United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

U.K., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS HEALTH ADMINISTRATION, 

New York, NY, Employer 

__________________________________________ 

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Docket No. 14-1564 

Issued: October 20, 2014 

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 HOWARD FITZGERALD, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On July 2, 2014 appellant filed a timely appeal from a decision of the Office of Workers’ 

Compensation Programs (OWCP) dated June 12, 2014. 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 sustained a lower back injury in the performance of duty 

on February 6, 2014. 

 

5 U.S.C. § 8101 et seq. 
2

FACTUAL HISTORY 

Appellant, a 34-year-old pipefitter supervisor, filed a claim for benefits on February 6, 

2014, alleging that on that day he felt something pop in his lower back while picking up bags of 

cast-iron fittings. 

In a February 11, 2014 report, Dr. Joseph T. Sanelli, an osteopath, reported that appellant 

had complaints of lumbar pain and weakness which radiated into his left buttock and left leg. He 

attributed these complaints to the February 6, 2014 work incident. Appellant rated the pain as a 

5 on a scale of 1 to 10, with a stabbing and aching sensation which gradually progressed and 

increased with bending, coughing, general activities, lying down, sitting, standing and walking. 

Dr. Sanelli referred appellant for a magnetic resonance imaging (MRI) scan of the lumbar spine 

in light of the fact that his complaint was lumbar radicular pain. He diagnosed disc displacement 

with lumbar myelopathy, sciatica, discogenic syndrome and facet syndrome and opined that 

there was a causal relationship between the diagnoses and the February 6, 2014 work incident. 

In a report dated March 10, 2014, Dr. Sanelli reported that appellant underwent a lumbar 

MRI scan which showed mild multilevel degenerative changes, in particular at L4-5 with mild 

facet hypertrophy and a diffuse disc bulge with slight flattening of the ventral thecal sac and 

minimal foraminal compromise. He diagnosed disc displacement without myelopathy, lumbar 

sciatica, facet syndrome and discogenic syndrome. On examination Dr. Sanelli noted that 

appellant showed painful motion during axial extension, axial flexion and left side axial rotation; 

lateral motion caused axial pain. Appellant’s range of motion was somewhat restricted, but motor 

strength testing revealed no gross weakness in the lower extremities. Dr. Sanelli advised that 

appellant had no sensory deficits, no myelopathic findings and that he had a normal lower 

extremity examination with regard to his joints. He recommended a course of physical therapy for 

his current lower back pain and a lower extremity electromyelogram (EMG) for further evaluation 

of a lumbosacral radiculopathy versus entrapment neuropathy in the event physical therapy did not 

produce an improvement of his lower back condition. Dr. Sanelli stated that there was a causal 

relationship between the diagnoses and the injury of record. 

Dr. Sanelli submitted several form reports on which he indicated that he had examined 

appellant for a lower back injury and checked a box indicating that appellant’s injury 

corresponded with his description of how the work incident occurred. In an April 10, 2014 

report, he essentially reiterated his previous findings and conclusions. Dr. Sanelli stated that 

appellant continued to experience constant, mechanical pain which was a 4 on a scale of 1 to 10. 

By letter dated May 7, 2014, OWCP informed appellant that, while it had initially handled 

his claim administratively and authorized payment of a limited amount of medical expenses, it 

was reopening his claim because his medical bills had exceeded $1,500.00. It noted that the 

merits of the claim now needed to be formally considered and advised that it required additional 

factual and medical evidence to determine whether he was eligible for compensation benefits. 

OWCP asked appellant to submit a comprehensive medical report from his treating physician 

describing his symptoms and the medical reasons for his condition, and an opinion as to whether 

his claimed condition was causally related to his federal employment. It requested that he submit 

the additional evidence within 30 days. 
3

In a May 22, 2014 report, Dr. Sanelli stated that appellant had continued back pain which 

he rated as a 5 on a scale of 1 to 10. He referred appellant for a lumbar EMG of the lower 

extremity to determine whether he had lumbar radiculopathy, entrapment neuropathy, double 

crush syndrome or peripheral neuropathy. 

In a May 30, 2014 report, Dr. Sanelli stated that appellant had constant lower back pain 

which was predominantly left sided, with left-sided lower back weakness and radiation into the left 

buttocks. He reviewed appellant’s treatment history and his account of injury and reiterated his 

previous findings and conclusions. Dr. Sanelli stated that radiographic studies of the lumbar spine 

showed straightening of the normal lumbar lordosis, most likely secondary to muscular spasm with 

mild degenerative changes of the lower lumbar segments. He reiterated his previous findings, 

conclusions and diagnoses. Dr. Sanelli opined that appellant’s symptoms were directly and 

causally related to the lifting injury he sustained while lifting bags of plumbing materials on 

February 6, 2014. Appellant also submitted several reports from a physical therapist which 

documented his treatment for his left knee condition. 

By decision dated June 12, 2014, OWCP denied appellant’s claim, finding that he failed to 

submit sufficient medical evidence in support of his claim that he sustained a lower back injury 

in the performance of duty on February 6, 2014. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA2 has the burden of establishing that 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, 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.3 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.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 The medical evidence required 

to establish causal relationship is usually rationalized medical evidence. Rationalized medical 

 2 Id. 

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

4

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

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

6 Id. For a definition of the term “injury,” see 20 C.F.R. § 10.5(a)(14). 
4

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.7

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.8

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

Neither the fact that appellant’s condition became apparent during a period of employment nor 

the belief that his condition was caused, precipitated or aggravated by his employment is 

sufficient to establish causal relationship.9 Causal relationship must be established by 

rationalized medical opinion evidence and appellant failed to submit such evidence. 

ANALYSIS 

OWCP accepted that appellant experienced lower back pain while picking up bags of castiron fittings on February 6, 2014. The question of whether an employment incident caused a 

personal injury can only be established by probative medical evidence.10 The Board finds that 

appellant has not submitted rationalized, probative medical evidence to establish that the 

February 6, 2014 employment incident would have been competent to cause the claimed injury. 

Dr. Sanelli submitted several reports in which he noted appellant’s complaints of lower 

back pain on examination and indicated that appellant had lumbar myelopathy, sciatica, 

discogenic syndrome and facet syndrome lumbar myelopathy, sciatica, discogenic syndrome and 

facet syndrome. These reports, however, did not sufficiently relate the diagnoses to the 

February 6, 2014 incident at work. The weight of medical opinion is determined by the 

opportunity for and thoroughness of examination, the accuracy and completeness of physician’s 

knowledge of the facts of the case, the medical history provided, the care of analysis manifested 

and the medical rationale expressed in support of stated conclusions.11

Dr. Sanelli advised in his February 11, 2014 report that appellant had complaints of 

lumbar pain and weakness which radiated into his left buttock and left leg, which he attributed to 

the February 6, 2014 work incident. He related that appellant rated the pain as a 5 on a scale of 1 

to 10. Dr. Sanelli diagnosed disc displacement with lumbar myelopathy, sciatica, discogenic 

syndrome and facet syndrome. He opined that there was a causal relationship between the 

 7 Id.

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

9 Id.

10 John J. Carlone, supra note 5. 

11 See Anna C. Leanza, 48 ECAB 115 (1996). 
5

diagnoses and the February 6, 2014 work incident. In his March 10, 2014 report, Dr. Sanelli 

stated that appellant underwent a lumbar MRI scan which showed mild multilevel degenerative 

changes, mostly at L4-5 with mild facet hypertrophy and a diffuse disc bulge with slight flattening 

of the ventral thecal sac and minimal foraminal compromise. He advised that appellant had no 

sensory deficits and no myelopathic findings and recommended a course of physical therapy. In 

his May 30, 2014 report, Dr. Sanelli reiterated his previous findings, conclusions and diagnoses. 

He stated that radiographic studies of the lumbar spine showed straightening of the normal lumbar 

lordosis, most likely secondary to muscular spasm with mild degenerative changes of the lower 

lumbar segments. Dr. Sanelli opined that appellant’s symptoms were directly and causally related 

to the lifting injury he sustained while lifting bags of plumbing materials on February 6, 2014. 

Although Dr. Sanelli presented several diagnoses of appellant’s condition, he did not 

adequately address how these diagnoses were causally related to the February 6, 2014 work 

incident. The medical reports of record do not explain how, medically, appellant would have 

sustained lumbar myelopathy, sciatica, discogenic syndrome and facet syndrome lumbar 

myelopathy, sciatica, discogenic syndrome and facet syndrome due to picking up bags of cast 

iron fittings on February 6, 2014. The medical evidence of record is to establish that appellant’s 

lower back injury was work related. The reports from Dr. Sanelli merely assert in summary 

fashion that appellant’s lower back condition was caused by the February 6, 2014 work incident, 

and that his conditions were caused by his injury. Dr. Sanelli’s opinion on causal relationship is 

of limited probative value in that he did not provide adequate medical rationale in support of his 

conclusions.12 He did not describe appellant’s incident in any detail or explain how 

physiologically it would have been competent to cause the claimed lower back conditions.13 

Furthermore, the form reports from Dr. Sanelli which support causal relationship with a check 

mark are insufficient to establish the claim, as the Board has held that without further 

explanation or rationale, a checked box is not sufficient to establish causation.14 Therefore, 

appellant failed to provide a medical report from a physician that explains how the work incident 

of February 6, 2014 caused or contributed to the claimed lower back injury. 

In addition, the Board notes that appellant submitted several reports from a physical 

therapist. These reports, however, do not constitute medical evidence under section 8101(2). 

Because healthcare providers such as nurses, acupuncturists, physicians assistants and physical 

therapists are not considered “physicians” under FECA, their reports and opinions do not 

constitute competent medical evidence to establish a medical condition, disability or causal 

relationship.15 

OWCP advised appellant of the evidence required to establish his claim; however, he 

failed to submit such evidence. Appellant did not provide a medical opinion which describes or 

explains the medical process through which the February 6, 2014 work incident would have 

 12 William C. Thomas, 45 ECAB 591 (1994). 

13 C.A., Docket No. 14-1123 (issued August 21, 2014). 

14 Debra S. King, 44 ECAB 203 (1992); Salvatore Dante Roscello, 31 ECAB 247 (1979). 

15 5 U.S.C. § 8101(2); see also G.G., 58 ECAB 389 (2007); Jerré R. Rinehart, 45 ECAB 518 (1994); Barbara J. 

Williams, 40 ECAB 649 (1989); Jan A. White, 34 ECAB 515 (1983). 
6

caused the claimed injury. Accordingly, he did not establish that he sustained a lower back 

injury in the performance of duty. OWCP properly denied appellant’s claim for compensation. 

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 has failed to establish that he sustained a lower back injury 

in the performance of duty on February 6, 2014. 

ORDER 

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

Workers’ Compensation Programs be affirmed. 

Issued: October 20, 2014 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board