United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

L.A., Appellant 

and 

GOVERNMENT PUBLISHING OFFICE, 

HUMAN RESOURCES, Washington, DC, 

Employer 

__________________________________________ 

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Docket No. 16-0348 

Issued: May 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 

COLLEEN DUFFY KIKO, Judge 

JURISDICTION 

On December 16, 2015 appellant filed a timely appeal from an August 11, 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. 

ISSUE 

The issue is whether appellant met her burden of proof to establish a diagnosed medical 

condition causally related to the April 29, 2014 employment incident. 

FACTUAL HISTORY 

On April 30, 2014 appellant, then a 44-year-old supervisory human resources specialist, 

filed a traumatic injury claim (Form CA-1) alleging that she injured her back, right arm, leg, 

 1

 5 U.S.C. § 8101 et seq. 
2

knee, foot, and shoulder on April 29, 2014 after slipping on liquid while descending a staircase. 

She stopped work on April 30, 2014. 

In a May 1, 2014 statement, appellant’s coworker advised that he and appellant were 

walking from the cafeteria to an appointment when she slipped on the slick stairs, approximately 

three to five steps. As she fell, appellant threw her drink down the stairs so she could use her left 

hand to grip the stairs rails to prevent her from falling down the stairs. Although she did not fall 

and tumble down the stairs, she clearly slid down a few steps and appeared to jerk her back. 

In a disability status report dated May 2, 2014, Dr. Marc Shepard, Board-certified in 

internal medicine, advised that appellant had been under his care from April 30 through 

May 16, 2014. He noted sciatica and advised that she would be able to return to work on 

May 19, 2014 without restrictions. 

By letter dated May 15, 2014, OWCP notified appellant that initially her claim had been 

administratively handled to allow medical payments, as it appeared to be a minor injury resulting 

in minimal or no lost time from work. However, it advised that it was now considering the 

merits of her claim because medical bills had exceeded $1,500.00. OWCP advised appellant of 

the type of evidence needed to establish her claim. 

In a May 2, 2014 report, Dr. Shepard advised that appellant had slipped on steps three 

days prior while at work. He explained that she twisted her back and hit her right side and 

shoulder. On examination Dr. Shepard documented tenderness on the right side of the posterior 

ribs. He noted that since the fall appellant’s symptoms were consistent with sciatica. 

Dr. Shepard, in a May 16, 2014 report, advised that appellant had some improvement, but 

still had an abnormal gait. He diagnosed sciatica and noted that she was unable to work. 

In May 16 and June 6, 2014 disability status reports, Dr. Shepard and Dr. Joshua Thomas, 

an osteopath, advised that appellant remained unable to work. 

In a June 4, 2014 statement, appellant advised that she slipped on liquid, which caused 

her to slide down several stairs. She noted that she lost her balance and jerked her back. 

Appellant stated that she went to the nurses’ station at the employing establishment that day and 

sought medical attention from her primary care physician the following day. 

By decision dated June 18, 2014, OWCP denied appellant’s claim because the medical 

evidence of record was insufficient to establish that a medical condition was caused by the 

claimed incident. 

On June 25, 2014 appellant requested review of the written record. In an accompanying 

statement she advised that there was medical evidence in the record that contained a diagnosis in 

connection with April 29, 2014 incident and she explained that she had not experienced any back 

symptoms prior to the work incident. 

Dr. Shepard, in a June 23, 2014 report, advised that appellant had right-sided low back 

pain radiating to the right leg. He noted that since appellant fell at work on April 29, 2014 she 

had been experiencing severe back and radicular pain. Dr. Shepard diagnosed sciatica and 
3

herniated disc which he attributed to the fall. He noted that appellant requested an open 

magnetic resonance imaging (MRI) scan. 

In a June 24, 2014 report, Dr. Thomas advised that appellant continued to complain of 

pain in the right leg, back, and buttock. He noted that she had a history of scoliosis and a workrelated injury on April 29, 2014 where she fell backwards on stairs hitting the right side of her 

back on the railing and stairs. Dr. Thomas further noted that appellant had immediate back pain 

and later developed leg pain. On examination he documented significant tenderness over the 

right sacroiliac joint, lumbar facet joints, and lower lumbar interspaces. Dr. Thomas diagnosed 

lumbago, lumbar spondylosis, right lumbar radiculopathy, lumbar disc displacement, and right 

sacroiliitis. 

On July 29, 2014 appellant filed a claim for compensation (Form CA-7), requesting leave 

buy back for the period June 16 through July 11, 2014. 

By decision dated January 5, 2015, an OWCP hearing representative affirmed the denial 

of appellant’s claim. The letter was retuned as undeliverable. On April 24, 2015 OWCP resent 

the decision to appellant.2

 

Appellant continued submitting evidence to OWCP in support of her claim. In a 

September 22, 2014 report, Dr. Lee Ann Rhodes, Board-certified in anesthesiology and pain 

medicine, advised that appellant had a history of low back pain since March 2014. In an 

October 8, 2014 diagnostic report, Dr. David Boyd, a Board-certified diagnostic radiologist, 

advised that a lumbar MRI scan marked levoscoliosis, multilevel degenerative changes, but no 

acute fracture. 

By letter dated April 6, 2015, received on May 5, 2015 appellant requested 

reconsideration. 

By decision dated August 11, 2015, OWCP denied modification of its prior decision 

finding that the medical evidence of record failed to establish that the diagnosed conditions were 

causally related to the April 29, 2014 work incident. 

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 FECA3, and that an injury was sustained in the performance 

 2

 Appellant appealed to the Board on July 13, 2015. The Board subsequently dismissed the appeal at her request. 

Docket No. 15-1562 (issued February 11, 2016). 

3 Joe D. Cameron, 41 ECAB 153 (1989). 
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of duty.4 These are the essential elements of each compensation claim regardless of whether the 

claim is predicated upon a traumatic injury or an occupational disease.5

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

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

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

submit sufficient evidence to establish that he or she actually experienced the employment 

incident at the time, place, and in the manner alleged.6 Second, the employee must submit 

sufficient evidence, generally only in the form of medical evidence, to establish that the 

employment incident caused a personal injury.7

 

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 

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

specific employment factors identified by the claimant.8

ANALYSIS 

Appellant claimed that she had sustained back, right arm, leg, knee, foot, and shoulder 

conditions as a result of slipping on stairs. It is undisputed that she slipped on stairs while at 

work. However, the medical evidence of record is insufficient to establish that her diagnosed 

medical conditions were causally related to the accepted work incident. 

In his June 23, 2014 report, Dr. Shepard advised that appellant fell at work on April 29, 

2014 and sustained severe back and radicular pain. He diagnosed sciatica and herniated disc 

which he attributed to the fall. Although Dr. Shepard attributes appellant’s condition to the fall 

at work, he does not explain how the work incident resulted in sciatica and a herniated disc. The 

Board has long held that medical opinions not containing rationale on causal relationship are of 

diminished probative value and are generally insufficient to meet her burden of proof.9

 

In his May 2, 2014 report, Dr. Shepard advised that appellant had slipped and fallen on 

stairs. He noted that she twisted her back and opined that her symptoms were consistent with 

sciatica following the fall. As this report also fails to provide medical rationale explaining how 

 4 James E. Chadden, Sr., 40 ECAB 312 (1988). 

5 Delores C. Ellyett, 41 ECAB 992 (1990). 

6 Julie B. Hawkins, 38 ECAB 393, 396 (1987); see Federal (FECA) Procedure Manual, Part 2 -- Claims, Fact of 

Injury, Chapter 2.803.2a (June 1995). 

7 Id. For a definition of the term “traumatic injury,” see 20 C.F.R. § 10.5(ee). 

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

9 Carolyn F. Allen, 47 ECAB 240 (1995). 
5

the fall caused the diagnosed condition, it is insufficient to discharge appellant’s burden of 

proof.10

In his June 24, 2014 report, Dr. Thomas noted that appellant sustained a work-related 

injury on April 29, 2014 when she fell backward on stairs hitting the right side of her back on the 

railing and stairs. He noted that she had immediate back pain and later developed leg pain. 

Dr. Thomas diagnosed lumbago, lumbar spondylosis, right lumbar radiculopathy, lumbar disc 

displacement, and right sacroiliitis. Although he attributed appellant’s conditions to the accepted 

work incident, he failed to explain how the incident resulted in the diagnosed conditions. 

In her September 22, 2014 report, Dr. Rhodes advised that appellant had a history of low 

back pain since March 2014, but provided no additional findings. This report does not address 

the April 29, 2014 work incident. 

Multiple diagnostic and disability status reports were submitted. However, they do not 

offer an opinion on causal relationship.11 There is no other medical evidence of record 

addressing how the accepted work incident caused or contributed to a diagnosed medical 

condition. 

Consequently, appellant has submitted insufficient medical evidence to establish her 

claim. As noted, causal relationship is a medical question that must be established by probative 

medical opinion from a physician.12 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.13 Because appellant has not provided such medical opinion 

evidence in this case, she has failed to meet her burden of proof. 

Appellant argued that she had never had these symptoms prior to the accident; however, 

the Board has held that simply because the employee was asymptomatic before the injury, but 

symptomatic after the incident is insufficient, without supporting rationale, to establish causal 

relationship.14 

Appellant may submit new evidence or argument as part of a formal 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. 

 10 Id. 

11 See Jaja K. Asaramo, 55 ECAB 200 (2004) (medical evidence that does not offer an opinion regarding the 

cause of an employee’s condition is of limited probative value on the issue of causal relationship). 

12 See supra note 7. 

13 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). 

14 Thomas D. Petrylak, 39 ECAB 276 (1987). 
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CONCLUSION 

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

condition causally related to the April 29, 2014 employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the August 11, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: May 18, 2016 

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