United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

R.H., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Richmond, VA, Employer 

__________________________________________ 

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Docket No. 16-1802 

Issued: February 1, 2017 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On September 9, 2016 appellant, through counsel, filed a timely appeal from a July 13, 

2016 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. 

ISSUE 

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

right shoulder, right arm, and cervical injuries causally related to a November 8, 2013 

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 November 12, 2013 appellant, then a 53-year-old city carrier, filed a traumatic injury 

claim (Form CA-1), alleging that, on November 8, 2013, while lifting a bucket of mail, he felt a 

pull in his shoulder and weakness in his right arm. He did not stop work. 

Appellant was treated by Dr. Joseph J. Andriano, a Board-certified internist with a 

specialty in occupational medicine, on November 12, 2013, for insidious onset of cervical pain. 

Dr. Andriano reported no injury or trauma which may have caused his symptoms. Appellant 

noted that, on November 8, 2013, while at work, he picked up a bucket full of mail and felt a 

sudden onset of pain in the right cervical paraspinals and right arm. He continued working his 

shift but noticed weakness in his right arm and shoulder. Dr. Andriano noted findings on 

examination of weakness of the lateral deltoid and weakness in his biceps. He diagnosed 

multilevel degenerative disc disease with herniated nucleus pulposus at C3-4, C4-5, C5-6, and 

C5-7 without lesion, and cord edema from C3-5. Dr. Andriano recommended a consultation 

with a neurosurgeon and returned appellant to modified duty. In an attending physician’s report 

(Form CA-20) dated November 12, 2013, he diagnosed multilevel degenerative disc disease, 

herniated nucleus pulposus and weakness. Dr. Andriano checked a box marked “yes,” indicating 

that appellant’s condition was caused or aggravated by an employment activity and returned 

appellant to work with restrictions. In a November 12, 2013 duty status report (Form CA-17), he 

diagnosed profound weakness at C5 and multiple level degenerative disc disease of the cervical 

spine. Dr. Andriano noted appellant’s work restrictions. 

A November 12, 2013 cervical spine magnetic resonance imaging (MRI) scan revealed 

disc herniation at C3-4 with abutment of the cord, disc herniation’s at C4-5 with cord 

compression and edema, discus protrusion at C5-6, and disc herniation at C6-7 abutting the 

ventral cord. 

By letter dated November 22, 2013, OWCP advised appellant of the type of evidence 

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

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

afforded her 30 days to provide this information. 

Appellant was treated by Dr. Mathew T. Mayr, a Board-certified neurosurgeon, on 

November 27, 2013, for right arm weakness. He reported working as a mail carrier and on 

November 8, 2013 he picked up a large bucket of mail and felt pain in his neck and a pop in his 

arm. Appellant indicated that his right arm became weak and he had difficulty lifting it. 

Dr. Mayr noted findings of muscle weakness of the right deltoid and biceps with no right deltoid 

reflex. X-rays revealed significant degenerative disc disease at C3-4 and C4-5 with large 

osteophytes. Dr. Mayr diagnosed cervical stenosis of the spine, C5 radiculopathy and C3-4 and 

C4-5 herniated discs. He recommended anterior cervical discectomy and fusion at C3-4 and 

C4-5. On December 9, 2013 Dr. Mayr noted appellant’s symptoms were worsening with 

progressive weakness. He recommended surgery. On December 11, 2013 Dr. Mayr performed 

an anterior cervical discectomy at C3-4, C4-5 and fusion at C3-4 and C4-5. 

In a November 29, 2013 statement, appellant indicated that, since his November 8, 2013 

injury, he experienced weakness in his shoulder and arm. He noted that he did not have any 

other disability or symptoms prior to this injury. 
3

In a December 24, 2013 decision, OWCP denied appellant’s claim, finding that he failed 

to establish an injury or medical condition causally related to the accepted November 8, 2013 

work incident. 

On January 16, 2014 appellant requested an oral hearing, before an OWCP hearing 

representative which was held on July 16, 2014. 

In a decision dated September 30, 2014, OWCP’s hearing representative affirmed the 

decision dated December 24, 2013. 

On February 12, 2015 appellant requested reconsideration. He submitted a report dated 

January 12, 2015 in which Dr. Mayr indicated that on November 8, 2013 appellant was lifting a 

bucket when he suffered severe pain followed by weakness in his right arm. Dr. Mayr noted that 

appellant was diagnosed with cervical radiculopathy and had an MRI scan which revealed disc 

herniations at C3-4 and C4-5. He opined to a reasonable degree of medical certainty that the 

lifting of the bucket was the causal factor to appellant’s injury. Dr. Mayr noted that, although 

appellant had underlying degeneration, he thought the stress on his arm and neck from lifting 

caused pressure on the disc space causing the herniation, subsequent severe nerve injury, pain, 

and weakness. 

In a decision dated May 7, 2015, OWCP denied modification of the September 30, 2014 

decision. 

On April 18, 2016 appellant again requested reconsideration. He submitted an April 7, 

2016 report from Dr. Mayr who noted that, although appellant had underlying degeneration, the 

stress on his arm and neck from lifting caused pressure on the disc space, which caused the disc 

herniation and subsequent severe nerve pain and severe nerve injury resulting in pain and 

weakness. Dr. Mayr opined that to a reasonable degree of medical certainty the lifting of the 

bucket was the proximate cause of appellant’s injury. 

Also submitted was a December 15, 2014 electromyogram (EMG) that showed 

significant right C5 motor radiculopathy. A December 12, 2014 report from a physician assistant 

was also submitted. 

In a decision dated July 13, 2016, OWCP denied modification of the decision dated 

May 7, 2015. 

LEGAL PRECEDENT 

 An employee seeking benefits under FECA has the burden of establishing 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 
4

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.3

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 

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

ANALYSIS 

It is not disputed that on November 8, 2013 appellant was injured when lifting a bucket 

of mail at his case. However, the Board finds that appellant has not submitted sufficient medical 

evidence to establish that this work incident caused or aggravated his diagnosed conditions. 

Appellant submitted reports from Dr. Mayr dated January 12, 2015 and April 7, 2016 

who indicated that on November 8, 2013 appellant was lifting a bucket when he suffered severe 

pain followed by weakness in his right arm. Dr. Mayr diagnosed cervical radiculopathy and disc 

herniations at C3-4 and C4-5. He opined that the lifting of the bucket was the causal factor to 

appellant’s injury. Dr. Mayr noted that, although appellant had underlying degeneration, he 

thought the stress on his arm and neck from lifting caused pressure on the disc space which 

caused the herniation and subsequent severe nerve injury with resulting pain and weakness. The 

Board finds that, although Dr. Mayr supported causal relationship, he did not provide medical 

rationale explaining the basis of his opinion.6 For example, Dr. Mayr did not explain the process 

by which lifting a bucket of mail would cause the diagnosed condition and why such condition 

would not be due to any nonwork factors such as age-related degenerative changes.7

 Therefore, 

this report is insufficient to meet appellant’s burden of proof. 

Other reports from Dr. Mayr dated November 27 and December 9, 2013 noted that 

appellant worked as a mail carrier and on November 8, 2013 he picked up a large bucket of mail 

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

4

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

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

6 See T.M., Docket No. 08-975 (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). 

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). 
5

and felt pain in his neck and weakness in his right arm. He diagnosed cervical stenosis of the 

spine, C5 radiculopathy and C3-4 and C4-5 herniated discs. The Board finds that these records 

are insufficient to establish the claim as Dr. Mayr did not clearly explain how the work incident 

of picking up a bucket of mail caused or aggravated any diagnosed medical condition.8

 

Appellant submitted a November 12, 2013 report from Dr. Andriano who noted that 

appellant reported picking up a bucket of mail at work on November 8, 2013 and felt a sudden 

onset of pain in the right cervical paraspinals and right arm. Dr. Andriano diagnosed multilevel 

degenerative disc disease with herniated cervical discs. This report is insufficient to meet 

appellant’s burden of proof as Dr. Andriano did not provide his own opinion regarding whether 

appellant’s condition was work related. Rather, he was merely repeating the history as related by 

appellant. Dr. Andriano also failed to provide a rationalized opinion regarding the causal 

relationship between appellant’s cervical condition the factors of employment believed to have 

caused or contributed to such condition.9

 His November 12, 2013 duty status report is also 

insufficient to establish the claim as he did not address the cause of appellant’s claimed 

condition. A November 12, 2013 attending physician’s report from Dr. Andriano diagnosed 

multilevel degenerative disc disease, herniated nucleus pulposus and weakness. He noted with a 

checkmark “yes” that appellant’s condition was caused or aggravated by an employment activity. 

The Board has held that when a physician’s opinion on causal relationship consists only of 

checking a box marked “yes” to a form question, without explanation or rationale, that opinion is 

of diminished probative value and is insufficient to establish a claim.10

Appellant was also treated by a physician assistant on December 12, 2014. However, the 

Board has held that documents signed by a physician assistant are not considered medical 

evidence as a physician assistant is not a physician under FECA.11 Thus, the treatment records 

from the physician assistant are of no probative medical value in establishing appellant’s claim. 

The remainder of the medical evidence, including an MRI scan of the cervical spine and 

an EMG, is of limited probative value as it fails to provide an opinion on the causal relationship 

between appellant’s job and his diagnosed cervical condition.12 For this reason, this evidence is 

insufficient to meet appellant’s burden of proof. 

An award of compensation may not be based on surmise, conjecture or speculation. 

Neither the fact that appellant’s condition became apparent during a period of employment nor 

the belief that his condition was caused, precipitated, or aggravated by his employment is 

sufficient to establish causal relationship. Causal relationships must be established by 

 8 Id.

9 Supra note 7. 

10 Sedi L. Graham, 57 ECAB 494 (2006); D.D., 57 ECAB 734 (2006). 

11 See David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006) (lay individuals such as physician 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). 

12 See S.E., Docket No. 08-2214 (issued May 6, 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). 
6

rationalized medical opinion evidence.13 Appellant failed to submit such evidence, and OWCP 

therefore properly denied appellant’s claim for compensation. 

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 not met his burden of proof to establish right shoulder, 

right arm, and cervical injuries causally related to the November 8, 2013 employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the July 13, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: February 1, 2017 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy 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 

 13 See Dennis M. Mascarenas, 49 ECAB 215 (1997).