United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

E.L., Appellant 

and 

DEPARTMENT OF HOMELAND SECURITY, 

TRANSPORTATION SECURITY 

ADMINISTRATION MASSACHUSETTS PORT 

AUTHORITY, East Boston, MA, Employer 

__________________________________________ 

) 

) 

) 

) 

) 

) 

) 

) 

) 

) 

Docket No. 16-0635 

Issued: November 7, 2016 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

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 18, 2016 appellant, through counsel, filed a timely appeal of a December 18, 

2015 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to 

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

Board has jurisdiction to consider the merits of this case. 

ISSUE 

The issue is whether appellant met his burden of proof to establish a traumatic injury on 

August 14, 2012 causally related to the accepted employment incident. 

 1

 In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for 

legal or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. 

§ 501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An 

attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject 

to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation 

2

 5 U.S.C. § 8101 et seq. 
2

On appeal counsel argues the decision is contrary to law and fact. 

FACTUAL HISTORY 

This case has previously been before the Board. 

On August 15, 2012 appellant, then a 59-year transportation security officer, filed a 

traumatic injury claim (Form CA-1) alleging that on August 14, 2012 he sustained a chest hernia 

and experienced pain in his lower back, radiating up to his neck when he attempted to grab a 

beer keg that had fallen off a cart at work. OWCP accepted that the August 14, 2012 incident 

occurred as alleged, but by decision dated May 13, 2013 denied the claim as it found that the 

medical evidence of record was insufficient to establish a back condition causally related to the 

August 14, 2012 incident. 

By decision dated July 16, 2014, the Board affirmed OWCP decisions dated 

November 27, 2013 and January 19, 2014.3

 The Board found that appellant failed to submit 

rationalized medical opinion evidence addressing whether the diagnosed conditions, work 

restrictions, and disability were caused by the August 14, 2012 employment incident. The facts 

and circumstances as referred to in the prior Board decisions are incorporated herein by 

reference.4

By letter dated December 10, 2014, appellant, through counsel, requested reconsideration 

and submitted the additional medical evidence including medical reports from Dr. Polly D. 

Fraga, an attending Board-certified internist. 

In an October 19, 2010 report, Gail Spellman, nurse practitioner, diagnosed low back 

pain due to the lifting of a heavy object. Appellant was lifting a heavy suitcase off the counter 

for a routine bag search when he twisted his back and felt a sharp pain. Ms. Spellman released 

appellant to return to work with restrictions of no lifting more than 15 pounds. 

In a November 6, 2014 report, signed by Ms. Spellman and cosigned by Dr. Fraga, it was 

noted that appellant was seen on October 19, 2010 for low back spasms and pain. The report 

listed a history that in the prior week, appellant had twisted his back while lifting a heavy 

suitcase for a routine bag check. Appellant continued to work despite pain and back spasms. He 

was unable to get out of bed a couple days later. 

An incomplete form report regarding causal relationship signed by Ms. Spellman on 

November 6, 2014 and cosigned by Dr. Fraga on November 13, 2014 concluded that appellant’s 

condition was causally related to the employment incident. 

 3

 Docket No. 14-0676 (issued July 16, 2014). 

4

 The record also indicates that appellant had filed three previous traumatic injury claims. At a hearing held on 

September 9, 2013 before an OWCP hearing representative, appellant testified that he sustained a back injury in 

October 2010, which caused intermittent days of disability. It appears that the claim was accepted by OWCP. 
3

Appellant also submitted an unsigned and undated5

 report diagnosing lower back pain, 

lumbar neuritis, and lumbar dysfunction. He also submitted findings from a physical 

examination and review of a November 4, 2012 magnetic resonance imaging (MRI) scan. 

In a January 30, 2014 nonmerit decision, OWCP found that the medical evidence 

appellant submitted failed to address whether appellant sustained a back injury causally related 

to the August 14, 2012 employment incident and was insufficient to warrant a merit review. 

Following the Board’s July 16, 2014 decision, by letter dated June 19, 2015, appellant, 

through counsel, requested reconsideration and submitted an April 6, 2015 report from 

Dr. Fraga. Dr. Fraga reported that appellant sustained two separate work injuries with the first 

occurring on October 10, 2010 and the second occurring on August 14, 2012. She opined that 

both work injuries contributed to his disability, physical and objective evidence findings, and 

medical conditions. Dr. Fraga provided appellant’s medical treatment history including 

treatment and a March 2013 surgery by a neurosurgeon. Physical examination findings were 

listed from when she first saw appellant on October 19, 2010 up to April 2015, when he was seen 

for his annual physical examination. A review of an October 2014 (MRI) scan revealed mild 

acromioclavicular osteoarthritis, some subdeltoid/subacromial bursitis, mild bicipital tendon 

tenosynovium and rotator cuff tendinopathy with partial supraspinatus/subscapularis thickness 

tears, and infraspinatus fraying. Dr. Fraga opined that the progression of changes shown on the 

MRI scans are “consistent with long-term sequela from the initial” October 2010 injury. She 

related that the findings from an October 2014 MRI scan of appellant’s left shoulder were 

consistent with the August 2012 work incident. Dr. Fraga reported that due to appellant’s back 

pain, he needed to have frequent position changes, could not lift more than five pounds, and was 

unable to sit or stand for more than 15 minutes. She opined that these findings were consistent 

with the type of injury sustained in August 2012. Dr. Fraga opined that the August 2012 

employment incident either directly or proximately caused appellant’s lower back, cervical 

spine, and shoulder injuries. She concluded that appellant’s L3-4, L4-5 disc bulging and 

foraminal narrowing, L5-S1 arthropathy which were consistent with the 2010 injury while the 

partial rotator cuff tears were consistent with the August 2012 incident. Dr. Fraga concluded that 

there might be other causes for appellant’s medical condition, but the primary causes were the 

work accidents and activities described in her report. 

By decision dated December 18, 2015, OWCP denied modification. It found that 

Dr. Fraga’s April 6, 2015 report was repetitive of appellant’s neurosurgeon’s reports and her 

prior medical notes, and was insufficiently rationalized to establish that appellant sustained a 

back injury causally related to the accepted August 14, 2012 employment incident. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA6

 has the burden of establishing 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 

 5

 There is a fax date of November 14, 2014 noted on the report. 

6

 5 U.S.C. § 8101 et seq. 
4

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

employment injury.7 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.8 

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

performance of duty it must first be determined whether a fact of injury has been established.9 

First, the employee must submit sufficient evidence to establish that she actually experienced the 

employment incident at the time, place, and in the manner alleged.10 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.11 

Causal relationship is a medical issue and the medical evidence generally required to 

establish causal relationship is rationalized medical opinion evidence.12 Rationalized medical 

opinion evidence is medical evidence which includes a physician’s rationalized opinion on 

whether there is a causal relationship between the employee’s diagnosed condition and the 

compensable employment factors.13 The opinion of the physician must be based on a complete 

factual and medical background of the employee, 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 employee.14 

ANALYSIS 

OWCP accepted that the August 14, 2012 employment incident occurred as alleged. The 

issue is whether appellant established that the incident caused a back, neck, and hernia 

conditions. By decision dated July 16, 2015, the Board affirmed OWCP’s denial of appellant’s 

claim. The Board’s review of the previous medical evidence of record is res judicata.

15 

Following the Board’s last decision, which affirmed the denial of the claim, appellant 

submitted to OWCP a December 10, 2014 request for reconsideration accompanied by medical 

evidence. OWCP denied reconsideration by decision dated January 30, 2015 as it found the 

 7 C.S., Docket No. 08-1585 (issued March 3, 2009); Bonnie A. Contreras, 57 ECAB 364 (2006). 

8 S.P., 59 ECAB 184 (2007); Joe D. Cameron, 41 ECAB 153 (1989). 

9 B.F., Docket No. 09-60 (issued March 17, 2009); Bonnie A. Contreras, supra note 7. 

10 D.B., 58 ECAB 464 (2007); David Apgar, 57 ECAB 137 (2005). 

11 C.B., Docket No. 08-1583 (issued December 9, 2008); D.G., 59 ECAB 734 (2008); Bonnie A. Contreras, supra

note 7. 

12 Y.J., Docket No. 08-1167 (issued October 7, 2008); A.D., 58 ECAB 149 (2006); D’Wayne Avila, 57 ECAB 

642 (2006). 

13 J.J., Docket No. 09-27 (issued February 10, 2009); Michael S. Mina, 57 ECAB 379 (2006) 

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

15 See R.L., Docket No. 15-1010 (issued July 21, 2015). See also A.P., Docket No. 14-1228 (issued 

October 15, 2014). 
5

medical evidence submitted was repetitive and insufficient to warrant a merit review. By letter 

dated June 19, 2014, appellant requested reconsideration and submitted additional evidence in 

support of his request. In a December 18, 2015 decision, OWCP denied modification as it found 

on merit review the medical evidence of record insufficiently rationalized to establish that 

appellant sustained an injury causally related to the August 14, 2012 employment incident. 

The issue on appeal is whether appellant established that he sustained an injury as a result 

of the August 14, 2012 employment incident. The Board finds that he has failed to submit 

sufficient medical evidence to supporting that he sustained an injury causally related to the 

August 14, 2012 employment incident.16

Dr. Fraga’s April 6, 2015 report found that both the October 10, 2010 work-related injury 

and the August 14, 2012 employment incident contributed to appellant’s disability and neck, 

lower back, and shoulder injuries. She provided a summary of medical treatment provided 

including treatment provided by appellant’s neurosurgeon from October 2010 to the present. 

While Dr. Fraga opined that the August 14, 2012 employment incident also contributed to 

appellant’s neck, lower back, and shoulder injuries, she failed to provide a rationalized opinion 

explaining how the August 14, 2012 employment incident caused or aggravated the diagnosed 

neck, lower back, and shoulder conditions. Dr. Fraga generally opined that the August 14, 2012 

incident was a proximate or direct cause of his medical conditions. This general statement fails 

to provide a sufficient explanation as to the mechanism of injury pertaining to this traumatic 

injury claim, namely, how attempting to grab a beer keg that had fallen off a cart at work would 

cause or aggravate appellant’s neck, lower back, and shoulder conditions.17 Without explaining 

physiologically how the movements involved in the employment incident caused or contributed 

to the diagnosed conditions, Dr. Fraga’s opinion that attempting to grab a beer keg was a direct 

or proximate cause of appellant’s injuries is equivocal in nature and of limited probative value.18 

The remaining medical evidence is also insufficient to support appellant’s claim. The 

undated and unsigned report diagnosing lower back pain, lumbar neuritis, and lumbar 

dysfunction is of no probative value. Reports that are unsigned or bear illegible signature and 

lack proper identification cannot be considered probative medical evidence.19 Additionally, the 

October 19, 2010 report signed by Ms. Spellman, a nurse practitioner, has no probative value as 

a nurse practitioner is not a physician as defined under FECA.20 

The November 6, 2014 report signed by Ms. Spellman and cosigned by Dr. Fraga, and an 

incomplete form report regarding causal relationship signed by Ms. Spellman on November 6, 

2014 and cosigned by Dr. Fraga on November 13, 2014 are insufficient to support appellant’s 

claim as neither report addressed whether appellant’s disability, work restrictions, and diagnosed 

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

17 S.W., Docket 08-2538 (issued May 21, 2009); Robert Broome, supra note 16. 

18 See L.M., Docket No. 14-973 (issued August 25, 2014); R.G., Docket No. 14-113 (issued April 25, 2014); 

K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-548 (issued November 16, 2012). 

19 R.M., 59 ECAB 690 (2008); D.D., 57 ECAB 734 (2006); Richard J. Charot, 43 ECAB 357 (1991). 

20 L.D., 59 ECAB 648 (2008); Paul Foster, 56 ECAB 208 (2004). 
6

conditions were caused or aggravated by the August 14, 2012 employment incident.21 Thus, the 

reports from Dr. Fraga and Ms. Spellman are insufficient to establish appellant’s claim. 

On appeal counsel contends that OWCP’s decision was contrary to fact and law. Based 

on the findings and reasons stated above, the Board finds that counsel’s arguments are not 

substantiated. 

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 to establish that he 

sustained an injury on August 14, 2012 causally related to the accepted employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ 

Compensation Programs dated December 18, 2015 is affirmed. 

Issued: November 7, 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 

 21 C.B., Docket No. 09-2027 (issued May 12, 2010); J.F., Docket No. 09-1061 (issued November 17, 2009); A.D., 

supra note 12; Jaja K. Asaramo, 55 ECAB 200 (2004).