K.B. and U.S. Postal Service, Post Office, South Plainfield, NJ (Board decision, August 8, 2016)

ECAB remand decision. The Board set aside OWCP’s January 28, 2016 decision and returned K.B.’s injury claim for review with the related claim files. Whether the claimed condition is compensable remains unresolved. A party may petition the Board for reconsideration within 30 days of issuance unless this order specifies another period, under 20 C.F.R. § 501.7(a).

Plain-English summary

K.B., a postal employee, claimed right chest, arm, and hand injuries from work. OWCP denied the claim after referring to evidence from her other right arm claims. The Board found that those other claim files were missing from the record before it, preventing informed review. It set aside the denial and directed OWCP to combine the related files, consider all the evidence, and issue a new decision.

Decision snapshot

• Authority: OWCP procedure for combining related injury claim files.
• Outcome: January 28, 2016 denial set aside; related files to be combined and claim reconsidered.
• Key point: The Board could not review a denial that relied on evidence absent from its record.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
K.B., Appellant
)
)
and ) Docket No. 16-1046
) Issued: August 8, 2016
U.S. POSTAL SERVICE, POST OFFICE,
)
South Plainfield, NJ, Employer
)
__________ )

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

ORDER REMANDING CASE

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

On April 22, 2016 appellant filed a timely appeal from a January 28, 2016 merit decision of the Office of Workers’ Compensation Programs (OWCP). The Board docketed the appeal as No. 16-1046.

The Board has duly considered the matter and concludes that the case is not in posture for a decision. Appellant filed a traumatic injury claim (Form CA-1) alleging that on March 13, 2013 she injured her right upper chest, right arm, and right hand in the performance of duty. On May 14, 2013 OWCP denied her claim, assigned file number xxxxxx511, as she had not submitted medical evidence sufficient to establish causal relationship. An OWCP hearing representative, in a December 9, 2013 decision, affirmed OWCP’s May 14, 2013 decision. He reviewed the evidence in the current case record and the case records relevant to appellant’s other right arm claims, assigned file numbers xxxxxx908 and xxxxxx856. On November 12, 2014 appellant’s representative requested reconsideration. In a January 20, 2015 decision, OWCP denied modification of the December 9, 2013 decision. It noted that it had previously denied appellant’s claim as the medical evidence in the current case file and the other case files failed to establish causal relationship. Appellant, through her representative, again requested reconsideration on August 31, 2015. By decision dated January 28, 2016, OWCP denied modification of its January 20, 2015 decision. It noted that appellant had filed an occupational disease claim, assigned file number xxxxxx810, alleging a similar condition. OWCP found that appellant’s physician opined that the March 13, 2013 work injury caused her complaints but that evidence from her other claims indicated that she had preexisting conditions.

OWCP procedures provide that cases should be doubled when a new injury is reported for an employee who previously filed an injury claim for a similar condition and further indicates that the cases should be doubled as soon as the need to do so becomes apparent.1 As it referenced prior claims in denying appellant’s claim for a right upper extremity condition, it should have combined the case files in accordance with its procedures.2

As the current record does not contain the evidence referenced by OWCP in denying appellant’s claim, the Board is unable to properly address the relevant issue in this case. The case is thus not in posture for decision as the record before the Board is incomplete and would not permit an informed adjudication of the case. On remand, OWCP should combine the present case record with claim numbers xxxxxx801, xxxxxx908, and xxxxxx856. After combining the case records, it should consider all the evidence and, following any necessary further development, issue an appropriate decision on appellant’s claim.

IT IS HEREBY ORDERED THAT the January 28, 2016 decision of the Office of Workers’ Compensation Programs is set aside and the case is remanded for further proceedings consistent with this order of the Board.

Issued: August 8, 2016
Washington, DC

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

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

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

1
Federal (FECA) Procedure Manual, Part 2 -- Claims, File Maintenance and Management, Chapter 2.400.8(c)(1) (February 2000).
2
Id.; see also Order Remanding Case, Docket No. 15-0756 (issued September 16, 2015).

2