United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

L.B., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Brooklyn, NY, Employer

__________________________________________

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Docket No. 17-1600

Issued: March 9, 2018

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

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On July 17, 2017 appellant filed a timely appeal from an April 13, 2017 merit decision 

and a July 10, 2017 nonmerit 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

ISSUES

The issues are: (1) whether appellant met her burden of proof to establish right lower 

extremity conditions causally related to the accepted February 18, 2016 employment incident; 

and (2) whether OWCP properly denied her request for reconsideration of the merits of her claim 

under 5 U.S.C. § 8128(a). 

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that appellant submitted additional evidence after OWCP rendered its July 10, 2017 decision. 

The Board’s jurisdiction is limited to reviewing the evidence that was before OWCP at the time of its final decision.

Therefore, the Board is precluded from reviewing this additional evidence for the first time on appeal. 20 C.F.R. 

§ 501.2(c)(1); Dennis E. Maddy, 47 ECAB 259 (1995); James C. Campbell, 5 ECAB 35, 36 n.2 (1952). 
2

FACTUAL HISTORY

On July 6, 2016 appellant, then a 56-year-old mail processor, filed a traumatic injury 

claim (Form CA-1) alleging that, on February 18, 2016, she sustained a right lower extremity

injury when taking mail out of a post con, including buckets of flats and magazines, to place on 

her work ledge. She notified her supervisor on June 23, 2016. On the reverse side of the claim 

form, appellant’s supervisor reported that appellant had originally filed a notice of recurrence 

(Form CA-2a) on February 18, 2016 under OWCP File No. xxxxxx379.

3

By letter dated July 18, 2016, OWCP informed appellant that the evidence of record was 

insufficient to establish her claim. It advised her of the type of medical and factual evidence 

needed and afforded her 30 days to submit the requested information. 

In an August 2, 2016 narrative statement, appellant reported that, on February 18, 2016, 

she was lifting buckets of mail weighing over 25 pounds to put on her work ledge. As she turned 

to place them on the ledge, she twisted her right foot which resulted in a right foot ligament tear. 

Appellant underwent foot surgery on March 11, 2016. Following the incident she notified her 

supervisor of the injury and they advised her to file a Form CA-2a recurrence claim under File 

No. xxxxxx379. Appellant reported that her claimed February 18, 2016 injury was not a 

recurrence of her previously accepted conditions and contended that this wrong direction resulted 

in her case being denied. She noted that she did not untimely file her Form CA-1 as she was 

incorrectly advised of which form to file. Appellant noted that a coworker had to drive her home 

following the claimed February 18, 2016 employment incident because she was unable to walk.

In an August 2, 2016 witness statement, a coworker reported that he saw appellant 

limping on February 18, 2016 following her work injury and that he drove her home.

In a February 29, 2016 medical report, Dr. Jose Loor, a Board-certified podiatrist, 

reported that appellant presented with a new injury to the right ankle which occurred at work on 

February 18, 2016, when she was carrying about 15 pounds of weight. He noted that appellant 

was in distress with an antalgic gait. Dr. Loor diagnosed right foot and ankle pain, bilateral heel 

spur, and tinea ungum.

In a March 11, 2016 operative report, Dr. Loor diagnosed partial tear of the right tibiofibular ligament and provided findings pertaining to appellant’s right ankle arthroscopy and 

repair of the tibio-fibular ligament.

By decision dated August 18, 2016, OWCP denied appellant’s claim, finding that the 

medical evidence of record was insufficient to establish right lower extremity conditions causally 

related to the accepted February 18, 2016 employment incident.

 

3 Appellant’s prior traumatic injury claim under OWCP File No. xxxxxx379 pertained to a December 26, 2004 

employment incident. OWCP accepted the claim for sprain/strain of the neck (cervical sprain), sprain/strain of the 

right shoulder/arm (unspecified), and unspecified neuralgia neuritis/radiculitis (cervicolumbar radiculopathy). 

Neither that claim, nor appellant’s other prior claims, are currently before the Board. 
3

On August 22, 2016 appellant requested an oral hearing before an OWCP hearing 

representative.

In an August 30, 2016 witness statement, another coworker described the circumstances 

surrounding the February 18, 2016 employment incident when appellant complained of right foot 

pain. She noted that appellant informed their manager that she was in pain and needed to go to 

the hospital, but the supervisor failed to follow protocol by providing her the proper paper work 

and told her to go home rather than sending her to the hospital.

In an undated narrative medical report received on December 13, 2016, Dr. Loor reported 

that appellant was under his care for ankle and foot conditions. He noted that she was first seen 

on August 17, 2015 for bilateral plantar heel spurs and plantar fasciitis. Appellant was treated 

conservatively through December 7, 2015. On her follow-up visit on February 29, 2016, she

complained of an injury sustained at work on February 18, 2016. Physical evaluation revealed a 

right subtalar and ankle joint injury. Dr. Loor recommended diagnostic arthroscopy of the 

subtalar joint and right ankle to help evaluate and prevent traumatic arthritis. The procedure was 

performed on March 11, 2016, at which time the joint was found to have inflammation and 

cartilage damage consistent with an acute injury. Appellant was treated and evaluated through 

October 10, 2016. Dr. Loor opined that the procedure performed supported her acute injury 

claim, reporting that appellant could require further surgery as she sustained pain requiring 

treatment from her weakened joints and ligaments due to trauma resulting from her work injury. 

During the hearing, held on March 13, 2017, appellant testified regarding the 

circumstances surrounding the employment incident and subsequent course of treatment. 

Following the hearing, she submitted additional medical evidence in support of her claim.

In an October 19, 2016 diagnostic report, Dr. Carolyn Boltin, a Board-certified diagnostic 

radiologist, reported that a magnetic resonance imaging (MRI) scan of appellant’s right knee 

revealed horizontal oblique and undersurface tears at the posterior horn of the medial meniscus 

with medial extrusion and two millimeters associated parameniscal cyst, moderate cartilage loss 

within the medial compartment, mild cartilage loss within the lateral and patellofemoral 

compartments, attenuation of the anterior cruciate ligament suspicious for a chronic partial tear, 

and moderate joint effusion.

In a March 16, 2017 medical report, Dr. Raisa Mitelman, Board-certified in internal 

medicine, reported that appellant was under her care for a right knee and foot injury sustained at 

work in February 2016. She noted that appellant underwent right foot surgery for a torn 

ligament on March 11, 2016 and presented to her office for evaluation on October 10, 2016 due 

to complaints of right knee pain and swelling. Appellant was then referred for a right knee MRI 

scan. The MRI scan was performed on October 19, 2016 and demonstrated horizontal oblique 

and undersurface tears at the posterior horn of the medial meniscus and parameniscal cyst, 

moderate cartilage loss within the medial compartment, mild cartilage loss within the lateral and 

patellofemoral compartments, attenuation of the anterior cruciate ligament suspicious for a 

chronic partial tear, and moderate joint effusion.

By decision dated April 13, 2017, an OWCP hearing representative affirmed the 

August 18, 2016 decision, finding that the medical evidence of record failed to establish that her 
4

diagnosed right lower extremity conditions were causally related to the accepted February 18, 

2016 employment incident.

On July 6, 2017 appellant requested reconsideration. She submitted an accompanying 

narrative statement describing the February 18, 2016 employment incident and subsequent 

treatment, noting that she was given the wrong form to file following her injury. Appellant 

resubmitted her claim forms and medical evidence previously of record. OWCP received a copy 

of Dr. Loor’s March 11, 2016 operative report, and Dr. Boltin’s October 19, 2016 diagnostic 

report. 

By decision dated July 10, 2017, OWCP denied appellant’s request for reconsideration,

finding that she neither raised substantive legal questions, nor included relevant and pertinent 

new evidence.

LEGAL PRECEDENT -- ISSUE 1

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 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 is causally related to the 

employment injury.5 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.6

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.7 The second 

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

established only by medical evidence. 

To establish 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 causal relationship.8 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 

 

4 Supra note 1.

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

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

7 Elaine Pendleton, supra note 5.

8 See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983).
5

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 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.9

ANALYSIS -- ISSUE 1

OWCP accepted that the February 18, 2016 employment incident occurred as alleged. 

The issue is whether appellant has established that the accepted incident caused her right lower 

extremity conditions. 

The Board finds that the medical evidence of record is insufficient to establish that 

appellant’s right lower extremity conditions are causally related to the accepted February 18, 

2016 employment incident.10 

In a February 29, 2016 medical report, Dr. Loor reported that appellant presented with a 

new injury to the right ankle which occurred at work on February 18, 2016 when she was 

carrying approximately 15 pounds of weights. In a March 11, 2016 operative report, he 

diagnosed partial tear of the right tibio-fibular ligament and provided findings pertaining to a 

right ankle arthroscopy and repair of the tibio-fibular ligament. In a December 13, 2016 medical 

report, Dr. Loor reported that on February 29, 2016 appellant complained of an injury sustained 

at work on February 18, 2016 with physical evaluation findings of a right subtalar and ankle joint 

injury. He opined that the March 11, 2016 arthroscopy of the subtalar joint and right ankle 

performed supported appellant’s acute injury claim.

The Board finds that the opinion of Dr. Loor is not well rationalized. Dr. Loor’s 

February 29, 2016 report only generally repeated appellant’s allegations pertaining to the 

employment incident. While he provided a history of the February 18, 2016 employment 

incident, such generalized statements do not establish causal relationship because they merely 

repeat appellant’s allegations and are unsupported by adequate medical rationale explaining how 

this physical activity actually caused the diagnosed conditions.11 Dr. Loor’s March 11, 2016 

report is also insufficient to establish appellant’s claim as he provided operative findings with no 

opinion on the cause of appellant’s conditions. The Board has held that medical evidence that 

does not offer any opinion regarding the cause of an employee’s condition is of limited probative 

value on the issue of causal relationship.12 

Dr. Loor’s December 13, 2016 medical report is similarly insufficient to establish 

appellant’s claim. While he referenced the February 18, 2016 employment incident, he failed to 

discuss the circumstances surrounding the incident, only generally stating that the March 11, 

 

9

James Mack, 43 ECAB 321 (1991).

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

11 K.W., Docket No. 10-0098 (issued September 10, 2010).

12 C.B., Docket No. 09-2027 (issued May 12, 2010); S.E., Docket No. 08-2214 (issued May 6, 2009).
6

2016 arthroscopy of the subtalar joint and right ankle performed supported appellant’s acute 

injury claim. Dr. Loor’s opinion on causal relationship did not adequately explain how the 

February 18, 2016 employment incident would have caused or aggravated appellant’s right ankle 

condition, other than generally noting the development of pain. His statement on causation fails 

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

injury claim, namely, how lifting mail weighing approximately 15 to 25 pounds would cause or 

aggravate appellant’s tear of the right tibio-fibular ligament.

13

 Medical reports without adequate 

rationale on causal relationship are of diminished probative value and are insufficient to meet an 

employee’s burden of proof.14 The opinion of a physician supporting causal relationship must 

rest on a complete factual and medical background supported by affirmative evidence, address 

the specific factual and medical evidence of record, and provide medical rationale explaining the 

relationship between the diagnosed condition and the established incident or factor of 

employment.15 Without explaining how, physiologically, the movements involved in the 

employment incident caused or contributed to the diagnosed condition, Dr. Loor’s opinion on 

causal relationship is equivocal in nature and of limited probative value.16

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

claim. Dr. Boltin’s October 19, 2016 report interpreted diagnostic imaging studies pertaining to 

the right knee and provided no opinion on the cause of appellant’s conditions. Dr. Mitelman’s 

March 16, 2017 report also failed to establish appellant’s traumatic injury claim as the physician 

merely repeated the findings of the right knee MRI scan. The Board has held that reports of 

diagnostic tests are of limited probative value as they fail to provide an opinion on causal 

relationship between appellant’s employment incident and the diagnosed conditions. For this 

reason, this evidence is insufficient to meet her burden of proof.17

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 relationship.

18

 An award of compensation may 

not be based on surmise, conjecture, speculation, or on the employee’s own belief of causal 

relation.19 Appellant’s honest belief that the February 18, 2016 employment incident caused her 

medical injury, however sincerely held, does not constitute the medical evidence necessary to 

establish causal relationship.20 In the instant case, the record lacks rationalized medical evidence 

 

13 S.W., Docket 08-2538 (issued May 21, 2009).

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

15 See Lee R. Haywood, 48 ECAB 145 (1996).

16 See L.M., Docket No. 14-0973 (issued August 25, 2014); R.G., Docket No. 14-0113 (issued April 25, 2014); 

K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-0548 (issued November 16, 2012).

17 M.L., Docket No. 17-0487 (issued December 8, 2017). 

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

19 D.D., 57 ECAB 734 (2006).

20 E.V., Docket No. 17-0037 (issued November 3, 2017). 
7

establishing a causal relationship between the February 18, 2016 employment incident and her 

right lower extremity injury. 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 this merit decision, pursuant to 5 U.S.C. § 8128(a) 

and 20 C.F.R. §§ 10.605 through 10.607.

LEGAL PRECEDENT -- ISSUE 2

To reopen a case for merit review under FECA section 8128(a), OWCP’s regulations 

provide that the evidence or argument submitted by a claimant must: (1) show that OWCP 

erroneously applied or interpreted a specific point of law; (2) advance a relevant legal argument 

not previously considered by OWCP; or (3) constitute relevant and pertinent new evidence not 

previously considered by OWCP.21 Section 10.608(b) of OWCP’s regulations provides that 

when an application for reconsideration does not meet at least one of the three requirements 

enumerated under section 10.606(b)(3), OWCP will deny the application for reconsideration 

without reopening the case for a review on the merits.22

ANALYSIS -- ISSUE 2

The Board finds that OWCP’s denial of reconsideration of the merits of appellant’s

claim, pursuant to 5 U.S.C. § 8128(a), did not constitute an abuse of discretion.

The issue presented on appeal is whether appellant met any of the requirements of 20 

C.F.R. § 10.606(b)(3), requiring OWCP to reopen the case for review of the merits of the claim. 

In her application for reconsideration, appellant did not show that OWCP erroneously applied or 

interpreted a specific point of law. She did not advance a new and relevant legal argument. 

Appellant argued that her injury was employment related and described the February 18, 2016 

employment incident and subsequent medical treatment.

23

 The underlying issue in this case was 

whether appellant sustained right knee and ankle conditions causally related to the accepted 

September 13, 2016 employment incident. That is a medical issue which must be addressed by 

pertinent and relevant medical evidence.24 Appellant, however, failed to submit new and 

relevant medical evidence in support of her claim.25

In support of her claim, appellant resubmitted medical reports previously of record. 

Material which is duplicative of that already contained in the case record does not constitute a 

basis for reopening a case.26 A claimant may obtain a merit review of an OWCP decision by 

 

21 20 C.F.R. § 10.606(b)(3); see also D.K., 59 ECAB 141 (2007).

22 Id. at § 10.608; see also K.H., 59 ECAB 495 (2008). 

23 Sherry A. Hunt, 49 ECAB 467 (1998).

24 See Bobbie F. Cowart, 55 ECAB 746 (2004).

25 See id.

26 See Kenneth R. Mroczkowski, 40 ECAB 855 (1989).
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submitting relevant and pertinent new evidence. In this case, appellant did not submit any 

relevant and pertinent new medical evidence.

27

The Board accordingly finds that appellant did not meet any of the requirements of 20 

C.F.R. § 10.606(b)(3). Appellant did not show that OWCP erroneously applied or interpreted a 

specific point of law, advance a relevant legal argument not previously considered by OWCP, or 

constitute relevant and pertinent new evidence not previously considered. Pursuant to 20 C.F.R. 

§ 10.608, OWCP properly denied merit review.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish right lower 

extremity conditions causally related to the accepted February 18, 2016 employment incident. 

The Board further finds that OWCP properly denied appellant’s request for reconsideration of 

the merits of her claim under 5 U.S.C. § 8128(a). 

ORDER

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

decisions dated July 10 and April 13, 2017 are affirmed.

Issued: March 9, 2018

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

 

27 M.H., Docket No. 13-2051 (issued February 21, 2014); M.C., Docket No. 14-0021 (issued March 11, 2014).