R.W. and U.S. Postal Service, Market Street Post Office, St. Louis, MO (Board decision, September 27, 2021)

ECAB final decision. The Board set aside two OWCP decisions and remanded to combine related right upper extremity injury files. A party may petition the Board for reconsideration within 30 days of issuance unless this decision specifies another period, under 20 C.F.R. § 501.7(a). FECA compensation decisions are generally not subject to court review under 5 U.S.C. § 8128(b).

Plain-English summary

R.W. reported a March 2020 fall that injured both hands and an April 2020 fall involving her right shoulder. OWCP decided the later shoulder claim without combining the earlier hand injury file, while a physician reported that her shoulder symptoms began on the date of the March fall. The Board held that both files were needed to review the related right upper extremity evidence. It set aside two OWCP decisions and remanded for combined consideration.

Decision snapshot

• Authority: FECA Procedure Manual, Chapter 2.400.8(c), on combining related claim files.
• Outcome: Two OWCP decisions set aside; related injury files must be combined.
• Key point: The earlier hand injury claim also involved the right upper extremity and could bear on the later shoulder claim.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
R.W., Appellant
)
)
and ) Docket No. 21-0618
) Issued: September 27, 2021
U.S. POSTAL SERVICE, MARKET STREET
)
POST OFFICE, St. Louis, MO, Employer
)
__________ )

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

ORDER REMANDING CASE

Before:
JANICE B. ASKIN, Judge
PATRICIA H. FITZGERALD, Alternate Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

On February 22, 2021 appellant filed a timely appeal from August 31, 2020 and January 29, 2021 merit decisions of the Office of Workers’ Compensation Programs (OWCP). The Clerk of the Appellate Boards docketed the appeal as No. 21-0618.

On May 14, 2020 appellant, then a 57-year-old distribution clerk, filed a traumatic injury claim (Form CA-1) alleging that on April 30, 2020 she sustained a right shoulder injury when she tripped and fell over a container latch while in the performance of duty.

Under OWCP File No. xxxxxx252, appellant previously filed a Form CA-1 on April 2, 2020 alleging that on March 27, 2020 she injured both hands when she tripped and fell over a strap on the floor while in the performance of duty. OWCP allowed payment of limited medical expenses without formal adjudication.

On June 18, 2020 appellant underwent right rotator cuff repair.

In July 9, 2020 e-mails, the employing establishment indicated that appellant attributed the need for the June 18, 2020 right shoulder surgery to the March 27, 2020 employment incident under File No. xxxxxx252 and not the April 30, 2020 employment incident under the present claim. In a development letter dated July 28, 2020, OWCP notified appellant of the deficiencies of her claim. It advised her of the type of factual and medical evidence required and attached a questionnaire for her completion. OWCP afforded appellant 30 days to submit the necessary evidence.

In response, appellant submitted a June 10, 2020 report by Dr. Katherine A. Burns, a Board-certified orthopedic surgeon, who noted the onset of right shoulder symptoms on March 27, 2020. On June 18, 2020 Dr. Burns performed arthroscopic right rotator cuff repair, arthroscopic biceps tenodesis, and arthroscopic subacromial decompression and acromioplasty. She held appellant off from work through September 14, 2020. Appellant also submitted medical management forms and surgical images related to the June 18, 2020 right rotator cuff repair.

By decision dated August 31, 2020, OWCP denied appellant’s traumatic injury claim, finding that the evidence of record was insufficient to establish a medical diagnosis causally related to the accepted April 30, 2020 employment incident.

On September 6, 2020 appellant requested an oral hearing before a representative of OWCP’s Branch of Hearings and Review, which was held on November 30, 2020. During the hearing, she affirmed that she tripped and fell forward onto her hands and arms while at work on March 27, 2020 and again on April 30, 2020.

By decision dated January 29, 2021, OWCP’s hearing representative modified the August 31, 2020 decision to find that appellant had established a medical diagnosis in connection with the April 30, 2020 employment incident, but denied the claim as causal relationship had not been established.

The Board has duly considered the matter and concludes that this case is not in posture for decision. OWCP’s procedures provide that cases should be administratively combined when correct adjudication of the issues depends on frequent cross-referencing between files. 1 For example, if a new injury case is reported for an employee who previously filed an injury claim for a similar condition or the same part of the body, doubling is required. 2 In the present claim, OWCP denied appellant’s claim for an April 30, 2020 traumatic right shoulder injury, finding that the medical evidence of record was insufficient to establish causal relationship between the accepted April 30, 2020 employment incident and a diagnosed medical condition. Under OWCP File No. xxxxxx252, appellant claimed injuries to both hands sustained on March 27, 2020 when she tripped over a plastic strap and fell forward onto her hands and knees. Dr. Burns noted in her June 10, 2020 report that appellant’s right shoulder symptoms had begun on March 27, 2020. Also, appellant testified regarding the March 27, 2020 incident at the November 30, 2020 telephonic hearing in the present claim. However, OWCP has not administratively combined the present claim with OWCP File No. xxxxx252, which also pertains to the right upper extremity.

1
Federal (FECA) Procedure Manual, Part 2 -- Claims, File Maintenance and Management, Chapter 2.400.8(c) (February 2000).
2
Id.; M.E., Docket No. 21-0094 (issued May 27, 2021); L.M., Docket No. 19-1490 (issued January 29, 2020); L.H., Docket No 18-1777 (issued July 2, 2019).

2
 For a full and fair adjudication of appellant’s current claim, the case must be returned to OWCP to administratively combine the current case record with OWCP File No. xxxxxx252. 3 Following this and other such further development as OWCP deems necessary, it shall issue a de novo decision.4

IT IS HEREBY ORDERED THAT the August 31, 2020 and January 29, 2021 decisions of the Office of Workers’ Compensation Programs are set aside and this case is remanded for further proceedings consistent with this order of the Board.

Issued: September 27, 2021
Washington, DC

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge
Employees’ Compensation Appeals Board

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

3
Id.
4
R.G., Docket No. 19-1755 (issued July 7, 2020); M.E., supra note 2; L.M., supra note 2.

3