United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.S., Appellant

and

DEPARTMENT OF JUSTICE, MARSHALS

SERVICE, Covington, KY, Employer

__________________________________________

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Docket No. 17-0868

Issued: October 19, 2017

Appearances:

Alan J. Shapiro, Esq., for the appellant1 Case Submitted on the Record

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 March 13, 2017 appellant, through counsel, filed a timely appeal from a January 30, 

2017 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 lumbar injury 

causally related to the accepted May 15, 2015 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

FACTUAL HISTORY

On May 18, 2015 appellant, then a 38-year-old deputy marshal, filed a traumatic injury

claim (Form CA-1), alleging that, on May 15, 2015, while lifting and carrying cases of 

ammunition, he strained his groin area. He did not stop work. 

Appellant was treated by Dr. Dean D. Skinner, a chiropractor, from May 18 to July 20, 

2015, for low back pain. Dr. Skinner reported that he sustained a work injury on May 15, 2015 

while he was lifting and carrying boxes of ammunition at work.

Dr. Onassis A. Caneris, a Board-certified neurologist, examined appellant on May 20, 

2015 for right lower abdominal and right groin pain. Appellant reported an onset a year ago of 

back pain that radiated to the inguinal area and posterior aspect of the hip. He was treated 

conservatively, but continued to have refractory problematic pain which interfered with his 

ability to work. Appellant related this pain to a work-related incident. Dr. Caneris noted 

findings on examination of normal range of motion of the musculoskeletal spine, slightly 

positive reverse straight leg raise on the right, intact motor strength in the upper and lower 

extremities, intact sensation, and intact reflexes. He diagnosed lumbar spondylosis, degenerative 

disc disease, and lumbar radiculopathy. Dr. Caneris recommended right-sided, two-level 

transforaminal injections at L4 and L5 and stretching and stabilization of the quadratus and psoas 

with L4 and L5 techniques. 

Appellant was examined by Dr. G. Stephen Cleves, a Board-certified internist, on 

May 22, 2015, for low back pain and stiffness with an onset of one month. Dr. Cleves noted 

findings of decreased range of motion of the musculoskeletal spine. He diagnosed backache, 

unspecified. In a June 10, 2015 addendum, Dr. Cleves noted that appellant had a history of 

ongoing back pain and on May 15, 2015 he aggravated his back and pulled something in his 

groin area while lifting boxes at work. He noted that appellant was scheduled for a steroid 

injection. 

By letter dated February 8, 2016, OWCP advised appellant of the type of evidence 

needed to establish his claim, particularly requesting that he submit a physician’s reasoned 

opinion addressing the relationship of his claimed condition and specific employment incident. 

It requested that the physician’s opinion be based upon the history and date of injury he had 

provided to the physician. OWCP noted that medical evidence must be submitted by a qualified 

physician and notified appellant of the circumstances under which a chiropractor can be

considered a physician under FECA. Appellant did not submit additional evidence responsive to 

the specific requests contained within OWCP’s development letter.

In a March 15, 2016 decision, OWCP denied appellant’s claim for compensation because 

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

to the accepted work incident.

On March 21, 2016 appellant through counsel requested a telephonic hearing which was 

held on December 19, 2016. 
3

On August 24, 2016 Dr. Mathew A. Hazzard, a Board-certified neurosurgeon, performed 

a bilateral percutaneous sacroiliac joint fixation, intraoperative fluoroscopy, and intraoperative

neuromonitoring. He diagnosed bilateral sacroiliac joint fixation. 

Appellant was treated by Dr. Neil Allen, a Board-certified neurologist, on November 9, 

2016, for back pain. Dr. Allen reported that appellant had sustained a low back injury and groin 

pain as a result of repetitive lifting and carrying boxes of ammunition. Appellant noted current 

symptoms of right-sided back pain, groin pain, numbness and tingling down the right leg, and 

hypersensitivity of the right foot. Dr. Allen noted appellant’s history was significant for a low 

back injury in 2007, which was refractive to conservative measures and he eventually required a 

lumbar fusion at L5-S1 in 2008. He diagnosed strain/sprain of the lumbar spine. Dr. Allen noted

the repetitive, forceful muscle contraction required to perform the task described by appellant on 

May 15, 2015, resulted in the overstretching and microscopic tearing of the ligaments and 

musculature of the lumbar spine resulting in the injury. He indicated that the surrounding soft 

tissues react and became inflamed, painful and stiff, restricting both functional and mobility 

within the affected area with radiating symptoms to the buttocks and thigh. Dr. Allen opined that 

appellant’s injury resulting from the repetitive occupational trauma on May 15, 2015 was both 

reasonable and expected based upon the mechanism described by appellant and the medical 

records. Appellant also submitted physical therapy notes. 

In a decision dated January 30, 2017, an OWCP hearing representative affirmed the 

decision dated March 15, 2016. 

LEGAL PRECEDENT

An employee seeking benefits under FECA3has 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 of FECA, that an injury was sustained in the performance of duty as alleged, and that 

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

the employment injury. These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated upon a traumatic injury or an occupational disease.4

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

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

There are two components involved in establishing fact of injury. 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 medical evidence 

sufficient to establish that the employment incident caused a personal injury.5

 

3

Id. 

4 Gary J. Watling, 52 ECAB 357 (2001).

5

T.H., 59 ECAB 388 (2008).
4

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.6

ANALYSIS

It is undisputed that on May 15, 2015 appellant was lifting and carrying cases of 

ammunition. However, he has failed to submit sufficient medical evidence to establish that his

diagnosed medical condition is causally related to the May 15, 2015 employment incident.

Appellant was treated by Dr. Allen on November 9, 2016. He reported sustaining a low 

back injury as a result of repetitive lifting and carrying boxes of ammunition. Dr. Allen noted 

that appellant’s history was significant for a low back injury in 2007, which required a 2008 

lumbar fusion of L5-S1. He diagnosed strain/sprain of the lumbar spine and opined that the 

repetitive, forceful muscle contraction required to perform the task described by appellant on 

May 15, 2015 resulted in the overstretching and microscopic tearing of the ligaments and 

musculature of the lumbar spine. Dr. Allen indicated that appellant’s injury resulted from the 

repetitive occupational trauma on May 15, 2015 was both reasonable and expected based upon 

the mechanism described by appellant and the medical records. However, he merely repeated 

the history of injury as reported by appellant without providing his own opinion explaining how 

particular work activities on May 15, 2015 caused a diagnosed condition. To the extent that

Dr. Allen is providing his own opinion, he failed to provide sufficient rationale regarding the 

causal relationship between appellant’s low back condition and the accepted work incident.7 

Therefore, this report is insufficient to meet his burden of proof. 

Similarly, in a report dated May 20, 2015, Dr. Caneris treated appellant for right lower 

abdominal and right groin pain. Appellant reported a first onset of pain over a year earlier and 

believed that his condition related to a work-related incident. Dr. Caneris diagnosed lumbar 

spondylosis, degenerative disc disease, and lumbar radiculopathy. As with Dr. Allen,

Dr. Caneris also merely repeated the history of injury as reported by appellant without providing 

his own opinion regarding whether his condition was work related. To the extent that

Dr. Caneris is providing his own opinion, he did not provide a rationalized opinion regarding the 

causal relationship between appellant’s low back condition and the May 15, 2015 work 

activities.

8

 

Appellant submitted a May 22, 2015 report from Dr. Cleves who treated him for low 

back pain and stiffness. Dr. Cleves diagnosed backache, unspecified. In an addendum note 

dated June 10, 2015, he noted that appellant had a history of back pain that was ongoing and on 

 

6

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

7 Franklin D. Haislah, 52 ECAB 457 (2001) (medical reports not containing rationale on causal relationship are 

entitled to little probative value); Jimmie H. Duckett, 52 ECAB 332 (2001). 

8

Id. 
5

May 15, 2015 he aggravated his back by pulling something in his groin area while lifting boxes 

at work. The Board finds that, although Dr. Cleves supported causal relationship, he did not 

provide medical rationale explaining the basis of his conclusory opinion that appellant’s back 

condition was due to the factors of employment.9 Dr. Cleves did not explain the process by 

which lifting boxes caused or aggravated the diagnosed conditions.10 Medical rationale is 

particularly necessary given that appellant had a preexisting low back condition and underwent a 

surgery in 2008. As the opinion of appellant’s physician regarding causal relationship was 

conclusory and unexplained, it was insufficient to meet appellant’s burden of proof.11

Appellant submitted an August 24, 2016 operative report from Dr. Hazzard who 

performed a bilateral percutaneous sacroiliac joint fixation, intraoperative fluoroscopy and 

intraoperative neuromonitoring, and diagnosed bilateral sacroiliac joint fixation. Dr. Hazzard’s 

notes are insufficient to establish the claim as he did not provide a history of injury12 or 

specifically address whether appellant’s employment activities had caused or aggravated a 

diagnosed medical condition.13 

Appellant was initially treated by Dr. Skinner, a chiropractor from May 18 to July 20, 

2015, for low back pain. He reported that he sustained a work injury on May 15, 2015 while he 

was lifting and carrying boxes of ammunition while working. Section 8101(2) of FECA 

provides that chiropractors are considered physicians “only to the extent that their reimbursable 

services are limited to treatment consisting of manual manipulation of the spine to correct a 

subluxation as demonstrated by x-ray to exist and subject to regulation by the Secretary.”

14

 

Thus, where x-rays do not demonstrate a spinal subluxation, a chiropractor is not considered a 

“physician,” and his or her reports cannot be considered as competent medical evidence under 

FECA.15 Dr. Skinner is not considered a physician in this case as he did not diagnose a spinal 

 

9

See T.M., Docket No. 08-0975 (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).

10 Id.

11 J.M., 58 ECAB 478 (2007) (where the Board found that appellant did not meet his burden of proof in 

establishing a work-related right wrist condition where his physician provided only conclusory support for causal 

relationship and did not identify any of the job duties appellant performed at the employing establishment which he 

believed were responsible for appellant’s condition or explain how his work duties at the employing establishment 

caused or contributed to his condition. Medical rationale was particularly necessary given that appellant injured his 

wrist while lifting luggage in private employment. As the opinion of appellant’s physician regarding causal 

relationship was conclusory and unexplained, it was insufficient to meet appellant’s burden of proof). 

12 Frank Luis Rembisz, 52 ECAB 147 (2000). 

13 A.D., 58 ECAB 149 (2006); Docket No. 06-1183 (issued November 14, 2006) (medical evidence which does 

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

causal relationship). 

14 5 U.S.C. § 8101(2); see also section 10.311 of the implementing federal regulations provides: “(c) A 

chiropractor may interpret his or her x-rays to the same extent as any other physician. To be given any weight, the 

medical report must state that x-rays support the finding of spinal subluxation. OWCP will not necessarily require 

submittal of the x-ray, or a report of the x-ray, but the report must be available for submittal on request.” 

15 See Susan M. Herman, 35 ECAB 669 (1984).
6

subluxation demonstrated by x-ray. Thus, his opinion is not considered competent medical 

evidence under FECA.

Appellant submitted physical therapy notes dated March 8, 2016. The Board has held 

that treatment notes signed by a physical therapist, are not considered medical evidence as they 

are not a physician under FECA16 and are not competent to render a medical opinion under 

FECA. Thus, this evidence is not sufficient to meet appellant’s burden of proof. 

Due to appellant’s history of prior injury and the lack of clarity between his claim for 

groin pain and the development of additional back pain, OWCP properly requested further 

medical evidence as to the specific history and date of his back conditions. As previously 

discussed above, appellant failed to submit a narrative medical report containing a history of 

injury and a physician’s opinion relative to same. The Board finds that he has failed to submit 

sufficient medical evidence to establish that his accepted work incident on May 15, 2015 caused 

or aggravated a diagnosed medical condition.

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 did not meet his burden of proof to establish a lumbar 

injury causally related to the accepted May 15, 2015 employment incident.

 

16 See David P. Sawchuk, 57 ECAB 316 (2006) (lay individuals such as physician’s 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).
7

ORDER

IT IS HEREBY ORDERED THAT the January 30, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: October 19, 2017

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