United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.F., Appellant 

and 

DEPARTMENT OF AGRICULTURE, 

FOOD & CONSUMER SERVICE, 

Parkersburg, WV, Employer 

__________________________________________ 

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Docket No. 14-2074 

Issued: February 9, 2015 

Appearances: Case Submitted on the Record

Debra Hauser, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

COLLEEN DUFFY KIKO, Judge 

PATRICIA HOWARD FITZGERALD, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On September 30, 2014 appellant, through her attorney, filed a timely appeal from a 

June 4, 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 this case. 

ISSUE 

The issue is whether appellant met her burden of proof to establish additional medical 

conditions related to her March 2, 2010 work injury. 

FACTUAL HISTORY 

On March 30, 2010 appellant, then a 55-year-old program specialist, filed a traumatic 

injury claim alleging that she sustained multiple injuries at work on March 2, 2010 when the 

 1

 5 U.S.C. §§ 8101-8193. 
2

vehicle in which she was a passenger was rear-ended by another vehicle.2

 OWCP accepted her 

claim for thoracic or lumbosacral neuritis or radiculitis, lumbar sprain, cervicalgia, lumbago, and 

degeneration of lumbar or lumbosacral intervertebral disc. Appellant stopped work on 

March 15, 2010 and was placed on continuation of pay.3

In a March 25, 2010 report, Dr. Juan L. Zamora, an attending Board-certified pathologist, 

indicated that appellant presented complaining of lower back pain radiating to both legs, but 

worse on the right with numbness and tingling. Appellant indicated to him that she was a front 

seat passenger in a vehicle which was slowing down to make a turn when another vehicle hit her 

vehicle from the back. Dr. Zamora stated that she developed pain in her lower back after the 

accident and that she had been seen by Dr. David Bauer, a Board-certified orthopedic surgeon, 

who prescribed her with Flexeril and an anti-inflammatory medication.4

 He indicated that no 

definitive diagnosis had been provided by Dr. Bauer. Upon physical examination, Dr. Zamora 

indicated that there was paresthesia of the right L5 and S1 dermatomes. The deep reflexes of the 

lower extremities were both equal and the range of motion was restricted and tender. 

Dr. Zamora stated that there was muscle spasm and tenderness to palpation over the 

paravertebral muscles. The Milgram’s test was positive and the straight leg rise test was also 

positive for pain at 30 degrees on the right. Dr. Zamora diagnosed lumbar spine radiculitis, 

lumbar spine strain and sprain, and lumbar spine, rule out disc disease. 

In a May 21, 2010 report, Dr. Francisco Batlle, an attending Board-certified 

neurosurgeon, stated that appellant reported being involved in a motor vehicle accident on 

March 2, 2010 which caused acute onset of low back pain. Appellant described a “constant deep 

ache” with “intermittent shooting pains” mainly into the right leg with associated numbness and 

tingling in a nondermatomal distribution. Dr. Batlle indicated that he reviewed an April 8, 2010 

magnetic resonance imaging (MRI) scan testing of appellant’s lumbar spine which demonstrated 

a spondylolisthesis of L4 and L5, approximately two to three millimeters without change in 

subluxation with flexion or extension views. There was a four-millimeter broad-based disc 

protrusion with bilateral foraminal stenosis, right side greater than left, and a loss of lumbar 

lordosis which was probably secondary to muscle spasms. Dr. Batlle further noted that the 

testing did not show significant disc desiccation and that the disc space was maintained at L4-5. 

He diagnosed lumbar disc displacement, lumbar radiculitis, lumbago, and lumbar myofascial 

injury. Dr. Batlle indicated that appellant was not a surgical candidate. 

 2

 Appellant was wearing a seat belt at the time of the accident, but her body was thrown forward by the impact. 

The air bags in the vehicle did not inflate and there was some minor damage to the vehicle’s bumper due to the 

accident. 

3

 It appears that appellant used leave to cover her absences after her continuation of pay expired. Beginning in 

late April 2010, the employing establishment accommodated her with limited-duty work. 

4

 Dr. Bauer obtained x-rays on March 15, 2010 which showed normal alignment of the cervical spine, but loss of 

the normal lordosis. Disc space height was slightly decreased with anterior osteophytes at C4 through C7. Lumbar 

spine x-rays taken on that same date showed normal alignment with no evidence of spondylolysis or 

spondylolisthesis. Lumbar disc space height was preserved and sacroiliac joints were normal, but moderate 

degenerative changes were seen. 
3

In an August 24, 2010 report, Dr. Zamora noted that appellant reported some 

improvement in her lumbar spine pain but that the pain still radiated down her right leg. He 

diagnosed lumbar spine spondylolisthesis, lumbar spine disc displacement, lumbar spine joint 

hypertrophy, and lumbar spine radiculopathy. 

In a February 8, 2011 report, Dr. Bernie L. McCaskill, an attending Board-certified 

orthopedic surgeon, stated that appellant’s chief complaint was intermittent, diffuse lower back 

pain with radiating diffuse right leg pain. Appellant also reported a history of chronic and 

intermittent neck and upper back pain that was not affected by her March 2, 2010 vehicular 

accident. Dr. McCaskill diagnosed spondylogenic lumbosacral spine pain associated with 

chronic right lower extremity pain noting that the anatomic etiology was undetermined. 

The findings on January 27, 2012 MRI scan testing of appellant’s lumbar spine showed a 

two-millimeter right paracentral disc protrusion at the L5-S1 level which came in close 

proximity to the right first sacral nerve root, and a two-millimeter broad-based central disc 

protrusion at L4-5 with moderate facet arthropathy resulting in left L4-5 formaminal narrowing. 

In an August 13, 2013 report, Dr. Deepak V. Chavda, an attending Board-certified 

orthopedic surgeon, indicated that he was examining appellant for the first time and noted that 

appellant reported that she had a motor vehicle accident back in 2010 when she was a passenger 

in a vehicle that was rear-ended at a stop light by a vehicle traveling at a speed “greater than 5 to 

10 miles per hour.” Appellant described an achy, stabbing pain that shot down her legs to her 

feet with some numbness and tingling, right side more than left. Dr. Chavda indicated that, upon 

physical examination of the cervical spine, she exhibited point tenderness to the cervical 

paraspinal musculature and spasm bilaterally in both levator scapulae and trapezium, right more 

than left. There was limitation on full flexion and extension of the cervical spine with a decrease 

in left and right lateral side bending. Dr. Chavda indicated that examination of the lumbar spine 

showed no point tenderness upon palpation of the lumbar paraspinous musculature. There was 

positive straight leg raising on the right side at 60 degrees and negative straight leg raising at 90 

degrees on the left side. Appellant had full dorsalis pedis and posterior tibial pulses bilaterally. 

Dr. Chavda diagnosed chronic low back pain and lumbago with lumbosacral disc disorder, 

lumbosacral sprain/strain, bilateral leg radiculopathy (right more than left), possible facet 

arthropathy, bilateral sacroiliac joint pain (right more than left), cervicalgia with trapezium and 

levator scapulae, and rule out herniated disc with radiculopathy. 

Dr. Chavda submitted an amended notation on August 21, 2013 which stated, “Based on 

my examination, medical records, and imaging studies, I request upgrade of [Department of 

Labor] codes to include facet arthropathy (724.8), herniated disc cervical (722.0) with radicular 

pain (723.4), bilateral [sacroiliac] syndrome (720.2), sacroiliitis (847.3), sprain of the sacrum 

(824.6), and disorders of the sacrum (724.6).” 

Appellant requested that the additional conditions related to her March 2, 2010 work 

injury be accepted to include the conditions denoted in Dr. Chavda’s August 21, 2013 addendum 

report. 
4

On May 20, 2014 appellant’s case file was forwarded to Dr. Ronald Blum, a Boardcertified orthopedic surgeon and OWCP medical adviser, to determine if the new conditions 

claimed by appellant were related to her March 2, 2010 work injury. 

In a report dated May 22, 2014, Dr. Blum provided a summary of appellant’s factual and 

medical history. He discussed the contents of Dr. Chavda’s August 13, 2013 report and his 

August 21, 2013 addendum. Dr. Blum noted, “It is my opinion the information in the record 

does no[t] support the requested upgrades including facet arthropathy, herniated cervical disc, 

and cervical radicular pain. It is my opinion Dr. Chavda’s requested upgraded diagnoses are the 

result of aging and not the result of the accepted work[-]related injury of March 2, 2010.” 

Dr. Blum also stated, “It is also my opinion the requested upgrade to include sacral sprain is 

medically reasonable. The remainder of requested sacral diagnoses are medically redundant.” 

In a June 4, 2014 decision, OWCP expanded the accepted conditions in her case to 

include the condition of “sacral sprain.” 

In another June 4, 2010 decision, OWCP found that the other conditions for which 

appellant had requested an upgrade had been disallowed. It discussed Dr. Chavda’s August 13, 

2013 report and his August 21, 2013 addendum as well as the May 22, 2014 report of Dr. Blum. 

OWCP stated: 

“It is recommended that ... facet arthropathy (724.8); herniated disc cervical 

(722.0) with radicular pain (723.4); bilateral [sacroiliac] syndrome (720.2) 

conditions be denied as the medical evidence of record does not support that these 

conditions claimed are due to the March 2, 2012 work injury. 

Your claim has been accepted for sacral sprain.” 

LEGAL PRECEDENT 

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

elements of his or her claim including the fact that the individual is an “employee of the United 

States” within the meaning of FECA, 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 specific condition for which compensation is claimed are causally related to the 

employment injury.5

 The medical evidence required to establish a causal relationship between a 

specific condition and an employment injury is rationalized medical opinion evidence. The 

opinion of the physician must be based on a complete factual and medical background of the 

claimant, 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.6

 5 J.F., Docket No. 09-1061 (issued November 17, 2009). 

6 See E.J., Docket No. 09-1481 (issued February 19, 2010). 
5

OWCP procedure provides that an OWCP medical adviser’s primary medical functions 

are evaluating medical evidence and interpreting physician reports. The claims examiner seeks 

evaluation from the medical adviser in order to proceed with developing and weighing the 

medical evidence. The claims examiner must always maintain responsibility for the case and 

should not consult the medical adviser to adjudicate claims or determine benefit entitlement, as 

these are primary functions of the claims examiner. The medical adviser has no authority to 

decide the facts in a case, as this is a function of the claims examiner. However, the medical 

adviser may state whether an accepted incident was competent to produce the injury claimed.7

ANALYSIS 

On March 30, 2010 appellant filed a traumatic injury claim alleging that she sustained 

multiple injuries at work on March 2, 2010 when the vehicle in which she was a passenger was 

rear-ended by another vehicle. OWCP accepted her claim for thoracic or lumbosacral neuritis or 

radiculitis, lumbar sprain, cervicalgia, lumbago, and degeneration of lumbar or lumbosacral 

intervertebral disc. 

Appellant received treatment for her medical condition by numerous attending 

physicians. In an August 13, 2013 report, Dr. Chavda, an attending Board-certified orthopedic 

surgeon, indicated that he was examining her for the first time and noted that she reported that 

she had a motor vehicle accident back in 2010 when she was a passenger in a vehicle that was 

rear-ended at a stop light by a vehicle traveling at a speed “greater than 5 to 10 miles per hour.” 

He reported his findings on examination and diagnosed chronic low back pain and lumbago with 

lumbosacral disc disorder, lumbosacral sprain/strain, bilateral leg radiculopathy (right more than 

left), possible facet arthropathy, bilateral sacroiliac joint pain (right more than left), cervicalgia 

with trapezium and levator scapulae, and rule out herniated disc with radiculopathy. 

Dr. Chavda submitted an amended notation on August 21, 2013 which stated, “Based on 

my examination, medical records, and imaging studies, I request upgrade of [Department of 

Labor] codes to include facet arthropathy (724.8), herniated disc cervical (722.0) with radicular 

pain (723.4), bilateral [sacroiliac] syndrome (720.2), sacroiliitis (847.3), sprain of the sacrum 

(824.6), and disorders of the sacrum (724.6).” 

Appellant requested that the conditions related to her March 2, 2010 work injury be 

upgraded to include the conditions denoted in Dr. Chavda’s August 21, 2013 addendum report. 

On May 22, 2014 Dr. Blum, a Board-certified orthopedic surgeon and OWCP medical adviser, 

noted, “It is my opinion the information in the record does no support the requested upgrades 

including facet arthropathy, herniated cervical disc, and cervical radicular pain. It is my opinion 

Dr. Chavda’s requested upgraded diagnoses are the result of aging and not the result of the 

accepted work-related injury of March 2, 2010.” Dr. Blum also stated, “It is also my opinion the 

requested upgrade to include sacral sprain is medically reasonable. The remainder of requested 

sacral diagnoses are medically redundant.” In a June 4, 2014 decision, OWCP denied 

appellant’s request to expand the claim beyond the acceptance of a sacral sprain. 

 7

 Federal (FECA) Procedure Manual, Part 2 -- Claims, Developing and Evaluating Medical Evidence, Chapter 

2.810.8(b), (c) (September 2010). 
6

The Board finds that appellant has not met her burden of proof to establish that additional 

medical conditions should be accepted due to her March 2, 2010 work injury. Appellant did not 

establish that the conditions of facet arthropathy, herniated cervical disc with radicular pain, 

bilateral sacroiliac syndrome, sacroiliitis, sprain of the sacrum, and disorders of the sacrum were 

related to her March 2, 2010 work injury. 

Although Dr. Chavda indicated in his August 21, 2013 addendum report that these 

conditions should be accepted as related to the March 2, 2010 work injury, his opinion is of 

limited probative value because he did not provide any medical rationale in support of this 

opinion.8

 He did not provide any explanation as to why these conditions were work related. 

Dr. Chavda did not discuss the March 2, 2010 vehicular accident in any great detail or explain 

how it could have been competent to cause these conditions. Such medical rationale is especially 

necessary in the present case because a number of these medical conditions were not diagnosed 

until a significant amount of time had passed since the March 2, 2010 vehicular accident. 

Dr. Chavda first examined appellant more than three years after the March 2, 2010 accident and 

his August 12 and 21, 2013 reports lack rationale, as he did not explain why these additional 

medical conditions were not due to some nonwork-related cause, such as natural age-related 

progression. 

On appeal, counsel argued that OWCP wrongly denied appellant’s claim for additional 

accepted work conditions by impermissibly finding that the weight of the medical evidence 

rested with the medical adviser, Dr. Blum. He cited OWCP precedent which discussed the role 

of OWCP medical advisers in evaluating medical evidence, including the limits of that role.9

 

The Board notes that counsel’s argument in this regard is misplaced because appellant’s claim 

was not denied on the basis that the weight of the medical evidence rested with Dr. Blum, but 

rather on the basis that she had not submitted sufficient rationalized medical evidence showing 

that the claimed additional medical conditions were related to her March 2, 2010 work injury. 

Appellant may submit new evidence or argument with a written request for 

reconsideration to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) 

and 20 C.F.R. §§ 10.605 through 10.607. 

CONCLUSION 

The Board finds that appellant did not meet her burden of proof to establish that medical 

conditions should be accepted as related to her March 2, 2010 work injury in addition to those 

already accepted. 

 8 See supra note 6. 

9 See supra note 7. 
7

ORDER 

IT IS HEREBY ORDERED THAT the June 4, 2014 decision of the Office of Workers’ 

Compensation Programs is affirmed. 

Issued: February 9, 2015 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board