No. 99-1144
In the Supreme Court of the United States
CLEOPATRA MCDOUGAL-SADDLER, PETITIONER
v.
ALEXIS M. HERMAN, SECRETARY OF LABOR
ON PETITION FOR A WRIT OF CERTIORARI
TO THE UNITED STATES COURT OF APPEALS
FOR THE THIRD CIRCUIT
BRIEF FOR THE RESPONDENT IN OPPOSITION
SETH P. WAXMAN
Solicitor General
Counsel of Record
Department of Justice
Washington, D.C. 20530-0001
(202) 514-2217
HENRY L. SOLANO
Solicitor of Labor
ALLEN H. FELDMAN
Associate Solicitor
EDWARD D. SIEGER
Attorney
Department of Labor
Washington, D.C. 20210
QUESTIONS PRESENTED
Section 8128(b) of Title 5, United States Code, provides that a decision
of the Secretary of Labor in allowing or denying a payment under the Federal
Employees' Compensation Act (FECA) "is (1) final and conclusive for
all purposes and with respect to all questions of law and fact; and (2)
not subject to review by another official of the United States or by a court
by mandamus or otherwise." The questions presented are:
1. Whether Section 8128(b) precludes a district court from reviewing a decision
of the Secretary denying payment under FECA where the claimant alleges that
the Secretary violated a clear statutory mandate.
2. Whether the Secretary violated a clear statutory mandate by declining
to appoint an additional physician to examine petitioner.
In the Supreme Court of the United States
No. 99-1144
CLEOPATRA MCDOUGAL-SADDLER, PETITIONER
v.
ALEXIS M. HERMAN, SECRETARY OF LABOR
ON PETITION FOR A WRIT OF CERTIORARI
TO THE UNITED STATES COURT OF APPEALS
FOR THE THIRD CIRCUIT
BRIEF FOR THE RESPONDENT IN OPPOSITION
OPINIONS BELOW
The opinion of the court of appeals on panel rehearing (Pet. App. 1a-17a)
is reported at 184 F.3d 207. The court of appeals' initial opinion (Pet.
App. 18a-37a) is reported at 161 F.3d 198, and the order vacating that opinion
(App., infra, 20a) is reported at 169 F.3d 178. The district court's memorandum
and order (Pet. App. 38a-47a) is not yet reported, but can be found at 1997
WL 835414. The decision and order of the Department of Labor Employees'
Compensation Appeals Board (App., infra, 1a-17a) is reported at 47 E.C.A.B.
480, and the Board's order denying reconsideration (App., infra, 18a-19a)
is unreported.
JURISDICTION
The court of appeals issued its decision on panel rehearing on July 2, 1999,
and denied rehearing on October 6, 1999 (Pet. App. 48a). The petition for
a writ of certiorari was filed on January 4, 2000. The jurisdiction of this
Court is invoked under 28 U.S.C. 1254(1).
STATEMENT
1. The Federal Employees' Compensation Act (FECA) provides workers' compensation
benefits to employees of the United States who become disabled or die from
work-related injuries. 5 U.S.C. 8102(a). The Secretary of Labor is authorized
to "administer, and decide all questions arising under" FECA,
and to make rules and regulations necessary for the administration and enforcement
of the statute. 5 U.S.C. 8145, 8149. The Secretary has delegated her authority
to administer and enforce the statute to the Director, Office of Workers'
Compensation Programs (OWCP). 20 C.F.R. 10.2.1 As required by statute, 5
U.S.C. 8149, the Secretary has also created an Employees' Compensation Appeals
Board (ECAB) to hear and make final decisions on appeals from OWCP determinations,
20 C.F.R. 10.301.
When a claim is filed, OWCP investigates and obtains necessary medical evidence.
5 U.S.C. 8121; 20 C.F.R. 10.130. An employee must submit to examination
by a medical officer of the United States, or by a physician designated
and approved by the Secretary, and may have a physician designated by the
employee present to participate in the examination. 5 U.S.C. 8123(a). The
statute further provides that, "[i]f there is disagreement between
the physician making the examination for the United States and the physician
of the employee, the Secretary shall appoint a third physician who shall
make an examination." 5 U.S.C. 8123(a).
When OWCP makes a decision adverse to a claimant, the claimant can either
request a hearing before an OWCP hearing representative, request reconsideration
before OWCP, or appeal to the ECAB. 5 U.S.C. 8124, 8128; 20 C.F.R. 10.131,
10.138, 10.139. Section 8128(b) of Title 5, United States Code, makes those
mechanisms for administrative review exclusive, and specifically precludes
judicial review of the Secretary's decisions under FECA:
The action of the Secretary or [her] designee in allowing or denying a payment
under [FECA] is- (1) final and conclusive for all purposes and with respect
to all questions of law and fact; and (2) not subject to review by another
official of the United States or by a court by mandamus or otherwise.
5 U.S.C. 8128(b).
2. In May 1982 and in April 1985, petitioner injured her back, neck and
shoulder while working for the United States Postal Service. Pet. App. 2a-3a,
39a. She received FECA benefits for temporary total disability on both occasions.
Ibid. In 1987, her treating physician, Dr. Schwartz, reported that she was
totally disabled "for the near indefinite future." Id. at 3a;
App., infra, 1a, 3a-4a. OWCP referred petitioner to an orthopedic surgeon,
Dr. Simon, who concluded that petitioner had a slowly developing degenerative
condition that was not due to any specific incidents of trauma occurring
at work. App., infra, 4a; see Pet. App. 3a. OWCP terminated petitioner's
benefits in November 1988, but reinstated them in February 1989 on the ground
that petitioner had not received a copy of Dr. Simon's report. Pet. App.
4a; App., infra, 5a. Because Dr. Simon's evaluation was by then almost two
years old, OWCP also asked him to do a reevaluation. App., infra, 5a; Pet.
App. 4a.
In October 1989, Dr. Simon again concluded that petitioner had a degenerative
condition that was not caused by her workplace injuries. App., infra, 6a-7a;
Pet. App. 39a. After obtaining further testing and a report from a radiologist,
however, Dr. Simon concluded that petitioner had abnormalities beyond degenerative
changes. App., infra, 7a; Pet. App. 4a, 39a-40a. Dr. Simon did not state
whether, in his view, those abnormalities were caused by a workplace injury.
He did state, however, that the abnormalities were only partially disabling
and that petitioner could return to some form of work. App., infra, 8a;
Pet. App. 22a.
Based on all the submitted reports, OWCP found a conflict in medical opinion
and in 1991 referred petitioner to another orthopedic surgeon, Dr. Williams,
pursuant to 5 U.S.C. 8123(a). Pet. App. 4a-5a, 40a; App., infra, 8a. Section
8123(a) provides that, "[i]f there is disagreement between the physician
making the examination for the United States and the physician of the employee,
the Secretary shall appoint a third physician who shall make an examination."
In 1992, after examining petitioner, her medical records-including x-ray
reports and findings from 1982, 1984, and 1987, as well as a 1989 CT scan-and
the reports of the other physicians who examined her, Dr. Williams reported
that petitioner had no work-related disability. App., infra, 9a-11a; see
Pet. App. 5a, 40a. Based on Dr. Williams' report, OWCP decided to terminate
petitioner's compensation. After affording petitioner a hearing and opportunities
to present additional evidence, OWCP adhered to that decision. See Pet.
App. 5a-6a; App., infra, 11a- 12a.
Petitioner appealed to the ECAB. She argued that Dr. Williams was not a
third physician under 5 U.S.C. 8123(a) because there was no conflict between
her physician and the orthopedic surgeon, Dr. Simon, to whom OWCP had previously
referred her. App., infra, 13a. The ECAB agreed with petitioner on that
point, App., infra, 15a-16a, but nevertheless affirmed OWCP's termination
of benefits. The ECAB reasoned that, although Dr. Williams' reports were
not entitled to the "special weight" that the ECAB gives to the
opinion of an impartial medical specialist appointed in response to a conflict
of medical opinion under 5 U.S.C. 8123(a), the reports could "still
be considered for their own intrinsic value and can still constitute the
weight of the medical evidence." App., infra, 16a-17a. Weighing the
medical evidence, the ECAB concluded that Dr. Williams' reports were the
most reliable and probative evidence and were sufficient to establish that
any disability related to petitioner's 1982 and 1985 injuries had ended
by September 1992. Ibid. The report of Dr. Schwartz, in contrast, was conclusory
in nature and failed to justify the conclusion that petitioner's disability
was causually related to her employment. App., infra, 15a. The ECAB subsequently
denied petitioner's request for reconsideration. App., infra, 18a-19a.
3. In March 1997, petitioner filed a district court action alleging, among
other things, that the ECAB violated a clear statutory mandate in 5 U.S.C.
8123(a). In particular, she argued that Section 8123(a) required the Secretary
to appoint a third physician to resolve the disagreement between her physician
and Dr. Williams, and that the Secretary had failed to do so. Pet. App.
41a. In particular, she argued that any inconsistency in medical opinions
was sufficient to trigger Section 8123(a), and she challenged the Secretary's
policy of weighing the evidence to determine whether appointment of a third
physician is necessary.2
The Secretary filed a motion to dismiss, which the district court granted.
Pet. App. 38a-47a. The district court noted that 5 U.S.C. 8128(b)(2) declares
that the Secretary's decisions respecting FECA claims are "not subject
to review by another official of the United States or by a court by mandamus
or otherwise." Nevertheless, the court assumed for the sake of argument
that it would have jurisdiction to hear the suit (notwithstanding 5 U.S.C.
8128(b)) if petitioner could show that the Secretary had violated a clear
statutory command. Pet. App. 45a-46a. Petitioner, however, had failed to
show such a violation. Ibid. Section 8123(a), the district court reasoned,
does require the appointment of a third physician to resolve a "disagreement"
between the employee's physician and the physician for the government. But
it does not set forth the quantum of proof or credibility an opinion must
have before it is sufficient to create a genuine "disagreement"
within the meaning of the statute. As a result, the district court concluded,
Section 8123(a) can plausibly be read to permit some weighing of medical
evidence, under specified criteria, to ensure that a material disagreement
exists, which is what the Secretary did here. Id. at 43a. Because the ECAB
did not violate a clear statutory mandate, the district court held judicial
review was not available-even if one were to recognize a "clear statutory
mandate" exception to the preclusion provided by 5 U.S.C. 8128(b).
Pet. App. 46a.
4. The court of appeals initially affirmed on the ground that petitioner
lacked standing to claim a violation of 5 U.S.C. 8123(a). Pet. App. 18a-37a.
The court reasoned that, although petitioner raised a "plausible"
challenge to the Secretary's policy of weighing evidence before appointing
a third physician in response to conflicting medical opinions, in this case
a third physician (Dr. Williams) had been appointed, and petitioner had
received the examination provided by Section 8123(a). Pet. App. 31a-33a.
Accordingly, the court held that petitioner had suffered no legal harm as
a consequence of the policy she sought to challenge. Id. at 35a-37a.
In response to petitioner's request for rehearing, the panel vacated its
decision and affirmed the district court on different grounds. In particular,
it held that 5 U.S.C. 8128(b) deprived the district court of subject matter
jurisdiction. Pet. App. 1a-17a.3 Initially, the court stated that it was
"difficult to square" the Secretary's policy, under which the
Secretary would weigh medical reports when determining whether to appoint
a third physician, with the statutory mandate to appoint a third physician
"if there is disagreement" between the government's and the employee's
physicians. Id. at 8a (quoting 5 U.S.C. 8123(a)). The court reasoned, however,
that Congress was "absolutely free" to limit the extent to which
it consents to suit against the United States or its instrumentalities and
that Section 8128(b) could "hardly be plainer" in barring judicial
review altogether. Pet. App. 11a. The court concluded that nothing in FECA's
legislative history permitted an exception that would allow judicial review
of an asserted violation of a clear statutory mandate. Id. at 12a. The language
of 5 U.S.C. 8128(b), the court of appeals explained, provides "clear
and convincing evidence that Congress intended to deny district courts jurisdiction
to review decisions of the [Secretary]," and "is broad enough
to include both policy or rule making decisions of the Secretary as well
as individual benefit determinations." Pet. App. 16a.
ARGUMENT
Petitioner argues (Pet. 4-7) that the Secretary violated the clear statutory
mandate of 5 U.S.C. 8123(a) by failing to appoint another physician to resolve
an alleged disagreement between her physician (Dr. Schwartz) and Dr. Williams.
Review is warranted, petitioner asserts, to resolve a conflict in the courts
of appeals on whether FECA allows judicial review of Secretarial action
that violates a clear statutory mandate. This case, however, would have
been resolved the same way regardless of the circuit in which it arose,
and it is far from clear that the alleged conflict petitioner identifies
is meaningful and genuine. As a result, further review is not warranted.
1. Congress gave the Secretary the authority to "administer, and decide
all questions arising under" FECA. 5 U.S.C. 8145. Consistent with that
grant of authority, Congress provided for hearings, review, and appeal within
the Department of Labor. 5 U.S.C. 8124, 8128(a), 8149. See also 20 C.F.R.
10.131, 10.138, 10.139. At the same time, Congress declined to provide for
judicial review of the Secretary's actions on such claims. In particular,
5 U.S.C. 8128(b) declares:
The action of the Secretary * * * in allowing or denying a payment * * *
is (1) final and conclusive for all purposes and with respect to all questions
of law and fact; and (2) not subject to review * * * by a court by mandamus
or otherwise.
This Court has twice recognized that FECA's prohibition against judicial
review uses the kind of "unambiguous and comprehensive" language
that Congress "typically employs" when it "intends to bar
judicial review altogether." Lindahl v. Office of Personnel Management,
470 U.S. 768, 779-780 & n.13 (1985); see Southwest Marine, Inc. v. Gizoni,
502 U.S. 81, 90 (1991). See also White v. United States, 143 F.3d 232, 237
(5th Cir. 1998) (explaining that the preclusion of review provision effectuates
Congress's intent to establish a uniform system of compensation, administered
by the Secretary, without generating the costs and delays associated with
litigation); Blanc v. United States, 244 F.2d 708, 710 (2d Cir.) (similar),
cert. denied, 355 U.S. 874 (1957). In this case, the court of appeals applied
the plain terms of Section 8128(b) to conclude that petitioner's challenge
to the Secretary's actions was not judicially cognizable.
Petitioner contends (Pet. 6-9) that the court of appeals' decision conflicts
with Hanauer v. Reich, 82 F.3d 1304 (4th Cir. 1996), and Staacke v. Secretary
of Labor, 841 F.2d 278 (9th Cir. 1988).4 In this case, the court of appeals
concluded that Section 8128(b) deprives district courts of jurisdiction
to review the Secretary's actions, even if the Secretary violates a clear
statutory mandate. Pet. App. 12a. See also Paluca v. Secretary of Labor,
813 F.2d 524, 527, 528 (1st Cir.), cert. denied, 484 U.S. 943 (1987). In
contrast, in Hanauer and in Staacke, the courts of appeals stated that,
if the Secretary violated a clear statutory mandate, Section 8128(b) would
not deprive district courts of jurisdiction. Hanauer, 82 F.3d at 1309 (district
courts have jurisdiction unless "a cursory review of the merits reveals
that the Secretary did not violate a clear statutory mandate"); Staacke,
841 F.2d at 280-282 (finding no violation of a clear statutory mandate).
Despite the inconsistent language in those cases, it is not clear that a
genuine circuit conflict exists. As petitioner recognizes (Pet. 6), no court
of appeals has ever actually held the Secretary's action to be reviewable
notwithstanding Section 8128(b). To the contrary, in both Hanauer and Staacke,
the courts concluded that,
because the Secretary had not violated a clear statutory mandate, Section
8128(b) barred judicial review. Hanauer, 82 F.3d at 1309-1311 (Secretary
may decide not to pay benefits in a lump sum for a class of cases instead
of adjudicating individual requests for lump sum payments); Staacke, 841
F.2d at 281 (Secretary may interpret statutory requirement to pay a scheduled
award "in addition to" temporary partial disability benefits to
mean pay the award subsequent to such benefits). For that reason, the Third
Circuit in this case characterized the language on which petitioner relies
from Hanauer and Staacke as dictum. Pet. App. 17a n.2.
Moreover, Staacke and Hanauer are not inconsistent with complete foreclosure
of judicial review, even where the plaintiff alleges violation of a clear
statutory mandate. In Staacke, the Ninth Circuit held that, because the
Secretary has "virtually limitless" discretion to make policy
choices under FECA, "there can be no review based on a violation of
a clear statutory mandate." Staacke, 841 F.2d at 282. At least one
court has therefore read Staacke as declaring that, while a "clear
statutory mandate" exception to Section 8128(b)'s preclusive scope
may exist in theory, in practice the Secretary's expansive discretion under
the statute precludes that "clear statutory mandate" standard
from ever being met. Soeken v. Herman, 35 F. Supp. 2d 99, 103 (D.D.C. 1999)
(Staacke "rejected the 'statutory mandate' exception"), aff'd
mem., No. 99-511, 1999 WL 1215942 (D.C. Cir. Nov. 23, 1999). The Fourth
Circuit, which has recognized the possibility of review where a clear statutory
mandate is violated, Hanauer, 82 F.3d at 1309, may yet reach the same conclusion.
Thus, while there is language in Staacke and Hanauer that appears inconsistent
with language in the opinion below, the inconsistency may be of just that-
language-and not of substance or results.
In any event, if the decision below is in tension with Hanauer and Staacke,
this case is not an appropriate vehicle for resolving that tension. As the
district court recognized, the "clear statutory mandate" exception
to Section 8128(b)'s preclusive scope would not result in jurisdiction over
this case even if that exception were recognized. See Pet. App. 45a-46a
(finding no jurisdiction even assuming, arguendo, that a clear statutory
mandate exception exists). Simply put, the Secretary's policy of "weighing"
the evidence to ensure that any dispute genuinely constitutes a "disagreement"
warranting the appointment of another physician does not violate a clear
statutory mandate.
While Section 8123(a) explicitly requires the Secretary to appoint a third
physician to make an examination "[i]f there is disagreement between
the physician making the examination for the United States and the physician
of the employee," 5 U.S.C. 8123(a),5 it does not define what constitutes
a "disagreement" within the meaning of that provision. Pursuant
to her authority to "administer, and decide all questions arising under,
this subchapter," 5 U.S.C. 8145, the Secretary has concluded that a
"disagreement" between physicians warranting a further examination
does not exist, for example, where the two allegedly conflicting opinions
are not both so well-supported that a factfinder could reasonably credit
either one. Thus, where one of the two reports or opinions is insufficient
to support a judgment-because it is shown to be based on faulty assumptions,
unsupported by objective evidence, unreasoned, or otherwise lacks the persuasiveness
necessary to support an award or denial of benefits-there is no material
"disagreement" within the meaning of the statute and no further
examination is required. Under petitioner's construction of "disagreement,"
by contrast, the Secretary would have to send a claimant for further medical
evaluation based on conclusory medical opinions that are insufficient to
support an award of benefits- increasing costs and delays without producing
benefits. Avedis v. Herman, 25 F. Supp. 2d 256, 264-265 (S.D.N.Y. 1998)
(broader view of "disagreement" would find a "'conflict'
between a Board-certified specialist providing a well-rationalized opinion
and a non-specialist who may have merely checked a box on a form indicating
the presence of causal relationship or disability without providing any
explanation"), appeal withdrawn, No. 99-6053 (2d Cir. May 3, 1999);
Pet. App. 32a (Secretary's reasoning). See Pet. App. 43a (citing FECA PM
2-810).6 Because the Secretary's construction is manifestly reasonable,
it would not be reviewable under a "clear statutory mandate" exception
to 5 U.S.C. 8128(b), even if one were recognized. See Hanauer, 82 F.3d at
1309 ("If a cursory review of the merits reveals that the Secretary
did not violate a clear statutory mandate," i.e., if the Secretary's
construction is "plausible," then "the case must be dismissed
for lack of subject matter jurisdiction.").7
2. Alternatively, petitioner argues (Pet. 7-10) that the court of appeals'
decision is inconsistent with Thunder Basin Coal Co. v. Reich, 510 U.S.
200 (1993), and Block v. Community Nutrition Institute, 467 U.S. 340 (1984).
According to petitioner, those cases permit judicial review to be precluded
only where "five elements combine to demonstrate Congress' desire to
cut off review: the reviewability statutory language, the structure of the
statutory scheme, the statute's objectives, the legislative history, and
the nature of the administrative action involved." Pet. 7. In fact,
this Court has recognized that the general presumption favoring judicial
review may be overcome by specific statutory language or by other reliable
indicia of congressional intent. Block, 467 U.S. at 349. Thus, in Block,
467 U.S. at 345-349, and Thunder Basin, 510 U.S. at 207-216, the Court relied
on implication rather than express statutory language to find that certain
agency actions were not judicially reviewable. See also United States v.
Fausto, 484 U.S. 439 (1988) (inferring an intent to preclude review from
the statutory structure). This Court has never suggested that express statutory
language is itself insufficient to preclude judicial review, and in fact
has recognized the opposite. See Board of Governors of the Fed. Reserve
Sys. v. MCorp Fin., Inc., 502 U.S. 32, 44 (1991) (statute providing that
"[n]o court shall have jurisdiction to affect by injunction or otherwise
the issuance or enforcement of any [Board] notice or order under this section"
provides the "clear and convincing evidence" of congressional
intent sufficient to preclude judicial review).8
Petitioner also argues that FECA's prohibition against judicial review of
"[t]he action of the Secretary or [her] designee in allowing or denying
a payment," 5 U.S.C. 8128(b), does not prohibit review of the Secretary's
"actions in issuing rules and policies that fundamentally change the
meaning and effect of statutory provisions." Pet. 8. Here, however,
petitioner is not asking for mere review of a rule or policy statement.
She seeks a declaration that the Secretary's action in terminating her benefits
is not permitted by FECA and an injunction requiring the Secretary to restore
benefits. See Pet. App. 36a. In other words, she seeks review of the application
of the Secretary's policy to her claim for benefits, conduct that clearly
qualifies as an "action of the Secretary * * * in allowing or denying
a payment" within the meaning of 5 U.S.C. 8128(b).9
3. Petitioner also asks this Court to consider whether the Secretary's construction
of 5 U.S.C. 8123(a) violates a clear statutory mandate. There is no division
in circuit authority on the meaning of Section 8123(a); the court of appeals
did not address that question; and the Secretary's construction of that
provision is in any event correct (see pp. 12-14, supra). Accordingly, further
review is not warranted.
CONCLUSION
The petition for a writ of certiorari should be denied.
Respectfully submitted.
SETH P. WAXMAN
Solicitor General
HENRY L. SOLANO
Solicitor of Labor
ALLEN H. FELDMAN
Associate Solicitor
EDWARD D. SIEGER
Attorney
Department of Labor
MARCH 2000
1 Unless otherwise stated, this brief, like the petition, cites the regulations
in effect at the time the decisions in this case were issued. See 20 C.F.R.
Pt. 10 (1998). The current regulations became effective January 4, 1999,
but do not apply to any issue decided for the first time before their effective
date. See 63 Fed. Reg. 65,284 (1998).
2 Petitioner also alleged that the Secretary's termination of her benefits
violated due process. Pet. App. 42a. The district court rejected that argument,
id. at 42a-45a, and petitioner neither raised it on appeal, id. at 9a, 12a,
nor raises it in this Court.
3 The Secretary supported rehearing on the ground that the panel's initial
decision had improperly reviewed the Secretary's action in terminating petitioner's
benefits instead of dismissing the appeal for lack of subject matter jurisdiction.
4 Petitioner errs in contending (Pet. 6) that the decision below also conflicts
with Woodruff v. Department of Labor, 954 F.2d 634 (11th Cir. 1992), and
Brumley v. Department of Labor, 28 F.3d 746 (8th Cir. 1994), cert. denied,
513 U.S. 1082 (1995). Neither Woodruff nor Brumley takes a position on whether
district courts can review Secretarial action alleged to conflict with a
"clear statutory mandate" notwithstanding Section 8128(b). Woodruff
specifically found it unnecessary to decide that question. 954 F.2d at 640-641
n.14. And, while Brumley (inaccurately) characterizes Woodruff as having
held such review to be permissible, Brumley itself did not state whether
or not it was inclined to follow that characterization of Woodruff. 28 F.3d
at 747. See also Owens v. Brock, 860 F.2d 1363, 1367 (6th Cir. 1988) (stating
that courts have unanimously held that FECA prohibits judicial review of
FECA benefit determinations "[e]xcept for cases alleging that the Secretary
violated a claimant's constitutional rights or exceeded the scope of his
congressional mandate").
5 Contrary to petitioner's assertions (Pet 3, 5), that Section does not
give the "third physician" the authority to act as a factfinder.
Instead, 5 U.S.C. 8124(a) expressly provides that "[t]he Secretary
of Labor shall determine and make a finding of facts * * * ."
6 Petitioner incorrectly asserts (Pet. 5) that the Secretary's weighing
process was instituted in 1983. Before 1983, the ECAB often resolved conflicting
evidence based on the weight of the evidence, see, e.g., In re Wallace E.
Mason, 4 E.C.A.B. 96, 97-98 (1950); In re William D. Wise, 4 E.C.A.B. 87,
89 (1950), and recognized that, in cases involving a conflict in medical
opinion, whether an independent expert's opinion is necessary "depends
on the nature of the particular conflict." In re Ruth L. Becker, 31
E.C.A.B. 441, 445 (1980). See also In re Madge V. Phares, 15 E.C.A.B. 146,
149 (1963). The Secretary's views on referrals and weighing have recently
been codified. See 20 C.F.R. 10.321, 10.502 (1999); 63 Fed. Reg. 65,284,
65,294 (1998). Similarly, because the Secretary permissibly interprets the
term "disagreement" to mean a disagreement from the perspective
of the claims examiner (i.e., differing medical views of sufficient weight
to be material to the claims adjudication so that the claims examiner cannot
resolve the claim on the existing record), it is not relevant that FECA,
before its 1966 codification, required referrals to a third physician for
"any disagreement." See Pet. 2-3 n.1. The term "any"
does not expand the term "disagreement" to include matters that
are either irrelevant or resolvable by the claims examiner.
7 Indeed, even under a much more modest standard of what constitutes a "disagreement"
within the meaning of Section 8123(a), the evidence and opinions petitioner
relies on would not be sufficient to establish a conflict. Dr. Williams
explained that: (1) the type of injury petitioner incurred in 1982 and that
flared up in 1985 was a soft tissue (strain) injury that is generally self-resolving,
App., infra, 9a; (2) the pain petitioner was suffering ten years later in
1992 was caused by abnormalities/degeneration of the cervical and lumbar
spine (bones), not soft-tissue problems, ibid.; and (3) the abnormalities
and degeneration were not caused by a work-related incident, but were rather
the product of genetic predisposition, age, and obesity, id. at 9a-10a.
Moreover, Dr. Williams pointed out, the abnormalities did not appear in
x-rays taken in 1982 and 1985 (shortly after petitioner's injury) but first
appeared instead in 1987, after petitioner had been out of work for years.
Because petitioner "had not been working during this interval,"
he explained, "there is no work-related trauma that produced the findings
noted on x-rays in 1987." Id. at 11a, 14a. Dr. Williams' opinion was
confirmed by the independent review conducted by another Board-certified
orthopedic surgeon, Dr. Glazer, id. at 14a, and was consistent with the
opinion of Dr. Simon, the other orthopedic surgeon who examined petitioner.
See id. at 4a, 15a-16a (citing "genetic predisposition to degenerative
disc disease" that is not "due to any specific incidents of trauma
occurring at work."). To establish a conflict in medical opinions,
petitioner relies on a statement by Dr. Schwartz-a physician not qualified
in the relevant area of specialty-that the disability should be considered
work-related because petitioner began suffering pain at the time of her
injury in 1982, and the matter had not been resolved by 1992. Id. at 15a.
But the Board consistently and sensibly has held that the mere fact that
symptoms first occur at the time of an injury is not sufficient, without
a supporting rationale, to demonstrate that symptoms occurring a decade
later are causally related to the prior injury. Ibid. Nor does Dr. Simon's
November, 1989, report create a genuine disagreement; while he noted that
petitioner had "cervical discogenic abnormalities beyond degenerative
changes," he nowhere suggested that those abnormalities were the result
of a 1982 or 1985 soft-tissue strain. See App., infra, 16a.
8 Petitioner argues (Pet. 11) that when this Court "has shut off review,
it has been careful to note that alternative remedies existed for judicial
relief." That is incorrect. See, e.g., Fausto, 484 U.S. at 455 (no
judicial action for backpay for federal employee who has no remedy under
Civil Service Reform Act). It is well established that "[t]he United
States is not, by the creation of claims against itself, bound to provide
a remedy in the courts. It may withhold all remedy or it may provide an
administrative remedy and make it exclusive, however mistaken its exercise."
Dismuke v. United States, 297 U.S. 167, 171-172 (1936) (citation omitted).
Accordingly, the courts of appeals have uniformly recognized that Congress
has authority to preclude judicial review of FECA claims. See Soderman v.
Civil Serv. Comm'n, 313 F.2d 694, 695 (9th Cir. 1962) (citing additional
cases), cert. denied, 372 U.S. 968 (1963); cf. Czerkies v. Department of
Labor, 73 F.3d 1435 (7th Cir. 1996) (en banc) (courts of appeals and government
have construed FECA not to prohibit review of substantial claims of constitutional
violations); note 2, supra (noting that petitioner does not assert a constitutional
violation before this Court). For similar reasons, petitioner's reliance
(Pet. 9) on Johnson v. Robison, 415 U.S. 361 (1974), and Traynor v. Turnage,
485 U.S. 535 (1988), is misplaced. In those cases, the Court concluded that
a statute barring judicial review of administrative decisions "on any
question of law or fact under any law administered by the Veterans' Administration,"
38 U.S.C. 211(a) (1970) (emphasis added), does not prohibit review of the
constitutionality of the statute itself, Johnson, 415 U.S. at 373, or a
claim that agency rules violate another statute, such as the Rehabilitation
Act of 1973, 29 U.S.C. 794, that is not "administered by the Veteran's
Administration," see Traynor, 485 U.S. at 541, 543-544. Petitioner
here does not challenge the constitutionality of FECA, but rather claims
that the Secretary misconstrued FECA, the very statute the Secretary is
charged with administering.
9 Moreover, the premise of petitioner's argument would "distort[] the
statute" by creating "the absurd result of permitting a court
to strike down a policy statement of the Secretary, notwithstanding the
court's inability to review any subsequent individual adjudications for
conformance with its policy decision." Paluca, 813 F.2d at 527.
APPENDIX A
U. S. DEPARTMENT OF LABOR
Employees' Compensation Appeals Board
IN THE MATTER OF CLEOPATRA MCDOUGAL-SADDLER AND U.S. POSTAL SERVICE, POST
OFFICE, PHILADELPHIA, PA.
Docket No. 95-2634; Submitted on the Record;
Issued March 20, 1996
DECISION AND ORDER
Before DAVID S. GERSON, WILLIE T.C. THOMAS, MICHAEL E. GROOM
The issue is whether appellant's disability related to her May 8, 1982 and
April 5, 1985 employment injuries ended by September 20, 1992.
On May 14, 1982 appellant, then a 39-year-old distribution clerk, filed
a claim for an injury to her back, upper neck, and shoulders sustained on
May 8, 1982 by handling trays of mail. Appellant stopped work on May 11,
1982 and received continuation of pay from that date until June 24, 1982,
after which the Office of Workers' Compensation Programs began payment of
compensation for temporary total disability.
Beginning August 1982, appellant was treated by Dr. David S. Schwartz, a
Board-certified internist and cardiologist, who diagnosed cervical and lumbosacral
strains and indicated that she was totally disabled. X-rays of the cervical
and lumbosacral spine and the right shoulder on June 14, 1982 showed no
bony traumatic changes. In a report of a fitness-for-duty examination done
on November 3, 1982, Dr. Henry S. Wieder, Jr., a Board-certified orthopedic
surgeon, stated that appellant's cervical and lumbosacral strain were precipitated
by her May 8, 1982 injury but were perpetuated by her obesity, faulty posture
and body mechanics.
In a report dated December 14, 1983, Dr. Schwartz stated that appellant
had experienced persistent and incapacitating neck and low back pain since
her May 1982 injury. The Office referred appellant to the Pain Control Center
of Temple University, where Dr. Edward J. Resnick, a Board-certified orthopedic
surgeon, stated in a March 9, 1984 report that her objective findings were
insufficient to correlate with her apparent degree of disablement, and diagnosed
strains of the neck and back from history, exogenous obesity with possible
postural musculo-ligamentous back strain and probable chronic pain syndrome.
Upon appellant's discharge from this inpatient program from August 6 to
24, 1984, Dr. Resnick stated that appellant's level of pain had not changed
but that she was much better able to control it and function with it.
After a fitness-for-duty evaluation on February 21, 1985 by Dr. Eugene L.
Thomas of the employing establishment, the employing establishment offered
and appellant accepted a reemployment offer as a distribution clerk with
use of a high-back chair, no reaching above the shoulder, and no lifting,
pushing, or pulling over 15 pounds. Appellant returned to work on March
31, 1985.
Appellant again stopped work on April 5, 1985. On April 8, 1985 she filed
a claim for a recurrence of disability due to her May 8, 1982 employment
injury. Appellant stated that on April 5, 1985, after casing mail for two
hours, she began to feel sharp pain in the right side of her neck, which
extended to her right shoulder and arm and to her entire back as she continued
to work.
Dr. Schwartz examined appellant on April 6, 1985, diagnosed cervical and
lumbar strain, and indicated that appellant was totally disabled.
By letter dated April 29, 1985, the Office advised appellant that the April
5, 1985 incident constituted a new injury, for which she should file a claim.
On May 7, 1985 appellant filed a claim for a traumatic injury to her neck,
shoulders, and upper and lower back sustained on April 5, 1985 by casing
mail. Appellant received continuation of pay from April 6 to May 20, 1985,
after which the Office again began payment of compensation for temporary
total disability.
In a report dated June 17, 1985, Dr. Schwartz diagnosed cervical radiculopathy.
In a report dated May 22, 1986, Dr. Schwartz diagnosed chronic pain syndrome
including chronic lumbosacral strain and chronic cervical strain. In a report
dated April 10, 1987, Dr. Schwartz stated:
"The diagnosis is chronic cervical strain and chronic lumbosacral strain,
with occasional radiculopathies. The clinical course over the last several
months has been of intermittent worsening, whereby the patient finds herself
mostly needing to be at complete bed rest. . . . [Appellant's] symptoms
first started on May 8, 1982, and though I did not see her then, her history
includes the pain in her low back and neck starting while at work pulling
heavy mail through a chute and tossing it in a bin. At this point, so many
years later, we have to assume that she has chronic pain syndrome secondary
to her initial work injury. Because of chronic debilitating pain and limited
range of motion due to muscle stiffness and spasm, despite intensive physical
therapy and medication, [appellant] is totally disabled from work at this
time and for the near indefinite future."
In a report dated May 4, 1987, Dr. William H. Simon, a Board-certified orthopedic
surgeon to whom the Office referred appellant for a second opinion, diagnosed
cervical and lumbar discogenic syndrome with cervical and lumbar nerve root
irritation. Dr. Simon concluded:
"Her present findings are those of cervical and lumbar discogenic syndrome
due to early degenerative disc disease in the cervical and lumbar spine.
This is indicative of a genetic predisposition to degenerative disc disease
and is not in my opinion due to any specific incidents of trauma occurring
at work."
* * *
"There is no evidence that she sustained any acute injury that is responsible
for this but that she has a slowly developing degenerative condition which
limits the amount of work that she can do. She will have to decide whether
she wishes to bear with the pain and continue her work or whether she wishes
to retire from the work force."
On December 31, 1987 the Office notified appellant of the proposed termination
of her compensation on the basis that her disability resulting from her
employment injuries had ceased. Appellant submitted a report dated February
16, 1988 from Dr. Schwartz stating that her symptoms were "specifically
due" to her May 8, 1982 injury, and that her April 5, 1985 injury "added
to her previous cervical and lumbosacral strain." In a report dated
April 28, 1988, Dr. Robert M. Glazer, a Board-certified orthopedic surgeon
to whom Dr. Schwartz referred appellant, diagnosed chronic musculoskeletal
pain syndrome, and stated that appellant's "extensive areas of pain
complaint would be inconsistent with any of the discogenic or nerve root
problems with which I am familiar," and that "[a]ny usual strain
or sprain or soft tissue injury should have healed long ago. Therefore,
it is my opinion that the present symptoms are most likely nonorganic in
origin. Whether this is a conscious or unconscious situation, I am not able
to say."
By decision dated December 19, 1988, the Office terminated appellant's compensation
on November 20, 1988 on the basis that the weight of the medical evidence
established that her disability from her employment injuries ceased by that
date.
Appellant requested a hearing, and an Office hearing representative, by
decision dated February 21, 1989, found that appellant was not afforded
due process, as she was not provided with a copy of Dr. Simon's May 4, 1987
report, despite her request for it. The Office hearing representative remanded
the case for reinstatement of compensation, and, as Dr. Simon's evaluation
was almost two years old, for a reevaluation by Dr. Simon.
In a report dated October 25, 1989, Dr. Simon noted that appellant continued
to complain of pain in the neck, shoulder, back, leg and hip "even
without working." After describing his findings on physical examination
and x-rays, Dr. Simon diagnosed mild degenerative joint disease and intervertebral
disc disease of the cervical spine, moderate degenerative joint disease
and intervertebral disc disease of the lumbosacral spine, and possible spondylolysis
of the lumbosacral spine. Dr. Simon concluded:
"This patient has had no objective studies to determine an organic
basis for her symptoms since 1982. By that I mean none of the records that
I have reviewed indicate that she underwent EMG [electromyogram], MRI [magnetic
resonance imaging], CAT [computerized axial tomography] scan, myelogram
studies. The patient herself states that she has not undergone any of these
studies. I do think it is time for us to try and determine if she has any
problems that can be identified as cause for her symptoms other than her
degenerative changes.
"The only report that I have concerning her condition since I saw her
is a report from David Schwartz, M.D. from Philadelphia Health Associates
dated April 10, 1987 which gives the diagnosis as 'chronic cervical strain
and chronic lumbosacral strain with occasional radiculopathies.'
"This obviously is not an adequate diagnosis to explain what the patient
says is continued symptoms since 1982."
* * *
"At the present time, the only findings are those of progressive degenerative
changes in her neck and back and these certainly would not be causally related
to one episode of trauma occurring in 1982 or in 1985.
"On a subjective basis, the patient says she cannot do her work. I
can not find any objective reasons why she could not return to work. The
degenerative changes in her neck and back may be causing her symptoms but
there is no evidence that she has a disc herniation or fracture or dislocation
or serious lumbar stenosis problem that would functionally incapacitate
her."
At Dr. Simon's request, Dr. Michael L. Brooks, a Board-certified radiologist,
performed a computerized tomography (CT) scan of appellant's lumbosacral
and cervical spine on November 13, 1989. Dr. Brooks stated that this study
showed "Broad-based central, with superimposed focal, right-sided mild
herniation L5- S1," "Facet degenerative changes without stenosis
at L3 through S1," "Small central disc protrusion C4-5,"
and "Mild left-sided neural foraminal narrowing secondary to small
osteophyte C5-6."
In a report dated November 15, 1989, Dr. Simon stated that he agreed with
Dr. Brooks' interpretation of the CT scan. Dr. Simon then stated:
"Therefore, we now have objective evidence that this patient has cervical
discogenic abnormalities beyond degenerative changes both in her neck and
back. These would now allow us to first of all explain some of her subjective
symptoms and second, tailor a work program for her which would not put extra
strain on her neck and back. Any such work program would be one in which
she would have to do sedentary work without lifting beyond 10 pounds and
she would be allowed to stand and sit as her comfort desired."
* * *
"I do think her discogenic abnormalities in her neck and back are enough
to partially disable her but certainly not to totally disable her from returning
to some form of work presuming that she is conditioned properly."
An Office medical adviser reviewed the medical evidence on December 19,
1989 and stated that she concurred with Dr. Simon that appellant's continuing
complaints were entirely due to preexisting progressive degenerative changes
rather than to her employment injuries. In a report dated April 4, 1990,
Dr. Schwartz diagnosed chronic cervical strain and chronic lumbosacral strain,
and concluded: "Due to the severe pain in the low back and neck with
any activity including prolonged standing, walking, minimal lifting, carrying
or pushing, [appellant] is totally disabled from work."
The Office found that there was a conflict of medical opinion, and on October
22, 1991 referred appellant, the case record and a statement of accepted
facts to Dr. John T. Williams, a Board-certified orthopedic surgeon, to
resolve the conflict. In a report dated January 21, 1992, Dr. Williams extensively
described appellant's complaints and her findings on physical examination.
Dr. Williams then concluded:
"The patient presents to the office today stating that she incurred
injury during the course of her employment approximately nine years ago,
in 1982. She states that she was working over head dispatching mail in what
she called a 'speed element.' She states that she began to experience discomfort
in her back and neck. This type of injury is a pull-plus stress fatiguing
soft tissue injury which is self-resolving. She stated that she returned
to work approximately three years later in a light-duty capacity and she
states that she has a recurrence of her discomfort and she has been out
of work ever since.
"She states that she had diagnostic studies performed in November 1989
and we obtained faxed reports of the CT scan of the cervical and lumbar
spine. These findings are on the basis of degenerative pathology in her
neck and back. The patient is a 48-year-old female and these changes are
compatible with degenerative pathology: i.e., a broad based central, with
superimposed focal right-sided mild herniation at L5, S1 with facet changes
all the way from L3 through S2. In the cervical spine there is evidence
of a small central disc protrusion at C4, C5 and mild left-sided neural
foraminal narrowing secondary to small osteophytes.
"These changes are compatible with the patient's age and with degenerative
pathology and they were not caused by a work-related injury of 1982 or aggravated
by the incident in 1985. The mechanism of injury does not correlate to the
findings on the CT scans. The mechanism of injury was a soft tissue self-resolving
type of muscle sprain strain or ligamentous sprain.
"On my physical examination today there are no positive objective findings
to correlate to her complaints. I see no residual pathology as it relates
to the injury of 1982 or 1985. I feel that she has recovered to the extent
that she is able to be gainfully employed. She has degenerative changes
in her cervical and lumbar spine which are compatible with her age and her
type of body build. She is obese.
"I feel that she is able to resume her normal duties without any restrictions.
If I were to place any restrictions on this patient they would be on the
basis of the degenerative pathology which obviously preexisted the work-related
injury of 1982. The restrictions would be related to the degenerative changes
in her cervical and lumbar spine."
In a report dated March 4, 1992, Dr. Williams stated that he had now reviewed
the medical records the Office provided to him. Dr. Williams stated:
"[T]his degenerative pathology [in appellant's lumbar and cervical
spine] is part and parcel of the normal aging process and has been aggravated
by the patient's weight. Since the day of her accident she has been carried
with a diagnosis of a cervical and lumbosacral sprain. These types of sprain
strains are of a temporary and transitory nature and are self-resolving.
The work-related incident may have aggravated the preexistent pathology
but again on a temporary and transitory nature which resolved leaving her
with her preexistent pathology."
After reviewing reports of x-ray findings from 1982, 1984 and 1987, Dr.
Williams stated:
"These studies were normal in 1982 and in 1984. Three years later in
1987 we see changes.
"The patient had not been working during this interval so there is
no work-related trauma that produced the findings noted on x-rays in 1987.
So it was on the basis of the normal wear and tear that she began to show
signs of degenerative pathology in 1987."
Dr. Williams then reviewed the findings of the 1989 CT scan and stated:
"So what we are seeing here is the progression of degenerative joint
and degenerative disc disease over a period of approximately seven years
secondary to the normal wear and tear on the body and the aging process.
"The work-related injury did not cause the degenerative pathology first
noted in 1987."
On July 10, 1992 the Office notified appellant of the proposed termination
of her compensation on the basis that the medical evidence indicated no
continuing disability as a result of her work injuries. Appellant submitted
a report dated May 28, 1992 from Dr. Schwartz, who described her symptoms
and findings on physical examination, and stated: "[Appellant's] medical
condition was a work-related injury and, since she has essentially never
recovered after that injury, this still must be considered a work-related
disability."
By decision dated September 2, 1992, the Office terminated appellant's compensation
on September 20, 1992 on the basis that the weight of the medical evidence,
represented by the reports of Dr. Williams, the impartial medical specialist
resolving a conflict of medical opinion, established that the effects of
appellant's April 5, 1985 and May 11, 1982 injuries had ceased.
Appellant requested a hearing before an Office hearing representative, which
was held on September 23, 1993. Appellant described her two employment injuries
and their sequelae, and testified that her back pain had never stopped since
these injuries and that she was unable to work due to pain.
By decision dated November 24, 1993, an Office hearing representative found
that the opinion of Dr. Williams, the impartial medical specialist resolving
a conflict of medical opinion, established that the effects of appellant's
May 11, 1982 and April 5, 1985 injuries had ceased by September 20, 1992.
Appellant requested reconsideration, and submitted an October 13, 1993 report
from Dr. Philip J. Spinuzza, an osteopath, diagnosing chronic pain syndrome,
deconditioning and obesity. Dr. Spinuzza stated, "Typically her pain
is aggravated by mechanical activity and relieved by recumbency."
By decision dated March 25, 1994, the Office found that the additional evidence
was not sufficient to warrant modification of its prior decisions.
By letter dated February 27, 1995 appellant, through her attorney, requested
reconsideration, contending that Dr. Williams was not an impartial medical
specialist entitled to special weight, as Dr. Simon's November 15, 1989
report did not conflict with the conclusions of Dr. Schwartz but rather
agreed with them. Appellant also contended that Dr. Williams' report was
"based upon what are now improper leading questions in that there was
never a conflict of medical opinion," that Dr. Williams did not review
the results of the November 13, 1989 CT scan, and that it was improper for
Dr. Williams to review appellant's medical records after his examination
and initial report.
By decision dated June 6, 1995, the Office found that the argument submitted
was insufficient to warrant modification of its prior decisions.
The Board finds that the weight of the medical evidence establishes that
appellant's disability related to her May 8, 1982 and April 5, 1985 employment
injuries ended by September 20, 1992.
The Board has stated that the weight of medical evidence is determined by
its reliability, its probative value, its convincing quality. The opportunity
for and thoroughness of examination, the accuracy and completeness of the
doctor's knowledge of the facts and medical history, the care of analysis
manifested and the medical rationale expressed in support of the doctor's
opinion are factors which enter into such evaluation.1
In the present case, the reports from Dr. Williams, a Board-certified orthopedic
surgeon to whom the Office referred appellant, constitute the most reliable
and probative evidence on the question of whether appellant's disability
in 1992 continued to be related to her May 8, 1982 and April 5, 1985 employment
injuries. Dr. Williams reviewed the prior medical evidence, reported findings
of an extensive examination of appellant, and, most importantly, provided
convincing rationale that appellant's continuing disability was not related
to her employment injuries. Noting that x-ray studies in 1982 and 1984 were
normal but that 1987 x-rays showed degenerative changes, Dr. Williams stated,
"The patient had not been working during this interval so there is
no work-related trauma that produced the findings noted on x-rays in 1987.
So it was on the basis of the normal wear and tear that she began to show
signs of degenerative pathology in 1987." Additional rationale by Dr.
Williams includes: "The mechanism of injury does not correlate to the
findings on the CT scans,"2 that the "degenerative changes in
her cervical and lumbar spine . . . are compatible with her age and her
type of body build," and that the "degenerative pathology . .
. obviously preexisted the work-related injury of 1982." Dr. Williams'
opinion is bolstered by that of another Board-certified orthopedic surgeon,
Dr. Glazer, who concluded that appellant's strain or sprain, the condition
accepted by the Office, resolved long ago.
In contrast with the reports of Dr. Williams, the reports from appellant's
attending physician, Dr. Schwartz, are not based on a complete history,
as they do not show any awareness of the results of the November 13, 1989
CT scan.3 Unlike Dr. Williams, Dr. Schwartz, a Board-certified internist
and cardiologist, is not a specialist in the appropriate field of medicine.4
The only rationale that Dr. Schwartz provided for his opinion that appellant
had not recovered from her employment injuries by 1992 was that her pain
began at the time of her May 8, 1982 employment injury and had not resolved.
The Board has held that an opinion that a condition is causally related
to an employment injury because the employee was asymptomatic before the
injury but symptomatic after it is insufficient, without supporting rationale,
to establish causal relation.5 For these reasons, the reports of Dr. Schwartz
are entitled to less probative value than those of Dr. Williams.
Appellant is correct in arguing that Dr. Williams was not an impartial medical
specialist because there was no conflict of medical opinion at the time
of the Office's referral to Dr. Williams.6 The reports of Dr. Simon, the
Board-certified orthopedic surgeon whose second opinion was the basis of
the Office's declaration of a conflict of medical opinion, were not sufficient
to create such a conflict. In his report dated October 25, 1989, Dr. Simon
stated that appellant's "only findings are those of progressive degenerative
changes in her neck and back and these certainly would not be causally related
to one episode of trauma occurring in 1982 or in 1985" and that "there
is no evidence that she has a disc herniation or fracture or dislocation
or serious lumbar stenosis problem that would functionally incapacitate
her." In his report dated November 15, 1989, Dr. Simon stated that
a CT scan done on November 13, 1989 showed "objective evidence that
this patient has cervical discogenic abnormalities beyond degenerative changes
both in her neck and back." While Dr. Simon did not attribute these
"discogenic abnormalities beyond degenerative changes" to appellant's
employment injuries, his November 15, 1989 report casts serious doubt on
the conclusion in his October 25, 1989 report that appellant had only progressive
degenerative changes.
Even though the reports of Dr. Williams are thus not entitled to the special
weight afforded to the opinion of an impartial medical specialist resolving
a conflict of medical opinion,7 his reports can still be considered for
their own intrinsic value8 and can still constitute the weight of the medical
evidence.9 For the reasons stated above, the Board finds that the reports
of Dr. Williams constitute the weight of the medical evidence and are sufficient
to establish that appellant's disability related to her May 8, 1982 and
April 5, 1985 employment injuries ended by September 20, 1992.
The decision of the Office of Workers' Compensation Programs dated June
6, 1995 is affirmed.
Dated, Washington, D.C.
March 20, 1996
David S. Gerson
Member
Willie T.C. Thomas
Alternate Member
Michael E. Groom
Alternate Member
1 Melvina Jackson, 38 ECAB 443 (1987); Naomi A. Lilly, 10 ECAB 560 (1959).
2 Earlier in his January 21, 1992 report, Dr. Williams makes it clear that
he reviewed the November 1989 CT scans.
3 Reports based on an incomplete or inaccurate history are of reduced probative
value. James A. Wyrich, 31 ECAB 1805 (1980).
4 The opinions of physicians who have training and knowledge in a specialized
field have greater probative value concerning medical questions peculiar
to that field than the opinions of other physicians. Elmer L. Fields, 20
ECAB 250 (1969).
5 Thomas D. Petrylak, 39 ECAB 276 (1987).
6 There is, however, no evidence in the case record to support appellant's
contention that the Office asked Dr. Williams leading questions.
7 In situations where there are opposing medical reports of virtually equal
weight and rationale, and the case is referred to an impartial medical specialist
for the purpose of resolving the conflict, the opinion of such specialist,
if sufficiently well rationalized and based on a proper factual background,
must be given special weight. James P. Roberts, 31 ECAB 1010 (1980).
8 See Myrtle C. Pittman, on petition for recon., 40 ECAB 880 (1989) for
a discussion of the use or exclusion of reports of purported impartial medical
specialists where a conflict of medical opinion was mistakenly identified
by the Office.
9 See Leanne E. Maynard, 43 ECAB 482 (1992) (The Board found that a physician's
"opinion is probative even though he was not an impartial medical examiner"
and that the opinion of this physician and another physician were sufficient
to establish causal relation.); Rosa Whitfield Swain, 38 ECAB 368 (1987)
(The Board found that a physician was improperly designated as an impartial
medical specialist, but that his opinion nonetheless constituted the weight
of the medical evidence).
APPENDIX B
U. S. DEPARTMENT OF LABOR
Employees' Compensation Appeals Board
Docket No. 95-2634
IN THE MATTER OF CLEOPATRA MCDOUGAL-SADDLER
AND U.S. POSTAL SERVICE, POST OFFICE,
PHILADELPHIA, PA
ORDER DENYING PETITION FOR RECONSIDERATION
The Board issued its decision and order in the above-entitled matter on
March 20, 1996. The Board found that the weight of the medical evidence
established that appellant's disability related to her May 8, 1982 and April
5, 1985 employment injuries ended by September 20, 1992.
Appellant filed a petition for reconsideration. The Director of the Office
of Workers' Compensation Programs was served with a copy of appellant's
petition, and, in reply, requested that it be denied on the ground that
no error of fact or law had been cited. Appellant was served with a copy
of the Director's reply, but did not respond within the time allotted.
The Board, having duly considered appellant's petition for reconsideration,
finds that it fails to establish any error of fact or law in the Board's
March 20, 1996 decision and order warranting further consideration.1
Accordingly, IT IS ORDERED that the petition for reconsideration be and
it hereby is denied.
Dated, Washington, D.C.
JUN 18, 1996
/s/ DAVID S. GERSON
DAVID S. GERSON
Member
/s/ WILLIE T.C. THOMAS
WILLIE T.C. THOMAS
Alternate Member
/s/ MICHAEL E. GROOM
MICHAEL E. GROOM
Alternate Member
1 See Virginia Faye Gabbert, 21 ECAB 149 (1969).
APPENDIX C
UNITED STATES COURT OF APPEALS
FOR THE THIRD CIRCUIT
No. 98-1068
CLEOPATRA MCDOUGAL-SADDLER, APPELLANT
v.
ALEXIS M. HERMAN, SECRETARY,
U.S. DEPARTMENT OF LABOR, APPELLEE
PRESENT: MCKEE, RENDELL, CIRCUIT JUDGES AND
DEBEVOISE, SENIOR DISTRICT JUDGE*
O R D E R
It is hereby ORDERED that the slip opinion filed in this case on November
17, 1998 be vacated.
By the Court,
/s/ signature illegible
_________________________
Circuit Judge
Hon. Theodore A. McKee
Dated: FEB 24 1999
DR/CC: JP2, NMO, KBK
* Honorable Dickinson R. Debevoise, United States District Judge for the
District of New Jersey, sitting by designation.