United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

G.R., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Kansas City, MO, Employer

__________________________________________

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Docket No. 18-0430

Issued: September 13, 2018

Appearances: Case Submitted on the Record

Stephanie N. Leet, 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 December 26, 2017 appellant, through counsel, filed a timely appeal from an August 8, 

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 this case.

ISSUE

The issue is whether appellant has met his burden of proof to establish the expansion of the

acceptance of his claim to include the additional conditions of aggravation of degenerative disc 

 

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

disease at L3-5 and L4-5, aggravation of mild facet arthropathy at L5-S1, radiculopathy, and 

sciatica as causally related to his accepted June 18, 2014 employment injury. 

FACTUAL HISTORY

On July 1, 2014 appellant, then a 48-year-old bulk mail dock clerk, filed a traumatic injury 

claim (Form CA-1) alleging that on June 18, 2014, while at work, he strained his lower back after 

lifting a trailer door. He stopped work and sought immediate medical treatment on the date of 

injury.

By development letter dated July 8, 2014, OWCP informed appellant that the evidence of 

record was insufficient to establish his traumatic injury claim. It advised him of the medical and 

factual evidence needed. OWCP afforded appellant 30 days to submit the necessary evidence. 

A June 18, 2014 emergency department discharge report reflected that appellant sought 

treatment with Dr. David Scheffler, a doctor of osteopathic medicine, who diagnosed sacroiliac 

inflammation.

In medical reports dated July 15 and September 16, 2014, Dr. Tiffany Williams, Boardcertified in physical medicine and rehabilitation, reported that appellant presented with complaints 

of left-sided low back pain which started on June 18, 2014 while at work. Appellant reported that 

on that date, he was opening a tractor trailer door when his back froze up. Dr. Williams noted that 

appellant was evaluated in July for acute onset of left-sided low back pain with radiation of pain 

into the left hip, buttock, and anterior thigh that started on June 18, 2014 while at work. A 

September 15, 2014 magnetic resonance imaging (MRI) scan revealed degenerative disc disease 

at L3-4 and L4-5, and mild facet arthropathy at L5-S1. Dr. Williams provided duty status reports 

(Form CA-17) dated July 15 and September 16, 2014 documenting work restrictions for a

diagnoses of low back pain and leg weakness.

By decision dated October 16, 2014, OWCP denied appellant’s claim finding that the 

evidence of record failed to establish that his diagnosed conditions were causally related to the 

accepted June 18, 2014 employment incident.

On November 12, 2014 appellant requested review of the written record before an OWCP 

hearing representative. 

In a September 16, 2014 diagnostic report, Dr. Ernest Madarang, a Board-certified 

diagnostic radiologist, reported that a lumbar spine MRI scan revealed no high-grade central spinal 

stenosis or foraminal narrowing, mild degenerative facet hypotrophy at L4-5 and L5-S1, and mild 

degenerative disc disease at L2-3.

In an October 20, 2014 report, Dr. Williams noted an acute onset of low back pain and 

radiation of pain in the left leg which started on June 18, 2014 while working. She related that 

appellant had some resolution of symptoms, but continued to experience pain. Dr. Williams also 

explained that appellant’s history, physical examination findings, and diagnostic studies revealed 

likely etiologies of axial low back pain, degenerative disc disease at L3-4 and L4-5, mild facet 

arthropathy at L5-S1, muscle strain in the lumbar region, and radicular like symptoms in the right 

lower extremity. She provided work restrictions. 
3

In a November 4, 2014 narrative report, Dr. Troy A. Burns, Board-certified in emergency 

medicine, reported that appellant had been under his care since 2004 and was last evaluated on 

June 23, 2014 following a June 18, 2014 work injury. Appellant experienced a sudden onset of 

severe left low back and hip pain when bending over to open a semi-trailer door. He was treated 

in the emergency department on that date and was subsequently referred to physical therapy. 

By decision dated April 21, 2015, an OWCP hearing representative affirmed the 

October 16, 2014 decision finding that the evidence of record failed to establish that his lumbar

injury was causally related to the accepted June 18, 2014 employment incident.

In medical reports dated November 17 and December 22, 2014, Dr. Williams diagnosed 

low back pain, left SI joint arthropathy, facet arthropathy at L4-5 and L5-S1, lumbar muscle strain, 

and spondylosis.

In an April 13, 2016 narrative report, Dr. Williams opined within a reasonable degree of 

medical certainty that appellant lifting the trailer door on June 18, 2014 aggravated the diagnoses 

of degenerative disc disease at L3-4 and L4-5 and mild facet arthropathy at L5-S1, causing 

radiculopathy and sciatica after the injury. She further reported that this incident also caused a 

lumbar strain. Dr. Williams noted that although the September 15, 2014 lumbar MRI scan showed 

a degenerative condition, appellant was asymptomatic prior to the June 18, 2014 injury, leading

her to the conclusion that the injury aggravated the above diagnoses.

By decision dated July 6, 2016, OWCP accepted the claim for lumbar strain. 

By decision dated July 6, 2016, OWCP vacated in part and affirmed in part the April 21, 

2015 decision. It found that appellant had established a causal relationship between the June 18, 

2014 employment incident and the diagnosis of lumbar strain. However, appellant failed to 

establish causal relationship for the diagnoses of aggravation of degenerative disc disease at L3-4 

and L4-5, aggravation of mild facet arthropathy at L5-S1, radiculopathy, and sciatica.3 

On June 30, 2017 appellant, through counsel, requested reconsideration of the July 6, 2016 

OWCP decision denying his claim for additional lumbar conditions. Counsel reported that the 

claim should be expanded to include the additional conditions of degenerative disc disease at L3-4 

and L4-5, mild facet atrophy at L5-S1, lumbar strain, radiculopathy, and sciatica as evidenced by 

the medical reports of Dr. Williams and Dr. John W. Ellis, Board-certified in family medicine.

In a June 29, 2017 medical report, Dr. Ellis described the June 18, 2014 employment 

incident when appellant was lifting a trailer door at work and felt sudden pain in his low back. He

noted that appellant experienced right low back pain approximately six years prior. Appellant was 

treated with epidural injections and physical therapy and was subsequently asymptomatic two 

months later. Dr. Ellis reported that he continued working heavy manual labor of opening and 

shutting the mail door and a lot of bending and lifting without difficulty until the acute June 18, 

2014 injury. He provided physical examination findings, a review of diagnostic testing, and

 

3

In another July 6, 2016 decision, OWCP determined that appellant was not entitled to continuation of pay during 

his absence from work for the period June 19 through August 2, 2014. This issue is not before the Board on the 

present appeal. 
4

diagnosed sprain of ligament lumbar spine, muscle tendon unit strain of left back, and strain of left 

iliolumbar ligament. 

Dr. Ellis opined that appellant’s conditions and disability set forth in his findings arose out 

of and in the course of appellant’s employment, and that employment factors and work duties 

contributed to, aggravated, and/or caused his injuries. He explained that the lifting of the trailer 

door caused a sudden increase of straining forces on the left iliolumbar and sacroiliac ligaments,

resulting in the need for emergency medical treatment. Dr. Ellis reported that the increased 

pressure from the tight muscles in appellant’s back from the injury to the sacroiliac ligaments and 

lumbar ligaments caused impingement of the left L5 and S1 spinal nerves. He noted that this was 

very minor and there was no evidence of a herniated disc on physical examination or the MRI scan 

study. Dr. Ellis noted that appellant injured his right low back about six years prior which was 

indicative of a ligamentous injury. He opined that this was caused from his work of lifting doors 

at the employing establishment and that appellant had been asymptomatic until the sudden injury 

on the other side of his low back on June 18, 2014. Dr. Ellis noted that because appellant was able 

to recover from the injury six years prior, it was indicative of a grade 1 strain whereas the June 18, 

2014 injury was a grade 2 or 3 strain on the muscles, ligaments, and fibers in his left low back. He 

reported that a grade 2 or 3 strain would result in the fibers being torn apart while a grade 1 strain 

results in the fibers stretching.

In a July 3, 2017 note, Dr. Ellis reported that, if OWCP declined to accept appellant’s claim 

for an obvious acute injury, he should consider filing an occupational disease claim (Form CA-2).

By decision dated August 8, 2017, OWCP affirmed the July 6, 2016 decision finding that 

the medical evidence of record failed to establish causal relationship between the accepted June 18, 

2014 employment injury and the additional conditions of aggravated degenerative disc disease at 

L3-4 and L4-5, aggravated mild facet atrophy at L5-S1, radiculopathy, and sciatica.

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 

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 are causally related to the 

employment injury.5 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.6

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

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

 

4 Supra note 2.

5 Gary J. Watling, 52 ECAB 278 (2001); Elaine Pendleton, 40 ECAB 1143, 1154 (1989).

6 Michael E. Smith, 50 ECAB 313 (1999).
5

medical opinion evidence supporting such causal relationship.7 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. This medical opinion must include an accurate history of the employee’s 

employment injury and must explain how the condition is related to the injury. 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.8

ANALYSIS

The Board finds that appellant did not submit sufficient medical evidence to support the 

expansion of his claim to include the additional conditions of aggravated degenerative disc disease 

at L3-4 and L4-5, aggravated mild facet atrophy at L5-S1, radiculopathy, and sciatica were 

causally related to the accepted June 18, 2014 employment injury.

9

 

On the date of injury, appellant sought emergency medical treatment for complaints of low 

back pain. While the emergency department discharge notes reflect immediate treatment for his

lumbar injury, the diagnosis provided was sacroiliac inflammation. This diagnosis is not at issue 

in this appeal.

In medical reports dated July 15, 2014 through April 13, 2016, Dr. Williams described the 

June 18, 2014 employment incident when appellant was lifting a trailer door and experienced low 

back pain. In an April 13, 2016 narrative report, she opined within a reasonable degree of medical 

certainty that lifting the trailer door on June 18, 2014 aggravated the diagnoses of degenerative 

disc disease at L3-4 and L4-5 and mild facet arthropathy at L5-S1, causing radiculopathy and 

sciatica following the injury. Dr. Williams further reported that this incident also caused a lumbar 

strain. The Board finds that the opinion of Dr. Williams is not well rationalized. While she opined 

that the diagnosed conditions were caused by the June 18, 2014 employment incident,

Dr. Williams failed to provide a sufficient explanation as to the mechanism of injury, namely, how 

lifting a trailer door would cause or aggravate appellant’s degenerative lumbar conditions.

10

 She

explained that, although the September 15, 2014 lumbar MRI scan showed a degenerative 

condition, appellant was asymptomatic prior to the June 18, 2014 employment injury, leading her 

to conclude that the injury aggravated the above diagnoses. The Board has held that an opinion 

that a condition is causally related because the employee was asymptomatic before the injury is 

insufficient, without adequate rationale, to establish causal relationship.11 As noted by

Dr. Williams, the September 15, 2015 lumbar spine MRI scan revealed preexisting degenerative 

 

7 See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983).

8

James Mack, 43 ECAB 321 (1991).

9 See Robert Broome, 55 ECAB 339 (2004).

10 S.W., Docket 08-2538 (issued May 21, 2009).

11 M.R., Docket No. 14-0011 (issued August 27, 2014).
6

conditions. However, she failed to discuss appellant’s medical history, did not address why his 

complaints were not caused by his preexisting degenerative condition, or discuss whether his 

preexisting injury had progressed beyond what might be expected from the natural progression of 

that condition.12 As it is unclear if appellant’s injury was caused by the June 18, 2014 employment 

incident, a result of a preexisting condition, or due to degenerative changes, a well-rationalized 

opinion is particularly warranted when there is a history of a preexisting condition.13 Without 

explaining how physiologically the movements involved in the June 18, 2014 employment 

incident caused or contributed to the diagnosed conditions, Dr. Williams’ opinion is equivocal in 

nature and of limited probative value.14 

The Board further finds that Dr. Ellis’ June 29, 2017 report fails to establish that appellant’s 

alleged additional lumbar conditions are causally related to the accepted employment injury. 

Dr. Ellis diagnosed sprain of ligament lumbar spine, muscle tendon unit strain of left back, and 

strain of left iliolumbar ligament. He opined that appellant’s conditions set forth in his diagnosis 

findings arose out of and in the course of appellant’s employment, and that employment factors 

and work duties contributed to, aggravated, and/or caused his conditions. The Board notes that

Dr. Ellis’ opinion pertaining to causation and the mechanism of injury relates to the diagnosed 

conditions of lumbar and ligament sprain. As noted above, OWCP already accepted the claim for 

lumbar sprain. However, Dr. Ellis failed to provide a rationalized opinion pertaining to causal 

relationship for the additional conditions of aggravated degenerative disc disease at L3-4 and L4-5, 

aggravated mild facet atrophy at L5-S1, radiculopathy, and sciatica. 

Dr. Ellis reported that the increased pressure from the tight muscles in his back due to 

injury to the sacroiliac ligaments and lumbar ligaments caused impingement of the left L5 and S1 

spinal nerves. However, as he reported this to be very minor with no evidence of herniated disc 

on physical examination or MRI scan, it is unclear what objective evidence exists to indicate that 

the preexisting degenerative conditions were caused or aggravated by the June 18, 2014 

employment incident. It appears that the physician can only relate causal relationship of the 

preexisting degenerative conditions through subjective means based on the longevity of appellant’s 

symptoms. Dr. Ellis failed to identify objective evidence via clinical studies and examination 

findings to provide support for the additional lumbar conditions. He further failed to discuss 

whether appellant’s preexisting injuries had progressed beyond what might be expected from the 

natural progression of that condition.15 As Dr. Ellis failed to provide a fully-rationalized opinion 

causally relating appellant’s degenerative lumbar injuries to the accepted June 18, 2014 

employment injury, his medical report fails to establish additional work-related injuries.16 

 

12 R.E., Docket No. 14-0868 (issued September 24, 2014).

13 T.M., Docket No. 08-0975 (issued February 6, 2009); Michael S. Mina, 57 ECAB 379 (2006).

14 See L.M., Docket No. 14-0973 (issued August 25, 2014); R.G., Docket No. 14-0113 (issued April 25, 2014); 

K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-0548 (issued November 16, 2012).

15 Supra note 12.

16 S.R., Docket No. 12-1098 (issued September 19, 2012).
7

The remaining medical evidence of record is also insufficient to establish appellant’s claim. 

Dr. Burns’ November 4, 2014 report noted the onset of severe left low back and hip pain following 

the June 18, 2014 employment incident when bending over to open a semi-trailer door. The Board 

has consistently held that pain is a symptom, rather than a compensable medical diagnosis.17 As

Dr. Burns is attributing appellant’s symptoms to his employment duties rather than the diagnosed 

medical conditions, his opinion on causal relationship is of limited probative value.18

Dr. Madarang’s September 16, 2014 report is also insufficient to establish appellant’s 

claim as he merely interpreted diagnostic studies and provided no opinion on the cause of 

appellant’s claimed conditions. The Board has held that medical evidence that does not offer any 

opinion regarding the cause of an employee’s condition is of limited probative value.19 Any 

medical opinion evidence appellant may submit to support his claim should reflect a correct history 

and offer a medically sound explanation by the physician of how the specific employment incident, 

in particular physiologically, caused or aggravated the claimed conditions.20

On appeal counsel for appellant argues that the medical reports establish that appellant’s 

claim should be accepted for additional diagnosed conditions. An award of compensation may not 

be based on surmise, conjecture, speculation, or on the employee’s own belief of causal relation.21 

Appellant’s honest belief that his accepted employment incident aggravated his degenerative

lumbar conditions, however sincerely held, does not constitute the medical evidence necessary to 

establish causal relationship.22 The Board finds that the record lacks rationalized medical evidence 

establishing causal relationship between the accepted June 18, 2014 employment injury and the 

additional conditions of aggravated degenerative disc disease at L3-4 and L4-5, aggravated mild 

facet atrophy at L5-S1, radiculopathy, and sciatica. 

Appellant may submit additional 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 did not meet his burden of proof to establish the expansion 

of the acceptance of his claim to include the additional conditions of aggravated degenerative disc 

disease at L3-4 and L4-5, aggravated mild facet atrophy at L5-S1, radiculopathy, and sciatica as 

causally related to the accepted June 18, 2014 employment injury. 

 

17 C.F., Docket No. 08-1102 (issued October 10, 2008).

18 Supra note 12.

19 S.E., Docket No. 08-2214 (issued May 6, 2009); C.B., Docket No. 09-2027 (issued May 12, 2010).

20 Supra note 8.

21 D.D., 57 ECAB 734 (2006).

22 See J.S., Docket No. 17-0967 (issued August 23, 2017).
8

ORDER

IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’

decision dated August 8, 2017 is affirmed.

Issued: September 13, 2018

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