S.J. and U.S. Postal Service, Post Office, O’Fallon, IL (Board decision, November 10, 2014)

ECAB remand decision. The Board set aside OWCP’s March 5, 2014 denial and returned the injury claim for review of all submitted medical evidence and a new decision. Whether the fall caused an injury remains unresolved. Under 20 C.F.R. § 501.6(d), this Board order becomes final as to the appealed decision 30 days after issuance. A party may petition the Board for reconsideration within 30 days unless the order specifies another period, under 20 C.F.R. § 501.7(a).

Plain-English summary

S.J., a Postal Service mail carrier, claimed an injury after slipping and falling on concrete at work. OWCP accepted that the fall occurred but denied the injury claim for lack of medical proof connecting the fall to his conditions. On reconsideration, OWCP discussed one medical report but did not review another physician’s report that was already in its file. The Board set aside the denial because OWCP needed to consider all submitted evidence before deciding the claim. It ordered OWCP to review the omitted report and issue a new decision.

Decision snapshot

• Authority: 20 C.F.R. § 501.2(c)(1), Board review of the record before OWCP.
• Outcome: March 5, 2014 denial set aside; claim remanded for review of all evidence and a new decision.
• Key point: OWCP could not issue a final merits decision without considering a physician’s report already in the record.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
S.J., Appellant
)
)
and ) Docket No. 14-1041
) Issued: November 10, 2014
U.S. POSTAL SERVICE, POST OFFICE,
)
O’Fallon, IL, Employer
)
__________ )

Appearances: Case Submitted on the Record
Alan J. Shapiro, Esq., for the appellant
Office of Solicitor, for the Director

ORDER REMANDING CASE

Before:
CHRISTOPHER J. GODFREY, Chief Judge
COLLEEN DUFFY KIKO, Judge
PATRICIA HOWARD FITZGERALD, Judge

On March 27, 2014 appellant, through counsel, filed a timely application for review of a March 5, 2014 merit decision by the Office of Workers’ Compensation Programs (OWCP) denying his claim for a traumatic injury. The Board docketed the appeal as No. 14-1041. Having reviewed the case record submitted by OWCP, the Board finds that this case is not in posture for decision.

This case has been before the Board. The facts as set forth in the Board’s prior decision are hereby incorporated by reference.1

By letter dated November 1, 2012 and received by OWCP on November 5, 2012, appellant, through counsel, requested reconsideration. In support of the request for reconsideration, appellant’s counsel submitted two new medical reports, a February 23, 2012 report by Dr. Rob Fast, a chiropractor, and a November 12, 2011 report by Dr. William H. Thom, a physician Board-certified in anesthesiology and pain medicine. Although this medical 1 S.J., Docket No. 11-321 (issued September 9, 2011). (On February 22, 2010 appellant, then a 45-year-old mail carrier, filed a traumatic injury claim alleging that on February 13, 2010, due to weather conditions, he slipped and fell on concrete injuring his head and hip. The Board affirmed OWCP’s October 20, 2010 denial of appellant’s claim. The Board found that, although appellant established that an employment incident occurred as alleged, he did not establish that an injury resulted from the fall). report was not new (it had previously been received by OWCP on December 12, 2011) it has never been reviewed by OWCP. By decision dated March 5, 2014, it denied modification of the denial of appellant’s claim. In the decision, OWCP discussed Dr. Fast’s report, but only referred to earlier reports of Dr. Thom which had been reviewed by the Board in its September 9, 2011 decision.

OWCP denied appellant’s claim for the reason that he did not submit medical evidence sufficient to establish a causal relationship between his accepted employment incident of February 13, 2010 and his medical diagnoses. As the Board’s jurisdiction of a case is limited to reviewing that evidence that was before OWCP at the time of its final decision,2 it is necessary that OWCP review all the evidence submitted by a claimant and received by OWCP prior to the issuance of its final decision.3

Accordingly, the Board finds that this case is not in posture for decision as OWCP did not review all the relevant evidence before issuing its decision. On remand, OWCP shall review all submitted evidence and, following any necessary further development, issue a de novo decision.

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ Compensation Programs dated March 5, 2014 is set aside, and the case is remanded for further development consistent with this order of the Board.

Issued: November 10, 2014
Washington, DC

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

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

Patricia Howard Fitzgerald, Judge
Employees’ Compensation Appeals Board

2
20 C.F.R. § 501.2(c)(1).
3
See William A. Couch, 41 ECAB 548 (1990).

2