United States Department of Labor 

Employees’ Compensation Appeals Board 

_________________________________________ 

K.G., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Louisville, KY, Employer 

__________________________________________ 

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Docket No. 15-1139 

Issued: September 28, 2016 

Appearances: Case Submitted on the Record 

Appellant, pro se 

Office of Solicitor, for the Director 

 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On April 23, 2015 appellant filed a timely appeal from a March 3, 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 over 

the merits of this case. 

ISSUE 

The issue is whether appellant met her burden of proof to establish an injury causally 

related to factors of her federal employment. 

                                                             1

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

This case has previously been before the Board.2 In an August 28, 2012 decision, the 

Board found that the case was not in posture for decision with regard to whether appellant 

sustained injuries to her lower back and upper right arm/shoulder on January 31, 2011 during her 

automation job assignments. The Board noted that the record contained reports from 

Dr. David L. Jackson, a treating Board-certified physiatrist, which attributed appellant’s 

condition to being placed on automation machines at work.3 The Board remanded the case to 

OWCP for referral of appellant to an appropriate Board-certified specialist to determine whether 

appellant’s work activities caused or aggravated her claimed condition. The facts and 

circumstances outlined in the prior appeal are incorporated herein by reference. 

The relevant medical reports upon which the Board based its remand were the May 10 

and June 13, 2011 reports from Dr. Jackson. In a May 10, 2011 report, Dr. Jackson noted that 

appellant presented earlier in the year with complaints of back and shoulder pain related to work 

activities. He indicated that appellant was doing some lifting at work and had increased lower 

back and right shoulder pain. The physician examined appellant and found muscle tightness and 

loss of mobility in the lower spine and findings consistent with rotator cuff impingement of the 

right shoulder and evidence of degenerative changes in the lumbar spine appeared to have been 

aggravated by her work conditions. Dr. Jackson opined that appellant had severe lower back 

and right shoulder pain related to work activities and advised that she could “not return to work 

at this time.” 

In a June 13, 2011 report, Dr. Jackson noted that on February 1, 2011 appellant had low 

back and right shoulder pain complaints. He explained that appellant returned to work on 

January 1, 2011 after she had not worked the previous eight months. Dr. Jackson related that she 

was placed on “machines” that required lifting and loading mail weighing up to 70 pounds. He 

advised that she had to lift, twist, and place it into the machine. Dr. Jackson explained that, 

while doing this work, she developed acute lower back and right shoulder pain which worsened 

and was aggravated by sweeping the mail out of the machine. He advised that when he saw 

appellant on February 1, 2011, he diagnosed right rotator cuff tendinitis secondary to 

impingement and overuse from the described work activity. Dr. Jackson indicated that appellant 

                                                             2

 Docket No. 11-1832 (issued August 28, 2012). Appellant filed a traumatic injury claim alleging that she 

sustained injuries on January 31, 2011 to her lower back and upper right arm and shoulder in her capacity as an 

automation clerk. OWCP adjudicated the claim as an occupational claim and initially denied it on May 4, 2011 as 

the medical evidence was insufficient to establish a causal relationship between the claimed conditions and 

employment factors. 

3

 In a September 27, 2010 report, Dr. Jackson noted seeing appellant for chronic skin ulceration related to allergic 

reactions at work. He found her disabled from work. On February 1, 2011 he treated her for chronic skin 

ulcerations and explained that appellant had returned to work in January 2011 and, since that time, her eruptions had 

recurred. She also had increasing low back and right arm pain. Dr. Jackson diagnosed chronic allergic reactions 

with subsequent skin ulcerations to lower extremities, chronic low back pain with possible degenerative spinal 

abnormalities, and right shoulder pain with evidence of rotator cuff impingement. A February 23, 2011 magnetic 

resonance imaging (MRI) scan of the lumbar spine revealed degenerative changes at L5-S1 that included a broadbased posterior disc bulge which was more prominent on the left, bilateral facet arthropathy, and mild bilateral 

neural foraminal narrowing. In a February 28, 2011 report, Dr. Jackson indicated that appellant had low back pain 

and right shoulder pain due to working on a machine at work. 
3

had low back pain with diagnostic tests revealing evidence of an L5-S1 bulging disc herniation 

with degenerative discs at multiple levels. The physician opined that appellant’s low back pain 

was related to the bulging disc that was inflamed and created discomfort secondary to work 

activities of lifting and twisting while loading machines. Dr. Jackson explained that he “assumed 

that her right rotator cuff tendinitis was caused by the activity at work which required her to do 

lifting and twisting which resulted in injury to her right rotator cuff tendon.” He concluded that 

appellant had L5-S1 bulging disc causing low back pain that was caused by lifting twisting and 

loading machines at work, and that she also had right rotator cuff tendinitis secondary to 

impingement from lifting and twisting and loading mail at work. 

Following the Board’s prior decision,4

 on September 12, 2012, OWCP referred appellant 

to Dr. Stanley W. Collis, a Board-certified orthopedic surgeon, for a second opinion. 

In an October 2, 2012 report, Dr. Collis noted appellant’s history and provided results on 

examination. He found the right shoulder normal, the right elbow, right wrist, and right hand 

examination was negative, and the lumbar spine revealed normal curvature and reasonably good 

motion. Dr. Collis indicated that x-rays of the right shoulder were normal and revealed nothing 

remarkable. Lumbar spine x-rays revealed good mineralization and a degenerative disc lesion at 

L5-S1. Dr. Collis diagnosed mild synovitis of the right shoulder and noted some discomfort on 

extreme abduction and flexion of the shoulder. He also diagnosed degenerative disc lesion of 

L5-S1. Dr. Collis explained that appellant’s mild synovitis of the right shoulder was not bad and 

she could use her shoulder. He indicated that appellant had a degenerative disc lesion at L5-S1 

which was preexisting the incident at work. Dr. Collis opined that her back pain was primarily 

due to degenerative disc at L5-S1, which was aggravated by her obesity. He further explained 

that he did not believe that her symptoms were severe enough to prevent her from work. 

Dr. Collis opined that appellant did not have any work-related problems with regard to the right 

shoulder and lumbar spine. He recommended injections to the right shoulder with cortisone and 

weight loss. Dr. Collis opined that he did not believe that the shoulder or back conditions caused 

disability from work. 

In September 24, 2012 treatment notes, Dr. Jackson diagnosed chronic right shoulder 

pain, chronic low back pain, left leg pain, obesity, and hypertension. 

By decision dated November 14, 2012, OWCP denied appellant’s claim. It found that the 

medical evidence of record failed to demonstrate that the claimed medical conditions were 

causally related to work. 

On May 8, 2013 appellant requested reconsideration. In an August 13, 2012 treatment 

note, Dr. Jackson diagnosed chronic low back pain, chronic right shoulder pain, right knee pain, 

and obesity. He indicated that appellant was unable to work. 

By decision dated June 13, 2013, OWCP denied modification of the prior decision. It 

found that Dr. Collis was entitled to the weight of the medical evidence. It also found that the 

reports from Dr. Jackson were insufficiently rationalized as he failed to provide objective 

findings to support his opinion. 

                                                             4 See supra note 2. 
4

On June 17, 2013 appellant again requested reconsideration. She requested that she be 

sent for a referee examination. 

OWCP received treatment notes from Dr. Jackson dating from June 13, 2011 to 

January 30, 2012, some of which were previously of record. Dr. Jackson indicated that her 

chronic low back pain and right shoulder pain were work related. He advised that appellant had 

pain, stiffness, and difficulty getting out of bed. She was not working. Dr. Jackson’s notes were 

partially illegible but he noted that she was overweight, had full range of motion of the right 

shoulder, had “give way” weakness, had tenderness in the low back region, and had an antalgic 

gait. He diagnosed chronic low back pain, right shoulder and right knee pain. Dr. Jackson 

advised keeping appellant off work, and recommended additional treatment. 

By decision dated August 6, 2013, OWCP denied appellant’s request as insufficient to 

require reopening the case for merit review. 

On May 27, 2014 appellant again requested reconsideration.5

 In a September 2, 2014 

treatment note, Dr. Jackson advised that appellant had chronic right shoulder and lower back 

pain for which she continued to receive treatment. He indicated that she was unable to stand or 

walk for any period of time and she had difficulty using her right arm secondary to right shoulder 

pain. Dr. Jackson determined that she had limited use of the right arm with reaching, lifting, 

pushing and pulling. He related that she believed that her back pain had worsened over the past 

12 months. Findings included that appellant was obese and had limited motion of the right 

shoulder. Appellant had pain with range of motion and pain with impingement testing. There 

was no evidence of pelvic obliquity. Appellant was tender to palpation over the left lumbar 

region and had limited lumbar range of motion. Motor examination was intact. Appellant 

walked with a slow wide base. Dr. Jackson diagnosed chronic low back pain, arthritis with 

degenerative disc disease, and chronic right shoulder pain with rotator cuff impingement and 

arthritis. He indicated that appellant was totally disabled. Dr. Jackson opined that appellant had 

a work-related injury resulting in chronic lower back and right shoulder pain. He indicated that 

it was not a preexisting condition and it was permanent and stationary. Dr. Jackson opined that 

her condition was progressive and worsening and “no therapy or treatment will allow her to 

return to work.” 

In a February 13, 2015 letter, appellant and her representative requested reconsideration. 

They argued that a conflict existed between the second opinion physician and the treating 

physician and that an impartial medical examination should be provided. They also noted that 

appellant was approved by the Office of Personnel Management (OPM) for disability retirement 

and Social Security Administration (SSA) disability benefits. OWCP also received copies of 

previously received reports. 

                                                             5

 In a June 10, 2014 letter addressed to OWCP, appellant requested a hearing before the Board. On June 26, 2014 

OWCP advised appellant that her appeal should be made to the Board if she would like review by the Board. On 

July 2, 2014 appellant appealed the August 6, 2013 OWCP decision to the Board. On September 24, 2014 the 

Board issued an order dismissing appeal. It found that appellant’s appeal was untimely filed. Docket No. 14-1563 

(issued September 24, 2014). Appellant also filed a second appeal on July 2, 2014 of the August 6, 2013 decision. 

The Board issued an order dismissing that appeal on February 3, 2015, finding that the duplicate appeal had been 

inadvertently docketed. Docket No. 14-1731 (issued February 3, 2015). 
5

By decision dated March 3, 2015, OWCP denied modification of the prior decision. It 

found that the medical evidence of record was insufficient to establish that her diagnosed 

condition was caused or aggravated by the accepted work factors. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of establishing the essential 

elements of his or her claim including the fact that the individual is an “employee of the United 

States” within the meaning 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.6 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.7

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (1) medical evidence establishing the 

presence or existence of the disease or condition for which compensation is claimed; (2) a factual 

statement identifying employment factors alleged to have caused or contributed to the presence or 

occurrence of the disease or condition; and (3) medical evidence establishing that the employment 

factors identified by the claimant were the proximate cause of the condition for which 

compensation is claimed or, stated differently, medical evidence establishing that the diagnosed 

condition is causally related to the employment factors identified by the claimant. The medical 

evidence required to establish causal relationship, generally, is rationalized medical opinion 

evidence. Rationalized medical 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.8

ANALYSIS 

Appellant alleged that she developed injuries to her lower back and upper right arm and 

shoulder while performing her work duties as an automation clerk. The evidence supports that 

appellant engaged in automation duties, but she has submitted insufficient medical evidence to 

establish that her conditions were caused or aggravated by these work duties or any other 

specific factors of her federal employment. 

In a prior appeal, the Board remanded the case for further medical development. OWCP 

referred appellant to Dr. Collis who, in an October 2, 2012 report, noted appellant’s history and 

                                                             6 Joe D. Cameron, 41 ECAB 153 (1989); Elaine Pendleton, 40 ECAB 1143, 1145 (1989). 

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

8 Id. 
6

provided results on examination. He found her right shoulder normal and the lumbar spine 

revealed normal curvature and reasonably good motion. Dr. Collis also explained that the right 

shoulder x-rays were normal while lumbar spine x-rays showed a degenerative disc lesion at 

L5-S1. He diagnosed mild synovitis of the right shoulder and degenerative disc lesion of L5-S1. 

Dr. Collis indicated that her mild right shoulder synovitis did not preclude her from using the 

shoulder and, furthermore, her degenerative disc lesion at L5-S1 preexisted the work incident. 

Dr. Collis explained that appellant’s back pain was primarily due to degenerative arthritis at L5-

S1, which was aggravated by her obesity. He further explained that he did not believe that her 

symptoms were severe enough to stop her from working. Dr. Collis opined that appellant was 

not disabled for work because of work-related problems in the shoulder or back. He explained 

that his examination of appellant was essentially normal, that x-rays showed a preexisting 

degenerative low back condition, and there was no basis to attribute any condition to work 

factors. The Board finds that Dr. Collis’ report is sufficiently detailed and well-reasoned to 

constitute the weight of the medical evidence. Dr. Collis’ report establishes that appellant has no 

employment-related low back or right shoulder condition. He explained that his examination of 

appellant was essentially normal and advised that she had a preexisting degenerative low back 

condition which was aggravated by her obesity. The Board finds that Dr. Collis based his report 

upon an accurate history and adequately attributed her current disability to nonwork-related 

conditions. 

 Appellant continued to submit evidence from Dr. Jackson. On September 2, 2014 

Dr. Jackson noted treating appellant for chronic right shoulder and lower back pain. He 

indicated that she was unable to stand or walk for any period and had difficulty using her right 

arm due to right shoulder pain. Dr. Jackson reported findings and diagnoses that included 

chronic low back pain, arthritis with degenerative disc disease, chronic right shoulder pain with 

rotator cuff impingement and arthritis. He opined that appellant had a work-related injury 

resulting in chronic lower back and right shoulder pain. Dr. Jackson indicated that it was not 

preexisting and it was permanent and stationary. He opined that her condition was progressive 

and that “no therapy or treatment will allow her to return to work.” 

The Board finds that this opinion is not rationalized as he fails to explain how he 

attributed appellant’s degenerative disc disease and low back and shoulder arthritis as related to 

the accepted condition. 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.9

 Neither the fact that the condition became apparent during a period of 

employment nor the belief that the condition was caused or aggravated by employment factors or 

incidents is sufficient to establish causal relationship.10 Causal relationship must be 

substantiated by reasoned medical opinion evidence, which is appellant’s responsibility to 

submit. The Board finds that this report is insufficiently rationalized and is of limited probative 

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

10 Id.
7

value with regard to causal relationship. The Board also notes that this report is not sufficiently 

rationalized to create a conflict with the opinion of Dr. Collis.11 

In his June 13, 2011 to January 30, 2012 notes, Dr. Jackson opined that appellant’s 

chronic low back pain and right shoulder pain were work related. However, he did not explain 

how particular work duties would cause or contribute to a diagnosed medical condition. As 

noted, part of appellant’s burden of proof includes the submission of rationalized medical opinion 

addressing whether there is a causal relationship between the claimant’s diagnosed condition and 

the implicated employment factors. Other medical evidence from Dr. Jackson does not offer an 

opinion on causal relationship. These reports are of limited probative value.12

As there is no reasoned medical evidence explaining how appellant’s employment duties 

caused or aggravated a medical condition involving her shoulders or low back, appellant has not 

met her burden of proof in establishing that she sustained a medical condition causally related to 

factors of her employment. 

On appeal appellant requested that she be allowed 30 days for further legal arguments. 

The Board notes that no further legal arguments were received.13 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 her burden of proof to establish an injury 

causally related to factors of her federal employment. 

                                                             11 See John D. Jackson, 55 ECAB 465 (2004) (a simple disagreement between two physicians does not, of itself, 

establish a conflict; to constitute a conflict of medical opinion, the opposing physicians’ reports must be of virtually 

equal weight and rationale). 

12 Linda I. Sprague, 48 ECAB 386 (1997) (medical evidence that does not offer any opinion regarding the cause 

of an employee’s condition is of diminished probative value on the issue of causal relationship). 

13 Before OWCP, appellant argued that her claim should be accepted noting that she was approved for OPM and 

SSA disability benefits. However, the Board has long held that entitlement to benefits under statutes administered 

by other federal agencies does not establish entitlement to benefits under FECA. Joseph R. Santos, 57 ECAB 554, 

558 (2006). 
8

ORDER 

IT IS HEREBY ORDERED THAT the March 3, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: September 28, 2016 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board