board notes that appellant submitted notes and reports signed by nurses,
physicians’ assistants and receptionists. As these reports were not signed by individuals that
qualify as “physicians” under the Act, the Board finds that they do not constitute probative

10

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

11

The Board has held that a diagnosis of pain does not constitute a basis of payment for compensation, as pain is
considered to be a symptom rather than a specific diagnosis. Robert Broom, supra note 4.

4

medical evidence.12 The unidentified reports bearing illegible signatures also lack probative
value in that they lack proper identification.13
Appellant expressed her belief that her right knee condition resulted from the July 28,
2006 employment incident. The Board has held that the mere fact that a condition manifests
itself during a period of employment does not raise an inference that there is a causal relationship
between the two.14 Neither the fact that the condition became apparent during a period of
employment, nor the belief that the condition was caused or aggravated by employment factors
or incidents, is sufficient to establish causal relationship.15 Causal relationship must be
substantiated by reasoned medical opinion evidence which it is appellant’s responsibility to
submit. Therefore, appellant’s belief that her condition was caused by the work-related incident
is not determinative.
The Office advised appellant that it was her responsibility to provide a comprehensive
medical report which described her symptoms, test results, diagnosis, treatment and the doctor’s
opinion, with medical reasons, on the cause of her condition. Appellant failed to submit
appropriate medical documentation in response to the Office’s request. As there is no probative,
rationalized medical evidence addressing how appellant’s claimed knee condition was caused or
aggravated by her employment, she has not met her burden of proof in establishing that she
sustained an injury in the performance of duty causally related to factors of her federal
employment.
CONCLUSION
The Board finds that appellant has failed to meet her burden of proof to establish that she
sustained a traumatic injury in the performance of duty on July 28, 2006.

12

A medical report may not be considered as probative medical evidence if there is no indication that the person
completing the report qualifies as “physician” as defined in 5 U.S.C. § 8101(2). Section 8101(2) of the Act provides
as follows: “(2) ‘physician’ includes surgeons, podiatrists, dentists, clinical psychologists, optometrists,
chiropractors, and osteopathic practitioners within the scope of their practice as defined by State law.” See
Merton J. Sills, 39 ECAB 572, 575 (1988).
13

See Merton J. Sills, supra note 12.

14

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

15

Id.

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ORDER
IT IS HEREBY ORDERED THAT the September 27, 2006 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: November 21, 2007
Washington, DC

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

David S. Gerson, Judge
Employees’ Compensation Appeals Board

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

6