United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

X.V., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Jayuya, PR, Employer

__________________________________________

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Docket No. 18-1360

Issued: April 12, 2019

Appearances: Case Submitted on the Record

Bruce H. Didriksen, for the appellant1

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 2, 2018 appellant, through her representative, filed a timely appeal from a May 7, 

2018 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 this case.

 

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

ISSUE

The issue is whether appellant has met her burden of proof to establish a back condition 

causally related to the accepted May 10, 2017 employment incident. 

FACTUAL HISTORY

On May 17, 2017 appellant, then a 28-year-old city carrier, filed a traumatic injury claim 

(Form CA-1) alleging that on May 10, 2017 she experienced low back pain that radiated down her

left leg while in the performance of duty. In an accompanying narrative statement, she explained 

that she drove to her route on May 10, 2017 and, when parking her vehicle, she tried to pull the

emergency brake (hand brake), but it was “too hard.” Appellant contended that the pulling caused 

a back injury. After this incident she walked her route to deliver mail, but limped as she did so. 

Appellant added that, when she returned to the employing establishment, she verbally notified

R.O., the officer-in-charge, of the alleged incident. She indicated that the window clerk, R.B., 

noticed that she was limping. Appellant stopped work on May 11, 2017. She further explained 

that on May 11, 2017 she conducted a vehicle check and prepared a vehicle repair tag. Appellant

indicated that she handed it to R.O., and he instructed her to deliver her route. She noted that on

May 12, 2017 she could not stand and therefore had to request sick leave. 

OWCP also received witness statements in support of appellant’s claim. In a May 17, 2017 

statement, G.S., a customer, related that she heard appellant scream and witnessed her limping on 

the afternoon of May 10, 2017. In an undated statement, R.B., a coworker, indicated that he 

witnessed appellant limping and walking uncomfortably on the afternoon of May 10, 2017 and the 

morning of May 11, 2017. 

OWCP received work excuse notes dated May 12 and 30, 2017, from Dr. Nilda CarrerasCoello, a family medicine specialist. In the May 12, 2017 note, Dr. Carreras-Coello diagnosed 

lumbago, sprain of the left spine, and deep neuropathy. She placed appellant off work until 

May 23, 2017. In the May 30, 2017 excuse, Dr. Carreras-Coello diagnosed lumbago, left 

radiculopathy, and neuropathy.3 She placed appellant off work until June 16, 2017.

In a June 13, 2017 duty status report (Form CA-17), Dr. Evelyn Rivera-Ocasio, a 

physiatrist, noted that appellant was “pulling the emergency hand brake” and hurt her lower back 

and left side. She indicated that appellant had low back pain radiating to the left lower leg. 

Dr. Rivera-Ocasio diagnosed low back pain and radiculopathy and placed appellant off work. 

By letter dated June 14, 2017, the employing establishment controverted the claim. 

In a July 10, 2017 development letter, OWCP advised appellant that, when her claim was 

received, it appeared to be a minor injury that resulted in minimal or no lost time from work. The 

claim was administratively approved to allow payment for limited medical expenses, but the merits 

of the claim had not been formally adjudicated. OWCP advised that because appellant had not 

returned to full-time work, her claim would be formally adjudicated. It requested that she submit 

factual and medical information, including a comprehensive report from her physician regarding 

 

3 The notes were translated from Spanish and were partially illegible to the translator. 
3

how a specific work incident contributed to her claimed injury. OWCP afforded appellant 30 days 

to submit the necessary evidence.

OWCP subsequently received diagnostic reports which included a May 16, 2017 lumbar 

spine magnetic resonance imaging (MRI) scan read by Dr. Gilberto A. Franceschini, a diagnostic 

radiologist, which revealed multilevel degenerative disc disease, worse at L5-S1, Schmorl’s nodes 

thoracolumbar spine, and levoscoliosis of the lumbar spine. A June 1, 2017 electromyography

(EMG) scan, read by Dr. Rivera-Ocasio, revealed left L5 radiculopathy. A June 22, 2017 lumbar 

MRI scan of the sacroiliac joint, read by Dr. Remy Rodriguez, a Board-certified diagnostic 

radiologist, revealed a significant disc herniation at L5-S1, a significant Schmorl’s node at L3-4,

and possible pseudo arthrosis. 

In an August 2, 2017 duty status report (Form CA-17), Dr. Rivera-Ocasio repeated her 

description of the employment incident, her findings, and diagnoses of low back pain and 

radiculopathy. She concluded that appellant could not return to work. 

In an August 11, 2017 report, Dr. Rivera-Ocasio noted that appellant was first evaluated 

on December 9, 2016 when she complained of “whole back pain,” which began a year and a half 

prior to the alleged May 10, 2017 employment incident. She indicated that appellant was 

diagnosed with myofascial back pain, secondary to mechanical imbalance. Dr. Rivera-Ocasio 

noted that scoliosis was confirmed by x-rays of the spine, taken on December 19, 2016, and that 

appellant enrolled in a rehabilitation program and experienced significant pain relief. She 

indicated that appellant was seen on March 8, 2017 with complaints of sudden onset of lower back 

pain, worse on the left. Dr. Rivera-Ocasio confirmed that a March 7, 2017 MRI scan revealed an 

L5-S1 herniated nucleus pulposus, degenerative disc, and end plates (Schmorl nodes). She next

saw appellant on May 15, 2017, after the May 10, 2017 employment incident, and ordered 

additional testing. Dr. Rivera-Ocasio determined that appellant’s bone scan revealed an “abnormal 

capitation on several bones, predominantly the spine.” She also noted that the diagnostic testing 

from the upper extremities from July 14, 2017, revealed right C6 radiculopathy, and a cervical 

spine MRI scan from July 17, 2017 revealed a small central disc herniation at C4-5.

Dr. Rivera-Ocasio explained that appellant’s condition of lower back pain secondary to the 

herniated disc and radiculopathy, had not improved. She indicated that appellant walked with a 

cane and had constant low back pain. Dr. Rivera-Ocasio opined that appellant presented with an

“acute exacerbation of her low back pain caused by the employment incident.” 

In an August 18, 2017 report, Dr. Carreras-Coello confirmed that appellant had been her 

patient for the past 14 years. She diagnosed chronic lumbago of the lumbosacral spine, severe low 

back pain, left spine deviation, peripheral neuropathy, severe low back pain, and pain in the left 

tibia. Dr. Carreras-Coello explained that appellant was able to perform her work in a slow manner. 

She noted that she saw appellant on May 12, 2017 for complaints of severe low back pain radiating 

towards the left inferior extremity and a burning sensation on the third toe of the left foot. 

Dr. Carreras-Coello noted that appellant related that, on “May 10, 2017 while [appellant] was 

driving [her work vehicle], she pulled the emergency [brake] and felt a strong low back pain that 

prevented her from walking.” 
4

Dr. Carreras-Coello further explained that she had been treating appellant for many years 

and she was aware of appellant’s health conditions, prior to the incident. She opined that “this 

incident could have been the triggering link that accelerated her condition now.” Dr. CarrerasCoello advised that appellant was suffering from severe lumbago with permanent left peripheral 

neuropathy. She indicated that appellant was dependent on a walking stick and not able to perform 

her daily activities as she had before the employment injury. Dr. Carreras-Coello recommended 

continued rest from work, until her physiatrist concluded her treatment. 

By decision dated November 3, 2017, OWCP denied appellant’s claim. It found that the 

medical evidence of record was insufficient to establish a diagnosed medical condition causally 

related to the accepted May 10, 2017 work incident. OWCP explained that there was evidence of 

a preexisting back condition. It indicated that the treating physician must differentiate the effects 

of the work-related injury and the preexisting back conditions.

On February 6, 2018 appellant requested reconsideration and submitted additional medical 

evidence. 

A December 1, 2017 computerized tomography scan of the lumbar spine, read by Dr. Pedro 

Farinacci, a diagnostic radiologist, revealed minimal lumbar dextroscoliosis, Schmorl’s nodes, 

mild disc bulging at L4-5, L5-S1, and bilateral neural foraminal stenosis. 

In a February 6, 2018 report, Dr. Carreras-Coello noted that she saw appellant on May 12, 

2017 for an incident at work on May 10, 2017. She opined, “it is my medical opinion that, within 

a reasonable degree of certainty, the diagnosed condition of chronic lumbago was permanently 

aggravated by the incident on May 10, 2017 when [appellant] struggled to engage the hand brake 

in her postal vehicle while delivering mail.” Dr. Carreras-Coello further opined that the diagnosed 

conditions were “directly caused by the incident on May 10, 2017 when [appellant] struggled to 

engage the hand brake in her postal vehicle while delivering mail.”

Dr. Carreras-Coello explained the mechanism of injury and noted that in order to engage 

the brake, appellant had to pull the handle in a downward motion. She further noted that the brake 

handle was “very difficult to move into the set position,” required that appellant “twist her body 

to the left and downward in order to gain sufficient leverage to complete the task.” Dr. CarrerasCoello explained that this action “required the use of muscles in the lumbar spine, and put 

abnormal stress on the spinal column because [appellant’s] lower body was stationary in the 

driver’s seat, while her upper body was contorting beyond a normal range of motion.”

Dr. Carreras-Coello also explained that appellant strained her lumbar spine, by “an 

extension of muscles beyond normal elasticity and a deviation from the normal alignment of the 

spinal column.” She noted that the spinal column had a network of nerves that “run through it.”

Dr. Carreras-Coello advised that, “[w]henever excessive stress to the spine results in a shift of the 

vertebrae out of alignment, there is always a chance of bone rubbing against bone and/or pinching 

the nerves in the spinal column, causing extreme pain and residual weakness due to damaging of 

the nerve(s).” She opined that this was “precisely what transpired in [appellant’s] case, and what 

led to my diagnoses of peripheral neuropathy and radiculopathy.” Dr. Carreras-Coello explained 

that her opinion was based on her physical examination of appellant, diagnostic test results, and 

her years of experience with similar injuries. 
5

By decision dated May 7, 2018, OWCP denied modification of the November 3, 2017 

decision. It found that the medical evidence of record was insufficient to establish causal 

relationship between appellant’s diagnosed conditions and the accepted May 10, 2017 

employment incident. OWCP found that it remained unclear how pulling an emergency brake 

resulted in the 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,4that 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.5 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.6

To determine if an employee sustained a traumatic 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 that must be considered in conjunction with one another. The 

first component is whether the employee actually experienced the employment incident that 

allegedly occurred.7 The second component is whether the employment incident caused a personal 

injury.8 

Causal relationship is a medical issue and the medical evidence required to establish causal

relationship is rationalized medical evidence.9 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 employee.10 

Neither the mere fact that a disease or condition manifests itself during a period of employment, 

 

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

153 (1989).

5

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

ECAB 312 (1988).

6 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).

7 R.E., Docket No. 17-0547 (issued November 13, 2018); David Apgar, 57 ECAB 137 (2005); Delphyne L. Glover,

51 ECAB 146 (1999).

8

Id.; see also John J. Carlone, 41 ECAB 354 (1989). 

9 G.N., Docket No. 18-0403 (issued September 13, 2018); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000). 

10 K.V., Docket No. 18-0723 (issued November 9, 2018); Leslie C. Moore, 52 ECAB 132 (2000); Gary L. Fowler,

45 ECAB 365 (1994).
6

nor the belief that the disease or condition was caused or aggravated by employment factors or 

incidents is sufficient to establish causal relationship.11

ANALYSIS

The Board finds that this case is not in posture for decision.

In support of her claim, appellant submitted medical evidence and work excuses dating 

from May 12, 2017 and onward from Dr. Carreras-Coello. In her August 18, 2017 report,

Dr. Carreras-Coello explained that she had treated appellant for her back conditions over the last 

14 years and appellant was able to work in a “slow manner.” She opined that “this incident could 

have been the triggering link that accelerated [appellant’s] condition now” and diagnosed severe 

lumbago with permanent left peripheral neuropathy. This report by itself is of limited probative 

value, as it was couched in speculative terms.

12

On reconsideration, Dr. Carreras-Coello provided additional details pertaining to causal 

relationship in her February 6, 2018 report. She explained the mechanism of injury related to how 

the accepted incident of pulling of the hand brake resulted in the work-related diagnoses. 

Dr. Carreras-Coello explained that, when appellant moved to lift the brake handle, she had to

“twist her body to the left and downward in order to gain sufficient leverage to complete the task.” 

She explained that this action “required the use of muscles in the lumbar spine and put abnormal 

stress on the spinal column because [appellant’s] lower body was stationary in the driver’s seat, 

while her upper body was contorting beyond a normal range of motion.” Furthermore,

Dr. Carreras-Coello explained that the spinal column had a network of nerves that “run through 

it.” She advised that “[w]henever excessive stress to the spine results in a shift of the vertebrae 

out of alignment, there is always a chance of bone rubbing against bone and/or pinching the nerves 

in the spinal column, causing extreme pain and residual weakness due to damaging of the 

nerve(s).” Dr. Carreras-Coello opined that this was “precisely what transpired in [appellant’s] 

case, and what led to my diagnoses of peripheral neuropathy and radiculopathy.” 

The Board finds that, while Dr. Carreras-Coello’s reports are not completely rationalized, 

they are consistent in indicating that appellant sustained a back injury causally related to the 

insufficient to meet appellant’s burden of proof to establish her claim, they raise an uncontroverted 

inference between her diagnosed condition and the work-related incident and are sufficient to 

require OWCP to further develop the medical evidence and the case record.13 

 

11 J.P., Docket No. 18-1165 (issued January 15, 2019); Alvin V. Gadd, 57 ECAB 172 (2005).

12 The Board has held that speculative and equivocal medical opinions regarding causal relationship have no 

probative value. R.C., Docket No. 18-1695 (issued March 12, 2019); see Ricky S. Storms, 52 ECAB 349 (2001) (while 

the opinion of a physician supporting causal relationship need not be one of absolute medical certainty, the opinion 

must not be speculative or equivocal. The opinion should be expressed in terms of a reasonable degree of medical 

certainty). 

13 D.W., Docket No. 17-1884 (issued November 8, 2018); see Robert A. Redmond, 40 ECAB 796, 801 (1989).
7

It is well established that proceedings under FECA are not adversarial in nature and while 

the claimant has the burden of proof to establish entitlement to compensation, OWCP shares 

responsibility in the development of the evidence to see that justice is done.14 

The Board will therefore remand the case for further development of the medical evidence. 

On remand, OWCP should prepare a statement of accepted facts and obtain a rationalized opinion 

from an appropriate Board-certified physician as to whether appellant’s back conditions are 

causally related to the May 10, 2017 employment incident, either directly or through aggravation, 

precipitation, or acceleration.15 Following this and any other further development deemed 

necessary, OWCP shall issue a de novo decision on appellant’s traumatic injury claim.

CONCLUSION

The Board finds that this case is not in posture for decision.

ORDER

IT IS HEREBY ORDERED THAT the May 7, 2018 decision of the Office of Workers’

Compensation Programs is set aside and the case remanded for further development consistent 

with this decision.

Issued: April 12, 2019

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

 

14 S.W., Docket No. 18-0119 (October 5, 2018); William J. Cantrell, 34 ECAB 1233 (1993).

15 P.A., Docket No. 09-0319 (issued November 23, 2009).