United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.S., Appellant

and

U.S. POSTAL SERVICE, WARREN POST 

OFFICE, Warren, MI, Employer

__________________________________________

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Docket No. 19-1774

Issued: April 3, 2020

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

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 August 21, 2019 appellant, through counsel, filed a timely appeal from a July 29, 2019

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 medical condition

causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On March 20, 2018 appellant, then a 56-year-old city letter carrier, filed an occupational 

disease claim (Form CA-2) alleging that he developed herniated discs in his lumbar spine due to 

factors of his federal employment. He noted that he first became aware of his conditions on 

April 6, 2016 and realized that they were caused or aggravated by factors of his federal 

employment on March 31, 2016. On the reverse side of the claim form, the employing 

establishment indicated that appellant first reported his condition on May 1, 2016 and was last 

exposed to the conditions alleged to have caused his conditions on May 21, 2018. Appellant did 

not stop work. 

In an accompanying narrative statement dated March 19, 2018, appellant noted that he had 

been working with restrictions since 2009, following his lumbar laminectomy spinal fusion surgery 

in 2008. He related that on March 31, 2016 he woke up with pain and a feeling of paralysis in his 

left leg and could not move the leg without difficulty and falling. On April 5, 2016 appellant

sought treatment from his primary care physician, Dr. Ronald Barnett, Board-certified in internal 

medicine, who referred him to Dr. Victtorio M. Morreale, a Board-certified neurosurgeon. On 

June 21, 2016 Dr. Morreale performed multilevel lumbar decompressive laminectomy and 

transforaminal interbody fusion. Appellant indicated that he returned to work in April 2017. He 

noted that he was currently diagnosed with herniated lumbar discs at L2-3 and L4-5 and that he 

had filed previous claims for lumbar spine conditions and other work-related injuries with OWCP 

from 2001 through 2013. Appellant concluded that significant increases in the number of business 

pick-ups and packages over the years caused and aggravated his preexisting lumbar spine and leg 

conditions, particularly the requirements for stooping, bending, lifting, and twisting and caused 

him to miss work several times. 

In a March 1, 2018 narrative report, Dr. William H. Kole, Board-certified in pain medicine, 

noted that he had treated appellant since June 17, 2004. He related that, when appellant returned 

to work in April 2017, appellant’s route began to change dramatically with the addition of 

hundreds of parcel pick-ups every day. Dr. Kole opined that appellant’s employment duties such 

as lifting and moving parcels and mail and bending and stooping while collecting mail had

aggravated and contributed to his preexisting conditions of degenerative lumbar disc disease, 

osteoarthritis, and lumbar radiculopathy. He noted that appellant still suffered from chronic 

permanent pain because of the physical requirements of his employment duties. Dr. Kole 

requested that appellant be given a job that did not require any lifting or moving of parcels and 

mail and with limited bending and stooping. 

In an April 5, 2018 development letter, OWCP advised appellant of the deficiencies in his 

claim and afforded him 30 days to submit the necessary medical evidence and factual information. 

OWCP also received a duty status report (Form CA-17) dated August 4, 2009 from an 

unidentifiable healthcare provider. 
3

An April 25, 2016 magnetic resonance imaging (MRI) scan of the lumbar spine revealed 

moderate underlying spondylosis with stenosis and right paracentral disc protrusion at L2-3 

impinging on the right L3 nerve root. In a May 11, 2016 lumbar spine computerized tomography 

scan report, Dr. Antony Hamame, a Board-certified diagnostic radiologist, provided impressions 

of multilevel degenerative disc disease and spondylotic changes as described in the April 25, 2016 

MRI scan, disc bulge resulting in moderate spinal canal narrowing at L2-3, and no evidence of

acute fractures or subluxations. 

In a July 3, 2017 narrative report, Dr. Barnett indicated that appellant was under his care 

since 2006 for work-related spine and knee injuries. He noted that appellant was previously 

diagnosed with an aggravation of degenerative lumbar disc disease, knee and leg sprains, a lumbar 

strain, and a lumbosacral strain. Dr. Barnett also noted that Dr. Asim Mahmood, a Board-certified 

neurosurgeon, performed a lumbar laminectomy spinal fusion surgery on February 8, 2008 and

appellant returned to work in 2009 with work restrictions. He related that appellant no longer 

delivered mail walking house to house following the February 8, 2008 surgery. Dr. Barnett

reported that when appellant woke up on March 31, 2016 he could not move his left leg, which 

was completely paralyzed. He further noted that appellant had not recently suffered an incident or 

accident to cause his left paralysis. Dr. Barnett opined that the chronic conditions of appellant’s

degenerative disc disease and the ongoing physical activities of lifting and moving parcels and 

mail, also the bending and stooping while collecting mail, had caused and permanently aggravated 

his lumbar spine conditions. 

In a subsequently submitted June 21, 2016 operative note, Dr. Morreale noted that 

appellant experienced no postoperative complications. 

In a July 6, 2017 narrative report, Dr. Morreale certified that appellant was under his care 

for work-related lumbar spine problems since May 5, 2016 including June 21, 2016 surgery. He 

note that appellant felt immediate relief following the surgery and returned for a series of postop 

appointments and gradually improved. Dr. Morreale indicated that x-rays of the lumbar spine 

showed fusion intact with no complicating factors. However, appellant returned on March 23, 

2017 with a complaint of pain across the lower lumbarsacral area. On June 22, 2017 Dr. Morreale 

diagnosed arthrodesis status and other mechanical complications. He noted that appellant was 

previously diagnosed with degenerative disc disease. Dr. Morreale opined that many years of 

working as a mail carrier lifting and carrying heavy loads throughout the day contributed to 

progression of degenerative disc disease which continued to cause appellant severe pain and 

difficulty ambulating without falling. 

In a response to OWCP’s questionnaire dated April 24, 2018, appellant noted that, when 

he resumed work in 2009 with modified duty following the February 8, 2008 surgery, he initially 

drove a minivan, delivered express mails, and picked up mail boxes, one business store employing 

establishment pick-up, and four or five other business stops. However, over the years, his 

responsibility significantly increased. Appellant now drove a two-ton box truck. His parcels 

ranged in size and weighted between 21 and 50 pounds. The number of parcels and mail pick-ups

also increased from 25 to 50 parcels a day to 2,000 to 4,000 parcels. Appellant noted that he has 

to off load his truck three to four times a day, sometimes going as many as five times a day. He 

struggled to work every day with the pain. Appellant asserted that the increased duties had 

aggravated his preexisting lumbar spine conditions. 
4

By decision dated May 23, 2018, OWCP denied appellant’s occupational disease claim 

finding that the medical evidence submitted was insufficient to establish a causal relationship 

between his conditions and the accepted factors of his federal employment. 

On May 20, 2019 appellant, through counsel, requested reconsideration. 

OWCP subsequently received photographs of appellant’s workstation, showing his box 

truck and the volume of typical parcels and packages he delivered daily. 

In a May 1, 2019 report, Dr. Barnett again related the history of appellant’s medical 

treatments. He noted that appellant saw him monthly and reported that, although appellant felt 

better the first few months following his February 8, 2008 lumbar surgery, the pain was 

progressively getting worse. Dr. Barnett noted that appellant injured his knees and back several 

times while working due to “poor posture and not abiding by [his] restrictions.” 

Dr. Barnett explained that appellant started working for the employing establishment in 

1994, performing regular duties until his injuries in 2003. He then again described the 

circumstances from March 31, 2016 leading up to the April 5, 2016 referral appointment with

Dr. Morreale, who subsequently performed the June 21, 2016 surgery. Within a year after 

returning to work following the June 21, 2016 surgery, Dr. Morreale had observed that x-rays of 

the thoracic spine revealed two broken screws and two new herniations. He opined that whatever 

appellant was doing was ruining his spine. Similarly, Dr. Barnett also opined that appellant’s

“numerous work injuries over the years and the type of work [appellant] was doing was causing 

his degenerative disc disease to be accelerating at a much faster rate than the normal aging 

process.” 

In a May 20, 2019 statement, appellant alleged that the May 1, 2019 narrative medical 

report from Dr. Barnett demonstrated that appellant’s employment factors, involving delivering 

and picking up packages, caused and aggravated his spine conditions. He reiterated that his job 

responsibilities require loading, unloading, and sorting several 100 parcels weighing up to 

thousands of pounds daily and exceeding his 20-pound weight restriction. 

By decision dated July 29, 2019, OWCP denied modification of the May 23, 2018 decision, 

finding that the medical evidence of record was insufficient to establish that appellant’s preexisting 

lumbar spine conditions were aggravated or accelerated by the accepted employment factors. 

LEGAL PRECEDENT

An employee seeking benefits under FECA3 has the burden of proof to establish the 

essential elements of his or her claim, including 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 of FECA,4that an injury was sustained in the performance of duty as alleged, and that 

 

3

Id.

4

J.W., Docket No. 18-0678 (issued March 3, 2020); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 

ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989). 
5

any disability or medical condition for which compensation is claimed is 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 upon a traumatic injury or an occupational disease. 6

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit: (1) a factual statement identifying employment factors 

alleged to have caused or contributed to the presence or occurrence of the disease or condition; 

(2) medical evidence establishing the presence or existence of the disease or condition for which 

compensation is claimed; and (3) medical evidence establishing that the diagnosed condition is 

causally related to the employment factors identified by the claimant.7 

Causal relationship is a medical issue, and the medical evidence required to establish causal 

relationship is rationalized medical opinion evidence.8 The opinion of the physician must be based 

on a complete factual and medical background of the employee, 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 specific employment factors identified by the employee.

9

In any 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 his burden of proof to establish a medical

condition causally related to the accepted factors of his federal employment.

In a July 3, 2017 narrative report, Dr. Barnett noted that appellant was previously diagnosed 

with an aggravation of degenerative lumbar disc. He opined that the ongoing physical activities 

of lifting and moving parcels and mail, as well as bending and stooping while collecting mail, 

caused and permanently aggravated appellant’s lumbar spine conditions. Additionally, in his 

May 1, 2019 narrative report, Dr. Barnett again opined that “numerous work injuries over the years 

 

5

J.S., Docket No. 18-0657 (issued February 26, 2020); J.M., Docket No. 17-0284 (issued February 7, 2018); 

James E.Chadden, Sr., 40 ECAB 312 (1988).

6 L.J., Docket No. 19-1343 (issued February 26, 2020); R.R., Docket No. 18-0914 (issued February 24, 2020); 

DeloresC.Ellyett, 41 ECAB 992 (1990).

7

S.C., Docket No. 18-1242 (issued March 13, 2019); R.H., 59 ECAB 382 (2008).

8 A.M., Docket No. 18-1748 (issued April24, 2019); T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 

238 (1996).

9 R.G., Docket No. 18-0792 (issued March 11, 2020); D.J., Docket No. 19-1301 (issued January 29, 2020); I.J., 59 

ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

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).
6

and the type of work” appellant was performing had caused his degenerative disc disease to 

accelerate faster than the usual aging process. 

The Board notes that Dr. Barnett provided a description of the employment factors believed 

to have either caused or contributed to appellant’s diagnosed condition, however, he failed to 

specifically differentiate between the effects of the preexisting conditions and the symptoms of the 

job-related factors.

11

 A well-rationalized opinion is particularly important since appellant has a 

history of preexisting degenerative disc disease.

12

 As Dr. Barnett did not provide a reasoned 

explanation of how appellant’s specific employment duties aggravated or contributed to his current 

lumbar spine conditions, his reports are insufficient to establish appellant’s claim. 

In a July 6, 2017 narrative report, Dr. Morreale related appellant’s history of clinical 

encounters, including his June 21, 2016 lumbar surgery. On June 22, 2017 he diagnosed 

arthrodesis status and other mechanical complications while noting appellant’s preexisting 

degenerative disc disease. Dr. Morreale opined that the many years of working as a mail carrier 

lifting and carrying heavy loads throughout the day contributed to progression of appellant’s 

degenerative disc disease. He, however, did not provide medical rationale supporting his

conclusory opinion. The Board has held that a medical opinion is of limited value if it is 

conclusory in nature.13 A medical opinion must explain how the implicated employment factors 

physiologically caused, contributed to, or aggravated the specific diagnosed conditions.14 Without 

this explanation, Dr. Morreale’s reports are insufficient to meet appellant’s burden of proof to 

establish his claim.15

In a March 1, 2018 narrative report, Dr. Kole similarly opined that lifting, moving, 

bending, and stooping while collecting parcels and mail have aggravated appellant’s preexisting 

degenerative lumbar disc disease. He also noted that appellant continued to suffer from chronic 

permanent pain because of the physical requirements of his employment duties. While Dr. Kole 

diagnosed medical conditions, his opinion also lacks the necessary medical rationale to explain 

how or why the accepted employment factors were sufficient to result in the diagnosed medical 

conditions.16 Accordingly, this report is also insufficient to establish appellant’s claim. 

Finally, appellant submitted several diagnostic testing reports. The Board has held, 

however, that diagnostic studies lack probative value on the issue of causal relationship as they do 

 

11 Id.

12 See K.M., Docket No. 19-1247 (issued February 21, 2020); B.R., Docket No. 16-0456 (issued April25, 2016).

13 C.M., Docket No. 19-0360 (issued February 25, 2020); B.H., Docket No. 18-1219 (issued January 25, 2019).

14 C.M., id.; K.G., Docket No. 18-1598 (issued January 7, 2020).

15 Id. 

16 L.S., Docket No. 18-0518 (issued February 19, 2020); J.D., Docket No. 14-2061 (issued February 27, 2015).
7

not address whether the employment factors caused the diagnosed conditions.17 The diagnostic 

testing reports are thus insufficient to establish the claim.

As appellant has not submitted sufficient rationalized medical evidence to establish causal 

relationship, the Board finds that he has not met his burden of proof to establish his occupational 

disease 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 his burden of proof to establish lumbar spine 

conditions causally related to the accepted factors of his federal employment.

ORDER

IT IS HEREBY ORDERED THAT the July 29, 2019 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: April 3, 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

 

17 K.G., supra note 14; J.P., Docket No. 19-0216 (issued December 13, 2019).