United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.S., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Tomball, TX, Employer 

__________________________________________ 

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Docket No. 15-0622 

Issued: September 22, 2015 

Appearances: Case Submitted on the Record

Douglas Sughrue, Esq., for the appellant

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, through counsel, filed a timely appeal of an August 25, 

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 has met her burden of proof to establish that she sustained 

an occupational disease in the performance of duty. 

FACTUAL HISTORY 

This matter has previously been before the Board.2

 On August 4, 2008 appellant, then a 

42-year-old letter carrier, filed a Form CA-2, an occupational disease claim, alleging that her 

 

 1 5 U.S.C. §§ 8101-8193. 

2

 Docket No. 11-1749 (issued April 12, 2012). 
2

preexisting pinched nerve developed into five herniated discs as a result of performing her letter 

carrier duties. She first became aware of her condition and realized it was causally related to her 

employment on December 19, 2006. Appellant did not stop work. 

Appellant submitted a July 27, 2007 magnetic resonance imaging (MRI) scan of the 

lumbar spine which revealed minimal disc bulging at L4-5, tiny central disc protrusions at 

L5-S1, and no disc herniation or nerve root impingement. On August 29, 2007 she was treated 

by Dr. Chandler Mann, a Board-certified anesthesiologist, for chronic back pain since 1995. 

Appellant reported to Dr. Mann that she was working as a letter carrier and in December she bent 

over and felt an acute searing pain in her low back with radiation into her right buttock. 

Dr. Mann noted an essentially normal examination and diagnosed lumbar facet dysfunction. In 

an October 25, 2007 report, he noted that appellant had right L3-4, L4-5, and L5-S1 facet blocks 

and had complete remittance of her pain for two weeks. Dr. Mann noted findings on 

examination and diagnosed lumbar facet syndrome and degenerative disc disease of the right L3-

4, L4-5, and L5-S1 facets. 

Dr. Leonard Trahan, a Board-certified orthopedic surgeon, administered facet blocks on 

November 1, 2007, and diagnosed low back syndrome, facet joint dysfunction. On November 28 

and December 10, 2007 he diagnosed lower back syndrome and facet joint dysfunction and 

recommended steroid and local injection of the right L3-4, L4-5 and L5-S1 facet joints. A 

July 10, 2008 computerized tomography (CT) scan of the of the lumbar spine revealed status 

post discogram from L3-S1, no contrast extravasation at L3-4 and L4-5, and probable disc 

herniation at L5-S1. 

On July 29, 2008 Dr. Stefan Pribil, a Board-certified neurosurgeon, noted that appellant 

was status post lumbar surgery and was partially disabled. 

On August 22, 2008 OWCP advised appellant of the type of factual and medical evidence 

needed to establish her claim. 

In a decision dated September 29, 2008, OWCP denied appellant’s claim finding that the 

evidence was insufficient to establish which employment factors caused an injury. 

On October 6, 2008 appellant requested a review of the written record. She submitted a 

September 5, 2007 operative report from Dr. Trahan who performed a diagnostic block for right 

L3-4, L4-5, and L5-S1 and diagnosed lower back syndrome with spondylosis and facet joint 

dysfunction. On March 20, 2008 Dr. Trahan noted the CT scan showed degenerative disc 

disease at L5-S1. On March 21, 2008 he performed radiofrequency ablation of the right L5-S1 

facet joint and diagnosed lumbar spondylosis with lower back syndrome. Appellant submitted a 

June 2, 2008 report from Dr. Mann who noted appellant’s long history of lumbar degenerative 

disc disease, spondylosis, and low back syndrome. Dr. Mann noted that appellant underwent 

several diagnostic medical branch blocks at L3-4, L4-5, L5-S1 and radiofrequency ablation of 

the right L5-Sl, but her pain recurred. He recommended a diagnostic lumbar discogram at L3-4, 

L4-5, and L5-S1. 
3

An August 7, 2008 report from Dr. Pribil noted appellant was status post-surgery3

 with 

minimal pain and spasm in the right leg. In an undated addendum, Dr. Pribil noted that the 

discogram CT showed disruption at L5-Sl and L4-5, along with delamination and fragmentation 

of the disc at L5-Sl with central extravasation. He recommended a microdiscectomy. 

In a decision dated April 8, 2009, an OWCP hearing representative found that appellant 

had established the factual element of her claim, but denied the claim because she had not 

submitted sufficient medical evidence to establish causal relationship. 

On July 13, 2009 appellant requested reconsideration. In a decision dated July 27, 2009, 

OWCP denied modification of the prior decision dated April 8, 2009. 

On November 7, 2009 appellant again requested reconsideration. She submitted a 

June 25, 2009 report from Dr. Curtis Fandrich, an osteopath, who noted her treatment for a 

medical condition directly related to her work duties. Appellant reported that her work duties 

consisted of repetitive bending, twisting, lifting, and carrying more than 10 pounds daily. 

Dr. Fandrich noted that the National Institute of Health and Occupational Safety and Health 

Administration studies revealed that these daily activities can result in work-related injuries. A 

September 9, 2009 MRI scan of the lumbar spine showed evidence of posterior annular tear at 

the L4-5 level, which could result in discogenic pain, a left lateral disc protrusion at this site in 

contact with the exiting left L4 dorsal ganglia, postoperative changes at L5-S1, and a disc bulge, 

resulting in mild-to-moderate right-sided neural foraminal encroachment. 

In a decision dated November 27, 2009, OWCP denied modification of the prior decision 

finding the medical evidence insufficient to establish causal relationship to appellant’s 

employment duties. On December 9, 2009 appellant requested reconsideration. In a decision 

dated December 29, 2009, OWCP denied her request for reconsideration finding that the 

evidence submitted was insufficient to warrant a merit review. 

On November 22, 2010 appellant requested reconsideration. She submitted a July 7, 

2010 report from Dr. Fandrich who first treated her on November 11, 2008 for bilateral lower 

back pain radiating down the right leg with numbness, tingling, and weakness. Dr. Fandrich 

noted that appellant was status post L5-S1 discectomy in July 2008. Appellant reported working 

for the employing establishment for 12 years and that she had been hired with a pinched nerve in 

her lower back from a prior lifting injury. Dr. Fandrich diagnosed right low back pain, right 

lower extremity radiculopathy, right sciatica, and hamstring somatic dysfunction. Appellant 

submitted a December 6, 2010 duty status report from Dr. Michael J. Leahy, a Board-certified 

orthopedic surgeon, who diagnosed spinal stenosis and returned appellant to work with 

restrictions. 

On February 14, 2011 OWCP denied appellant’s request for reconsideration finding that 

the evidence submitted was insufficient to warrant a merit review. 

 3

 The record does not contain an operative report regarding the referenced surgery. 
4

On July 26, 2011 appellant appealed her claim to the Board.4

 In an order dated April 12, 

2012, the Board set aside OWCP’s February 14, 2011 decision. The Board noted that it failed to 

review Dr. Leahy’s December 6, 2010 report, prior to issuing its February 14, 2011 decision. 

The Board remanded the matter so that OWCP could properly consider all evidence submitted at 

the time of the February 14, 2011 decision. 

In a decision dated August 7, 2012, OWCP noted reviewing the December 6, 2010 report 

from Dr. Leahy and denied modification of the decision dated November 27, 2009. 

On July 24, 2013 appellant requested reconsideration. She submitted a June 26, 2013 

report from Dr. Frank L. Barnes, a Board-certified orthopedic surgeon, who treated her for 

radiating lumbar pain. Dr. Barnes noted that appellant was a letter carrier and initially injured 

her back in 1996 when she lifted an obese patient. He noted that she was treated with 

medications, physical therapy, and a two-level lumbar fusion surgery in 2008. Dr. Barnes noted 

that despite surgery appellant’s pain persisted with numbness of her feet. He diagnosed 

herniated lumbar disc at L4-5 and L5-SI and a L2-3 herniated disc. Dr. Barnes noted appellant’s 

work as a letter carrier required repeated lifting which placed stress on her lumbar spine and 

caused the herniated discs and current symptoms. He opined that she could perform sedentary 

work with lifting restrictions. 

In a decision dated October 2, 2013, OWCP denied modification of the prior decision. 

On June 16, 2014 appellant, through counsel, requested reconsideration. In an April 10, 

2014 report, Dr. Barnes noted treating her for lumbar pain that radiated to her feet. Appellant 

reported working as a letter carrier and initially injuring her back in 1996 when she lifted an 

obese patient. She reported reinjuring her back at work December 19, 2006 when she bent over 

and got a “pinch in the back.” Dr. Barnes opined that appellant’s work injury aggravated the 

1996 injury. He treated her on September 12, 2013 for pain over her entire right lower extremity 

and numbness in both feet. Dr. Barnes diagnosed herniated lumbar disc at L4-5, L5-S1, and 

L2-3. He opined that appellant’s work as a letter carrier required repeated lifting of 70-pound 

objects which placed stress on her lumbar spine and caused a herniated disc and her current 

symptoms. Dr. Barnes advised that she could return to sedentary work. He opined that the 2006 

injury caused a permanent aggravation and resulted in permanent impairment of appellant’s 

lumbar spine. 

Appellant also submitted a February 4, 2013 report from Dr. Randolph Evans, a Boardcertified neurologist, who performed an electromyogram (EMG) and nerve conduction studies 

which revealed no abnormalities and no evidence of lumbosacral radiculopathy. 

In a decision dated August 25, 2014, OWCP denied modification of the prior decision. 

LEGAL PRECEDENT 

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

essential elements of his or her claim. When an employee claims that he or she sustained an 

 4 See supra note 2. 
5

injury in the performance of duty, he or she must submit sufficient evidence to establish that he 

or she experienced a specific event, incident or exposure occurring at the time, place, and in the 

manner alleged. Appellant must also establish that such event, incident, or exposure caused an 

injury.5

 

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (1) medical evidence establishing the 

presence or existence of the disease or condition for which compensation is claimed; (2) factual 

statement identifying employment factors alleged to have caused or contributed to the presence 

or occurrence of the disease or condition; and (3) medical evidence establishing that the 

employment factors identified by the claimant were the proximate cause of the condition for 

which compensation is claimed or, stated differently, medical evidence establishing that the 

diagnosed condition is causally related to the employment factors identified by claimant. The 

medical evidence required to establish causal relationship is generally rationalized medical 

opinion evidence. Rationalized medical opinion evidence is medical evidence which includes a 

physician’s rationalized opinion on the issue of whether there is a causal relationship between the 

claimant’s diagnosed condition and the implicated employment factors. 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

ANALYSIS 

It is undisputed that appellant’s work duties as a letter carrier included repetitive bending, 

twisting, turning, walking, and lifting. However, she has not submitted sufficient medical 

evidence to establish that her diagnosed conditions are causally related to specific employment 

factors. 

 Appellant submitted reports from Dr. Barnes dated June 26 and September 12, 2013 who 

noted she was a letter carrier who initially injured her back in 1996 when lifting an obese patient. 

She underwent a two-level lumbar fusion surgery in 2008, but continued to be symptomatic. 

Dr. Barnes noted appellant’s work as a carrier which required repeated lifting of up to 70 pounds 

which placed stress on her lumbar spine and caused herniated discs and her current symptoms. 

He diagnosed herniated lumbar discs at L2-3, L4-5, and L5-SI. Similarly, on April 10, 2014 

Dr. Barnes opined that appellant’s 2006 work injury permanently aggravated the original 1996 

injury and resulted in permanent impairment of her lumbar spine. The Board finds that, although 

he supports causal relationship, he has not provided sufficient medical rationale explaining the 

basis of his conclusory opinion regarding the causal relationship between appellant’s lumbar 

 

5 See Walter D. Morehead, 31 ECAB 188, 194 (1979) (occupational disease or illness); Max Haber, 19 ECAB 

243, 247 (1967) (traumatic injury). See generally John J. Carlone, 41 ECAB 354 (1989); Elaine Pendleton, 40 

ECAB 1143 (1989). 

6 Solomon Polen, 51 ECAB 341 (2000). 
6

condition and the factors of employment.7

 Dr. Barnes has not explained the process by which 

bending or lifting would have caused the diagnosed disc herniation or other conditions. 

Appellant submitted a June 25, 2009 report from Dr. Fandrich who noted treating her for 

a medical condition directly related to her work duties. She reported that her work duties 

consisted of repetitive bending, twisting, lifting, and carrying more than 10 pounds on a daily 

basis. Dr. Fandrich noted that these activities could result in similar injuries to what appellant 

experienced. Similarly, in a July 7, 2010 report, he noted appellant’s history of working for the 

employing establishment for l2 years. Dr. Fandrich diagnosed right low back pain, right lower 

extremity radiculopathy, right sciatica, and hamstring somatic dysfunction. The Board finds that, 

although he supported causal relationship, he has not provided medical rationale explaining the 

basis of his opinion regarding the causal relationship between appellant’s diagnosed conditions 

and factors of employment.8

 Dr. Fandrich did not explain how the accepted work activities 

would cause or aggravate her diagnosed conditions. Therefore, these reports are insufficient to 

meet appellant’s burden to establish appellant’s claim. 

Appellant was treated by Dr. Mann on October 25, 2007 and June 2, 2008 for a long 

history of lumbar degenerative disc disease, spondylosis, and low back syndrome. She reported 

working as a letter carrier and bending over and experiencing acute searing pain in her low back 

with radiation into her right buttock. Dr. Mann relates the history of injury reported by appellant 

instead of providing his own opinion on causal relationship. He did not otherwise address why 

or how particular work activities would cause or aggravate a diagnosed condition. 

Consequently, these reports are of limited probative value. 

The remainder of the medical evidence, including reports from Drs. Trahan, Pribil, and 

Leahy, is also of limited probative value as it does not offer a specific opinion on the causal 

relationship between appellant’s job duties and her diagnosed conditions.9 

On appeal appellant, through counsel, provides a detailed summary of her injury, 

subsequent medical treatment and the procedural process of her claim. She asserts that she 

submitted reports from Dr. Barnes dated June 26, 2013 and April 10, 2014 which support that 

her work duties permanently aggravated her preexisting condition and caused her disability. 

Appellant asserts that Dr. Barnes’ reports provide reliable detail as to appellant’s diagnosed 

conditions, her work duties, and how those work duties permanently aggravated her preexisting 

1996 disc herniation. As noted above, although Dr. Barnes supported causal relationship, he did 

not provide a sufficiently rationalized medical opinion explaining the basis of his conclusory 

 7 See T.M., 60 ECAB Docket No. 08-975 (issued February 6, 2009) (a medical report is of limited probative value 

on the issue of causal relationship if it contains a conclusion regarding causal relationship which is unsupported by 

medical rationale). 

8

 Jimmie H. Duckett, 52 ECAB 332 (2001); Franklin D. Haislah, 52 ECAB 457 (2001) (medical reports not 

containing rationale on causal relationship are entitled to little probative value). 

9 A.D., 58 ECAB 149 (2006) (medical evidence which does not offer any opinion regarding the cause of an 

employee’s condition is of limited probative value on the issue of causal relationship). 
7

opinion regarding the causal relationship between appellant’s lumbar condition and the factors of 

employment.10 Therefore, these reports are insufficient to meet appellant’s burden of proof. 

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 she 

sustained an occupational disease in the performance of duty. 

ORDER 

IT IS HEREBY ORDERED THAT the August 25, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: September 22, 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 

 10 See T.M., supra note 7.