United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

C.J., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

McLean, VA, Employer 

__________________________________________ 

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Docket No. 16-0055 

Issued: April 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 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On October 13, 2015 appellant filed a timely appeal from an August 5, 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.2

ISSUE 

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

related to a March 2, 2015 employment incident. 

 1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that appellant submitted additional evidence to OWCP after it rendered its August 5, 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. § 510.2(c)(1). 
2

FACTUAL HISTORY 

On March 3, 2015 appellant, then a 61-year-old city carrier, filed a traumatic injury claim 

(Form CA-1) alleging that he sustained an ankle injury on March 2, 2015. He claimed that a 

coworker hit his ankle with a piece of equipment causing him to fall. Appellant stopped work 

that day. 

In a March 2, 2015 duty status report (Form CA-17), Dr. Jong Hee Cho, a chiropractor, 

advised that appellant was unable to return to work until March 23, 2015. In a March 2, 2015 

prescription form, he advised that appellant sustained a right ankle injury, Achilles tendon sprain, 

and contusion. Dr. Cho noted that an x-ray was unremarkable and recommended further 

evaluation by a podiatrist. 

By letter dated March 11, 2015, the employing establishment controverted appellant’s 

claim because he failed to submit medical evidence from a qualified physician. 

By letter dated March 11, 2015, OWCP advised appellant of the type of evidence needed 

to establish his claim. 

In a March 9, 2015 report, Dr. Joonhyun Yoon, a podiatric surgeon, advised that 

appellant’s symptoms began a week earlier at work when a mail cart hit his right leg. He noted 

that appellant indicated that the pain was improving, but increased with ambulation and activity. 

On examination Dr. Yoon noted an antalgic gait on the right, resolving ecchymosis and swelling 

on the posterior right distal leg, healing red granulation tissue on the posterior right leg, moderate 

ankle tenderness, mild ankle swelling, and pain along the distal Achilles tendon and distal 

posterior fibula with no crepitation. He assessed right tendinitis and right ankle fracture. 

However, an x-ray of the right ankle and foot revealed no acute fracture. Dr. Yoon noted that 

appellant had a work-related injury and was unable to perform his work. On March 17, 2015 he 

prescribed physical therapy and acupuncture. 

In a March 19, 2015 statement, appellant advised that he was pushing a mail hamper at 

work when a coworker ran into his heel, ankle, and right hip with a large metal crate. He noted 

that he sustained a laceration and fell to the ground landing on his right elbow and hip. 

By decision dated April 14, 2015, OWCP denied appellant’s claim finding that the 

evidence of record did not support that the claimed injury occurred as alleged. 

On May 2, 2015 appellant requested reconsideration. He submitted a witness statement 

supporting that he was accidentally struck by an all-purpose container pushed by a coworker. 

Appellant also submitted additional medical evidence. In a March 2, 2015 report, 

Dr. Cho advised that appellant was injured at work when a coworker hit his right foot with a 

piece of equipment. He indicated that appellant related that he fell immediately and felt acute 

pain on the right foot with bleeding. Dr. Cho noted that appellant could not stand or walk and 

also felt pain in his right calf, thigh, hip, and low back. He assessed ankle injury, lumbago, 

sciatica, and lumbar subluxation. Dr. Cho advised that a right ankle x-ray was unremarkable, but 

there was a possibility of hairline fracture not shown on the plain x-ray film. 
3

Several progress reports from Dr. Yoon were submitted. In a March 17, 2015 report, 

Dr. Yoon advised that appellant was experiencing right ankle pain. He noted that he felt less 

pain when wearing a fracture boot, but felt intermittent shooting pain to his posterior leg when he 

tried to move his ankle. In an April 2, 2015 report, Dr. Yoon advised that appellant was 

experiencing some improvement with chiropractic physical therapy. He assessed tendinitis and 

ankle fracture. Dr. Yoon noted that appellant experienced a work-related injury and was unable 

to work. In an April 13, 2015 report, he detailed appellant’s treatment history. Dr. Yoon noted 

that appellant was doing better, but was still experiencing stiffness. Examination of the right 

ankle revealed no tenderness, mild swelling, no erythema, and a slightly thickened distal Achilles 

tendon. Dr. Yoon noted that appellant’s condition was work related and indicated that he 

reached maximum medical improvement (MMI). 

In an April 22, 2015 report, Dr. Chin Oh Kim, an internist, advised that appellant was 

seen and diagnosed with an ankle injury on March 2, 2015. He noted that appellant needed to 

see a foot and ankle specialist for his condition. 

By decision dated August 5, 2015, OWCP modified its prior decision finding that the 

factual basis for the claim was accepted, but that the medical evidence of record remained 

insufficient to establish that the work incident caused or contributed to the claimed condition. 

LEGAL PRECEDENT 

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

essential elements of his or her claim by the weight of reliable, probative, and substantial 

evidence,3 including that the individual is an “employee” within the meaning of FECA and that 

he or she filed a claim within the applicable time limitation.4

 The employee must also establish 

an injury in the performance of duty as alleged and that any disability for work was causally 

related to the employment injury.5

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, it first must be determined whether fact of injury has been established. 

There are two components involved in establishing fact of injury. First, the employee must 

submit sufficient evidence to establish that he actually experienced the employment incident at 

the time, place, and in the manner alleged. Second, the employee must submit medical evidence 

to establish that the employment incident caused a personal injury.6

Rationalized medical opinion evidence is generally required to establish causal 

relationship. The opinion of the physician must be based on a complete factual and medical 

background, must be one of reasonable medical certainty, and must be supported by medical 

 3

 J.P., 59 ECAB 178 (2007); Joseph M. Whelan, 20 ECAB 55, 57 (1968). 

4 R.C., 59 ECAB 427 (2008). 

5 Id.; Elaine Pendleton, 40 ECAB 1143, 1145 (1989). 

6

 T.H., 59 ECAB 388 (2008). 
4

rationale explaining the nature of the relationship between the diagnosed condition and the 

specific employment factors identified by the claimant.7

ANALYSIS 

On March 2, 2015 appellant’s right ankle was hit by a piece of equipment. The evidence 

supports that the claimed work incident occurred as alleged. However, the Board finds that the 

medical evidence of record is insufficient to establish that the employment incident on March 2, 

2015 caused a right ankle injury. 

In his March 9, 2015 report, Dr. Yoon advised that appellant’s symptoms began when a 

mail cart hit his right leg at work. He assessed right tendinitis and right ankle fracture; yet he 

noted that an x ray of the right ankle and foot revealed no acute fracture. Dr. Yoon advised that 

appellant had a work injury and could not perform his work. Although he attributed appellant’s 

condition to the March 2, 2015 work incident, Dr. Yoon failed to explain how the incident 

caused appellant’s tendinitis and right ankle fracture. The Board has long held that medical 

opinions not containing rationale on causal relation are of diminished probative value and are 

generally insufficient to meet appellant’s burden of proof.8

 Dr. Yoon also failed to explain how 

he determined that appellant had a right ankle fracture, despite the fact that an x-ray revealed no 

acute fracture. Other reports by Dr. Yoon are also insufficient to discharge appellant’s burden of 

proof. In his March 17, April 2, and 13, 2015 progress reports, Dr. Yoon described appellant’s 

condition as work related. These reports are insufficient to discharge appellant’s burden of proof 

as they also fail to provide adequate rationale explaining how the March 2, 2015 employment 

incident caused tendinitis and right ankle fracture. 

Reports from Dr. Cho including his March 2, 2015 report, which advised that appellant 

was injured at work and assessed ankle injury, lumbago, sciatica, and lumbar subluxation, cannot 

constitute competent medical evidence. Medical opinion evidence, in general, can only be given 

by a qualified physician.9

 As defined under FECA, a physician includes a chiropractor only to 

the extent that his reimbursable services are limited to treatment consisting of manual 

manipulation of the spine to correct a subluxation as demonstrated by x-ray to exist.10 

Subluxation means an incomplete dislocation, off-centering, misalignment, fixation, or abnormal 

spacing of the vertebrae which must be demonstrable on any x-ray film to an individual trained 

in the reading of x-rays.11 Dr. Cho diagnosed lumbar subluxation, but there was no indication in 

the report that the chiropractor obtained or reviewed x-rays in rendering his diagnosis of 

subluxation. As a result, he does not meet the statutory definition of physician, and his reports 

lack probative value.12 Furthermore, appellant claimed an ankle injury, not a spine injury. The 

 7 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345 (1989). 

8 Carolyn F. Allen, 47 ECAB 240 (1995). 

9 Charley V.B. Harley, 2 ECAB 208, 211 (1949). 

10 5 U.S.C. § 8101(2); Merton J. Sills, 39 ECAB 572, 575 (1988). 

11 20 C.F.R. § 10.5(bb). 

12 L.S., Docket No. 07-560 (issued June 22, 2007). 
5

Board has held that even under the circumstances where a chiropractor is recognized as a 

physician under FECA, the chiropractor is still not considered a physician in diagnosing or 

evaluating disorders of the extremities, although those disorders may originate in the spine.13

The Board notes that appellant indicated that he sustained a laceration as a result of the 

work injury. OWCP procedures will allow a minor injury to be accepted without a medical 

report if the condition can be verified on visual inspection by a lay person, (e.g., burn, laceration, 

insect sting or animal bite).14 This provision, however, is only applicable if no time is lost from 

work due to disability. In the present case, appellant has indicated that he stopped work on 

March 2, 2013. 

Consequently, appellant has submitted insufficient medical evidence to establish his 

claim. Causal relationship is a medical question that must be established by probative medical 

opinion from a physician.15 The physician must accurately describe appellant’s work duties and 

medically explain the pathophysiological process by which these duties would have caused or 

aggravated his condition.16

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 of proof in establishing that he 

sustained an injury causally related to a March 2, 2015 employment incident. 

 13 George E. Williams, 44 ECAB 530 (1993). 

14 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3(d)(1) 

(January 2013). 

15 Jennifer Atkerson, 55 ECAB 317 (2004). 

16 Solomon Polen, 51 ECAB 341 (2000) (rationalized medical evidence must relate specific employment factors 

identified by the claimant to the claimant’s condition, with stated reasons by a physician). See also S.T., Docket No. 

11-237 (issued September 9, 2011). 
6

ORDER 

IT IS HEREBY ORDERED THAT the August 5, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: April 5, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board