United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.L., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Jamaica, NY, Employer 

__________________________________________ 

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Docket No. 15-0830 

Issued: January 15, 2016 

Appearances: Case Submitted on the Record

Thomas S. Harkins, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On March 3, 2015 appellant, through counsel, filed a timely appeal from a December 12, 

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 an injury causally 

related to a November 26, 2011 employment incident. 

FACTUAL HISTORY 

On November 27, 2011 appellant, then a 53-year-old Express Mail clerk, filed a

traumatic injury claim (Form CA-1) alleging that on November 26, 2011 while in the 

 1

 5 U.S.C. § 8101 et seq. 
2

performance of duty she was carrying heavy bags and pulling them into a postal container when 

she felt pain in her left leg and hip. 

Appellant submitted several reports dating from November 27 to December 27, 2011 

from Dr. Demetrios Mikelis, a physiatrist. In his November 27, 2011 report, Dr. Mikelis noted 

that appellant was lifting bags and felt a sharp pain in her left leg. He diagnosed strain and 

sprain of left quadriceps and reported that she could not return to work. In the November 29, 

2011 report, Dr. Mikelis noted that appellant was lifting heavy bags into a postal container and 

felt a sharp pain in her left leg radiating to her left hip. He diagnosed left hip pain, left thigh 

pain, and ruled out muscle strain. Dr. Mikelis checked a box marked “yes” as to whether the 

condition was caused or aggravated by an employment activity. For period of disability, he 

filled in “undetermined.” Likewise, in his December 27, 2011 report, Dr. Mikelis noted the 

history above, and diagnosed left hip and left thigh pain. He again checked a box marked “yes” 

as to whether the condition was caused or aggravated by an employment activity. Dr. Mikelis 

noted that appellant was experiencing lower back pain and was unable to work from 

November 29 to December 27, 2011. He opined that, if the history was true, then her conditions 

were caused by her work injury. 

By letter dated February 3, 2012, OWCP informed appellant of the type of evidence 

needed to support her claim. 

In reports dated December 27, 2011 and January 31, 2012, Dr. Mikelis noted that 

appellant had traumatic lumbar spine pain syndrome, left hip pain, rule out sprain and strain, left 

thigh pain, rule out muscle strain. He noted that x-rays of the lumbosacral spine revealed 

multilevel degenerative changes, and x-rays of the left hip revealed arthritic changes, showing 

possible old trauma. 

By decision dated March 14, 2012, OWCP denied appellant’s claim. It found that the 

medical evidence did not establish a firm medical diagnosis in connection with the 

November 26, 2011 employment incident. 

On March 29, 2012 appellant requested a review of the written record by an OWCP 

hearing representative. OWCP received statements from appellant dated March 29 and 

May 14, 2012. Appellant argued that she had worked 23 years for the employing establishment 

and sustained her injuries at work lifting heavy bags on hard floors. She noted that her injury 

began on November 26, 2011 while lifting 30- to 50-pound bags and she felt a sharp pain in her 

left leg radiating straight to her left hip. Appellant indicated that she could hardly walk, could 

not sit for a long time, used a cane, and needed physical therapy. 

Appellant also submitted additional medical reports from Dr. Mikelis dating from 

January 31 to April 24, 2012. In his reports, Dr. Mikelis continued to indicate that appellant was 

status post work-related accident who had returned for a follow-up and remained totally disabled 

due to left hip, thigh, and lumbar spine pain. He noted arthritic changes on a magnetic resonance 

imaging (MRI) scan. Dr. Mikelis checked a box marked “yes’ as to whether the condition was 

caused or aggravated by an employment activity and recommended physical therapy. OWCP 

also received copies of previously submitted reports. 
3

A March 12, 2012 MRI scan of the left hip read by Dr. Robert D. Solomon, a Boardcertified diagnostic radiologist, revealed arthritic changes and no muscular soft tissue mass and 

no evidence of a strain. 

By decision dated July 11, 2012, an OWCP hearing representative affirmed that 

March 14, 2012 decision. 

By letter dated March 13, 2013, counsel for appellant requested reconsideration. On 

March 19, 2013 OWCP received a December 7, 2011 report in which Dr. Mikelis noted 

appellant’s history, diagnosed traumatic sprain of the left hip, left thigh pain, bronchial asthma, 

by history, under treatment, and allergies to Penicillin. Dr. Mikelis opined that, with a degree of 

medical certainty, the work incident was the competent producing cause of appellant’s injuries 

and that there was a causal relationship between the accident and the injuries. He further opined 

that she was partially disabled from her employment as a postal clerk. OWCP also received 

copies of previously submitted reports. 

By decision dated June 14, 2013, OWCP denied the claim finding that appellant had 

failed to establish a causal relationship between the employment incident of November 26, 2011 

and a firm medical diagnosis. 

On October 21 and November 17, 2013 appellant requested reconsideration. In a July 11, 

2013 report, Dr. Andrew Brown, a Board-certified internist, noted that appellant had reported 

that on November 26, 2011 she was lifting 30- to 50-pound bags into a postal container when she 

felt a sharp pain in her left hip and thigh. Thereafter, appellant was limping and unable to walk. 

She related that her pain was a 9 on a scale of 1 to 10 and was constant. Appellant indicated that 

it had increased since the accident and affected her sleep. The pain radiated down to the left 

knee and then to the foot. Appellant reported symptoms of buckling and giving way. She 

related that the pain was worsened by standing, sitting, walking, and bending. It limited her 

ability to lift, stand, carry, walk, run, climb stairs, and exercise. The pain was reduced by lying 

down. Appellant reported that she needed assistance with cleaning, cooking, and shopping. 

Dr. Brown noted that appellant’s mobility on and off the examining table was moderately to 

maximally impaired. Appellant was able to squat fully and rise without assistance. She used a 

cane to ambulate. Going from a sitting to standing position was difficult. Appellant was able to 

dress slowly with pain. Her gait was slow, guarded, and deliberate. Dr. Brown found that heel 

to toe walking was absent secondary to pain. Appellant’s tandem gait was normal. Dr. Brown 

opined that “I feel that there is a direct causal relationship between the accident described and the 

patient’s current injuries. The patient’s symptoms and clinical findings are consistent with 

musculoskeletal injuries to the described areas.” Dr. Brown diagnosed a left hip strain, with 

trochanteric bursitis, iliotibial band syndrome, and aggravation of degenerative joint disease. In 

a separate July 11, 2013 report, he found decreased motion and muscle strength. 

In a September 12, 2013 report, Dr. Brown again noted appellant’s history of injury and 

diagnosed a strain of the left hip, with trochanteric bursitis, iliotibial band syndrome, and 

aggravation of degenerative joint disease. He opined that the incident described by appellant 

was “a competent producing cause for the patient’s clinical presentation.” Dr. Brown noted that 

appellant’s complaints were consistent with the history of injury and objective findings. 
4

By decision dated February 19, 2014, OWCP denied modification of its prior decision. 

On May 15, 2014 counsel for appellant requested reconsideration. In support of the 

request, appellant submitted an April 3, 2014 report from Dr. Brown. Dr. Brown explained that 

appellant reported left leg pain which she rated as a 10 out of 10. Appellant noted being unable 

to take public transportation and related limitations in her ability to ambulate, stand, lift, carry, 

kneel, squat, negotiate stairs and ladders, and perform repetitive-type activities with the left leg. 

She reported that her sleep was disrupted and difficulty maintaining one position. Dr. Brown 

noted appellant’s past medical history that included hypertension, asthma, bronchitis, and “fatty 

liver.” On examination, appellant was in obvious pain with significantly impaired mobility. 

Dr. Brown determined that she had difficulty rising from a sitting to a standing position as well 

as getting on and off the examining table. He noted that appellant had an antalgic gait which 

favored the left side and she ambulated with a cane. Dr. Brown examined her range of motion 

and provided findings which included pain with movement. He also found that palpation 

revealed tenderness along the iliotibial band, over the trochanteric bursa, and in the anterior 

aspect of the hip. Dr. Brown conducted muscle, grip, and vascular examination which revealed 

no acute pathology for the left leg. He diagnosed a strain of the left hip, with trochanteric 

bursitis, iliotibial band syndrome, aggravation of degenerative joint disease, and possible lateral 

femoral cutaneous nerve (LFCN) compression. Dr. Brown opined that the incident that appellant 

described was a competent producing cause of her clinical presentation. He explained that her 

complaints are consistent with appellant’s history of injury and her objective findings. 

Dr. Brown opined that appellant was totally disabled. OWCP also received copies of previous 

reports. 

By decision dated July 8, 2014, OWCP denied modification of its prior decision. 

On September 30, 2014 counsel for appellant requested reconsideration. He submitted 

new medical evidence and argued that appellant established causal relationship. 

The medical evidence included a July 11, 2014 report from Dr. Brown. Dr. Brown 

indicated that appellant was considering a possible left total hip replacement with another 

physician. Appellant reported residual left hip pain and greater radiation into the left leg along 

the lateral aspect to the ankle. Dr. Brown noted accounts of numbness and tingling and 

functional limitations as noted in his prior reports. He advised that her past surgical history 

included right and left knee surgery. Dr. Brown examined appellant and noted that she was in 

obvious pain, had impaired mobility, and exhibited difficulty rising from a seated to a standing 

position and from the examining table. He found that she had an antalgic gait favoring the left 

side and she ambulated with a cane. Dr. Brown provided range of motion measurements and 

found pain with movement, palpation that revealed tenderness over the iliotibial band, over the 

trochanteric bursa, and in the anterior aspect of the hip. He diagnosed a left hip strain, with 

trochanteric bursitis, iliotibial band syndrome, and aggravation of degenerative joint disease. 

Dr. Brown opined that the incident that appellant described was a competent producing cause for 

her clinical presentation. He advised that her complaints were consistent with the history of 

injury. Dr. Brown noted the history of injury was consistent with the objective findings. He 

opined that appellant was totally disabled. 
5

In a July 14, 2014 attending physician’s report, Dr. Brown checked a box “yes” to 

indicate that appellant’s condition was employment related. He indicated the period of disability 

began on November 26, 2011 and was ongoing. 

On October 17, 2014 OWCP received an undated statement from appellant. Appellant 

noted that on November 26, 2011 she had an injury to her left hip while in the performance of 

duty. She argued that it was almost three years and she “had not gotten any better.” 

In a decision dated December 12, 2014, OWCP denied modification of its prior decision. 

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 timely filed within the applicable time 

limitation period of FECA,2 and that an injury was sustained in the performance of duty.3 These 

are the essential elements of each compensation claim, regardless of whether the claim is 

predicated upon a traumatic injury or an occupational disease.4

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

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

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.5 Second, the 

employee must submit sufficient evidence, generally only in the form of medical evidence, to 

establish that the employment incident caused a personal injury.6

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

causal relationship is rationalized medical opinion evidence. Rationalized medical opinion 

evidence is evidence which includes a physician’s 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, 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.7

 2 Joe D. Cameron, 41 ECAB 153 (1989). 

3 James E. Chadden, Sr., 40 ECAB 312 (1988). 

4 Delores C. Ellyett, 41 ECAB 992 (1990). 

5 John J. Carlone, 41 ECAB 354 (1989). 

6 Id. 

7 I.J., 59 ECAB 408 (2008). 
6

ANALYSIS 

Appellant alleged that she sustained a traumatic left leg and hip injury while carrying 

heavy bags and pulling them at work on November 26, 2011. OWCP accepted the incident but 

denied the claim because the medical evidence was insufficient to establish that the employment 

incident caused an injury. The medical reports of record do not establish that the carrying heavy 

bags and pulling them at work caused a personal injury on November 26, 2011. 

Appellant submitted several reports from Dr. Mikelis. In his December 7, 2011 report, 

Dr. Mikelis noted appellant’s history and offered diagnoses that included traumatic sprain of the 

left hip and left thigh pain. He opined that, to a degree of medical certainty, the work incident 

was the competent producing cause of appellant’s injuries and that there was a causal 

relationship between the accident and the diagnosed condition. However, Dr. Mikelis did not 

explain the medical reasoning, or provide rationale, to support his opinion on causal 

relationship.8

 On January 31, 2012 he noted findings, including x-ray findings of left hip 

arthritic changes and possible old trauma. Dr. Mikelis opined that “if” appellant’s history was 

true, then her conditions were caused by her employment injury. The Board notes that this 

opinion is speculative in nature.9

 Dr. Mikelis did not explain how a specific activity at work on 

November 26, 2011 caused or aggravated an injury. The need for reasoning is especially 

important as the evidence indicates that diagnostic tests of the left hip showed preexisting 

arthritis. 

Reports from Dr. Mikelis also included several attending physician’s reports in which he 

supported causal relationship simply by checking a box marked “yes” that appellant’s condition 

was work related. However, 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 little probative value.10 Dr. Mikelis did not explain the medical reasoning 

providing the basis for his opinion. In his November 27, 2011 report, he noted that appellant was 

lifting bags and felt a sharp pain in her left leg. Although, Dr. Mikelis diagnosed a strain, he did 

not offer any reasoning to support how the work activity caused or contributed to the strain. 

The record contains several reports from Dr. Brown. They include reports dated July 11 

and September 12, 2013 in which he noted appellant’s history and findings on examination. 

Dr. Brown diagnosed a left hip strain, with trochanteric bursitis, iliotibial band syndrome, and 

aggravation of degenerative joint disease. Dr. Brown opined that the incident described by 

appellant was “a competent producing cause for the patient’s clinical presentation” and noted 

that appellant’s complaints were consistent with the history of injury and objective findings. He 

opined that “I feel that there is a direct causal relationship between the accident described and the 

 8 See George Randolph Taylor, 6 ECAB 986, 988 (1954) (where the Board found that a medical opinion not 

fortified by medical rationale is of little probative value). 

9 Ricky S. Storms, 52 ECAB 349 (2001) (while the opinion of a physician supporting causal relationship need not 

be one of absolute medical certainty, the opinion must not be speculative or equivocal. The opinion should be 

expressed in terms of a reasonable degree of medical certainty). 

10 Alberta S. Williamson, 47 ECAB 569 (1996). 
7

patient’s current injuries. The patient’s symptoms and clinical findings are consistent with 

musculoskeletal injuries to the described areas.” In reports dated April 3 and July 11, 2014, 

Dr. Brown also opined that the work incident was a competent producing cause of appellant’s 

condition. He explained that her complaints are consistent with her history of injury and her 

objective findings. Dr. Brown opined that appellant was totally disabled. In a July 14, 2014 

form report, he checked a box marked “yes” to indicate that appellant’s condition was 

employment related. However, Dr. Brown has failed to explain the medical processes by which 

this particular employment incident caused appellant’s condition. He did not explain how 

carrying heavy bags and pushing and pulling them at work caused or contributed to the 

diagnosed conditions. Without sufficient reasoning to support the conclusion, these reports are 

insufficient to meet appellant’s burden of proof.11 Moreover, the July 14, 2014 form report is of 

limited probative value as it provides support for causal relationship by checking a box “yes” 

without further reasoning or rationale.12

Other evidence provided by appellant is insufficient to establish the claim as it does not 

address the crucial issue of the causal relationship between appellant’s hip and back conditions 

and her federal employment.13

An award of compensation may not be based on surmise, conjecture, or speculation.14 As 

there is no reasoned medical evidence in the record explaining how the accepted employment 

incident caused or aggravated a medically diagnosed condition, appellant has not met her burden 

of proof. 

On appeal, counsel for appellant argues that the submitted medical additional evidence 

was sufficient to establish her claim. However, as found above, the Board has found that 

evidence lacking. 

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 failed to meet her burden of proof to establish an injury 

causally related to a November 26, 2011 employment incident. 

 11 See supra note 8. 

12 See supra note 10. 

13 Jaja K. Asaramo, 55 ECAB 200 (2004) (medical evidence that does not offer any opinion regarding the cause 

of an employee’s condition is of diminished probative value on the issue of causal relationship. 

14 D.I., 59 ECAB 158 (2007); Ruth R. Price, 16 ECAB 688, 691 (1965). 
8

ORDER 

IT IS HEREBY ORDERED THAT the December 12, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: January 15, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board