United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.L., Appellant 

and 

U.S. POSTAL SERVICE, NEW YORK 

LOGISTICS & DISTRIBUTION CENTER, 

Bethpage, NY, Employer 

__________________________________________ 

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Docket No. 16-0222 

Issued: August 1, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

JURISDICTION 

On November 17, 2015 appellant timely appealed from a May 22, 2015 merit decision 

and an August 18, 2015 nonmerit 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

ISSUES 

The issues are: (1) whether appellant established that his claimed left elbow condition is 

causally related to the September 3, 2014 employment incident; and (2) whether OWCP properly 

denied further merit review pursuant to 5 U.S.C. § 8128(a). 

 1

 5 U.S.C. §§ 8101 et seq. 

2

 Appellant submitted additional evidence with his appeal. The Board, however, is precluded from considering 

any evidence that was not in the case record at the time OWCP issued its final decision. 20 C.F.R. 

§ 501.2(c)(1) (2014). 
2

FACTUAL HISTORY 

On October 3, 2014 appellant, then a 52-year-old mail handler, filed a traumatic injury 

claim (Form CA-1) alleging that he injured his left elbow on September 3, 2014 while lifting a 

heavy parcel. He stated that, when he lifted the parcel off the floor, he felt a sharp pain in his left 

elbow. After placing the parcel in a postal container (postcon), appellant inspected his elbow 

and noticed it was swollen. Because there was only an hour left on his shift, he decided to keep 

working while minimizing the use of his left elbow.3 The next day appellant sought medical 

treatment. 

Appellant had previously injured the same elbow at work on April 12, 2014, which 

OWCP accepted for left elbow sprain under File No. xxxxxx651. Within a couple months of his 

April 2014 injury he was able to resume full-duty without restrictions. With respect to the 

current left elbow condition, appellant initially filed a recurrence claim (Form CA-2a) under File 

No. xxxxxx651, and after consulting with a union representative, he decided to file a Form CA-1 

for a new left elbow injury. 

OWCP initially received an October 6, 2014 form report from Dr. Lihua Mo, a Boardcertified physiatrist. Dr. Mo’s clinical impressions included status post work-related injury, left 

elbow pain, left elbow sprain, elbow swelling, and elbow tendon tear. She advised that appellant 

was totally disabled from October 7 through November 7, 2014. 

On November 6, 2014 OWCP advised appellant that the evidence received to date was 

insufficient to establish entitlement to benefits under FECA. It requested additional factual and 

medical evidence, and afforded him 30 days to submit the required information. 

OWCP subsequently received a September 4, 2014 left elbow magnetic resonance 

imaging (MRI) scan, which Dr. Mo had requested. The MRI scan revealed degenerative joint 

disease, moderate joint effusion suggestive of synovitis, partial thickness tear of the common 

extensor tendon (lateral epicondylitis), and a partial tear of the common flexor tendon (medial 

epicondylitis). 

By decision dated December 12, 2014, OWCP denied appellant’s traumatic injury claim. 

Although appellant established that the September 3, 2014 lifting incident occurred as alleged, it 

found the evidence of record insufficient to establish a medical diagnosis in connection with the 

accepted employment incident. Consequently, OWCP denied the claim as appellant had not 

established the medical component of fact of injury. 

Appellant timely requested a review of the written record before an OWCP hearing 

representative. He also submitted additional medical evidence, which included a May 13, 2014 

left elbow x-ray and a similarly dated narrative report from Dr. Mo. The x-ray revealed mild 

degenerative changes, but no fracture or dislocation. There was also no evidence of elbow joint 

effusion, and the soft tissues were noted to be unremarkable. 

 3

 Appellant’s regular tour of duty was 7:30 p.m. until 4:00 a.m. He indicated on his CA-1 form that the injury 

occurred at 2:30 a.m., on September 3, 2014. 
3

In her May 13, 2014 narrative report, Dr. Mo noted that appellant was a mail handler who 

complained of a left elbow injury on April 12, 2014, which was due to constant and repetitive 

handling of heavy parcels at work. Appellant’s then-current complaints included left elbow pain, 

swelling, and difficulty lifting and holding objects due to pain and weakness. His pain was 

reportedly 7 on a scale of 1 to 10. Physical examination of the left elbow revealed decreased 

range of motion (ROM) with swelling and tenderness, especially at the lateral epicondyle. 

Elbow muscle strength was 4/5. Appellant’s neurological examination was unremarkable. 

Dr. Mo’s diagnoses included left elbow sprain/strain, tendinitis, and lateral epicondylitis, which 

she attributed to his April 12, 2014 work-related injury. She further noted that appellant had 

been totally disabled since April 12, 2014. 

Appellant had another left elbow MRI scan on January 9, 2015, which revealed a 

moderate to large joint effusion with minimal debris, lateral epicondylitis, and a partial thickness 

tear of the common extensor tendon. His left elbow common flexor tendon was noted to be 

intact. 

In a January 10, 2015 follow-up report, Dr. Mo noted that appellant sustained injuries on 

April 12 and September 3, 2014. With respect to the April 12, 2014 injury, she indicated that he 

was diagnosed with work-related left elbow sprain/strain and epicondylitis. Appellant’s 

treatment at the time included physical therapy and acupuncture. Dr. Mo further noted that he 

significantly improved and was able to return to full time and full duty on June 10, 2014. 

Regarding appellant’s latest injury, Dr. Mo noted that he returned to the office on 

“[September 2, 2014]” and reported that his left elbow pain had worsened due to “handling 

heavy parcels constantly and repetitively at work as (sic) mail handler.” She further noted that 

he reportedly advised his supervisor about his new left elbow injury on September 3, 2014. 

Appellant’s September 2, 2014 left elbow physical examination revealed decreased ROM, 

tenderness, swelling, and muscle strength of 4/5. Dr. Mo also reported that his September 4, 

2014 left elbow MRI scan revealed partial tears of the common extensor and common flexor 

tendons, medial and lateral epicondylitis, and joint effusion. She noted that appellant’s treatment 

included continued physical therapy, acupuncture, and an elbow injection. However, there had 

been no significant improvement since the new injury, and appellant continued to complain of 

left elbow pain and swelling. Dr. Mo also discussed the results of appellant’s latest MRI scan 

dated January 9, 2015. Her diagnoses with respect to appellant’s “new injury on [September 3, 

2014]” included work-related left elbow tear of the common extensor and common flexor 

tendons, medial and lateral epicondylitis, joint effusion, and elbow derangement. Dr. Mo 

explained that, based on the history and medical data, it was her professional opinion that the 

above-noted new clinical impressions were the direct result of appellant’s new injury at work on 

September 3, 2014. 

OWCP also received a March 24, 2015 left elbow x-ray that revealed no evidence of 

acute fracture or dislocation, normal alignment, and no definite joint effusion. 

In a May 22, 2015 decision, the OWCP hearing representative modified OWCP’s 

December 12, 2014 decision, but affirmed the denial of appellant’s traumatic injury claim. He 

found that, although appellant had since established fact of injury, the medical evidence of record 

failed to demonstrate a causal relationship between his current left elbow diagnoses and the 
4

September 3, 2014 lifting incident. Specifically, the hearing representative found that Dr. Mo’s 

latest report was based on an inaccurate history of injury. He noted that Dr. Mo reported 

examining appellant on September 2, 2014 which was a day prior to the September 3, 2014 

employment incident. The hearing representative also noted that Dr. Mo attributed appellant’s 

current left elbow condition to repetitive handling of parcels, rather than the accepted 

September 3, 2014 lifting incident. Consequently, he found that appellant failed to establish 

causal relationship. 

On June 11, 2015 appellant timely requested reconsideration. In a follow-up letter dated 

June 18, 2015, he reiterated that he was seeking reconsideration. Appellant also noted that he 

had enclosed a narrative report from his physician in support of the request for reconsideration. 

However, the record does not include any additional medical evidence received after the hearing 

representative’s May 22, 2015 decision. 

In a nonmerit decision dated August 18, 2015, OWCP denied appellant’s request for 

reconsideration. It noted, inter alia, that it had not received any new and relevant evidence. 

LEGAL PRECEDENT -- ISSUE 1 

A claimant seeking benefits under FECA has the burden of proof to establish the essential 

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

including that an injury was sustained in the performance of duty as alleged and that any specific 

condition or disability claimed is causally related to the employment injury.4

To determine if an employee sustained a traumatic 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 that must be considered in conjunction with one another. 

The first component is whether the employee actually experienced the employment incident that 

allegedly occurred.5 The second component is whether the employment incident caused a 

personal injury.6

 An employee may establish that an injury occurred in the performance of duty 

as alleged, but fail to establish that the disability or specific condition for which compensation is 

being claimed is causally related to the injury.7

 4

 20 C.F.R. § 10.115(e), (f); see Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996). 

5 Elaine Pendleton, 40 ECAB 1143 (1989). 

6 John J. Carlone, 41 ECAB 354 (1989). Causal relationship is a medical question that generally requires 

rationalized medical opinion evidence to resolve the issue. Robert G. Morris, 48 ECAB 238 (1996). A physician’s 

opinion on whether there is a causal relationship between the diagnosed condition and the implicated employment 

factor(s) must be based on a complete factual and medical background. Victor J. Woodhams, 41 ECAB 345, 

352 (1989). Additionally, the physician’s opinion must be expressed in terms of a reasonable degree of medical 

certainty, and must be supported by medical rationale, explaining the nature of the relationship between the 

diagnosed condition and appellant’s specific employment factor(s). Id.

7 Shirley A. Temple, 48 ECAB 404, 407 (1997). 
5

ANALYSIS -- ISSUE 1 

The mere fact that a condition manifests itself during a period of employment is not 

sufficient to establish causal relationship.8

 Temporal relationship alone will not suffice.9 

Generally, medical evidence is required to establish causal relationship.10 The current medical 

evidence of record consists of a series of left elbow diagnostic studies and reports from Dr. Mo. 

Appellant’s x-rays and MRI scans document various left elbow conditions, including 

degenerative joint disease, lateral and medial epicondylitis, common flexor and extensor tendon 

tears, and joint effusion/synovitis. However, these studies do not specifically address the cause 

of the documented left elbow condition(s). Consequently, appellant’s left elbow x-rays and MRI 

scans do not satisfy his burden of establishing a causal relationship between the diagnosed 

condition(s) and his accepted September 3, 2014 employment exposure. 

A physician’s opinion on causal relationship must be based on a complete factual and 

medical background and must be supported by medical rationale.11 As previously mentioned, 

the record includes reports from Dr. Mo dated May 13, October 6, and December 2, 2014, and 

January 10, 2015. Dr. Mo’s May 13, 2014 report predates the September 3, 2014 lifting incident, 

and thus, cannot establish a causal relationship between appellant’s current left elbow condition 

and the accepted employment incident. Additionally, while her October 6 and December 2, 2014 

form reports referenced a “work-related injury” and included a diagnosis of left elbow tendon 

tear, she did not identify a date of injury or otherwise describe the cause of appellant’s “workrelated injury.” Consequently, Dr. Mo’s October 6 and December 2, 2014 form reports are of 

little or no probative value in determining the etiology of his current left elbow condition.12

Dr. Mo’s latest report, dated January 10, 2015, referenced work-related injuries sustained 

on April 12 and September 3, 2014. The first injury was reportedly the result of “handling heavy 

mails constantly and repetitively,” and the September 2014 injury was due to “handling heavy 

parcels constantly and repetitively at work as [a] mail handler.”13 With respect to the 

September 3, 2014 “work-related injury,” Dr. Mo diagnosed tears of the common extensor and 

common flexor tendons, medial and lateral epicondylitis, left elbow joint effusion, and elbow 

derangement. The hearing representative previously found her January 10, 2015 report 

insufficient to establish causal relationship because she relied upon an inaccurate history of 

injury. Whereas appellant attributed his September 3, 2014 injury to lifting a heavy parcel off 

the floor and placing it in a postcon, Dr. Mo described an overuse-type injury that involved 

“handling heavy parcels constantly and repetitively....” As noted, a physician’s opinion on 

causal relationship must be based on a complete factual and medical background and must be 

 8

 20 C.F.R. § 10.115(e). 

9 See D.I., 59 ECAB 158, 162 (2007). 

10 Robert G. Morris, supra note 6. 

11 Victor J. Woodhams, supra note 6. 

12 Id.

13 Dr. Mo mistakenly reported that she examined appellant on September 2, 2014. 
6

supported by medical rationale.14 Dr. Mo’s history of injury is inconsistent with appellant’s 

description of the September 3, 2014 employment incident, which OWCP accepted as having 

been factually established. Therefore, the Board finds her reliance on an inaccurate history 

renders his January 10, 2015 report is insufficient to establish causal relationship.15

The Board finds that the evidence of record fails to establish causal relationship between 

the September 3, 2014 employment incident and appellant’s diagnosed left elbow condition(s).16 

Accordingly, OWCP properly denied his traumatic injury 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. 

LEGAL PRECEDENT -- ISSUE 2 

Section 8128(a) of FECA does not entitle a claimant to review of an OWCP decision as a 

matter of right.17 OWCP has discretionary authority in this regard and has imposed certain 

limitations in exercising its authority.18 One such limitation is that the request for 

reconsideration must be received by OWCP within one year of the date of the decision for which 

review is sought.19 A timely application for reconsideration, including all supporting documents, 

must set forth arguments and contain evidence that either: (1) shows that OWCP erroneously 

applied or interpreted a specific point of law; (2) advances a relevant legal argument not 

previously considered by OWCP; or (3) constitutes relevant and pertinent new evidence not 

previously considered by OWCP.20 When a timely application for reconsideration does not meet 

 14 Victor J. Woodhams, supra note 6. 

15 Id.

16 Appellant’s personal belief that his employment activities either caused or contributed to his condition is 

insufficient, by itself, to establish causal relationship. 20 C.F.R. § 10.115(e); Phillip L. Barnes, 55 ECAB 426, 

440 (2004). 

17 This section provides in pertinent part: “[t]he Secretary of Labor may review an award for or against payment 

of compensation at any time on [his or her] own motion or on application.” 5 U.S.C. § 8128(a). 

18 20 C.F.R. § 10.607. 

19 Id. at § 10.607(a). The one-year period begins on the next day after the date of the original contested decision. 

For merit decisions issued on or after August 29, 2011, a request for reconsideration must be “received” by OWCP 

within one year of the OWCP decision for which review is sought. Federal (FECA) Procedure Manual, Part 2 -- 

Claims, Reconsiderations, Chapter 2.1602.4 (February 2016). Timeliness is determined by the document receipt 

date of the request for reconsideration as indicated by the “received date” in the Integrated Federal Employees’ 

Compensation System (iFECS). Id. at Chapter 2.1602.4b. For decisions issued on or after June 1, 1987 through 

August 28, 2011, the request for reconsideration must be “mailed” to OWCP within one year of the OWCP decision 

for which review is sought. Id. at Chapter 2.1602.4e. 

20 Id. at § 10.606(b)(3). 
7

at least one of the above-noted requirements, OWCP will deny the request for reconsideration 

without reopening the case for a review on the merits.21

ANALYSIS -- ISSUE 2 

Appellant timely requested reconsideration. The Board finds, however, that his June 11 

and 18, 2015 letters neither alleged nor demonstrated that OWCP erroneously applied or 

interpreted a specific point of law. Additionally, appellant did not advance any relevant legal 

arguments not previously considered by OWCP. Accordingly, he is not entitled to a review of 

the merits based on the first and second requirements under section 10.606(b)(3).22

Appellant also failed to submit any “relevant and pertinent new evidence” with his 

request for reconsideration. Although he claimed to have enclosed a narrative report with his 

June 18, 2015 correspondence, OWCP noted in its decision that “no such report was enclosed.” 

Because appellant did not provide OWCP with any “relevant and pertinent new evidence,” he is 

not entitled to a review of the merits based on the third requirement under section 10.606(b)(3).23 

Accordingly, OWCP properly declined to reopen his case under 5 U.S.C. § 8128(a). 

CONCLUSION 

Appellant failed to establish that his claimed left elbow condition is causally related to 

the September 3, 2014 employment incident. The Board further finds that OWCP properly 

denied appellant’s June 11, 2015 request for reconsideration under 5 U.S.C. § 8128(a). 

 21 Id. at § 10.608(a), (b). 

22 Id. at § 10.606(b)(3)(i) and (ii). 

23 Id. at § 10.606(b)(3)(iii). 
8

ORDER 

IT IS HEREBY ORDERED THAT the August 18 and May 22, 2015 decisions of the 

Office of Workers’ Compensation Programs are affirmed. 

Issued: August 1, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board