United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

F.W., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Brooklyn, NY, Employer 

__________________________________________ 

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Docket No. 15-1435 

Issued: September 15, 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 June 19, 2015 appellant filed a timely appeal from a June 1, 2015 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.2

ISSUE 

The issue is whether appellant met his burden of proof to establish an injury as a result of 

an April 2, 2015 employment incident. 

 1

 5 U.S.C. § 8101 et seq.

2

 The Board notes that appellant submitted additional evidence following the June 1, 2015 decision. Since the 

Board’s jurisdiction is limited to evidence that was before OWCP at the time it issued its final decision, the Board 

may not consider this evidence for the first time on appeal. See 20 C.F.R. § 501.2(c); Sandra D. Pruitt, 57 ECAB 

126 (2005). Appellant may submit that evidence to OWCP along with a request for reconsideration, pursuant to 

5 U.S.C. § 8128(a) and 20 C.F.R. § 10.606(b)(2). 
2

FACTUAL HISTORY 

On April 3, 2015 appellant, then a 64-year-old city carrier, filed a traumatic injury claim 

alleging that on April 2, 2015 he injured his lower back when he picked up a parcel at work. He 

stopped work following this incident. 

Appellant also submitted an April 3, 2015 Form CA-16 authorization for examination 

and/or treatment issued to Dr. Howard J. Rosner, a chiropractor, for an April 2, 2014 lower back 

injury. Dr. Rosner completed the form and related that on April 2, 2015 appellant had sustained 

a lower back injury when he lifted a 25-pound package at work. He diagnosed lumbar sprain and 

indicated “yes” that appellant’s condition was caused or aggravated by the April 2, 2015 work 

incident. Dr. Rosner reported that appellant was totally disabled from April 3 to May 2, 2015 

and could return to work on May 4, 2015. He included a duty status report which documented 

that appellant could resume work with certain restrictions. 

By letter dated April 28, 2015, OWCP informed appellant that his claim was initially 

accepted as a minor injury but was now reopened because he had not returned to work. It 

requested additional factual information to substantiate the factual elements of his claim and 

medical evidence to establish that he sustained a diagnosed condition causally related to the 

April 2, 2015 employment incident. 

Dr. Rosner submitted a May 4, 2015 termination of disability form and indicated that 

appellant could return to full duty on May 4, 2015. 

In a decision dated June 1, 2015, OWCP denied appellant’s traumatic injury claim. It 

accepted that the April 2, 2015 employment incident occurred as alleged, but denied the claim 

finding insufficient medical evidence to demonstrate a low back condition causally related to the 

accepted incident. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA3

 has the burden of proof to establish the 

essential elements of his claim by the weight of the reliable, probative, and substantial evidence4

including that he sustained an injury in the performance of duty and that any specific condition 

or disability for work for which he 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 

 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). 
3

submit sufficient evidence to establish that he 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 disability or condition relates to the employment 

incident.9

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

submission of rationalized medical opinion evidence.10 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.11 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.12

ANALYSIS 

Appellant alleged that on April 2, 2015 he sustained a low back condition when he lifted 

a heavy parcel at work. OWCP accepted that the incident occurred as alleged but denied his 

traumatic injury claim finding insufficient medical evidence to establish a diagnosed back 

condition causally related to the accepted incident. The Board finds that appellant did not meet 

his burden of proof to demonstrate a back condition as a result of the April 2, 2015 employment 

incident. 

In support of his claim, appellant submitted an April 3, 2015 Form CA-16 and treatment 

notes by Dr. Rosner, a chiropractor. Section 8101(2) provides that 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.13 OWCP regulations at 20 C.F.R. § 10.5(bb) have defined subluxation as an incomplete 

dislocation, off-centering, misalignment, fixation, or abnormal spacing of the vertebrae which 

must be demonstrable on any x-ray film to an individual trained in the reading of x-rays.14 If the 

diagnosis of a subluxation as demonstrated by x-ray is not established, the chiropractor is not a 

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

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

12 James Mack, 43 ECAB 321 (1991). 

13 5 U.S.C. § 8101(2). 

14 20 C.F.R. § 10.5(bb); see also Bruce Chameroy, 42 ECAB 121 (1990). 
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physician as defined under FECA and his or her report is of no probative value to the medical 

issue presented.15 Because Dr. Rosner has not provided a diagnosis of subluxation nor provided 

x-rays of appellant’s alleged back condition, he is not a physician as defined under FECA. 

Accordingly, his reports lack probative value and are insufficient to establish appellant’s 

traumatic injury claim. The Board therefore finds appellant has not met his burden of proof to 

establish an injury as a result of the April 2, 2015 employment incident. 

On appeal appellant notes the Form CA-16 authorization form of April 3, 2015 issued to 

Dr. Rosner. A properly executed Form CA-16 can form a contractual agreement for payment of 

medical expense, even if the claim is not accepted. See 20 C.F.R. § 10.300; Val D. Wynn, 40 

ECAB 666 (1989). Upon return of the case record, OWCP shall review this aspect of the case. 

CONCLUSION 

The Board finds that appellant did not meet his burden of proof to establish an injury as a 

result of the April 2, 2015 employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the June 1, 2015 decision of the Office of Workers’ 

Compensation Programs is affirmed. 

Issued: September 15, 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 

 15 See Jack B. Wood, 40 ECAB 95, 109 (1988).