United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

A.S., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

White Plains, NY, Employer 

__________________________________________ 

) 

) 

) 

) 

) 

) 

) 

) 

Docket No. 15-0614 

Issued: June 25, 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 

COLLEEN DUFFY KIKO, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On January 26, 2015 appellant filed a timely appeal from an August 20, 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 his burden of proof to establish that he sustained a 

back condition causally related to the January 25, 2014 employment incident. 

FACTUAL HISTORY 

On January 25, 2014 appellant, then a 59-year-old mail carrier, filed a traumatic injury 

claim alleging that he slipped on ice and fell in the performance of duty. He stated that on 

January 25, 2015 at approximately 12:25 p.m., he was walking out the front door when he 

slipped and fell hard on ice on the sidewalk. Appellant’s back hit the ground hard and he heard 

 1

 5 U.S.C. § 8101 et seq.
2

an audible snapping sound. He partially broke the fall with his left palm and bruised it. 

Appellant drove himself back to the employing establishment’s office and requested to go to the 

emergency room. He stopped work on January 25, 2014. 

Appellant was initially treated in the emergency room by Dr. Jeffrey Mayer, Boardcertified in emergency medicine. In a January 25, 2014 report, Dr. Mayer stated that appellant 

was walking his route as a mailman when he slipped on ice and fell on his lower back. He 

related that appellant heard a pop/crack sound and experienced pain. Dr. Mayer reviewed 

appellant’s history and noted that he had a history of ankylosing spondylitis. Upon examination 

of appellant’s lumbar spine, he observed tenderness and kyphosis. Dr. Mayer reported full range 

of motion of the extremities and no tenderness. He reviewed appellant’s computerized 

tomography (CT) scan of the lumbar spine and diagnosed chronic lower back pain.2

 Dr. Mayer 

concluded that appellant was a 59-year-old male with a history of ankylosing spondylitis who 

fell at work and now had lower back pain. 

On January 30, 2014 Dr. Jason A. Melnick, Board-certified in physical medicine and 

rehabilitation, related appellant’s complaints of low back pain after a fall on Saturday. He noted 

that appellant was a postal worker who slipped on ice and went to the emergency room. 

Dr. Melnick noted appellant’s history of ankylosing spondylosis and increased thoracic kyphosis. 

He reviewed appellant’s CT scan report which revealed degenerative disc changes and diffuse 

osteopenia. Upon examination, Dr. Melnick observed tenderness to palpation of the thoracic 

kyphosis and abnormal range of motion of appellant’s lumbar spine. Straight leg raise testing 

and Patrick’s test were both negative. Dr. Melnick referred appellant to physical therapy. In a 

work status note, he stated that appellant was unable to work until February 21, 2014. 

In a letter dated February 20, 2014, OWCP advised appellant that the evidence submitted 

was insufficient to establish his traumatic injury claim. It requested additional medical evidence 

to demonstrate that he sustained a diagnosed medical condition as a result of the January 25, 

2014 employment incident. 

Dr. Melnick reexamined appellant on February 19, 2014 and related that he was doing 

better since his fall last week, but still complained of nonradicular low back pain. He reviewed 

the lumbar CT scan report and noted an old compression fracture and ankylosing spondylosis. In 

a work status note, Dr. Melnick requested that appellant be excused from work until physical 

therapy was approved. 

On March 6, 2014 OWCP advised appellant via telephone that additional medical 

evidence was needed as indicated in the February 20, 2014 development letter. Appellant stated 

that additional medical evidence was sent. He also explained that he had a preexisting condition 

that was aggravated by the January 25, 2014 fall. 

In a decision dated March 26, 2014, OWCP denied appellant’s traumatic injury claim. It 

accepted that the January 25, 2014 employment incident occurred as alleged, but denied the 

 2

 In a January 25, 2014 CT scan examination of appellant’s lumbar spine, Dr. Sai C. Park, a Board-certified 

diagnostic radiologist, observed mild-to-moderate degenerative disc disease at L2-3 and degenerative disc disease at 

L3-4. He also noted compression deformity of L1 body with no retroversion, which he stated may be chronic in 

nature. 
3

claim finding insufficient medical evidence to demonstrate that he sustained a diagnosed 

condition causally related to the incident. 

In a May 21, 2014 statement, received by OWCP on May 27, 2014, appellant requested 

reconsideration. He stated that Dr. Melnick provided medical evidence of a causal relationship 

between his injury and the January 25, 2014 fall on ice. Appellant also reported that his 

physicians recommended a thoracic x-ray and physical therapy. He explained that it was a 

financial burden on himself and his family to pay for all his medical expenses out of pocket and 

to pay back the initial 45-day waiting period. 

In a handwritten April 18, 2014 work status note, Dr. Melnick reported that appellant was 

unable to work. He reevaluated him on May 6, 2014 and stated that he was undergoing physical 

therapy three times a week. Dr. Melnick opined that appellant should improve and make a full 

recovery through physical therapy. 

Appellant was also examined by Dr. Andrew M. Peretz, a Board-certified orthopedic 

surgeon. In an April 24, 2014 report, Dr. Peretz stated that appellant was improving from his 

fall, but continued to have some right lower lumbar pain. He reported that a CT scan showed 

that appellant had ankylosing spondylitis. Upon examination, Dr. Peretz observed that appellant 

walked in a flexed position which was consistent with his ankylosing spondylitis. He diagnosed 

right lower lumbar pain and opined that it appeared to be related to a fall. 

In an April 25, 2014 narrative report, Dr. Melnick related that appellant was examined on 

January 30, 2014 for low back pain following a slip and fall on ice on Saturday while at work as 

a postal officer. He noted that appellant went to the emergency room where a CT scan was done 

that revealed diffuse osteopenia, severe disc degeneration, and bony changes of ankylosing 

spondylitis. Dr. Melnick reviewed the medical treatment appellant received. He also stated that 

prior to the January 30, 2014 visit he had seen appellant two and a half years prior, in 2011, 

when he was treated for nonradicular low back pain and ankylosing spondylitis. Appellant 

received treatment for his ankylosing spondylitis and had not experienced back pain until his 

January 2014 slip and fall. Dr. Melnick explained that at the time of his examination appellant 

suffered from low back pain, ankylosing spondylitis, moderate degenerative disc disease with 

severe posterior spurring, severe disc narrowing at L4-5, diffuse osteopenia, fusion of disc spaces 

throughout the lumbar spine, and compression deformity likely chronic in nature. He found that 

appellant had a “causal relationship of his new-onset acute low back pain to his fall on ice.” 

Dr. Melnick explained that appellant was doing well from his back pain since his treatment and 

the pain did not slowly return in time, but was explosive in nature after his fall. He noted that at 

the time of the January 2014 injury appellant had not had any back pain in the three years prior 

to that fall. 

Dr. Melnick reported in a July 3, 2014 work status note that appellant had a procedure for 

his back and would return to work on July 11, 2014. 

By decision dated August 20, 2014, OWCP denied modification of the March 26, 2014 

denial decision. 
4

LEGAL PRECEDENT 

An employee seeking benefits under FECA3 has the burden of proof to establish the 

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

evidence4

 including that he or she sustained an injury in the performance of duty and that any 

specific condition or disability for work for which he or she claims compensation is causally 

related to that employment injury.5

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, it first must be determined whether “fact of injury” has been established.6 

There are two components involved in establishing the fact of injury. First, the employee must 

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

incident at the time, place, and in the manner alleged.7 Second, the employee must submit 

evidence, generally only in the form of probative medical evidence, to establish that the 

employment incident caused a personal injury.8 An employee may establish that the 

employment incident occurred as alleged, but fail to show that his or her disability or condition 

relates to the employment incident.9

Under FECA, when employment factors cause an aggravation of an underlying physical 

condition, the employee is entitled to compensation for the periods of disability related to the 

aggravation.10 Where the medical evidence supports an aggravation or acceleration of an 

underlying condition precipitated by working conditions or injuries, such disability is 

compensable.11 However, the normal progression of untreated disease cannot be stated to 

constitute aggravation of a condition merely because the performance of normal work duties 

reveals the underlying condition.12 For the conditions of employment to bring about an 

aggravation of preexisting disease, the employment must cause acceleration of the disease or 

precipitate disability. When the aggravation is temporary and leaves no permanent residuals, 

compensation is not payable for periods after the aggravation ceased.13

 3

 5 U.S.C. §§ 8101-8193. 

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

5 G.T., 59 ECAB 447 (2008); Elaine Pendleton, 40 ECAB 1143, 1145 (1989). 

6 S.P., 59 ECAB 184 (2007); Alvin V. Gadd, 57 ECAB 172 (2005). 

7 Bonnie A. Contreras, 57 ECAB 364 (2006); Edward C. Lawrence, 19 ECAB 442 (1968). 

8

 David Apgar, 57 ECAB 137 (2005); John J. Carlone, 41 ECAB 354 (1989). 

9 T.H., 59 ECAB 388 (2008); see also Roma A. Mortenson-Kindschi, 57 ECAB 418 (2006). 

10 Raymond W. Behrens, 50 ECAB 221 (1999); James L. Hearn, 29 ECAB 278 (1978). 

11 A.C., Docket No. 08-1453 (issued November 18, 2008). 

12 Glenn C. Chasteen, 42 ECAB 493 (1991). 

13 Raymond W. Behrens, supra note 10. 
5

Whether an employee sustained an injury in the performance of duty requires the 

submission of rationalized medical opinion evidence.14 The opinion of the 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.15 The weight of the 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.16

ANALYSIS 

Appellant alleged that on January 25, 2014 he injured his lower back and left palm when 

he slipped on ice and fell down in the performance of duty. OWCP accepted that the incident 

occurred as alleged, but denied his traumatic injury claim finding insufficient medical evidence 

to establish that he sustained a diagnosed medical condition as a result of the employment 

incident. The Board finds that appellant did not meet his burden of proof to demonstrate that he 

sustained a diagnosed back condition causally related to the January 25, 2014 employment 

incident. 

The record reveals that in 2011 appellant was treated for low back pain that resulted from 

ankylosing spondylitis. Appellant received medical treatment and reported that he did not 

experience any more back pain until the January 25, 2014 slip and fall at work. On March 6, 

2014 he informed OWCP via telephone that his preexisting condition was aggravated by the 

January 25, 2014 fall. 

In support of his claim, appellant submitted various reports by Dr. Melnick dated 

January 25 to April 25, 2014. Dr. Melnick provided an accurate history of the January 2014 slip 

and fall at work and of appellant’s history of ankylosing spondylosis and increased thoracic 

kyphosis. Upon examination, he observed tenderness to palpation of appellant’s thoracic 

kyphosis and abnormal range of motion of appellant’s lumbar spine. Straight leg raise and 

Patrick’s test were both negative. Dr. Melnick diagnosed low back pain, ankylosing spondylitis, 

moderate degenerative disc disease with severe posterior spurring, severe disc narrowing at L4-5, 

diffuse osteopenia, fusion of disc spaces throughout the lumbar spine, and compression 

deformity likely chronic in nature. In an April 25, 2014 narrative report, he opined that appellant 

had a “causal relationship of his new-onset acute low back pain to his fall on ice.” Dr. Melnick 

noted that at the time of the January 2014 injury appellant had not had any back pain in the three 

years prior to that fall. He further explained that appellant was doing well from his back pain 

since his treatment and the pain did not slowly return in time, but was explosive in nature after 

his fall. 

The Board notes that Dr. Melnick provided an accurate history, findings on examination, 

and a diagnosis of a back condition. Dr. Melnick opined that there was a causal relationship 

 14 See J.Z., 58 ECAB 529 (2007); Paul E. Thams, 56 ECAB 503 (2005). 

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

16 James Mack, 43 ECAB 321 (1991). 
6

between appellant’s low back symptoms and the January 2014 slip and fall on ice. The Board 

finds, however, that he did not provide sufficient medical rationale explaining how appellant’s 

slip and fall at work aggravated his previous back condition or caused a new condition.17 The 

only explanation that Dr. Melnick provided was that appellant was doing well before the fall and 

had not experienced back pain until the January 2014 injury. He did not explain how the slip and 

fall incident would have aggravated the preexisting back condition or caused any newly 

diagnosed medical condition. The Board has held that an opinion that a condition is causally 

related because the employee was asymptomatic before the injury is insufficient, without 

sufficient rationale, to establish causal relationship.18 

Appellant also received treatment in the emergency room by Dr. Mayer who related that 

appellant had a history of ankylosing spondylitis and recently slipped on ice and fell on his lower 

back. He conducted an examination and diagnosed chronic lower back pain. Dr. Mayer reported 

that appellant was a 59-year-old male with a history of ankylosing spondylitis who fell at work 

and now had lower back pain. Although he accurately described the January 25, 2014 slip and 

fall at work and provided physical examination findings, he did not provide any diagnosis of a 

back condition other than back pain.19 Furthermore, Dr. Mayer does not provide any opinion on 

the cause of appellant’s back symptoms. The Board has held that medical evidence that does not 

offer any opinion regarding the cause of an employee’s condition is of limited probative value on 

the issue of causal relationship.20 Likewise, Dr. Park’s January 25, 2014 CT scan diagnostic 

report is also insufficient to establish causal relationship as he does not provide any opinion on 

the cause of appellant’s back conditions. 

In an April 24, 2014 report, Dr. Peretz noted that appellant was improving from his 

injury, but continued to complain of right lower lumbar pain. He related that a CT scan showed 

that appellant had ankylosing spondylitis. Dr. Peretz diagnosed right lower lumbar pain and 

opined that it appeared to be related to a fall. The Board notes that he also failed to provide a 

diagnosed condition, other than back pain. Furthermore, Dr. Peretz’s opinion that appellant’s 

back symptoms “appeared to be” related to the January 25, 2014 incident is speculative in nature. 

The Board has held that medical opinions that are speculative or equivocal in character are of 

diminished probative value.21 

On appeal appellant alleges that the evidence is sufficient to accept his claim. He 

specifically quoted several paragraphs of Dr. Melnick’s narrative report as evidence of a causal 

relationship. As stated above, however, Dr. Melnick’s reports lack the level of probative value 

necessary and are thus insufficient to establish that the January 25, 2014 employment incident 

caused his current back symptoms or aggravated his preexisting condition. An employee’s belief 

 17 Medical evidence that states a conclusion but does not offer any rationalized medical explanation regarding the 

cause of an employee’s condition is of limited probative value on the issue of causal relationship. See J.F., Docket 

No. 09-1061 (issued November 17, 2009); A.D., 58 ECAB 149 (2006). 

18 T.M., Docket No. 08-975 (issued February 6, 2009); Michael S. Mina, 57 ECAB 379 (2006). 

19 The Board has held that pain is a description of a symptom, and not considered compensable medical diagnosis. 

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

20 C.B., Docket No. 09-2027 (issued May 12, 2010); J.F., supra note 17; A.D., supra note 17. 

21 D.D., 57 ECAB 734, 738 (2006); Kathy A. Kelley, 55 ECAB 206 (2004). 
7

that the disease or condition was caused or aggravated by employment factors or incidents is 

sufficient to establish causal relationship.22 Causal relationship is a medical question that must 

be established by probative medical opinion from a physician.23 As appellant failed to provide 

such probative medical opinion in this case, the Board finds that he did not meet his burden of 

proof to establish his claim. 

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 his burden of proof to establish a back 

condition as a result of the January 25, 2014 employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the August 20, 2014 merit decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: June 25, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board 

 22 Jennifer Atkerson, 55 ECAB 317 (2004). 

23 W.W., Docket No. 09-1619 (June 2, 2010); David Apgar, supra note 8.