United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

Y.C., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Philadelphia, PA, Employer

__________________________________________

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Docket No. 17-1938

Issued: January 7, 2019

Appearances: Case Submitted on the Record

Russell T. Uliase, 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On September 15, 2017 appellant, through counsel, filed a timely appeal from a June 14, 

2017 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 the 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 that her claim should 

be expanded to include a right shoulder condition causally related to the accepted April 30, 2001 

employment injury.

FACTUAL HISTORY

This case has previously been before the Board.3 The facts and circumstances set forth in 

the Board’s prior decisions are incorporated herein by reference. The relevant facts follow. 

On July 18, 2001 appellant then a 44-year-old letter carrier, filed a traumatic injury claim 

(Form CA-1) alleging that, on April 30, 2001, she experienced neck, shoulder, and arm pain while 

in the performance of duty. She noted carrying mail on her right shoulder. Appellant was treated 

by Dr. Stuart L. Trager, a Board-certified orthopedist, on May 2, 2001 for right shoulder pain. 

Dr. Trager noted findings of positive Phalen’s and Tinel’s signs, pain of the right shoulder with 

range of motion, and positive impingement sign. He recommended a course of physical therapy 

for appellant’s right shoulder and to avoid casing mail for two weeks.

Appellant stopped work on July 18, 2001 and returned on September 26, 2002 and worked 

intermittently thereafter. OWCP subsequently accepted her claim for aggravation of degenerative 

disc disease of the cervical spine, based on reports by Dr. Steven J. Valentino, an osteopath, who 

began treating appellant on June 13, 2001, for cervical degenerative disc disease and neck pain 

radiating into the right arm. OWCP paid appellant wage-loss compensation benefits. 

By decision dated August 15, 2011, OWCP reduced appellant’s compensation to reflect 

her wage-earning capacity as an accounting clerk, effective August 28, 2011. 

Reports from Dr. Valentino from March 19 to July 23, 2013 diagnosed facet mediated pain, 

cervical degenerative disc disease, cervical radiculitis, and spinal stenosis. In a March 20, 2013 

report, he noted that appellant complained of right shoulder pain when she was treated on 

June 13, 2001. Dr. Valentino noted her written account of her work injury established that her 

right shoulder symptoms were related to her work injury. He noted that a magnetic resonance 

imaging (MRI) scan of the right shoulder dated November 8, 2012 revealed a full-thickness 

supraspinatus tendon tear. Dr. Valentino opined that after reviewing records, the etiology of 

appellant’s right shoulder injury, along with the rotator cuff tear was apportioned to her work 

injury. He found no other etiology. OWCP referred appellant’s case record to an OWCP medical 

adviser for a determination as to whether the acceptance of her claim should be expanded to include 

right shoulder rotator cuff tear.

 

3 Docket No. 08-1545 (issued March 10, 2009); Docket No. 12-1407 (issued January 24, 2013), petition for recon. 

denied, Docket No. 12-1407 (issued August 13, 2013); Docket No. 14-1605 (issued November 21, 2014); Order 

Remanding Case, Docket No. 15-1302 (issued October 8, 2015); and Docket No. 17-0380 (issued March 9, 2018).
3

In a September 22, 2013 report, OWCP’s medical adviser opined that there was no medical 

evidence that supported causal relationship between the right shoulder rotator cuff tear to the 

employment injury that occurred 11 years prior.

On January 8, 2014 appellant requested reconsideration. She asserted that a prior loss of 

wage-earning capacity (LWEC) determination dated August 15, 2011 was erroneous as it was 

based solely on the accepted condition of aggravation of cervical disc disease when she sustained 

a right shoulder injury causally related to the April 30, 2001 work injury.4 In an April 14, 2014 

decision, OWCP denied appellant’s request for reconsideration as the evidence submitted was 

insufficient to warrant a merit review.

Appellant appealed to the Board. By decision dated November 21, 2014, the Board set 

aside the April 14, 2014 decision. The Board found that appellant requested modification of the 

August 25, 2011 LWEC determination and was entitled to a merit review of the wage-earning 

capacity issue and remanded the matter for further development.5

On September 9, 2014 OWCP referred appellant to Dr. Robert F. Draper, Jr., a Boardcertified orthopedist, for a second opinion to determine whether she had residuals of her workrelated conditions, whether she sustained a right shoulder injury causally related to the April 30, 

2001 work injury, and whether she could return to work subject to restrictions. In a September 26,

2014 report, Dr. Draper diagnosed aggravation of preexisting degenerative cervical disc disease 

and right shoulder pain associated with cervical disc disease. He opined that appellant continued 

to have residuals of the work injury of April 30, 2001. Dr. Draper opined that the right shoulder 

discomfort was related to the aggravated degenerative cervical disc disease, likely C5-6 levels. He

opined that there was no evidence of a separate pathological injury involving the right shoulder 

which could be related to the April 30, 2001 work injury. Dr. Draper concluded that the right 

shoulder complaints were due to the aggravation of the cervical degenerative disc disease and not 

due to an injury to the right shoulder. He opined that appellant could work full-time light duty, no 

lifting greater than 20 pounds occasionally and 10 pounds frequently, standing and walking for six 

hours a day, and sitting for six hours a day, and avoid excessive overhead use of the right shoulder. 

In a work capacity evaluation (Form OWCP-5c) he noted that she could work full time subject

to restrictions of no lifting greater than 20 pounds occasionally and 10 pounds frequently.

Appellant was treated by Dr. Valentino on September 23 and November 18, 2014 for

worsening complaints of neck, right shoulder, and arm pain. He noted positive findings and 

diagnosed neck pain, facet mediated pain, cervical degenerative joint disease, cervical radiculitis,

and cervical spinal stenosis.

In reports dated February 10 and 12, 2015, Dr. Scott M. Fried, an osteopath, diagnosed 

cervical strain/sprain with radiculopathy on the right, disc bulges at C5-6 and C6-7, radial and 

median neuropathy on the right, brachial plexopathy/cervical radiculopathy on the right, thoracic 

 

4 By decision dated August 15, 2011, OWCP had reduced appellant’s compensation to reflect her wage-earning 

capacity as an accounting clerk, effective August 28, 2011.

5 Docket No. 14-1605 (issued November 21, 2014).
4

neuritis, scapular winging, right rotator cuff strain, capsulitis of the shoulder, and neuralgia of the 

right side. He noted that appellant could not return to regular work.

By decision dated March 19, 2015, OWCP denied modification of the August 15, 2011

LWEC determination. 

Appellant was treated by Dr. Fried on April 6 and 16, 2015, who diagnosed cervical 

strain/sprain with radiculopathy on the right, disc bulges at C5-6 and C6-7, radial and median 

neuropathy on the right, brachial plexopathy/cervical radiculopathy on the right, thoracic neuritis, 

scapular winging, right rotator cuff strain, capsulitis of the shoulder, and neuralgia of the right 

side. Dr. Fried noted that she could not return to regular work.

In a report dated April 14, 2015, Dr. Valentino treated appellant for neck pain localized at 

C4 to C7 and right shoulder and arm pain. He diagnosed neck pain, facet mediated pain, and 

cervical degenerative joint disease. On June 16, 2015 appellant presented with bilateral L3-S1 

pain with radiation into the legs and Dr. Valentino diagnosed sciatica, lumbago and 

chondromalacia patellae of the left knee.

Appellant again appealed to the Board. By order dated October 8, 2015, the Board set 

aside the March 19, 2015 decision. The Board found that OWCP had failed to review all the 

medical evidence submitted at the time of the March 19, 2015 decision and remanded the case for 

further development.6

Appellant submitted a November 10, 2015 report from Dr. Valentino who treated her for 

neck pain localized at C4 to C7 and right shoulder and arm pain related to her work injury. 

Dr. Valentino diagnosed cervical disc degeneration, cervical pain, neck pain, and facet arthritis of 

the cervical region. 

Dr. Fried treated appellant on October 27, 2015 and January 4, 2016 for a flare-up of 

symptoms at the cervical/neck area. He diagnosed cervical strain/sprain with radiculopathy on the 

right, disc bulges at C5-6 and C6-7, median neuropathy on the right and left side, and radial and 

medial neuropathy on the right. Dr. Fried noted other problems including scapular winging, right 

rotator cuff strain, and capsulitis of the shoulder and noted that appellant could not return to regular 

work.

By decision dated February 2, 2016, OWCP denied modification of the August 15, 2011

LWEC determination.

Appellant subsequently submitted reports from Dr. Valentino dated January 19 and 

April 5, 2016 who treated her for neck pain localized at C4 to C7. Dr. Valentino opined that her

right shoulder symptoms were related to her work injury. He noted findings of significant 

limitations in all planes. Dr. Valentino diagnosed cervical disc degeneration, cervical pain, neck 

pain, facet arthritis of the cervical region, cervical strain, and neck pain. He performed bilateral 

cervical facet injections at C4 to C7.

 

6 Docket No. 15-1302 (issued October 8, 2015).
5

In a report dated March 28, 2016, Dr. Fried treated appellant for neck and shoulder pain. 

He noted the cervical spine injections helped her symptoms locally, but she still experienced 

radiating pain. Dr. Fried diagnosed cervical strain/sprain with radiculopathy on the right, disc 

bulges at C5-6 and C6-7, median neuropathy on the right and left side, radial and median

neuropathy on the right. He noted other problems including brachial plexopathy/cervical 

radiculopathy on the right, thoracic neuritis, scapular winging, right rotator cuff strain, capsulitis 

of the shoulder, and neuralgia of the right side. Dr. Fried noted that appellant could not return to 

regular work.

On July 12, 2016 appellant through counsel, requested reconsideration. She referenced a 

May 25, 2016 report from Dr. Clancy McKenzie, a Board-certified psychiatrist,7 which supported 

that her right shoulder and depression were related to the work injury and that she could not 

perform the accounting clerk position because of these conditions. 

Appellant submitted a May 25, 2016 report from Dr. McKenzie who opined that based on 

his review of the medical records her claim should be expanded to include a right shoulder injury. 

Dr. McKenzie noted that the records dating back to 2001 acknowledged that the shoulder condition

was part of the original injury. He explained that appellant carried a mailbag on her right shoulder, 

delivered mail with her right hand, cased and slotted mail with her right hand, and drove a postal 

vehicle with manual operation on the right side. Dr. McKenzie indicated that her shoulder 

condition was exacerbated by drafting résumés and applying for jobs on the computer.

Appellant submitted reports from Dr. Fried dated June 6 to September 12, 2016, who 

diagnosed cervical strain/sprain with radiculopathy on the right, disc bulges at C5-6 and C6-7, 

median neuropathy on the right and left side, radial and medial neuropathy on the right. Dr. Fried 

noted other problems including scapular winging, right rotator cuff strain, and capsulitis of the 

shoulder. He noted that appellant could not return to regular work.

Appellant was treated in follow-up by Dr. Valentino on June 7, 2016 for neck pain 

localized at C4 to C7 and right shoulder symptoms related to her work injury. Dr. Valentino noted 

findings and diagnosed cervical disc degeneration, cervical pain, facet arthritis of the cervical 

region, and cervical strain. He performed bilateral cervical facet injections at C4 to C7. In a 

separate statement dated June 7, 2016, Dr. Valentino noted reviewing Dr. McKenzie’s and

Dr. Fried’s reports and agreed that appellant was disabled from her carrier job. In a report dated 

September 13, 2016, he treated her for neck pain localized at C4 to C7 and right shoulder 

symptoms and more recently left shoulder pain. Dr. Valentino diagnosed cervical disc 

degeneration, cervical pain, facet arthritis of the cervical region, cervical strain and neck pain. He

performed bilateral cervical facet injections at C4 to C7.

By decision dated October 7, 2016, OWCP denied modification of its February 2, 2016

decision.

In a January 5, 2017 report, Dr. Fried noted appellant’s symptoms of neck and cervical 

spine pain radiating down the right arm limiting her activity. He noted diagnoses and other 

problems including right rotator cuff strain, capsulitis of the shoulder, and neuralgia of the right 

 

7 Dr. McKenzie treated appellant since September 14, 2011 for severe chronic pain and major depression.
6

side. Dr. Fried further noted that the right shoulder was getting progressively worse, but was not 

accepted. He noted that appellant could not return to regular work. 

On October 25, 2016 Dr. Valentino noted appellant symptoms of bilaterally localized C4 

to C7 radiation into the right arm with paraesthesia and weakness. He noted range of motion was 

significantly limited in all planes and diagnosed cervical pain and cervical degenerative disc 

disease. Appellant underwent trigger point injections about the cervical spine. In a letter dated 

December 13, 2016, Dr. Valentino opined that appellant’s right rotator cuff tear was a direct result 

of her work-related injury as she was carrying mail with the mailbag on her right shoulder. He

found no other etiology and opined that appellant could not return to work and was totally disabled.

In a letter dated January 13, 2017, appellant, through counsel, requested that appellant’s 

right shoulder condition be accepted as work related.

In a report dated December 13, 2016, Dr. Valentino noted symptoms of neck pain

bilaterally localized C4 to C7 with right shoulder pain and weakness. He noted range of motion 

was significantly limited in all planes and diagnosed cervical pain and strain, cervical degenerative 

disc disease, and facet arthritis of the cervical region. Appellant underwent cervical facet 

injections.

By decision dated February 9, 2017, OWCP denied appellant’s request to expand the 

acceptance of her claim to include a right shoulder condition. It noted that the medical evidence 

of record was insufficient to establish that the diagnosed medical conditions were causally related 

to accepted work events.

On February 16, 2017 appellant, through counsel, requested an oral hearing before an 

OWCP hearing representative, which was held on May 10, 2017.

An electromyogram (EMG) dated March 1, 2017 revealed evidence of bilateral midcervical nerve root impairment at C5, C6, and C7, mild bilateral brachial plexus impairment, 

moderate left ulnar nerve impairment at medial elbow level, and borderline bilateral median nerve 

impairments at wrist levels.

Reports from Dr. Valentino dated March 21 to May 16, 2017, noted appellant’s symptoms 

of neck pain bilaterally localized C4 to C7 radiation into the right arm with paraesthesia and 

weakness. He noted that range of motion was significantly limited in all planes and diagnosed 

cervical pain, cervical radiculopathy, spinal stenosis, cervical strain, and facet arthritis of the 

cervical region. In a work capacity evaluation (OWCP-5c) dated March 21, 2017 Dr. Valentino 

diagnosed cervical disc degeneration and noted that appellant reached maximum medical 

improvement and was totally disabled due to neck pain.

A cervical spine MRI scan dated May 2, 2017 revealed midline focal disc protrusions at 

C2-3 and C3-4, midline disc herniations at C4-5, central disc protrusions at C5-6, disc 

degeneration, and disc protrusion at C6-7 and C7-T1.

By decision dated June 14, 2017, an OWCP hearing representative affirmed the 

February 9, 2017 decision denying expansion of the claim.
7

LEGAL PRECEDENT

Where an employee claims that a condition not accepted or approved by OWCP was due 

to an employment injury, he or she bears the burden of proof to establish that the condition is 

causally related to the employment injury.8

Causal relationship is a medical issue that must be established by rationalized medical 

opinion evidence.9 Rationalized medical opinion evidence is medical evidence which includes a 

physician’s rationalized opinion on the issue of whether there is a 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.10 The weight of medical evidence is determined by its reliability, its 

probative value, its convincing quality, the care of analysis manifested, and the medical rationale 

expressed in support of the physician’s opinion.11

ANALYSIS

The Board finds that the medical evidence of record is insufficient to establish that 

appellant’s claim should be expanded to include a right shoulder condition causally related to the 

April 30, 2001 work injury. 

In a March 20, 2013 report, Dr. Valentino noted that appellant complained of right shoulder 

pain when she was treated on June 13, 2001. He noted a right shoulder MRI scan dated 

November 8, 2012 revealed a full-thickness supraspinatus tendon tear. Dr. Valentino opined that 

after reviewing records the etiology of her right shoulder injury along with the rotator cuff tear 

was apportioned to her work injury. He found no other etiology. Other reports from Dr. Valentino 

dated November 10, 2015 to June 7, 2016 noted treatment for neck pain localized at C4-7. He 

opined that appellant’s right shoulder symptoms related to her work injury. Dr. Valentino 

diagnosed cervical disc degeneration, cervical pain, neck pain, facet arthritis of the cervical region, 

cervical strain, and neck pain. Similarly, in a letter dated December 13, 2016, he noted that

appellant had shoulder problems since 2001 noting the pain never ceased and she continued to 

have difficulty using her right upper extremity. Dr. Valentino opined that her right rotator cuff 

tear was a direct result of her work-related injury as she was carrying mail with the mailbag on her 

right shoulder. The Board finds that, although he supported causal relationship, he did not provide 

medical rationale explaining the basis of his conclusory opinion regarding the causal relationship 

 

8

Jaja K. Asaramo, 55 ECAB 200 (2004).

9 Elizabeth H. Kramm (Leonard O. Kramm), 57 ECAB 117 (2005).

10 Leslie C. Moore, 52 ECAB 132 (2000).

11 Franklin D. Haislah, 52 ECAB 457 (2001) (medical reports not containing rationale on causal relationship are 

entitled to little probative value); Jimmie H. Duckett, 52 ECAB 332 (2001).
8

between appellant’s right shoulder condition and the April 30, 2001 work injury.

12

 That is, there 

is no medical explanation regarding how her letter carrier duties which include carrying mail on 

her right shoulder would have caused or aggravated these conditions. Thus, this evidence is

insufficient to meet appellant’s burden of proof. 

In his remaining reports, Dr. Valentino did not specifically address how a right shoulder 

condition was causally related to the accepted work injury of April 30, 2001. As the Board has 

held, 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.13 

Appellant was treated by Dr. Fried who likewise did not specifically address how a right 

rotator cuff strain and capsulitis of the shoulder or other nonaccepted conditions were due to the 

accepted work injury of April 30, 2001. Thus, these reports are of no probative value and are 

insufficient to establish that any additional conditions are employment related.

Dr. McKenzie, noted appellant’s duties included carrying a mailbag on her right shoulder, 

delivering mail, and casing mail with her right hand. He opined that her right shoulder condition 

was causally related to her accepted employment injury. However, Dr. McKenzie did not 

specifically explain the mechanism of how appellant’s letter carrier duties also resulted in a right 

shoulder injury causally related to her April 30, 2001 work injury. As such, his opinions are 

insufficient to establish appellant’s claim.14

OWCP referred appellant to Dr. Draper for a second opinion evaluation to determine 

whether appellant had residuals of her work injury and whether she sustained a right shoulder 

injury causally related to the April 30, 2001 work injury. In a September 26, 2014 report,

Dr. Draper diagnosed aggravation of preexisting degenerative cervical disc disease and right 

shoulder pain associated with cervical disc disease. He opined that appellant continued to have 

residuals of the work injury of April 30, 2001. Dr. Draper opined the right shoulder discomfort 

was related to the aggravated degenerative cervical disc disease, likely C5-6 levels. He opined 

that there was no evidence of a separate pathological injury involving the right shoulder which 

could be related to the April 30, 2001 work injury. Dr. Draper concluded that the right shoulder 

complaints were due to the aggravation of the cervical degenerative disc disease and not due to an 

injury to the right shoulder. He opined that appellant could work full-time light duty.

On appeal appellant asserts that OWCP improperly denied her request to expand the 

acceptance of her claim to include a right shoulder condition. She asserts that she submitted 

sufficient evidence to establish causal relationship between the work injury and the right shoulder 

condition. As found above, the evidence submitted did not provide medical rationale from a 

 

12 See T.M., Docket No. 08-0975 (issued February 6, 2009) (a medical report is of limited probative value on the 

issue of causal relationship if it contains a conclusion regarding causal relationship which is unsupported by medical 

rationale).

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

14 See C.F., Docket No. 18-0583 (issued October 16, 2018).
9

physician explaining the causal relationship between appellant’s right shoulder conditions and the 

factors of employment.15 

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 that her claim 

should be expanded to include a right shoulder condition causally related to the accepted April 30, 

2001 employment injury.

ORDER

IT IS HEREBY ORDERED THAT the June 14, 2017 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: January 7, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

 

15 See supra note 12.