United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

P.D., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Plainview, NY, Employer 

__________________________________________ 

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Docket No. 17-0289 

Issued: June 9, 2017 

Appearances: Case Submitted on the Record

William Bothwell, for the appellant1

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On November 21, 2016 appellant, through his representative, filed a timely appeal from 

an October 3, 2016 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 over the merits of this case.3

 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. 

3

 Appellant timely requested oral argument before the Board. By order dated April 20, 2017, the Board exercised 

its discretion and denied the request finding that the issues could properly be adjudicated based on the evidence of 

record. Order Denying Oral Argument, Docket No. 17-0289 (issued April 20, 2017). 
2

ISSUE 

The issue is whether appellant met his burden of proof to establish an injury causally 

related to the accepted December 9, 2014 employment incident. 

FACTUAL HISTORY 

On December 9, 2014 appellant, then a 49-year-old city carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on that date he injured his lower back when he slipped on mud. 

On the claim form a supervisor noted that, during an investigation, no mud was found. 

In a letter dated December 17, 2014, the employing establishment challenged appellant’s 

claim. It noted that before the incident appellant had been involved in an argument with 

supervisors over being tracked on his route and the time he could take a lunch break. An hour 

into appellant’s route he claimed that he slipped on mud and hurt his back. An investigation was 

completed by supervisors who found no mud at the described location or on his clothing. The 

supervisors also noted that the date of injury was appellant’s first day back to work after being 

on leave due to nonwork-related sciatica. 

On December 12, 2014 Dr. Matthew Goldstein, Board-certified in orthopedic surgery, 

examined appellant and diagnosed a coccygeal fracture and trace retrolisthesis at L4-5 with 

extension. He noted that appellant reported a fall at work on December 9, 2014, landing on his 

backside. 

By letter dated December 22, 2014, OWCP informed appellant of the evidence needed to 

establish his claim. It noted that he had not submitted sufficient medical or factual evidence in 

support of his claim. Appellant was afforded 30 days to submit this additional evidence. 

In a report dated December 26, 2014, Dr. Goldstein examined x-rays of appellant’s 

lumbosacral spine and diagnosed lumbar pain with radiculopathy, L4-5 trace retrolisthesis, and a 

coccygeal fracture. He also noted that appellant was out of work because no light-duty positions 

were available with the employing establishment. Dr. Goldstein recommended that appellant 

stay out of work until further notice. 

By decision dated January 30, 2015, OWCP denied appellant’s claim. It found that he 

had failed to establish that the incident of December 9, 2014 occurred as described, due to 

discrepancies in his statement regarding how he fell. 

In a work status note dated January 16, 2015, Dr. Goldstein diagnosed a fractured coccyx, 

degenerative lumbar spondylolisthesis, and lumbar radiculopathy. He recommended that 

appellant stay out of work until further notice. 

On February 20, 2015 appellant requested an oral hearing before an OWCP hearing 

representative. The hearing was held on July 21, 2015. At the hearing appellant described the 

events of December 9, 2014 stating that he had been instructed to take all obvious shortcuts. 

Walking alongside a flower bed on a dirt path, while it was raining, he stepped on wet dirt and 

slipped. Appellant noted that he was wearing his rubber raincoat, rubber boots, and rubber rain 

pants at the time, and that the reason his clothes were clean after the incident was that they were 
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made of rubber and it was raining, so the dirt washed off. He explained that he never claimed 

that he fell on a concrete walkway or sidewalk. 

In a report dated August 13, 2015, Dr. Goldstein reiterated appellant’s history of injury, 

noting that he sustained a fall at work on December 9, 2014 and landed on his backside. He 

noted that since that time appellant had experienced severe low back and buttock pain, mostly on 

the left. 

By decision dated September 8, 2015, the hearing representative affirmed OWCP’s prior 

decision of January 30, 2015. She concurred with OWCP’s prior determination that the facts 

surrounding appellant’s fall were suspect. 

By letter dated July 6, 2016, appellant, through his representative, requested 

reconsideration of OWCP’s September 8, 2015 decision. He argued that the employing 

establishment had made contradictory factual claims, noting that the employing establishment 

first claimed that the event did not occur, then disciplined appellant for committing an unsafe act 

leading to his fall and injury. The representative reiterated appellant’s statement as to how the 

injury occurred. He noted that the only condition claimed to have been caused by the fall was 

the coccygeal fracture. 

By letter dated May 5, 2016, Dr. Goldstein opined that appellant sustained a fall at work 

on December 9, 2014 that resulted in a coccygeal fracture. He described appellant falling at 

work and landing on his backside. Dr. Goldstein noted that x-rays revealed a coccygeal fracture, 

and explained that appellant sustained the fracture following the fall. He noted, “In my opinion, 

[appellant’s] current condition/coccygeal fracture is causally related to the work-related 

injury/fall which occurred on December 9, 2014.” 

By decision dated October 3, 2016, OWCP noted that the employing establishment was 

no longer disputing that the slip and fall occurred as alleged, but rather was disputing whether 

appellant worked in a safe manner. It therefore found that he had established the factual 

components of his claim, but denied his claim finding that he had not submitted sufficient 

medical evidence to establish a causal relationship between the fall on December 9, 2014 and his 

claimed conditions. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA4

 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 FECA, that an injury5 was sustained in the performance of 

 4 Supra note 1. 

5

 OWCP’s regulations define a traumatic injury as a condition of the body caused by a specific event or incident, 

or series of events of incidents, within a single workday or shift. Such condition must be caused by external force, 

including stress or strain, which is identifiable as to time and place of occurrence and member or function of the 

body affected. 20 C.F.R. § 10.5(ee). 
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duty as alleged, and that any disability or medical condition for which compensation is claimed 

is causally related to the employment injury.6

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. 

A fact of injury determination is based on two elements. First, the employee must submit 

sufficient evidence to establish that he actually experienced the employment incident at the time, 

place, and in the manner alleged. 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. An employee may establish that the employment incident occurred as alleged, 

but fail to show that his or her condition relates to the employment incident.7

The claimant has the burden of proof to establish by the weight of reliable, probative, and 

substantial evidence that the condition for which compensation is sought is causally related to a 

specific employment incident or to specific conditions of employment.8 An award of 

compensation may not be based on appellant’s belief of causal relationship. Neither the mere 

fact that a disease or condition manifests itself during a period of employment nor the belief that 

the disease or condition was caused or aggravated by employment factors or incidents is 

sufficient to establish a causal relationship.9

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

establish causal relationship is rationalized medical opinion evidence.10 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 

compensable employment factors.11 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.12

ANALYSIS 

Appellant alleged that on December 9, 2014 he sustained a fall at work that resulted in a 

fractured coccyx. OWCP denied his claim finding that he had failed to submit sufficient medical 

 6 T.H., 59 ECAB 388, 393 (2008); see Steven S. Saleh, 55 ECAB 169, 171-72 (2003); Elaine Pendleton, 40 

ECAB 1143, 1145 (1989). 

7 See Shirley A. Temple, 48 ECAB 404, 407 (1997); John J. Carlone 41 ECAB 354, 356-57 (1989). 

8 Roma A. Mortenson-Kindschi, 57 ECAB 418, 428 n.37 (2006); Katherine J. Friday, 47 ECAB 591, 594 (1996). 

9 P.K., Docket No. 08-2551 (issued June 2, 2009); Dennis M. Mascarenas, 49 ECAB 215, 218 (1997). 

10 Y.J., Docket No. 08-1167 (issued October 7, 2008); A.D., 58 ECAB 149, 155-56 (2006); D’Wayne Avila, 57 

ECAB 642, 649 (2006). 

11 J.J., Docket No. 09-27 (issued February 10, 2009); Michael S. Mina, 57 ECAB 379, 384 (2006). 

12 I.J., 59 ECAB 408, 415 (2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989). 
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evidence to establish a causal relationship between his claimed condition and the fall of 

December 9, 2014. The Board finds that appellant has not met his burden of proof. 

Dr. Goldstein initially reported on December 12, 2014 that appellant had fallen at work 

on December 9, 2014, landing on his backside. He diagnosed coccygeal fracture and trace 

retrolisthesis at L4-5. OWCP received reports dated December 26, 2014 and January 16, 2015 

wherein Dr. Goldstein reiterated these diagnoses. He did not however offer any opinion 

regarding causal relationship in these reports.13 By report dated May 5, 2016, Dr. Goldstein 

opined that appellant sustained a fall at work on December 9, 2014 that resulted in a coccygeal 

fracture. He described appellant falling at work and landing on his backside. Dr. Goldstein 

noted that x-rays revealed a coccygeal fracture, and explained that appellant sustained the 

fracture following the fall. He noted, “In my opinion, [appellant’s] current condition/coccygeal 

fracture is causally related to the work-related injury/fall which occurred on December 9, 2014.” 

Appellant alleged that he slipped in mud while walking alongside a flower bed. He 

specifically stated that he did not fall on concrete or a sidewalk. It is unclear from 

Dr. Goldstein’s report whether he had a complete factual history regarding appellant’s fall as he 

did not describe appellant’s fall in any detail. As his report does not contain an accurate and 

complete history of appellant’s injury, his opinion is of limited probative value.14 

The Board has also held that 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.15 Dr. Goldstein provided a conclusory opinion, but did not explain how the 

December 9, 2014 work incident could have caused or aggravated the diagnosed conditions. His 

May 5, 2016 report contains a medical opinion that the fall caused the fracture and a brief 

explanation of the fall itself. This is insufficient to establish appellant’s claim because 

Dr. Goldstein’s opinion lacks a detailed explanation as to how the fall caused the coccygeal 

fracture.16

As appellant has not submitted any sufficiently rationalized medical evidence to support 

his allegation that he sustained an injury causally related to a work-related incident of 

December 9, 2014, he has not met his burden of proof to establish his claim.17

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 The Board has found that medical evidence that does not offer any opinion regarding the cause of an 

employee’s condition or disability is of limited probative value. C.B., Docket No. 09-2027 (issued May 12, 2010); 

J.F., Docket No. 09-1061 (issued November 17, 2009); A.D., 58 ECAB 149 (2006). 

14 See Robert L. Lawson, Jr., Docket No. 95-2933 (issued September 23, 2997). 

15 N.L., Docket No. 17-0454 (issued April 6, 2017). 

16 See W.N., Docket No. 16-1722 (issued March 22, 2017). 

17 Id. 
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CONCLUSION 

The Board finds that appellant has not met his burden of proof to establish an injury 

causally related to the accepted December 9, 2014 employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the October 3, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: June 9, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board