United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.M., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Jamaica Plain, MA, Employer

__________________________________________

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Docket No. 18-0847

Issued: December 5, 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 March 13, 2018 appellant filed a timely appeal from a November 2, 2017 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 the case.2

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following the November 2, 2017 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 

evidence for the first time on appeal. Id. 
2

ISSUE

The issue is whether appellant met his burden of proof to establish a recurrence of disability 

commencing January 21, 2017 causally related to the accepted February 17, 2014 employment 

injury.

FACTUAL HISTORY

On March 17, 2014 appellant, then a 46-year-old mail city carrier, filed an occupational 

disease claim (Form CA-2) alleging that he developed neck pain, and shoulder and arm numbness 

due to factors of his federal employment including repetitively carrying a mail satchel on his 

shoulder. He noted that he first became aware of his condition and realized it was causally related 

to his employment on February 17, 2014. After initially denying the claim, by decision dated

May 1, 2015, OWCP accepted the conditions of aggravation of degenerative disc disease/disc 

herniation at C5-6 level and aggravation of diffuse cervical spondylosis. 

Appellant had a prior work injury which had resulted in a sustained period of total 

disability. On January 13, 2015 he sustained a work-related right knee injury which was accepted 

by OWCP for effusion of joint and a right lower leg and right medial meniscus tear, in a claim in 

which OWCP assigned File No. xxxxx2884. On May 8, 2015 appellant had right knee 

arthroscopic surgery. He received continuation of pay from February 2 to March 18, 2015 and 

OWCP paid him compensation for total disability from March 19, 2015 to January 6, 2017. 

Appellant returned to a part-time limited-duty position on January 7, 2017 and OWCP paid him 

compensation working partial shifts through January 20, 2017. No claim for disability under File 

No. xxxxx2884 was requested beyond January 20, 2017.

Appellant submitted wage-loss compensation claims (Form CA-7) for partial disability for 

January 21, 24, and 25, 2017 and total disability commencing January 26, 2017.

In a duty status report (Form CA-17) dated January 25, 2017, Dr. Francis X. Rocket, a 

Board-certified neurologist, noted clinical findings of a marked restriction of range of motion of 

appellant’s cervical spine. He noted that appellant could not perform his regular work duties, but 

could work: subject to lifting and carrying continuously up to 15 pounds and 20 pounds 

intermittently for four hours a day; intermittent sitting and standing for six hours a day; walking 

for six hours a day; no climbing, intermittent kneeling for one hour a day; intermittent 

bending/stooping for two hours a day; no twisting, pushing, or pulling intermittently for two hours 

a day; intermittent simple grasping for eight hours a day; intermittent fine manipulation for six

hours a day; and driving for one hour a day.

On February 15, 2017 Dr. Michael W. Groff, a Board-certified neurosurgeon, treated 

appellant in follow-up for cervical spondylitic myelopathy. He noted that appellant reported 

dropping items and some bowel urgency. Dr. Groff noted an electromyogram (EMG) revealed C6 

and C7 denervation. He indicated that appellant returned to work for three hours per day with 

restrictions of lifting limited to 15 pounds. 

On March 8, 2017 the employing establishment offered appellant a light-duty position as

a city carrier effective March 8, 2017. The duties of the modified assignment were handling 
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unendorsed bulk business mail, picking up and delivering express mail, answering the telephone,

and “loop mail.” The physical requirements of the offered position were standing up to two hours

a day, walking up to one hour a day, lifting up to 15 pounds for three hours a day, and reaching 

above the shoulder for two hours a day. 

On March 10, 2017 appellant refused to accept the offered position noting that he was not 

medically cleared under File No. xxxxxx2884 pursuant to the Form CA-17 dated January 25, 2017. 

He further noted that the Social Security Administration had deemed him unemployable. 

In a March 26, 2017 letter, OWCP acknowledged receipt of appellant’s claim for ongoing 

wage-loss compensation for the period commencing January 26, 2017 due to a material 

change/worsening of his accepted employment injury. It indicated that his claim would be 

developed as a recurrence of disability and requested that he submit additional factual and medical 

evidence necessary to establish his claim.

On November 15, 2016 Dr. Jeffrey L. Zilberfarb, a Board-certified orthopedist, treated 

appellant for bilateral shoulder pain, radicular neck pain, and a C5-6 disc herniation which he 

attributed to an injury sustained while at work. He diagnosed spondylosis without myelopathy of 

the cervical region and impingement syndrome of both shoulders.

On April 11, 2017 Dr. Zilberfarb treated appellant for right knee pain and bilateral shoulder 

rotator cuff tendinitis. He noted that appellant remained off work as a mail carrier. Dr. Zilberfarb 

advised that his C5-6 right disc herniation was being treated conservatively. Findings on 

examination revealed mildly positive impingement sign bilaterally. Dr. Zilberfarb diagnosed older 

cervical disc degeneration, mid-cervical region, impingement syndrome of the right shoulder, and 

primary osteoarthritis of the right knee. Appellant requested to remain off work on disability. 

Dr. Zilberfarb opined that appellant was unable to return to work as a mail carrier on a permanent 

basis due to his cervical spine disc herniation and right knee osteoarthritis. Appellant underwent 

physical therapy from November 18, 2016 to March 17, 2017.

An April 11, 2017 right knee x-ray scan revealed mild narrowing of the medial tibiofemoral 

compartment.

Appellant submitted wage-loss compensation claims (Form CA-7) for total disability for 

the period March 4 to 17, 2017. 

In a statement dated March 26, 2017, appellant indicated that he had sustained a right knee 

injury on January 13, 2015, File No. xxxxx2884, and underwent arthroscopic surgery on 

May 8, 2015. He noted that he had received compensation under File No. xxxxx2884 when he 

returned to work for three weeks in January 2017. 

Appellant saw Dr. Rocket on January 25, 2017 who prepared a duty status report (Form 

CA-17) noting that he was not permitted to twist or reach above the shoulder.

In a letter dated April 19, 2017, the employing establishment indicated that appellant was 

cleared for limited-duty work on both claims, File No. xxxxx2884 for his knee and File No.
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xxxxx8884 for his cervical condition pursuant to the duty status report (Form CA-17) dated 

January 25, 2017. Appellant was offered a modified-duty assignment which he refused noting 

“Not medically cleared claim # xxxx8884 per CA 17.” Appellant’s supervisor modified the 

original job offer to exclude reaching above the shoulder and appellant refused the position stating 

“I don’t believe I can perform these duties with my medical restrictions without aggravating my 

condition.” The supervisor requested that OWCP review the job offer to determine whether the 

offer was consistent with appellant’s restrictions.

By decision dated May 3, 2017, OWCP denied appellant’s claim for a recurrence of 

disability commencing January 21, 2017. It found that the evidence of record did not establish

that he was disabled due to a material change or worsening of his accepted work-related condition. 

Appellant submitted a job offer dated March 16, 2017 under File No. xxxxx2884, for a 

modified city carrier position effective March 16, 2017. On March 30, 2017 he declined the 

position and noted that he did not believe he could perform the duties within his medical 

restrictions without aggravating his condition. 

Appellant submitted additional wage-loss compensation claims (Form CA-7) for total 

disability for the periods April 15 to May 12, 2017 and May 27 to June 9, 2017.

On May 9, 2017 appellant requested an oral hearing before an OWCP hearing 

representative which was held on September 29, 2017. In a statement dated May 8, 2017, he noted 

that he had been out of work for several years and noted his symptoms in his two claim files. 

On August 15, 2017 Dr. Zilberfarb diagnosed right knee osteoarthritis and left knee pain. 

Radiographs of both knees revealed mild degenerative changes. 

On August 15, 2017 appellant underwent an x-ray of the left knee which revealed arthritic 

narrowing of weight bearing cartilages of medial and lateral joint compartments with mild joint 

effusion.

On September 11, 2017 Dr. Rocket treated appellant for right-sided neck pain radiating 

down the right arm with numbness affecting the fingers on the right hand. He diagnosed C4-5 and 

C5-6 herniated discs and degenerative changes of the spine. Findings on examination revealed 

limited range of motion of the neck, atrophy of the right thigh and calf, and absent deep tendon 

reflexes in the right upper extremity. Dr. Rocket opined that appellant was unable to bear weight 

on his shoulders without worsening neck pain bilaterally, he could not perform twisting 

movements with his head and neck, he could not work overhead, and could not push or pull more 

than 50 pounds at a time. He indicated that appellant was capable of sedentary work. 

On October 4, 2017 Dr. Rocket noted that appellant was off work due to bilateral neck pain 

from January 2015 to February 7, 2017. Appellant reported returning to work for three hours per

day which included bending, lifting, and twisting. He indicated, however, that he was unable to 

continue to work after three weeks and has been out of work since this time. Dr. Rocket advised 

that the symptoms that occurred while appellant attempted to return to work were related to his 

previous work-related injuries caused by repetitive lifting of a mail carrier bag. He diagnosed 
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foraminal compression due to osteophyte and disc disease at C4-5 and C5-6. Appellant reported 

being unable to continue to work because of progression and worsening of his symptoms. 

By decision dated November 2, 2017, an OWCP hearing representative affirmed the 

decision dated May 3, 2017. 

LEGAL PRECEDENT

A recurrence of disability means an inability to work after an employee has returned to 

work, caused by a spontaneous change in a medical condition which has resulted from a previous 

injury or illness without an intervening injury or new exposure to the work environment that caused 

the illness.3 This term also means an inability to work that takes place when a light-duty 

assignment made specifically to accommodate an employee’s physical limitations due to her workrelated injury or illness is withdrawn (except when such withdrawal occurs for reasons of 

misconduct, nonperformance of job duties, or a reduction-in-force) or when the physical 

requirements of such an assignment are altered so that they exceed the established physical 

limitations.4

When an employee who is disabled from the job he or she held when injured on account 

of employment-related residuals returns to a limited-duty position or the medical evidence of 

record establishes that he or she can perform the limited-duty position, the employee has the burden 

of proof to establish by the weight of the reliable, probative, and substantial evidence a recurrence 

of total disability and to show that he or she cannot perform such limited-duty work. As part of 

this burden, the employee must show a change in the nature and extent of the injury-related 

condition or a change in the nature and extent of the limited-duty job requirements.5 This burden 

includes the necessity of furnishing evidence from a qualified physician who concludes, on the 

basis of a complete and accurate factual and medical history, that the disabling condition is causally 

related to the employment injury. The medical evidence must demonstrate that the claimed 

recurrence was caused, precipitated, accelerated, or aggravated by the accepted injury.6

To establish causal relationship between the condition, as well as any attendant disability 

claimed and the employment event or incident, the employee must submit rationalized medical 

opinion evidence supporting such causal relationship.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 

 

3 20 C.F.R. § 10.5(x); S.W., Docket No. 18-1489 (issued June 25, 2019).

4

Id.

5

J.B., Docket Nos. 18-1752, 19-0792 (issued May 6, 2019).

6 L.F., Docket No. 14-1817 (issued February 2, 2015); Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal 

Relationship, Chapter 2.805.2 (January 2013).

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J.L., Docket No. 18-0698 (issued November 5, 2018); I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 

465 (2005).

8 L.D., Docket No. 17-1581 (issued January 23, 2018); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).
6

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

ANALYSIS

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

disability commencing January 21, 2017 causally related to the accepted February 17, 2014 

employment injury.

In a duty status report (Form CA-17) dated January 25, 2017, Dr. Rocket noted clinical 

findings of marked restriction of range of motion of the cervical spine. He noted that appellant 

could not perform his regular work duties, but could work subject to restrictions. Similarly, on 

September 11, 2017 Dr. Rocket noted that appellant presented with right-sided neck pain radiating 

down the right arm with numbness affecting the fingers on the right hand. He diagnosed C4-5 and 

C5-6 herniated discs and degenerative changes of the spine. Dr. Rocket opined that appellant was 

unable to bear weight on his shoulders without worsening neck pain bilaterally, he could not 

perform twisting movements with his head and neck, he could not work overhead, or push and pull 

more than 50 pounds at a time, and was only capable of sedentary work. Likewise, on October 4, 

2017, he diagnosed foraminal compression due to osteophyte and disc disease at C4-5 and C5-6. 

Dr. Rocket noted that appellant was out of work due to bilateral neck pain from January 2015 to 

February 7, 2017. Appellant returned to work for three hours a day in January 2017 and his work 

involved bending, lifting, and twisting, but he was unable to continue this job after three weeks 

and has claimed total disability thereafter. Dr. Rocket advised that the symptoms that occurred 

while appellant attempted to return to work were related to his previous work-related injuries 

caused by repetitive lifting of mail carrier bags. Although Dr. Rocket noted that appellant 

experienced bilateral neck pain and was off work due to disc disease at C4-5 and C5-6, he failed 

to provide medical reasoning to explain why the current condition or disability was causally related 

to the employment injury of February 19, 2014. Such rationale is particularly important as 

appellant stopped work on February 2, 2015 due to an unrelated right knee condition, underwent 

right knee arthroscopic surgery on May 1, 2015, and returned in January 2017 for three weeks part 

time with restrictions due to his right knee condition. Dr. Rocket failed to provide an explanation 

as to how carrying a mail satchel two years earlier would cause or contribute to his current cervical 

spine symptoms and disability beginning January 21, 2017, especially in light of his prior period 

of disability. The Board has found that vague and unrationalized medical opinions on causal 

relationship have little probative value.10 

On February 15, 2017 Dr. Groff treated appellant in follow-up for cervical spondylitic 

myelopathy. Appellant reported difficulty dropping items and some bowel urgency. Dr. Groff 

noted appellant returned to work three hours a day with lifting limited to 15 pounds and believed 

this work schedule was suitable. Dr. Groff failed to provide a rationalized opinion explaining the 

 

9 L.D., id.; see also Leslie C. Moore, 52 ECAB 132 (2000); Gary L. Fowler, 45 ECAB 365 (1994).

10 See Jimmie H. Duckett, 52 ECAB 332 (2001).
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reasons why the claimed recurrent disability and need for part-time work was causally related to 

the accepted employment injury of February 19, 2014.

11

 

In reports dated April 11 and August 15, 2017, Dr. Zilberfarb treated appellant for right 

knee pain and bilateral shoulder rotator cuff tendinitis. He noted that appellant remained out of 

work as a mail carrier. Dr. Zilberfarb diagnosed older cervical disc degeneration, mid-cervical 

region, impingement syndrome of the right shoulder, and primary osteoarthritis of the right knee.

He noted that appellant would like to remain out of work on disability and he agreed that he would 

not be able to go back to work as a mail carrier on a permanent basis due to his neck disc herniation 

and right knee osteoarthritis. However, Dr. Zilberfarb did not specifically address whether 

appellant had a recurrence of disability on January 21, 2017 causally related to the accepted

employment conditions or otherwise provide medical reasoning explaining why any current

condition or disability was due to the accepted February 19, 2014 injury.12 There was no 

explanation as to how carrying a mail satchel two years prior would continue to be contributory to 

the progression of his cervical spine conditions warranting disability in 2017. There is no evidence 

that appellant’s recurrent disability was due to the accepted February 19, 2014 employment injury.

Appellant also submitted diagnostic test results into the record of the case. However, the 

Board has held that reports of diagnostic tests lack probative value as they fail to provide an 

opinion on the causal relationship between his employment duties and the diagnosed conditions.13 

Appellant also submitted reports from a physical therapist dated March 22 to 

May 19, 2017. The Board has held that treatment notes signed by a physical therapist14 are not 

considered medical evidence as these providers are not a physician under FECA15 and are not 

competent to render a medical opinion under FECA. Thus, this evidence is insufficient to meet 

appellant’s burden of proof. 

On appeal appellant asserts that on January 25, 2017 Dr. Rockett advised that he could not 

work three hours a day due to his medical restrictions. He asserts that he was entitled to receive 

compensation during this time because he was disabled due to his accepted work-related condition.

However, as noted above, the medical evidence submitted does not contain a rationalized medical

 

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

entitled to little probative value). 

12 Id. 

13 K.S., Docket No. 18-1781 (issued April 8, 2019); G.S., Docket No. 18-1696 (issued March 26, 2019); J.M., 

Docket No. 17-1688 (issued December 13, 2018).

14 See S.E., Docket No. 08-2214 (issued May 6, 2009) (reports of a physician assistant have no probative value as 

medical evidence).

15 See V.G., Docket No. 19-0908 (issued October 25, 2019) (physical therapists are not considered physicians as 

defined under FECA and their reports are of no probative value); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006) 

(lay individuals such as physician assistants, nurses and physical therapists are not competent to render a medical 

opinion under the FECA); 5 U.S.C. § 8101(2) (this subsection defines a “physician” as surgeons, podiatrists, dentists, 

clinical psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as 

defined by State law).
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opinion explaining how and why appellant’s claimed recurrent condition or recurrence of 

disability on January 21, 2017 was due to the February 19, 2014 employment injury. As such, the 

Board finds that she has not met her 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(a) 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 a recurrence of 

disability commencing January 21, 2017 causally related to the accepted February 17, 2014 

employment injury. 

ORDER

IT IS HEREBY ORDERED THAT the November 2, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: December 5, 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