United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

L.S., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

East St. Louis, IL, Employer

__________________________________________

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Docket No. 19-0135

Issued: April 25, 2019

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 October 24, 2018 appellant, through counsel, filed a timely appeal from an August 13, 

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.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 Board notes that following the August 13, 2018 decision, OWCP received additional evidence. However, the 

Board’s Rules of Procedure provides: “The Board’s review of a case is limited to the evidence in the case record that 

was before OWCP at the time of its final decision. Evidence not before OWCP will not be considered by the Board 

for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this additional 

evidence for the first time on appeal. Id.
2

ISSUE

The issue is whether appellant has met his burden of proof to establish an injury causally 

related to the accepted June 8, 2017 employment incident.

FACTUAL HISTORY

On June 12, 2017 appellant, then a 50-year-old carrier technician, filed a traumatic injury 

claim (Form CA-1) for a right shoulder injury that he attributed to a June 8, 2017 work-related 

motor vehicle accident (MVA). He indicated that a tractor-trailer backed into his work van while 

in the performance of duty. The employing establishment did not contest the June 8, 2017 incident 

or whether appellant was in the performance of duty at the time of the MVA. It also completed an

authorization for examination and/or treatment (Form CA-16) following his reported June 8, 2017 

MVA.

In a June 12, 2017 work activity status report, Dr. Christine E. Jones, whose specialty is 

unknown, diagnosed cervicalgia, right shoulder pain, and low back pain. She stated that appellant 

could return to work on June 12, 2017 with restrictions.

By development letter dated June 15, 2018, OWCP informed appellant that he had not 

submitted sufficient evidence to establish his claim. It advised him of the type of factual and 

medical evidence needed and provided a questionnaire for his completion. OWCP afforded him

30 days to submit additional evidence and respond to its inquiries. 

OWCP subsequently received June 8, 2017 emergency department discharge instructions 

for a diagnosis of lumbosacral strain. The instructions noted that appellant had been treated by 

Matthew R. Peterson, a physician assistant. 

In a report dated June 12, 2017, Dr. Jones examined appellant for complaints of a back 

injury. She noted that he stated while his postal vehicle was still, an 18-wheeler truck backed into 

his vehicle. Although he felt a little sore at the time, he was able to complete his regular route 

driving and delivering mail. However, the next morning appellant experienced discomfort in his 

lower back, right shoulder, and neck. He then went to the emergency department, where he was 

evaluated and given medication. Appellant was off work for three days. On examination of 

appellant’s lumbar spine, Dr. Jones noted tenderness to palpation. She assessed acute bilateral low 

back pain without sciatica, right shoulder pain, and neck pain. Dr. Jones recommended physical 

therapy and provided work restrictions of lifting up to 20 pounds frequently, bending occasionally, 

changing positions periodically to relieve discomfort, and no reaching above the head with his 

affected extremities.

On June 15, 2017 Denise Jordan, a family nurse practitioner, referred appellant for physical 

therapy. In a June 29, 2017 work excuse note, she opined that he should remain off work until 

reevaluated on July 28, 2017. OWCP also received a July 10, 2017 initial physical therapy 

evaluation report from Jenna Mueth, a physical therapist.

By decision dated July 26, 2017, OWCP denied appellant’s claim, finding that he had not

submitted medical evidence containing a medical diagnosis in connection with the accepted 

employment incident of June 8, 2017.
3

In a prescription dated July 27, 2017, Dr. Bassam Albarcha, a Board-certified internist, 

noted that appellant had been injured in a motor vehicle incident, providing an ICD-10 diagnosis 

code corresponding to an assessment of a person injured in an unspecified motor vehicle incident, 

subsequent encounter. He prescribed appellant physical therapy two to three times per week for 

six weeks.

Appellant resubmitted the physical therapy evaluation report dated July 10, 2017, 

countersigned by Dr. Albarcha on July 31, 2017. The report noted that he had been diagnosed 

with lumbar sprain at the emergency department and that he was in constant pain, which was only 

relieved by pain medication. On examination, appellant was noted to have discomfort to the 

paraspinal lumbar area, mild tightness bilaterally, and reduced range of motion. His plan of care 

was a home exercise program of core and hip strengthening and stretching as tolerated to assist 

with activities of daily living, and techniques that the physical therapy saw fit for pain relief. 

By letter dated August 1, 2017 from a nurse practitioner, countersigned by Dr. Albarcha, 

it was noted that appellant was involved in a motor vehicle incident in June 2017 and as a result, 

suffered a back injury, back pain, neck injury, neck pain, muscle and shoulder pain, and a pinsand-needles sensation in the arms and hands. The letter stated that a reduced work duty was 

required due to these assessments and that he would return to duty with limitations.

On August 7, 2017 appellant, through counsel, requested a telephonic hearing before an 

OWCP hearing representative.

Appellant submitted records of physical therapy from July 10 through August 1, 2017, 

which were unsigned. He also submitted reports signed by a nurse practitioner dated from June 15 

through August 29, 2017. 

The hearing was held on January 16, 2018. During the hearing, appellant described the 

circumstances of a motor vehicle incident on June 8, 2017, and noted that he went to the emergency 

room on the date of the incident. The hearing representative noted that the record did not contain 

reports from individuals that could be accepted as physicians rendering concrete diagnoses. He 

kept the record open for 30 days for the submission of additional evidence. 

By decision dated March 7, 2018, OWCP’s hearing representative affirmed the July 26, 

2017 decision, finding that the medical evidence of record was insufficient to establish a diagnosed 

condition causally related to the accepted June 8, 2017 employment incident.

On April 5, 2018 appellant, through counsel, requested reconsideration of the decision of 

March 7, 2018 and submitted a March 2, 2018 letter from a nurse practitioner, which had been

countersigned by Dr. Albarcha. The letter stated that appellant was involved in a motor vehicle 

incident in June 2017 while delivering mail in a postal truck. Appellant was treated in the 

emergency room on the date of the incident. The letter noted that he sustained a neck injury, 

shoulder injury, upper back injury, lower back injury, and a pins-and-needles sensation in the arms 

and hands. Over the months following the incident, appellant experienced numerous episodes of 

pain with activity, and he was later diagnosed with cervical spondylosis and cervical 

spondylolisthesis. He received physical therapy and remained on reduced work duty.

By decision dated August 13, 2018, OWCP denied modification of its March 7, 2018

decision. It found that the March 2, 2018 note failed to provide a rationalized explanation of how 
4

the cervical spondylosis and cervical spondylolisthesis resulted from the accepted June 8, 2017 

employment incident. 

LEGAL PRECEDENT

An employee seeking benefits under FECA4 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 of FECA,5that 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.6 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.7

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.8 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.9 The second component is whether the employment incident caused a personal 

injury.10 An employee may establish that an injury occurred in the performance of duty as alleged, 

but fail to establish that the disability or specific condition for which compensation is being 

claimed is causally related to the injury.11

Causal relationship is a medical question that generally requires rationalized medical 

opinion evidence to resolve the issue.12 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.13 Additionally, the physician’s opinion must 

be expressed in terms of a reasonable degree of medical certainty, and must be supported by 

 

4 Supra note 2.

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

153 (1989). 

6

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

ECAB 312 (1988).

7 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).

8 D.B., Docket No. 18-1348 (issued January 4, 2019); T.H., 59 ECAB 388, 393-94 (2008).

9 D.S., Docket No. 17-1422 (issued November 9, 2017); Elaine Pendleton, 40 ECAB 1143 (1989).

10 B.M., Docket No. 17-0796 (issued July 5, 2018); John J. Carlone, 41 ECAB 354 (1989).

11 Shirley A. Temple, 48 ECAB 404, 407 (1997).

12 T.H., supra note 8; Robert G. Morris, 48 ECAB 238 (1996).

13 M.V., Docket No. 18-0884 (issued December 28, 2018).
5

medical rationale, explaining the nature of the relationship between the diagnosed condition and 

appellant’s specific employment factor(s).14

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish an injury 

causally related to the accepted June 8, 2017 employment incident.

In support of his claim, appellant submitted numerous notes and reports that were authored 

by a nurse practitioner and/or a physician assistant. Because these reports were not prepared by 

or countersigned by a qualified physician as defined under FECA, the evidence will not suffice for 

purposes of establishing entitlement to FECA benefits.15

Appellant submitted a physical therapy evaluation report dated July 10, 2017, 

countersigned by Dr. Albarcha on July 31, 2017. The Board finds that, as Dr. Albarcha has 

countersigned this report, it constitutes medical evidence.16 The report noted that appellant had 

been diagnosed with lumbar sprain at the emergency department and that he was in constant pain.17 

The Board has held that medical evidence that does not offer any opinion regarding the cause of 

an employee’s condition is of no probative value.18 As such, this report, which did not contain 

any opinion on the cause of appellant’s condition, is of no probative value on the issue of causal 

relationship.19

On June 12, 2017 Dr. Jones assessed appellant with acute bilateral low back pain without 

sciatica, right shoulder pain, and neck pain. In a prescription dated July 27, 2017, Dr. Albarcha 

noted that appellant had been injured in a motor vehicle incident. By letter dated August 1, 2017 

from a nurse practitioner, countersigned by Dr. Albarcha, it was noted that appellant had been 

involved in a motor vehicle incident and suffered a back injury, back pain, neck injury, neck pain, 

muscle and shoulder pain, and a pins-and-needles sensation in the arms and hands. The Board has 

held that a medical report is of no probative value if it does not provide an opinion on causal 

relationship.

20

 As such, these notes, letters, and reports are insufficient to establish the claim.

In a letter dated March 2, 2018 from a nurse practitioner, which was countersigned by

Dr. Albarcha, it was noted that appellant was involved in a motor vehicle incident in June 2017 

while delivering mail in a postal truck. Appellant was treated in the emergency room on the date 

of the incident. The letter noted that he sustained a neck injury, shoulder injury, upper back injury, 

 

14 Id.; Victor J. Woodhams, 41 ECAB 345, 352 (1989).

15 See 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t). K.W., 59 ECAB 271, 279 (2007); David P. Sawchuk, 57 ECAB 316, 

320 n.11 (2006). A report from a physician assistant or certified nurse practitioner will be considered medical evidence 

if countersigned by a qualified physician. Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, 

Chapter 2.805.3a(1).

16 K.W., id.; David P. Sawchuk, id. Federal (FECA) Procedure Manual, id.

17 See T.G., Docket No. 13-0076 (issued March 22, 2013).

18 C.B., Docket No. 09-2027 (issued May 12, 2010); S.E., Docket No. 08-2214 (issued May 6, 2009).

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

20 Id.
6

lower back injury, and a pins-and-needles sensation in the arms and hands. Over the months 

following the incident, appellant experienced numerous episodes of pain with activity, and he was 

later diagnosed with cervical spondylosis and cervical spondylolisthesis. The letter of March 2, 

2018 did not contain a clear rationale as to how his cervical conditions were related to the incident 

of June 8, 2017; rather, the opinion was conclusory in nature.21 A mere conclusory opinion 

provided by a physician without the necessary rationale explaining how and why the incident was 

sufficient to result in the diagnosed medical condition is not sufficient to meet a claimant’s burden 

of proof to establish a claim.22 As such, the letter dated March 2, 2018 is insufficient to establish 

causal relationship between the incident of June 8, 2017 and appellant’s diagnosed cervical 

conditions.

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 his burden of proof.

23

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 did not meet his burden of proof to establish an injury 

causally related to the accepted June 8, 2017 employment incident.

 

21 See D.O., Docket No. 18-0086 (issued March 28, 2018).

22 J.D., Docket No. 14-2061 (issued February 27, 2015).

23 The Board notes that the employing establishment issued appellant a signed Form CA-16 authorizing treatment 

for her June 12, 2016 right shoulder injury. The Board has held that where an employing establishment properly 

executes a CA-16 form, which authorizes medical treatment as a result of an employee s claim for an employmentrelated injury, it creates a contractual obligation which does not involve the employee directly to pay the cost of the 

examination or treatment regardless of the action taken on the claim. See 20 C.F.R. §§ 10.300, 10.304; R.W., Docket 

No. 18-0894 (issued December 4, 2018).
7

ORDER

IT IS HEREBY ORDERED THAT the August 13, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: April 25, 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