United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

G.B., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Zephyrhills, FL, Employer 

__________________________________________ 

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Docket No. 15-1319 

Issued: December 8, 2015 

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 

COLLEEN DUFFY KIKO, Judge 

JURISDICTION 

On May 26, 2015 appellant filed a timely appeal from a December 8, 2014 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 has met her burden of proof to establish a recurrence of 

total disability from June 4 to 17, 2014 causally related to her October 26, 2010 employment 

injuries. 

On appeal, appellant contends that she was disabled for work during the claimed period 

as a result of the treatment she received for her continuing employment-related residuals. She 

asserts that she sustains a recurrence of disability every year as a result of this treatment. 

 1

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

OWCP accepted that on October 26, 2010 appellant, then a 44-year-old rural mail carrier, 

sustained a lumbar strain and sprain, and inflamed lumbar facet joints while in the performance 

of duty. 

On May 1, 2013 OWCP accepted a recurrence of disability on March 25, 2013. It paid 

compensation benefits for total disability through June 15, 2013 when she returned to full-time 

full-duty work. 

On June 9, 2014 appellant filed a claim for compensation (Form CA-7) for leave without 

pay (LWOP) from June 4 to 17, 2014. 

In a June 6, 2014 medical report, Dr. Ashraf F. Hanna, an attending Board-certified 

anesthesiologist, noted that appellant presented for a follow-up evaluation of her low back pain 

and chronic pain. He provided a history of her social background and medical treatment. 

Dr. Hanna provided findings on physical examination and diagnosed chronic pain, lumbar 

myofascial pain, sacroilitis, spinal enthesopathy, facet syndrome, and thoracic and lumbosacral 

neuritis or radiculitis. He addressed appellant’s pain management plan and advised that he could 

not predict with any medical degree of certainty whether her symptoms would progress or 

worsen over time. In a June 6, 2014 return to work slip, Dr. Hanna advised that appellant could 

not work from June 4 to 17, 2014. 

By letter dated June 20, 2014, OWCP advised appellant that the evidence submitted was 

insufficient to establish her claim. It requested that she submit rationalized medical evidence 

explaining why she was totally disabled from work due to her accepted conditions. 

In a June 12, 2014 surgical report, Dr. Hanna described appellant’s radiofrequency 

lesioning of the right L2, L3, L4, and L5 median branch nerves and radiofrequency of the right 

sacral alar notch with fluoroscopic guidance to treat her lumbar facet joint disease and lumbar 

spondylosis. In a July 11, 2014 report, he noted that she presented for a follow-up evaluation of 

her low back pain and chronic pain. Dr. Hanna provided findings on physical examination, and 

diagnosed discogenic syndrome and displacement of lumbar intervertebral disc without 

myelopathy. In another report dated July 11, 2014, he indicated that appellant received a right 

sacral tuberous ligament injection to treat her SI joint pain. On July 24, 2014 Dr. Hanna noted 

that she was first seen in his office on December 3, 2010 for the October 26, 2010 employment 

injury. 

In an August 5, 2014 decision, OWCP denied appellant’s claim for compensation from 

June 4 to 17 2014, finding that the medical evidence did not establish total disability during the 

claimed period due to her accepted October 26, 2010 employment injuries. 

On November 2, 2014 appellant requested reconsideration. 

In a September 2, 2014 report, Dr. Hanna addressed the need for appellant to continue to 

receive sacroiliac injections to properly address her approved work-related lumbar spine sprain, 

lumbosacral spondylosis, and lumbar disc displacement. In an October 13, 2014 report, he 

reiterated that she had accepted diagnoses of sprain of the lumbar region, lumbosacral 
3

spondylosis, and lumbar disc displacement. Dr. Hanna requested that appellant be excused from 

work from June 4 to 17, 2014 due to severe pain that was and continued to be directly related to 

her work injury. He indicated that she was scheduled to undergo a radiofrequency ablation at the 

right L2-5 levels on June 12, 2014. Dr. Hanna advised that it was medically necessary for 

appellant to have time off work due to increased pain that directly stemmed from her October 26, 

2010 work injury. Appellant had to be off work because she was not able to sit, stand, or walk 

for a prolonged time due to her disabling pain. She also needed time off work to recover from 

the procedure. Dr. Hanna reviewed imaging test results and noted that a physical examination 

showed significant tenderness of the lumbar spine, muscle spasms, and decreased range of 

motion. 

In an October 2, 2014 report, Dr. James B. Billys, a Board-certified orthopedic surgeon, 

noted that appellant was doing quite well following a facet rhizotomy and injections as she had 

minimal complaints of pain. He provided findings on examination and advised that she could 

continue with her usual and customary duties at work. 

In a December 8, 2014 decision, OWCP denied modification of the August 5, 2014 

decision finding the medical evidence submitted was insufficient to establish a material 

worsening of appellant’s accepted October 26, 2010 employment injuries. 

LEGAL PRECEDENT 

Section 10.5(x) of OWCP’s regulations provide that a recurrence of disability means an 

inability to work after an employee has returned to work, caused by a spontaneous change in a 

medical condition which had resulted from a previous injury or illness without an intervening 

injury or new exposure to the work environment that caused the illness.2

OWCP procedures state that a recurrence of disability includes a work stoppage caused 

by a spontaneous material change in the medical condition demonstrated by objective findings. 

That change must result from a previous injury or occupational illness rather than an intervening 

injury or new exposure to factors causing the original illness. It does not include a condition that 

results from a new injury, even if it involves the same part of the body previously injured.3

An individual who claims a recurrence of disability resulting from an accepted 

employment injury has the burden of establishing that the disability is related to the accepted 

injury. This burden requires furnishing medical evidence from a physician who, on the basis of a 

complete and accurate factual and medical history, concludes that the disabling condition is 

causally related to the employment injury and who supports that conclusion with sound medical 

reasoning.4

 Where no such rationale is present, the medical evidence is of diminished probative 

value.5

 2

 20 C.F.R. § 10.5(x); see S.F., 59 ECAB 525 (2008). 

3

 Federal (FECA) Procedure Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.3(c)(5) (June 2013). 

4 Dennis E. Twardzik, 34 ECAB 536 (1983); Max Grossman, 8 ECAB 508 (1956); 20 C.F.R. § 10.104. 

5 Mary A. Ceglia, 55 ECAB 626 (2004); Albert C. Brown, 52 ECAB 152 (2000). 
4

ANALYSIS 

OWCP accepted that appellant sustained a traumatic lumbar strain and sprain, and 

inflamed lumbar facet joints while in the performance of duty on October 26, 2010. It 

subsequently accepted that she sustained a recurrence of disability on March 25, 2013. 

Appellant returned to full-time regular duty on June 15, 2013. 

Appellant filed a Form CA-7 for compensation for LWOP on June 9, 2014, alleging that 

from June 4 to 17, 2014 she became disabled due to her accepted October 26, 2010 work 

injuries. The Board finds that she has failed to submit sufficient reasoned medical evidence to 

establish that her disability in June 2014 was causally related to her October 26, 2014 

employment injuries. 

Appellant submitted reports from her attending physician, Dr. Hanna. In a June 6, 2014 

return to work slip, Dr. Hanna advised that she could not work from June 4 to 17, 2014. In an 

October 13, 2014 report, he requested that appellant be excused from work from June 4 to 17, 

2014 due to severe pain that was and continued to be directly related to her accepted work injury. 

Dr. Hanna noted that it was medically necessary for her to have time off work as she was not 

able to sit, stand, or walk for a prolonged time due to her disabling pain and she needed time to 

recover from a radiofrequency ablation at the right L2-5 levels performed on June 12, 2014. 

Although he supported that appellant was disabled during the claimed period, his reports did not 

specifically explain how any continuing disability was directly related to the accepted 

October 26, 2014 employment injuries or related to the medical procedures. The Board has 

found that a medical opinion not fortified with medical rationale is of diminished probative 

value.6

 Further, the Board notes that contrary to Dr. Hanna’s finding in his October 13, 2014 

report, appellant’s claim has not been accepted for lumbosacral spondylosis and lumbar disc 

displacement. 

Dr. Hanna’s June 6 and 12, 2014 reports addressed appellant’s lumbar conditions and 

treatment, but failed to provide a rationalized opinion regarding the causal relationship between 

the accepted October 26, 2010 work injuries and her claimed disability. Thus, his reports do not 

support her claim of total disability from June 4 to 17, 2014 due to the accepted employment 

injuries.7

 Similarly, the remaining reports from Dr. Hanna do not contain an opinion relating 

appellant’s diagnosed lumbar conditions and claimed disability to the accepted employment 

injuries. As such, these reports are of diminished probative value on the issue of whether 

appellant was disabled from June 4 to 17, 2014.8

Likewise, Dr. Billys’ October 2, 2014 report which addressed appellant’s treatment and 

ability to perform her usual and customary work duties is insufficient to establish her claim for a 

 6 J.R., Docket No. 12-1099 (issued November 7, 2012); Douglas M. McQuaid, 52 ECAB 382 (2001). 

7 Id. 

8 Id. 
5

recurrence of disability. He did not provide an opinion stating that she was totally disabled for 

work from June 4, to 17, 2014 due to her accepted work injuries.9

Accordingly, the Board finds that appellant has not met her burden of proof to establish 

that the period of total disability from June 4 to 17, 2014 was caused by or related to the 

October 26, 2014 employment injuries. 

On appeal, appellant contends that she was disabled for work during the claimed period 

as a result of the treatment she received for her continuing employment-related residuals. She 

asserts that she sustains a recurrence of disability every year as a result of this treatment. 

However, as discussed above, the medical evidence is insufficient to establish that the treatment 

requiring appellant to be off work is related to the accepted conditions. 

Appellant may submit new evidence to OWCP with a written request for reconsideration 

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 did not meet her burden of proof to establish a recurrence 

of total disability from June 4 to 17, 2014 causally related to her October 26, 2010 employment 

injuries. 

 9 Id. 
6

ORDER 

IT IS HEREBY ORDERED THAT the December 8, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: December 8, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board