United States Department of Labor 

Employees’ Compensation Appeals Board 

_________________________________________ 

M.G., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Bloomfield Hills, MI, Employer 

___________________________________________

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Docket No. 16-0110 

Issued: April 4, 2016 

Appearances: Case Submitted on the Record 

Paul H. Kullen, Esq., for the appellant

Office of Solicitor, for the Director 

 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On October 26, 2015 appellant, through counsel, filed a timely appeal from an August 24, 

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. 

ISSUE 

The issue is whether appellant met her burden of proof to establish an occupational 

disease in the performance of duty. 

FACTUAL HISTORY 

This case has previously been on appeal before the Board. In a May 19, 2009 decision, 

the Board affirmed April 1 and September 3, 2008 OWCP decisions, which found that the 

medical evidence was not sufficient to establish that appellant’s medical condition was causally 

 1

 5 U.S.C. § 8101 et seq.
2

related to her employment duties.2

 In an April 17, 2012 decision, the Board affirmed an 

April 26, 2011 OWCP decision, which denied modification of its prior decisions, finding that 

appellant had not met her burden of proof to establish an injury in the performance of duty.3

 In 

an April 17, 2014 decision, the Board found that OWCP improperly refused to reopen 

appellant’s case for further review of the merits of her claim under 5 U.S.C. § 8128(a). The 

Board found that the June 25, 2010 report from Dr. Robert A. Krasnick, a Board-certified 

physiatrist, constituted relevant and pertinent new evidence, not previously considered by 

OWCP. The Board remanded the case for OWCP to conduct a merit review and after such 

further development as deemed necessary, and advised that OWCP should issue an appropriate 

merit decision.4 The facts and history contained in the prior appeals are incorporated herein by 

reference. 

The relevant facts include that on November 25, 2006 appellant, then a 31-year-old 

distribution clerk, filed an occupational disease claim (Form CA-2) alleging that she sustained 

grade 1 anterolisthesis of L5-S1 due to lifting magazines at work. She first became aware that 

her condition was employment related in November 1998.5 On February 5, 2002 a nonwork 

accident occurred when a car hood fell onto appellant’s neck causing headaches and severe neck 

and low back pain. Appellant continued to work with restricted duties due to her low back. The 

employing establishment controverted appellant’s claim and noted that she was last exposed to 

the work conditions alleged to have caused her condition on November 30, 2006 and that she had 

been placed on light-duty work. On September 11, 2008 appellant stopped work. 

On remand from the appeal in Docket No. 14-0106, OWCP conducted a merit review. In 

a May 19, 2014 decision, it denied modification of its prior decision. 

On May 19, 2015 appellant’s counsel requested reconsideration. He submitted new 

medical evidence to support that the nonwork injury to her neck did not impact the development 

of her work-related lumbar spondylolisthesis, from which she was disabled from her 

employment. 

In a May 18, 2015 report, Dr. Krasnick noted that he had treated appellant’s lower back 

pain since March 8, 2010. He advised that he previously noted appellant’s history which 

included that she had worked at the employing establishment as a distribution clerk since 1996. 

Dr. Krasnick advised that in 1998 appellant had a work injury when she developed lower back 

pain. He explained that on November 4, 1998 she was putting flats of mail into cases, when she 

developed lower back pain and was diagnosed with back strain. Dr. Krasnick related that 

appellant had chronic worsening back and leg pain which he described in his June 25, 2010 

 2

 Docket No. 08-2474 (issued May 19, 2009). 

3

 Docket No. 11-1886 (issued April 17, 2012). 

4

 Docket No. 14-0106 (issued April 17, 2014). 

5

 The record reflects that in November 1998, appellant experienced low back pain after putting up routed flats. 

The claim was allowed for limited medical treatment under separate case number xxxxxx543. Appellant worked as 

a sale and service associate from approximately 2002 through approximately 2005, at which time, she returned to 

her job as a distribution clerk. 
3

report. He addressed the relevance of appellant’s 2002 nonwork injury, which occurred when 

the hood of a car fell on her neck. Dr. Krasnick explained that the medical evidence revealed 

that appellant sustained some trauma to the head without loss of consciousness. He related that 

she had x-rays of the cervical spine due to neck pain; however, the x-rays were unremarkable. 

Dr. Krasnick noted that appellant was taken off work for a short period of time due to the 

headaches or neck pain. He related that “co-existent” with the head and neck injury, she still had 

ongoing back pain and spondylolisthesis. Dr. Krasnick opined that her injuries to the head and 

neck had resolved, had no direct effect on her lower back, and were “unrelated injuries.” He 

opined that starting with the low back strain of 1998, she had gradually progressive symptoms 

related to her back and leg symptoms, including pain, numbness, tingling and increasing 

disability in regards to her abilities at work. Dr. Krasnick advised that it was not until 2002, and 

despite a concurrent injury to the head and neck, “clearly without any causal relationship to the 

head and neck, that further imaging was done of her lower back and diagnosis of 

spondylolisthesis was made.” 

By decision dated August 24, 2015, 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 FECA, that the claim was timely filed within the applicable time 

limitation period of FECA, that an injury was sustained in the performance of duty as alleged and 

that any disability and/or specific condition for which compensation is claimed are causally related 

to the employment injury.6 These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated upon a traumatic injury or an occupational disease.7

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) a 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 the claimant. The medical 

evidence required to establish causal relationship, generally, is 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 

 6 Joe D. Cameron, 41 ECAB 153 (1989); Elaine Pendleton, 40 ECAB 1143, 1145 (1989). 

7 Victor J. Woodhams, 41 ECAB 345 (1989). 
4

relationship between the diagnosed condition and the specific employment factors identified by the 

claimant.8

ANALYSIS 

OWCP denied appellant’s reconsideration request because the evidence of record failed 

to establish the relationship between any diagnosed condition and established work-related 

events, such as lifting magazines at work occurred. 

The Board finds that appellant submitted insufficient medical evidence to establish that 

her conditions of back pain and spondylolisthesis were caused or aggravated by the established 

work activities or any other specific factors of her federal employment. 

Dr. Krasnick, in his June 25, 2010 report, explained that appellant did not have back pain 

until 1998 when she was working at the employing establishment. He asserted that in 1998, after 

heavy lifting and repetitive bending, she developed progressive back pain also affecting both 

legs. Dr. Krasnick advised that diagnostic testing since 2002 showed a progression of 

spondylolisthesis at the L5-Sl level as well as increased facet joint arthritic changes and 

foraminal narrowing. He opined that “within reasonable medical certainty, bending, lifting and 

twisting during the course of work caused injury to the L5-S1 disc, causing pain and further 

instability in 1998” and continued to progress thereafter. Dr. Krasnick advised that “because of 

the injury to the disc and the underlying nature of [appellant’s] problem, it is more likely than not 

that the L5-S1 level was permanently and irreversibly damaged.” He opined that “a workplace 

injury would not only have caused precipitation of symptoms, but acceleration of her underlying 

disease. This is consistent with [appellant’s] history of having no back or leg pain prior to 1998 

and progressive symptomatology since that time.” This report is of limited probative value as 

Dr. Krasnick did not address the impact of the 2002 incident in which a car hood fell on 

appellant’s neck. This is particularly important since 2002 is the year that appellant’s condition 

began to progress.9

Appellant also provided a May 18, 2015 report from Dr. Krasnick who noted appellant’s 

history and addressed the relevance of 2002 nonwork injury when a car hood fell on her neck. 

Dr. Krasnick noted that the medical evidence revealed some trauma to the head without loss of 

consciousness and that cervical spine x-rays were unremarkable. He also noted that appellant 

was taken off work for a short period of time due to the headaches or neck pain and that 

“coexistent” with the head and neck injury, she still had ongoing back pain and 

spondylolisthesis. Dr. Krasnick asserted that appellant’s head and neck injuries resolved and had 

no direct effect on her lower back and they were “unrelated injuries.” He reported that starting 

with the low back strain of 1998, she had gradually progressive symptoms related to her back 

and leg symptoms, including pain, numbness, tingling, and increasing disability in regards to her 

abilities at work. Dr. Krasnick explained that it was not until 2002, and despite a concurrent 

injury to the head and neck, “clearly without any causal relationship to the head and neck, that 

further imaging was done of [appellant’s] lower back and diagnosis of spondylolisthesis was 

 8 Id. 

9 See Leonard J. O’Keefe, 14 ECAB 42, 48 (1962) (where the Board held that medical opinions based upon an 

incomplete history have little probative value). 
5

made.” The Board finds that this report does not sufficiently explain why he discounted the 

2002 incident as the cause of her condition as Dr. Krasnick clearly notes that this was the year 

the spondylolisthesis diagnosis was made. He did not sufficiently explain how particular work 

duties would cause or contribute to a diagnosed medical condition. The need for detailed 

rationale is particularly important as Dr. Krasnick did not begin treating appellant until 2010, 

nearly 12 years after the onset of back pain in 1998, and about eight years after the car hood fell 

on her neck.10 

The Board has held that the mere fact that a condition manifests itself during a period of 

employment does not raise an inference that there is a causal relationship between the two.11 

Neither the fact that the condition became apparent during a period of employment nor the belief 

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

establish causal relationship.12 Causal relationship must be substantiated by reasoned medical 

opinion evidence, which is appellant’s responsibility to submit. The Board finds that these 

reports are insufficiently rationalized and of limited probative value with regard to causal 

relationship. 

On appeal, appellant’s counsel argues that the medical evidence supported the approval 

of appellant’s claim. However, as explained, the medical evidence is insufficient to establish the 

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 her burden of proof to establish an 

occupational disease in the performance of duty.

 10 See S.S., 59 ECAB 315 (2008) (the Board has held that contemporaneous evidence is entitled to greater 

probative value than later evidence). 

11 See Joe T. Williams, 44 ECAB 518, 521 (1993). 

12 Id.
6

ORDER 

IT IS HEREBY ORDERED THAT the August 24, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: April 4, 2016 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board