United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.T., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Brooklyn, NY, Employer

__________________________________________

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Docket No. 18-0581

Issued: October 3, 2018

Appearances: Case Submitted on the Record

Alan J. Shapiro, 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

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On January 25, 2018 appellant, through counsel, filed a timely appeal from a November 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 this 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 his burden of proof to establish a lumbar condition 

causally related to the accepted October 15, 2014 employment incident. 

FACTUAL HISTORY

On October 17, 2014 appellant, then a 42-year-old letter carrier, filed a traumatic injury 

claim (Form CA-1) alleging that, while at work on October 15, 2014, he sustained a back injury 

when lifting a caster and felt pain in his lower back and legs. He notified his supervisor, stopped 

work, and received initial medical care on the date of injury. In support of his claim, appellant

submitted Brooklyn Hospital Center discharge instructions documenting treatment on 

October 15, 2014.

In an October 27, 2014 attending physician’s report (Form CA-20), Dr. Alexandre 

De Moura, a Board-certified orthopedic surgeon, reported that appellant experienced low back and 

neck pain after lifting a heavy object on October 15, 2014. He diagnosed low back pain, lumbar 

radiculitis, and cervicalgia. Dr. De Moura checked the box marked “yes” to indicate that the 

condition was caused or aggravated by the employment activity, noting that appellant’s history, 

clinical examination, and symptoms were consistent with the employment incident described. 

By development letter dated November 6, 2014, OWCP informed appellant that the 

evidence of record was insufficient to establish his traumatic injury claim. Appellant was advised 

of the type of medical and factual evidence needed to establish his claim and was provided a

questionnaire for completion. OWCP afforded him 30 days to submit the necessary evidence.

In an October 23, 2014 medical report, Dr. De Moura reported that appellant sustained an 

employment injury on October 15, 2014 when he was lifting a heavy object which “jerked him,”

causing him to develop symptomology. He provided findings on physical examination, 

recommended physical therapy, and restricted appellant from returning to work. 

In a November 6, 2014 medical report, Dr. Joseph Cardinale, Board-certified in pain 

medicine, reported that appellant’s injury occurred on October 15, 2014 while at work as a letter 

carrier when he was lifting casters of mail. He reported no preexisting conditions or pertinent past 

medical history. Dr. Cardinale diagnosed lumbago, lumbar herniated nucleus pulposus, lumbar 

radiculopathy, and cervicalgia, restricting appellant from returning to work. He explained that the 

incident described by appellant was the competent medical cause of the injury, his complaints were 

“consistent with the injury, and the history of injury was consistent with his objective findings.” 

In a December 3, 2014 medical report, Dr. Andrew Tarleton, a Board-certified orthopedic 

surgeon, reported that appellant was injured on October 15, 2014 while working as a letter carrier 

when he was lifting a caster and felt a pinch on his right side and felt pain and nausea. Appellant 

complained of pain in the neck, lower back, and legs. He reported that Dr. Cardinale had ordered 

magnetic resonance imaging (MRI) scans which were not yet completed. Dr. Tarleton noted that 

appellant had MRI scans of the lumbar and cervical spine from 2009. The 2009 cervical spine 

study showed diffuse hydration loss and posterior disc bulges impressing on the thecal sac from 

C2-3 through C6-7. Dr. Tarleton reported that the lumbar spine MRI scan revealed multilevel disc 
3

issues as well. He stated that appellant was not working and this problem had been present for 

two months. Dr. Tarleton also noted that he had this problem before, having started in May 2009. 

He reviewed x-rays of the cervical and lumbar spine and provided findings on physical 

examination. Dr. Tarleton diagnosed lumbago, lumbar herniated nucleus pulposus, lumbar

radiculopathy, and cervicalgia. 

By decision dated December 9, 2014, OWCP denied appellant’s claim, finding that the 

evidence of record was insufficient to establish that the October 15, 2014 employment incident 

occurred as alleged. It noted that he failed to respond to the questionnaire that was sent with the 

November 6, 2014 development letter.

On December 30, 2014 appellant requested an oral hearing before an OWCP hearing 

representative. 

In a December 7, 2014 diagnostic report, Dr. Linda Harkavy, a Board-certified radiologist, 

reported that a lumbar spine MRI scan revealed L2-3 mild disc bulging and minimal osteophyte 

with encroachment upon the thecal sac and the right lateral recess, L4-5 disc degeneration with a 

shallow desiccated disc herniation with encroachment upon the thecal sac and mild recess 

narrowing, and L5-S1 disc degeneration with a small desiccated disc herniation favoring the left 

with narrowing of the left lateral recess and neural foramen with mild encroachment upon both 

foraminal nerve roots.

In medical reports dated December 10, 2014 to April 29, 2015, Dr. Tarleton noted 

appellant’s complaints of back and leg pain and provided findings on physical examination. He 

reported that a lumbar MRI scan revealed L2-3 mild disc bulging and disc degeneration at L4-5 

and L5-S1. Appellant was not yet approved for a cervical spine MRI scan. Dr. Tarleton diagnosed 

lumbago, lumbar herniated nucleus pulposus, lumbar radiculopathy, and cervicalgia. He opined 

that with regard to workers’ compensation, lifting a caster could certainly hurt the lower back and 

lead to disc disease, muscle issues, or an exacerbation of any underlying condition in the lumbar 

spine that could result in persistent pain, especially if the caster is overweight. A December 10, 

2014 Form CA-20 was also submitted.

A hearing was held on April 16, 2015, during which appellant testified in support of his 

claim. He reported that he was taken to the hospital via ambulance immediately following his 

injury. Appellant submitted a safety hazard report explaining that the canisters they were required 

to lift were past the required weight limits. He further reported that he had a lifting injury six years 

prior, but it was nothing like what had occurred after this work injury. Appellant also reported 

that he was in a car accident seven years prior which resulted in one week of missed work and 

temporary light duty. In support of his claim, appellant submitted witness statements from 

coworkers attesting to the circumstances surrounding the October 15, 2014 incident. 

By decision dated July 6, 2015, an OWCP hearing representative affirmed the December 9, 

2014 decision as modified, finding that appellant had established that the October 15, 2014 

employment incident occurred as alleged, but that the evidence of record was insufficient to 

establish that his diagnosed condition was causally related to the accepted October 15, 2014 

employment incident. 
4

On October 9, 2015 appellant requested reconsideration of the July 6, 2015 decision. He 

argued that Dr. Tarleton’s reports, diagnostic testing, and witness statements established his 

traumatic injury claim. 

In a July 30, 2015 diagnostic report, Dr. Adam Landskowsky, a Board-certified diagnostic 

radiologist, reported that an x-ray of appellant’s lumbar spine revealed L3-4 and L4-5 grade 1

degenerative anterolisthesis and L3 to S1 degenerative spondylosis with facet arthrosis. He 

reported that an x-ray of the cervical spine revealed straightening of the normal cervical lordosis, 

multilevel facet arthrosis, and C5-6 and C6-7 degenerative disc disease. 

A partial medical report dated August 12, 2015 was also submitted from Dr. Tarleton. 

Dr. Tarleton diagnosed cervicalgia, lumbago, and lumbar radiculopathy. He opined that lifting a 

caster can certainly hurt the lower back and lead to disc disease, muscle issues, or an exacerbation 

of any underlying condition in the lumbar spine that could result in persistent pain, especially if 

the caster is overweight. Dr. Tarleton reported that in this case, lifting the caster coincided 

chronologically with the onset of symptoms and therefore, “it appeared” that the overweight caster

was responsible.

By decision dated November 14, 2017, OWCP denied modification of the July 6, 2015

decision, finding that the evidence of record was insufficient to establish that appellant’s diagnosed 

lumbar condition was causally related to the accepted October 15, 2014 employment incident.

LEGAL PRECEDENT

An employee seeking benefits under FECA3 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 is causally related to the 

employment injury.4 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.5

In order to determine whether an employee actually sustained an 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 which must be considered in conjunction with one 

another. The first component to be established is that the employee actually experienced the 

employment incident which is alleged to have occurred.6 The second component is whether the 

employment incident caused a personal injury and generally can be established only by medical 

evidence.

 

3 Supra note 2.

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

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

6 Elaine Pendleton, supra note 4.
5

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 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 has not submitted sufficient medical evidence to establish 

that his lumbar condition is causally related to the accepted October 15, 2014 employment 

incident. 

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

back pain at Brooklyn Hospital Center. However, these notes do not provide findings and an 

opinion regarding the cause of appellant’s condition. As such, this report is insufficient to establish 

his traumatic injury claim.9

In an October 23, 2014 medical report and October 27, 2014 Form CA-20, Dr. De Moura 

described the October 15, 2014 employment incident and diagnosed low back pain, lumbar 

radiculitis, and cervicalgia. On the Form CA-20, he checked the box marked “yes” when asked if 

the condition was caused or aggravated by the employment activity. The Board, however, has 

held that a report that addresses causal relationship with a checkmark, without medical rationale 

explaining how the work condition caused the alleged injury, is of diminished probative value and 

insufficient to establish causal relationship.10 Moreover, his statement that causation is supported 

by appellant’s history, clinical examination, and symptoms fail to provide a sufficient explanation 

as to the mechanism of injury pertaining to this traumatic injury claim.11 As such, his opinion is 

of diminished probative value.12

Dr. Cardinale’s November 6, 2014 report is also insufficient to establish appellant’s claim. 

While the physician provided a diagnosis, he failed to discuss appellant’s medical history and only 

repeated his assertions pertaining to the employment incident. Such generalized statements do not 

establish causal relationship because they merely repeat appellant’s allegations and are 

 

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

8

James Mack, 43 ECAB 321 (1991).

9

J.P., Docket No. 14-0087 (issued March 14, 2014).

10 See Calvin E. King, Jr., 51 ECAB 394 (2000); see also Frederick E. Howard, Jr., 41 ECAB 843 (1990).

11 S.W., Docket No. 08-2538 (issued May 21, 2009).

12 Id.
6

unsupported by adequate medical rationale explaining how this physical activity actually caused 

the diagnosed conditions.13 

Dr. Tarleton noted that causation was established because appellant’s complaints were 

“consistent with the injury and the history of injury was consistent with objective findings.” His 

statement on causation is vague without discussion of the objective evidence that supported his 

conclusion. As Dr. Tarleton’s failed to provide sufficient explanation as to the mechanism of 

injury explaining how lifting a heavy caster would cause his lumbar injuries, his opinion is of 

diminished probative value.

14

 In medical reports dated December 3, 2014 to August 12, 2015,

Dr. Tarleton described the October 15, 2014 employment incident and diagnosed work-related 

lumbago, lumbar herniated nucleus pulposus, lumbar radiculopathy, and cervicalgia. The Board 

finds that the opinion of Dr. Tarleton is insufficiently rationalized. 

Dr. Tarleton discussed previous diagnostic testing and noted that appellant’s conditions

began in May 2009. He reported that a 2009 cervical spine MRI scan revealed diffuse hydration 

loss and posterior disc bulges impressing on the thecal sac from C2-3 through C6-7. Dr. Tarleton

further noted that a 2009 lumbar spine MRI scan also revealed multilevel disc issues. The Board 

notes that the previous diagnostic studies revealed a preexisting injury given that appellant’s 

current lumbar MRI scan showed L2-3 mild disc bulging and disc degeneration at L4-5 and L5-S1. 

Dr. Tarleton failed to discuss whether appellant’s preexisting injury had progressed beyond what 

might be expected from the natural progression of that condition.15 It is unclear whether 

appellant’s multilevel degenerative disc issues and radiculopathy were caused or aggravated by 

the October 15, 2014 employment incident, a result of a preexisting condition, or due to 

degenerative changes. Moreover, appellant reported prior nonoccupational lumbar-related 

injuries. However, Dr. Tarleton failed to adequately discuss his medical history when assessing 

the cause of his condition. A well-rationalized opinion is particularly warranted when there is a 

history of a preexisting condition.16 

Dr. Tarleton further failed to provide a sufficient explanation as to the mechanism of injury 

pertaining to this traumatic injury claim. While he had some understanding of the October 14, 

2015 employment incident, noting that appellant was lifting a heavy caster, he failed to provide 

sufficient detail regarding the circumstances surrounding the incident pertaining to the weight and 

size of the caster and the specific movements involved which would result in appellant’s injury. 

Dr. Tarleton reported that lifting a caster can certainly hurt the lower back and lead to disc disease, 

muscle issues, or an exacerbation of any underlying condition in the lumbar spine that could result 

in persistent pain, especially if the caster is overweight. His statement that lifting a caster could 

cause injury is vague and couched in speculative terms without a definitive statement that the 

incident in this claim caused appellant’s injury. Dr. Tarleton further noted that lifting the caster 

coincided chronologically with the onset of symptoms and therefore, it appeared that the 

overweight caster was responsible. The Board has held that an opinion that a condition is causally 

 

13 K.W., Docket No. 10-0098 (issued September 10, 2010).

14 John W. Montoya, 54 ECAB 306 (2003).

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

16 T.M., Docket No. 08-0975 (issued February 6, 2009); Michael S. Mina, 57 ECAB 379 (2006).
7

related because the employee was asymptomatic before the injury, without adequate rationale, is 

insufficient to establish causal relationship.17 Dr. Tarleton’s statement is vague and generalized 

without sufficient detail explaining how the October 15, 2014 incident caused appellant’s injury. 

Without explaining how, physiologically, the movements involved in the employment incident 

caused or contributed to appellant’s lumbar injuries, Dr. Tarleton’s opinion on causal relationship 

is of limited probative value.18 

The remaining medical evidence of record is also insufficient to establish causal 

relationship between appellant’s lumbar injury and the October 15, 2014 employment incident. 

Dr. Harkavy’s and Dr. Landskowsky’s reports simply interpret diagnostic studies with no firm 

medical diagnosis or opinion on the cause of appellant’s injury.19 The Board has held that medical 

evidence that does not offer an opinion regarding the cause of an employee’s condition is of limited 

probative value.20 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 his lumbar 

injury.21

An award of compensation may not be based on surmise, conjecture, speculation, or on the 

employee’s own belief of causal relationship.

22

 Appellant’s honest belief that his accepted 

employment incident caused his lumbar injury, however sincerely held, does not constitute 

medical evidence necessary to establish causal relationship.23 In the instant case, the record lacks 

rationalized medical evidence establishing causal relationship between the October 14, 2015

employment incident and his diagnosed lumbar injuries. Thus, appellant has not met his burden 

of proof. 

Appellant may submit additional evidence, together with a written request for 

reconsideration, to OWCP within one year of the Board’s 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 lumbar

condition causally related to the accepted October 15, 2014 employment incident. 

 

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

18 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).

19 It is not possible to establish the cause of a medical condition if the physician has not stated a firm medical 

diagnosis. T.G., Docket No. 13-0076 (issued March 22, 2013).

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

21 Id.

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

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

ORDER

IT IS HEREBY ORDERED THAT the November 14, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: October 3, 2018

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board