Employees Compensation Appeal Board Cases
Year 2015
Involving Treasury Employees
There were approximately 43 ECAB cases involving Treasury employees. The following is a review of the cases that I thought were of some import. I will review them with you by date of decision.
S.L. Docket 14-1701 January 26 2015
Issue: Whether an account management clerk’s bilateral carpal syndrome caused temporary total disability from 4 4 2011 through 7 31 2011.
Discussion: The attending surgeon and the physician of record indicated that the claimant had a number of other medical problems. None of the physicians could explain why the carpal tunnel syndrome kept her from working as distinguished from her other non-work medical problems.
Decision: Compensation denied
Reason: The doctors did not explain the “causal relationship” between the allowed injury and the lost time. A naked assertion is not sufficient. The doctor must explain why the allowed medical condition is at least one of the reasons for the inability to work.
A.S. Docket 14-1820 February 10 2015
Issue: Whether a tax examiner technician’s low back injury occurring December 14 2007 continued to render her temporary and totally disabled as of June 6 2013.
Discussion: The physician of record opined that the medical problem prevented the claimant from doing more than sedentary work. The attending physician could not explain why the claimant’s pain was so intense that she could not do her regular job. He further could not explain why the actual injury was causing the problem rather than pre-existing non related medical problems. The IME stated that the injury had healed and there were no findings that the recognized injury still existed.
Decision: Compensation denied
Reason: The IME is entitled to the greater weight of the evidence. The attending physician could not site any objective findings of injury.
P.J. Docket 14-2042 February 10 2015
Issue: Whether medical evidence established that claimant sustained an injury when his automobile was struck from the rear.
Discussion: Claimant was struck from the rear by an automobile while in the course of his employment. Claimant contends that he fractured a finger and injured his back.
Decision: Claim denied
Reason: The physician did not discuss how the accident caused the fracture of the finger or any injury to the claimant’s back. The doctor did not describe the mechanism of injury. The doctor did not analyze the x-ray reports. Note that compensation will not be paid based on surmise, conjecture, or speculation. Causal relationship must be established by a reasoned medical opinion. The medical opinion must explain how and why the employment incident caused or contributed to the medical diagnosis.
J.K. Docket 15-198 March 10 2015
Issue: Whether a revenue agent, who worked from home, was in the course of his employment when he was involved in an automobile accident while driving to a park to take a walk and “clear his head”.
Discussion: The usual rule is that an employee is not in the course of his/her employment during lunch hour.
Decision: Claim denied
Reason: Telework does not change the basic rule as to injuries during lunch hour.
B.T. Docket 15-786 June 10 2015
Issue: Whether a claimant who is assaulted by a co-worker due to non-employment factors occurred while in the performance of duty.
Discussion: A criminal investigator had a dating relationship with a co-employee. While at work, the co-employee attacked her. The dispute arose out of personal animosity due to their private life and relationship.
Decision: Claim Denied
Reason: Usually the innocent party to an assault has a compensable claim. The Board, however, stated that since this assault had absolutely nothing to do with the employment, took the parties out of performance of duty. Unless the injured party can show that the employment exacerbated the reason for the assault, the claim is not compensable.
J.M. Docket 15-0398 July 24 2015
Issue: Whether a report by a chiropractor who diagnosed a subluxation from x-rays constituted sufficient medical evidence to establish a claim.
Discussion: The claimant, a contact representative, fell due to an improperly placed rug. X-rays were taken of her body. She sought treatment with a chiropractor. The radiologist did not diagnose a subluxation, however, the chiropractor, in reviewing the same x-rays, was of the opinion the x-rays did establish a subluxation.
Decision: Claim approved.
Reason: The Law gives the Chiropractor the right to review x-rays and render a diagnostic opinion. If the Chiropractor finds that the x-rays establish a subluxation, then this diagnosis will stand.
M.B. Docket 15-0287 August 20 2015
Issue: Whether medical evidence of causal relationship is always necessary.
Discussion: A contact representative lacerated her right index finger while at work. She was treated by a nurse on premises.
Decision: Claim approved
Reason: If the injury is minor in nature: can be visualized by a lay person; reported promptly; and there is no time lost, then medical evidence is not necessary.
J.J. Docket 15-1365 September 23 2015
Issue: Whether revenue officer, who worked from home, was in the course of her employment when she injured her knee when standing up.
Discussion: Claimant contended that she was working at home. She finished a telephone call with a taxpayer representative. She went to Fax a document, and when stepping down, she felt an extreme pain in her knee. The medical reports, however, stated that she felt the pop in her knee walking down stairs. Claimant stated that the supervisor completed the CA1 incorrectly, but she failed to call it to supervisor’s attention.
Decision: The Board accepted the factual basis for the claim, however the Board denied the claim on the medical causal relationship basis.
Reason: The doctor did not provide sufficient causal relationship.
J.W. Docket 15-0325 October 2 2015
Issue: Whether a tax examiner had the burden to prove additional medical conditions which were not previously accepted by OWCP.
Discussion: A tax examiner sustained a recognized claim for brachial neuritis and radiculitis. Claimant subsequently stated that these conditions were the result of a C4- C5 C5-C6 and C6-C7 disc injury. She claimed that the allowances of the claim encompassed the disc injuries. In other words, Radiculitis and Neuritis are not really injuries, but rather diagnoses caused by disc injuries. You do not have a Radiculopathy without nerve damage.
Decision: Claim Denied.
Reason: The claimant has the burden to prove that any additional medical condition was causally related to the accepted June 18th injury. OWCP did not have to disprove anything.
R.R. Docket 15-1395 December 11 2015
Issue: Whether the claimant was at fault at creating an overpayment.
Discussion: Claimant, a painter for the Treasury, returned to work after receiving temporary total benefits. He failed to return payments made to him after he returned to work. The first payment was made at or near the time he returned to work. The 2nd payment was to him one month after he returned to work.
Decision: Claimant was without fault as to the first payment, but not the 2nd payment.
Reason: The mere fact that a claimant returns to work and receives payment does not automatically create fault against the claimant. In this case, the claimant did not know that date payment was made to him. However, he clearly knew he had returned to work when he received the 2nd payment. In either instance, he still has to pay the money back.