United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.G., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Buffalo, NY, Employer 

__________________________________________ 

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Docket No. 15-1468 

Issued: October 7, 2015 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On June 29, 2015 appellant filed a timely appeal from an April 28, 2015 merit decision of 

the Office of Workers’ Compensation Programs (OWCP) denying his occupational disease 

claim. 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 met his burden of proof to establish that he developed a 

back injury as a result of his federal employment duties. 

 1

 5 U.S.C. § 8101 et seq.

2

 The Board notes that appellant submitted additional evidence after OWCP rendered its April 28, 2015 decision. 

The Board’s jurisdiction is limited to reviewing the evidence that was before OWCP at the time of its final decision. 

Therefore, this additional evidence cannot be considered by the Board. 20 C.F.R. § 510.2(c)(1); Dennis E. Maddy, 

47 ECAB 259 (1995); James C. Campbell, 5 ECAB 35, 36 n.2 (1952). 
2

FACTUAL HISTORY 

On January 24, 2015 appellant, then a 56-year-old seasonal mail handler, filed an 

occupational disease claim (Form CA-2) alleging that he developed a back strain as a result of 

his federal employment duties. He first became aware of his condition and of its relationship to 

his employment on December 10, 2014. 

By letters dated January 23 and 28, 2015, the employing establishment controverted the 

claim stating that appellant did not notify his supervisor about the injury until one month later 

when he was no longer employed by the employing establishment. It further stated that he was a 

temporary employee who was hired to support the regular workforce during the holiday season. 

In a February 16, 2015 diagnostic report, Dr. Gregory Dieudonne, a Board-certified 

diagnostic radiologist, reported that frontal and lateral radiographs of the lumbar spine revealed 

normal lumbar lordosis, mild convex right curvature at L3, lumbarization of the S1 vertebral 

body, no fractures, no spondylosis, preserved vertebral body heights, mild disc space narrowing 

at L5-S1, rudimentary S1-2 disc, and mild facet joint arthropathy at L4-5 and L5-S1. 

In a February 16, 2015 work status summary note, Anne Schwalm, a nurse practitioner, 

diagnosed work-related back sprain. 

In reports dated February 19 to 24, 2015, Dr. Jacob Loturco, a treating chiropractor, 

reported that appellant was working as a package handler for the employing establishment and 

was loading and unloading boxes weighing approximately 50 pounds when he strained his back 

on December 10, 2014. He diagnosed lumbar sprain, nonallopathic lesions of lumbar region, 

nonallopathic lesions of pelvic region, and pain in limb. Dr. Loturco noted that an x-ray revealed 

mild degenerative joint disease generalized at L4-5 and L5-S1, negative fracture dislocation, and 

negative pathologic process. He checked the box marked “yes” when asked if the incident 

described was the competent cause of the medical injury. 

By letter dated March 6, 2015, OWCP informed appellant that the evidence of record was 

insufficient to support his claim. Appellant was advised that a chiropractor did not qualify as a 

physician under FECA unless there is a diagnosed spinal subluxation as demonstrated by x-ray to 

exist. He was further instructed on the medical and factual evidence needed and was provided 

30 days to respond. 

In reports dated February 16 to March 26, 2015, Ms. Schwalm reported that appellant 

complained of back pain which began on December 10, 2014 after lifting and moving boxes for 

days during the holiday season. She diagnosed work-related back sprain. 

Chiropractic progress notes dated February 19 to March 27, 2015 were also submitted. 

These notes were unsigned and did not diagnose a spinal subluxation, based upon x-ray. 

In a March 28, 2015 narrative statement, appellant described his employment duties as a 

seasonal mail handler. 

By letter dated April 2, 2015, the employing establishment reported that appellant was a 

seasonal casual mail handler and provided an official position description describing his 
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employment duties. It noted that he was required to lift packages, push equipment, and was 

allowed to rotate jobs from loading on the belt, scanning packages, and sorting mail. 

By decision dated April 28, 2015, OWCP denied appellant’s claim finding that the 

medical evidence of record failed to establish that a medical condition was caused by the 

accepted federal employment duties. 

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 filed within the applicable time 

limitation; that an injury was sustained while 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 every compensation claim regardless of 

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

In order to determine whether an employee actually sustained an 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 which must be considered in 

conjunction with one another. The first component to be established is that the employee 

actually experienced the employment incident which is alleged to have occurred.5 The second 

component is whether the employment incident caused a personal injury and generally can be 

established only by medical evidence. 

To establish that an injury was sustained in the performance of duty in a claim for 

occupational disease, an employee must submit: (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 

To establish a causal relationship between the condition, as well as any attendant 

disability claimed and the employment event or incident, the employee must submit rationalized 

medical opinion evidence based on a complete factual and medical background, supporting such 

a causal relationship.7

 The opinion of the physician 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. This 

 3 Gary J. Watling, 52 ECAB 278 (2001); Elaine Pendleton, 40 ECAB 1143, 1154 (1989). 

4 Michael E. Smith, 50 ECAB 313 (1999). 

5 Elaine Pendleton, supra note 3. 

6 See Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. Fish, 46 ECAB 276, 279 (1994). 

7 See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983). 
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medical opinion must include an accurate history of the employee’s employment injury and must 

explain how the condition is related to the injury. The weight of medical evidence is determined 

by its reliability, its probative value, its convincing quality, the care of analysis manifested, and 

the medical rationale expressed in support of the physician’s opinion.8

ANALYSIS 

OWCP accepted that appellant engaged in repetitive activities as a seasonal mail handler. 

The issue, therefore, is whether appellant submitted sufficient medical evidence to establish that 

the employment activities caused a back injury. The Board finds that he failed to submit 

sufficient medical evidence to support that he sustained a back injury causally related to factors 

of his federal employment as a seasonal mail handler.9 

The only medical evidence appellant submitted from a physician was Dr. Dieudonne’s 

February 16, 2015 diagnostic report. This report is insufficient to establish his claim as the 

physician only provided diagnostic findings, but failed to offer any medical opinion regarding 

causal relationship. Dr. Dieudonne’s report did not provide a history of injury and did not 

explain, with medical rationale, how appellant’s employment duties would have caused any of 

the diagnosed conditions. Lacking an opinion regarding causal relationship, Dr. Dieudonne’s 

report is of limited probative value.10 

Appellant also submitted reports for the period February 19 to March 27, 2015 from 

Dr. Loturco, his treating chiropractor. Dr. Loturco reported that appellant was working as a 

package handler for the employing establishment and was loading and unloading boxes weighing 

approximately 50 pounds when he strained his back on December 10, 2014. He noted that an xray of the lumbar spine revealed mild degenerative joint disease at L4-5 and L5-S1 and 

diagnosed lumbar sprain. Dr. Loturco checked the box marked “yes” when asked if the incident 

described was the competent cause of the medical injury. 

In assessing the probative value of chiropractic evidence, the initial question is whether 

the chiropractor is considered a physician under 5 U.S.C. § 8101(2). A chiropractor is not 

considered a physician under FECA unless it is established that there is a spinal subluxation as 

demonstrated by x-ray to exist.11 The evidence does not reflect that Dr. Loturco diagnosed 

subluxation based on the results of an x-ray.12 While Dr. Loturco reviewed lumbar x-rays, his 

 8 James Mack, 43 ECAB 321 (1991). 

9 See Robert Broome, 55 ECAB 339 (2004). 

10 See C.W., Docket No. 15-1011 (issued August 20, 2015). 

11 See Kathryn Haggerty, 45 ECAB 383 (1994). 

12 Section 8101(2) of FECA provides as follows: “(2) ‘physician’ includes surgeons, podiatrists, dentists, clinical 

psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined 

by State law. The term ‘physician’ includes chiropractors only to the extent that their reimbursable services are 

limited to treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by 

x-ray to exist and subject to regulation by the secretary.” See Merton J. Sills, 39 ECAB 572, 575 (1988). 
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lumbar sprain diagnosis does not constitute probative medical evidence as he does not meet the 

statutory definition of a physician.13

The remaining medical evidence of record is also insufficient to establish appellant’s 

claim. Ms. Schwalm’s February 16 to March 26, 2015 treatment notes were not signed by a 

physician. Registered nurses, physical therapists, and physician assistants, are not physicians as 

defined under FECA, and their opinions are therefore of no probative value.14 The Board notes 

that while some of Ms. Schwalm’s reports were cosigned, it could not be discerned regarding 

whether a physician signed or authored the document.15 

On appeal, appellant argues that the reports submitted from Ms. Schwalm and 

Dr. Loturco are sufficient to establish his claim. As previously noted, he must submit medical 

evidence from a qualified physician as defined under FECA.16 Appellant further argues that 

Dr. Bruce Barron, Board-certified in occupational medicine, reviewed and countersigned all 

reports provided by Ms. Schwalm. The Board notes that the medical evidence submitted prior to 

OWCP’s April 28, 2015 decision did not indicate that the reports were countersigned by 

Dr. Barron.17 As such they are of no probative value. 

In the instant case, the record is without rationalized medical evidence establishing that 

appellant has a diagnosed medical condition causally related to the accepted federal employment 

duties. OWCP advised appellant of the type of medical evidence required to establish his claim; 

however, he failed to submit such evidence. The Board has held that the mere fact that a 

condition manifests itself during a period of employment does not raise an inference of causal 

relation.18 An award of compensation may not be based on surmise, conjecture, speculation, or 

on the employee’s own belief of causal relation.19 To establish causal relationship, appellant 

must submit a physician’s report in which the physician reviews those factors of employment 

alleged to have caused his condition and, taking these factors into consideration, as well as 

findings upon examination and his medical history, explain how these employment factors 

caused or aggravated any diagnosed condition, and present medical rationale in support of his 

opinion.20 Thus, he has failed to meet his burden of proof. 

 13 L.S., Docket No. 07-560 (issued June 22, 2007). See also Alberta S. Williamson, 47 ECAB 569 (1996) (the 

Board has held that an opinion on causal relationship which consists only of a physician checking “yes” on a 

medical form report without further explanation or rationale is of diminished probative value). 

14 Supra note 11. See also Roy L. Humphrey, supra note 6. 

15 See also Sheila A. Johnson, 46 ECAB 323, 327 (1994); see Merton J. Sills, supra note 12. 

16 Supra note 11. 

17 Supra note 14. 

18 Daniel O. Vasquez, 57 ECAB 559 (2006). 

19 D.D., 57 ECAB 734 (2006). 

20 See L.M., Docket No. 14-973 (issued August 25, 2014); R.G., Docket No. 14-113 (issued April 25, 2014); 

K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-548 (issued November 16, 2012). 
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CONCLUSION 

The Board finds that appellant failed to meet his burden of proof to establish that he 

developed a back injury as a result of his federal employment duties. 

ORDER 

IT IS HEREBY ORDERED THAT the April 28, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: October 7, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board