United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

C.P., Appellant 

and 

DEPARTMENT OF THE NAVY, NORFOLK 

NAVAL SHIPYARD, Portsmouth, VA, Employer 

__________________________________________ 

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Docket No. 17-0042 

Issued: December 27, 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 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On October 14, 2016 appellant filed a timely appeal from a September 30, 2016 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 his burden of proof to establish that his lumbar 

condition was causally related to the accepted June 1, 2016 employment incident. 

FACTUAL HISTORY 

On June 2, 2016 appellant, a 49-year-old boilermaker, filed a traumatic injury claim 

(Form CA-1) alleging that he injured his lower back in the performance of duty on June 1, 2016. 

At that time, he was working on a nuclear-powered ballistic missile submarine, water jetting 

 1

 5 U.S.C. § 8101 et seq. 
2

condenser tubes. Appellant experienced a sharp pain down both legs, his feet became cold and 

numb, and his lower back started to hurt. He stopped work on June 1, 2016. 

On June 1, 2016 appellant was seen in the employing establishment health clinic by 

Dr. Ernest L. Fair, a Board-certified occupational medicine specialist. Dr. Fair reported that 

appellant had been working inside a workbox lancing the main condenser when he started feeling 

numbness and tingling in both feet and pain in his lower back. He also noted that appellant had a 

history of chronic back pain and had received injections in 2013 at the Naval Medical Center -- 

Portsmouth (NMCP). Dr. Fair made a provisional diagnosis of low back pain and referred 

appellant to neurosurgery at NMCP. He also indicated that appellant was temporarily totally 

disabled. 

Appellant returned to the employing establishment health clinic on June 6, 2016 for 

follow-up. Dr. Gary E. Caplan, a Board-certified occupational medicine specialist, released him 

to sedentary or modified light-duty work. Appellant subsequently returned to work performing 

office duties with a 15-pound lifting restriction. 

In a July 28, 2016 report, Dr. Qi Lin, a Board-certified pain management specialist, 

diagnosed lumbar radiculopathy, osteoarthritis of the spine with radiculopathy -- lumbar region, 

chronic lower back pain, and lumbosacral disc degeneration. He noted that the onset of 

appellant’s back injury was many years prior, but worsened since June 2016. 

In an August 10, 2016 attending physician’s report (Form CA-20), Dr. Fair reiterated his 

diagnosis of low back pain and opined that appellant was totally disabled for the period June 1 

to 5, 2016. 

In an August 29, 2016 letter, OWCP advised appellant that the evidence received thus far 

was insufficient to establish entitlement to FECA benefits. It requested additional factual and 

medical evidence and afforded appellant 30 days to submit the required evidence. 

OWCP subsequently received additional employing establishment treatment records, 

including several diagnostic studies of appellant’s lumbar spine. An August 6, 2006 magnetic 

resonance imaging (MRI) scan showed disc herniation and degenerative disc disease at L4-5 in 

association with a mild annular bulge, loss of the normal lumbar lordosis, and perhaps minimal 

bilateral L5 lateral recess narrowing. A January 24, 2013 computerized tomography (CT) scan 

of the lumbar spine was normal, and a February 25, 2013 lumbar CT scan revealed an L4-5 disc 

extrusion and left sacroiliac joint osteophytes. Additionally, an April 18, 2014 MRI scan of the 

lumbar spine demonstrated a borderline disc protrusion at L3-4 without impingement and an 

L4-5 disc herniation. 

OWCP also received medical reports and physical therapy treatment records from 

January 2013 through October 2014. The relevant treatment records, dated January 24, 

February 26, March 4, April 4, June 25, September 13, October 23, 2013, March 5, July 8, and 

October 6, 2014, were from NMCP’s pain management, neurosurgery, and chiropractic clinics. 

Appellant’s diagnoses included sciatica, lumbago, lumbar neuritis, lumbosacral disc 

degeneration, and herniated intervertebral lumbar disc. The treatment records also indicated that 

appellant received a series of caudal epidural steroid injections in 2013 and 2014. 
3

In a July 6, 2016 report, Dr. John Engler, a Board-certified neurologist, noted that 

appellant had a long, multi-year history of low back and right hip region pain described as 

stiffness with rare radiation into the lower extremity. He further noted that one month prior 

appellant had developed a severe onset of new symptoms, including burning and cramping in the 

bilateral lateral thighs and pain into the right lateral calf which occurred intermittently. 

Dr. Engler noted that appellant’s diagnostic studies showed an annular tear at L4-5 with severe 

central canal stenosis. He diagnosed lumbar spinal stenosis. Dr. Engler believed appellant’s 

acute back pain was from the annular tear, which likely exacerbated his preexisting canal 

stenosis and was secondarily causing the claudication symptoms. He referred appellant for 

additional physical therapy and recommended additional lumbar epidural steroid injections. 

By decision dated September 30, 2016, OWCP denied the claim as the medical evidence 

submitted was insufficient to establish a causal relationship between appellant’s conditions and 

the June 1, 2016 employment incident. 

LEGAL PRECEDENT 

A claimant 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 that an injury was sustained in the performance of duty as alleged and that any specific 

condition or disability claimed is causally related to the employment injury.2

To determine if an employee sustained a traumatic injury in the performance of duty, 

OWCP begins with an analysis of whether “fact of injury” has been established. Generally, fact 

of injury consists of two components that must be considered in conjunction with one another. 

The first component is whether the employee actually experienced the employment incident that 

allegedly occurred.3 The second component is whether the employment incident caused a 

personal injury.4 An employee may establish that an injury occurred in the performance of duty 

as alleged, but fail to establish that the disability or specific condition for which compensation is 

being claimed is causally related to the injury.5

Certain healthcare providers such as physician assistants, nurse practitioners, physical 

therapists, and social workers are not considered “physician[s]” as defined under FECA.6

 

 2

 20 C.F.R. § 10.115(e), (f); see Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996). 

3 Elaine Pendleton, 40 ECAB 1143 (1989). 

4 John J. Carlone, 41 ECAB 354 (1989). Causal relationship is a medical question that generally requires 

rationalized medical opinion evidence to resolve the issue. Robert G. Morris, 48 ECAB 238 (1996). A physician’s 

opinion on whether there is a causal relationship between the diagnosed condition and the implicated employment 

factor(s) must be based on a complete factual and medical background. Victor J. Woodhams, 41 ECAB 345, 

352 (1989). Additionally, the physician’s opinion must be expressed in terms of a reasonable degree of medical 

certainty and must be supported by medical rationale, explaining the nature of the relationship between the 

diagnosed condition and appellant’s specific employment factor(s). Id.

5 Shirley A. Temple, 48 ECAB 404, 407 (1997). 

6

 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t). 
4

Consequently, their medical findings and/or opinions will not suffice for purposes of establishing 

entitlement to FECA benefits.7

ANALYSIS 

OWCP has accepted that the employment incident of June 1, 2016 occurred at the time, 

place, and in the manner alleged. The issue is whether appellant’s lower back condition resulted 

from the June 1, 2016 employment incident. The Board finds that appellant did not meet his 

burden of proof to establish a causal relationship. 

The record is replete with medical evidence demonstrating a preexisting lumbar 

condition. Appellant’s lumbar MRI scans revealed an L4-5 disc herniation as early as 

August 2006. Additionally, records from NMCP revealed that appellant received treatment for 

several lumbar-related conditions during the period January 2013 through October 2014. His 

prior diagnoses included sciatica, lumbago, lumbar neuritis, lumbosacral disc degeneration, and 

herniated intervertebral lumbar disc. 

When Dr. Fair examined appellant on June 1, 2016 following the condenser tube water 

jetting incident, he noted that appellant had a history of chronic back pain for which he received 

injections in 2013. He diagnosed low back pain in his initial June 1, 2016 treatment notes, and 

he provided the same finding/diagnosis in his August 10, 2016 attending physician’s report 

(Form CA-20). However, low back pain is a symptom, not a specific medical diagnosis.8

 

Furthermore, Dr. Fair did not provide an explanation of how the June 1, 2016 employment 

incident either caused or contributed to appellant’s current lumbar complaints. He noted that 

appellant was previously diagnosed with L4-5 disc herniation, and experienced an exacerbation 

secondary to a new injury incurred while at work on June 1, 2016. The mere fact that a 

condition manifests itself during a period of employment is not sufficient to establish causal 

relationship.9 Temporal relationship alone will not suffice.10 Accordingly, Dr. Fair’s June 1 and 

August 10, 2016 reports are insufficient to establish that appellant’s claimed lumbar condition is 

causally related to the accepted June 1, 2016 employment incident. 

In his July 6, 2016 report, Dr. Engler noted appellant’s long, multi-year history of low 

back and right hip complaints. He also noted that one month prior, appellant experienced a 

severe onset of new symptoms, including burning and cramping in the bilateral thighs and pain 

into the right lateral calf, which occurred intermittently. Dr. Engler noted that appellant’s 

diagnostic studies showed an annular tear at L4-5 with severe central canal stenosis. He 

 7 K.W., 59 ECAB 271, 279 (2007); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006). A report from a physician 

assistant or certified nurse practitioner will be considered medical evidence if countersigned by a qualified 

physician. Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3a(1) 

(January 2013). 

8

 The Board has consistently held that pain is a symptom, rather than a compensable medical diagnosis. See P.S., 

Docket No. 12-1601 (issued January 2, 2013); C.F., Docket No. 08-1102 (issued October 10, 2008). 

9

 20 C.F.R. § 10.115(e). 

10 See D.I., 59 ECAB 158, 162 (2007). 
5

diagnosed lumbar spinal stenosis. Dr. Engler believed appellant’s acute back pain was due to the 

annular tear, which likely exacerbated his preexisting canal stenosis and was secondarily causing 

the claudication symptoms. A physician’s opinion on causal relationship must be based on a 

complete factual and medical background and must be supported by medical rationale.11 

Dr. Engler did not indicate whether there was a causal relationship between appellant’s current 

condition and the June 1, 2016 employment incident. 

In his July 28, 2016 report, Dr. Lin diagnosed chronic lower back pain, lumbar 

radiculopathy, lumbosacral disc degeneration, and osteoarthritis of the lumbar spine with 

radiculopathy. He asserted that appellant’s condition had an onset many years prior, but 

worsened since June 2016. The Board finds that Dr. Lin failed to provide sufficient medical 

rationale explaining the mechanism of how work on water jetting condenser tubes at work on 

June 1, 2016 caused appellant’s lower back condition to worsen. The need for rationale is 

particularly important as the evidence of record indicates that appellant had a preexisting lower 

back condition. As noted, a temporal relationship alone will not suffice for purposes of 

establishing causal relationship.12

Appellant also submitted copies of physical therapy notes. However, reports from a 

physical therapist do not rise to the level of competent medical opinion evidence under FECA.13

The Board finds that the evidence of record fails to establish a causal relationship 

between the June 1, 2016 employment incident and appellant’s diagnosed lumbar condition.14 

Accordingly, appellant has failed to meet his burden of proof. 

CONCLUSION 

The Board finds that appellant has not met his burden of proof to establish that his lumbar 

condition is causally related to the June 1, 2016 employment incident. 

 11 Victor J. Woodhams, supra note 4. 

12 See D.I., supra note 10. 

13 Supra notes 6 and 7. 

14 Appellant’s personal belief that his employment activities either caused or contributed to his condition is 

insufficient, by itself, to establish causal relationship. 20 C.F.R. § 10.115(e); Phillip L. Barnes, 55 ECAB 426, 

440 (2004). 
6

ORDER 

IT IS HEREBY ORDERED THAT the September 30, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: December 27, 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