United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.P., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Coppell, TX, Employer

__________________________________________

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Docket No. 18-1690

Issued: December 12, 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

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On September 6, 2018 appellant filed a timely appeal from May 3 and August 2, 2018 

merit decisions of the Office of Workers’ Compensation Programs (OWCP).1 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 her burden of proof to establish a right shoulder and 

neck condition causally related to the accepted factors of her federal employment.

 

1 The Board notes that following the August 2, 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 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On March 28, 2018 appellant, then a 44-year-old carrier technician, filed an occupational 

disease claim (Form CA-2) alleging that she experienced right shoulder pain causally related to 

factors of her federal employment. She did not stop work.

In a development letter dated April 2, 2018, OWCP advised appellant of the factual and 

medical evidence necessary to establish her claim, including a detailed description of the 

employment activities that she believed caused or contributed to her condition and a detailed 

medical report explaining how the identified employment factors resulted in a diagnosed condition. 

It also provided a questionnaire for her completion. OWCP afforded appellant 30 days to submit 

the required evidence. 

Thereafter, OWCP received a report dated March 13, 2018, Dr. Rory Allen, an osteopath

specializing in family medicine. Dr. Allen evaluated appellant for pain and burning in her lower 

neck radiating into her shoulder and right trapezius. He noted that her employment duties required 

continual use of the right upper extremity and that her pain decreased when she was off work. 

Dr. Allen diagnosed right shoulder and cervical pain/strain. He additionally diagnosed paresthesia 

of the right arm as a result of repetitive movements. 

A March 20, 2018 magnetic resonance imaging (MRI) scan of appellant’s right shoulder 

revealed mild subacromial/subdeltoid interstitial edema that was likely inflammatory, a small 

glenohumeral joint effusion, and a cyst in the anterior humeral head. A cervical spine MRI scan 

of even date revealed mid-anterior wedging at C5 “suspected to be due to axial loading stress,”

multilevel spondylosis with disc dehydration, endplate irregularity, disc bulges mildly 

impingement the ventral cord at C5-6, mild-to-moderate right neural foraminal narrowing at C3-

4, and left foraminal narrowing mild at C3-4 and minimal at C4-5.

An electromyogram and a nerve conduction velocity (EMG/NCV) study obtained on 

April 10, 2018 revealed bilateral carpal tunnel syndrome greater on the left side, right elbow ulnar 

motor neuropathy, and left ulnar sensory neuropathy with no evidence of cervical radiculopathy 

or underlying peripheral neuropathy.

In an April 18, 2018 progress report, Dr. Allen noted that appellant’s neck and right 

shoulder pain increased when working, at night, and with increased activity. He reviewed the 

result of diagnostic testing and diagnosed multilevel cervical spondylosis with disc dehydration, 

endplate irregularity, annular and disc bulges with mild C5-6 cord impingement, neuroforminal 

narrowing mild-to-moderate at C3-4 on the right and minimal from C3 to C5 on the left, cervical 

sprain and pain with radiculopathy, left more than right bilateral carpal tunnel syndrome, right 

ulnar motor neuropathy, and left ulnar sensory neuropathy. Dr. Allen opined that appellant should 

“[a]void aggravating activity.”

On April 24, 2018 appellant described the work duties to which she attributed her 

condition, including the repetitive use of her right hand to case and deliver mail, and lifting and 

carrying boxes.
3

By decision dated May 3, 2018, OWCP denied appellant’s occupational disease claim. It 

found that the medical evidence of record was insufficient to establish that she had sustained a 

medical condition causally related to the accepted employment factors.

On May 22, 2018 Dr. Allen discussed appellant’s complaints of intermittent right shoulder 

and neck pain. He noted that she had experienced increased pain and paresthesias of the right 

“lower extremity” after working 11 hours.3 Dr. Allen provided the same diagnoses as in his 

April 18, 2018 report and advised that she should avoid painful or aggravating activities.

In a report dated May 29, 2018, Dr. Allen advised that appellant’s right shoulder pain had 

begun when she worked as a mail carrier and had increased after she was transferred and began 

performing extensive pushing and pulling with her upper extremity for six days a week while 

working in a new location. Appellant initially experienced symptoms on December 14, 2017 after 

working a 12-hour day. Dr. Allen indicated that appellant had sustained employment-related neck 

and right shoulder injuries and also carpal tunnel syndrome. He requested that OWCP accept the 

diagnoses of multilevel cervical spondylosis with disc dehydration, endplate irregularity, annual 

and disc bulges with mild C5-6 cord impingement, neuroforminal narrowing mild-to-moderate at 

C3-4 on the right and minimal from C3 to C5 on the left, cervical sprain and pain with 

radiculopathy, left more than right bilateral carpal tunnel syndrome, right ulnar motor neuropathy, 

and left ulnar sensory neuropathy. Dr. Allen related, “Based on the mechanism of pulling, pushing 

using [her] right upper extremity constantly [8 to 10] hours per day repetitively has caused the 

diagnosis listed in the diagnostic test results.”

On May 31, 2018 appellant requested reconsideration.

On June 25, 2018 Dr. Allen indicated that appellant had experienced increased pain in her 

shoulder and right side of her neck after working 52 hours per week. He diagnosed cervical sprain 

with radiculopathy, bilateral carpal tunnel syndrome more on the left, right ulnar motor 

neuropathy, and left ulnar sensory neuropathy.

In a report dated July 19, 2018, Dr. J. Kevin Kaufman, a neurosurgeon, evaluated appellant 

for right shoulder and neck pain. He advised that her pain had worsened in December 2017. 

Dr. Kaufman noted that appellant performed repetitive work duties reaching out of her vehicle to 

deliver mail and had a history of carrying heavy bags of mail. He diagnosed cervical 

radiculopathy, cervical spondylosis without myelopathy or radiculopathy, and cervicalgia.

Dr. Kaufman referred her for physical therapy.

By decision dated August 2, 2018, OWCP denied modification of its May 3, 2018 decision. 

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 

 

3

It appears from the context of Dr. Allen’s report that he meant increased pain and paresthesia of the right upper 

rather than lower extremity.

4 Supra note 2.
4

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

limitation period of FECA,5that 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.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

In an occupational disease claim, appellant’s burden requires submission of the following: 

(1) a factual statement identifying employment factors alleged to have caused or contributed to the 

presence or occurrence of the disease or condition; (2) medical evidence establishing the presence 

or existence of the disease or condition for which compensation is claimed; and (3) medical 

evidence establishing that the diagnosed condition is causally related to the employment factors 

identified by the employee.8

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

relationship is rationalized medical opinion evidence. 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.9

ANALYSIS

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

and neck condition causally related to the accepted factors of her federal employment.

On March 13, 2018 Dr. Allen reviewed appellant’s symptoms of pain and burning in her 

lower neck radiating into her shoulder and right trapezius. He noted that she repetitively used her 

right upper extremity performing her employment duties. Dr. Allen diagnosed right shoulder and 

cervical pain/strain. He additionally diagnosed paresthesia of the right arm as a result of repetitive 

movements. While he discussed appellant’s work duties, Dr. Allen did not specifically address 

the cause of the diagnosed conditions. Medical evidence that does not offer an opinion regarding 

the cause of an employee’s condition is of no probative value on the issue of causal relationship.10

In progress reports dated April 18 and 22, 2018, Dr. Allen evaluated appellant for neck and 

right shoulder pain that increased with work. He diagnosed multilevel cervical spondylosis with 

 

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 R.M., Docket No. 18-0976 (issued January 3, 2019); P.D., Docket No. 17-1885 (issued September 17, 2018).

9 H.B., Docket No. 18-0781 (issued September 5, 2018).

10 See J.H., Docket No. 19-0838 (issued October 1, 2019); S.G., Docket No. 19-0041 (issued May 2, 2019); L.B., 

Docket No. 18-0533 (issued August 27, 2018).
5

disc dehydration, endplate irregularity, disc bulges with mild C5-6 cord impingement, 

neuroforminal narrowing mild-to-moderate at C3-4 on the right and minimal from C3 to C5 on the 

left, cervical sprain and pain with radiculopathy, left more than right bilateral carpal tunnel 

syndrome, right ulnar motor neuropathy, and left ulnar sensory neuropathy. Dr. Allen advised that 

appellant should avoid activity that aggravated her symptoms. He did not, however, address 

causation, and thus these progress reports are of no probative value regarding the cause of the 

diagnosed conditions.11

On May 29, 2018 Dr. Allen related that appellant had a history of right shoulder pain while 

working as a mail carrier that had increased after she had transferred to her current location and 

had begun performing significant upper extremity pushing and pulling at work six days a week. 

He opined that she had sustained employment-related neck and right shoulder injuries and also 

carpal tunnel syndrome. Dr. Allen requested that OWCP accept the conditions he had diagnosed. 

He attributed the diagnosed conditions to appellant’s repetitive use of her right upper extremity 

pushing and pulling for 8 to 10 hours per day. Although he supported causal relationship, Dr. Allen

did not explain the process by which repetitive use of her right upper extremity at work would 

have caused the diagnosed conditions.12 A medical opinion must provide an explanation of how 

the specific employment factors physiologically caused or aggravated the diagnosed conditions.13 

As Dr. Allen’s opinion regarding causal relationship was conclusory and unexplained, it is 

insufficient to meet appellant’s burden of proof to establish her claim.14

In a progress report dated June 25, 2018, Dr. Allen discussed appellant’s complaints of 

increased shoulder and neck pain on the right side after working overtime. He diagnosed cervical 

and upper extremity conditions. In a July 19, 2018 progress report, Dr. Kaufman discussed 

appellant’s complaints of right shoulder and neck pain and her history of performing repetitive 

employment duties. He again diagnosed cervical and upper extremity conditions. Neither

Dr. Allen nor Dr. Kaufman offered a medical opinion finding that the diagnosed conditions were 

due to the accepted employment factors. As noted above, the Board has held that medical evidence 

that does not offer an opinion regarding the cause of an employee’s condition is of no probative 

value on the issue of causal relationship.15 The Board finds, therefore, that these reports are 

insufficient to meet appellant’s burden of proof.

Additionally, the March 20, 2018 MRI scans and April 10, 2018 electrodiagnostic testing 

are insufficient to establish appellant’s claim, as the Board has held that diagnostic test reports lack 

probative value as they do not provide an opinion on causal relationship between the accepted 

employment factors and a diagnosed condition.16 

 

11 Id.

12 A.P., Docket No. 19-1158 (issued October 29, 2019).

13 A.H., Docket No. 19-0270 (issued June 25, 2019); M.W., Docket No. 18-1624 (issued April 3, 2019).

14 Id.

15 K.B., Docket No. 19-0411 (issued July 19, 2019); S.S., Docket No. 17-1256 (issued December 13, 2018).

16 See R.M., Docket No. 18-0976 (issued January 3, 2019).
6

As appellant has not provided sufficiently rationalized medical evidence to establish that 

her neck and right shoulder condition were causally related to the accepted factors of her federal 

employment, the Board finds that she has not met her burden of proof to establish her occupational 

disease claim.17

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 

or neck condition causally related to the accepted factors of her federal employment.

ORDER

IT IS HEREBY ORDERED THAT the August 2 and May 3, 2018 decisions of the Office 

of Workers’ Compensation Programs are affirmed.

Issued: December 12, 2019

Washington, DC

Christopher J. Godfrey, 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

 

17 A.P., supra note 12.