United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

F.S., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

San Leandro, CA, Employer

__________________________________________

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Docket No. 18-0098

Issued: August 13, 2018

Appearances: Case Submitted on the Record

Sylvia R. Johnson, for the appellant1

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 October 16, 2017 appellant, through his representative, filed a timely appeal from a 

June 15, 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 over the merits of the claim.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 The record provided to the Board includes evidence received after OWCP issued its June 15, 2017 decision. The 

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

20 C.F.R. § 501.2(c)(1). Therefore, the Board is precluded from reviewing this additional evidence for the first time 

on appeal. Id.
2

ISSUE

The issue is whether appellant met his burden of proof to establish total disability for the 

period October 14 through December 16, 2015 causally related to his accepted employment injury. 

FACTUAL HISTORY

On September 19, 2015 appellant, then a 51-year-old city carrier assistant, filed a traumatic 

injury claim (Form CA-1) alleging that, on August 29, 2015, he collapsed at work while preparing 

to leave for his street mail route. He alleged that, when he fell, he hit his head on the desk and 

landed on his back. Appellant claimed injuries to his head, chest, heart, and left elbow. He was 

admitted to the hospital on August 29, 2015 for syncope and atrial fibrillation with rapid 

ventricular rate and was discharged on August 31, 2015. The employing establishment paid 

continuation of pay (COP) for the period August 30 to October 13, 2015. OWCP initially accepted 

appellant’s claim for syncope and collapse. 

On October 19, 2015 appellant was admitted to the hospital for a left-sided heart 

catheterization procedure. He was discharged on October 20, 2015.4

On November 3, 2015 appellant filed a claim for wage-loss compensation (Form CA-7) 

for disability during the period August 29 to November 16, 2015. 

In support of his claim, appellant submitted work status reports dated September 24, 

October 8, 9, and 14 and November 2, 2015 and an October 14, 2015 disability note from

Dr. Seema K. Pursnani, a Board-certified internist. Dr. Pursnani placed him on temporary total 

disability status from August 29, 2015 and continuing. In her October 8, 2015 note, she found 

appellant medically competent to return to full-duty capacity on October 30, 2015. On October 14, 

2015 Dr. Pursnani advised that, due to a recent hospitalization and continued medical care, 

appellant had been unable to work since August 29, 2015. She recommended that he remain off 

work until November 2, 2015. In a November 2, 2015 note, Dr. Pursnani placed appellant off 

work from November 2 through 16, 2015.

By development letter dated November 20, 2015, OWCP advised appellant that he was not 

entitled to wage-loss compensation for the period August 30 through October 13, 2015 as he had 

received COP from the employing establishment for that same period. For the period October 14 

through November 16, 2015 and continuing, appellant was advised that the medical reports of 

record were insufficient to establish his disability claim. OWCP requested that he submit 

additional evidence to establish that he was disabled from work during the claimed period as a 

result of his accepted employment injury. It afforded appellant 30 days to submit the additional 

information. 

In a November 6, 2015 report, Dr. Pursnani placed appellant off work from November 2 

through 16, 2015. She clarified that appellant was previously off work from September 2 through 

November 2, 2015.

 

4 Dr. Joseph Aloysius Walsh, a Board-certified internist, performed the catheterization procedure. 
3

In a November 16, 2015 note, Dr. Elmer Chang, a Board-certified internist, placed 

appellant off work from November 16 through 30, 2015. In a December 4, 2015 report, he

returned appellant to modified work activity from December 4 through 11, 2015. 

Appellant returned to work on or about December 17, 2015 before again stopping work.5 

In a December 17, 2015 report, Dr. Jaishree S. Acharya, a Board-certified internist, 

described appellant’s symptoms of neck pain and numbness radiating down the left upper 

extremity after the August 29, 2015 fainting episode and fall at work. Dr. Acharya noted that 

appellant had been seeing his personal physician for workup regarding his syncopal episode and 

had returned to modified duty. The cardiac workup revealed coronary artery disease and appellant 

underwent stent placement. Appellant had been off work since August 29, 2015 to take care of 

his heart condition. Physical findings were normal except for appellant’s report of tenderness on 

examination. Dr. Acharya indicated that the cervical spine x-ray had no evidence of fracture or

malalignment, but multilevel cervical spondylosis. The head computerized tomography (CT) scan 

showed no acute intracranial abnormality. The magnetic resonance imaging (MRI) scan of the 

cervical spine showed mild-to-moderate multilevel degenerative changes. Dr. Acharya diagnosed 

cervical radiculopathy, cervical sprain, and head contusion, which she opined were consistent with 

the fall and the head contusion during the fall. Appellant was referred to physical therapy. 

In a work status report of December 16, 2015, January 5 and 22, 2016, Dr. Acharya placed 

appellant on modified duty. In January 5 and 28, and February 1, 2016 reports, she noted that 

appellant was working without restrictions. In a February 11, 2016 report, Dr. Acharya noted that 

appellant was working with restrictions.

On January 7, 2016 appellant filed a Form CA-7 claim for wage-loss compensation for 

disability from October 14 to December 17, 2015.

In a March 4, 2016 report, Dr. Acharya diagnosed neck sprain, cervical radiculopathy, and 

a head contusion. She indicated that appellant could continue to perform modified work and that 

there was no indication for him to be off work due to his work injury. Dr. Acharya noted that 

appellant chose to stay home and was taking online classes. She also noted that appellant’s second 

set of physical therapy was helping and that the numbness, which traveled down into the left upper 

extremity, had almost completely resolved. Based on the history and mechanism of injury,

Dr. Acharya opined that appellant’s syncopal episode from atrial fibrillation and coronary artery 

disease was not caused or aggravated by factors of employment. She further opined that 

appellant’s cervical strain with radiculopathy was consistent with the fall and the head contusion. 

In her April 1, 2016 report, Dr. Acharya indicated that appellant was off on Family Medical Leave 

Act (FMLA) and considering transferring care to Dr. Richard A. Nolan, a Board-certified 

orthopedic surgeon, Dr. Nolan. 

In a March 4, 2016 report, Dr. Nolan noted the history of appellant’s employment injury. 

He provided an impression of left cerebral concussion, musculoligamentous strain of the 

cervicothoracic spine, left cervicobrachial syndrome, and bilateral cervical radiculitis. Dr. Nolan 

 

5 On January 31, 2017 OWCP began paying appellant disability compensation on the supplemental rolls retroactive 

to March 4, 2016. It began paying appellant wage-loss compensation on the periodic rolls beginning May 2, 2017 for 

the period beginning April 25, 2017. 
4

indicated that appellant sustained significant injury to his cranium and cervical spine due to the 

employment incident. He explained that appellant’s persistent cervical symptoms were a result of 

the direct and sudden blow to his cranium which forced his neck into unexpected positioning. 

Dr. Nolan opined that appellant was totally disabled from work as a result of the work injury. He 

recommended electromyography (EMG) and MRI scan tests. Dr. Nolan also referred appellant to 

physical therapy. 

OWCP also received progress notes pertaining to appellant’s cardiac condition dated 

August 3 and October 20, 2015, along with a copy of the November 17, 2015 MRI scan of cervical 

spine, which had indicated mild-to-moderate multilevel degenerative changes, most prominently 

affecting C5-6 and C6-7. 

By decision dated April 6, 2016, OWCP denied appellant’s claim for wage-loss

compensation for the period commencing August 29, 2015. It found that the medical evidence of 

record failed to establish that he was disabled from work during the period claimed due to his 

work-related medical condition. OWCP noted that the medical evidence which opined that 

appellant should be on temporary total disability status failed to provide objective findings and 

medical rationale to substantiate his disability status.

In a separate April 6, 2016 decision, OWCP expanded the acceptance of appellant’s claim 

to include: contusion of unspecified part of head; strain of muscle, fascia, and tendon at neck level; 

and aggravation cervical spinal stenosis.6

On May 4, 2016 appellant’s representative requested an oral hearing before an OWCP 

hearing representative. 

OWCP received copies of appellant’s August 29, 2015 chest and cervical spine x-rays, an 

August 30, 2015 echocardiogram, and an August 31, 2015 computerized tomography (CT) scan 

of the head. Also received was Dr. Acharya’s December 16, 2015 report in which she opined that 

appellant was able to perform modified duty. Dr. Acharya noted that appellant’s syncopal episode 

was diagnosed as paroxysmal atrial fibrillation, which she opined was nonindustrial in nature. She

opined that the cervical strain, head contusion, and radiculopathy were consistent with the fall.

By decision dated August 1, 2016, OWCP expanded the acceptance of appellant’s claim to 

include an aggravation of cervical disc degeneration and aggravation of cervical spinal stenosis. 

A hearing was held on March 31, 2017. Appellant testified that he was off work from 

August 29, 2015 and had three stents placed in his arteries on October 19, 2015. He returned to 

work on December 17, 2015.

By decision dated June 15, 2017, an OWCP hearing representative affirmed the prior 

decision. She found that the medical evidence of record was insufficient to establish total disability 

during the claimed period causally related to the accepted conditions. 

 

6 On March 4 and May 10, 2016 appellant requested that his treating physician be changed to Dr. Nolan due to his 

difficulty obtaining treatment at Kaiser Permanente. In an April 11, 2016 letter, OWCP denied appellant’s request to 

change physicians for his work-related injury. 
5

LEGAL PRECEDENT

Under FECA,7the term disability is defined as incapacity, because of employment injury, 

to earn the wages that the employee was receiving at the time of injury.8 Whether a particular 

injury causes an employee to be disabled from work and the duration of that disability are medical 

issues which must be proved by a preponderance of the reliable, probative, and substantial medical 

evidence.9 Findings on examination are generally needed to support a physician’s opinion that an 

employee is disabled from work. When a physician’s statements consist only of a repetition of the 

employee’s complaints that excessive pain caused an inability to work, without making an 

objective finding of disability, the physician has not presented a medical opinion on the issue of 

disability or a basis for payment of compensation.10 The Board will not require OWCP to pay 

compensation for disability without any medical evidence directly addressing the specific dates of 

disability for which compensation is claimed. To do so would essentially allow employees to selfcertify their disability and entitlement to compensation.11

Where an employee claims that a condition not accepted or approved by OWCP was due 

to an employment injury, he or she bears the burden of proof to establish that the condition is 

causally related to the employment injury.12 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.13 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 the claimant.14 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 

causal relationship.15

 

7 Supra note 2.

8 See Prince E. Wallace, 52 ECAB 357 (2001).

9 See Fereidoon Kharabi, 52 ECAB 291, 293 (2001); Edward H. Horton, 41 ECAB 301, 303 (1989).

10 G.T., 59 ECAB 447 (2008); see Huie Lee Goal, 1 ECAB 180, 182 (1948).

11 Id.

12 Jaja K. Asaramo, 55 ECAB 200 (2004). 

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

14 James Mack, 43 ECAB 321 (1991).

15 V.W., 58 ECAB 428 (2007); Ernest St. Pierre, 51 ECAB 623 (2000).
6

ANALYSIS

The Board finds that appellant has not submitted sufficient medical opinion evidence to 

establish total disability for the period October 14, 2015 through December 16, 2015 causally 

related to his accepted employment conditions.

OWCP initially accepted that appellant’s fall on August 29, 2015 resulted in syncope and 

collapse. Appellant received COP for the period August 30 through October 13, 2015. OWCP 

later expanded acceptance of the claim to include the additional conditions of contusion of 

unspecified part of head, strain of muscle, fascia, and tendon at neck level, aggravation cervical 

spinal stenosis, and aggravation other cervical disc degeneration, unspecified. 

Appellant filed CA-7 forms claiming wage-loss compensation due to total disability up 

until December 17, 2015. He returned to work on December 17, 2015 and then stopped work. 

OWCP retroactively paid appellant wage-loss compensation for total disability beginning 

March 4, 2016. Appellant continues to receive wage-loss compensation on the periodic rolls. 

Thus, the issue is whether he has established total disability for the period from October 14, 2015

through December 16, 2015.

The evidence reflects that, following the August 29, 2015 work incident, appellant 

underwent a cardiac workup of his syncopal episode. The workup revealed coronary artery disease 

and appellant underwent stent placement to treat his cardiac condition on October 19 and 20, 2015. 

Dr. Pursnani placed appellant on temporary total disability status from August 29 until 

November 16, 2015. However, he provided no explanation in his disability slips or notes 

pertaining to how appellant’s cardiac condition was causally related to the August 29, 2015 

employment incident and/or why appellant was totally disabled until November 16, 2015. Medical 

evidence that provides a conclusion, but does not offer any rationalized medical explanation 

regarding the cause of an employee’s condition is of limited probative value on the issue of causal 

relationship.16 It is the employee’s burden of proof to provide rationalized medical evidence 

sufficient to establish causal relationship for conditions not accepted by OWCP as being 

employment related, not OWCP’s burden to disprove such relationship.17 Because Dr. Pursnani 

failed to provide any medical rationale for his conclusion regarding total disability, his opinion is 

of diminished probative value.18 

Dr. Chang, in his note of November 16, 2015, placed appellant off work from November 16 

through 30, 2015. In his December 4, 2015 report, he opined that appellant could perform 

modified work activity from December 4 through 11, 2015. However, Dr. Chang’s opinion is of 

diminished probative value as he did not offer any rationalized medical explanation regarding the 

cause of appellant’s condition or provide any rationale for his conclusion relative to disability.19

 

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

17 See O.G., Docket No. 17-1501 (issued January 5, 2018). 

18 S.B., Docket No. 13-1162 (issued December 12, 2013).

19 Id.
7

In her December 17, 2015 report, Dr. Acharya noted that appellant had been off work since 

August 29, 2015 to take care of his heart condition. She indicated that appellant had been seeing 

his personal physician and that his cardiac workup revealed coronary artery disease for which he 

had stent placement. In work status reports dated December 16, 2015 and January 5 and 22, 2016,

and also in subsequent reports, Dr. Acharya placed appellant on modified duty. Based on the 

history and mechanism of injury, she opined that appellant’s syncopal episode from atrial 

fibrillation and coronary artery disease, which was later diagnosed as paroxysmal atrial fibrillation,

was not caused or aggravated by factors of employment. Dr. Acharya further opined that cervical 

radiculopathy, cervical sprain, and head contusion were consistent with the fall and the head 

contusion during the fall. She indicated that appellant was capable of performing modified work

and noted, in her March 4, 2016 report, that appellant chose to stay home and take online classes. 

As Dr. Acharya indicated that appellant could continue modified work, her reports failed to 

establish total disability from work during the claimed period.

20

Dr. Nolan submitted several reports in which he found that appellant was temporarily 

totally disabled as a result of his work-related conditions. His first report of record was 

March 4, 2016. As noted, OWCP paid appellant retroactive total disability compensation 

beginning March 4, 2016. Thus, Dr. Nolan’s reports do not establish disability during the

remaining claimed period of disability.

OWCP also received a number of diagnostic reports. However, medical evidence of 

diagnostic testing is of limited probative value as it fails to provide a physician’s reasoned opinion 

on causal relationship between appellant’s work incident and the diagnosed conditions.21

For each period of disability claimed, the employee has the burden of proof to establish 

disability from work as a result of the accepted employment injury.22 Because appellant has not 

submitted any reasoned medical opinion evidence sufficient to establish that he suffered from 

employment-related residuals or disability for the claimed period as a result of his accepted 

employment-related conditions, the Board finds that appellant has not met his burden of proof to 

establish his claim for disability compensation.23

Appellant may submit additional evidence, together with a written request for 

reconsideration, to OWCP within one year of the Board’s merit decision, pursuant to 5 U.S.C. 

§ 8128(a) and 20 C.F.R. §§ 10.605 through 10.607.

 

20 See M.C., Docket No. 16-1238 (issued January 26, 2017).

21 See M.S., Docket No. 17-1044 (issued February 2, 2018).

22 See supra note 12. 

23 The Board will not require OWCP to pay compensation for disability in the absence of any medical evidence 

directly addressing the specific dates of disability for which compensation is claimed. To do so would essentially 

allow employees to self-certify their disability and entitlement to compensation. L.L., Docket No. 13-2146 (issued 

March 12, 2014). See also William A. Archer, 55 ECAB 674, 679 (2004).
8

CONCLUSION

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

for the period October 14 through December 16, 2015 causally related to his accepted employment 

injury. 

ORDER

IT IS HEREBY ORDERED THAT the June 15, 2017 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: August 13, 2018

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