United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

K.S., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Richmond, VA, Employer 

__________________________________________ 

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Docket No. 16-0164 

Issued: February 24, 2016 

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 H. FITZGERALD, Deputy Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On November 5, 2015 appellant filed a timely appeal of a May 19, 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)(1) 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 that she was 

totally disabled from February 22 through May 11, 2010. 

FACTUAL HISTORY 

On June 8, 2010 appellant, then a 59-year-old laborer custodian, filed a traumatic injury 

claim (Form CA-1) alleging that on January 27, 2010 she fell on her right side when trying to 

avoid machinery. She further alleged that she injured her right shoulder during the fall. 

 1

 5 U.S.C. § 8101 et seq.
2

Appellant initially sought treatment from a chiropractor, Dr. Alan S. Cason, for her right 

shoulder condition, and submitted his treatment notes. Dr. Cason reviewed x-rays of appellant’s 

cervical spine dated February 17, 2010 and found left lateral listhesis of the vertebral bodies at 

C4 and C5. In a note dated February 22, 2010, he diagnosed subluxations demonstrated by x-ray 

at C5-6, C6-7, C7-T1, and C3-4. 

In a note dated June 7, 2010, Dr. Basil Smith, a Board-certified orthopedic surgeon, 

opined that appellant was totally disabled through June 14, 2010 and after that date could return 

to work with restrictions on overhead work and climbing. He completed a note on June 6, 2010 

and report on June 7, 2010 and described her fall on January 27, 2010 and resulting pain in her 

right shoulder. Dr. Smith found that appellant could return to work with restrictions and 

diagnosed right shoulder sprain, subacromial bursitis and acromial joint dysfunction. 

On June 21, 2010 OWCP denied appellant’s claim for continuation of pay on the basis 

that her injury was not reported on an appropriate form within 30 days following the injury. 

In an August 22, 2010 narrative statement, appellant alleged on January 27, 2010 that she 

was walking to the ladies room when she heard a bulk mail carrier behind her. She attempted to 

move to the right to get out of the way, but stumbled, lost her balance, and fell on the concrete 

floor. Appellant landed on her right arm and her right shoulder hit the metal leg of a mail case. 

She did not seek medical attention until February 17, 2010 from Dr. Cason. 

OWCP accepted appellant’s claim on September 2, 2010 for closed dislocation of the 

right shoulder, sprain of the right shoulder and upper arm, and disorder of the bursae and tendons 

in the right shoulder region. Appellant returned to light-duty work on September 9, 2010. 

On October 6, 2010 appellant filed a claim for compensation (Form CA-7) requesting 

wage-loss compensation for leave without pay from April 10 through June 24, 2010. On 

October 14, 2010 she filed a second Form CA-7 requesting compensation from February 22 

through May 11, 2010. Appellant returned to full duty on October 20, 2010. OWCP authorized 

compensation for both periods claimed on October 26, 2010. 

On March 12, 2013 appellant telephoned OWCP and advised that she had not received 

compensation in accordance with her Form CA-7s. 

In a letter dated June 12, 2013, OWCP requested additional medical evidence 

establishing appellant’s disability for work during the periods claimed. It noted that a 

chiropractor was not a physician under FECA in regard to her accepted shoulder conditions. 

By decision dated September 20, 2013, OWCP denied appellant’s claim for 

compensation for the period February 22 through May 11, 2010. It found that she had not 

established that she sustained cervical subluxations as a result of her January 27, 2010 

employment injury. Appellant requested an oral hearing from OWCP’s Branch of Hearings and 

Review on October 15, 2013. 

The oral hearing was held on May 28, 2014. Following the oral hearing, appellant 

explained that Dr. Smith had died and could not provide additional medical evidence. By 

decision dated July 14, 2014, an OWCP hearing representative affirmed the September 20, 2013 
3

decision, finding that the medical evidence did not support appellant’s claimed period of 

disability.2

On January 23, 2015 appellant requested reconsideration and indicated that she was 

providing additional medical evidence. She resubmitted Dr. Smith’s June 7, 2010 report as well 

as his notes following that date through October 12, 2010. Dr. James R. Schwartz, a Boardcertified orthopedic surgeon, reviewed Dr. Smith’s notes and indicated that Dr. Smith first 

examined appellant on June 7, 2010. He concluded, “She was off work because of the injury and 

totally disabled from February 22 through May 24, 2010.” Dr. Schwartz indicated that he was 

basing his opinion on review of Dr. Smith’s medical records, as Dr. Smith had passed away. 

By decision dated May 19, 2015, OWCP declined modification of its prior decisions and 

found that appellant had not submitted the medical evidence necessary to establish that she was 

totally disabled during the period claimed. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden to establish the essential 

elements of his or her claim, including that any disability or specific condition for which 

compensation is claimed is causally related to the employment injury.3 The term disability is 

defined as the incapacity because of an employment injury to earn the wages the employee was 

receiving at the time of the injury, i.e., a physical impairment resulting in loss of wage-earning 

capacity.4 

Whether a particular injury causes an employee to be disabled for employment and the 

duration of that disability are medical issues which must be proved by a preponderance of the 

reliable, probative, and substantial medical evidence.5

 Findings on examination are generally 

needed to support a physician’s opinion that an employee is disabled for work. When a 

physician’s statements regarding an employee’s ability to work consist only of repetition of the 

employee’s complaints that he or she hurt too much to work, without objective findings of 

disability being shown, the physician has not presented a medical opinion on the issue of 

disability or a basis for payment of compensation.6

 The Board will not require OWCP to pay 

compensation for disability in the absence of any medical evidence directly addressing the 

specific dates of disability for which compensation is claimed. To do so would essentially allow 

employees to self-certify their disability and entitlement to compensation.7

 

 2

 The hearing representative modified the September 20, 2013 decision as a denial of leave buyback benefits, 

rather than wage-loss compensation which was not claimed. 

3 G.T., 59 ECAB 447 (2008); Kathryn Haggerty, 45 ECAB 383 (1994); Elaine Pendleton, 40 ECAB 1143 (1989). 

4

 20 C.F.R. § 10.5(f); see, e.g., Cheryl L. Decavitch, 50 ECAB 397 (1999) (where appellant had an injury but no 

loss of wage-earning capacity). 

5 See Fereidoon Kharabi, 52 ECAB 291 (2001). 

6 Id.

7 Id. 
4

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

causal relationship is rationalized medical evidence.8

 Rationalized medical evidence is medical 

evidence which includes a physician’s detailed medical 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.9 Neither the fact that a disease or 

condition manifests itself during a period of employment nor the belief that the disease or 

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

causal relationship.10

ANALYSIS 

The Board finds that appellant has not submitted the necessary medical opinion evidence 

to establish that she was totally disabled from February 22 through May 11, 2010. 

OWCP accepted that appellant injured her right shoulder on January 27, 2010 when she 

fell in the performance of duty. The accepted conditions included closed dislocation of the right 

shoulder, sprain of the right shoulder and upper arm, and disorder of the bursae and tendons in 

the right shoulder region. Appellant filed Form CA-7s requesting compensation for the periods 

April 10 through June 24, 2010 and February 22 through May 11, 2010 for total disability due to 

her accepted conditions. 

Appellant initially sought treatment from Dr. Cason, a chiropractor. Dr. Cason reviewed 

x-rays of appellant’s cervical spine dated February 17, 2010 and in a note dated February 22, 

2010 diagnosed subluxations demonstrated by x-ray at C5-6, C6-7, C7-T1, and C3-4. Section 

8101(2) of FECA11 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 demonstrated by x-ray to exist. While Dr. Cason is a physician in 

regard to his treatment of appellant’s spine, his reports cannot establish a period of disability as a 

result of the accepted right shoulder conditions. A chiropractor’s opinion is not considered 

competent medical evidence in evaluation of other disorders, including those of the extremities.12

Appellant’s attending physician at the time of her injury, Dr. Smith, did not address in his 

notes any period of disability predating his examination of appellant. His reports do not support 

appellant’s claim for total disability prior to June 7, 2010. 

 8 Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000). 

9 Leslie C. Moore, 52 ECAB 132 (2000). 

10 Dennis M. Mascarenas, 49 ECAB 215 (1997). 

11 5 U.S.C. § 8101(2). 

12 Pamela K. Guesford, 53 ECAB 726 (2002). 
5

Dr. Schwartz, in his January 19, 2015 report, indicated that he had reviewed Dr. Smith’s 

notes. He concluded that appellant was off work because of the injury and totally disabled from 

February 22 through May 11, 2010. Dr. Schwartz did not provide any basis for his conclusion 

that her disability from February 22, 2010 was due to her accepted injury. He failed to indicate 

the medical reasoning behind his conclusions, the medical notes from Dr. Smith that supported 

his conclusions or any other basis on which he relied in formulating his opinion. 

Due to the deficits in the medical evidence, the Board finds that appellant has failed to 

establish that she was totally disabled from February 22 through May 11, 2010 and has not 

established that wage-loss compensation is due. 

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 the medical evidence does not establish that appellant was totally 

disabled from February 22 through May 11, 2010 and that she has not established that wage-loss 

compensation is due for this period. 

ORDER 

IT IS HEREBY ORDERED THAT the May 19, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: February 24, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board