I.S. and U.S. Postal Service, New Jersey International & National Distribution Center (Board decision, March 14, 2025)

ECAB remand decision. The Board upheld OWCP's finding that the accepted shoulder sprain had resolved but returned the claim for review of additional shoulder conditions; entitlement to those conditions 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). FECA compensation decisions are generally not subject to court review under 5 U.S.C. § 8128(b).

Plain-English summary

A postal worker sought continued benefits and expansion of an accepted right-shoulder sprain claim. The Board upheld OWCP's finding that the sprain had resolved by August 2023 and that no continuing disability from it was established. It found the request to add other shoulder conditions required further review and remanded that issue.

Decision snapshot

• Authority: Federal Employees' Compensation Act, 5 U.S.C. § 8101 et seq.
• Outcome: Sprain resolution affirmed; additional-condition issue remanded.
• Key point: Resolution of one accepted condition did not settle the separate expansion claim.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
I.S., Appellant
)
)
and ) Docket No. 25-0093
)
Issued: March 14, 2025
U.S. POSTAL SERVICE, NEW JERSEY )
INTERNATIONAL & NATIONAL
)
DISTRIBUTION CENTER, Jersey City, NJ, )
Employer
)
_________ )

Appearances: Case Submitted on the Record
James D. Muirhead, Esq., for the appellant1
Office of Solicitor, for the Director

DECISION AND ORDER

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

JURISDICTION

On November 6, 2024 appellant, through counsel, filed a timely appeal from a September 11, 2024 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal Employees’ Compensation Act2 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over the merits of this case.

1
In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for legal or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. § 501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a representative, prior to approval by the Board, may be reported to appropriate authorities for investigation. 2 5 U.S.C. § 8101 et seq.
ISSUES

The issues are: (1) whether OWCP met its burden of proof to establish that appellant’s accepted right shoulder sprain had resolved as of August 3, 2023; (2) whether appellant has met her burden of proof to establish continuing disability and/or residuals, with regard to her right shoulder sprain, on or after August 3, 2023, causally related to the accepted December 14, 2019 employment injury; and (3) whether appellant has met her burden of proof to expand the acceptance of her claim to include additional right shoulder conditions as causally related to the accepted December 14, 2019 employment injury.

FACTUAL HISTORY

This case has previously been before the Board. The facts and circumstances of the case as set forth in the Board’s prior decision are incorporated herein by reference.3 The relevant facts are as follows.

On December 14, 2019 appellant, then a 56-year-old clerk, filed a traumatic injury claim (Form CA-1) alleging that on that date she injured her right shoulder while in the performance of duty. She stopped work on December 14, 2019.

In support of her claim, appellant submitted statements, which indicated that on December 14, 2019 she was throwing packages overhead into all-purpose containers (APCs) and felt pain in her right shoulder. She also submitted medical evidence, including reports of Dr. Anthony I. Parks, a Board-certified orthopedic surgeon, who diagnosed right shoulder rotator cuff impingement that was caused or aggravated by an employment activity on December 14, 2019.

By decision dated February 19, 2020, OWCP denied appellant’s claim, finding that the evidence of record was insufficient to establish causal relationship between her diagnosed right shoulder conditions and the accepted December 14, 2019 employment incident.

Appellant, through counsel, timely requested an oral hearing before a representative of OWCP’s Branch of Hearings and Review, which was held on June 11, 2020.

By decision dated August 19, 2020, OWCP’s hearing representative affirmed OWCP’s February 19, 2020 decision.

In a March 15, 2021 permanent impairment evaluation report, Dr. Albert Johnson, a Board- certified orthopedic surgeon, noted that appellant related complaints of right shoulder pain and stiffness due to lifting and throwing boxes weighing up to 50 pounds at work on December 14, 2019. He reviewed the December 27, 2019 x-rays, and a March 3, 2020 magnetic resonance imaging (MRI) scan of the right shoulder, which he found revealed degenerative changes of the acromioclavicular (AC) and glenohumeral joints, thickening of the inferior glenohumeral ligament suggesting adhesive capsulitis, degeneration of the glenoid labrum with posterior superior tear, tendinosis, and an interstitial tear of the supraspinatus with bursitis in the

3
Docket No. 22-1210 (issued December 29, 2022).

2 subacromial region. Dr. Johnson performed a physical examination, and documented tenderness over the right AC joint and bicipital groove and reduced range of motion (ROM). He diagnosed post-traumatic sprain/strain syndrome of the right shoulder, aggravation of underlying quiescent AC and glenohumeral arthropathy, interstitial tear of the supraspinatus with rotator cuff tendinosis and bursitis in the subacromial bursa, and aggravation of degenerated glenoid labrum with a tear in the posterosuperior margin. Dr. Johnson opined that the December 14, 2019 employment incident caused the diagnosed conditions.

On June 9, 2021, appellant, through counsel, requested reconsideration of OWCP’s August 19, 2020 decision. In support thereof, counsel submitted a May 24, 2021 narrative report by Dr. Johnson, who noted that, based upon a review of medical literature, the AC joint can be injured by repetitive overload resulting in either degeneration or osteolysis of the clavicle and that awkward postures of the shoulder, such as 60 degrees of flexion, are considered occupational risk factors for shoulder pathology. He also noted that repeating the same shoulder motions can stress the rotator cuff muscles and tendons and lead to overuse tears. Dr. Johnson opined that the December 14, 2019 employment incident caused an aggravation of preexisting underlying quiescent AC and glenohumeral arthropathies and an aggravation of the degenerated labrum. He explained that repetitively reaching overhead and throwing packages “can certainly cause impingement leading to the rotator cuff tendinopathy found on [appellant’s] MRI.” Dr. Johnson further explained that preexisting age-related osteoarthritis in the AC joint resulted in less space in the area, which caused a greater probability of shoulder tendinopathy with shoulder elevation.

By decision dated August 31, 2021, OWCP denied modification of the August 19, 2020 decision.

On October 25, 2021, appellant, through counsel, requested reconsideration of the August 31, 2021 decision. In support thereof, counsel submitted an October 6, 2021 narrative report by Dr. Johnson, who opined that repetitive overhead activity caused impingement of the rotator cuff, which led to a rotator cuff tear and a posterior labral tear. He explained that repetitive overhead activity was directly responsible for the tear of the supraspinatus and labrum as well as aggravation of underlying right shoulder arthropathy.

By decision dated June 9, 2022, OWCP denied modification of its August 31, 2021 decision.

On August 15, 2022, appellant, through counsel, appealed the June 9, 2022 decision to the Board.

By decision dated December 29, 2022,4 the Board set aside OWCP’s June 9, 2022 decision and remanded the case to OWCP for further development of the medical evidence including referring appellant, together with a statement of accepted facts (SOAF), for a second opinion evaluation with a physician in an appropriate field of medicine for an opinion as to whether the accepted December 14, 2019 employment incident caused, contributed to, or aggravated the diagnosed right shoulder conditions.

4
Id.

3
On April 12, 2023, OWCP referred appellant, along with the medical record, a SOAF, and a series of questions, to Dr. Leon Sultan, a Board-certified orthopedic surgeon, for a second opinion examination.

In a report dated May 17, 2023, Dr. Sultan noted appellant’s history of injury and medical course. He reviewed the medical record, discussed his examination findings, and diagnosed a musculoskeletal sprain and/or strain of the right shoulder, causally related to the December 14, 2019 employment incident. Dr. Sultan opined that there were no residuals of the injury at the time of his May 17, 2023 examination. He also indicated that appellant was not in need of any further treatment or work restrictions as it related to the December 14, 2019 employment incident.

On June 15, 2023, OWCP requested that Dr. Sultan provide a supplemental opinion, addressing the March 15 and May 24, 2021 reports of Dr. Johnson.

In a supplemental report dated June 28, 2023, Dr. Sultan noted that he was “not in agreement with Dr. Johnson’s opinions expressed in his report of [March 15, 2021] and follow-up report of [May 24, 2021].” He reiterated that appellant sustained a right shoulder sprain, which had resolved, and explained that his examination of the right shoulder on May 17, 2023 revealed no clinical evidence of localized swelling, deformity, or discoloration; no complaints with palpation of the AC joint or long head of the biceps tendon; no disuse muscle atrophy ; intact ROM in all planes; and negative provocative testing of the right shoulder, including negative impingement test, negative drop arm test, and negative Hawkins test.

By decision dated August 3, 2023, OWCP accepted the claim for unspecified sprain of the right shoulder joint, as resolved. It denied expansion of the acceptance of the claim to include aggravation of preexisting underlying quiescent AC and glenohumeral arthropathy and degenerative glenoid labrum as causally related to the accepted December 14, 2019 employment injury. OWCP accorded the weight of the medical evidence to the opinion of Dr. Sultan.

On September 22, 2023, appellant, through counsel, requested reconsideration of OWCP’s August 3, 2023 decision and resubmitted Dr. Johnson’s March 15 and May 24, 2021 reports, which were previously reviewed by OWCP.

By decision dated June 6, 2024, OWCP denied modification of its August 3, 2023 decision.

On July 12, 2024, appellant, through counsel, requested reconsideration of OWCP’s June 6, 2024 decision.

By decision dated July 15, 2024, OWCP denied appellant’s request for reconsideration of the merits of her claim, pursuant to 5 U.S.C. § 8128(a).

On September 9, 2024, appellant, through counsel, again requested reconsideration of OWCP’s June 6, 2024 decision. In support thereof, counsel submitted an August 15, 2024 narrative report by Dr. Johnson, who opined that appellant’s duties of lifting and pushing heavy objects caused wear and tear and increased friction and pressure on the cartilage of the shoulder joint surface, which caused an exacerbation and worsening of underlying tears and arthritis in the glenohumeral joint and labrum. Dr. Johnson diagnosed post-traumatic strain/sprain syndrome of the right shoulder; post-traumatic aggravation of underlying quiescent AC and glenohumeral

4 arthropathy; post-traumatic interstitial tear of the supraspinatus with rotator cuff tendinosis and bursitis in the subacromial bursa; and post-traumatic aggravation of degenerated glenoid labrum with a tear in the posterosuperior margin, causally related to the accepted December 14, 2019 employment incident.

By decision dated September 11, 2024, OWCP denied modification of its June 6, 2024 decision.

LEGAL PRECEDENT -- ISSUE 1

Once OWCP accepts a claim, it has the burden of proof to justify termination or modification of an employee’s entitlement to benefits. 5 The right to medical benefits for an accepted condition is not limited to the period of entitlement for disability compensation. 6 To terminate entitlement to medical benefits, OWCP must establish that appellant no longer has residuals of an employment-related condition which require further medical treatment. 7

ANALYSIS -- ISSUE 1

The Board finds that OWCP has met its burden of proof to establish that appellant’s accepted right shoulder sprain had resolved as of August 3, 2023.

In his May 17, 2023 report, Dr. Sultan, OWCP’s second opinion specialist, noted his review of the SOAF and appellant’s medical records. He discussed his examination findings and diagnosed a musculoskeletal sprain and/or strain of the right shoulder, causally related to the December 14, 2019 employment injury. Dr. Sultan opined that there were no residuals of the injury at the time of his May 17, 2023 examination. He also indicated that appellant was not in need of any further treatment or work restrictions as it related to the December 14, 2019 employment injury. In his June 28, 2023 report, Dr. Sultan explained that his examination of the right shoulder on May 17, 2023 revealed no clinical evidence of localized swelling, deformity, or discoloration; no complaints with palpation of the AC joint or long head of the biceps tendon; no disuse muscle atrophy; intact ROM in all planes; and negative provocative testing of the right shoulder, including negative impingement test, negative drop arm test, and negative Hawkins test.

Dr. Sultan based his opinion on a proper factual and medical history and detailed findings on examination. 8 He further provided a well-rationalized opinion that appellant’s right shoulder sprain had resolved, explaining that findings on examination and objective studies demonstrated

5
See R.P., Docket No. 17-1133 (issued January 18, 2018); S.F., 59 ECAB 642 (2008); Kelly Y. Simpson, 57 ECAB 197 (2005); Paul L. Stewart, 54 ECAB 824 (2003). 6 A.G., Docket No. 19-0220 (issued August 1, 2019); A.P., Docket No. 08-1822 (issued August 5, 2009); T.P., 58 ECAB 524 (2007); Kathryn E. Demarsh, 56 ECAB 677 (2005); Furman G. Peake, 41 ECAB 361, 364 (1990). 7 See A.G., id.; James F. Weikel, 54 ECAB 660 (2003); Pamela K. Guesford, 53 ECAB 727 (2002); Furman G. Peake, id. 8 See M.R., Docket No. 23-1052 (issued March 5, 2024); S.V., Docket No. 23-0474 (issued August 1, 2023); J.S., Docket No. 20-1409 (issued September 1, 2021).

5 no continued employment-related condition. 9 Accordingly, the Board finds that Dr. Sultan’s second opinion reports represent the weight of the medical evidence in finding that appellant’s accepted right shoulder sprain had resolved.10

The Board, therefore, finds that OWCP met its burden of proof.

LEGAL PRECEDENT -- ISSUE 2

Once OWCP properly terminates a claimant’s compensation benefits, the burden shifts to appellant to establish continuing disability after that date causally related to the accepted injury. 11 To establish causal relationship, an employee must submit rationalized medical evidence based on a complete medical and factual background, supporting such causal relationship .12

ANALYSIS -- ISSUE 2

The Board finds that appellant has not met her burden of proof to establish continuing employment-related disability and/or residuals, with regard to her right shoulder sprain, on or after August 3, 2023, causally related to the accepted December 14, 2019 employment injury.

Dr. Johnson, in his August 15, 2024 narrative report, diagnosed post-traumatic strain/sprain syndrome of the right shoulder; post-traumatic aggravation of underlying quiescent AC and glenohumeral arthropathy; post-traumatic interstitial tear of the supraspinatus with rotator cuff tendinosis and bursitis in the subacromial bursa; and post-traumatic aggravation of degenerated glenoid labrum with a tear in the posterosuperior margin, causally related to the accepted December 14, 2019 employment incident. He did not, however, document any physical examination findings or provide a rationalized medical opinion supporting continuing disability or residuals, with regard to appellant’s right shoulder sprain, on or after August 3, 2023 causally related to appellant’s accepted December 14, 2019 employment injury.13

As the medical evidence of record is insufficient to establish continuing disability and/or residuals, with regard to appellant’s right shoulder sprain, on or after August 3, 2023 causally

9
J.P., Docket No. 23-0075 (issued March 26, 2023); J.S., id.
10
H.J., Docket No. 24-0879 (issued October 29, 2024); M.H., Docket No. 24-0470 (issued July 25, 2024); R.P., Docket No. 20-0891 (issued September 20, 2021); N.G., Docket No. 18-1340 (issued March 6, 2019); A.F., Docket No. 16-0393 (issued June 24, 2016). 11 S.G., Docket No. 23-0652 (issued October 11,2023); V.W., Docket No. 20-0693 (issued June 2, 2021); D.G., Docket No. 19-1259 (issued January 29, 2020); S.M., Docket No. 18-0673 (issued January 25, 2019); J.R., Docket No. 17-1352 (issued August 13, 2018); Manuel Gill, 52 ECAB 282 (2001). 12 Id.
13
Id.

6 related to appellant’s accepted December 14, 2019 employment injury, the Board finds that she has not met her burden of proof .14

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.

LEGAL PRECEDENT -- ISSUE 3

When an employee claims that a condition not accepted or approved by OWCP was due to an employment injury, he or she bears the burden of proof to establish that the condition is causally related to the employment injury. 15 When an injury arises in the course of employment, every natural consequence that flows from that injury likewise arises out of the employment, unless it is the result of an independent intervening cause attributable to the claimant’s own intentional misconduct.16 Thus, a subsequent injury, be it an aggravation of the original injury or a new and distinct injury, is compensable if it is the direct and natural result of a compensable primary injury.17

To establish causal relationship between a specific condition, as well as any attendant disability claimed, and the employment injury, an employee must submit rationalized medical evidence.18 The opinion of the physician 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 specific employment factors identified by the claimant. 19

ANALYSIS -- ISSUE 3

The Board finds that the case is not in posture for decision with regard to appellant’s expansion claim.

On May 17, 2023, second opinion physician Dr. Sultan diagnosed a musculoskeletal sprain and/or strain of the right shoulder, causally related to the December 14, 2019 employment injury. In a supplemental report dated June 28, 2023, he noted that Dr. Johnson had diagnosed an aggravation of preexisting underlying quiescent AC and glenohumeral arthropathy and

14
C.L., Docket No. 23-0012 (issued April 26, 2024); P.H., Docket No. 21-1072 (issued May 18, 2022); R.C., Docket No. 19-0376 (issued July 15, 2019).
15
M.M., Docket No. 19-0951 (issued October 24, 2019); Jaja K. Asaramo, 55 ECAB 200, 204 (2004).
16
See J.M., Docket No. 19-1926 (issued March 19, 2021); I.S., Docket No. 19-1461 (issued April 30, 2020); see also Charles W. Downey, 54 ECAB 421 (2003).
17
J.M., id.; Susanne W. Underwood (Randall L. Underwood), 53 ECAB 139, 141 n.7 (2001).
18
See V.A., Docket No. 21-1023 (issued March 6, 2023); M.W., 57 ECAB 710 (2006); John D. Jackson, 55 ECAB 465 (2004).
19
E.P., Docket No. 20-0272 (issued December 19, 2022); I.J., 59 ECAB 408 (2008).

7 aggravation of degenerated glenoid labrum due to the work injury. Regarding the additional diagnoses, Dr. Sultan merely indicated that he was “not in agreement with Dr. Johnson’s opinions expressed in his report of March 15, 2021 and follow-up report of May 24, 2021.” The Board finds that Dr. Sultan’s opinion regarding claim expansion was conclusory in nature. A conclusory opinion provided by a physician, without the necessary rationale, is insufficient to resolve the issue.20

Proceedings under FECA are not adversarial in nature and OWCP is not a disinterested arbiter. The claimant has the burden of proof to establish entitlement to compensation, but OWCP shares responsibility in the development of the evidence to see that justice is done.21 Once OWCP undertook development of the evidence by referring appellant’s case for a second opinion evaluation, it was required to obtain a proper evaluation and report regarding the issue in this case.22

The case must therefore be remanded for further development. On remand, OWCP shall obtain a supplemental opinion from Dr. Sultan regarding whether appellant’s additional diagnosed conditions are causally related to the accepted employment injury .23 If he is unavailable or unwilling to provide a supplemental opinion, OWCP shall refer appellant to a new second opinion physician.24 After this and other such further development as deemed necessary, it shall issue a de novo decision.

CONCLUSION

The Board finds that OWCP met its burden of proof to establish that appellant’s accepted right shoulder sprain had resolved as of August 3, 2023. The Board further finds that appellant has not met her burden of proof to establish continuing disability or residuals, on or after August 3, 2023, with regard to her right shoulder sprain, causally related to the accepted December 14, 2019 employment injury. The Board also finds that the case is not in posture for decision regarding expansion of the acceptance of the claim to include additional right shoulder conditions as causally related to the accepted December 14, 2019 employment injury.

20
See C.P., Docket No. 21-1120 (issued January 27, 2023); C.W., Docket No. 20-1339 (issued September 15, 2021); J.A., Docket No. 20-1258 (issued August 4, 2021); G.Y., Docket No. 19-1683 (issued March 16, 2021); A.C., Docket No. 19-1522 (issued July 27, 2020); J.O., Docket No. 19-0326 (issued July 16, 2019); J.D., Docket No. 14- 2061 (issued February 27, 2015). 21 C.M., Docket No. 17-1977 (issued January 29, 2019); S.S., Docket No. 18-0397 (issued January 15, 2019);
William J. Cantrell, 34 ECAB 1223 (1983).
22
See S.S., Docket No. 24-0147 (issued July 2, 2024); Richard F. Williams, 55 ECAB 343, 346 (2004).
23
See P.J., Docket No. 23-1168 (issued February 6, 2024).
24
J.F., Docket No. 23-0963 (issued December 8, 2023); S.G., Docket No. 22-0014 (issued November 3, 2022); see also D.L., Docket No. 20-0886 (issued November 9, 2021).

8
ORDER

IT IS HEREBY ORDERED THAT the September 11, 2024 decision of the Office of Workers’ Compensation Programs is affirmed in part and set aside in part. The case is remanded for further proceedings consistent with this decision of the Board.

Issued: March 14, 2025
Washington, DC

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

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

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

9