United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

E.V., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Ponce, PR, Employer

__________________________________________

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Docket No. 18-1617

Issued: February 26, 2019

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

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On August 21, 2018 appellant filed a timely appeal from an August 3, 2018 merit 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.

ISSUE

The issue is whether appellant has met his burden of proof to establish that his diagnosed 

back conditions are causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On January 18, 2018 appellant, then a 62-year-old letter carrier, filed an occupational 

disease claim (Form CA-2) alleging that he injured his back when working a mounted route and 

enduring bad road conditions while in the performance of duty. He noted that he had previously 

injured his back on March 8, 2016 while on his route and that he underwent lumbar surgery on 

 

1 5 U.S.C. § 8101 et seq.
2

April 11, 2016. Appellant noted that he first became aware of his claimed condition on 

February 14, 2016 and realized its relation to his federal employment on March 15, 2016. On the 

reverse side of the claim form, a supervisor noted that appellant had not worked since June 2017.

By development letter dated February 5, 2018, OWCP informed appellant that additional 

evidence was needed to establish his occupational disease claim. It advised him of the type of 

factual and medical evidence needed and provided a questionnaire for his completion. OWCP 

afforded appellant 30 days to submit additional evidence.

In support of his claim, appellant submitted largely-illegible progress notes from

Dr. Gilberto Alvarado, an orthopedic surgeon, dated June 14, July 1, and August 28, 2013. He

also submitted numerous diagnostic testing reports. A September 4, 2013 magnetic resonance 

imaging (MRI) scan of appellant’s cervical spine demonstrated multilevel degenerative changes 

with a disc osteophyte complex more prominent at the C3-C4 and C5-C6 levels, causing mild-tomoderate and moderate-to-severe spinal canal and foramina stenosis. A January 23, 2014 report 

of a computerized tomography (CT) scan of appellant’s cervical spine demonstrated that appellant 

was status post fusion at C3-C4 and C4-C5 and that the fusion device was intact. A January 25, 

2014 report of x-rays of appellant’s cervical spine demonstrated internal fixation with an 

orthopedic plate and screws entering the C3 through C6 vertebral bodies anteriorly.

Appellant subsequently submitted additional largely-illegible progress notes dated 

September 19, October 31, and November 17, 2014 from Dr. Alvarado. He also submitted an 

illegible operative report dated February 4, 2015, along with an undated and illegible prescription 

note.

In a preoperative clearance report dated January 16, 2015, Dr. Marta Benitez, specializing 

in critical care medicine, noted that appellant had no contraindications to cervical disc disease 

surgery and surgery of the left arm at that time, noting trauma to the left elbow.

On November 19, 2015 Dr. Yamil C. Rivera, a Board-certified orthopedic surgeon, 

examined appellant for complaints of low back pain, radiating into the left leg. He noted that 

appellant had undergone two previous epidural steroid injections with some relief. On 

examination Dr. Rivera noted full strength of the lower and upper extremities. He reviewed the 

MRI scan of appellant’s lumbar spine, which demonstrated lumbar disc degeneration, a left L5-S1 

small disc herniation, and mild stenosis at L4-L5. Dr. Rivera diagnosed appellant with lumbar 

spondylosis with radiculopathy and lumbar disc prolapse with radiculopathy. He recommended 

that appellant consider an additional epidural steroid injection.

On January 28, 2016 Dr. Rivera evaluated appellant and noted left leg pain. He noted that 

appellant had an epidural steroid injection with some relief, but was once again experiencing pain. 

On examination Dr. Rivera noted reduced strength of the lower left extremity and a positive 

straight leg raise on the left. He noted that a lumbar spine MRI scan demonstrated L5-S1 

degenerative disc disease and disc herniation. Dr. Rivera diagnosed lumbosacral spondylosis with 

radiculopathy and lumbar disc prolapse with radiculopathy. He recommended that appellant 

undergo a left L5-S1.
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In an operative report dated April 11, 2016, Dr. Rivera noted the diagnosis of lumbar 

stenosis and the surgical procedure of a lumbar laminotomy at L5-S1.

In a follow-up report dated April 28, 2016, Dr. Rivera noted full strength of appellant’s 

lower and upper extremities. Appellant informed Dr. Rivera that he had improved left leg pain 

with mild numbness at the L5 nerve root.

Appellant submitted an additional illegible progress note from Dr. Alvarado dated 

October 31, 2016.

In a medical summary dated February 15, 2018, Dr. Alberto Rivera-Sanchez, an internist, 

noted that appellant underwent an anterior cervical discectomy on January 8, 2014, after which his 

shoulder pain and numbness in his hand persisted. 

On July 31, 2014 appellant had an extensor digitorum communis injection. On January 21, 

2015 he underwent a left extensor carpi radialis brevis surgery. 

An August 19, 2015 MRI scan demonstrated left lateral bulging discs at the L3-L4 and L4-

L5 levels, encroaching the neural foramen with left foraminal stenosis, left foraminal stenosis at 

L5-S1, and loss of normal lumbar lordosis, likely secondary to muscle spasm. Dr. Rivera-Sanchez 

diagnosed spinal stenosis of the lumbar region with neurogenic claudication, thoracic or 

lumbosacral neuritis or radiculitis, displacement of the cervical intervertebral disc without 

myelopathy, postlaminectomy syndrome of the cervical region, and chronic pain syndrome. 

Appellant had epidural steroid injections on January 24 and October 1, 2015.

Subsequent to these injections, appellant was reexamined by Dr. Rivera, who updated his 

list of diagnoses to include lumbosacral spinal stenosis, lumbar intervertebral disc displacement, 

lumbosacral intervertebral disc displacement, and postlaminectomy syndrome. He had a 

transforaminal epidural injection on December 10, 2015, and later underwent lumbar spine surgery 

on April 11, 2016 with Dr. Rivera. Appellant continued to have neck pain and lower back pain at 

subsequent visits, which were treated with medication. On March 7, 2017 he reported a recent fall 

for which he had to seek treatment at the emergency room. Dr. Rivera-Sanchez noted that 

appellant would be out of work until September 2017. On August 1, 2017 appellant complained 

of neck pain and lower back pain, which impaired some of his activities of daily living. Dr. RiveraSanchez noted that his pain was partially relieved with medication. He noted that appellant’s 

postlaminectomy syndrome and lumbar spinal stenosis would pose a lifelong problem. Dr. RiveraSanchez noted that his pain impacted activities of daily living and that at some point in the near 

future he may require surgical decompression. He noted that appellant should be enrolled in a 

sedentary job with a flexible schedule or to remain out of work.

By decision dated April 25, 2018, OWCP denied appellant’s claim, finding that he had not 

provided a description of the claimed work activities he believed caused his condition.

On May 7, 2018 appellant requested reconsideration of OWCP’s April 25, 2018 decision. 

With his request, he submitted an April 20, 2018 report from Dr. Andres Delanoy, a family 

medicine specialist, who noted that he had a spinal condition and was unable to perform duties of 

his employment. Appellant also submitted an April 20, 2018 duty status report from Dr. Delanoy, 

noting that he had been advised not to resume work. Dr. Delanoy diagnosed thoracic, 
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thoracolumbar, and lumbosacral intervertebral disc displacement and cervical disc disorder with 

radiculopathy, and noting low back pain. He checked a box noting that the diagnosed conditions 

were due to an employment injury. Appellant also resubmitted the February 15, 2018 medical 

summary of Dr. Rivera-Sanchez.

In a statement dated May 2, 2018, appellant explained that his back conditions occurred 

due to his mounted route and bad conditions on the road. He alleged that, in August 2013, his 

truck fell into a pit and he injured his cervical spine, requiring surgery. Subsequently, appellant

injured his left forearm. On September 12, 2015 he lost control of his truck and hit a gate. On 

May 5, 2017 appellant injured his back while on his route.

By letter dated May 17, 2018, OWCP requested that appellant clarify whether he was 

claiming a traumatic injury or occupational disease. It afforded him 20 days to respond.

Appellant responded by letter dated May 22, 2018. He clarified that his claim was for an 

occupational disease, as he had worked at the employing establishment for 32 years, and that he 

had been suffering from back pain for the last 5 years. Appellant attributed his back pain to the 

bad conditions on his route and making deliveries outside his vehicle, noting that he performed 

these duties six days per week for the last eight years. He stated that he had not returned to work.

By decision dated August 3, 2018, OWCP affirmed as modified its prior decision and 

found that appellant had established the factual components of his claim. However, it further 

found that he had not submitted sufficient medical evidence to establish causal relationship 

between the accepted factors of his federal employment and his diagnosed conditions.

LEGAL PRECEDENT

An employee seeking benefits under FECA 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,2and that an injury was sustained in the performance of duty as 

alleged, and that any disability or medical condition for which compensation is claimed is causally 

related to the employment injury.3 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 establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit: (1) medical evidence establishing the presence or existence 

 

2 S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989).

3

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

4 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); 

Delores C. Ellyett, 41 ECAB 992 (1990).
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of the disease or condition for which compensation is claimed; (2) a factual statement identifying 

employment factors alleged to have caused or contributed to the presence or occurrence of the 

disease or condition; and (3) medical evidence establishing that the diagnosed condition is causally 

related to the identified employment factors.5

Causal relationship is a medical question, which requires rationalized medical opinion 

evidence to resolve the issue.6 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factors must be based on a 

complete factual and medical background.7 Additionally, the physician’s opinion must be 

expressed in terms of a reasonable degree of medical certainty, and must be supported by medical 

rationale, explaining the nature of the relationship between the diagnosed condition and appellant’s 

specific employment factors.8

ANALYSIS

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

diagnosed back conditions are causally related to the accepted factors of his federal employment. 

Appellant submitted a medical summary dated February 15, 2018 from Dr. RiveraSanchez, which outlined appellant’s history of medical diagnoses and treatment for cervical, 

lumbar, and elbow conditions. Dr. Rivera-Sanchez noted that appellant was either disabled from 

work or could only work in a sedentary position, but failed to offer an opinion on the cause of 

appellant’s diagnosed conditions. Medical reports from Dr. Rivera dated November 19, 2015 

through April 28, 2016, and the January 16, 2015 report of Dr. Benitez also fail to provide an 

opinion as to the cause of appellant’s diagnosed conditions. Dr. Alvarado’s notes are largely 

illegible, but none provide an opinion on causation. The Board has held that medical evidence that 

does not offer an opinion regarding the cause of an employee’s condition is of no probative value 

on the issue of causal relationship.9 These reports, therefore, are insufficient to establish 

appellant’s claim. 

In an April 20, 2018 duty status report, Dr. Delanoy diagnosed appellant with thoracic, 

thoracolumbar, and lumbosacral intervertebral disc displacement and cervical disc disorder with 

radiculopathy, and noting low back pain. He checked a box noting that the diagnosed conditions 

were due to an employment injury. The Board has held, however, that when a physician’s opinion 

on causal relationship consists only of checking a response to a form question, without explanation 

or rationale, that opinion has little probative value and is insufficient to establish a claim.10 As 

 

5 Victor J. Woodhams, 41 ECAB 345, 352 (1989).

6 See Robert G. Morris, 48 ECAB 238 (1996). 

7 Supra note 5.

8

Id.

9 See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

10 See M.O., Docket No. 18-1056 (issued November 6, 2018); Deborah L. Beatty, 54 ECAB 3234 (2003).
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such, the April 20, 2018 duty status report of Dr. Delanoy is insufficient to establish appellant’s 

claim.

Appellant also submitted a plethora of diagnostic test results in support of his claim. The 

Board has held, however, that diagnostic studies are of limited probative value as they do not 

address whether the employment incident caused any of the diagnosed conditions.11 Such 

diagnostic reports are therefore insufficient to establish appellant’s claim.

Finally, appellant submitted numerous illegible medical records in support of his claim. 

However, a note which contains an illegible signature has no probative value, as it is not 

established that the author is a physician.12 Such illegible records therefore lack probative value. 

As noted above, appellant bears the burden of proof to establish the essential elements of 

his claim. The Board finds that he has not met his burden of proof to provide sufficient medical 

evidence to establish that his diagnosed conditions were causally related to the accepted factors of 

his federal employment, he has thus not met his burden of proof to establish his claim.

Appellant may submit new evidence or argument as part of 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 his 

diagnosed back conditions are causally related to the accepted factors of his federal employment.

 

11 See J.S., Docket No. 17-1039 (issued October 6, 2017). 

12 See D.D., 57 ECAB 734 (2006); Merton J. Sills, 39 ECAB 572, 575 (1988).
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ORDER

IT IS HEREBY ORDERED THAT the August 3, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: February 26, 2019

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