United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

W.H., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Long Beach, CA, Employer

__________________________________________

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Docket No. 19-0139

Issued: July 8, 2019

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On October 24, 2018 appellant filed a timely appeal from an August 1, 2018 merit decision

of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal Employees’

Compensation Act1(FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over 

the merits of this case.2

ISSUE

The issue is whether appellant has met his burden of proof to establish lumbar conditions 

causally related to the accepted factors of his federal employment. 

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that, following the August 1, 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

FACTUAL HISTORY

On October 26, 2015 appellant, then a 67-year-old mail carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on October 24, 2015 he injured his lower back while in the 

performance of duty. He noted that he carried a 30-pound mailbag. In an attached October 26, 

2015 statement, appellant related that he felt lower back pain half way through his route on 

October 24, 2015, but that he was able to finish his route. The next day, however, his back pain 

had intensified and he struggled to get out of bed. 

In an October 26, 2015 report, Dr. Charles Brian Tang, Board-certified in occupational 

medicine, noted appellant’s history of injury. He indicated that x-rays of appellant’s lumbar spine 

were negative for fractures. Dr. Tang diagnosed sprain of ligaments of lumbar spine and 

recommended physical therapy. In subsequent progress reports and duty status reports (Form CA17) dated November 2 through December 28, 2015, Dr. Tang diagnosed lumbosacral strain and 

provided work restrictions.

In a development letter dated January 8, 2016, OWCP noted that appellant was claiming a 

traumatic injury as a result of carrying satchels of mail on October 24, 2015. It advised him of the 

deficiencies in his claim and requested additional factual and medical evidence, including a wellrationalized medical report from a physician which contained objective findings and an opinion of 

how the incident caused or aggravated the claimed condition. OWCP also provided the definitions 

of a traumatic injury and an occupational disease and requested that appellant clarify which type 

of injury he was claiming. 

In progress reports and CA-17 forms dated January 11 and 25, 2016, Dr. Tang continued 

to diagnose lumbosacral strain and provide work restrictions. 

By decision dated February 12, 2016, OWCP denied appellant’s traumatic injury claim. It 

found that the medical evidence of record was insufficient to establish that his diagnosed medical 

condition was causally related to the accepted October 24, 2015 employment incident.

In reports dated February 4 through May 19, 2017, Dr. Shamel Hashish, a Board-certified 

physiatrist, diagnosed strain of muscle, fascia, and tendon of lower back and lumbar radiculopathy 

and he also provided work restrictions. In his February 4, 2016 progress note, he provided an 

impression of lumbar sprain, sacroilitis, and lumbar radiculopathy. Dr. Hashish noted that 

appellant gradually developed low back pain until October 24, 2014 when the pain became severe. 

He opined that the October 24, 2015 employment injury occurred as a result of cumulative strain 

on the back because appellant carried mail using a satchel. 

In a June 22, 2016 statement, appellant indicated that his injury gradually occurred over a 

period of time. He also noted that he did not wish to pursue his traumatic injury claim. In a 

July 20, 2016 statement, appellant responded to OWCP’s questions. He attributed his back 

condition to loading and delivering large and heavy boxes, delivering mail with two satchels 

because of heavy mail volume, and walking his route with no cart or dolly. Appellant reiterated 

that his back condition occurred gradually over time. 
3

A July 25, 2016 magnetic resonance imaging (MRI) scan of appellant’s lumbar spine 

indicated disc herniation and bilateral facet arthopathy at L1-2, L2-3, L5-S1; disc bulges at L3-4, 

L4-5; severe scoliosis of the lumbar spine; lateral listhesis of L2 on L3 and L4 on L5, L2-3 disc 

herniation and bilateral facet arthopathy; possibly an osseous lesion; and edematous changes at the 

anterior superior endplate of L2. 

A July 29, 2016 electromyogram and nerve conduction velocity (EMG/NCV) of 

appellant’s lower extremities reported findings suggestive of underlying peripheral 

polyneuropathy affecting motor and sensory fibers and a superimposed chronic radiculopathy of 

proximal nerve root involving the L4, L5, and S1 nerves. 

An August 29, 2016 computerized tomography (CT) scan of appellant’s lumbar spine 

revealed multilevel degenerative spondyloarthropathy with disc bulges and facet arthopathy 

resulting in canal stenosis and neural foraminal narrowing; unilateral left spondylosis at L5; and 

sacroiliac joint arthroplasty. 

In an August 24, 2016 report, Dr. Hosea Brown, a Board-certified internist, noted that

appellant had worked as a letter carrier since 2007. In the past year, the employing establishment 

had contracted with Amazon, additional heavy parcels were added to appellant’s route, and he 

noticed progressively increasing back pain. Dr. Brown described appellant’s daily duties of casing 

mail, pulling and bundling mail into trays, loading and lifting trays and parcels onto a hamper, and 

loading the mail into his postal vehicle. He also described appellant’s duties on his delivery route. 

Dr. Brown noted that appellant complained of low back injury due to carrying two loaded satchels 

over each shoulder and walking on uneven surfaces. He reported examination findings and his 

review of diagnostic testing. Dr. Brown diagnosed kyphoscoliosis (permanent aggravation); 

degenerative joint disease, lumbosacral spine (permanent aggravation); lumbar intervertebral disc 

syndrome without myelopathy; and lumbosacral radiculopathy as documented by physical 

examination and EMG/NCV studies. He explained that carrying and lifting heavy packages as 

well as carrying a satchel or double satchel with heavy packages for approximately six to eight 

hours on a daily basis increased the biomechanical load to appellant’s lumbar spine and caused 

pathological damage as noted on his radiological studies. Dr. Brown opined that such exposure 

accelerated and aggravated the degenerative changes of his lumbar spine, contributed to 

progressive lumbar intervertebral disc herniation, and caused a lumbar intervertebral disc 

syndrome and lumbosacral radiculopathy and permanently aggravated appellant’s scoliosis and 

his underlying kyphoscoliosis. He further opined that it was medically reasonable to infer a causal 

relationship between appellant’s extensive injuries to his lumbar spine and the performance of his 

duties as a city letter carrier throughout his nine-year employment history. 

On November 15, 2016 appellant requested reconsideration. 

By decision dated February 8, 2017, OWCP denied modification of its February 12, 2016 

decision. It noted that appellant was now claiming an occupational disease due to loading and 

lifting boxes of various sizes and satchels of mail over an extended period of time and that these 

were accepted employment factors. OWCP concluded that the medical evidence was still 

insufficient to establish causal relationship between the diagnosed medical conditions and the 

established work factors. 
4

On May 31, 2017 appellant requested reconsideration. 

In an October 7, 2016 report, Dr. James T. Tran, a Board-certified neurosurgeon, noted 

examination findings and his review of diagnostic studies. He diagnosed spinal stenosis of the 

lumbar region with neurogenic claudication, lumbar disc degeneration, aggravation, lumbar disc 

displacement; connective tissue and disc stenosis of intervertebral foramina of lumbar region; and 

osseous stenosis of neural canal of lumbar region. Dr. Tran noted that appellant had been working 

as a letter carrier from 2007 to the present. He discussed appellant’s work duties, including casing 

and delivering mail, the biomechanical movements involved in such tasks, and the effect on the 

lumbar spine. Dr. Tran noted that on October 24, 2015 appellant delivered his route and had 

soreness in the low back, which was not unusual after a long day at work. The following morning 

he had severe low back pain that prevented him from getting out of bed. Dr. Tran explained that 

in the setting of lumbar spinal stenosis at L1-2, L2-3, L3-4, L4-5, and L5-S1, the act of appellant 

delivering his route while carrying a mail satchel caused extension and twisting of lumbosacral 

spine in the low back. The twisting of low back and force exerted on to the lumbar spine from 

extension of low back caused disengagement of facet joints in the lumbar spine at the above areas. 

The disengagement of lumbar facet joints then exerted pressure or force on the lumbar discs at the 

above areas and caused disc bulging and compression of lumbar nerve roots, which resulted in low 

back pain. Based on repetitive job duties on a daily basis, Dr. Tran opined that appellant’s injuries 

occurred overtime and culminated on October 24, 2014. He opined, based on physical 

examination, review of the medical record, and review of the diagnostic studies, that it was 

medically reasonable to infer causation between appellant’s repetitive job duties and his low back 

injury.

In a May 30, 2017 progress report, Dr. Brown reported that appellant was working one to 

eight hours daily with restrictions depending on the availability of work and that he had been 

evaluated by Dr. Tran. He provided examination findings and diagnoses, and thereafter 

recommended that appellant continue to work in a modified capacity with restrictions. 

By decision dated August 29, 2017, OWCP denied modification of its February 8, 2017 

decision.

On May 15, 2018 appellant requested reconsideration.

In a May 2, 2018 report, Dr. Brown indicated that the current claim was for an occupational 

injury. He opined that the years of carrying and delivering heavy packages to residential locations

were responsible for appellant’s back conditions. Dr. Brown reiterated his prior explanations of 

the biomechanical movements involved in the repetitive lifting of heavy packages when 

performing mail delivery on appellant’s lumbar spine as well as the increased biomechanical 

workload associated with heavy satchels. He also discussed appellant’s diagnostic testing and 

indicated that the increased biomechanical load associated with heavy packages and a satchel 

caused and permanently aggravated appellant’s diagnosed conditions. Dr. Brown concluded that 

causation was clearly established on the basis of both direct causation and permanent aggravation. 

By decision dated August 1, 2018, OWCP denied modification of its prior decision.
5

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,3that 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.4 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.5

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (1) medical evidence establishing the 

presence or existence of the disease or condition for which compensation is claimed; (2) a factual 

statement identifying employment factors alleged to have caused or contributed to the presence or 

occurrence of the disease or condition; and (3) medical evidence establishing that the employment 

factors identified by the claimant were the proximate cause of the condition for which 

compensation is claimed or, stated differently, medical evidence establishing that the diagnosed

condition is causally related to the employment factors identified by the claimant.6

The medical evidence required to establish causal relationship is rationalized medical 

opinion evidence.7 Rationalized medical opinion evidence is medical evidence which includes a 

physician’s rationalized opinion on the issue of whether there is causal relationship between the 

claimant’s diagnosed condition and the implicated employment factors. 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.8

ANALYSIS

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

While appellant initially filed a claim for traumatic injury, appellant subsequently clarified 

that occupational factors over the course of years, namely carrying a satchel during the delivery of 

 

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

153 (1989).

4

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

ECAB 312 (1988).

5 S.C., Docket No. 18-1242 (issued March 13, 2019); K.M., Docket No. 15-1660 (issued September 16, 2016).

6 C.D., Docket No. 17-2011 (issued November 6, 2018); Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996).

7 M.B., Docket No. 17-1999 (issued November 13, 2018).

8 M.L., Docket No. 18-1605 (issued February 26, 2019).
6

mail, caused his diagnosed lumbar conditions. OWCP accepted that the alleged occupational 

factors occurred as alleged. 

The Board finds that, although the medical evidence is insufficiently rationalized to 

establish that appellant sustained a work-related condition, the medical reports of record are 

generally supportive that his accepted employment factors caused or aggravated his diagnosed 

conditions.9

In a February 4, 2016 report, Dr. Hashish provided an impression of lumbar sprain, 

sacroilitis and lumbar radiculopathy. He noted that appellant had gradually developed low back 

pain. Dr. Hashish opined that appellant’s lumbar conditions occurred as a result of cumulative 

strain on the back due to appellant’s use of a satchel while delivering mail. 

Dr. Brown, in his August 24, 2016 report, explained that appellant’s diagnostic studies 

confirmed pathologic damage to appellant’s lumbar spine. He related that appellant’s employment 

duties over the course of his nine-year employment history required that he carry and lift heavy 

packages and a satchel daily which increased the biomechanical load to his lumbar spine, and 

accelerated and aggravated the degenerative changes in his lumbar spine. 

Similarly, Dr. Tran, in his October 7, 2016 report, diagnosed lumbar conditions and opined 

that appellant’s conditions occurred over a period of time and culminated on October 24, 2014. 

He explained that appellant had delivered mail carrying a satchel since 2007. This activity caused 

extension and twisting of the low back and exerted force on the lumbar spine, which caused 

disengagement of facet joints in the lumbar spine, which then exerted pressure or force on the 

lumbar discs, which caused disc bulging and compression of the lumbar nerve roots. 

While none of these reports were completely rationalized, they were consistent in 

indicating that appellant sustained an employment-related lumbar condition. There is also no 

opposing medical evidence.10

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.11 Thus, while the 

reports from Drs. Hashish, Tran, Brown, and Tang are insufficient to meet appellant’s burden of 

proof to establish his claim, they raise an inference of causal relationship between the accepted 

factors of employment and the diagnosed condition and are sufficient to require further 

development of the medical record.12

On remand OWCP shall develop the claim by referring appellant, a statement of accepted 

facts, and the medical evidence of record to an appropriate specialist to obtain a rationalized 

 

9

J.S., Docket No. 13-2022 (issued July 28, 2014).

10 D.G., Docket No. 18-0043 (issued May 7, 2017). 

11 T.H., Docket No. 18-1585 (issued March 22, 2019); Phillip L. Barnes, 55 ECAB 426 (2004).

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

opinion regarding whether his lumbar conditions have been caused or aggravated by the accepted 

factors of his federal employment. After such further development as OWCP deems necessary, it 

shall issue a de novo decision. 

CONCLUSION

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

ORDER

IT IS HEREBY ORDERED THAT the August 1, 2018 decision of the Office of 

Workers’ Compensation Programs is set aside and this case is remanded for further proceedings 

consistent with this opinion.

Issued: July 8, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board