United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.C., Appellant 

and 

PEACE CORPS, VOLUNTEER SERVICES, 

Washington, DC, Employer 

__________________________________________ 

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Docket No. 14-383 

Issued: May 28, 2014 

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

COLLEEN DUFFY KIKO, Judge 

MICHAEL E. GROOM, Alternate Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On December 6, 2013 appellant filed a timely appeal from a September 27, 2013 merit 

decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal 

Employees’ Compensation Act1

 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has 

jurisdiction over the merits of this case. 

ISSUE 

The issue is whether appellant met his burden of proof to establish an occupational 

disease in the performance of duty. 

On appeal, appellant contends that the evidence he submitted is sufficient to establish a 

paracentral annular fissure at L5-S1 as a direct result of his volunteer service in the Ukraine from 

sleeping on bad beds, long train rides and work-related travel with heavy backpacks and luggage. 

 1

 5 U.S.C. § 8101 et seq. 
2

FACTUAL HISTORY 

On July 1, 2013 appellant, then a 27-year-old former Peace Corps volunteer, filed a Form 

CA-2 an occupational disease while he served in the Ukraine. In a narrative statement, appellant 

related that he first noticed his back pain in April 2010 during his preservice training. He slept 

on a very uncomfortable and uneven couch as suggested by his host family. Later, appellant 

moved to a bed, but the lack of back support did not help. He traveled frequently and carried 

around luggage and backpacks, which further aggravated his back condition. Appellant’s tour of 

duty lasted from March 29, 2010 to June 27, 2012. 

In a Peace Corps medical evaluation report dated March 29, 2012 appellant described 

slight back pain with stiffness in the morning. An unidentifiable physician stated that appellant’s 

back pain was caused by the use of an uncomfortable bed and stretching in the morning relieved 

the pain. On June 26, 2012 an unidentifiable physician stated that appellant was still having back 

pain but it was better than in March 2012. 

In a July 12, 2013 letter, OWCP notified appellant of the deficiencies of his claim. It 

afforded him 30 days to respond to its inquiries and to submit additional evidence. 

Appellant submitted a July 19, 2013 narrative statement, reiterating that during his 

volunteer service in Ukraine he slept on cots that rested on spring-supported frames that dipped 

like a hammock and had back discomfort every single morning he woke up. He stated that he 

would do a specific stretch and would have to crack his back in a certain way for the pain to 

dissipate, but when he sat upright in a chair there would be some back discomfort. 

In a February 28, 2013 report, Dr. Eun A. Kim, a Board-certified family practitioner, 

obtained a history that appellant was in Ukraine for the Peace Corps and believed his back pain 

was from sleeping in bad beds. Dr. Kim diagnosed back, right shoulder and right elbow pain 

with psoriasis. 

An x-ray of the lumbosacral spine dated February 28, 2013 revealed indistinctness of the 

mid aspect of the articular process of L5. Dr. Mithilesh Singh, a Board-certified radiologist, 

stated that the “[f]inding may represent spondylosis. It is, however, not definitely noted on the 

oblique views.” 

A March 7, 2013 magnetic resonance imaging (MRI) scan obtained by Dr. Myung-Soo 

Lee, a radiologist, revealed a left paracentral annular fissure at L5-S1. The MRI scan was 

otherwise unremarkable of the lumbar spine. 

By decision dated September 27, 2013, OWCP denied appellant’s claim. It found that 

the work exposures occurred as alleged but that the medical evidence was insufficient to 

establish his lumbar condition was caused by his Peace Corp volunteer service. 

LEGAL PRECEDENT 

FECA provides that an injury or illness sustained by a Peace Corps volunteer when he or 

she is outside the United States shall be presumed to have been sustained while in the 

performance of duty and proximately caused by federal employment. This presumption may be 
3

rebutted by evidence demonstrating that the injury or illness: (1) was caused by the volunteer’s 

willful misconduct or intent to bring about injury to self or another; (2) was proximately caused 

by the volunteer’s intoxication by alcohol or illegal drugs; (3) preexisted the period of service 

abroad; or (4) manifested symptoms of, or consequent to, a preexisting congenital defect or 

abnormality.2 If the presumption is rebutted by evidence showing that the injury or illness 

preexisted the period of service abroad or manifested symptoms of, or consequent to, a 

preexisting congenital defect or abnormality, the volunteer may still prove his or her claim and 

be entitled to compensation if he or she submits substantial, probative and rationalized evidence 

establishing that the injury or illness was proximately caused or materially aggravated, 

accelerated or precipitated by factors or conditions of Peace Corps service.3 

While Peace Corps volunteers are normally entitled to the presumption that an injury or 

illness sustained while abroad is proximately related to federal employment, the presumption 

will not arise if no injury or illness is diagnosed. Without a firm medical diagnosis, it is not 

possible to ascertain whether the condition was preexisting or congenital.4

 

ANALYSIS 

Appellant was a Peace Corps volunteer in Ukraine from March 29, 2010 to 

June 27, 2012. He filed an occupational disease claim for a low back condition sustained while 

abroad. The presumption arises that appellant, as a Peace Corps volunteer, sustained an 

employment-related injury while in the performance of duty. As noted above, this presumption 

is rebuttable.5 The case record does not establish that appellant’s condition preexisted his period 

of service abroad, was a preexisting congenital defect or the result of his willful misconduct, 

intent to bring about injury to himself or another or intoxication by alcohol or illegal drugs. To 

establish his claim, appellant must submit substantial medical evidence proving that his back 

condition was proximately caused or materially aggravated, accelerated or precipitated by work 

factors.6 

Rationalized medical opinion evidence is generally required to establish causal 

relationship. The opinion of the physician must be based on a complete factual and medical 

background, 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.7

 The Board finds that the medical 

evidence does not sufficiently establish that factors of appellant’s Peace Corps service caused or 

contributed to his back condition. In a February 28, 2013 report, Dr. Kim merely diagnosed back 

pain and indicated that appellant believed that it arose from sleeping in bad beds during his Peace 

 2

 5 U.S.C. § 8142(c)(3); 20 C.F.R. § 10.730(a). 

3

 20 C.F.R. § 10.730(b)-(c). 

4 See S.S., 59 ECAB 152 (2007). 

5 See supra note 2. 

6 See Charles S. Hamilton, 52 ECAB 110, 114-15 (2000); A.W., Docket No. 13-648 (issued June 4, 2013). 

7 See I.J., 59 ECAB 408 (2008). 
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Corps service in Ukraine. He did not provide a firm diagnosis or a rationalized opinion 

explaining how factors of appellant’s Peace Corps service, such as sleeping on bad beds, 

frequent travel and carrying backpacks and luggage, caused or aggravated his back pain. 

Dr. Kim noted that appellant’s condition possibly occurred while he was in Ukraine, but such 

generalized statements are speculative and do not establish causal relationship. They merely 

repeat appellant’s allegations and are unsupported by adequate medical rationale explaining how 

his physical activity at work actually caused or aggravated the diagnosed conditions.8

 The Board 

finds that the report from Dr. Kim is insufficient to establish that appellant sustained an 

employment-related injury. 

In Peace Corps medical evaluation reports dated March 29 and June 26, 2012 from an 

unidentifiable physician noted that appellant’s back pain was caused by the use of an 

uncomfortable bed. These forms, lacking proper identification, cannot be considered as 

probative evidence. A medical report may not be considered as probative medical evidence if 

there is no indication that the person completing the report qualifies as a physician as defined in 

FECA.9

 Therefore, appellant did not meet his burden of proof with these submissions. 

Dr. Singh’s February 28, 2013 x-ray and Dr. Lee’s March 7, 2013 MRI scan, offered 

limited probative value on the issue of causal relationship. Neither of the diagnostic reports 

addressed whether appellant’s service in the Peace Corps caused or contributed to his back 

condition.10 In the absence of rationalized medical opinion evidence, appellant failed to meet his 

burden of proof. 

On appeal, appellant contends that the evidence he submitted is sufficient to establish that 

he sustained a paracentral annular fissure at L5-S1 a direct result of his volunteer service in 

Ukraine from sleeping on bad beds, long train rides and work-related travel with heavy 

backpacks and luggage. The Board has held that the mere fact that appellant’s symptoms arise 

during a period of employment or produce symptoms revelatory of an underlying condition does 

not establish a causal relationship between his condition and his employment factors.11 The 

Board finds that the medical evidence of record is insufficient to establish that appellant’s Peace 

Corps service caused or contributed to his low back condition. 

CONCLUSION 

The Board finds that appellant has not met his burden of proof to establish that he 

sustained an occupational disease while in the performance of duty. 

 8 See K.W., Docket No. 10-98 (issued September 10, 2010). 

9 See Merton J. Sills, 39 ECAB 572 (1988). See also Bradford L. Sutherland, 33 ECAB 1568 (1982). 

10 See J.F., Docket No. 09-1061 (issued November 17, 2009); S.E., Docket No. 08-2214 (issued May 6, 2009). 

11 See Richard B. Cissel, 32 ECAB 1910, 1917 (1981); William Nimitz, Jr., 30 ECAB 567, 570 (1979). 
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ORDER 

IT IS HEREBY ORDERED THAT the September 27, 2013 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: May 28, 2014 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees' Compensation Appeals Board 

 

 Michael E. Groom, Alternate Judge 

 Employees' Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees' Compensation Appeals Board