United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.G., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Philadelphia, PA, Employer 

__________________________________________ 

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Docket No. 15-0900 

Issued: August 11, 2015 

Appearances: Case Submitted on the Record

Thomas R. Uliase, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On March 18, 2015 appellant, through counsel, timely appealed a December 8, 2014 

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 the claim.2

ISSUE 

The issue is whether appellant sustained an injury in the performance of duty on 

November 20, 2013. 

 1

 5 U.S.C. §§ 8101-8193 (2006). 

2

 The record on appeal contains evidence received after OWCP issued its December 8, 2014 decision. The Board 

is precluded from considering evidence that was not in the case record at the time OWCP issued its final decision. 

20 C.F.R. § 501.2(c)(1) (2014). 
2

FACTUAL HISTORY 

Appellant, a 58-year-old letter carrier, filed a Form CA-1 claim for traumatic injury, 

alleging that she sustained a lower back injury on November 20, 2013 while lifting a tub of mail. 

She reported having felt a sharp pain in her left lower back after lifting and turning to place the 

mail tub on the case ledge. The lower back pain then radiated down appellant’s left leg. She 

stopped work effective November 21, 2013. Appellant previously injured her back at work on 

September 6, 2002, which OWCP accepted for sacroiliac sprain (OWCP File No. xxxxxx916).3 

Additionally, the record indicates a prior history of lumbar degenerative disc disease. At the 

time of the November 20, 2013 employment incident, appellant was working part-time limited 

duty as a consequence of her prior injury.4

Dr. Paul H. Steinfield, a Board-certified orthopedic surgeon, examined appellant on 

November 20, 2013, and diagnosed exacerbation of left-sided lumbar radiculopathy. He noted 

that appellant reported having developed severe left-sided buttock pain with radiation down the 

left calf after she picked up a tub of mail and twisted. The pain was reportedly similar to pain 

appellant experienced in the past, but more severe. On physical examination, there was 

tenderness over the left sacroiliac joint, and tenderness about the left sciatic notch and left greater 

trochanter. Dr. Steinfield also reported that left straight leg raise test produced buttock pain at 60 

degrees. He prescribed a 10-day course of methylprednisolone (corticosteroid), as well as a 

muscle relaxant, and pain medications. Dr. Steinfield advised that appellant would have 

difficulty working for the next two weeks. 

In a follow-up report dated December 4, 2013, Dr. Steinfield noted that appellant had not 

tolerated the methylprednisolone and still complained of left-sided buttock pain with radiation 

into her left foot. Appellant’s current physical examination demonstrated tenderness of the 

spinous processes between T7 and L3, as well as tenderness over the left sacroiliac joint, and 

tenderness of the left sciatic notch. Dr. Steinfield also reported some left buttock pain with left 

hip rotation. He noted that appellant continued to have left-sided lumbar radiculopathy. 

Dr. Steinfield administered a left sciatic notch corticosteroid injection, which she tolerated well. 

He placed her on limited duty and advised appellant to return for follow up in one month. 

Dr. Steinfield also submitted a duty status report (Form CA-17). 

On December 10, 2013 appellant returned to work in a part-time (3 hours), limited-duty 

capacity. 

Dr. Steinfield provided a December 12, 2013 Form CA-17, which included a three-hour 

workday restriction. He limited appellant to 11⁄2 hours casing her route and 11⁄2 hours of street 

work using a mail cart. 

On December 13, 2013 the employing establishment provided appellant with a limitedduty assignment as a letter carrier/collector. Appellant had a three-hour workday with 

 3

 Appellant also has an accepted claim for a left foot/ankle injury sustained on July 6, 2010 (OWCP File No. 

xxxxxx470). 

4

 The employing establishment was only able to accommodate three hours of limited-duty work per day. 
3

restrictions. Her duties were divided among casing (11⁄2 hours) and street work (11⁄2 hours), 

which involved delivery and collection. The physical requirements of appellant’s limited-duty 

assignment consisted of 3 hours standing/walking, a 1⁄2 hour climbing, 11⁄2 hours 

bending/stooping/twisting, and a 1⁄2 hour pulling/pushing. 

In a January 8, 2014 form report, Dr. Steinfield diagnosed lumbar radiculopathy with a 

November 20, 2013 date of injury. Appellant’s treatment consisted of pain medication and back 

support. Dr. Steinfield also noted that she was able to work three hours per day with no more 

than three hours of standing/walking. 

In a January 24, 2014 decision, OWCP denied appellant’s claim because the medical 

evidence failed to establish that her lumbar radiculopathy was causally related to her accepted 

employment exposure as Dr. Steinfield had not explained how lifting up a tub of mail 

exacerbated her left-sided lumbar radiculopathy. 

On July 30, 2014 appellant’s counsel requested reconsideration and he submitted 

additional evidence. 

A November 20, 2013 Form CA-17 duty status report from Dr. Steinfield noted that 

appellant was out of work for two weeks. It also noted findings of exacerbation of lumbar 

radiculopathy with a November 20, 2013 history of injury. Appellant reportedly picked up a tub 

of mail, twisted to place it on the mail case ledge, and experienced left lower back pain running 

down her left leg. 

OWCP also received a March 25, 2014 part-time (3 hours), limited-duty employing 

establishment job offer as lobby assistant, which appellant accepted on March 31, 2014. 

According to the job description, appellant provided customer service. Her recognized 

limitations included 3 hours standing/walking, 11⁄2 hours bending/stooping/twisting, and a 1⁄2 hour 

pulling/pushing. 

Additionally, OWCP received two new reports from Dr. Steinfield. In a March 7, 2014 

narrative report, Dr. Steinfield noted having followed appellant for an injury that occurred on 

November 20, 2013. Appellant came to Dr. Steinfield’s office that same day after developing 

severe left-sided buttock pain that radiated down her left leg. She had reportedly picked up a tub 

of mail. Dr. Steinfield noted that he had previously seen appellant for similar pain, but it had not 

been as severe as when he saw her on November 20, 2013. After examining her, he diagnosed 

exacerbation of left-sided lumbar radiculopathy and prescribed various medications. When 

appellant returned on December 4, 2013, Dr. Steinfield noted that she continued to complain of 

left-sided buttock pain with radiation down to the left foot. He again thought she had persistent 

symptoms of lumbar radiculopathy. Appellant returned on January 18, 2014 and advised that her 

pain level was somewhat better. At the time, Dr. Steinfield recommended that she remain on a 

three-hour workday schedule. During follow up on February 7, 2014, appellant received a left 

sacroiliac joint injection due to persistent symptoms, and when last seen on March 7, 2014, her 

pain had improved somewhat. Dr. Steinfield continued to prescribe various medications and 

recommended that appellant remain on a three-hour workday. In conclusion, he stated that she 

exacerbated her lumbar radiculopathy on November 20, 2013 when she picked up a tub of mail. 
4

Dr. Steinfield also provided a July 9, 2014 narrative report wherein he reviewed 

appellant’s treatment records dating back to October 2002. At that time, a colleague, Dr. Mark 

Desmond, diagnosed lower back pain and degenerative disc disease following a September 6, 

2002 work injury she sustained while carrying a heavy mailbag. Dr. Steinfield noted that a 

contemporaneous magnetic resonance imaging (MRI) scan revealed degenerative changes at 

L5-S1. When Dr. Desmond next saw appellant on November 14, 2002, her back pain had 

resolved, but she returned in February 2003 with complaints of persistent low back pain. In the 

interim period, appellant had been seen by a pain management specialist who administered a 

series of injections. When Dr. Desmond saw her on February 21, 2003, her pain persisted. 

Appellant’s pain continued through April 2003, at which time he placed her on modified work 

activities. Dr. Desmond next saw her on May 23, 2003, and she reported no improvement with 

respect to her pain. After a seven-year absence, appellant returned in May 2010 with complaints 

of left-sided low back pain. She reportedly returned to full-time work with restrictions and had 

been functioning well for several years. 

Dr. Steinfield indicated that he examined appellant on July 7, 2010 for complaints of left 

foot pain following a work-related fall. Appellant initially received a diagnosis of left foot sprain 

and left ankle sprain. However, on a subsequent visit she complained of left thigh pain, left foot 

numbness, and persistent left foot pain, and was diagnosed with lumbar radiculopathy. 

Dr. Steinfield noted that appellant was treated for low back pain associated with lumbar 

radiculopathy. He also noted that a December 2011 electromyography (EMG) demonstrated left 

side L5 radiculopathy. In 2012, appellant received a series of lumbar epidural injections, but as 

of July 23, 2012 she continued to have symptoms of lumbar radiculopathy. Dr. Steinfield 

indicated that appellant had been managing with light-duty activity. During follow-up visits on 

February 1, July 24 and October 7, 2013, appellant complained of persistent left-sided low back 

pain, as well as left leg/calf/ankle pain, which was felt to be associated with lumbar 

radiculopathy. As of October 7, 2013, Dr. Steinfield diagnosed low back pain associated with 

lumbar disc disease and lumbar radiculopathy. 

Appellant returned on November 20, 2013, and informed Dr. Steinfield that, earlier in the 

day, she picked up a tub of mail, twisted, and developed severe left buttock pain that radiated 

into her left calf. She also indicated that her current pain was similar to her previous pain, but 

more severe. Dr. Steinfield noted that he diagnosed an exacerbation of left-sided lumbar 

radiculopathy. He also noted having seen appellant on several occasions since then; most 

recently on March 7, 2014. At that time, appellant continued to complain of left buttock pain, 

left-sided low back pain, left calf pain, left foot pain, and numbness of the left foot. 

Dr. Steinfield concluded his July 9, 2014 report as follows: 

“On [November 20, 2013] [appellant] had an exacerbation of her underlying 

condition of low back pain and lumbar radiculopathy when she picked up a tub of 

mail while working. [Appellant] had a long history of low back pain and lumbar 

radiculopathy prior to [November 20, 2013]. However, this episode on 

[November 20, 2013] did produce an exacerbation of the underlying condition.” 

Lastly, OWCP received Dr. Steinfield’s July 21, 2014 treatment notes. Appellant 

reported that her pain had increased in severity over the past several weeks. Her pain radiated 
5

into the left leg and she had been limping intermittently. Dr. Steinfield also noted that appellant 

presently worked three hours per day with little difficulty. Appellant had not been taking her 

pain medication and muscle relaxant, but she continued to use her Flector (nonsteroidal antiinflammatory drug) patch. On physical examination, Dr. Steinfield noted a normal gait, 

tenderness over the left sacroiliac joint, and tenderness about the left sciatic notch. He indicated 

that appellant continued to have low back pain associated with lumbar radiculopathy. 

Dr. Steinfield noted that her last epidural injections were two years ago, and he recommended a 

repeat series of lumbar epidural injections. He also prescribed Percocet, Soma, and Ultram, and 

advised appellant to continue with her three-hour workday and to follow up in one month. 

By decision dated December 8, 2014, OWCP reviewed the merits of appellant’s claim 

but denied modification of the January 24, 2014 decision. It found that Dr. Steinfield had not 

provided a well-reasoned opinion on how her accepted November 20, 2013 employment 

exposure aggravated her lumbar radiculopathy. 

LEGAL PRECEDENT 

A claimant seeking benefits under FECA has the burden of establishing the essential 

elements of his or her claim by the weight of the reliable, probative, and substantial evidence, 

including that an injury was sustained in the performance of duty as alleged and that any specific 

condition or disability claimed is causally related to the employment injury.5

To determine if an employee sustained a traumatic injury in the performance of duty, 

OWCP begins with an analysis of whether “fact of injury” has been established. Generally, fact 

of injury consists of two components that must be considered in conjunction with one another. 

The first component is whether the employee actually experienced the employment incident that 

allegedly occurred.6 The second component is whether the employment incident caused a 

personal injury.7 An employee may establish that an injury occurred in the performance of duty 

as alleged, but fail to establish that the disability or specific condition for which compensation is 

being claimed is causally related to the injury.8

ANALYSIS 

Appellant claims to have injured her lower back in the performance of duty on 

November 20, 2013. At the time, she was working part-time limited duty. Appellant indicated 

 5

 20 C.F.R. § 10.115(e), (f); see Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996). 

6 Elaine Pendleton, 40 ECAB 1143 (1989). 

7 John J. Carlone, 41 ECAB 354 (1989). Causal relationship is a medical question that generally requires 

rationalized medical opinion evidence to resolve the issue. See Robert G. Morris, 48 ECAB 238 (1996). A 

physician’s opinion on whether there is a causal relationship between the diagnosed condition and the implicated 

employment factor(s) must be based on a complete factual and medical background. Victor J. Woodhams, 41 ECAB 

345, 352 (1989). Additionally, the physician’s opinion must be expressed in terms of a reasonable degree of 

medical certainty, and must be supported by medical rationale, explaining the nature of the relationship between the 

diagnosed condition and appellant’s specific employment factor(s). Id.

8 Shirley A. Temple, 48 ECAB 404, 407 (1997). 
6

that she stooped to lift a tub of mail then turned to place the mail tub on the case ledge. In the 

process, she experienced a sharp pain in her left lower back that radiated down her left leg. 

Dr. Steinfield examined appellant on November 20, 2013 and diagnosed exacerbation of leftsided lumbar radiculopathy. Appellant stopped work following the November 20, 2013 

employment incident, and resumed part-time limited-duty work on December 10, 2013. 

Appellant has a history of two prior work-related injuries. On September 6, 2002 she 

injured her back, which OWCP accepted for sacroiliac sprain (OWCP File No. xxxxxx916). 

Appellant also sustained a work-related left foot/ankle injury on July 6, 2010 (OWCP File No. 

xxxxx470). Dr. Steinfield was aware of her two prior work-related injuries. He was also aware 

of appellant’s prior history of lumbar degenerative disc disease and lumbar radiculopathy. In his 

July 9, 2014 report, Dr. Steinfield noted that a 2002 lumbar MRI scan revealed degenerative 

changes at L5-S1, and a 2011 EMG demonstrated left side L5 radiculopathy. He also noted that, 

when he saw appellant approximately six weeks prior to the November 20, 2013 employment 

incident, her diagnosis at the time was low back pain associated with lumbar disc disease and 

lumbar radiculopathy. According to Dr. Steinfield, when he examined her on October 7, 2013 

she complained of left-sided low back pain and left leg pain, which radiated to her left calf, and 

when she returned on November 20, 2013 she reported similar complaints. However, in her 

estimation, the pain was more severe than in the past. 

Dr. Steinfield’s opinion is that the November 20, 2013 employment incident exacerbated 

appellant’s underlying condition of low back pain and lumbar radiculopathy. However, other 

than noting that she picked up a tub of mail and twisted, he has not explained how this particular 

activity exacerbated her underlying lumbar condition. It is also unclear from his various reports 

how Dr. Steinfield was able to distinguish appellant’s preexisting lumbar condition from the 

aggravating effects of the November 20, 2013 employment incident. At the time, appellant 

reported that her pain was similar, but more severe than in the past. However, the Board notes 

that appellant similarly noted an increase in the severity of her pain when he examined her on 

July 21, 2014, but there was no specific mention of a cause for her latest increase in pain. 

A physician’s opinion on causal relationship must be expressed in terms of a reasonable 

degree of medical certainty, and must be supported by medical rationale, explaining the nature of 

the relationship between the diagnosed condition and appellant’s specific employment factor(s).9

 

While Dr. Steinfield stated that the November 20, 2013 employment incident exacerbated her 

lumbar radiculopathy, he has yet to adequately explain the basis for his opinion on causal 

relationship. Accordingly, the Board finds that appellant failed to establish that her claimed 

lumbar radiculopathy is causally related to her accepted November 20, 2013 employment 

exposure. 

CONCLUSION 

Appellant failed to establish that she sustained an injury in the performance of duty on 

November 20, 2013. 

 9 Victor J. Woodhams, supra note 7. 
7

ORDER 

IT IS HEREBY ORDERED THAT the December 8, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: August 11, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board