United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

P.S., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Eighty Four, PA, Employer

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Docket No. 19-0549

Issued: July 26, 2019

Appearances: Case Submitted on the Record

William J. Worthington, 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 January 11, 2019 appellant, through counsel, filed a timely appeal from a July 19, 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 right shoulder 

condition causally related to the accepted November 30, 2017 employment incident.

FACTUAL HISTORY

On December 5, 2017 appellant, then a 66-year-old rural carrier associate, filed a traumatic 

injury claim (Form CA-1) alleging that, on November 30, 2017, she sprained her right shoulder 

when delivering a 50-pound bag of dog food, which slipped from her grasp and fell in a driveway

while in the performance of duty. She stopped work on December 4, 2017. 

In a statement dated December 2, 2017, appellant described the events of 

November 30, 2017. She stated that she continued to work, but that she believed it had not helped 

the situation. 

In a prescription note dated December 4, 2017, Dr. Justin Zenner, a Board-certified 

orthopedic surgeon, diagnosed right shoulder pain and recommended a magnetic resonance 

imaging (MRI) scan of appellant’s right shoulder. In a letter of even date, Dr. Zenner 

recommended that appellant not return to work until after her MRI scan. 

In a report dated December 4, 2017, Dr. Zenner examined appellant’sright shoulder, which 

she claimed to have injured while lifting a package on November 30, 2017. On examination, he

noted limited abduction and forward elevation of her right shoulder due to discomfort, as well as 

a grossly positive painful arc of motion. Dr. Zenner found a positive Neer impingement test, 

Hawkins impingement sign, and pain over the biceps tendon. He stated that appellant had no 

obvious mechanical symptoms, but the pain was apparent. X-rays of the right shoulder 

demonstrated no obvious acute fracture, dislocation, or subluxation, but appellant had signs of 

glenohumeral arthrosis and acromioclavicular joint arthrosis. Dr. Zenner diagnosed significant 

right shoulder pain with an abrupt onset of symptoms. He recommended rest, ice, activity 

modification, physical therapy, anti-inflammatory medications, and an MRI scan.

In a development letter dated January 8, 2018, OWCP informed appellant that she had not 

submitted sufficient factual or medical evidence to establish her claim. It advised her of the type 

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

afforded appellant 30 days to respond.

An MRI scan of the right shoulder dated December 28, 2017 demonstrated a complete 

rotator cuff tear of the right shoulder in the anterolateral aspect of the right supraspinatus tendon 

and the superior aspect of the right subscapularis tendon, medial subluxation of the biceps tendon 

of the right shoulder, degenerative arthritis in the right glenohumeral joint, and moderate right 

acromioclavicular joint arthrosis.

In a work excuse note dated January 8, 2018, Dr. Zenner opined that appellant could return 

to work with restrictions of no lifting over two pounds with the right upper extremity and no 

overhead reaching. In a report of the same date, Dr. Zenner noted his evaluation of appellant and 

his review of the December 28, 2017 MRI scan. On examination, he noted weakness of 
3

supraspinatus strength testing with pain, a positive Neer impingement test and Hawkins 

impingement sign, pain over the biceps tendon, and a grossly positive O’Brien’s test. Dr. Zenner

diagnosed rotator cuff pathology of the right shoulder, with medialization of the biceps and known 

arthrosis of the shoulder, degenerative arthritis, and rheumatoid arthritis. He recommended antiinflammatory treatments and physical therapy. 

In a note dated January 15, 2018, a physical therapist noted that appellant was injured at 

work on November 20, 2017 when she unloaded a 50-pound bag of dog food and felt immediate 

right shoulder pain. Appellant continued to submit physical therapy notes through 

January 31, 2018.

On February 5, 2018 Dr. Zenner advised that appellant could return to light-duty work with 

restrictions of no overhead activity. 

By decision dated February 12, 2018, OWCP denied appellant’s claim, finding that she 

had not submitted sufficient evidence to establish that the incident of November 30, 2017 occurred

as alleged. It concluded, therefore, that the requirements had not been met to establish an injury 

as defined by FECA.

Appellant continued to submit physical therapy notes dated February 2 through 9, 2018. 

On February 22, 2018 appellant responded to OWCP’s development letter. She stated that 

she sustained her claimed injury when she was delivering a 50-pound package of dog food and it 

fell onto a driveway. Thereafter, appellant had trouble lifting, reaching, and sleeping. She noted 

that she did not have any similar disability or symptoms prior to the claimed injury. 

On February 26, 2018 appellant requested a review of the written record before a 

representative of OWCP’s Branch of Hearings and Review. 

In a report dated February 5, 2018, Dr. Zenner noted that appellant was taking steroids for

rheumatoid arthritis, which seemed to help significantly. On examination, he noted that she

demonstrated good abduction and forward elevation, weakness with supraspinatus strength testing, 

a biceps tendon which was medialized into her subscapularis rotator cuff tendon tear and an 

asymptomatic sulcus. Dr. Zenner diagnosed acute rotator cuff tendon tear of the right shoulder 

and medialization of appellant’s biceps tendon. He advised that she could return to light-duty 

work with restrictions of no overhead activities. 

By decision dated July 19, 2018, the hearing representative affirmed OWCP’s February 12, 

2018 decision as modified. She found that appellant had submitted sufficient evidence to establish 

that the incident of November 30, 2017 occurred as alleged, but denied the claim because she had 

not submitted medical evidence containing a specific diagnosis and a rationalized opinion 

explaining how her diagnosed conditions were causally related to the accepted November 30, 2017 

employment incident.

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 
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United States within the meaning of FECA, that the claim was timely filed within the applicable 

time limitation of FECA, 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 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.5 The second component is whether the employment incident caused a personal 

injury.6

Causal relationship is a medical question that requires rationalized medical opinion 

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

between the diagnosed condition and the implicated employment factor(s) must be based on a 

complete factual and medical background. 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 factor(s).7

In any case where a preexisting condition involving the same part of the body is present 

and the issue of causal relationship therefore involves aggravation, acceleration or precipitation, 

the physician must provide a rationalized medical opinion that differentiates between the effects 

of the work-related injury or disease and the preexisting condition.8

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a right shoulder 

condition causally related to the accepted November 30, 2017 employment incident.

In support of her claim, appellant submitted medical evidence from Dr. Zenner. On 

December 4, 2017 Dr. Zenner indicated that she injured her shoulder while lifting a 50-pound 

package of dog food on November 30, 2017. He diagnosed significant right shoulder pain with an 

 

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).

5 Elaine Pendleton, 40 ECAB 1143 (1989).

6 M.H., Docket No. 18-1737 (issued March 13, 2019); John J. Carlone, 41 ECAB 354 (1989). 

7 S.S., Docket No. 18-1488 (issued March 11, 2019).

8 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013); N.S., 

Docket No. 19-0167 (issued June 21, 2019).
5

abrupt onset of symptoms. While Dr. Zenner recounted the history of injury as communicated by 

appellant to him, such a generalized statement does not establish causal relationship because it 

merely repeats appellant’s allegations and is unsupported by adequate medical rationale explaining 

how the incident of November 30, 2017 actually caused the diagnosed condition.9 The Board 

further notes that pain and/or discomfort is only considered a symptom, not a firm medical 

diagnosis.10 As such, the report of December 4, 2017 is insufficient to meet appellant’s burden of 

proof with respect to causal relationship.11

In a December 4, 2017 letter, Dr. Zenner advised that appellant was unable to return to 

work until after her MRI scan. Appellant submitted an MRI scan report dated December 28, 2017. 

On January 8, 2018 Dr. Zenner stated that appellant could return to work with restrictions. On the 

same day, he diagnosed rotator cuff pathology of the right shoulder, with medialization of the 

biceps and known arthrosis of the shoulder, degenerative arthritis, and rheumatoid arthritis. On 

February 5, 2018 Dr. Zenner recommended that appellant could return to light-duty work. In a 

report of the same date, he diagnosed acute rotator cuff tendon tear of the right shoulder and 

medialization of her biceps tendon. The Board has held that a medical report is of no probative 

value on the issue of causal relationship if it does not provide an opinion on causal relationship.12 

The Board has also held that reports of diagnostic testing lack probative value as they do not 

provide an opinion on causal relationship between appellant’s employment duties and a diagnosed 

condition.13 As these reports did not contain an opinion on causal relationship, they are insufficient 

to establish the claim.14

The treatment records from physical therapists dated from January 15 through February 9, 

2018 are also insufficient to meet appellant’s burden of proof, as physical therapists are not 

considered physicians as defined under FECA and, as such, their reports are of not probative 

value.

15

On appeal counsel contends that appellant has established that her right rotator cuff tear 

was causally related to the accepted November 30, 2017 employment incident. However, as the 

medical evidence of record does not contain a rationalized explanation sufficient to establish causal 

relationship, the Board finds that appellant has not met her burden of proof.

 

9 See J.B., Docket No. 18-1006 (issued May 3, 2019); K.W., 59 ECAB 271, 279 (2007).

10 Findings of pain or discomfort alone do not satisfy the medical aspect of the fact of injury medical determination. 

Federal (FECA) Procedure Manual, Part 2 -- Claims, Fact of Injury, Chapter 2.803.4a(6) (August 2012); J.A., Docket 

No. 18-0882 (issued December 31, 2018).

11 Id.

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

13 See J.M., Docket No. 17-1688 (issued December 13, 2018).

14 Id. See L.S., Docket No. 19-0135 (issued April 25, 2019).

15 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t); D.F., Docket No. 19-0108 (issued April 16, 2019); K.W., 59 ECAB 271, 

279 (2007); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006).
6

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 her burden of proof to establish a right shoulder 

condition causally related to the accepted November 30, 2017 employment incident. 

ORDER

IT IS HEREBY ORDERED THAT the July 19, 2018 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: July 26, 2019

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