United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

F.P., Appellant

and

U.S. POSTAL SERVICE, FORT WORTH 

PERFORMANCE CLUSTER, Fort Worth, TX, 

Employer

__________________________________________

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Docket No. 19-1489

Issued: March 18, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

CHRISTOPHER J. GODFREY, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On July 1, 2019 appellant filed a timely appeal from a May 20, 2019 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 this case.2

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following the May 20, 2019 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 her burden of proof to establish a recurrence of total 

disability commencing on or after May 11, 2018 due to her accepted May 15, 2003 employment 

injury.

FACTUAL HISTORY

OWCP accepted that on May 15, 2003 appellant, then a 36-year-old flat sorting machine 

operator, sustained a lumbar sprain, thoracic sprain, closed dislocation of a lumbar vertebra, and 

closed dislocation of a thoracic vertebra when lifting and moving a mail tub while in the 

performance of duty. Appellant stopped work on May 16, 2003 and periodically returned to work 

in modified positions for the employing establishment.

Appellant received regular medical treatment from Dr. Christopher R. Mann, an osteopath 

Board-certified in occupational medicine, and Dr. Patrick K. Stanton, an osteopath Board-certified 

in anesthesiology. The physicians reported that she primarily complained of low back pain/spasms 

and pain which radiated from the low back into her lower extremities. In October 2016, appellant

began working on a full-time basis in a modified clerk position which limited her continuous lifting 

to 15 pounds and her intermittent lifting to 20 pounds.3

In an April 25, 2018 report, Dr. Mann advised that appellant continued to manifest such 

symptoms/conditions as low back spasms, decreased functional range of back motion, and bilateral

radiculopathy which he opined were related to the accepted May 15, 2003 employment injury. He 

opined that it was medically necessary to upgrade her diagnosis to include the additional condition 

of lumbosacral intervertebral disc disorder with radiculopathy.

Appellant stopped work on May 11, 2018 and later filed a notice of recurrence (Form CA2a) alleging a recurrence of disability commencing on May 11, 2018 due to her accepted May 15, 

2003 employment injury. She asserted that she experienced a spontaneous worsening of the 

symptoms in her low back and lower extremities.

Appellant subsequently submitted a May 9, 2018 report from Dr. Stanton, who indicated 

that she reported experiencing low back pain radiating into her lower extremities, as well as 

bilateral lower extremity numbness and occasional weakness of the right lower extremity.

Dr. Stanton reported physical examination findings including tenderness upon low back palpation, 

limited range of motion of the back, and negative results upon bilateral leg raise testing. He

diagnosed lumbar sprain, thoracic sprain, vertebrae subluxations at L4-5 and T8-9, herniated disc 

at L4-5, and chronic pain, and he recommended that appellant continue with her current medication 

regimen.4 

 

3 OWCP paid appellant wage-loss compensation benefits through May 4, 2013 for her intermittent periods of 

disability.

4 On June 6, 2018 Dr. Stanton reported physical examination findings and provided an assessment of appellant’s 

medical condition which was similar to that contained in his May 9, 2018 report.
3

In a May 11, 2018 report, Dr. Mann advised that appellant had suffered a recurrence of her 

May 15, 2003 employment injury. He reported that she experienced a spontaneous worsening of 

her low back and lower extremity symptoms, including weakness and loss of range of motion in 

her lower extremities (right greater than left). Dr. Mann maintained that she could not tolerate 

prolonged repetitive work duties and indicated that she was totally disabled from May 11 to 

30, 2018.5 In May 30, June 13, and July 9, 2018 reports, he again opined that appellant had 

suffered a recurrence of her May 15, 2003 employment injury and advised that she was totally 

disabled from May 30 to June 27, and July 9 to 25, 2018.

In a July 18, 2018 development letter, OWCP requested that appellant submit additional 

evidence in support of her claim, including a physician’s opinion supported by a medical 

explanation as to how the accepted May 15, 2003 employment injury contributed to the claimed 

recurrence of disability. It afforded her 30 days to respond.

In response, appellant submitted a July 18, 2018 attending physician’s report (Form 

CA-20) from Dr. Mann who listed May 15, 2003 as the date of injury and provided diagnoses 

related to the “employment activity” of lumbar and thoracic sprains and vertebrae subluxations at 

L4-5 and T8-9.

6

 Dr. Mann checked a box marked “Yes” to indicate that the diagnosed conditions 

were caused or aggravated by the reported employment activity. He noted that appellant was 

totally disabled from May 11 to September 24, 2018.

In a July 25, 2018 report, Dr. Mann indicated that appellant reported on May 11, 2018 that 

she was performing her normal limited-duty job when she experienced a spontaneous onset of 

increased bilateral paraspinal muscle spasms with lower extremity weakness. He advised that his

May 11, 2018 physical examination revealed that she had losses upon straight leg testing of 32 

degrees on the right and 55 degrees on the left, increased sensory loss down the right lateral thigh, 

and decreased flexion against resistance of her right hallicus muscle (+2 or 3 out of +5). Dr. Mann 

maintained that appellant’s recurrent injury was severe enough to cause temporary total disability 

secondary to her inability to walk more than a few steps at a time. He discussed her work duties 

and the results of recent diagnostic testing and he opined that she sustained a material worsening 

of her May 15, 2003 work injury such that she was temporarily totally disabled from returning to 

work.7

By decision dated August 27, 2018, OWCP denied appellant’s claim finding that she had 

not submitted sufficient medical evidence to establish a recurrence of total disability commencing 

on or after May 11, 2018 causally related to her accepted May 15, 2003 employment injury. It 

 

5

In a May 2, 2018 duty status report (Form CA-17), Dr. Mann advised that appellant could continuously lift up to 

15 pounds and intermittently lift up to 20 pounds. Appellant also submitted the findings of May 17, 2018 magnetic 

resonance imaging testing of her lumbar spine which showed degenerative changes at L1-2 through L5-S1.

6 With respect to the May 15, 2003 employment injury, Dr. Mann noted that appellant reported that she experienced 

increased low back pain and difficulty reaching/standing while performing the “regular duties of her job.”

7 Appellant also submitted findings of July 16, 2018 electromyogram and nerve conduction velocity testing of the 

lower extremities (showing right L2 and/or L3 radiculopathy and bilateral trochanteric bursitis). In July 10 and 

August 7, 2018 reports, Dr. Stanton recommended that she continue with her current medication regimen.
4

concluded therefore that she had not established that she was totally disabled for the claimed period 

“due to a material change/worsening of [her] accepted work-related conditions.”

In a September 4, 2018 report, Dr. John A. Sklar, a Board-certified physical medicine and 

rehabilitation physician serving as an OWCP referral physician,8indicated that his August 30, 

2018 physical examination revealed mild-to-moderate tenderness of the lumbar paraspinal, but no 

evidence of radiculopathy in the lower extremities. He concluded that appellant did not have 

residuals of her May 15, 2003 employment injury and that her accepted conditions should not be 

upgraded to include lumbar intervertebral disc disorder with radiculopathy. Dr. Sklar maintained 

that her continuing medical condition was due to nonwork-related progression of degenerative 

disease of the lumbar spine.

On September 6, 2018 appellant requested reconsideration of the August 27, 2018 

decision.

Appellant subsequently submitted September 5, October 3 and 31, and November 28, 2018 

reports from Dr. Stanton who reported physical examination findings and diagnoses which were 

similar to those in his previous reports.

In September 24 and November 26, 2018 Form CA-20 reports, Dr. Mann listed May 15, 

2003 as the date of injury and provided diagnoses related to the employment activity of lumbar 

and thoracic sprains and subluxations at L4-5 and T8-9.9 He checked a box marked “Yes” to 

indicate that the diagnosed conditions were caused or aggravated by the reported employment 

activity. Dr. Mann noted that appellant was totally disabled from May 11, 2018 to 

January 28, 2019.

By decision dated December 10, 2018, OWCP denied modification of the August 27, 2018 

decision. It found that appellant had not submitted probative medical evidence establishing that 

she sustained a recurrence of total disability commencing on or after May 11, 2018 due to her 

accepted May 15, 2003 employment injury.

On January 22, 2019 appellant requested reconsideration of the December 10, 2018 

decision.

Appellant submitted a December 21, 2018 report from Dr. Mann who indicated that, in his 

July 25, 2018 report, he had explained that diagnostic testing showed that she sustained a “material 

worsening” of her condition. Dr. Mann again maintained that on May 11, 2018 she sustained a 

recurrence of her May 15, 2003 employment injury.

 

8

In July 2018, OWCP had referred appellant to Dr. Sklar for a second opinion examination and requested that he 

indicate whether she had residuals of her May 15, 2003 employment injury and whether her accepted conditions 

should be upgraded to include lumbar intervertebral disc disorder with radiculopathy related to her May 15, 2003 

employment injury.

9

In these and later submitted Form CA-20 reports, Dr. Mann noted that, with respect to the May 15, 2003 

employment injury, appellant reported that she experienced increased low back pain and difficulty reaching/standing 

while performing the “regular duties of [appellant] job.”
5

In reports dated January 4, February 12, March 20, and April 17, 2019, Dr. Stanton 

reported physical examination findings and diagnoses which were similar to those previously 

reported. In Form CA-20 reports dated January 28, March 4, and April 29, 2019, Dr. Mann listed 

May 15, 2003 as the date of injury and provided diagnoses related to the employment activity of 

lumbar and thoracic sprains and subluxations at L4-5 and T8-9. He checked a box marked “Yes”

to indicate that the diagnosed conditions were caused or aggravated by the reported employment 

activity. Dr. Mann noted that appellant was totally disabled from May 11, 2018 to June 21, 2019.

By decision dated May 20, 2019, OWCP denied modification of the December 10, 2018 

decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of his or her claim including that any disability or specific condition for which 

compensation is claimed is causally related to the employment injury.10 

Under FECA the term “disability” means the incapacity, because of an employment injury, 

to earn the wages that the employee was receiving at the time of injury.11 Disability is thus not 

synonymous with physical impairment, which may or may not result in an incapacity to earn 

wages.12 An employee who has a physical impairment causally related to a federal employment 

injury, but who nevertheless has the capacity to earn the wages he or she was receiving at the time 

of injury, has no disability as that term is used in FECA.13 When, however, the medical evidence 

establishes that the residuals or sequelae of an employment injury are such that, from a medical 

standpoint, they prevent the employee from continuing in his or her employment, he or she is 

entitled to compensation for loss of wages.14

The medical evidence required to establish causal relationship between a claimed period 

of disability and an employment injury is rationalized medical opinion evidence. 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 claimed disability and the specific employment factors 

identified by the claimant.15

 

10 S.W., Docket No. 18-1529 (issued April 19, 2019); J.F., Docket No. 09-1061 (issued November 17, 2009).

11 20 C.F.R. § 10.5(f); S.T., Docket No. 18-0412 (issued October 22, 2018).

12 See L.W., Docket No. 17-1685 (issued October 9, 2018).

13 See D.G., Docket No. 18-0597 (issued October 3, 2018).

14 See D.R., Docket No. 18-0323 (issued October 2, 2018).

15 V.A., Docket No. 19-1123 (issued October 29, 2019).
6

ANALYSIS

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

total disability commencing on or after May 11, 2018 due to her accepted May 15, 2003 

employment injury.

In May 11 and 30, June 13, and July 9, 2018 reports, Dr. Mann advised that appellant had 

suffered a recurrence of her May 15, 2003 employment injury. He reported that she experienced 

a spontaneous worsening of her low back and lower extremity symptoms, and he maintained that 

she was totally disabled from May 11 to June 27 and July 9 to 25, 2018. In a July 25, 2018 report,

Dr. Mann detailed the results of his May 11, 2018 physical examination with respect to appellant’s 

back and lower extremities. He discussed her diagnostic testing and opined that she sustained a 

material worsening of her May 15, 2003 employment injury such that she was temporarily totally 

disabled from returning to work. In a December 21, 2018 report, Dr. Mann indicated that, in his 

July 25, 2018 report, he had explained that diagnostic testing showed that appellant sustained a 

material worsening of her condition. He again maintained that on May 11, 2018 she sustained a 

recurrence of her May 15, 2003 employment injury. 

The Board finds that these reports are of limited probative value on the underlying issue of 

this case because Dr. Mann did not provide medical rationale in support of his opinion on the cause 

of appellant’s disability on or after May 11, 2018. Dr. Mann did not provide a notable discussion 

of the accepted May 15, 2003 employment injury or explain why it would have been competent to 

cause total disability 15 years later. The Board has held that 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.16 Therefore, these reports of Dr. Mann are insufficient 

to establish appellant’s claim.

In Form CA-20 reports dated July 18, September 24, and November 26, 2018 and

January 28, March 4, and April 29, 2019, Dr. Mann listed May 15, 2003 as the date of injury and 

provided diagnoses related to the employment activity of lumbar and thoracic sprains and 

subluxations at L4-5 and T8-9.17 He checked boxes marked “Yes” to indicate that the diagnosed 

conditions were caused or aggravated by the reported employment activity. Dr. Mann noted that 

appellant was totally disabled from May 11, 2018 to June 21, 2019. Appellant’s burden of proof 

includes the necessity of furnishing an affirmative opinion from a physician who supports his or her 

conclusion with sound medical reasoning.18 In these reports, Dr. Mann provided no rationale for his 

opinion on causal relationship with respect to appellant’s disability from work. The Board has held 

that when a physician’s opinion on causal relationship consists only of checking “Yes” to a form 

question, without more by the way of medical rationale, that opinion is of limited probative value 

 

16 L.G., Docket No. 19-0142 (issued August 8, 2019); C.M., Docket No. 14-0088 (issued April 18, 2014).

17 In these reports, Dr. Mann noted that, with respect to the May 15, 2003 employment injury, appellant reported 

she experienced increased low back pain and difficulty reaching/standing while performing the “regular duties of her 

job.”

18 J.A., Docket No. 18-1586 (issued April 9, 2019); Lillian M. Jones, 34 ECAB 379, 381 (1982).
7

and is insufficient to establish causal relationship.19 As such, Dr. Mann’s reports are insufficient to 

discharge appellant’s burden of proof with respect her recurrence of disability claim.

In numerous reports dated between May 9, 2018 and April 17, 2019, Dr. Stanton reported 

physical examinations findings and diagnosed lumbar sprain, thoracic sprain, vertebrae 

subluxations at L4-5 and T8-9, herniated disc at L4-5, and chronic pain. In these reports, he did 

not provide an opinion regarding appellant’s disability from work. The Board has held that 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.20 Therefore, these reports of Dr. Stanton 

are insufficient to establish appellant’s claim.21 Appellant also submitted several reports of 

diagnostic testing regarding her back and lower extremities. However, diagnostic studies lack 

probative value as they do not address whether a given medical condition/period of disability was 

caused by the employment.

22

As appellant has not submitted rationalized medical evidence establishing causal relationship 

between her accepted May 15, 2003 employment injury and the claimed recurrence of total disability 

commencing May 11, 2018, she has not met her burden of proof.23 

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 a recurrence of 

total disability commencing on or after May 11, 2018 due to her accepted May 15, 2003 

employment injury.

 

19 Id.

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

21 Id. In a May 2, 2018 Form CA-17 report, Dr. Mann advised that appellant could continuously lift up to 15 pounds 

and intermittently lift up to 20 pounds. These restrictions were within the requirements of the limited-duty job she 

was performing when she stopped work on May 11, 2018 and therefore this report would not show a recurrence of 

total disability around that time.

22 C.S., Docket No. 19-1279 (issued December 30, 2019).

23 The Board further notes that Dr. Sklar, an OWCP referral physician, indicated in a September 4, 2018 report that 

appellant did not have residuals of her May 15, 2003 employment injury at the time he conducted a physical 

examination on August 30, 2018.
8

ORDER

IT IS HEREBY ORDERED THAT the May 20, 2019 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: March 18, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Christopher J. Godfrey, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board