United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.M., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Macclesfield, NC, Employer 

__________________________________________ 

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Docket No. 16-1885 

Issued: February 15, 2017 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On September 26, 2016 appellant filed a timely appeal from a July 21, 2016 

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.2

ISSUE 

The issue is whether appellant met her burden of proof to establish a back injury causally 

related to the accepted May 27, 2016 employment incident. 

On appeal, appellant contends that she still has issues/problems that have kept her off 

work since May 2016. 

 1

 5 U.S.C. § 8101 et seq.

2

 Following the issuance of the July 21, 2016 OWCP decision, appellant submitted new evidence to OWCP. The 

Board is precluded from reviewing evidence which was not before OWCP at the time it issued its final decision. 

Therefore, the Board lacks jurisdiction to review this additional evidence. See 20 C.F.R. § 501.2(c)(1). 
2

FACTUAL HISTORY 

On June 2, 2016 appellant, then a 49-year-old rural carrier, filed a traumatic injury claim 

(Form CA-1) alleging that on May 27, 2016 she experienced right lower back pain that was 

diagnosed as a subluxation. She advised that the pain went down her right thigh to her calf area 

when she tried to turn to her left to move long mail trays that she was holding on her lap. 

Appellant stopped work on the date of injury. 

In a June 2, 2016 work excuse note, Dr. James Carraher, an attending chiropractor, 

indicated that appellant was unable to work through June 9, 2016. 

In letters dated June 3, 2016, the employing establishment controverted appellant’s claim. 

It noted that she was being treated by a chiropractor who had not provided a medical diagnosis. 

By letter dated June 14, 2016, OWCP advised appellant that her claim initially appeared 

to be a minor injury that resulted in minimal or no lost time from work and her claim was 

administratively handled to allow a limited amount of medical payments. However, appellant’s 

claim was now being reopened because she had not returned to work. OWCP informed her of 

the type of medical evidence needed to support her claim and advised that medical evidence 

must be from a qualified physician. It noted how a chiropractor can be considered a physician 

under FECA. 

In a June 3, 2016 duty status report (Form CA-17), Dr. Carraher noted May 27, 2016 as 

the date of injury, listed clinical findings, and diagnosed degenerative joint disease at L5 due to 

injury. He placed appellant off work for one week. On June 13, 2016 Dr. Carraher completed 

another Form CA-17 with the same date of injury. He listed a clinical finding of lower back 

pain. Dr. Carraher released appellant to return to full-time regular work with restrictions. 

In a June 10, 2016 disability certificate, Dr. Chawki A. Lahoud, a Board-certified 

internist, advised that appellant could return to work on June 17, 2016. In Forms CA-17 dated 

June 22 and July 1, 2016, he noted the date of injury as May 27, 2016, listed clinical findings, 

and diagnosed muscular contracture and degenerative joint disease due to injury. Dr. Lahoud 

related that appellant could not perform her regular work, but she could perform light work 

indoors with restrictions and not much work in the field. On July 1, 2016 he advised that she 

could perform such work two hours a day. 

In an order dated June 20, 2016, Dr. William D. Hage, a Board-certified orthopedic 

surgeon, diagnosed bursitis of the left shoulder and advised that appellant could return to work 

with restrictions. 

The employing establishment offered appellant a modified temporary position on 

July 1, 2016. Appellant declined the job offer as she did not want to give up her day off, which 

was Saturday. 

By decision dated July 21, 2016, OWCP accepted that the May 27, 2016 incident 

occurred as alleged. However, it denied appellant’s claim finding that fact of injury was not 

established as the medical evidence did not contain a medical diagnosis in connection with the 

accepted employment incident. 
3

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of his or her claim by the weight of the reliable, probative, and substantial 

evidence3 including that he or she sustained an injury in the performance of duty and that any 

specific condition or disability for work for which he or she claims compensation is causally 

related to that employment injury.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.5

 

There are two components involved in establishing the fact of injury. First, the employee must 

submit sufficient evidence to establish that he or she actually experienced the employment 

incident at the time, place, and in the manner alleged.6

 

The second component is whether the employment incident caused a personal injury and 

generally can be established only by medical evidence.7

 The evidence required to establish 

causal relationship is rationalized medical opinion evidence, based upon a complete factual and 

medical background, showing a causal relationship between the claimed condition and the 

identified factors.8 The belief of the claimant that a condition was caused or aggravated by the 

employment is insufficient to establish a causal relationship.9

ANALYSIS 

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

sustained a traumatic injury caused by the accepted May 27, 2016 employment incident. 

Appellant failed to submit sufficient medical evidence to establish that she had a back injury 

causally related to the accepted employment incident. 

Dr. Lahoud’s June 22 and July 1, 2016 CA-17 forms found that appellant had muscular 

contracture and degenerative joint disease due to the May 27, 2016 employment incident. 

However, he did not address how work duties on May 27, 2016 caused or aggravated the 

diagnosed conditions. As Dr. Lahoud provided no medical rationale to support causal 

 3 J.P., 59 ECAB 178 (2007); Joseph M. Whelan, 20 ECAB 55, 58 (1968). 

4 G.T., 59 ECAB 447 (2008); Elaine Pendleton, 40 ECAB 1143, 1145 (1989). 

5 S.P., 59 ECAB 184 (2007); Alvin V. Gadd, 57 ECAB 172 (2005). 

6 Bonnie A. Contreras, 57 ECAB 364 (2006); Edward C. Lawrence, 19 ECAB 442 (1968). 

7 John J. Carlone, 41 ECAB 354 (1989); see 5 U.S.C. § 8101(5) (injury defined); 20 C.F.R. §§ 10.5(ee), 10.5(q) 

(traumatic injury and occupational disease defined, respectively). 

8 Lourdes Harris, 45 ECAB 545 (1994); see Walter D. Morehead, 31 ECAB 188 (1979). 

9 Kathryn Haggerty, 45 ECAB 383, 389 (1994). 
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relationship, his reports are of limited probative value.10 His June 10, 2016 disability certificate 

is also of limited probative value as this evidence failed to provide a history of injury,11

examination findings, a firm diagnosis of a particular medical condition,12 or a specific opinion 

as to whether the accepted May 27, 2016 employment incident caused or aggravated appellant’s 

condition and resultant disability.13

Dr. Hage’s June 20, 2016 report diagnosed bursitis of the left shoulder and found that 

appellant could return to work with restrictions. He did not provide any medical opinion 

addressing whether the diagnosed condition and resultant disability were caused or aggravated 

by the accepted May 27, 2016 employment incident.14 Further, the Board notes that appellant 

did not allege that she sustained a left shoulder injury as a result of the accepted work incident. 

In a work excuse note dated June 2, 2016 and CA-17 forms dated June 3 and 13, 2016, 

Dr. Carraher, appellant’s attending chiropractor, addressed her lumbar conditions, the causal 

relationship between these conditions and the accepted employment incident, and her work 

capacity. Under FECA a chiropractor is considered a “physician” only to the extent that the 

reimbursable services are limited to treatment consisting of manual manipulation of the spine to 

correct a subluxation as demonstrated by x-ray to exist.15 Dr. Carraher did not document that he 

obtained x-rays to diagnose a spinal subluxation.16 Without a diagnosis of spinal subluxation 

from an x-ray, a chiropractor is not considered a physician under FECA and his opinion does not 

constitute medical evidence.17 Thus, Dr. Carraher’s reports are insufficient to establish a workrelated diagnosis from a qualified physician under FECA. 

The Board finds that appellant has failed to submit any rationalized probative medical 

evidence to establish that she sustained a back injury causally related to the May 27, 2016 

employment incident. Appellant, therefore, did not meet her burden of proof. 

 10 F.T., Docket No. 09-919 (issued December 7, 2009) (medical opinions not fortified by rationale are of 

diminished probative value); Sedi L. Graham, 57 ECAB 494 (2006) (medical form reports and narrative statements 

merely asserting causal relationship generally do not discharge a claimant’s burden of proof). 

11 Frank Luis Rembisz, 52 ECAB 147 (2000) (medical opinions based on an incomplete history have little 

probative value). 

12 See Deborah L. Beatty, 54 ECAB 340 (2003) (where the Board found that in the absence of a medical report 

providing a diagnosed condition and a reasoned opinion on causal relationship with the employment incident, 

appellant did not meet her burden of proof). 

13 See J.F., Docket No. 09-1061 (issued November 17, 2009) (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). 

14 Id. 

15 5 U.S.C. § 8101(2). 

16 OWCP’s implementing regulations define subluxation to mean an incomplete dislocation, off-centering, 

misalignment, fixation or abnormal spacing of the vertebrae which must be demonstrated on x-ray. See 20 C.F.R. 

§ 10.5(bb). 

17 See Jay K. Tomokiyo, 51 ECAB 361 (2000). 
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On appeal, appellant contends that she still has issues/problems that have kept her off 

work since May 2016. As found above, the Board finds that appellant did not submit any 

rationalized probative medical evidence supporting a causal relationship between her diagnosed 

back and left shoulder conditions, resultant disability, and the established employment incident. 

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 has failed to meet her burden of proof to establish a back 

injury causally related to the accepted May 27, 2016 employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the July 21, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: February 15, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board