United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

D.C., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE,

Bronx, NY, Employer

__________________________________________

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Docket No. 18-1664

Issued: April 1, 2019

Appearances: Case Submitted on the Record

James D. Muirhead, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On September 4, 2018 appellant, through counsel, filed a timely appeal from a June 22, 

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 his burden of proof to establish cervical spine, 

lumbar spine, left knee, and left shoulder injuries causally related to the accepted November 1, 

2016 employment incident.

FACTUAL HISTORY

On November 1, 2016 appellant, then a 22-year-old city carrier, filed a traumatic injury 

claim (Form CA-1) alleging that, at 11:00 a.m. that day, a taxi cab struck his delivery vehicle while 

in the performance of duty. The accident caused his vehicle to jerk, resulting in pain in his neck 

and lower back. He stopped work on November 5, 2016, returned to work on November 15, 2016,

and then experienced intermittent periods of work absences.

By development letter dated November 7, 2016, OWCP notified appellant of the additional 

medical and factual evidence needed to establish his claim, including a detailed description of the 

November 1, 2016 employment incident and a report from his attending physician explaining how 

and why the collision would cause the claimed injuries. It afforded 30 days to submit the necessary 

evidence.

In response, appellant submitted a November 1, 2016 emergency department slip signed 

by Dr. Chiraag Gupta, a treating physician specializing in emergency medicine, who held appellant 

off work until November 4, 2016.

In a report dated November 17, 2016, Dr. Jeffrey Cohen, an attending Board-certified 

orthopedic surgeon, returned appellant to light-duty work effective November 18, 2016.

By decision dated December 12, 2016, OWCP accepted that the November 1, 2016 

employment incident occurred as alleged, but denied appellant’s claim finding that fact of injury 

had not been established as the medical evidence of record did not contain a diagnosis related to 

the accepted incident.

On January 31, 2017 appellant requested reconsideration and submitted additional 

evidence.

The evidence submitted on reconsideration also included a series of imaging studies. A 

December 1, 2016 magnetic resonance imaging (MRI) scan of the left shoulder showed tendinitis 

of the distal supraspinatus and subscapularis tendons, an anterior glenoid labrum tear, hypertrophic 

changes of the acromioclavicular (AC) joint, and a small effusion extending into the subscapular 

space. A December 1, 2016 MRI scan of the left knee showed mild lateral subluxation of the 

patella, edema in the anterior cruciate ligament consistent with a sprain, and a joint effusion. A 

December 2, 2016 MRI scan of the lumbar spine demonstrated a broad-based posterior disc 

herniation at L5-S1, and posterior disc bulges at L3-4 and L4-5. A December 2, 2016 MRI scan 

of the cervical spine demonstrated a posterior subligamentous disc bulge at C6-7.

In a report dated November 3, 2016, Dr. Mark Kramer, a Board-certified orthopedic 

surgeon, noted the November 1, 2016 incident and diagnosed traumatic impingement syndrome of 
3

the left shoulder. He and his associate, Dr. Cohen, continued appellant on light duty through 

December 1, 2016. 

Dr. Jodi Jacobs, a chiropractor, provided manual manipulation treatments commencing 

November 3, 2017 and performed range of motion tests. In an April 7, 2017 report, she diagnosed 

cervical, thoracic, and lumbar subluxations.

Dr. Wendell Joseph Gorum, an attending orthopedic surgeon, performed a left shoulder 

arthroscopy on December 22, 2016 with complete synovectomy and debridement, subacromial 

decompression, and lysis of adhesions. In a report dated January 24, 2017, he noted a history of 

the November 1, 2016 motor vehicle accident with subsequent neck, back, left shoulder, and left 

knee pain. On February 7, 2017 Dr. Gorum diagnosed a cervical disc herniation, lumbar disc 

herniation, left knee pain, and status post left shoulder arthroscopy.

An Authorization for Medical Treatment (Form CA-16), which is largely illegible, was 

completed by Dr. Mark Kramer on November 17, 2016 noting treatment. Part A of the form, 

which is to be completed by the employing establishment, is incomplete and does not bear a 

signature or date.

Dr. Elizabeth Kulesza, a treating internist specializing in nephrology, obtained 

electromyogram/nerve conduction velocity (EMG/NCV) studies on January 5, 2017 which 

demonstrated right C5-6 radiculopathy and left L5-S1 radiculopathy. In a February 10, 2017 form 

report, she checked a box marked “yes” indicating that the diagnosed conditions were causally 

related to the November 1, 2016 employment incident.

In a report dated February 10, 2017, Dr. Andrew Cordaro, an attending general surgeon, 

diagnosed cervicalgia, lumbalgia, a left shoulder sprain/strain, and left knee sprain/strain with an 

onset date of November 1, 2016.

By decision dated May 2, 2017, OWCP modified its prior decision, finding that appellant 

had established fact of injury. However, it denied the claim finding that causal relationship had 

not been established.

On March 26, 2018 appellant, through counsel, requested reconsideration and submitted 

additional evidence. 

In a report dated March 21, 2017, Dr. Gorum diagnosed cervical spine pain, cervical disc 

disease, acute low back pain, lumbar paraspinal spasm, left shoulder weakness, and 

chondromalacia of the left knee.

In a report dated March 23, 2018, Dr. Gorum noted that the impact of the accepted 

November 1, 2016 motor vehicle collision jolted appellant “back and forth causing pain and injury 

to his neck, back, left shoulder, and left knee.” He explained that “based on the force of the impact 

causing injury and tearing of the labral tissue that functions inside the shoulder as a chock block 

to prevent dislocation or subluxation” and appellant’s young age, he was at a higher risk for 

recurrent injury and; therefore, surgery was necessary. Dr. Gorum opined that appellant’s anterior 

glenoid labrum tear with AC joint impingement resulted from the traumatic impact on 

November 1, 2016. He explained that the rotator cuff tendons “pass through a narrow space 
4

between the acromion process of the scapula” and the humeral head. Trauma further narrowed 

this space, resulting in impingement syndrome. Post-traumatic inflammation also thickened the 

subacromial bursa, causing additional impingement.

Also submitted were physical therapy treatment notes dated from February to June 2018, 

and chiropractic treatment and test reports dated from April to May 2018 by Dr. Walter E. 

Mendoza, a treating chiropractor.

By decision dated June 22, 2018, OWCP denied the claim finding that causal relationship 

had not been established.

LEGAL PRECEDENT

An employee seeking benefits under FECA3 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 filed within the applicable time 

limitation, that an injury was sustained while in the performance of duty as alleged, and that any 

disability or specific 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 on a traumatic injury or an occupational disease.5

In order to determine whether 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, which must be considered in conjunction with one 

another. The first component to be established is that the employee actually experienced the 

employment incident which is alleged to have occurred.6 The second component is whether the 

employment incident caused a personal injury and generally can be established only by medical 

evidence.7

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

relationship is rationalized medical evidence.8 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.9 

 

3 Supra note 2.

4 Alvin V. Gadd, 57 ECAB 172 (2005); Anthony P. Silva, 55 ECAB 179 (2003). 

5 See Elizabeth H. Kramm (Leonard O. Kramm), 57 ECAB 117 (2005); Ellen L. Noble, 55 ECAB 530 (2004).

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

51 ECAB 146 (1999). 

7 R.E., id. 

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

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

45 ECAB 365 (1994).
5

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

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

incidents is sufficient to establish causal relationship.10

ANALYSIS

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

In support of his claim, appellant submitted medical evidence from Dr. Gupta, Dr. Kramer,

and Dr. Cohen. These physicians, however, did not provide an opinion as to causal relationship 

in their reports. Medical evidence that does not offer an opinion regarding the cause of an 

employee’s condition or disability is of no probative value on the issue of causal relationship, and 

are therefore, insufficient to establish appellant’s traumatic injury claim.11

Appellant has submitted reports from Dr. Kulesza and Dr. Cordaro. In his report, 

Dr. Cordao diagnosed cervical, lumbar, left knee, and left shoulder injuries resulting from the 

November 1, 2016 incident, but did not provide supporting medical rationale. The Board has held 

that a report is of limited probative value regarding causal relationship if it does not contain 

medical rationale explaining how a given medical condition/disability was related to employment 

factors.12 Dr. Kulesza checked a box on a form report indicating her general support for causal 

relationship. The Board has held that, without further explanation or rationale, a checked box is 

insufficient to establish causation.13

Dr. Gorum, an attending orthopedic surgeon, performed a left shoulder arthroscopy on 

December 22, 2016. He provided an affirmative opinion on causal relationship and accurately 

identified the history of the accepted November 1, 2016 employment incident. In his March 23, 

2018 report, Dr. Gorum opined that the accepted motor vehicle collision was competent to cause 

the claimed cervical, lumbar, left shoulder, and left knee injuries. He explained how the jolting 

forces of the accepted November 1, 2016 employment-related motor vehicle collision would cause 

glenoid labrum tears and AC joint impingement as observed during the December 22, 2016 surgery

and that the force of the impact caused the tearing of the labral tissue. Dr. Gorum also specified 

the pathophysiologic mechanisms whereby post-traumatic inflammation would cause additional 

impingement as in appellant’s presentation.

 

10 Dennis M. Mascarenas, 49 ECAB 215 (1997).

11 L.D., 18-1468 (issued February 11, 2019). See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket 

No. 17-1549 (issued July 6, 2018).

12 See Y.D., Docket No. 16-1896 (issued February 10, 2017).

13 D.S., Docket No. 17-1566 (issued December 31, 2018); see Debra S. King, 44 ECAB 203 (1992); Salvatore 

Dante Roscello, 31 ECAB 247 (1979).
6

The Board finds that Dr. Gorum’s March 23, 2018 opinion is sufficient, given the absence 

of any opposing medical evidence, to require further development of the record.14 The Board notes 

that his reports are not contradicted by any substantial medical or factual evidence of record. While 

they are insufficiently rationalized to meet appellant’s burden of proof to establish his claim, they 

raise an uncontroverted inference between his left shoulder injury and the accepted employment 

incident and therefore, are sufficient to require OWCP to further develop the medical evidence and 

the case record.15 

It is well established that proceedings under FECA are not adversarial in nature, nor is 

OWCP a disinterested arbiter. While the claimant has the burden of proof to establish entitlement 

to compensation, OWCP shares responsibility in the development of the evidence.16 OWCP has 

an obligation to see that justice is done.17 The case shall, therefore, be remanded to OWCP. 

On remand OWCP shall refer appellant, a statement of accepted facts, and the medical 

evidence of record to an appropriate Board-certified specialist for an examination, diagnosis, and 

a rationalized opinion as to whether the cervical spine, lumbar spine, left knee, and left shoulder 

conditions are causally related to the accepted November 1, 2016 employment incident. After this 

and other such further development deemed necessary, OWCP shall issue a de novo decision.18

CONCLUSION

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

 

14 D.W., Docket No. 17-1884 (issued November 8, 2018). See S.S., Docket No. 17-0322 (issued June 26, 2018); 

J.G., Docket No. 17-1062 (issued February 13, 2018); A.F., Docket No. 15-1687 (issued June 9, 2016). See also 

John J. Carlone, 41 ECAB 354 (1989); Horace Langhorne, 29 ECAB 820 (1978).

15 D.W., id.; John J. Carlone, id. 

16 D.W., supra note 14. See, e.g., Walter A. Fundinger, Jr., 37 ECAB 200, 204 (1985); Dorothy Sidwell, 36 ECAB 

699, 707 (1985); Michael Gallo, 29 ECAB 159, 161 (1978).

17 D.W., supra note 14; William J. Cantrell, 34 ECAB 1233, 1237 (1983); Gertrude E. Evans, 26 ECAB 195 (1974).

18 The record contains Part B of a Form CA-16 Authorization for Medical Treatment completed by Dr. Mark 

Kramer on November 17, 2016. Part A, the employing establishment’s section of the form, is incomplete, and does 

not bear a signature or date. The Board notes, however, that a properly completed CA-16 form authorization may 

constitute a contract for payment of medical expenses to a medical facility or physician, when properly executed. The 

form creates a contractual obligation, which does not involve the employee directly, to pay for the cost of the 

examination or treatment regardless of the action taken on the claim. The period for which treatment is authorized by 

a Form CA-16 is limited to 60 days from the date of issuance, unless terminated earlier by OWCP. See 20 C.F.R. 

§ 10.300(c); P.R., Docket No. 18-0737 (issued November 2, 2018); N.M., Docket No. 17-1655 (issued January 24, 

2018), Tracy P. Spillane, 54 ECAB 608 (2003). 
7

ORDER

IT IS HEREBY ORDERED THAT the June 22, 2018 decision of the Office of Workers’

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

this decision.

Issued: April 1, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board