G.D. and U.S. Postal Service, Post Office, Babylon, NY (Board decision, February 27, 2013)

ECAB remand decision. The Board set aside OWCP’s May 1, 2012 denial and ordered it to consolidate G.D.’s related case files before deciding his claim again. Whether the 2011 knee injury claim will be accepted remains unresolved. A party may petition the Board for reconsideration within 30 days of issuance unless the order specifies another period, under 20 C.F.R. § 501.7(a).

Plain-English summary

G.D., a postal worker, filed a new claim after his right knee gave out while he was walking his mail route in 2011. OWCP had accepted an earlier claim involving both knees, but the Board did not have that earlier case file when it reviewed the new claim denial. The Board found that medical evidence in the earlier file could bear directly on the new claim. It set aside the denial and directed OWCP to combine the files, reconstruct the record and make a new decision on the merits.

Decision snapshot

• Authority: OWCP procedure for combining files when adjudication requires cross-referencing them.
• Outcome: May 1, 2012 claim denial set aside; case remanded for consolidation and a new decision.
• Key point: The Board could not review the knee claim fairly without the related accepted claim's medical file.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
G.D., Appellant
)
)
and ) Docket No. 12-1817
) Issued: February 27, 2013
U.S. POSTAL SERVICE, POST OFFICE,
)
Babylon, NY, Employer
)
__________ )

Appearances: Case Submitted on the Record
Appellant, pro se
Office of Solicitor, for the Director

ORDER REMANDING CASE

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

Appellant filed an application for review of the Office of Workers’ Compensation Programs’ (OWCP) May 1, 2012 merit decision denying his traumatic injury claim. The appeal was docketed as number 12-1817. The Board finds that this case is not in posture for a decision.

OWCP accepted appellant’s June 30, 1999 traumatic injury claim (File No. xxxxxx594) for sprain tear and derangement of the right knee and derangement of the left knee. Appellant underwent a complete right knee replacement and returned to full duty on June 13, 2011.

The present appeal involves appellant’s December 1, 2011 traumatic injury claim (File xxxxxx130), in which he alleged that he sustained a right knee injury on November 20, 2011 when his knee gave out while he was walking on his mail route. Appellant noted that he first filed a claim for a recurrence of disability under his 1999 accepted claim, but was told by OWCP to file a new traumatic injury claim. Due to the overlapping nature of the claims, the medical evidence contained in File xxxxxx594 will necessarily bear directly on appellant’s claim for compensation in File xxxxxx130. Without reviewing the case record in File No. xxxxxx594, the Board is unable to determine whether OWCP properly considered all relevant evidence in rendering its final decision. Pursuant to its procedures, OWCP has determined that cases should be combined where correct adjudication depends on cross-referencing between files.1

Because it is essential for the Board to review the medical evidence contained in File No. xxxxxx594 in order to render a full and fair adjudication of the present appeal, this case will be remanded for OWCP to consolidate case File No. xxxxxx594 with File No. xxxxxx130. Reconstruction of the record will be followed by a de novo decision on the merits of the claim, in order to protect appellant’s appeal rights.

IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs May 1, 2012 decision be set aside and the case remanded for further development consistent with this order.

Issued: February 27, 2013
Washington, DC

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

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

Patricia Howard Fitzgerald, Judge
Employees’ Compensation Appeals Board

1
Federal (FECA) Procedure Manual, Part 2 -- Claims, File Maintenance and Management, Chapter 2.400.8(c) (February 2000); D.R., Docket No. 12-696 (issued July 25, 2012).

2