United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

R.G., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Elizabeth, NJ, Employer 

__________________________________________ 

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Docket No. 16-0271 

Issued: May 18, 2017 

Appearances: Case Submitted on the Record

James D. Muirhead, Esq., for the appellant1

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On November 30, 2015 appellant, through counsel, filed a timely appeal of a 

September 14, 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. 

ISSUES 

The issues are: (1) whether OWCP properly terminated appellant’s wage-loss 

compensation, effective February 29, 2012, as she was no longer disabled due to the accepted 

employment injuries; (2) whether OWCP properly terminated appellant’s medical benefits, 

 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

effective April 3, 2012, as she no longer had medical residuals of her accepted employment 

injuries; and (3) whether appellant met her burden of proof to establish continuing disability or 

residuals after her benefits were terminated. 

FACTUAL HISTORY 

On August 2, 2011 appellant, then a 39-year-old letter carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on August 2, 2011 she picked up a tub of flats and felt a pop 

and pull in her chest and left shoulder. She stopped work on the date of injury. 

Appellant was treated in the emergency room on August 2, 2011 by Dr. Stephen J. 

Hricko, a Board-certified emergency physician, for pain in her sternum, radiating into her left 

arm and elbow after lifting a tub of magazines at work on August 2, 2011. Dr. Hricko diagnosed 

costochondral strain and trapezius muscle strain. He found appellant to be disabled from work. 

On August 9, 2011 OWCP accepted appellant’s claim for costochondral sprain and 

trapezius strain. 

Appellant was seen by Dr. Dyana Aldea, a Board-certified physiatrist, for the period 

August 3 to October 14, 2011, for left shoulder pain and anterior chest wall pain radiating to the 

left arm which began after lifting a heavy bin of mail. Dr. Aldea diagnosed left shoulder 

acromioclavicular (AC) joint osteoarthritis, left shoulder strain, anterior chest wall strain, 

myospasm, and myofascitis. On August 22, 2011 she administered a steroid injection over the 

cervical and left supraspinatus area. Dr. Aldea noted that appellant was disabled from work from 

October 18 to November 18, 2011. On November 14, 2011 she prescribed physical therapy and 

returned appellant to work full-time light duty. On December 12, 2011 appellant presented with 

anterior left chest wall pain with spasms. She reported contacting her employing establishment 

for light duty, but related that she was told that she could not return to work until she could work 

without restrictions. Dr. Aldea provided a trigger point injection into the left thoracic paraspinal 

and took appellant off work from December 12, 2011 to January 10, 2012. In a duty status 

report (Form CA-17) dated December 12, 2011, she diagnosed shoulder impingement and noted 

that appellant could not resume work. 

OWCP referred appellant to a second opinion physician, Dr. Jeffrey Lakin, a Boardcertified orthopedic surgeon, to determine her current disability status. In a report dated 

February 2, 2012, Dr. Lakin related appellant’s history of injury and reviewed various diagnostic 

studies. Appellant continued to have left shoulder and chest area pain with occasional shooting 

pain to the elbow. Dr. Lakin noted findings of minimal tenderness to the left trapezial area, no 

spasms, full range of motion of the left shoulder, and nontender over the AC joint. He noted 

intact motor examination of the left shoulder, minimal tenderness in the anterior chest wall, no 

crepitus, no deformities, intact motor and sensory examination in the upper extremities, negative 

Tinel’s and Phalen’s tests, negative compression test, and reflexes in the arms and legs were 

positive and symmetrical. Dr. Lakin found an October 10, 2011 chest x-ray unremarkable. He 

noted an August 17, 2011 magnetic resonance imaging (MRI) scan of the left shoulder revealed 

mild AC osteoarthritis but no evidence of a rotator cuff tear. An August 17, 2011 MRI scan of 

the chest showed no evidence of a pectoralis major or minor muscle tear. Dr. Lakin diagnosed 

resolved costochondral sprain and trapezial sprain. He noted that his evaluation showed 
3

appellant had excellent function of her spine and extremities and the sensory examination 

revealed no deficits. Dr. Lakin advised that she had reached maximum medical improvement 

(MMI) and could return to full duty with no further treatment. He advised that appellant did not 

have disabling residuals of the accepted conditions, as the conditions had resolved with only has 

minimal tenderness in the trapezius and anterior chest region. Dr. Lakin further noted that her 

subjective complaints did not correlate with the objective findings. He found that appellant had 

no additional injuries due to employment factors. Dr. Lakin noted that, at the time of his 

examination, there were no objective findings that she sustained an aggravation of a prior 

existing condition due to the work-related injury. In a work capacity evaluation form (OWCP5c) dated February 2, 2012, he diagnosed costochondral sprain and trapezius strain and noted 

that appellant had reached MMI and could return to her usual job. 

On January 12, 2012 Dr. John S. Cho, a Board-certified anesthesiologist, noted treating 

appellant for shoulder pain and advised that she was unable to work from January 12 to 

February 12, 2012. 

Appellant filed claims for compensation (Form CA-7) for the period beginning 

September 17, 2011. She received three supplemental payments for wage-loss compensation for 

total disability that ended on February 24, 2012.3

 

By decision dated February 29, 2012, OWCP terminated appellant’s wage-loss 

compensation benefits effective that day based on the February 2, 2012 report of the second 

opinion physician, Dr. Lakin, who opined that appellant was no longer disabled as a result of her 

accepted employment injuries. 

Also on February 29, 2012 OWCP proposed to terminate appellant’s medical benefits as 

she no longer had residuals of her accepted work injury. 

By letter to OWCP’s Branch of Hearings and Review dated March 24, 2012, appellant 

requested an “appeal” from the February 29, 2012 OWCP decision terminating wage-loss 

compensation. She submitted additional evidence that included an October 11, 2011 x-ray of the 

left ribs and chest which was normal. Findings from a February 28, 2012 thoracic spine MRI 

scan included a broad-based central disc herniation at T4-5 and T6-7 with ventral compression. 

Also provided were August 8 and September 19, 2011 duty status reports from Dr. Aldea 

who diagnosed shoulder impingement and noted that appellant could not work. In an 

October 14, 2011 duty status report, Dr. Aldea returned appellant to work part-time light duty 

and on November 14, 2011 appellant had returned to work full time with restrictions. In a 

December 12, 2011 duty status report, she diagnosed shoulder impingement and again took 

appellant off work. In a March 14, 2012 letter of medical necessity, Dr. Aldea sought treatment 

for thoracic radiculitis. She noted that appellant had presented on August 3, 2011 with left 

shoulder and anterior chest wall pain secondary to an injury while lifting a heavy bin of mail. 

Appellant’s anterior chest wall pain did not diminish after physical therapy. Dr. Aldea requested 

authorization for thoracic epidural steroid injection to aid in recovery. He noted that appellant 

 3

 These payments covered the periods September 17 through November 4, 2011, December 17 through 30, 2011, 

and December 31, 2011 through February 24, 2012. 
4

had a long history of anterior chest wall pain and left shoulder pain most of which was due to 

multiple thoracic herniated discs. 

In a December 29, 2011 report, Dr. Cho provided a history of injury, noted diagnoses, 

and performed a trigger point injection in the left thoracic paraspinal muscle. In January 9 to 19, 

2012 reports, he noted no permanent improvement in symptoms after the trigger point injection. 

Dr. Cho diagnosed left shoulder AC osteoarthritis, left shoulder strain/sprain, thoracic 

sprain/strain, anterior chest wall strain, myospasms, and thoracic and lumbar scoliosis. He 

continued physical therapy, repeat trigger point injections, and noted that appellant could return 

to work in two weeks. In duty status reports dated January 12 to February 23, 2012, Dr. Cho 

diagnosed shoulder impingement and advised that appellant could work part-time light duty on 

March 20, 2012. On February 27, 2012 he noted that appellant was having mid-back pain on the 

left side radiating into the left flank and left anterior chest wall since her accident and requested 

authorization for a thoracic spine MRI scan. 

In reports dated February 23 and March 1, 2012, Dr. Cho noted that appellant continued 

to have the same symptoms and advised that physical therapy and trigger point injections only 

provided temporary relief. He noted diminished range of motion of the cervical spine, positive 

paraspinal tenderness, positive facet tenderness, myospasms of the mid-back, and decreased 

range of motion of the lumbar spine secondary to pain. Dr. Cho diagnosed thoracic radiculitis, 

thoracic herniated nucleus pulposus, thoracolumbar scoliosis, cervical, thoracic spine and 

anterior chest wall strain/sprain, left shoulder AC joint osteoarthritis, left shoulder tendinitis, left 

shoulder strain/sprain, and myospasm. He performed a thoracic epidural steroid injection at 

T6-7. In a duty status report dated March 19, 2012, Dr. Cho noted clinical findings of left 

shoulder, chest, and mid-back pain and advised that appellant could not resume work. 

Appellant was also seen by Dr. Aditi Menon, a Board-certified physiatrist. On 

February 21, 2012 Dr. Menon treated her for significant left shoulder pain with range of motion. 

He diagnosed left shoulder tendinitis and AC osteoarthritis, thoracolumbar scoliosis, thoracic 

sprain, anterior chest wall sprain, and anterior chest myospasms. Dr. Menon recommended 

physical therapy and a left shoulder injection. On March 13, 2012 he provided an AC joint 

injection. Examination revealed limited range of motion of the thoracic spine, tenderness along 

the T6-7 paraspinal area, and mild impingement. Dr. Menon diagnosed left AC joint 

osteoarthritis, left shoulder tendinitis, thoracic radiculitis, thoracolumbar scoliosis, cervical and 

thoracic sprain/strain, left chest wall sprain/strain, and myospasms. He recommended physical 

therapy. 

By decision dated April 3, 2012, OWCP finalized the termination of medical benefits 

effective that day as it determined that she no longer had medical residuals as a result of her 

accepted injury or illness pursuant to the opinion of Dr. Lakin. 

On June 5, 2012 appellant requested a review of the written record of the April 3, 2012 

decision by an OWCP hearing representative. She submitted August 17, 2011 MRI scan reports 

for the left shoulder and chest which showed mild AC osteoarthritis, but no evidence of a 

pectoralis major or minor muscle tear. 
5

Reports from Dr. Cho dated March 29, April 9 and 19, and May 7 and 21, 2012 noted 

appellant had 70 percent relief with T6-T7 epidural steroid injections, however, she still had 

flare-ups of mid-back, left chest wall, and left arm pain. He noted diminished cervical spine 

range of motion, positive paraspinal, cervical spine facet tenderness, and myospasms. Dr. Cho 

diagnosed thoracic radiculitis, left AC joint osteoarthritis, left shoulder tendinitis, myospasm, 

thoracic herniated nucleus pulposus, thoracolumbar scoliosis, and cervical and thoracic spine 

strain/sprain. He recommended continued physical therapy and steroid injections. In an 

April 19, 2012 duty status report, Dr. Cho noted findings of left shoulder, chest, and mid-back 

pain and noted appellant could not resume work. On September 6, 2012 he noted that appellant 

had again injured herself at work. Appellant related carrying items for prolonged periods which 

aggravated her symptoms. Dr. Cho noted that appellant’s left-side chest pain persisted from the 

prior injury. He diagnosed left shoulder tendinitis, left shoulder AC joint osteoarthritis, thoracic 

herniated nucleus pulposus, and myospasm. Dr. Cho recommended therapy and restrictions. 

On May 29, 2012 appellant was treated by Dr. Franklin Chen, a Board-certified 

orthopedist, for left shoulder pain radiating into the left chest region. Dr. Chen noted that 

appellant’s symptoms began after a work injury when she was lifting heavy tubs of magazines 

and felt a pop in her left shoulder and pain in the chest region. Cortisone injections and physical 

therapy provided minimal symptom relief. Findings included mild laxity of the anterior 

translation, positive isolated supraspinatus test, and positive Hawkin’s test. Dr. Chen diagnosed 

left shoulder instability, possible superior labral tear, left shoulder impingement, and left 

pectoralis strain. He opined that based on appellant’s history and examination it was within 

medical probability that the current orthopedic complaints were causally related to appellant’s 

work history. Appellant also submitted a physical therapy report. 

By decision dated October 11, 2012, an OWCP hearing representative affirmed the 

February 29 and April 3, 2012 decisions regarding termination of medical benefits and 

termination of wage-loss compensation. 

On October 10, 2013 appellant requested reconsideration. Evidence submitted on 

reconsideration included July 12 and October 8, 2012 reports from Dr. Cho who noted that 

appellant had experienced steady improvement with physical therapy, but continued to have pain 

in the mid-back, chest wall, and at T4-6. Dr. Cho noted diminished range of motion of the left 

shoulder, and positive paraspinal and facet tenderness of the thoracic spine. He diagnosed 

thoracic facet arthropathy, radiculitis, left AC joint osteoarthritis, left shoulder tendinitis, and 

myospasm. Dr. Cho continued physical therapy and epidural steroid injections. 

In a decision dated December 31, 2013, OWCP denied modification of the October 11, 

2012 decision. 

On August 1, 2014 appellant again requested reconsideration. She submitted an April 21, 

2014 report from Dr. Cho who noted that her left shoulder, chest wall, and mid-back pain 

remained present and radiated into the anterior chest wall. Dr. Cho noted findings and diagnosed 

thoracic radiculitis, thoracic disc herniation, left shoulder AC joint degeneration and sprain and 

strain, thoracic spine and anterior chest wall strain and sprain, and myospasm. He opined that, 

based on the proximity of the treatment to the date of injury and the fact that appellant was not 

under treatment to the areas injured before the occurrence, to a reasonable degree of medical 
6

probability there was a direct causal relationship between the treatment findings and the accident 

involved. Dr. Cho advised that, based on objective findings and testing, to a reasonable degree 

of medical probability, appellant sustained a permanent injury with permanent residuals. 

In a decision dated September 14, 2015, OWCP denied modification of the decision 

dated December 31, 2013. 

LEGAL PRECEDENT -- ISSUE 1 & ISSUE 2 

Once OWCP accepts a claim, it has the burden of proof to justify termination or 

modification of compensation benefits.4 After it has determined that an employee has disability 

causally related to his or her federal employment, OWCP may not terminate compensation 

without establishing that the disability has ceased or that it is no longer related to the 

employment.5

 The right to medical benefits for an accepted condition is not limited to the period 

of entitlement for disability. To terminate authorization for medical treatment, OWCP must 

establish that a claimant no longer has residuals of an employment-related condition, which 

requires further medical treatment.6

ANALYSIS -- ISSUE 1 

OWCP accepted appellant’s claim for costochondral sprain and trapezius strain. The 

Board finds that OWCP met its burden of proof to justify termination of appellant’s wage-loss 

compensation benefits effective February 29, 2012. OWCP referred appellant for a second 

opinion evaluation by Dr. Lakin to determine the extent of her work-related condition and 

disability. 

In his February 2, 2012 report, Dr. Lakin provided an extensive review of appellant’s 

medical history and reported examination findings. He noted subjective complaints of pain in 

her left shoulder and chest area. Dr. Lakin noted a left shoulder MRI scan dated August 17, 

2011 revealed mild AC osteoarthritis and no evidence of a rotator cuff tear. He indicated that a 

chest MRI scan dated August 17, 2011 revealed no evidence of a pectoralis major or minor 

muscle tear. Dr. Lakin diagnosed a resolved costochondral sprain and trapezial sprain. He noted 

that his evaluation showed appellant had excellent function of her spine and extremities, and had 

no sensory deficits. Dr. Lakin indicated that appellant had reached MMI on February 2, 2012 

and could return to full-time work without restrictions as her accepted conditions had resolved 

without residuals. He advised that appellant did not have disabling residuals of the accepted 

conditions and that appellant’s subjective complaints did not correlate with the objective 

findings. In a February 2, 2012 work capacity evaluation form (OWCP-5c), Dr. Lakin confirmed 

that appellant could return to her usual job. 

The Board finds that Dr. Lakin’s report represents the weight of the medical evidence and 

that OWCP properly relied on his report in terminating appellant’s wage-loss compensation. 

 4 Gewin C. Hawkins, 52 ECAB 242 (2001). 

5 Mary A. Lowe, 52 ECAB 223 (2001). 

6 Id.; Leonard M. Burger, 51 ECAB 369 (2000). 
7

Dr. Lakin’s opinion is based on proper factual and medical history as he reviewed a statement of 

accepted facts and appellant’s prior medical treatment and test results. He also related his 

comprehensive examination findings in support of his opinion. Dr. Lakin reported no basis on 

which to find that appellant had any continuing disability for her job due to the accepted 

conditions. 

At the time of the termination of wage-loss benefits, there was no rationalized medical 

evidence supporting continuing disability due to the accepted conditions.7

 Reports dated 

August 3 to December 12, 2011 from Dr. Aldea noted her treatment of persistent anterior left 

chest wall pain and her diagnoses of left shoulder AC joint osteoarthritis, left shoulder strain, 

anterior chest wall strain, myospasm, and myofascitis. She found that appellant was disabled 

from work from October 18 to November 18, 2011 and December 12, 2011 to January 10, 2012. 

Although Dr. Aldea supported that appellant had continuing symptoms and was unable to 

perform regular duties, these reports predate the termination decision and do not support 

disability beginning February 29, 2012. Likewise, Dr. Cho’s January 12, 2012 report noted 

treating appellant for shoulder pain and took her off work from January 12 to February 12, 2012. 

These reports are of limited probative value as they also predate the termination and do not 

otherwise support disability due to her accepted conditions beginning February 29, 2012.8 

The Board finds that OWCP met its burden of proof in terminating appellant’s wage-loss 

compensation benefits for her accepted conditions. 

ANALYSIS -- ISSUE 2 

The Board finds that OWCP also met its burden of proof to terminate medical benefits, 

effective April 3, 2012, for her accepted costochondral sprain and trapezius strain. 

As explained, OWCP referred appellant to Dr. Lakin to determine the extent of her workrelated condition. In his February 2, 2012 report, Dr. Lakin diagnosed a resolved costochondral 

sprain and trapezial sprain. He found that appellant had excellent function of her spine and 

extremities and no sensory deficits. Dr. Lakin advised that the accepted conditions had resolved 

and she only had minimal tenderness in the trapezius and anterior chest region. He found no 

objective findings of an aggravation of a preexisting condition due to the work injury. Dr. Lakin 

noted that appellant no longer required any type of treatment or testing related to the accepted 

conditions. He indicated that appellant could return to full-time work without restrictions as her 

accepted conditions had resolved without residuals. 

The Board finds that Dr. Lakin’s report represents the weight of the medical evidence and 

that OWCP properly relied on his report in terminating appellant’s medical benefits. 

Dr. Lakin’s related his examination findings in support of his opinion that the accepted workrelated conditions had resolved. He reported no basis on which to find that appellant had any 

continuing residuals of her accepted costochondral sprain and trapezius strain. There is no 

 7 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). 

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

cause of an employee’s condition is of diminished probative value on the issue of causal relationship). 
8

contemporaneous medical evidence of equal weight supporting appellant’s claim for continuing 

residuals of the accepted condition. 

As noted, many of the reports from Dr. Aldea, Dr. Cho, and other practitioners predate 

the termination of medical benefits and do not specifically support that residuals of the accepted 

conditions continued after April 3, 2012.9 Although Drs. Aldea and Cho supported that appellant 

had continuing symptoms and was unable to perform regular duties, none of the reports 

specifically explain how appellant’s current medical condition was causally related to the 

accepted employment incident of August 2, 2011. For example a March 14, 2012 letter of 

medical necessity from Dr. Aldea sought authorization for thoracic epidural steroid injection in 

conjunction with rehabilitative procedures to treat thoracic radiculitis. She noted that appellant 

presented on August 3, 2011 with left shoulder pain and anterior chest wall pain secondary to an 

injury while lifting a heavy bin of mail. Dr. Aldea noted that appellant had a long history of 

anterior chest wall pain and left shoulder pain most of which was due to multiple herniated discs 

in the thoracic region. However, she did not provide a rationalized opinion regarding the causal 

relationship between appellant’s current medical condition and proposed treatment and the 

accepted August 2, 2011 employment injury.10 The need for rationale is particularly important 

where left shoulder AC joint osteoarthritic changes were preexisting.11 Moreover, OWCP never 

accepted that appellant sustained thoracic radiculitis or multiple herniated discs in the thoracic 

region as a result of her work injury and there is no medical rationalized evidence to support 

such a conclusion.12 

Likewise, on February 27, 2012 Dr. Cho noted that appellant was experiencing mid-back 

pain on the left side radiating into the left flank and left anterior chest wall since her accident and 

requested authorization for a thoracic spine MRI scan while, on March 19, 2012, he noted 

findings of left shoulder, chest, and mid-back pain and advised that appellant could not resume 

work. However, Dr. Cho did not specifically address with medical rationale how any continuing 

conditions were causally related to the accepted employment injury of August 2, 2011.13 

Appellant submitted February 21 and March 13, 2012 reports from Dr. Menon who noted 

appellant’s complaints of significant pain along the AC joint area, the mid-back and chest wall 

after steroid injections. Dr. Menon diagnosed left AC joint osteoarthritis, left shoulder tendinitis, 

thoracic radiculitis, thoracolumbar scoliosis, cervical and thoracic sprain/strain, left chest wall 

sprain/strain and myospasms. However, he failed to specifically address how any continuing 

osteoarthritis, tendinitis, thoracic radiculitis, and scoliosis was causally related to the accepted 

 9 See id. 

10 See supra note 7. 

11 See C.P., Docket No. 17-0042 (issued December 27, 2016). 

12 See Alice J. Tysinger, 51 ECAB 638 (2000) (for conditions not accepted by OWCP as being employment 

related, it is the employee’s burden to provide rationalized medical evidence sufficient to establish causal relation, 

not OWCP’s burden to disprove such relationship). 

13 See supra note 7. 
9

employment injury of August 2, 2011. As noted above these conditions were not accepted by 

OWCP as work related.14 

For these reasons, OWCP met its burden of proof in terminating appellant’s medical 

benefits for her accepted conditions. 

LEGAL PRECEDENT -- ISSUE 3 

After termination or modification of compensation benefits, clearly warranted on the 

basis of the evidence, the burden for reinstating compensation benefits shifts to appellant. In 

order to prevail, appellant must establish by the weight of the reliable, probative, and substantial 

evidence that she had an employment-related disability which continued after termination of 

compensation benefits.15

ANALYSIS -- ISSUE 3 

The Board finds that appellant has not established continuing residuals of her workrelated costochondral sprain and trapezius strain on or after February 29, 2012. 

Following termination of appellant’s compensation benefits, appellant continued to 

submit medical evidence in support of her claim. This included a September 6, 2012 report from 

Dr. Cho who noted that appellant injured herself again at work when she carried items for 

prolonged periods of time which aggravated her symptoms. He noted that appellant’s left-sided 

chest pain persisted from the previous injury. Dr. Cho diagnosed left shoulder tendinitis, left 

shoulder AC joint osteoarthritis, thoracic herniated nucleus pulposus, and myospasm and 

continued her work restrictions. This report does not support continuing disability or residuals 

from the accepted August 2, 2011 work injury. Instead, Dr. Cho notes that appellant sustained a 

new injury after returning to work. He further advised that appellant was able to work subject to 

restrictions. To the extent that Dr. Cho noted appellant’s left-sided chest pain persisted from the 

previous injury he failed to provide a rationalized opinion regarding the causal relationship 

between her current condition and her accepted work-related injury of August 2, 2011.16 

An April 21, 2014 report from Dr. Cho noted appellant’s complaints of left shoulder, 

chest wall and mid-back pain radiating into the anterior chest wall. He diagnosed thoracic 

radiculitis, thoracic disc herniation, left shoulder AC joint degeneration and sprain and strain, 

thoracic spine, and anterior chest wall strain and sprain, and myospasm. Dr. Cho opined that 

based on the proximity of the treatment to the date of injury and the fact that appellant was not 

under treatment to the areas injured prior to the occurrence, to a reasonable degree of medical 

probability, there was a direct causal relationship between the treatment findings and the accident 

involved. He further advised that based on the objective findings and tests to a reasonable 

degree of medical probability appellant had a permanent injury with permanent residuals. 

 14 See supra note 8. 

15 M.B., Docket No. 15-1125 (issued September 14, 2016). 

16 See Jimmie H. Duckett, 52 ECAB 332 (2001) (medical reports not containing rationale on causal relationship 

are entitled to little probative value). 
10

However, as Dr. Cho’s report fails to specifically provide any medical reasoning to explain how 

any continuing residuals were causally related to the August 2, 2011 work injury, it is, therefore, 

of limited probative value.17 His basic reasoning for relating appellant’s current conditions to the 

work injury is that appellant was not under treatment to the areas injured prior to the original 

work injury. The Board has held that an opinion that a condition is causally related to an 

employment injury because the employee was asymptomatic before the injury is insufficient, 

without supporting rationale, to support a causal relationship.18 For this reason, this evidence is 

insufficient to meet appellant’s burden of proof. 

Other reports and treatment records from Dr. Cho are likewise insufficient to meet 

appellant’s burden of proof as they failed to provide a rationalized opinion explaining why 

appellant had continuing disability or residuals causally related to her accepted conditions.19 

Accordingly, the Board finds that this evidence is insufficient to meet her burden of proof to 

establish continuing disability or residuals after the termination of benefits. 

Appellant also provided a May 29, 2012 report from Dr. Chen who noted diagnoses and 

opined that, based on appellant’s history and examination, it was within medical probability that 

the current orthopedic complaints are causally related to appellant’s work history. Although 

Dr. Chen supported causal relationship, he did not provide medical rationale explaining the basis 

of his conclusory opinion regarding the causal relationship between appellant’s current condition 

and disability and the employment injury of August 2, 2011.20 

Other medical reports received after benefits were terminated are of limited probative 

value as they do not specifically address whether appellant had continuing residuals of her 

accepted conditions.21 

Appellant submitted physical therapy records. The Board has held that treatment notes 

signed by a physical therapist are not medical evidence as these providers are not considered 

physicians under FECA.22 

 17 See id., see also supra note 7. 

18 Kimper Lee, 45 ECAB 565 (1994). Furthermore, for conditions not accepted by OWCP as being employment 

related, the claimant bears the burden of proof to establish that the condition is causally related to the employment 

injury. See supra note 8. 

19 See supra note 16. 

20 See T.M., Docket No. 08-975 (issued February 6, 2009) (a medical report is of limited probative value on the 

issue of causal relationship if it contains a conclusion regarding causal relationship which is unsupported by medical 

rationale). 

21 See supra note 8. 

22 See David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006) (lay individuals such as physician assistants, nurses, 

and physical therapists are not competent to render a medical opinion under FECA); 5 U.S.C. § 8101(2) (this 

subsection defines a “physician” as surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, 

and osteopathic practitioners within the scope of their practice as defined by State law). See also V.W., Docket No. 

16-1444 (issued March 14, 2017) and F.G., Docket No. 16-1482 (issued January 25, 2017) (physical therapist are 

not physicians under FECA). 
11

Consequently, appellant did not establish that she had any continuing disability or 

residuals of her accepted conditions after her benefits were terminated. 

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 OWCP properly terminated appellant’s wage-loss compensation 

benefits effective February 29, 2012 and terminated appellant’s medical benefits on 

April 3, 2012 as there were no employment-related residuals or disability. The Board further 

finds that appellant did not meet her burden of proof to establish continuing disability or 

residuals after her benefits were terminated. 

ORDER 

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

Compensation Programs dated September 14, 2015 is affirmed. 

Issued: May 18, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board