United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

L.N., Appellant 

and 

DEPARTMENT OF HOMELAND SECURITY, 

TRANSPORTATION SECURITY 

ADMINISTRATION, MCCARRAN 

INTERNATIONAL AIRPORT, Las Vegas, NV, 

Employer 

__________________________________________ 

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Docket No. 16-0566 

Issued: October 18, 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 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On February 3, 2016 appellant filed a timely appeal from a December 23, 2015 merit 

decision of the Office of Workers’ Compensation Programs (OWCP).1 Pursuant to the Federal 

Employees’ Compensation Act2 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has 

jurisdiction over the merits of this claim. 

 1

 The Board notes that appellant submitted additional evidence after OWCP rendered its December 23, 2015 

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

decision and therefore, this additional evidence cannot be considered on appeal. 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

 5 U.S.C. § 8101 et seq.
2

ISSUE 

The issue is whether appellant has established a recurrence of disability on or after 

October 4, 2015 as a result of her June 26, 2013 accepted work injuries. 

FACTUAL HISTORY 

On June 27, 2013 appellant, then a 61-year-old transportation security officer, filed a 

traumatic injury claim (Form CA-1) alleging that on June 26, 2013 she tripped on a mat causing 

her to wrench her back. OWCP accepted the claim for lumbar sprain, temporary aggravation of 

L5 radiculopathy, temporary aggravation of degenerative disc disease, and temporary 

aggravation of L3-L4 disc bulge. Appellant stopped work on the date of injury. She received 

compensation benefits on the supplemental and periodic rolls from August 15, 2013 to 

April 4, 2015. 

On October 29, 2014 appellant underwent the removal of hardware at L4-L5 with 

decompression and L3-L4 posterior lumbar interbody fusion (PLIF) and posterior lateral fusion 

by Dr. William Muir, Board-certified in orthopedic surgery. OWCP approved both the lumbar 

spine and disc surgery. The claim was later expanded to include the accepted conditions of 

lumbar sprain, lumbosacral radiculitis, degeneration of lumbar intervertebral disc, and 

displacement of lumbar intervertebral disc without myelopathy. 

Per Dr. Muir’s instructions, appellant was released to work with permanent light-duty 

restrictions on March 28, 2015. She accepted a limited-duty assignment, effective March 30, 

2015, which restricted her to intermittent walking, standing, lifting, pushing, and pulling, and no 

twisting at the waist or bending/stooping. 

In a September 16, 2015 report, Dr. Muir noted complaints of numbness in the right thigh 

and back pain. He noted postoperative findings of persistent L5 radiculopathy and chronic L5 

sensory radiculopathy significantly worsened after the June 2013 injury. Dr. Muir requested a 

magnetic resonance imaging (MRI) scan of the lumbar spine. 

In an October 1, 2015 diagnostic report, Dr. Bhuvana P. Kittusamy, a Board-certified 

diagnostic radiologist, reported that the lumbar spine MRI scan revealed L2-L3 broad-based 

posterior disc osteophyte complex including central disc protrusion with ligamentum flavum and 

facet joint hypertrophic changes causing mild-to-moderate narrowing of the lateral recess and 

neural foramina; L3-L4 postsurgical changes with posterior hypertrophic and facet joint 

hypertrophic changes causing moderate bilateral neural foraminal narrowing; L4-L5 postsurgical 

changes with posterior hypertrophic and facet joint hypertrophic changes; postsurgical changes 

in the posterior elements and posterior paraspinal soft tissues at L4-L5 and L5-S1 and mild soft 

tissue enhancement likely representing scar tissue; L5-S1 broad-based posterior annular bulge 

with ligamentum flavum and facet joint hypertrophic changes; and posterior intervertebral disc 

abnormalities from T10-T11 to T12-L1 which were only seen in the sagittal images. 

In an October 8, 2015 medical report, Dr. Muir reported that review of the October 1, 

2015 lumbar spine MRI scan revealed right foraminal disc herniation at L2-3. He recommended 
3

a right-sided discectomy at L2-L3 and restricted appellant from working due to disc herniation 

requiring surgery and progressive loss of strength and sensation. 

In an October 8, 2015 attending physician’s report (Form CA-20), Dr. Muir reported 

findings of lumbar stenosis, lumbar radiculitis, and lumbar postlaminectomy syndrome. He 

noted prior treatment on October 29, 2014 for hardware removal at L4-L5 and lumbar fusion. 

Dr. Muir diagnosed lumbar degenerative disc disease and lumbar disc displacement without 

myelopathy. He checked the box marked “yes” when asked if the condition was caused or 

aggravated by the employment activity, noting the slip and fall back injury on the job in 

June 2013. Dr. Muir restricted appellant from walking, standing, lifting up to 10 pounds, 

kneeling, and using stairs. He reported that she was to remain off work until 

November 20, 2015. An October 8, 2015 work capacity evaluation (OWCP-5c) form was also 

submitted providing appellant restrictions. 

On October 16, 2015 appellant filed a claim for compensation (Form CA-7) for leave 

without pay beginning October 4, 2015 and continuing. 

By letter dated November 16, 2015, OWCP informed appellant that the evidence of 

record was insufficient to support her recurrence claim beginning October 4, 2015. It noted that 

her Form CA-7 claiming compensation for the period beginning October 4, 2015 appeared to be 

claiming disability due to a material change/worsening of her accepted work-related conditions. 

Appellant was advised of the medical and factual evidence necessary to support a recurrence 

claim and was afforded 30 days to submit the additional evidence. 

On November 12, 2015 appellant filed a notice of recurrence (Form CA-2a) alleging a 

return/increase of disability as of October 4, 2015. She reported that she was on limited duty and 

was required to monitor an exit, which entailed a lot of walking. Appellant explained that after 

returning to work she used her cane to walk, but experienced pain. She reported that in 

August 2015 she was bending and felt pain radiate down her thigh which did not subside. 

Appellant stated that her physician informed her that she had a new herniated disc which could 

weaken and reoccur. He provided her permanent restrictions noting that she could never return 

to full duty. 

In a November 17, 2015 Form CA-20, Dr. Muir restricted appellant from working until 

December 20, 2015. 

In a November 17 and December 15, 2015 medical report, Dr. Muir reported that 

appellant sustained a right foraminal disc herniation at L2-L3 as evidenced by physical 

examination and an October 1, 2015 MRI scan of the lumbar spine. He recommended a rightsided discectomy at L2-3 due to progressive weakness and pain. Dr. Muir further reported that 

appellant was unable to work due to disc herniation requiring surgery and progressive loss of 

strength and sensation. 

By decision dated December 23, 2015, OWCP denied appellant’s recurrence claim as the 

medical evidence failed to establish that her alleged disability beginning October 4, 2015 was 

due to a material change/worsening of her accepted work-related conditions. 
4

LEGAL PRECEDENT 

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 resulted from a previous 

compensable injury or illness and without an intervening injury or new exposure in the work 

environment.3

 This term also means an inability to work because a light-duty assignment made 

specifically to accommodate an employee’s physical limitations and which is necessary because 

of a work-related injury or illness is withdrawn or altered so that the assignment exceeds the 

employee’s physical limitations.4

OWCP procedures provide 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.5

 

An employee who claims a recurrence of disability due to an accepted employmentrelated injury has the burden of proof to establish, by the weight of the substantial, reliable, and 

probative evidence, that the disability for which he or she claims compensation is causally 

related to the accepted injury. This burden of proof requires that a claimant furnish medical 

evidence from a physician who, on the basis of a complete and accurate factual and medical 

history, concludes that, for each period of disability claimed, the disabling condition is causally 

related to the employment injury, and supports that conclusion with medical reasoning.6 Where 

no such rationale is present, the medical evidence is of diminished probative value.7

ANALYSIS 

OWCP accepted appellant’s claim for a sprain of the back lumbar region, lumbosacral 

radiculitis, degeneration of lumbar intervertebral disc, and displacement of lumbar intervertebral 

disc without myelopathy. On October 29, 2014 appellant underwent removal of hardware at L4-

L5 with decompression and L3-L4 PLIF and posterior lateral fusion which was approved by 

OWCP. She stopped work on the date of injury and returned to full duty with restrictions on 

March 30, 2015. The issue is whether appellant has established a recurrence of total disability 

beginning October 4, 2015 and continuing causally related to her accepted June 26, 2013 

injuries. 

 3

 20 C.F.R. § 10.5(x); see S.F., 59 ECAB 525 (2008). See 20 C.F.R. § 10.5(y) (defines recurrence of a medical 

condition as a documented need for medical treatment after release from treatment for the accepted condition). 

4 Id. 

5

 Federal (FECA) Procedure Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.2 (June 2013). Kenneth R. 

Love, 50 ECAB 193, 199 (1998). 

6 Ronald A. Eldridge, 53 ECAB 218 (2001). 

7 Mary A. Ceglia, Docket No. 04-113 (issued July 22, 2004). 
5

Appellant has not alleged a change in her light-duty job requirements. Instead, she 

attributed her inability to work to a change in the nature and extent of her employment-related 

conditions. Appellant, therefore, has the burden of proof to provide medical evidence to 

establish that she was disabled due to a worsening of her accepted work-related conditions.8

 She 

filed claims for compensation for the period beginning October 4, 2015 alleging that she was 

totally disabled due to her accepted June 26, 2013 employment injuries. However, appellant did 

not submit probative medical evidence demonstrating total disability for this period of time due 

to her accepted conditions. The Board finds that she has not met her burden of proof to establish 

her recurrence claim. 

In medical reports dated September 16 through December 15, 2015, Dr. Muir treated 

appellant for complaints of numbness in the right thigh and back pain. He noted that an 

October 1, 2015 MRI scan of her lumbar spine revealed right foraminal disc herniation at L2-L3 

and recommended a right-sided discectomy at L2-3. Dr. Muir restricted appellant from working 

beginning October 8, 2015 due to disc herniation requiring surgery and progressive loss of 

strength and sensation. 

The Board finds that the opinion of Dr. Muir is insufficiently rationalized. The reports of 

Dr. Muir fail to provide sufficient medical rationale to establish total disability due to a 

recurrence. Dr. Muir did not relate appellant’s L2-L3 right foraminal disc herniation to her 

June 26, 2013 employment injuries or residuals of the October 29, 2014 lumbar surgery, nor did 

he provide adequate bridging evidence to show a spontaneous worsening of the accepted 

conditions.9

 His lack of explanation makes it unclear if the October 1, 2015 MRI scan findings 

are the result of a preexisting nonoccupational condition, caused by a new injury from 

appellant’s limited-duty assignment, or due to a recurrence of disability.10 While Dr. Muir found 

her disabled as a result of the L2-L3 disc herniation, he failed to provide the required link 

relating the disability to her previously accepted work injuries to establish a spontaneous 

worsening of the accepted conditions.11 

On his Form CA-20 Dr. Muir restricted appellant from returning to work and checked the 

box marked “yes” when asked if her condition was caused or aggravated by the employment 

activity, noting the slip and fall back injury on the job in June 2013. However, the Board has 

held that a report that addresses causal relationship with a checkmark, without medical rationale 

explaining how the work condition caused the alleged injury, is of diminished probative value 

and insufficient to establish causal relationship.12 Although Dr. Muir generally supported that 

appellant’s continued symptoms were a result of her occupational lumbar injuries, his opinion on 

 8 D.L., Docket No. 13-1653 (issued November 22, 2013). 

9 J.H., Docket No. 14-775 (issues July 14, 2014). 

10 P.O., Docket No. 14-1675 (issued December 3, 2015). 

11 T.M., Docket No. 06-440 (issued August 7, 2006). 

12 See Calvin E. King, Jr., 51 ECAB 394 (2000); see also Frederick E. Howard, Jr., 41 ECAB 843 (1990). 
6

causal relationship was conclusory as to how the conditions caused disability or remained 

symptomatic.13 

Dr. Muir restricted appellant from standing, walking, lifting up to 10 pounds, kneeling, 

stooping, and using stairs. He reported that appellant’s progressive loss of strength and 

sensation, and need for surgery, rendered her unable to return to work. While Dr. Muir generally 

explained appellant’s inability to work, he failed to relate the L2-L3 disc herniation to her 

accepted conditions to establish total disability.14 He did not discuss her limited-duty assignment 

to profess some knowledge as to why she could not work for the claimed periods. The Board has 

held that a medical opinion that is not fortified by rationale is of diminished probative value.15

OWCP also received an October 1, 2015 MRI scan report from Dr. Kittusamy. This 

diagnostic report, however, did not address disability or causal relationship and was therefore of 

limited probative value.16

Appellant did not submit any medical reports from a physician who, on the basis of a 

complete and accurate factual and medical history, concluded that she was totally disabled on or 

after October 4, 2015 due to residuals of her accepted injuries.17 She failed to establish by the 

weight of the reliable, probative, and substantial evidence, a change in the nature and extent of 

the injury-related condition resulting in her inability to perform her employment duties. 

As appellant has not submitted medical evidence establishing a recurrence of disability 

on or after October 4, 2015 due to her accepted employment injuries, the Board finds that she has 

not met her burden of proof.18 For the reasons stated above, OWCP’s denial of the claimed 

compensation for disability was proper under the law and facts of the case.19

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. 

 13 See George Randolph Taylor, 6 ECAB 986, 988 (1954) (where the Board found that a medical opinion not 

fortified by medical rationale is of little probative value). 

14 R.A., Docket No. 14-1327 (issued October 10, 2014). 

15 Cecilia M. Corley, 56 ECAB 662 (2005). 

16 See S.B., Docket No. 13-1162 (issued December 12, 2013). 

17 The Board notes that appellant could be entitled to wage-loss compensation for attending medical appointments 

on or after October 4, 2015. If a claimant has returned to work following an accepted injury or the onset of an 

occupational disease and must leave work and lose pay or use leave to undergo treatment, examination or testing for 

the accepted condition, compensation should be paid for wage loss under section 8105 of FECA, while undergoing 

the medical services and for a reasonable time spent traveling to and from the location where services were 

rendered. 5 U.S.C. § 8105. For a routine medical appointment, a maximum of four hours of compensation is 

usually allowed. See FECA Manual, Part 2 -- Claims, Computing Compensation, Chapter 2.901.19 

(February 2013). See also William A. Archer, 55 ECAB 674 (2004).

18 J.G., Docket No. 13-737 (issued October 29, 2013). 

19 Beverly A. Spencer, 55 ECAB 501 (2004). 
7

CONCLUSION 

The Board finds that appellant did not meet her burden of proof to establish a recurrence 

of total disability on or after October 4, 2015, causally related to her accepted employment 

injuries. 

ORDER 

IT IS HEREBY ORDERED THAT the December 23, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: October 18, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board