United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.P., Appellant

and

U.S. POSTAL SERVICE, PROCESSING & 

DISTRIBUTION CENTER, Buffalo, NY, 

Employer

__________________________________________

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Docket No. 19-0216

Issued: December 13, 2019

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On November 7, 2018 appellant, through counsel, filed a timely appeal from an August 20, 

2018 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 August 20, 2018 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 his burden of proof to establish a right shoulder 

condition causally related to the accepted December 7, 2017 employment incident. 

FACTUAL HISTORY

On December 7, 2017 appellant, then a 50-year-old mail handler, filed a traumatic injury 

claim (Form CA-1) alleging that he sprained his right shoulder on that date when he reached to 

unlock the wheel of an all-purpose container (APC) while in the performance of duty. He indicated 

that he felt a pop in his shoulder and was immediately in a great deal of pain. Appellant stopped 

work on that day.

In hospital records dated December 7, 2017, Dr. David Levine, Board-certified in 

emergency medicine, reported that appellant complained of right shoulder pain that began about 

one hour ago when he was doing his usual activity of back and forth movement of his right arm 

and suddenly felt a pop in his right outer shoulder area. He reported that examination of appellant’s 

right shoulder was positive for decreased range of motion (ROM) and moderate tenderness in the 

outer aspect of the upper area of the bicipital area. Dr. Levine diagnosed rotator cuff injury.

A December 7, 2017 right shoulder diagnostic imaging report revealed advanced 

degenerative joint disease (DJD) and moderate DJD of the glenohumeral joint.

In a report dated December 18, 2017, Dr. Andrew L. Ohara, an osteopath Board-certified 

in orthopedic surgery, indicated that appellant was treated for right shoulder pain. He recounted 

that on December 7, 2017 appellant was moving a box of heavy mail at work when he felt a snap 

in the right shoulder. Upon examination of appellant’s right shoulder, Dr. Ohara observed no 

tenderness and positive Neer and Hawkins’ impingement syndrome. He provided ROM findings 

and indicated that x-rays showed moderate acromioclavicular (AC) joint arthritis and mild 

glenohumeral joint arthritis. Dr. Ohara diagnosed right shoulder pain. He responded “yes”

indicating that the incident described was the competent medical cause of the injury.

Appellant underwent a right shoulder magnetic resonance imaging (MRI) scan on 

December 19, 2017, which revealed a retracted, complex supraspinatus tear and complex partial 

tearing of the infraspinatus, moderate tendinopathy, partial tearing of the subscapularis, moderate 

degenerative changes, and marked active arthropathy of the AC joint.

In a December 22, 2017 report, Dr. Ohara discussed appellant’s right shoulder MRI scan 

and indicated that appellant suffered a full-thickness retracted rotator cuff tear. He recommended 

surgical arthroscopy of the right shoulder with rotator cuff repair. Dr. Ohara noted examination 

findings of 3/5 strength in flexion and abduction and positive Neer and Hawkins’ impingement. 

He again responded “yes” indicating that the incident that the patient described was the competent 

medical cause of the injury.

In a January 11, 2018 development letter, OWCP informed appellant that his claim was 

initially accepted as a minor injury, but was now being reopened to formally consider the merits 

of the claim. It advised him of the factual and medical evidence necessary to establish his claim 

and also provided a questionnaire for completion. OWCP afforded appellant 30 days to provide 

the necessary evidence.
3

On January 25, 2018 OWCP received an undated letter by Dr. Ohara. Dr. Ohara recounted 

that he was currently treating appellant for a right shoulder work-related injury that occurred on 

December 7, 2017. He explained that the injury was a result of moving work-related equipment 

from a postal truck. Dr. Ohara noted that appellant had no similar injury to the right shoulder. He

reported that the injury required surgical treatment.

By decision dated February 28, 2018, OWCP denied appellant’s claim. It accepted that the 

December 7, 2017 incident occurred as alleged. However, OWCP found that the evidence of 

record was insufficient to establish causal relationship between appellant’s right shoulder 

condition and the accepted December 7, 2017 employment incident.

On March 22, 2018 appellant requested a review of the written record before a 

representative of OWCP’s Branch of Hearings and Review. 

In a March 9, 2018 addendum report, Dr. Ohara noted diagnoses of right shoulder fullthickness, rotator cuff tear, biceps tendinopathy tearing, subscapularis tendinopathy, and 

glenohumeral and AC joint degenerative changes. He related that appellant clearly stated that he 

heard a sharp pull/snap in his shoulder subsequent to his work-related injury. Dr. Ohara recounted 

that appellant was moving an APC, which could be in excess of 500 pounds. He indicated that 

appellant was a relatively active person so some degenerative changes within the shoulder would 

be expected. Dr. Ohara noted that, prior to the work-related injury, appellant was able to range 

the shoulder without issue. He explained: “with his ability to fully range the shoulder with 

adequate strength prior to date of injury, leads me to have the opinion that a work-related injury 

led to a full-thickness, rotator cuff tear.” Dr. Ohara requested that they proceed with scheduling 

appellant for surgery.

Appellant submitted a statement dated March 14, 2018. He indicated that he worked the 

night shift and was required to load and unload APCs and bulk mail containers (BMCs) from 

approximately 22 tractor trailers. Appellant described that on the night of the incident he was 

unloading APCs and BMCs, which were incorrectly loaded sideways into a trailer. He explained 

that he was forced to pull the heavy containers towards him in order to get access to the brake. 

Appellant related that, while he was trying to maneuver the last APC in order to unlock the brake

with his foot, he felt a pop in his shoulder and instant pain. He included several pictures and 

sketches of the loaded trailers.

In a March 21, 2018 letter, Dr. Ohara indicated that he was treating appellant for a workrelated injury to the right shoulder that occurred on December 7, 2017. He opined that the injury 

was a result of moving equipment from a postal truck and now required surgical treatment. 

Dr. Ohara reported that appellant suffered a full-thickness retracted rotator cuff tear and had 

significant weakness and pain with attempted range of motion. He opined that, based on his 

clinical findings and MRI findings, he recommended moving forward with right shoulder surgery.

By decision dated August 20, 2018, an OWCP hearing representative affirmed the 

February 28, 2018 decision, finding that the medical evidence of record was insufficient to 

establish causal relationship between appellant’s right shoulder condition and the accepted 

December 7, 2017 employment incident.
4

LEGAL PRECEDENT

An employee seeking benefits under FECA4 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 of FECA,5that 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.6 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.7

In order to determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, OWCP must first determine whether fact of injury has been established.8 

There are two components involved in establishing fact of injury. First, whether the employee 

actually experienced the employment incident at the time, place, and in the manner alleged.9 

Second is whether the employment incident caused a personal injury.10 

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.11 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 

the specific employment factor(s) identified by the employee.12 The weight of the 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.13

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, 

 

4 Supra note 2.

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

153 (1989). 

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

ECAB 312 (1988).

7 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).

8 D.B., Docket No. 18-1348 (issued January 4, 2019); S.P., 59 ECAB 184 (2007).

9 See D.S., Docket No. 17-1422 (issued November 9, 2017); Bonnie A. Contreras, 57 ECAB 364 (2006).

10 See B.M., Docket No. 17-0796 (issued July 5, 2018); David Apgar, 57 ECAB 137 (2005); John J. Carlone, 41 

ECAB 354 (1989).

11 See S.A., Docket No. 18-0399 (issued October 16, 2018); see also Robert G. Morris, 48 ECAB 238 (1996).

12 M.V., Docket No. 18-0884 (issued December 28, 2018); I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 

ECAB 345 (1989).

13 James Mack, 43 ECAB 321 (1991).
5

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

of the work-related injury or disease and the preexisting condition.14

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish a right shoulder 

condition causally related to the accepted December 7, 2017 employment incident. 

Appellant submitted medical reports dated December 18, 2017 to March 9, 2018 by

Dr. Ohara. In the December 18, 2017 report, Dr. Ohara recounted that on December 7, 2017 

appellant was moving a box of heavy mail at work when he felt a snap in his right shoulder. He

noted right shoulder examination findings of positive Neer and Hawkins’ impingement syndrome 

and provided ROM findings. In the subsequent reports, Dr. Ohara indicated that an MRI scan 

revealed that appellant suffered a full-thickness rotator cuff tear. He diagnosed right shoulder pain 

and right rotator cuff tear. Dr. Ohara responded “yes” indicating that the incident the patient 

described was the competent medical cause of the injury. The Board has held, however, that when 

a physician’s opinion on causal relationship consists only of an affirmative opinion without 

explanation or rationale, that opinion is of diminished probative value and is insufficient to 

establish a claim.15 Thus, the Board finds that these medical reports are insufficient to establish 

appellant’s claim.

In a March 9, 2018 report, Dr. Ohara recounted that appellant was moving an APC, which 

could weigh in excess of 500 pounds. He noted that, prior to the work-related injury, appellant 

was able to range the shoulder without issue. Dr. Ohara reported: “with his ability to fully range 

the shoulder with adequate strength prior to date of injury, leads me to have the opinion that a 

work-related injury led to a full-thickness, rotator cuff tear.” While Dr. Ohara provided an 

affirmative opinion on causal relationship, he did not provide adequate medical rationale

explaining how appellant’s right shoulder condition was causally related to the accepted 

employment incident. Medical evidence that states a conclusion, but does not offer a rationalized 

medical explanation regarding the cause of an employee’s condition is of limited probative value 

on the issue of causal relationship.16 Furthermore, the need for rationalized medical opinion 

evidence is particularly important in this case because a December 7, 2017 right shoulder x-ray 

revealed advanced degenerative joint disease in the AC joint.17 For these reasons, these medical 

reports are insufficient to establish appellant’s claim.

The remaining medical evidence of record, including the December 7, 2017 hospital 

records, December 7, 2017 right shoulder x-ray, and December 19, 2017 right shoulder MRI scan 

 

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

15 M.E., Docket No. 18-0330 (issued September 14, 2018); D.D., 57 ECAB 734, 738 (2006); Deborah L. Beatty, 

54 ECAB 340 (2003).

16 D.H., Docket No. 17-1913 (issued December 13, 2018); J.F., Docket No. 09-1061 (issued November 17, 2009); 

A.D., 58 ECAB 149 (2006); see also R.V., Docket No. 18-1037 (issued March 26, 2019); M.R., Docket No. 14-0011 

(issued August 27, 2014) (an opinion that a condition is causally related because the employee was asymptomatic 

before the injury, without adequate rationale, is insufficient to establish causal relationship). 

17 Supra note 14; see also W.S., Docket No. 17-1769 (issued July 26, 2018); B.R., Docket No. 16-0456 (issued 

April 25, 2016).
6

are also insufficient to establish appellant’s claim. None of the reports contain an opinion or any 

discussion on the causal relationship between appellant’s diagnosed right shoulder conditions and 

the accepted December 7, 2017 employment incident and, therefore, lack probative value.18 These 

reports, therefore, are insufficient to establish appellant’s claim.

On appeal counsel alleges that OWCP’s decision was contrary to law and fact. As 

explained above, the medical evidence in the record was insufficient to establish that appellant 

sustained a right shoulder condition causally related to the accepted December 7, 2017 

employment incident. As such, appellant has not met his burden of proof to establish his traumatic 

injury 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 a right shoulder 

condition causally related to the accepted December 7, 2017 employment incident. 

 

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

also A.B., Docket No. 17-0301 (issued May 19, 2017) (diagnostic tests, lack probative value as they fail to provide an 

opinion on the causal relationship). 
7

ORDER

IT IS HEREBY ORDERED THAT the August 20, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: December 13, 2019

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board