United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

M.J., Appellant

and

GOVERNMENT PRINTING OFFICE, 

Washington, DC, Employer

__________________________________________

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Docket No. 17-1241

Issued: October 17, 2017

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

COLLEEN DUFFY KIKO, Judge

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On May 16, 2017 appellant, through counsel, filed a timely appeal from a January 12, 

2017 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 to consider the merits of this case.

ISSUE

The issue is whether appellant has met his burden of proof to establish a head, neck, and 

back condition causally related to a November 15, 2016 employment incident. 

 

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

FACTUAL HISTORY

On November 23, 2016 appellant, then a 55-year-old motor vehicle operator, filed a 

traumatic injury claim (Form CA-1) alleging that on November 15, 2016, while he was backing 

up a van, he collided with a storage unit and injured his head, neck, and back. He stopped work 

on November 15, 2016. 

Appellant was treated by a physician assistant on November 15, 2016 in the emergency 

room at MedStar Washington Hospital Center who diagnosed acute bilateral low back pain from 

a motor vehicle collision. The physician assistant provided discharge instructions and returned

appellant to work without restrictions on November 17, 2016. An x-ray of the lumbar spine 

dated November 15, 2016 revealed no fracture. 

Appellant was treated by Dr. Temketem L. Tsige, a Board-certified internist, on 

November 16, 2016, who diagnosed neck, low back, and left thigh pain. He had reported being 

in a motor vehicle accident. Dr. Tsige recommended physical therapy. In verification of 

treatment forms dated November 16 and 21, 2016, she noted that appellant was unable to work 

from November 16 to 25, 2016. On November 21, 2016 Dr. Tsige diagnosed low back pain, 

headache, and ecchymosis from trauma and indicated that the cause of the injury was a motor 

vehicle accident. She recommended a computerized tomography scan of the head and x-ray of 

the back. 

Appellant was treated by Dr. Christine Assia, Board-certified in emergency medicine, on 

November 18, 2016. In a verification of treatment form dated November 18, 2016, Dr. Assia

diagnosed back pain and returned appellant to work on November 23, 2016.

In a report dated November 29, 2016, Dr. Gregory M. Ford, a Board-certified 

orthopedist, diagnosed low back contusion and lumbar muscle strain. He prescribed prednisone 

and referred appellant for physical therapy. In a December 1, 2016 work status report, Dr. Ford 

noted that appellant was placed off work from November 29 to December 9, 2016. 

By letter dated December 6, 2016, OWCP advised appellant of the type of evidence 

needed to establish his claim, particularly requesting that he submit a physician’s reasoned 

opinion addressing the relationship of his claimed condition and the specific employment 

incident. It noted that medical evidence must be submitted by a qualified physician and that a 

physician assistant is not considered a qualified physician under FECA. OWCP requested that 

appellant substantiate the factual elements of his claim and respond to an attached questionnaire.

In an employing establishment statement form dated November 15, 2016, appellant 

indicated that he was driving an agency vehicle and put the vehicle in reverse and collided with a 

storage unit in the alley. Also submitted was a District of Columbia notice of infraction dated 

November 18, 2016 which charged appellant for backing up without caution causing an accident. 

Appellant also provided medical evidence. On November 16, 2016 Dr. Tsige treated him

for neck and low back pain. Appellant reported driving a work van the day before and bumped 

into a vehicle while backing up. On November 21, 2016 Dr. Tsige treated appellant in follow-up 

for neck and low back pain, and left thigh numbness following a motor vehicle accident. 

Appellant reported continued low back pain. Dr. Tsige noted findings of lower back bruise and 
3

tenderness. She diagnosed low back pain, headache, and traumatic ecchymosis. Dr. Tsige 

opined that the cause of the injury was a motor vehicle accident and a collision with another car. 

She noted that appellant could not work. In a November 28, 2016 report, Dr. Tsige treated him 

for neck and low back pain, left thigh numbness, and periodic headaches after a motor vehicle 

accident. She noted findings of a bruise of the lower back, mildly tender, but improving. 

Dr. Tsige diagnosed low back pain, ecchymosis, lumbosacral spondylosis, and headache. She 

opined that the cause of the injury was a car collision 

Appellant was treated by Dr. Assia on November 18, 2016 for back pain after a motor 

vehicle accident. She reported that appellant was a truck driver with the employing 

establishment who was “rear ended” three days before his visit. Appellant noted treatment from 

his primary care provider, but still had pain. Dr. Assia noted findings of back pain, neck pain,

and neck stiffness. She opined that appellant’s back pain was consistent with a musculoskeletal 

etiology. 

In a November 29, 2016 progress note, Dr. Ford reported that appellant was involved in a 

motor vehicle accident on November 15, 2016 when he was driving a van and struck a wall. 

Appellant reported low back and left thigh pain with tingling which did not improve. He noted 

examination findings of a small area of ecchymosis and bruising on the right side of the lower 

lumbar spine at L4-5, mild decreased range of motion, and negative straight leg testing. 

Dr. Ford diagnosed low back contusion, lumbar muscle strain, and sciatica. In an attending 

physician’s report (Form CA-20) dated December 2, 2016, he noted that on November 15, 2016 

appellant was backing up a van and struck a wall. Dr. Ford diagnosed low back contusion, 

lumbar muscle strain, and sciatica. He noted by checking a box marked “yes” that appellant’s 

condition was caused or aggravated by an employment activity and prescribed prednisone and 

physical therapy. 

A magnetic resonance imaging (MRI) scan of the lumbar spine dated December 1, 2016

revealed multifactorial mild spinal canal narrowing at L4-5 and L5-S1, marked bilateral neural 

foraminal narrowing, and a soft tissue edema presacral collection which may represent a 

hematoma.

Appellant also submitted a December 7, 2016 report from Dr. Ian D. Gordon, a Boardcertified orthopedist, who treated him for lumbar pain after a motor vehicle accident. He 

reported driving a truck for a living and while backing up he struck a trailer unit that was being 

used for storage. Appellant indicated that the panel truck was totaled. He sustained forcible 

injury to his back, ecchymosis in his lumbar area, neck pain, and radiating leg pain with 

paresthesias. A lumbar spine MRI scan revealed broad-based circumferential disc bulging at 

L4-5 with small annular tears. Examination revealed full range of motion with pain. Dr. Gordon 

diagnosed cervical strain, lumbar strain, and aggravation of degenerative disc disease. He 

recommended physical therapy and placed appellant on light duty for four to six weeks. In a 

December 7, 2016 work status report, Dr. Gordon placed appellant on modified duty from 

December 7, 2016 to January 31, 2017. 

In a statement dated December 12, 2016, appellant indicated that his supervisor, G.R.,

had direct knowledge of his injury. He noted the immediate effects of his injury were neck and 

lower back pain and were immediately reported to his supervisor. Appellant advised that he did 
4

not have any similar back-related disability or symptoms before the injury. He also submitted 

reports from a physical therapist.

In a January 12, 2017 decision, OWCP denied the claim finding that appellant had failed 

to submit medical evidence establishing a medical condition in connection with the accepted 

work incident.

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 filed within the applicable time 

limitation of FECA, that an injury was sustained in the performance of duty as alleged, and that 

any disability and/or specific condition for which compensation is claimed are causally related to 

the employment injury. 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.3

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

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

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

submit sufficient evidence to establish that he actually experienced the employment incident at 

the time, place, and in the manner alleged. Second, the employee must submit medical evidence 

to establish that the employment incident caused a personal injury.4

Rationalized medical opinion evidence is generally required to establish causal 

relationship. The opinion of the physician must be based on a complete factual and medical 

background, 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 factors identified by the claimant.5

ANALYSIS

It is undisputed that on November 15, 2016, while appellant was backing up in an agency 

van, he collided with a storage unit. However, the Board finds that he failed to submit sufficient 

medical evidence to establish that this work incident caused or aggravated his diagnosed head, 

neck, and back conditions. In a letter dated December 6, 2016, OWCP requested that appellant 

submit a comprehensive medical report from his treating physician which included a reasoned 

explanation as to how the accepted work incident had caused his claimed injury. 

Appellant submitted reports dated November 16, 2016 from Dr. Tsige who diagnosed 

neck, low back, and left thigh pain after a motor vehicle accident. He reported driving a work 

van when he bumped into a vehicle while backing up. Other reports from Dr. Tsige dated 

November 21 and 28, 2016 noted appellant’s treatment in follow up for neck and low back pain, 

 

3 Gary J. Watling, 52 ECAB 357 (2001). 

4

T.H., 59 ECAB 388 (2008).

5

I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345 (1989).
5

left thigh numbness, and periodic headaches after a motor vehicle accident. Dr. Tsige diagnosed 

low back pain, headache, and traumatic ecchymosis. She opined that the cause of the injury was 

a motor vehicle accident and advised that appellant was disabled from work. The Board finds 

that, although Dr. Tsige supported causal relationship, she did not provide medical rationale 

explaining the basis of her conclusory opinion regarding the causal relationship.6 Dr. Tsige did 

not explain the process by which colliding with a storage unit while backing up a van would 

have caused or aggravated the diagnosed conditions. As such, these reports are thus insufficient 

to establish appellant’s claim. November 16 and 21, 2016 verification of treatment forms from

Dr. Tsige are also insufficient as they do not provide a history of injury7or specifically address 

whether appellant’s employment activities had caused or aggravated a diagnosed medical 

condition.8 

Appellant submitted a report from Dr. Assia dated November 18, 2016 who treated him 

for back pain after a motor vehicle accident. He had reported that he was a truck driver for the 

employing establishment and had been “rear ended.” Dr. Assia noted findings on examination 

and opined that appellant’s back pain was consistent with a musculoskeletal etiology. Regarding 

causal relationship, she repeats the history of injury as reported by appellant without providing 

her own opinion regarding whether appellant’s condition was work related. To the extent that

Dr. Assia is providing her own opinion, she failed to provide a rationalized opinion regarding the 

causal relationship between appellant’s diagnosed conditions and the accepted work incident of 

November 15, 2016.

9

 Furthermore, the history of injury provided by Dr. Assia, of appellant 

being “rear ended,” differs from appellant’s statement that he backed into a storage unit.10 

Therefore, these reports are insufficient to meet appellant’s burden of proof. Other reports from

Dr. Assia are of limited probative value as she failed to specifically address whether appellant’s 

employment activities had caused or aggravated a diagnosed medical condition.11 

Appellant submitted a progress note from Dr. Ford dated November 29, 2016, who

indicated that appellant was involved in a motor vehicle accident on November 15, 2016 when 

he was driving a van and struck a wall. Dr. Ford diagnosed low back contusion, lumbar muscle 

strain, and sciatica. In a work status report dated December 1, 2016, he placed appellant off 

work from November 29 to December 9, 2016. However, Dr. Ford failed to indicate that this 

 

6

See T.M., Docket No. 08-975 (issued February 6, 2009) (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).

7 Frank Luis Rembisz, 52 ECAB 147 (2000) (medical opinions based on an incomplete history or which are 

speculative or equivocal in character have little probative value). 

8 A.D., 58 ECAB 149 (2006); Docket No. 06-1183 (issued November 14, 2006) (medical evidence which does not 

offer any opinion regarding the cause of an employee’s condition is of limited probative value on the issue of causal 

relationship). 

9 Franklin D. Haislah, 52 ECAB 457 (2001) (medical reports not containing rationale on causal relationship are 

entitled to little probative value); Jimmie H. Duckett, 52 ECAB 332 (2001).

10 See Vernon R. Stewart, 5 ECAB 276, 280 (1953) (where the Board held that medical opinions based on histories 

that do not adequately reflect the basic facts are of little probative value in establishing a claim).

11 Supra note 8. 
6

was a work injury12or specifically addressed whether appellant’s employment activities had 

caused or aggravated a diagnosed medical condition.13 An attending physician’s report (Form 

CA-20) from Dr. Ford, dated December 2, 2016, noted that on November 15, 2016 appellant was 

backing up a van and struck a wall. He diagnosed low back contusion, lumbar muscle strain, and 

sciatica. Dr. Ford noted by checking a box marked “yes” that his condition was caused or 

aggravated by an employment activity. The Board has held that, when a physician’s opinion on 

causal relationship consists only of checking “yes” to a form question without explanation or 

rationale, it is of diminished probative value and is insufficient to establish a claim.14 

Furthermore, the history provided by Dr. Ford, striking a wall, differs from appellant’s statement 

that he backed into a storage unit.15

Appellant submitted a December 7, 2016 report from Dr. Gordon who treated him for 

lumbar pain after a motor vehicle accident. He reported backing up a truck and striking a trailer 

unit that was being used for storage. Dr. Gordon noted that appellant had sustained a forcible 

injury to his back, ecchymosis in his lumbar area, neck pain, and radiating leg pain with 

paresthesias. He diagnosed cervical strain, lumbar strain, and aggravation of degenerative disc 

disease. Dr. Gordon recommended physical therapy and placed appellant on light duty for four 

to six weeks. Similarly, in a work status report dated December 7, 2016, he noted that appellant 

was placed on modified duty from December 7, 2016 to January 31, 2017. However,

Dr. Gordon failed to provide a rationalized opinion regarding the causal relationship between 

appellant’s cervical strain, lumbar strain, and aggravation of degenerative disc disease and the 

accepted work incident of November 15, 2016.

16

 Therefore, this report is insufficient to meet 

appellant’s burden of proof.

Appellant was treated by a physician assistant and a physical therapist. The Board has 

held that notes signed by a physician assistant or a physical therapist are not considered medical 

evidence as they are not physicians under FECA.17 Thus, these treatment records are of no 

probative medical value in establishing causal relationship. 

The remainder of the medical evidence is of limited probative value as it fails to provide 

a physician’s opinion on the causal relationship between appellant’s work incident and his

diagnosed cervical and lumbar condition.18 

 

12 Supra note 7.

13 Supra note 8. 

14 D.D., 57 ECAB 734 (2006); Sedi L. Graham, 57 ECAB 494 (2006).

15 See supra note 10.

16 Jimmie H. Duckett, 52 ECAB 332 (2001).

17 See David P. Sawchuk, 57 ECAB 316, 320n.11 (2006) (lay individuals such as physician assistants, nurses and 

physical therapists are not competent to render a medical opinion under FECA); 5 U.S.C. § 8101(2) (this subsection 

defines a “physician” as surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and 

osteopathic practitioners within the scope of their practice as defined by State law).

18 See S.E., Docket No. 08-2214 (issued May 6, 2009) (medical evidence that does not offer any opinion 

regarding the cause of an employee’s condition is of limited probative value on the issue of causal relationship). 
7

An award of compensation may not be based on surmise, conjecture, or speculation. 

Neither the fact that appellant’s condition became apparent during a period of employment nor 

the belief that his condition was caused, precipitated, or aggravated by his employment is 

sufficient to establish causal relationship. Causal relationships must be established by 

rationalized medical opinion evidence.19 Appellant failed to submit such evidence and therefore 

he has not met his burden of proof.

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 did not meet his burden of proof to establish a head, neck,

and back condition causally related to a November 15, 2016 employment incident. 

ORDER

IT IS HEREBY ORDERED THAT the January 12, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: October 17, 2017

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

 

19 See Dennis M. Mascarenas, 49 ECAB 215 (1997).