United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.C., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Bellmawr, NJ, Employer 

__________________________________________ 

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Docket No. 14-1673 

Issued: November 14, 2014 

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 HOWARD FITZGERALD, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On July 28, 2014 appellant, through counsel, filed a timely appeal of a May 9, 2014 

Office of Workers’ Compensation Programs’ (OWCP) merit decision denying her traumatic 

injury claim. Pursuant to the Federal Employees’ Compensation Act1

 (FECA) and 20 C.F.R. 

§§ 501.2(c) and 501.3, the Board has jurisdiction to consider the merits of the case. 

ISSUE 

The issue is whether appellant has met her burden of proof in establishing that she 

sustained a traumatic injury on August 9, 2013 in the performance of duty. 

On appeal, counsel argued that a prima facie traumatic injury claim has been established 

or that OWCP abused its discretion in failing to develop the matter further from a medical 

standpoint. 

 1

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

On August 12, 2013 appellant, then a 46-year-old letter carrier, filed a traumatic injury 

claim alleging that on August 9, 2013 she injured her back while bending over to lift a tray of 

mail at the employing establishment. She stated that she felt something move in her back. 

Appellant’s attending physician, Dr. Mark Filippone, a Board-certified physiatrist, recommended 

physical therapy on August 14, 2013. Dr. Filippone completed a form report on the same date 

and diagnosed lumbar radiculitis. 

In a letter dated September 4, 2013, OWCP requested additional factual and medical 

evidence in support of appellant’s claim. Dr. Filippone completed a report dated August 14, 

2013 and noted her history of bending and lifting in the performance of duty and experiencing a 

pop in her back. He noted that appellant was involved in a motor vehicle accident in 2008 which 

resulted in epidural steroid injections of the low back and neck. Dr. Filippone stated that she 

returned to full-time regular duty following the 2008 accident. On physical examination he 

found that appellant had low back pain with radiation into the left lower extremity with flexion at 

the waist. Dr. Filippone stated that she experienced more pain on the left side of her back. He 

diagnosed acute injury to the lumbosacral spine directly and opined that this condition was solely 

the result of the employment injuries on August 9, 2013. Dr. Filippone completed a form report 

on September 4, 2013 and diagnosed acute injury to the lumbar spine and indicated with a 

checkmark “yes” that he believed that this condition was caused or aggravated by an 

employment activity. 

A magnetic resonance imaging (MRI) scan dated August 13, 2008 demonstrated left 

lateral disc herniation at L4-5 and central disc herniation at L5-S1. An MRI scan of the cervical 

spine on August 13, 2008 demonstrated cervical spondylosis at C5-6 and disc bulges from C4-7. 

Appellant’s thoracic spine MRI scan on August 31, 2008 demonstrated small central disc 

protrusion at T7-8 and T8-9. Chest x-rays dated August 10, 2008 demonstrated a compression 

fracture at T9. A computerized tomography (CT) scan of appellant’s chest demonstrated a 

probable rib fracture. Appellant underwent a bone scan on August 22, 2008 which demonstrated 

abnormal mid right rib anteriorly and abnormal sternum which were likely probable fractures. 

Appellant submitted a narrative statement dated August 31, 2013 and described her 

employment. She noted her motor vehicle accident on August 10, 2008. Appellant stated that 

she pulled something in her back while working on August 9, 2013. In a statement dated 

August 10, 2013, appellant reported on August 9, 2013 she bent over to pick up a delivery point 

sequence, a foot-long tray of letters, when she felt something pull in her lower back. She stated 

that she felt sore, but continued to work. Appellant reported the incident to her supervisor and 

proceeded with her duties. She stated that as the day progressed the pain worsened in her back 

and traveled from her hip down into her knee and ankle. Appellant utilized leave on 

August 10, 2013. 

By decision dated October 8, 2013, OWCP denied appellant’s claim finding that she had 

not submitted medical evidence of a specific condition resulting from the August 9, 2013 

employment incident. It found that Dr. Filippone’s diagnoses of acute injury to the lumbosacral 

spine was not sufficient to meet her burden of proof. 
3

Appellant requested an oral hearing before an OWCP hearing representative on 

October 15, 2013. In a report dated October 7, 2013, Dr. Filippone diagnosed lumbar spine 

trauma. He indicated with a checkmark “yes” that he believed that appellant’s diagnosed 

condition was due to her employment activity. Dr. Filippone completed narrative reports on 

September 4 and October 7, 2013 and noted her complaints of low back pain. He requested 

authorization for an MRI scan and electrodiagnostic testing. Dr. Filippone completed a report on 

October 31, 2013 and diagnosed cervical radiculopathy, occipital headache, internal 

derangement of the shoulders, elbows and wrists and lumbar radiculopathy. He stated, “In my 

professional medical opinion, it is well within reasonable medical probability that all of the 

patient’s present complaints and physical abnormalities are directly and solely the result of the 

injury sustained while at work on August 9, 2013....” 

Appellant underwent an MRI scan of the lumbar spine on October 22, 2013 which 

demonstrated disc desiccation and an annular tear at L3-4, with disc bulges at L4-5 and L5-S1. 

Dr. Filippone reviewed this test on November 8, 2013 and attributed appellant’s condition to her 

acute low back injury. In a report dated December 5, 2013, he found her condition unchanged. 

On January 9, 2014 Dr. Filippone noted that appellant reported back pain rated 7 of 10 radiating 

into the left lower extremity and down into the left foot. He found pain, guarding and spasm in 

the lumbar paraspinals. Dr. Filippone noted that appellant’s prior low back condition had 

resolved completely such that she was able to return to regular full-time duty. 

Appellant testified at the oral hearing on February 19, 2014. She noted a preemployment 

back injury in 1987 which did not interfere with her position as letter carrier. Appellant noted 

that her mail bag averaged 30 pounds and that she was required to lift up to 75 pounds. She 

described the 2008 motor vehicle accident which was not related to her employment. Appellant 

stated that she was out of work for five weeks with neck and low back pain. She then returned to 

full duty. On September 27, 2008 appellant sustained a work-related right knee meniscus tear 

due to twisting her knee while walking down steps in the performance of duty. She again 

returned to full duty and was in full-duty status on August 9, 2013 when she injured her back. 

Appellant stated that she bent down to lift up the tray of DPS and felt something move in her 

back. She experienced soreness and tightness, reported the incident to her acting supervisor and 

continued to work. Appellant stated that the pain increased and that she could not take normal 

size steps. She had difficulty locating a physician that would accept workers’ compensation 

cases and eventually visited Dr. Filippone on August 14, 2013. 

Dr. Filippone completed a report on February 18, 2014 and reviewed appellant’s 

electrodiagnostic studies. He found a partial denervation in muscles innervated by the L5-S1 

lumbosacral nerve roots bilateral and to a lesser extent in muscles innervated by the left L3-4 

lumbar nerve roots. Dr. Filippone concluded that appellant had electrodiagnostic evidence of left 

L3-4 and L5-S1 lumbosacral radiculopathy and right L5-S1 lumbosacral radiculopathy. He 

opined, “In my professional medical opinion, the above abnormalities are totally consistent with 

the injuries sustained at work ... and it is consistent with the pathology noted on the MRI of the 

lumbar spine....” Dr. Filippone also examined appellant on February 26 and March 24, 2014. 

By decision dated May 9, 2014, an OWCP hearing representative found that 

Dr. Filippone’s reports were not sufficiently rationalized to meet appellant’s burden of proof. 
4

LEGAL PRECEDENT 

An employee seeking benefits under FECA2 has the burden of establishing the essential 

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

including the fact that the individual is an “employee of the United States” within the meaning of 

FECA and that the claim was timely filed within the applicable time limitation period of FECA, 

that an injury was sustained in the performance of duty as alleged and that any disability or 

specific condition for which compensation is claimed is causally related to the employment 

injury.3 These are the essential elements of each and every compensation claim regardless of 

whether the claim is predicated upon a traumatic injury or an occupational disease.4

OWCP defines a traumatic injury as, “[A] condition of the body caused by a specific 

event or incident, or series of events or incidents, within a single workday or shift. Such 

condition must be caused by external force, including stress or strain which is identifiable as to 

time and place of occurrence and member or function of the body affected.”5 To determine 

whether a federal employee has sustained a traumatic injury in the performance of duty, it must 

first be determined whether a “fact of injury” has been established. First the employee must 

submit sufficient evidence to establish that he and she actually experienced the employment 

incident at the time, place and in the manner alleged.6 Second, the employee must submit 

sufficient evidence, generally only in the form a medical evidence, to establish that the 

employment incident caused a personal injury.7

A medical report is of limited probative value on a given medical question if it is 

unsupported by medical rationale.8 Medical rationale includes a physician’s detailed opinion on 

the issue of whether these is a causal relationship between the claimant’s diagnosed condition 

and the implicated employment activity. The opinion of the physician must be based on a 

complete factual and medical background of the claim, 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 specific employment activity or factors identified by the 

claimant.9

 2

 5 U.S.C. §§ 8101-8193. 

3 Kathryn Haggerty, 45 ECAB 383, 388 (1994); Elaine Pendleton, 41 ECAB 1143 (1989). 

4 Victor J. Woodhams, 41 ECAB 345 (1989). 

5

 20 C.F.R. § 10.5(ee). 

6 John J. Carlone, 41 ECAB 354 (1989). 

7 J.Z., 58 ECAB 529 (2007). 

8 T.F., 58 ECAB 128 (2006). 

9 A.D., 58 ECAB 149 (2006). 
5

ANALYSIS 

OWCP accepted that appellant sustained an employment incident on August 9, 2013, 

during which she stated that she pulled something in her back while bending over to pick up a 

DPS, but found that she had not submitted sufficient medical evidence to establish that this 

incident resulted in an employment-related back condition. 

The medical evidence consists of a series of reports from Dr. Filippone, who first 

examined appellant on August 14, 2013 and diagnosed lumbar radiculitis. Dr. Filippone noted 

that appellant was involved in a motor vehicle accident in 2008. The record contains an MRI 

scan dated August 13, 2008 demonstrated left lateral disc herniation at L4-5 and central disc 

herniation at L5-S1. Dr. Filippone diagnosed acute injury to the lumbosacral spine and opined 

that this condition was solely the result of the employment injuries on August 9, 2013. He 

completed form reports and indicated with a checkmark “yes” that he believed that appellant’s 

current back condition was caused or aggravated by an employment activity. 

The Board finds that these reports are not sufficient to meet appellant’s burden of proof 

in establishing a traumatic injury claim. Dr. Filippone did not explain how or why he believed 

that appellant’s current lumbar condition was due to her bending and lifting incident at work 

given the severity of her preexisting spine injuries in 2008. It is not clear that his report was 

based on a complete medical history including the previously diagnosed herniated discs as found 

on the 2008 MRI scan. Without a detailed medical history and medical reasoning explaining 

how bending and lifting a tray of mail could cause or aggravate appellant’s lumbar spine 

conditions, these reports cannot establish appellant’s claim. The Board has held that an opinion 

on causal relationship which consists only of a physician checking “yes” to a medical form report 

question on whether the claimant’s condition was related to the history given is of little probative 

value. Without any explanation or rationale for the conclusion reached, such report is insufficient 

to establish causal relationship.10 

On October 31, 2013 Dr. Filippone diagnosed lumbar radiculopathy and stated, “In my 

professional medical opinion, it is well within reasonable medical probability that all of the 

patient’s present complaints and physical abnormalities are directly and solely the result of the 

injury sustained while at work on August 9, 2013.” This report again fails to address appellant’s 

prior diagnostic studies and fails to explain the factual and medical basis for Dr. Filippone’s 

opinion. 

Following appellant’s October 22, 2013 lumbar MRI scan which demonstrated disc 

desiccation and an annular tear at L3-4, with disc bulges at L4-5 and L5-S1, Dr. Filippone noted 

that appellant’s prior low back condition had resolved completely such that she was able to 

return to regular full-time duty. He also concluded that she had electrodiagnostic evidence of left 

L3-4 and L5-S1 lumbosacral radiculopathy and right L5-S1 lumbosacral radiculopathy. 

Dr. Filippone opined, “In my professional medical opinion, the above abnormalities are totally 

consistent with the injuries sustained at work ... and it is consistent with the pathology noted on 

the MRI scan of the lumbar spine....” These reports do not address the central issue, whether the 

employment incident on August 9, 2013 of bending and lifting a tray of mail was sufficient to 

 10 Lucrecia M. Nielson, 41 ECAB 583, 594 (1991). 
6

cause or aggravate appellant’s lumbar spine so as to result in the current diagnoses. 

Dr. Filippone stated that appellant’s conditions were consistent with her work and that her 2008 

condition had resolved such that she could return to work, but he did not explain how the 2008 

condition had resolved based on diagnostic studies and further did not explain the process by 

which bending and lifting could and did result in the diagnosed lumbar radiculopathy. Without 

medical rationale, his reports supporting causal relationship are not sufficient to meet her burden 

of proof. 

Counsel argued on appeal that appellant had established her claim or, in the alterative, 

that OWCP failed to adequately develop the medical evidence in the record. For the reasons 

listed above, the Board finds that the medical evidence did not include the necessary factual and 

medical history and the needed medical reasoning to meet her burden of proof or to require 

further development by OWCP. 

CONCLUSION 

The Board finds that appellant has not submitted the necessary rationalized medical 

opinion evidence based on a proper factual background to meet her burden of proof in 

establishing that she sustained lumbar radiculopathy as a result of her August 9, 2013 

employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the May 9, 2014 decision of the Office of Workers’ 

Compensation Programs is affirmed. 

Issued: November 14, 2014 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board