United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

K.M., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Chagrin Falls, OH, Employer 

__________________________________________ 

) 

) 

) 

) 

) 

) 

) 

) 

Docket No. 15-0820 

Issued: July 17, 2015 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On February 26, 2015 appellant, through counsel, filed a timely appeal from the 

February 11, 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 to review the merits of this case. 

ISSUE 

The issue is whether appellant established that the September 24, 2013 work incident 

caused an L5-S1 disc herniation. 

FACTUAL HISTORY 

On March 27, 2014 appellant, then a 50-year-old letter carrier, filed a traumatic injury 

claim alleging that he felt a pull and a pinch in his lower back when he lifted a bucket of mail on 

 1

 5 U.S.C. § 8101 et seq.
2

September 24, 2013 at 11 a.m. He stopped work on November 5, 2013. Upon receiving notice 

of the injury claim in March 2014, the postmaster noted no prior knowledge of the incident. 

Appellant first sought medical attention on November 1, 2013 from Dr. Keith A. Fuller, a 

Board-certified internist, who noted that appellant presented with a complaint of low back pain 

with a chronic onset and an acute increase two months ago. He stated that he had been seen in 

August, and just after that he lifted something minor and felt a sharp pain in the right low back. 

Dr. Fuller had a lot of mail to deliver after Labor Day, September 2, 2013, and the next day was 

very tight and stiff in his low back. Appellant stayed in bed, took pain medication, and went to 

physical therapy. He then had low back pain with tightness, but no radiating pain except for one 

episode as he was getting off of the physical therapy table and had a sharp pain in his left lateral 

thigh. Dr. Fuller diagnosed low back pain, sciatica, and the need for an influenza vaccination. 

A January 9, 2014 imaging study showed a herniated disc at L5-S1. Dr. Fuller completed 

an attending physician’s form report on April 24, 2014. He noted that appellant was lifting a tub 

of mail on September 24, 2013 and felt a pull and a pinch in his low back. Dr. Fuller noted the 

imaging study and diagnosed lumbar disc herniation with back pain and sciatica. With an 

affirmative mark, he indicated that this condition was caused or aggravated by the employment 

activity. Dr. Fuller added: “Symptoms began at the time of work[-]related lifting.” On 

April 25, 2014 he noted that appellant’s injury occurred just after Columbus Day, October 14, 

2013, not Labor Day. 

In a decision dated May 14, 2014, OWCP denied appellant’s injury claim. It accepted 

that the September 24, 2013 work incident occurred as alleged but found that the medical 

evidence was insufficient to establish that his diagnosed medical condition was causally related 

to the accepted work incident. OWCP noted that Dr. Fuller failed to give a well-rationalized 

opinion as to how appellant’s back condition was causally related to a specific event that 

occurred almost seven months prior to his assessment. 

Appellant, through counsel, requested reconsideration. In support thereof, he submitted 

the June 18, 2014 report of Dr. Fuller, who explained that appellant had further clarified the 

timeline of his back injury. Sometime during the week of approximately September 24, 2013, 

appellant experienced some discomfort in his low back. He had a lot of mail to deliver that week 

and felt some stiffness and soreness. Appellant stayed in bed a lot, took pain medication, and 

went to physical therapy. He was undergoing physical therapy for an unrelated problem. 

Appellant thought the soreness would improve, particularly with a holiday coming up. He 

worked October 15 and 16, 2013, and his symptoms worsened. Appellant saw Dr. Fuller on 

November 1, 2013 with new back stiffness and radiation to the buttocks, hips, and thighs. From 

Dr. Fuller’s discussion with appellant and the timeline of his symptoms, it was Dr. Fuller’s 

opinion that appellant’s current back problems could be dated to the week of approximately 

September 24, 2013. 

In a decision dated February 11, 2015, OWCP reviewed the merits of appellant’s claim 

and denied modification of its prior decision. It found that this medical evidence was insufficient 

to support appellant’s claim. Dr. Fuller failed to provide a complete history of the events on 

September 24, 2013, findings on physical examination, a definitive diagnosis beyond back pain, 
3

or a well-reasoned opinion explaining how the claimed medical condition was related to the 

traumatic work incident. 

On appeal, counsel argues that OWCP did not properly consider the reports of Dr. Fuller. 

LEGAL PRECEDENT 

FECA provides compensation for the disability of an employee resulting from personal 

injury sustained while in the performance of duty.2

 An employee seeking benefits under FECA 

has the burden of proof to establish the essential elements of his or her claim. When an 

employee claims that he or she sustained an injury in the performance of duty, he or she must 

submit sufficient evidence to establish that he or she experienced a specific event, incident, or 

exposure occurring at the time and place and in the manner alleged. He or she must also 

establish that such event, incident, or exposure caused an injury.3

Causal relationship is a medical issue4 and the medical evidence generally required to 

establish causal relationship is rationalized medical opinion evidence. The opinion of the 

physician must be based on a complete factual and medical background of the claimant,5

 must be 

one of reasonable medical certainty6

 and must be supported by medical rationale explaining the 

nature of the relationship between the diagnosed condition and the established incident or factor 

of employment.7

ANALYSIS 

Although appellant’s account of when the event occurred changed from October 14 to 

November 1, 2013, OWCP nonetheless accepted that the September 24, 2013 lifting incident 

occurred as alleged. The question for the Board is whether lifting a bucket of mail on 

September 24, 2013 caused the L5-S1 herniated disc shown on the January 9, 2014 imaging 

study. 

The record contains visit summaries and disability slips, but there are only two reports 

that address the issue of causal relationship. In his April 24, 2014 attending physician’s form 

report, Dr. Fuller indicated with an affirmative mark that appellant’s lumbar disc herniation was 

caused or aggravated by lifting a tub of mail on September 24, 2013. He mentioned that 

appellant felt a pull and a pinch in his lower back. This opinion is certainly supportive of causal 

relationship. However, the only rationale Dr. Fuller offered was that appellant’s symptoms 

 2

 5 U.S.C. § 8102(a). 

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

4 Mary J. Briggs, 37 ECAB 578 (1986). 

5 William Nimitz, Jr., 30 ECAB 567, 570 (1979). 

6 See Morris Scanlon, 11 ECAB 384, 385 (1960). 

7 See William E. Enright, 31 ECAB 426, 430 (1980). 
4

began at the time of the work-related lifting. The Board has held that when a physician concludes 

that a condition is causally related to a work incident only because the employee was 

asymptomatic before the work incident, the opinion is insufficient, without supporting medical 

rationale, to establish causal relationship.8

 In other words, it is not enough to note the temporal 

coincidence of events. Dr. Fuller must explain how the incident caused the diagnosed condition. 

Because he did not provide this explanation, his opinion on causal relationship has little probative 

value.9

The other evidence that addresses causal relationship is Dr. Fuller’s June 18, 2014 report. 

In this report, Dr. Fuller clarified the timeline of appellant’s back injury, but in doing so, he altered 

the accepted history of injury. He now reported that appellant experienced some discomfort in his 

low back sometime during the week of approximately September 24, 2013. Appellant was no 

longer lifting a tub of mail at 11 a.m. that day but simply had a lot of mail to deliver that week and 

felt some stiffness and soreness after working the two days following Columbus Day, his 

symptoms worsened. It was Dr. Fuller’s opinion that given the timeline of appellant’s symptoms, 

his current back problems could be dated to the week of approximately September 24, 2013. 

This presents two problems. The history of injury appeared inconsistent with the history 

appellant described on his claim for compensation10 and Dr. Fuller still offered no medical 

rationale to explain how the September 24, 2013 work incident caused the diagnosed herniated 

disc at L5-S1. Dr. Fuller’s June 18, 2014 report is no more probative on the issue of causal 

relationship than his attending physician’s form report. 

Because the medical opinion evidence is insufficient to establish the critical element of 

causal relationship, the Board finds that appellant has not met his burden to establish that the 

September 24, 2013 work incident cause a herniated disc at L5-S1. The Board will, therefore, 

affirm OWCP’s February 11, 2014 decision. 

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 not met his burden to establish that the September 24, 

2013 work incident caused an L5-S1 disc herniation. 

 8 Thomas D. Petrylak, 39 ECAB 276 (1987). 

9

 Medical conclusions unsupported by rationale are of little probative value. Ceferino L. Gonzales, 32 ECAB 1591 

(1981); George Randolph Taylor, 6 ECAB 968 (1954). 

10 Medical conclusions based on inaccurate or incomplete histories are of little probative value. James A. Wyrick, 

31 ECAB 1805 (1980) (physician’s report was entitled to little probative value because the history was both inaccurate 

and incomplete). See generally Melvina Jackson, 38 ECAB 443, 450 (1987) (addressing factors that bear on the 

probative value of medical opinions). 
5

ORDER 

IT IS HEREBY ORDERED THAT the February 11, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: July 17, 2015 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board