United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.M., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Richmond, PA, Employer

__________________________________________

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Docket No. 18-1578

Issued: February 27, 2019

Appearances: Case Submitted on the Record

Michael D. Overman, Esq., for the appellant1

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 August 13, 2018 appellant, through counsel, filed a timely appeal from a February 21, 

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 February 21, 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 that his back 

condition was causally related to the accepted October 28, 2015 employment incident.

FACTUAL HISTORY

This case has previously been before the Board.4 The facts and circumstances as set forth 

in the Board’s prior decision are incorporated herein by reference. The relevant facts are as 

follows.

On October 30, 2015 appellant, then a 52-year-old letter carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on October 28, 2015 he was loading a cart while in the 

performance of duty and when he stood up he felt a sharp back pain. He stopped work on 

October 28, 2015.

By decision dated December 10, 2015, OWCP denied appellant’s claim. It found that the 

medical evidence submitted was insufficient to establish a medical diagnosis in connection with 

the accepted October 28, 2015 employment incident. OWCP also noted that he must also submit 

evidence to establish that the medically diagnosed condition was causally related to the accepted 

October 28, 2015 employment incident.

On December 17, 2015 appellant, through counsel, requested a hearing before an OWCP 

hearing representative. The hearing was held on March 3, 2016. 

By decision dated May 19, 2016, the hearing representative affirmed as modified OWCP’s 

December 10, 2015 decision. He found that the medical evidence then of record did not provide 

a rationalized medical opinion establishing causal relationship between the diagnosed condition 

and the accepted employment incident. 

On September 20, 2016 appellant, through counsel, requested reconsideration.

By decision dated November 30, 2016, OWCP denied modification.

On April 10, 2017 appellant, through counsel, appealed to the Board. By decision dated 

August 22, 2017,

5

the Board found that appellant had not met his burden of proof to establish a

back injury causally related to the accepted October 28, 2015 employment incident. The Board 

explained that the record did not contain a medical report with a rationalized medical opinion, 

based on a complete and accurate background, explaining how the accepted employment incident 

physiologically caused the diagnosed back condition. 

On November 28, 2017 appellant, through counsel, requested reconsideration and 

submitted additional medical evidence.

In a report dated November 9, 2017, Dr. Steven J. Valentino, a Board-certified orthopedic 

surgeon, diagnosed moderate degenerative disc disease with bulge, superimposed left 

 

4

J.M., Docket No. 17-1002 (issued August 22, 2017).

5

Id.
3

posterolateral disc protrusion with moderate facet and ligamentum flavum hypertrophy resulting 

in severe spinal stenosis as well as mild narrowing of the central portions of the neural foramen, 

at L3-4. He also found that appellant had mild-to-moderate degenerative changes with mild 

osteophyte disc complex asymmetric to the right with severe narrowing of the right neural foramen 

and a grade 1 subluxation at L4-5. Dr. Valentino noted that appellant’s increasing symptoms were 

related to the aggravation of the preexisting lumbar degenerative disc disease, spondylolisthesis, 

stenosis, and facet syndrome causally related to the October 28, 2015 employment incident. He 

indicated that torsional forces were well known to exacerbate underlying degenerative changes 

about the lumbar spine. 

In a report dated November 27, 2017, Dr. Valentino indicated that appellant’s torsional 

mechanism of injury was sufficient to cause an aggravation of the lumbar degenerative disc 

disease. He related that immediately prior to the October 28, 2015 employment incident, appellant 

was working full-time, full duty without ongoing back pain, and that the October 28, 2015 

employment incident was a significant contributing factor leading to the aggravation of 

degenerative disc disease, subsequent restrictions of work, and need for treatment.

By decision dated February 21, 2018, OWCP denied modification of the August 22, 2017

decision. It found that the medical evidence submitted indicated medical findings without 

providing a well-rationalized opinion as to how appellant’s accepted employment incident 

aggravated his condition. OWCP noted that appellant’s physician neither differentiated the effects 

of the work-related injury and his preexisting condition, nor provided an accurate history that 

matched appellant’s description of the work incident. 

LEGAL PRECEDENT

An employee seeking benefits under FECA6has 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.7 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.8

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 that must be considered conjunctively. First, the 

employee must submit sufficient evidence to establish that he actually experienced the 

employment incident that is alleged to have occurred.9 Second, the employee must submit 

 

6 Supra note 2.

7 S.S., Docket No. 17-1106 (issued June 5, 2018); Joe D. Cameron, 41 ECAB 153 (1989).

8 C.P., Docket No. 18-0665 (issued November 8, 2018); see Irene St. John, 50 ECAB 521 (1999); Michael E. 

Smith, 50 ECAB 313 (1999).

9

J.F., Docket No. 18-0904 (issued November 27, 2018); Gary J. Watling, 52 ECAB 278 (2001).
4

sufficient evidence, generally only in the form of medical evidence, to establish that the 

employment incident caused a personal injury.10

Causal relationship is a medical question that generally requires rationalized medical 

opinion evidence to resolve the issue.11 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.12

ANALYSIS

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

condition was causally related to the accepted October 28, 2015 employment incident.

Preliminarily, the Board notes that it is unnecessary for the Board to consider the evidence 

appellant submitted prior to the issuance of OWCP’s November 30, 2016 decision because the 

Board has already considered this evidence in its August 22, 2017 decision, and found that it was 

insufficient to establish his claim. Findings made in prior Board decisions are res judicata absent 

any further review by OWCP under section 8128 of FECA.13 The Board will, therefore, not review 

the evidence addressed in the prior appeal. 

Following the Board’s review of the case, appellant submitted November 9 and 27, 2017

reports from Dr. Valentino. In these reports, Dr. Valentino made multiple diagnoses with regard 

to appellant’s back condition. He opined that appellant’s conditions were related to his 

employment incident sustained on October 28, 2015, due to a torsional mechanism, and he also 

opined that the employment incident aggravated a preexisting injury. A conclusory statement 

regarding causal relationship is of limited probative value.14 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 is causally related to an employment incident.15

Dr. Valentino did not explain how appellant’s employment incident on October 28, 2015, 

caused his diagnosed conditions or contributed to or aggravated his preexisting conditions. The 

need for medical rationale is particularly important given that Dr. Valentino indicated that 

 

10 S.S., supra note 7; Deborah L. Beatty, 54 ECAB 340 (2003).

11 N.L., Docket No. 17-1823 (issued December 17, 2018). 

12 R.R., Docket No. 18-1093 (issued December 18, 2018); Solomon Polen, 51 ECAB 341 (2000).

13 S.S., supra note 7; see H.G., Docket No. 16-1191 (issued November 25, 2016).

14 See B.B., Docket No. 18-1036 (issued December 31, 2018). 

15 J.L., Docket No. 17-1460 (issued December 21, 2018); see Y.D., Docket No. 16-1896 (issued February 10, 2017) 

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

describing the relation between work factors and a diagnosed condition/disability).
5

appellant had a preexisting condition.16 In cases where a claimant has a preexisting condition, the 

physician must provide a rationalized medical opinion that differentiates between the effects of the 

work-related injury and the preexisting condition.17 Dr. Valentino did not sufficiently explain how 

appellant injured his back when he stood up after loading a cart on October 28, 2015 and how this 

activity altered or aggravated his preexisting condition.

18

 While he noted that immediately prior 

to the October 28, 2015, appellant was working full-time, full duty without ongoing back pain, and 

that the October 28, 2015 employment incident was a significant contributing factor leading to the 

aggravation of degenerative disc disease, a medical opinion that a condition is causally related to 

an employment injury because the employee was asymptomatic before the injury, but symptomatic 

after it is insufficient, without supporting rationale, to establish causal relationship.19

The Board finds that there is no medical evidence of record which contains a reasoned 

explanation of how the October 28, 2015 employment incident caused or aggravated appellant’s 

diagnosed conditions.20 Thus, appellant has not met his burden of proof.

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 and 20 C.F.R. 

§§ 10.605 through 10.607.

CONCLUSION

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

condition was causally related to the accepted October 28, 2015 employment incident.

 

16 K.R., Docket No. 18-1388 (issued January 9, 2019); see C.D., Docket No. 17-2011 (issued November 6, 2018).

17 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013).

18 See K.C., Docket No. 17-1693 (issued October 29, 2018).

19 K.R., supra note 16; E.D., Docket No. 16-1854 (issued March 3, 2017); Cleopatra McDougal-Saddler, 47 ECAB 

480 (1996).

20 J.L., supra note 15; see George Randolph Taylor, 6 ECAB 986, 988 (1954) (where the Board found that a medical 

opinion not fortified by medical rationale is of little probative value).
6

ORDER

IT IS HEREBY ORDERED THAT the February 21, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: February 27, 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