United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.S., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Minneapolis, MN, Employer 

__________________________________________ 

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Docket No. 15-1618 

Issued: March 7, 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 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On July 23, 2015 appellant filed a timely appeal from a July 16, 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 met her burden of proof to establish an injury in the 

performance of duty on December 8, 2014. 

 1

 5 U.S.C. § 8101 et seq.

2

 Appellant filed a timely request for oral argument in this case. By order dated December 29, 2015, the Board 

denied her request for oral argument as the Board does not have jurisdiction over the merits of the case and oral 

argument would further delay issuance of a Board decision and not serve a useful purpose. Order Denying Request

for Oral Argument, Docket No. 15-1618 (issued December 29, 2015). 
2

FACTUAL HISTORY 

On May 30, 2015 appellant, then a 51-year-old rural carrier, filed a traumatic injury claim 

(Form CA-1) alleging that on December 8, 2014 she sustained a strain of the right hip and 

buttock when she slipped on ice while carrying a package. She first received medical care on the 

date of injury and did not stop work. Appellant notified her supervisor on June 1, 2015. On the 

reverse side of the form, the employing establishment challenged the claim arguing that it was 

not filed within 30 days. 

By letter dated June 11, 2015, OWCP notified appellant that the evidence of record was 

insufficient to support her claim. Appellant was advised of the medical and factual evidence 

needed and was afforded 30 days to respond. 

By letters dated June 5 and 23, 2015, the employing establishment controverted the claim 

arguing that appellant did not file a timely claim and failed to establish fact of injury and causal 

relationship. It further argued that the medical evidence of record indicated that her injury was 

not work related. 

In a December 8, 2014 CentraCare Health medical report, Dr. Bruce W. Kuhlmann, a 

doctor of osteopathic medicine, reported that appellant complained of pain in the right sacroiliac 

and right buttocks region which occurred when she was carrying packages and slipped. He noted 

that she worked as a rural carrier and as of December 1, 2014 had begun parcel delivery which 

entailed pushing large wheeled flats to load the truck which she would then drive around and 

deliver. Dr. Kuhlmann provided findings on physical examination noting tenderness to palpation 

over the gluteal muscles on the right side and anterior cecum on the right side. He reported that 

appellant suffered a new injury to the lumbar and pelvis region. 

In a December 12, 2014 medical report, Dr. Kuhlmann reported that appellant’s original 

date of injury was May 6, 2009 when she worked as a rural carrier. Appellant recently returned 

after a long hiatus and reported that her duties required a lot of lifting and arm work to deliver 

parcel packages. She believed that she had reached maximum medical improvement, but then 

had significant deterioration since returning back to work. Dr. Kuhlmann noted pain in the upper 

back and neck. 

In a February 13, 2015 medical report, Dr. Kuhlmann provided appellant work 

restrictions due to pain in the lateral epicondyles bilaterally given that her work involved the use 

of her hands. 

Progress notes dated December 9, 2014 through May 5, 2015 from CentraCare Health 

were also submitted from certified medical assistants and registered nurses. In a December 22, 

2014 progress note, Joanna Myers, a certified medical assistant, reported that appellant called 

complaining of back pain. Ms. Myers noted a history of back surgery one and a half years prior. 

She noted that appellant slipped at work and was seen on December 8, 2014 for this injury with 

complaints of difficulty sitting, walking, and standing. In a December 29, 2014 note, Ms. Myers 

reported that Dr. Kuhlmann did not believe the back issue to be work related. 
3

In a July 6, 2015 medical report, Dr. Joel C. Shobe, a Board-certified orthopedic surgeon, 

reported that appellant returned for a follow-up due to left hip and leg symptoms with difficulty 

sitting. He noted a history of laminectomy surgery at L4-5 with left L4-5 discectomy and facet 

joint cyst excision in March 2014. Review of a May 11, 2015 magnetic resonance imaging 

(MRI) scan of the lumbar spine revealed evidence to suggest recurrent disc herniation on the left 

at L4-5 with some facet hypertrophy contributing to subarticular recess stenosis. Dr. Shobe 

further noted collapse of the L2-3 and L4-5 disc. He recommended surgical intervention by 

redoing the left L4-5 laminectomy and discectomy. Dr. Shobe provided appellant work 

restrictions. 

By decision dated July 16, 2015, OWCP denied appellant’s claim finding that the 

evidence of record failed to establish that her diagnosed condition of recurrent disc herniation on 

the left at L4-5 was causally related to the accepted December 8, 2014 employment incident. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden 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 filed within the applicable time 

limitation, that an injury was sustained while in the performance of duty as alleged, and that any 

disability or specific condition for which compensation is claimed are causally related to the 

employment injury.3 These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated on a traumatic injury or an occupational disease.4

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 which is alleged to have occurred.5 The second 

component is whether the employment incident caused a personal injury and generally can be 

established only by medical evidence. 

To establish a causal relationship between the condition, as well as any attendant 

disability claimed and the employment event or incident, the employee must submit rationalized 

medical opinion evidence supporting such a causal relationship.6

 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. This medical opinion must include an accurate history of the 

employee’s employment injury and must explain how the condition is related to the injury. The 

 3 Gary J. Watling, 52 ECAB 278 (2001); Elaine Pendleton, 40 ECAB 1143, 1154 (1989). 

4 Michael E. Smith, 50 ECAB 313 (1999). 

5 Elaine Pendleton, supra note 3 at 1143. 

6 See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983). 
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weight of medical evidence is determined by its reliability, its probative value, its convincing 

quality, the care of analysis manifested, and the medical rationale expressed in support of the 

physician’s opinion.7

ANALYSIS 

OWCP accepted that the December 8, 2014 employment incident occurred as alleged and 

that the claim was timely filed. While the employing establishment controverted appellant’s 

claim alleging that it was untimely filed, there is no requirement that a claim be filed on the date 

of injury. In cases of injury on or after September 7, 1974, section 8122(a) of FECA provides 

that an original claim for compensation for disability or death must be filed within three years 

after the injury or death.8 The issue is whether appellant established that the incident caused an 

injury. The Board finds that she did not submit sufficient medical evidence to support that she 

sustained an injury causally related to the December 8, 2014 employment incident.9

 

In a December 8, 2014 medical report, Dr. Kuhlmann reported that appellant complained 

of pain in the right sacroiliac and buttocks region which occurred when she was carrying 

packages as a rural carrier and her feet slipped. He provided findings on physical examination 

noting tenderness to palpation over the gluteal muscles on the right side and anterior cecum on 

the right side. Dr. Kuhlmann reported that appellant suffered a new injury to the lumbar and 

pelvis region. Pain and tenderness upon examination are, however, symptoms and not diagnoses 

of a verifiable condition.10 In a December 12, 2014 medical report, Dr. Kuhlmann reported that 

appellant’s original date of injury was May 6, 2009 when she worked as a rural carrier, noting 

complaints of pain in the upper back and neck. On February 13, 2015 he provided her work 

restrictions due to pain in the lateral epicondyles bilaterally. 

The Board finds that the opinion of Dr. Kuhlmann is not well rationalized. While 

Dr. Kuhlmann had some understanding of the December 8, 2014 employment incident, he failed 

to establish a firm medical diagnosis and did not provide a rationalized opinion on causal 

relationship. He failed to provide a detailed medical history, only briefly noting an original 

May 6, 2009 injury. A well-rationalized opinion is particularly warranted when there is a history 

of a preexisting condition.11 

Subsequent to his December 8, 2014 report, Dr. Kaufmann noted complaints to the upper 

neck, back, and elbows. The findings in these reports are of no probative value as appellant has 

 7 James Mack, 43 ECAB 321 (1991). 

8

 5 U.S.C. § 8122(a); section 10.100(b) of OWCP regulations also provides that for injuries sustained on or after 

September 7, 1974, a notice of injury must be filed within three years of the injury. 20 C.F.R. § 10.100(b). See 

also A.D., Docket No. 15-0732 (issued September 29, 2015). 

9 See Robert Broome, 55 ECAB 339 (2004). 

10 See P.O., Docket No. 14-1675 (issued December 3, 2015) hip tenderness is a report of a symptom without a 

diagnosis of a verifiable medical condition. See D.N., Docket No. 15-1587 (issued December 23, 2015) pain is a 

symptom not a diagnosis. 

11 T.M., Docket No. 08-975 (issued February 6, 2009); Michael S. Mina, 57 ECAB 379 (2006). 
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alleged a right hip and buttock injury in this claim. Thus, Dr. Kaufmann’s medical reports do not 

constitute probative medical evidence because he failed to provide a clear diagnosis and does not 

adequately explain the cause of appellant’s injury.12 

The remaining medical evidence of record is also insufficient to establish that appellant 

sustained an injury causally related to the December 8, 2014 employment incident. Dr. Shobe’s 

July 6, 2015 report is of limited probative value as he failed to provide findings pertaining to the 

right hip and buttock as alleged by appellant in this traumatic injury claim.13 Rather, he 

referenced a history of left L4-5 laminectomy and discectomy in March 2014 and recommended 

redoing the surgery after a May 11, 2015 MRI scan of the lumbar spine revealed recurrent disc 

herniation on the left at L4-5. Dr. Shobe’s report provides support for a preexisting condition 

unrelated to the December 8, 2014 employment incident as he submitted no findings related to 

the right hip and buttock injury as alleged by appellant in this claim. It is appellant’s burden to 

specify the nature of her claim.14 

The progress notes dated December 9, 2014 through May 5, 2015 from CentraCare 

Health are also insufficient to establish appellant’s claim as the reports were submitted by 

certified medical assistants and registered nurses. Registered nurses, physical therapists, and 

physician assistants, are not considered physicians as defined under FECA and their opinions are 

of no probative value.15 Any medical opinion evidence appellant may submit to support her 

claim should reflect a correct history and offer a medically sound explanation by the physician of 

how the specific employment incident pathophysiologically caused or aggravated her right hip 

and buttock injury.16

The Board has held that the mere fact that a condition manifests itself during a period of 

employment does not raise an inference of causal relation.17 An award of compensation may not 

be based on surmise, conjecture, speculation, or on the employee’s own belief of causal 

relation.18 Appellant’s honest belief that the December 8, 2014 employment incident caused her 

medical injury is not in question, but that belief, however, sincerely held, does not constitute the 

medical evidence necessary to establish causal relationship. To establish a firm medical 

 12 Ceferino L. Gonzales, 32 ECAB 1591 (1981). 

13 The Board notes that appellant has a November 22, 2006 occupational disease Claim No. xxxxxx223 and a 

May 6, 2009 occupational disease Claim No. xxxxxx517. The record before the Board contains no other 

information pertaining to these claims. 

14 O.S., Docket No. 13-438 (issued July 15, 2014). 

15 5 U.S.C. § 8102(2) of FECA provides as follows: (2) physician includes surgeons, podiatrists, dentists, 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 (2005) wherein the Board noted that as registered nurses, 

licensed practical nurses, and physician assistants were not physicians as defined by FECA, their opinions were of 

no probative value. 

16 T.G., Docket No. 14-751 (issued October 20, 2014). 

17 Daniel O. Vasquez, 57 ECAB 559 (2006). 

18 D.D., 57 ECAB 734 (2006). 
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diagnosis and causal relationship, she must submit a physician’s report in which the physician 

reviews those factors of employment alleged to have caused her condition and, taking these 

factors into consideration, as well as findings upon examination and her medical history, explain 

how these employment factors caused or aggravated any diagnosed condition, and present 

medical rationale in support of his opinion.19 

In the instant case, the record lacks rationalized medical evidence establishing a causal 

relationship between the December 8, 2014 employment incident and a medical condition. Thus, 

appellant has failed to meet her burden of proof. 

Appellant may submit additional evidence, together with a written request for 

reconsideration, to OWCP within one year of the Board’s merit decision, pursuant to 5 U.S.C. 

§ 8128(a) and 20 C.F.R. §§ 10.606 and 10.607. 

CONCLUSION 

The Board finds that appellant did not meet her burden of proof to establish an injury 

causally related to the December 8, 2014 employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’ 

decision dated July 16, 2015 is affirmed. 

Issued: March 7, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board 

 19 Supra note 10.