United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

P.F., Appellant 

and 

DEPARTMENT OF JUSTICE, U.S. MARSHALS 

SERVICE, San Diego, CA, Employer 

__________________________________________ 

) 

) 

) 

) 

) 

) 

) 

) 

Docket No. 14-1295 

Issued: September 16, 2014 

Appearances: Case Submitted on the Record

David A. Testone, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On May 13, 2014 appellant, through counsel, filed a timely appeal from an April 3, 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.2

ISSUE 

The issue is whether appellant sustained an occupational disease causally related to 

factors of her employment. 

 1

 5 U.S.C. § 8101 et seq.

2

 The Board notes that appellant submitted additional evidence following the April 3, 2014 decision. Since the 

Board’s jurisdiction is limited to evidence that was before OWCP at the time it issued its final decision, the Board 

may not consider this evidence for the first time on appeal. See 20 C.F.R. § 501.2(c); Sandra D. Pruitt, 57 ECAB 

126 (2005). Appellant may submit that evidence to OWCP along with a request for reconsideration. 
2

FACTUAL HISTORY 

On January 13, 2014 appellant, then a 49-year-old administrative support assistant, filed 

an occupational disease claim alleging that she experienced pain on her neck, shoulders, arms, 

and both hands and tingling on her fingers, legs and knees as a result of daily computer key entry 

and processing of documents. She first became aware of her condition and realized it resulted 

from her employment on June 17, 2013. Appellant’s supervisor noted on the claim form that she 

was last exposed to these work conditions on January 15, 2014.3 

In a June 17, 2013 report, Dr. Richard Mantell, a Board-certified internist, related 

appellant’s complaints of pain in her neck, low back, right shoulder and right hand along with 

numbness and tingling of her right upper extremity. He stated that appellant worked as an 

administrative support assistant who performed duties of receiving, reviewing, coordinating, 

maintaining, monitoring and recording a variety of criminal case actions; initiating all necessary 

documentation to complete the enforcement of the action; serving as the district focal point for 

prisoner movement services; and receiving criminal writs, court orders, detainers, judgment and 

commitment orders. Dr. Mantell noted that appellant’s work involved repetitive movement of 

the arms, shoulders, neck and low back. He opined that because of appellant’s job duties and 

pain related to her work it seemed reasonable that the repetitive motions that her job entailed 

contributed to the pain in her cervical, lumbar, right shoulder and right wrist. Upon examination 

of the lumbar spine, Dr. Mantell observed mild-to-moderate tenderness at bilateral trapezius and 

lumbar paraspinal musculature. Sensation was intact and strength measured 3/5. Dr. Mantell 

also provided findings for cervical and lumbar range of motion. He stated that appellant’s 

injuries that she sustained from her job had responded reasonably well to injection therapy, 

physical therapy, pain management and chiropractic treatments. Dr. Mantell recommended that 

she continue this treatment along with pain management once a month as needed. 

In July 12 and August 16, 2013 reports, Robert Paul, a certified physician’s assistant, 

stated that appellant received trigger point injections for cervical paraspinals and trapezius 

muscles. He noted diagnoses of unspecified vertiginous syndromes and labyrinthine disorders, 

pain in joint involving shoulder region, intervertebral disc disorder with myelopathy, lumbago 

and unspecified sleep disturbance. 

In November 22 and December 16, 2013 electrodiagnostic and nerve conduction study 

(NCV) reports, Mr. Paul noted a presumptive diagnosis of pain associated with cervical 

plexopathy without motor deficit. He reported higher than average measures of the right greater 

occipital nerve, +1 mild, the left greater occipital nerve, +2, right suprascapular nerve, +4, and 

right radial nerve lateral branch, +2. Mr. Paul noted lower than average measures of the left 

ulnar nerve, -1, right second thoracic nerve, -1, and left second thoracic nerve, -1. He stated that 

the lower than average measures suggested irritation which warranted investigation. 

In physical therapy reports dated December 6, 2013 to January 10, 2014, James Ward, a 

physical therapist, related appellant’s complaints of cervical and low back pain with numbness 

and tingling of right upper extremity, especially during work-related computer data entry. He 

 3

 The record reveals that appellant previously filed a traumatic injury claim on December 9, 2013. 
3

noted that appellant had been under his care since June 17, 2013 due to cervical and lumbar pain 

with radiculopathy. Mr. Ward provided a diagnosis of cervical and lumbar pain with 

radiculopathy. He provided findings on examination and work restrictions and recommended a 

treatment plan. 

Appellant provided a position description for an administrative support assistant. 

In a January 10, 2014 prescription note, Mr. Paul stated that appellant needed medical 

treatment for her carpal tunnel syndrome, lumbago and degenerative cervical and bilateral wrist 

osteoarthritis. 

On February 4, 2014 OWCP advised appellant that the evidence submitted was 

insufficient to establish her claim. It requested additional medical evidence from a physician to 

establish a diagnosed condition as a result of her employment duties. 

In a February 7, 2014 report, Dr. Milnes R. Henson, a Board-certified family practitioner, 

stated that appellant was his patient. He reported that appellant had a diagnosis of cervical 

spondylosis. Dr. Henson noted that appellant was referred to physical therapy by Dr. Patrick 

Kearney, a neurosurgeon. 

In a decision dated April 3, 2014, OWCP denied appellant’s claim. It accepted that 

appellant worked as an administrative support assistant and was diagnosed with various medical 

conditions but denied her claim finding insufficient medical evidence to establish that her 

conditions were causally related to her employment duties. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of her claim by the weight of the reliable, probative and substantial evidence4

including that she sustained an injury in the performance of duty and that any specific condition 

or disability for work for which she claims compensation is causally related to that employment 

injury.5

 In an occupational disease claim, appellant’s burden requires submission of the 

following: (1) a factual statement identifying employment factors alleged to have caused or 

contributed to the presence or occurrence of the disease or condition; (2) medical evidence 

establishing the presence or existence of the disease or condition for which compensation is 

claimed; and (3) medical evidence establishing that the diagnosed condition is causally related to 

the employment factors identified by the employee.6

Causal relationship is a medical issue and the medical evidence generally required to 

establish causal relationship is rationalized medical opinion evidence.7

 The opinion of the 

 4 J.P., 59 ECAB 178 (2007); Joseph M. Whelan, 20 ECAB 55, 58 (1968). 

5 M.M., Docket No. 08-1510 (issued November 25, 2010); G.T., 59 ECAB 447 (2008); Elaine Pendleton, 40 

ECAB 1143, 1145 (1989). 

6 R.H., 59 ECAB 382 (2008); Ernest St. Pierre, 51 ECAB 623 (2000). 

7 I.R., Docket No. 09-1229 (issued February 24, 2010); D.I., 59 ECAB 158 (2007). 
4

physician must be based on a complete factual and medical background of the employee, 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 employee.8

 

ANALYSIS 

Appellant alleges that she sustained chronic pain in her neck, shoulders, arms, hands and 

fingers as a result of her repetitive duties as an administrative support assistant. OWCP accepted 

her duties as an administrative support assistant and that appellant was diagnosed with cervical 

spondylosis. It denied her claim finding insufficient medical evidence to establish that her 

diagnosed condition was causally related to factors of her employment. The Board finds that 

appellant did not meet her burden of proof to establish an occupational disease as a result of her 

employment duties. 

The June 17, 2013 report by Dr. Mantell related appellant’s complaints of pain in her 

neck, low back, right shoulder and right hand. He described her duties as an administrative 

support assistant and noted that her work involved repetitive movements of the arms, shoulders, 

neck and low back. Dr. Mantell provided physical findings on examination. He opined that 

because of appellant’s job duties and pain related to her work it seemed reasonable that the 

repetitive motions that her job entailed contributed to the pain in her cervical, lumbar, right 

shoulder and right wrist. The Board notes that, although Dr. Mantell attributes appellant’s pain 

to her repetitive duties as an administrative support assistant, he does not provide a medical 

diagnosis other than pain.9

 Furthermore, his opinion that it “seemed reasonable” that appellant’s 

employment duties contributed to her painful conditions is speculative and equivocal. 

Dr. Mantell does not affirmatively conclude that appellant sustained an occupational disease as a 

result of her employment duties. The Board has held that medical opinions that are speculative 

or equivocal in character are of diminished probative value.10 An award of compensation may 

not be based on surmise, conjecture, speculation or upon appellant’s own belief that there is 

causal relationship between his claimed condition and his employment.11 For these reasons, 

Dr. Mantell’s report is insufficient to establish causal relationship. 

Appellant also provided a February 7, 2014 report by Dr. Henson, who diagnosed 

cervical spondylosis. He does not, however, provide any opinion on the cause of appellant’s 

condition. The Board has held that medical evidence that does not offer any opinion regarding 

 8

 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 465 (2005). 

9

 Pain is a description of a symptom and not considered a compensable medical diagnosis. B.P., Docket No. 

12 1345 (issued November 13, 2012); C.F., Docket No. 08-1102 (issued October 2008). 

10 D.D., 57 ECAB 734, 738 (2006); Kathy A. Kelley, 55 ECAB 206 (2004). 

11 Robert A. Boyle, 54 ECAB 381 (2003); Patricia J. Glenn, 53 ECAB 159 (2001). 
5

the cause of an employee’s condition is of limited probative value on the issue of causal 

relationship.12 Accordingly, Dr. Henson’s report fails to establish appellant’s claim. 

The additional treatment reports by Mr. Paul, a certified physician assistant, and 

Mr. Ward, a physical therapist, are also insufficient to establish appellant’s claim as they are not 

considered “physicians” under FECA. Section 8102(2) provides that the term “physician” 

includes surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors and 

osteopathic practitioners within the scope of their practice as defined by State law. As 

physician’s assistants and physical therapists are not “physicians” as defined by FECA, their 

medical opinions regarding diagnosis and causal relationship are of no probative medical value.13 

CONCLUSION 

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

sustained an occupational disease as a result of factors of her employment. 

ORDER 

IT IS HEREBY ORDERED THAT the April 3, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: September 16, 2014 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 12 C.B., Docket No. 09-2027 (issued May 12, 2010); J.F., Docket No. 09-1061 (issued November 17, 2009); A.D., 

58 ECAB 149 (2006). 

13 5 U.S.C. § 8101(2); Roy L. Humphrey, 57 ECAB 238 (2005).