United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.M., Appellant 

and 

U.S. POSTAL SERVICE, NORTHERN OHIO 

PERFORMANCE CLUSTER, Cleveland, OH, 

Employer 

__________________________________________ 

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Docket No. 16-0641 

Issued: July 5, 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 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On February 17, 2016 appellant filed a timely appeal of an October 27, 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 consider the merits of the case.2

ISSUE 

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

related to the accepted August 31, 2015 employment incident. 

 1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that appellant submitted additional evidence after OWCP rendered its October 27, 2015 

decision. The Board’s jurisdiction is limited to reviewing the evidence that was before OWCP at the time of its final 

decision. Therefore, this additional evidence cannot be considered by the Board. 20 C.F.R. § 501.2(c)(1); Dennis E. 

Maddy, 47 ECAB 259 (1995); James C. Campbell, 5 ECAB 35, 36 n.2 (1952). 
2

FACTUAL HISTORY 

On September 1, 2015 appellant, then a 52-year-old city carrier assistant, filed a 

traumatic injury claim (Form CA-1) alleging that on August 31, 2015, while carrying/loading 

large boxes from carts on the dock into the truck, she injured her left shoulder and low back 

center. She stopped work on September 1, 2015 and returned to work on September 4, 2015. 

In support of her claim, appellant submitted a September 1, 2015 report from 

Dr. Jonathon Leizman, a family practitioner. Dr. Leizman related that appellant’s work-related 

diagnoses were left shoulder and lumbar strain. 

By letter dated September 23, 2015, OWCP informed appellant that further medical 

evidence was necessary to establish her claim. Appellant was afforded 30 days within which to 

submit the information. 

 In response, appellant submitted a September 10, 2015 request for medical service 

wherein Dr. Leizman requested that appellant seek follow up with physical therapy and a left 

shoulder magnetic resonance imaging scan. She also submitted an October 1, 2015 duty status 

report (Form CA-17) from Dr. Leizman which prohibited appellant from reaching above her 

shoulder and provided limitations on simple grasping and lifting over 10 pounds. 

On October 23, 2015 OWCP received a September 10, 2015 report from a physician 

assistant which noted diagnoses of left shoulder strain and lumbar strain. 

By decision dated October 27, 2015, OWCP denied appellant’s claim as the medical 

evidence did not demonstrate that the claimed medical conditions were related to the established 

work-related event. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of his or her claim, 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 and/or specific condition for which compensation is claimed are 

causally related to the employment injury. 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.3 

In order to determine whether an employee actually sustained an 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, which must be considered in 

conjunction with one another. The first component to be established is that the employee 

actually experienced the employment incident or exposure, which is alleged to have occurred.4

 

 3 Jussara L. Arcanjo, 55 ECAB 281, 283 (2004). 

4 See Federal (FECA) Procedure Manual, Part 2 -- Claims, Fact of Injury, Chapter 2.803(2)(a) (August 2012). 
3

In order to meet his or her burden of proof to establish the fact that he or she sustained an injury 

in the performance of duty, an employee must submit sufficient evidence to establish that he or 

she actually experienced the employment injury or exposure at the time, place, and in the manner 

alleged.5

The second component is whether the employment incident caused a personal injury and 

generally can be established only by medical evidence.6

 The medical evidence required to 

establish causal relationship is usually rationalized medical 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.7

ANALYSIS 

OWCP accepted that the work incident had occurred as alleged and that the medical 

evidence established a diagnosis of left shoulder and lumbar strain. However, it denied 

appellant’s claim as she had failed to submit rationalized medical evidence describing how the 

accepted incident caused or aggravated her diagnosed conditions. 

In his September 1, 2015 report, Dr. Leizman noted diagnoses of left shoulder and 

lumbar strain. However, he did not provide a history of injury or any opinion regarding the 

cause of the diagnosed conditions. The Board has found that medical opinions which provide 

diagnoses, but lack opinion regarding the cause of the diagnosed conditions, and specifically lack 

any opinion on the issue of whether the conditions were caused or aggravated by the 

employment incident are of limited probative value on the issue of causal relationship.8 

Similarly, in his September 10, 2015 report, Dr. Leizman requested physical therapy 

treatments and a left shoulder MRI scan, but did not provide any opinion regarding causal 

relationship. Likewise, in his October 1, 2015 duty status report, Dr. Leizman noted appellant’s 

work restrictions, but offered no opinion regarding causal relationship. Lacking a rationalized 

opinion regarding causal relationship, these reports are of little probative value in establishing 

appellant’s claim.9

 

 5 Linda S. Jackson, 49 ECAB 486 (1998). 

6 John J. Carlone, 41 ECAB 354 (1989); Horace Langhorne, 29 ECAB 820 (1978). 

7 Judith A. Peot, 46 ECAB 1036 (1995); Ruby I. Fish, 46 ECAB 276 (1994). 

8 See A.M., Docket No. 14-1399 (issued September 23, 2014). 

9 Id. 
4

Finally, appellant submitted a form report signed by a physician assistant. This does not 

constitute competent medical evidence as a physician assistant is not considered a physician 

under FECA.10

The Board finds that as appellant failed to submit rationalized medical evidence 

establishing a causal relationship between the accepted incident and a medical diagnosis, OWCP 

properly denied her claim. 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 

the employment factors or incident is sufficient to establish causal relationship.11 

An award of compensation may not be based on surmise, conjecture, or speculation.12 To 

support a claim for compensation, the evidence should offer a medically-sound explanation of 

how the claimed work event caused or aggravated the claimed condition.13 No physician 

provided a rationalized medical opinion explaining a causal relationship between appellant’s 

accepted employment incident and a medical diagnosis. Appellant, therefore, did not meet her 

burden of proof to establish an injury causally related to the accepted August 31, 2015 

employment incident. 

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 failed to meet her burden of proof to establish an 

employment-related injury on August 31, 2015 causally related to the accepted employment 

incident. 

 10 5 U.S.C. § 8101(2) (this subsection defines a physician as surgeons, podiatrists, dentist, clinical psychologists, 

optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by State law.) 

See also Roy L. Humphrey, 57 ECAB 238, 242 (2005). 

11 See Dennis M. Mascarenas, 49 ECAB 215 (1997). 

12 D.I., 59 ECAB 158 (2007); Ruth R. Price, 16 ECAB 688, 691 (1965). 

13 K.H., Docket No. 15-1809 (issued January 7, 2016). 
5

ORDER 

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ 

Compensation Programs dated October 27, 2015 is affirmed. 

Issued: July 5, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board