United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

D.S., Appellant

and

U.S. POSTAL SERVICE, ALPHARETTA 

CARRIER ANNEX, Alpharetta, GA, Employer

__________________________________________

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Docket No. 20-1060

Issued: December 22, 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

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On April 22, 2020 appellant, through counsel, filed a timely appeal from a February 12, 

2020 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.3

 

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.

3 The Board notes that, following the February 12, 2020 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 medical condition

causally related to the accepted July 5, 2019 employment incident.

FACTUAL HISTORY

On July 9, 2019 appellant, then a 55-year-old rural carrier, filed a traumatic injury claim 

(Form CA-1) alleging that on July 5, 2019 she suffered a left shoulder injury when removing mail 

from the back of her vehicle while in the performance of duty. She noted that she experienced 

pain from the left side of her neck to the fingertips in her left hand. On the reverse side of the 

claim form the employing establishment controverted appellant’s claim, noting that she never 

reported the incident to her supervisor. Appellant did not stop work. 

In a development letter dated July 22, 2019, OWCP informed appellant that the evidence 

of record was insufficient to establish her claim. It advised her of the type of factual and medical 

evidence needed and provided a questionnaire for her completion. OWCP afforded appellant 30 

days to submit the necessary evidence. 

In an attending physician’s report (Form CA-20), dated August 8, 2019, a physician 

assistant diagnosed right shoulder tendinitis and impingement. 

By decision dated August 26, 2019, OWCP denied appellant’s traumatic injury claim, 

finding that the medical evidence of record was insufficient to establish a medical diagnosis in 

connection with the accepted July 5, 2019 employment incident. It concluded therefore that the 

requirements had not been met to establish an injury as defined by FECA. 

On September 3, 2019 appellant, through counsel, requested a telephonic hearing before a 

representative of OWCP’s Branch of Hearings and Review. 

OWCP subsequently received an August 27, 2019 report from Dr. Charles Willis, II, a

Board-certified anesthesiologist. Dr. Willis noted that on July 5, 2019 appellant pulled her left 

arm and upper torso while grabbing a falling box of mail. He indicated that she felt pain and 

discomfort in her left shoulder, but continued to work, thinking her symptoms were minor and 

would resolve naturally. Dr. Willis noted that appellant’s symptoms progressively worsened to 

include pain and discomfort in her neck and back. He examined her on August 21, 2019 and 

reviewed her medical history. Dr. Willis noted objective findings and diagnosed neck strain, 

thoracic strain, left shoulder sprain, and mononeuropathy of the left upper limb. He opined that 

the employment incident of grabbing a falling box of mail created a sufficient amount of force to 

cause appellant’s upper torso to suddenly change from a static position to a moving position with 

her arm and torso toward the ground. Dr. Willis explained that this unexpected change in body 

position caused overstretching sprain/strain injuries to the soft tissue structures of her neck, back, 

and upper left extremity, forcing the structures beyond their physiological capacity. He further 

noted that peripheral nerve injuries could be caused by a variety of mechanisms including acute 

stretch injury. Dr. Willis, therefore, found that appellant’s mononeuropathy of the left upper limb 
3

also resulted from the accepted employment incident.

4

 In an accompanying August 21, 2019 work 

capacity evaluation (Form OWCP-5c), he noted that she was unable to perform her usual job 

without restrictions. 

In a September 11, 2019 report, Dr. Willis noted that appellant’s symptoms were 

unchanged since her last visit. He examined her and found no significant changes. 

A telephonic hearing was held on December 6, 2019. During the hearing, appellant 

testified that she injured her left shoulder, neck, and back while attempting to lift a plastic bin of 

mail, weighing approximately 50 to 60 pounds when it shifted. She indicated that she had no prior 

injuries or conditions related to her neck, back, or left leg. Appellant noted that she received

physical therapy treatment for her left shoulder in 2006 or 2007. She stated that she reported the 

employment incident to her supervisor and first received medical treatment on July 7, 2019. 

Appellant indicated that she did not return to work with the employing establishment, but was 

presently working as a florist. 

Appellant submitted a magnetic resonance imaging (MRI) scan report of her left shoulder, 

dated July 12, 2019, which revealed mild supraspinatus and infraspinatus tendinopathy. 

In a July 19, 2019 note, Dr. Stephen Brown, a Board-certified specialist in orthopedic 

sports medicine, reviewed the MRI scan of appellant’s left shoulder and found that she had 

tendinitis and internal tendinopathy. He also found bursitis and mild biceps tendon irritation. 

Dr. Brown diagnosed left shoulder impingement with bursitis and rotator cuff tendinitis and left 

shoulder biceps tenosynovitis. He planned for arthroscopic labral debridement, subacromial 

decompression with rotator cuff debridement, and possible biceps tenodesis procedures. 

By decision dated February 12, 2020, OWCP’s hearing representative affirmed the

August 26, 2019 decision, as modified, finding that appellant had established valid medical 

diagnoses. However, the claim remained denied because the medical evidence of record was 

insufficient to establish a causal relationship between the diagnosed medical conditions and the 

accepted July 5, 2019 employment incident. The hearing representative found that Dr. Willis’ 

August 27, 2019 report was not based on a complete and accurate factual background as he did 

not demonstrate awareness of appellant’s preexisting left shoulder complaints or mention the 

July 12, 2019 left shoulder MRI scan. 

LEGAL PRECEDENT

An employee seeking benefits under FECA5 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,6that an injury was sustained in the performance of duty as alleged, 

 

4 Dr. Willis correctly identified the date of the employment incident as July 5, 2019 throughout his report, but 

incorrectly listed the date as August 7, 2018 in his conclusion.

5 Supra note 2.

6 M.O., Docket No. 19-1398 (issued August 13, 2020); S.B., Docket No. 17-1779 (issued February 7, 2018); Joe D. 

Cameron, 41 ECAB 153 (1989).
4

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

to the employment injury.7 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.8

To determine if an employee has sustained a traumatic injury in the performance of duty, 

OWCP begins with an analysis of whether fact of injury has been established. Fact of injury 

consists of two components that must be considered in conjunction with one another. The first 

component is whether the employee actually experienced the employment incident that allegedly 

occurred.9 The second component is whether the employment incident caused a personal injury.10

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.11 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 incident identified by the claimant.12

In a case in which 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.13

ANALYSIS

The Board finds that this case is not in posture for decision.

In support of her claim, appellant submitted an August 27, 2019 report from Dr. Willis who 

accurately described the history of the accepted employment incident. Dr. Willis diagnosed neck 

strain, thoracic strain, left shoulder sprain, and mononeuropathy of the left upper limb. He opined 

that the accepted employment incident of grabbing a falling box of mail created a sufficient amount 

of force to cause a rapid change in appellant’s upper torso position. Dr. Willis found that this 

sudden, unexpected change in body position caused sprain/strain injuries to the soft tissue 

structures of her neck, back, and upper left extremity as the structures overstretched beyond their 

physiological capacity. He related that peripheral nerve injuries could be caused by an acute 

 

7

J.R., Docket No. 20-0496 (issued August 13, 2020); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 ECAB 

312 (1988).

8 B.M., Docket No. 19-1341 (issued August 12, 2020); L.M., Docket No. 13-1402 (issued February 7, 2014); 

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

9 T.J., Docket No. 19-0461 (issued August 11, 2020); Elaine Pendleton, 40 ECAB 1143 (1989).

10 D.M., Docket No. 20-0386 (issued August 10, 2020); John J. Carlone, 41 ECAB 354 (1989).

11 A.R., Docket No. 19-0465 (issued August 10, 2020); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

12 W.L., Docket No. 19-1581 (issued August 5, 2020); Leslie C. Moore, 52 ECAB 132 (2000).

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

C.C., Docket No. 19-1071 (issued August 26, 2020); V.W., Docket No. 19-1537 (issued May 13, 2020).
5

stretch injury and, therefore, found that appellant’s mononeuropathy of the left upper limb also 

resulted from the accepted employment injury.

The Board finds that the August 27, 2019 report of Dr. Willis is sufficient to require further 

development of the medical evidence. Dr. Willis is a Board-certified physician who is qualified 

in his field of medicine to render rationalized opinions on the issue of causal relationship. He 

reviewed appellant’s medical records and provided a comprehensive understanding of the case 

history. Dr. Willis provided a pathophysiological explanation as to how the mechanism of the 

accepted employment incident was sufficient to cause her diagnosed conditions. His opinion is 

not contradicted by any substantial medical or factual evidence of record.14 The Board has long 

held that it is unnecessary that the evidence of record in a case be so conclusive as to suggest causal 

connection beyond all possible doubt. Rather, the evidence is only that necessary to convince the 

adjudicator that the conclusion drawn is rational, sound, and logical.15 Following review of

Dr. Willis’ August 27, 2019 report, the Board finds that his medical opinion is rationalized and 

logical and is, therefore, sufficient to require further development of appellant’s claim.16

It is well established that proceedings under FECA are not adversarial in nature and, while 

appellant has the burden of proof to establish entitlement to compensation, OWCP shares 

responsibility in the development of the evidence.17 OWCP has an obligation to see that justice is 

done.18

On remand OWCP shall refer appellant to a specialist in the appropriate field of medicine, 

along with the case record and a statement of accepted facts. Its referral physician shall provide a 

well-rationalized opinion as to whether appellant’s diagnosed conditions are causally related to the 

accepted July 5, 2019 employment incident. If the physician opines that the diagnosed conditions 

are not causally related to the employment incident, he or she must explain with rationale how or 

why their opinion differs from that of Dr. Willis. After such further development of the case record 

as OWCP deems necessary, it shall issue a de novo decision.

CONCLUSION

The Board finds that this case is not in posture for decision.

 

14 See A.M., Docket No. 18-1656 (issued October 23, 2020).

15 See J.S., Docket No. 20-0379 (issued October 28, 2020); W.M., Docket No. 17-1244 (issued November 7, 2017); 

E.M., Docket No. 11-1106 (issued December 28, 2011); Kenneth J. Deerman, 34 ECAB 641, 645 (1983).

16 See S.J., Docket No. 19-1029 (issued October 22, 2020).

17 See A.M., supra note 14; see also A.P., Docket No. 17-0813 (issued January 3, 2018); Jimmy A. Hammons, 51 

ECAB 219, 223 (1999).

18 See J.S., supra note 15; B.C., Docket No. 15-1853 (issued January 19, 2016); E.J., Docket No. 09-1481 (issued 

February 19, 2010); John J. Carlone, 41 ECAB 354 (1989).
6

ORDER

IT IS HEREBY ORDERED THAT the February 12, 2020 decision of the Office of 

Workers’ Compensation Programs is set aside and the case is remanded for further proceedings 

consistent with this decision of the Board.

Issued: December 22, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board