United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

H.F., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Philadelphia, PA, Employer 

__________________________________________ 

) 

) 

) 

) 

) 

) 

) 

) 

Docket No. 16-1603 

Issued: December 14, 2016 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

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 August 4, 2016 appellant, through counsel, filed a timely appeal of a May 17, 2016 

merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the 

Federal Employees’ Compensation Act2

 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board 

has jurisdiction to consider the merits of the case. 

ISSUE 

The issue is whether appellant has met her burden of proof to establish a traumatic injury 

causally related to a June 5, 2015 employment incident. 

 1

 In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for 

legal or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. 

§ 501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An 

attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject 

to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation. 

2

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

On June 5, 2015 appellant, then a 52-year-old clerk, filed a traumatic injury claim (Form 

CA-1) alleging that she sustained lower back pain that day while sitting and reaching for a parcel 

while in the performance of duty. She felt a pop in her lower middle back. 

Dr. Alicia Rech, an osteopath, examined appellant on June 6, 2015 and noted her history 

of reaching for something while sitting on a stool at work and acutely hurting her back. She 

reported that appellant had a history of degenerative disc disease. Dr. Rech diagnosed back pain. 

The employing establishment provided appellant with an authorization for examination 

(Form CA-16) on June 5, 2015. Dr. Vincent C. Sacco, an osteopath, completed this form on 

June 9, 2015 and indicated by checking a box marked “yes” that appellant’s back injury was 

caused or aggravated by her employment activity of sitting on a work stool, reaching with her 

left hand to get a package, and hearing a pop with immediate pain in her back. In an 

accompanying form report, he repeated appellant’s history of injury and noted that she 

experienced back pain starting in her lower back radiating to her neck resulting in headaches. 

Dr. Sacco diagnosed cervical back pain. 

In a letter dated June 26, 2015, OWCP requested that appellant provide additional 

information in support of her traumatic injury claim. It noted that she had not provided a 

medical diagnosis resulting from her employment incident. OWCP explained that under FECA a 

finding of pain was considered a symptom and not a valid diagnosis. It further requested 

medical opinion evidence explaining how appellant’s employment incident resulted in a 

diagnosed medical condition. OWCP allowed 30 days for a response. 

Dr. Jason D. Berk, a physiatrist, examined appellant on June 23, 2015 and noted her 

history of degenerative disc disease. He reported her history of reaching at work and 

experiencing a “pop” in the low back that radiated up to her neck. Dr. Berk found that appellant 

had an acute flare of axial low back pain as a result of this work injury. He diagnosed back pain, 

degeneration of lumbar or lumbosacral disc, myalgia and myositis, and thoracic or lumbosacral 

neuritis or radiculitis. Dr. Berk concluded, “Acute-on-chronic back pain in a patient reporting a 

history of lumbar [degenerative disc disease] due to a work-related injury, in which the patient 

describes having been working in a machine requiring lot of reaching-like activities when she 

experienced an acute ‘pop’ in the low back with overall clinical picture and exam[ination] raising 

clinical suspicion that her current pain symptomatology may be related to a discogenic etiology 

with associated myofascial component.” He recommended a magnetic resonance imaging (MRI) 

scan of the lumbar spine. 

Dr. Matthew McLean, an orthopedic surgeon, examined appellant on July 17, 2015 and 

diagnosed lumbar degenerative disc disease and lumbar radiculopathy. He described her history 

of injury on June 6, 2015 as reaching for a package while sitting at work and developing pain in 

her lower back. Dr. McLean reviewed a July 14, 2015 lumbar MRI scan which demonstrated 

degenerative disc bulge on the left at L4-5 and a degenerative disc at L5-S1. 

By decision dated August 5, 2015, OWCP denied appellant’s traumatic injury claim 

finding that Dr. Berk attributed her current condition to her preexisting degenerative disc disease. 
3

It noted that appellant had failed to establish causal relationship between her diagnosed condition 

and the accepted work incident. 

Appellant requested reconsideration on February 18, 2016. She submitted additional 

medical evidence. In a note dated July 1, 2015, Dr. Berk diagnosed lumbar disc herniation based 

on MRI scan. Appellant underwent a July 14, 2015 MRI scan which demonstrated disc bulges at 

L4-5 with mild central canal narrowing, and L5-S1 with superimposed left foraminal disc 

protrusion and moderate left foraminal narrowing. 

On September 25 and December 8, 2015 Dr. McLean noted that, although appellant had a 

history of back problems, she did not have any symptoms until she reaggravated her back during 

the June 5, 2015 work incident. He reported that on June 5, 2015 appellant injured her back 

when she reached for a package and developed pain in her lower back which radiated to her left 

leg. Dr. McLean opined that this condition was directly related to appellant’s June 5, 2015 work 

incident. He diagnosed lumbar degenerative disc disease and lumbar radiculopathy. Dr. Sacco 

completed a report on November 20, 2013 and diagnosed degenerative joint disease, lumbosacral 

joint ligament sprain, myalgia and myositis, neck sprain, thoracic sprain, and sprain of the 

shoulder and upper arm. Appellant also resubmitted Dr. Berk’s June 23, 2015 reports. 

By decision dated May 17, 2016, OWCP denied review of the additional evidence and 

modification of its prior decision. It found that appellant failed to submit rationalized medical 

opinion evidence establishing that her diagnosed conditions were causally related to her June 5, 

2015 employment incident. 

LEGAL PRECEDENT 

An employee 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 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 

or specific condition for which compensation is claimed is 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

OWCP defines a traumatic injury as, “[A] condition of the body caused by a specific 

event or incident, or series of events or incidents, within a single workday or shift. Such 

condition must be caused by external force, including stress or strain which is identifiable as to 

time and place of occurrence and member or function of the body affected.”5

 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 

 3 Kathryn Haggerty, 45 ECAB 383, 388 (1994); Elaine Pendleton, 41 ECAB 1143 (1989). 

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

5

 20 C.F.R. § 10.5(ee). 
4

submit sufficient evidence to establish that she actually experienced the employment incident at 

the time, place, and in the manner alleged.6 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.7

A medical report is of limited probative value on a given medical question if it is 

unsupported by medical rationale.8

 Medical rationale includes a physician’s detailed opinion on 

the issue of whether there is a causal relationship between the claimant’s diagnosed condition 

and the implicated employment activity. The opinion of the physician must be based on a 

complete factual and medical background of the claim, 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 specific employment activity or factors identified by the 

claimant.9

ANALYSIS 

The Board finds that appellant has failed to meet her burden of proof to establish a 

traumatic injury causally related to a June 5, 2015 employment incident. 

Appellant alleged that she sustained a back injury on June 5, 2015 when she reached for a 

package and felt a “pop” in her back. She experienced pain radiating from her low back to her 

neck. OWCP accepted that the employment incident occurred as alleged, but denied appellant’s 

claim finding that she had failed to submit the necessary medical opinion evidence to establish 

an employment-related diagnosed condition in addition to her preexisting degenerative disc 

disease. 

In support of her claim, appellant submitted a series of reports from Dr. Sacco. Dr. Sacco 

initially diagnosed back pain and indicated on a form by checking a box marked “yes” that 

appellant’s condition of back pain was caused or aggravated by her accepted employment 

activity. His initial reports are insufficient to meet appellant’s burden of proof as he did not 

provide a clear diagnosis. The Board has held that the mere diagnosis of “pain” does not 

constitute the basis for payment of compensation.10 Dr. Sacco completed a report on 

November 20, 2013 and diagnosed a series of conditions including degenerative joint disease, 

lumbosacral joint ligament sprain, myalgia and myositis, neck sprain, thoracic sprain, and sprain 

of the shoulder and upper arm. He did not provide a medical opinion that any of these diagnosed 

conditions were caused or aggravated by appellant’s June 5, 2015 employment incident. As 

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

7 J.Z., 58 ECAB 529 (2007). 

8 T.F., 58 ECAB 128 (2006). 

9 A.D., 58 ECAB 149 (2006). 

10 Robert Broome, 55 ECAB 339 (2004). 
5

Dr. Sacco did not explain how or why appellant’s back conditions were related to her accepted 

employment incident, the reports are insufficient to meet appellant’s burden of proof.11

Appellant submitted several reports from Dr. Berk, beginning on June 23, 2015 and 

including her history of degenerative disc disease and her history of injury on June 5, 2015. 

Dr. Berk initially diagnosed back pain and radiculitis, but later diagnosed lumbar disc herniation 

based on MRI scan findings. He described appellant’s condition as an, “Acute-on-chronic back 

pain in a patient reporting a history of lumbar [degenerative disc disease] due to a work-related 

injury, in which the patient describes having been working in a machine requiring lot of 

reaching-like activities when she experienced an acute ‘pop’ in the low back with overall clinical 

picture and exam[ination] raising clinical suspicion that her current pain symptomatology may be 

related to a discogenic etiology with associated myofascial component.” While Dr. Berk offered 

his “clinical suspicion” that appellant’s later diagnosed condition of lumbar disc herniation was 

due to the experienced “acute ‘pop’ in the low back” that she experienced on June 5, 2015, this 

suspicion is insufficient to meet appellant’s burden of proof to establish a traumatic injury claim. 

His use of the term “clinical suspicion” renders his opinion speculative in nature and insufficient 

to meet appellant’s burden of proof to establish a traumatic injury claim.12

Dr. McLean submitted a series of notes dated June 6, 2015 on September 25 and 

December 8, 2015. He noted appellant’s history of back problems and found that she had not 

had any symptoms until she reaggravated her back during the work injury on June 6, 2015. 

Dr. McLean provided an accurate history of injury noting that on June 5, 2015 appellant 

sustained an injury to her back when she reached for a package and developed pain in her lower 

back which radiated to her left leg. He diagnosed lumbar degenerative disc disease and lumbar 

radiculopathy and opined that this condition was directly related to appellant’s June 5, 2015 

work injury. Dr. McLean has provided a clear diagnosis, an appropriate history of injury, and an 

opinion that appellant’s diagnosed condition is related to her June 5, 2015 work incident. His 

reports are insufficient to meet appellant’s burden of proof, however, as he failed to provide any 

medical reasoning explaining how and why appellant’s reaching incident caused or aggravated 

her lumbar degenerative disc disease and lumbar radiculopathy.13 Without medical rationale, 

Dr. McLean’s reports are insufficient to meet appellant’s burden of proof. 

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 meet her burden of proof to establish a 

traumatic injury causally related to a June 5, 2015 employment incident. 

 11 See supra note 9. 

12 L.B., Docket No. 16-0924 (issued August 1, 2016); L.R. (E.R.), 58 ECAB 369 (2007); D.D., 57 ECAB 734 

(2006); M.W., 57 ECAB 710 (2006); Ceclia M. Corley, 56 ECAB 662 (2005). 

13 J.D., Docket No. 14-2061(issued February 27, 2015). 
6

ORDER 

IT IS HEREBY ORDERED THAT the May 17, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: December 14, 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