United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

D.F., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Queenstown, MD, Employer

__________________________________________

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Docket No. 20-0093

Issued: June 15, 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

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On October 16, 2019 appellant filed a timely appeal from a September 9, 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.

ISSUE

The issue is whether appellant has met her burden of proof to establish a lumbar injury 

causally related to the accepted May 16, 2018 employment incident.

FACTUAL HISTORY

On June 1, 2018 appellant, then a 54-year-old regional rural carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on May 16, 2018 she injured her back when pulling a box toward 

 

1 5 U.S.C. § 8101 et seq.
2

her and lifting it at hip level when it shifted while in the performance of duty. She stopped work 

on May 21, 2018. 

In a June 13, 2018 duty status report (Form CA-17), Dr. Tushar Sharma, Board-certified 

in internal medicine, noted traumatic injuries to appellant’s back and right shoulder and referenced 

resultant lower back and right shoulder pain radiating into her right lower extremity. In a referral 

order and pain management visit summary of even date, he diagnosed her with lumbar 

radiculopathy and referred her to physical and interventional therapy. Additionally, Dr. Sharma 

indicated in a June 13, 2018 note that appellant could return to light-duty work on June 27, 2018.

By development letter dated June 25, 2018, OWCP informed appellant that her claim 

initially appeared to be a minor injury that resulted in minimal or no lost time from work and that 

continuation of pay was not controverted by the employing establishment, and thus, limited 

expenses had therefore been authorized. However, a formal decision was now required. OWCP

advised appellant of the type of factual and medical evidence required to establish her traumatic 

injury claim and asked her to complete a questionnaire and provide further details regarding the 

circumstances of the claimed May 16, 2018 employment incident. It also requested a narrative 

medical report from her physician which provided a rationalized medical explanation as to how 

the alleged employment incident caused her diagnosed condition. OWCP afforded appellant 30 

days to respond. 

In a May 21, 2018 medical report, Kevin Slayton, a physician assistant, noted appellant’s 

low back pain and right lower extremity symptoms that began on May 19, 2018 after she lifted a 

heavy package at work on May 17, 2018. He recounted that she experienced intense pain in her 

right buttock and right posterolateral thigh pain while she was vacuuming. Mr. Slayton reviewed 

her medical history, reporting that she previously underwent a right L4-5 microdiscectomy in 

March 2017 and that, after the surgery, she still experienced pain in her lower back and right lower 

extremity, but had returned to work. On review of a magnetic resonance imaging (MRI) scan of 

appellant’s lumbosacral spine, he indicated recurrent disc herniation at L4-5 on the right. 

Mr. Slayton opined that she was suffering from right L4 radicular symptoms due to her disc 

herniation and noted that her symptoms began while lifting a heavy package at work. He

diagnosed lumbar postlaminectomy syndrome, low back pain, prolapsed lumbar intervertebral 

disc, degeneration of lumbar intervertebral disc, and lumbosacral spondylosis without myelopathy. 

In a June 13, 2018 medical report, Dr. Sharma evaluated appellant’s symptoms related to 

her lower back pain. He diagnosed lumbar radiculopathy, degeneration of lumbar intervertebral 

disc, and low back pain. 

A June 21, 2018 letter with an illegible signature instructed appellant to report back to

Dr. Stephen D. Brown after she received back injections from Dr. Sharma and thereafter, she 

would be able to further discuss options for surgery. 

By decision dated July 26, 2018, OWCP denied appellant’s traumatic injury claim, finding 

that the evidence of record was insufficient to establish that the injury and/or events occurred as 

she described. It noted that she failed to respond to OWCP’s June 25, 2018 questionnaire. 
3

On July 31, 2018 appellant requested a review of the written record before a representative 

of OWCP’s Branch of Hearings and Review. In an attached response to OWCP’s questionnaire, 

she explained that she was lifting a box in the post office to her hip level. When appellant pulled 

the box closer to her, the 250 coils of copper wire inside the package shifted and were heavy, 

causing her to drop the package. She indicated that she felt extreme pain down her right side as 

the package pulled her down when she tried to lift it. Appellant continued to work the next two 

days with her postmaster’s help, but her pain continued to become more intense to the point she 

could not get out of bed on Saturday morning. She also referenced a prior injury that she sustained 

in 2013. 

In an August 1, 2018 return to work form, Dr. Sharma indicated that appellant could return 

to full-duty work on August 2, 2018. 

In an August 8, 2018 medical report, Dr. Timothy Burke, a Board-certified neurosurgeon, 

evaluated appellant’s symptoms and noted her history of a previous right L4-5 disc herniation and 

microdiscectomy. He opined that it was possible that her proximal right leg pain was due to an 

extraforaminal disc at L3-4, but her symptoms were somewhat atypical, which suggested a primary 

issue at the hip. Dr. Burke opined that appellant’s injury “sounded like a work-related injury”

caused when she lifted a heavy crate of copper wire. He further opined that it was likely that this 

action exacerbated her preexisting condition. Dr. Burke diagnosed a prolapsed lumbar 

intervertebral disc and pain in the right lower limb. In a medical note of even date, he

recommended that appellant remain out of work until August 23, 2018. 

By decision dated December 7, 2018, a hearing representative set aside the July 26, 2018 

decision and ordered OWCP to prepare a statement of accepted facts and solicit a new report from 

appellant’s treating physician. Specifically, the hearing representative requested that Dr. Burke 

should discuss the mechanism of injury and offer a reasoned opinion on which diagnoses bear a 

relationship with the May 16, 2018 employment incident and appellant’s physician assistant 

should provide further clarification regarding appellant’s pain after vacuuming. 

In an August 23, 2018 medical report, Dr. Burke explained that appellant’s condition had 

worsened and recommended surgical treatment for her right L4-5 disc herniation. He also noted 

that her symptoms were somewhat out of proportion to the relatively small size of the disc 

herniation. Dr. Burke diagnosed a prolapsed lumbar intervertebral disc and discussed surgical 

options with appellant. 

In a January 21, 2019 medical report, Carol Jerosimich, a physician assistant, indicated that 

appellant presented to review an MRI scan of her lumbar spine that was requested due to her right 

buttock and lateral right thigh pain. She indicated that appellant underwent an L4-5 extraforaminal 

microdiscectomy on September 12, 2018 and also noted appellant’s March 2017 L4-5 

microdiscectomy. Ms. Jerosimich assessed a history of L4-5 disc herniation and lumbar 

spondylosis and provided appellant with a plan for treatment. 

In a May 13, 2019 letter, Dr. Burke recounted appellant’s history of injury and indicated 

that she was treated for a lumbar disc herniation and underwent surgical treatment for an 

extraforaminal on September 12, 2018. He opined that the work events were causally related to 

her lumbar disc herniation and subsequent need for surgical treatment. 
4

By decision dated June 4, 2019, OWCP denied appellant’s claim, finding that the evidence 

of record was insufficient to establish that her diagnosed lumbar conditions were causally related 

to the accepted May 16, 2018 employment incident. 

On June 20, 2019 appellant requested reconsideration of OWCP’s June 4, 2019 decision. 

Appellant submitted medical evidence referencing treatment she received from July 24, 

2017 to August 23, 2018. 

By decision dated September 9, 2019, OWCP affirmed its June 4, 2019 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 the fact that the individual is an employee of the 

United States within the meaning of FECA, that the claim was timely filed within the applicable 

time limitation period of FECA,2that an injury was sustained in the performance of duty as alleged, 

and that any disability or medical condition for which compensation is claimed is causally related 

to the employment injury.3 These are the essential elements of each and every compensation claim, 

regardless of whether the claim is predicated upon a traumatic injury or an occupational disease.4

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty it must first be determined whether fact of injury has been established.5 First, 

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

employment incident at the time, place, and in the manner alleged.6 Second, the employee must 

submit sufficient evidence to establish that the employment incident caused a personal injury.7

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 sufficient to establish such causal relationship.8 The opinion of the physician 

must be based on a complete factual and medical background, must be one of reasonable medical 

 

2 S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989).

3

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

4 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); 

Delores C. Ellyett, 41 ECAB 992 (1990).

5 D.B., Docket No. 18-1348 (issued January 4, 2019); T.H., 59 ECAB 388, 393-94 (2008).

6 D.S., Docket No. 17-1422 (issued November 9, 2017); Elaine Pendleton, 40 ECAB 1143 (1989).

7 B.M., Docket No. 17-0796 (issued July 5, 2018); John J. Carlone, 41 ECAB 354 (1989).

8 K.V., Docket No. 18-0723 (issued November 9, 2018).
5

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.9 

In a case where a preexisting condition involving the same part of the body is present and 

the issue of causal relationship therefore involves aggravation, acceleration, or precipitation, the 

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

work-related injury or disease and the preexisting condition.10

ANALYSIS

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

causally related to the accepted May 16, 2018 employment incident.

In his August 8, 2018 medical report, Dr. Burke noted appellant’s history of a previous L4-

5 disc herniation and microdiscectomy. He opined that he believed that her injury “sounded like 

a work-related injury” caused when she lifted a crate of heavy copper wire and that it was likely 

that this action exacerbated her preexisting condition. On evaluation Dr. Burke opined that it was 

possible that appellant’s proximal right leg pain was due to an extraforaminal disc at L3-4, but her 

symptoms were somewhat atypical, which suggested a primary issue at the hip. He diagnosed a 

prolapsed lumbar intervertebral disc and pain in the right lower limb. While Dr. Burke provided 

an affirmative opinion on causal relationship, he failed to specifically differentiate between the 

effects of the preexisting disc herniation and the symptoms related to the May 16, 2018 

employment incident.11 The Board has held that a well-rationalized opinion is particularly 

warranted when there is a history of preexisting condition, as in this case.12 Without explaining 

how lifting a crate caused or contributed to appellant’s diagnosed condition, Dr. Burke’s report is 

insufficient. Additionally, his statements that her injury “sounded like a work-related injury,” that 

it was “likely” her work activity that exacerbated her preexisting condition and that it was

“possible” her proximal leg pain was due to an extraforaminal disc at L3-4 are speculative and 

equivocal, and thus insufficient to establish her burden of proof.13 For these reasons, Dr. Burke’s 

August 8, 2018 medical report is insufficient to establish appellant’s burden of proof.

In his August 23, 2018 medical report, Dr. Burke diagnosed a prolapsed lumbar 

intervertebral disc and recommended surgical treatment to treat appellant’s worsening symptoms

without providing an opinion on causal relationship. The Board has held that medical evidence 

 

9

I.J., 59 ECAB 408 (2008).

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

N.C., Docket No. 19-1191 (issued December 19, 2019); R.D., Docket No. 18-1551 (issued March 1, 2019).

11 Id.

12 M.E., Docket No. 18-1135 (issued January 4, 2019); Kathryn Haggerty, 45 ECAB 383, 388 (1994).

13 The Board has held that speculative and equivocal medical opinions regarding causal relationship have no 

probative value. R.C., Docket No. 18-1695 (issued March 12, 2019); see Ricky S. Storms, 52 ECAB 349 (2001) 

(While the opinion of a physician supporting causal relationship need not be one of absolute medical certainty, the 

opinion must not be speculative or equivocal. The opinion should be expressed in terms of a reasonable degree of 

medical certainty).
6

that does not offer an opinion regarding the cause of an employee’s condition is of no probative 

value on the issue of causal relationship.14 Dr. Burke also failed to discuss whether appellant’s 

previous injuries or preexisting conditions contributed to her current lumbar conditions.15 For 

these reasons, his August 23, 2018 report is insufficient to meet her burden of proof.

In his May 13, 2019 letter, Dr. Burke recounted appellant’s May 16, 2018 work injury and 

subsequent surgical treatment for lumbar disc herniation. He opined that the work events were 

causally related to her lumbar disc herniation and subsequent need for surgical treatment. While

he provided an affirmative opinion which supported causal relationship, Dr. Burke did not provide 

a pathophysiological explanation as to how the accepted incident either caused or contributed to 

appellant’s diagnosed conditions.16 A mere conclusory opinion provided by a physician without 

the necessary rationale explaining how and why the incident was sufficient to result in the 

diagnosed medical condition is insufficient to meet a claimant’s burden of proof to establish a 

claim.17 For this reason, Dr. Burke’s May 13, 2019 letter is also insufficient to meet appellant’s 

burden of proof.

Dr. Sharma’s June 13, 2018 notes referenced appellant’s lower back pain and pain in her 

right shoulder radiating down to her right lower extremity. He diagnosed her with lumbar 

radiculopathy, degeneration of lumbar intervertebral disc, and low back pain. As stated previously, 

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

of no probative value on the issue of causal relationship.18 For this reason, Dr. Sharma’s June 13, 

2018 notes are insufficient to meet appellant’s burden of proof.

Appellant also submitted medical reports from Mr. Slayton and Ms. Jerosimich, physician 

assistants. Certain healthcare providers such as physician assistants, nurse practitioners, physical 

therapists, and social workers are not considered physicians as defined under FECA.19 

Consequently, their medical findings and/or opinions will not suffice for purposes of establishing 

entitlement to FECA benefits.20

Additional medical evidence referenced dates of treatment from July 24, 2017 to 

August 23, 2018. As this evidence predated the May 16, 2018 employment incident, it is irrelevant 

 

14 R.Z., Docket No. 19-0408 (issued June 26 2019); P.S., Docket No. 18-1222 (issued January 8, 2019); L.B., 

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

15 K.R., Docket No. 18-1388 (issued January 9, 2019).

16 Victor J. Woodhams, 41 ECAB 345 (1989). Supra note 10 at Chapter 2.805.3e (January 2013). See supra note 

10 at R.D.

17 J.O., Docket No. 19-0326 (issued July 16, 2019); J.D., Docket No. 14-2061 (issued February 27, 2015).

18 Supra note 14.

19 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t).

20 See M.F., Docket No. 17-1973 (issued December 31, 2018); K.W., 59 ECAB 271, 279 (2007); David P. Sawchuk,

57 ECAB 316, 320 n.11 (2006). A report from a physician assistant or certified nurse practitioner will be considered 

medical evidence if countersigned by a qualified physician. Supra note 10 at Chapter 2.805.3a(1) (January 2013).
7

to the instant claim.21 Further, the remaining evidence dated after the May 16, 2018 date of injury 

fails to offer an opinion regarding the cause of appellant’s condition.22

As appellant has not submitted rationalized medical evidence establishing that her lumbar 

injury is causally related to the accepted May 16, 2018, the Board finds that she has not met her 

burden of proof to establish her claim.

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 lumbar injury 

causally related to the accepted May 16, 2018 employment incident.

 

21 P.C., Docket No. 18-0167 (issued May 7, 2019).

22 Supra note 14.
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ORDER

IT IS HEREBY ORDERED THAT the September 9, 2019 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: June 15, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board