United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.L., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Ann Arbor, MI, Employer

__________________________________________

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Docket No. 18-1316

Issued: March 15, 2019

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

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 20, 2018 appellant, through counsel, filed a timely appeal from a May 1, 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.

 

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 lumbar condition 

causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On April 11, 2016 appellant, then a 29-year-old carrier technician, filed an occupational 

disease claim (Form CA-2) alleging that he developed “a curve in [his] lower back spine that [was] 

putting pressure on [his] nerves effect[ing his] hamstrings” due to factors of his federal 

employment. He stated that he had a mild irritation for a few days and that the pain became 

overbearing over time. Appellant indicated that he first became aware of his condition and first 

realized it was caused or aggravated by his employment on November 15, 2015. He did not stop 

work. 

Appellant submitted an April 14, 2016 report from Dr. Ramachandra Meera 

Krishnashastry, a Board-certified family medicine specialist, who indicated that he had been 

suffering with low back pain with sciatica for which he was undergoing physical therapy. Upon 

noting the symptoms and appellant’s work requirements, Dr. Krishnashastry opined that carrying 

the satchel along the right shoulder could be adding to a lot of strain to the back and be precipitating 

the symptoms of back pain.

In a development letter dated April 28, 2016, OWCP notified appellant of the deficiencies 

of his claim. It instructed him to respond to a questionnaire and to provide a narrative medical 

report from his physician which contained a detailed description of findings and diagnoses, 

explaining how his employment activities caused or aggravated his medical condition. OWCP 

afforded appellant 30 days to submit the requested information. In response, appellant submitted 

a position description, a statement from his immediate supervisor dated May 13, 2016, and a 

May 5, 2016 narrative statement indicating that his sciatica had effected his sleep and personal life 

as he felt pain walking up and down stairs as well as walking for long periods of time. He stated 

that he worked 10 to 12 hours per day while carrying a satchel for five-to-six days a week. 

Appellant argued that he wore his satchel on his right side day in and day out with the level of 

weight that had caused sciatica on his lower back. 

Appellant also submitted a February 20, 2016 report from Dr. Marlis Pacifico, Boardcertified in internal medicine, who advised that appellant was currently under her medical care and 

was excused from work. Dr. Pacifico opined that appellant was capable of returning to work with 

restrictions beginning February 22, 2016, including walking up to four hours per day for the next 

two weeks due to sciatica. 

In a May 27, 2016 report, Dr. Krishnashastry diagnosed low back pain with right-sided 

sciatica and indicated that a magnetic resonance imaging scan also showed some bulging of the 

lumbar intervertebral disc.

By decision dated June 21, 2016, OWCP denied appellant’s claim, finding that the medical 

evidence of record was insufficient to establish causal relationship between his diagnosed 

conditions and accepted factors of his federal employment. 
3

On July 11, 2016 appellant, through counsel, requested an oral hearing before a 

representative of OWCP’s Branch of Hearings and Review.

In reports dated March 31, April 28, May 25, June 21, July 8, August 19, September 5, 9, 

and 20, 2016, Dr. Krishnashastry reiterated her initial diagnosis of right-sided low back pain with 

right-sided sciatica and later diagnosed “acute bilateral low back pain with bilateral sciatica, and 

lumbago with sciatica, left side and right side.” She related that appellant presented with 

complaints of back pain, symptoms aggravated after he was at work, when he tried to get out of 

the truck. Appellant was in a lot of pain with pain radiating down his legs. It was also noted that 

he reported that, after he informed his supervisor of the injury, he was told that he should have 

stopped driving and reported the injury at the time of the incident.

On February 20, 2016 Dr. Pacifico diagnosed sciatica associated with disorder of lumbar 

spine on the right, acute pain of both knees, and low back pain. 

In a March 3, 2016 report, Dr. Michael Bruderly, a Board-certified family practitioner, 

diagnosed right-sided low back pain without sciatica. 

On August 23, 2016 a certified nurse practitioner diagnosed chronic bilateral low back pain 

with bilateral sciatica; lumbago with sciatica, right side; and other chronic pain and indicated that 

appellant sustained an injury to his back while at work in early December.

In an August 31, 2016 report, Dr. Michael Szymanski, a Board-certified family 

practitioner, diagnosed acute bilateral low back pain with bilateral sciatica and noted that appellant 

had sharp lower back pain for a few months. 

On November 29, 2016 a physician assistant diagnosed sacroiliitis, myofascial pain, and 

lumbar radiculitis.

In reports dated June 28, September 14, 26, and 29, and November 14, 2016 and 

January 30, 2017, Dr. Luke Y. Kim, Board-certified in physical medicine and rehabilitation, noted 

that appellant was a mail carrier who started to have significant back pain around December 1, 

2015 which he felt was related to carrying heavy mailbags and packages. He noted that initially 

appellant felt a pulled muscle and then his pain got worse. Dr. Kim diagnosed L4-5 disc herniation 

with lateral recess stenosis and opined that appellant’s lifting, carrying, pushing, and pulling and 

repetitive bending, stooping, and twisting at work had created this condition. 

During the telephonic hearing held on January 25, 2017, appellant provided testimony and 

the hearing representative held the case record open for 30 days for the submission of additional 

evidence.

Appellant subsequently submitted an August 24, 2016 report from Dr. Arthur Tai, Boardcertified in internal medicine, who diagnosed acute bilateral low back pain with bilateral sciatica 

and lumbago with sciatica, right side. Dr. Tai reported that appellant described exacerbation of 

his chronic low back pain “with the increased workload at the workplace of lifting, more 

packages.”
4

By decision dated March 3, 2017, the hearing representative affirmed the June 21, 2016 

decision, finding that the medical evidence of record was insufficient to establish that the 

diagnosed low back condition was causally related to the accepted factors of his federal 

employment. 

On February 21, 2018 counsel requested reconsideration and submitted a February 19, 

2018 report from Dr. Neil Allen, a Board-certified internist and neurologist. Dr. Allen indicated 

that he had reviewed appellant’s medical record in order to establish whether causal relationship 

exists between his lumbar spine condition(s) and occupational exposure on and prior to 

November 15, 2015. He opined that appellant’s case should be updated to include aggravation of 

intervertebral disc disorders with radiculopathy, lumbar region, and other spondylosis with 

radiculopathy, lumbar region. Dr. Allen explained that appellant’s “underlying degenerative 

conditions combined with the repetitive occupation related microtrauma on and before 

November 15, 2015 contributed to the manifestation of a symptomatic lumbar facet syndrome.” 

He indicated that appellant’s regular duties required him to repetitively lift from the ground and/or 

about the shoulder, both activities requiring forceful lumbar extension, over time stressing the 

joints of the spine, more so than what would be expected to perform daily activities. Dr. Allen 

concluded that appellant’s lumbar spine conditions were aggregated by and became symptomatic 

as a direct result of repetitive occupation-related trauma.

By decision dated May 1, 2018, OWCP denied modification of its prior 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,3that 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.4 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.5 

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

claim, an employee must submit the following: (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 

 

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

153 (1989).

4

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

ECAB 312 (1988).

5 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

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

condition is causally related to the employment factors identified by the employee.6

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

relationship is rationalized medical opinion evidence.7 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 factors identified by the employee.8

ANALYSIS

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

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

Appellant identified the factors of employment that he believed caused his conditions, 

including carrying a satchel and lifting mail and packages at work, which OWCP accepted as 

factual. However, in order to establish an employment-related injury he must also submit 

rationalized medical evidence which explains how his medical conditions were caused or 

aggravated by the implicated employment factors.9

Appellant submitted medical reports from his treating physicians. In their reports,

Dr. Pacifico, Dr. Bruderly, Dr. Tai, and Dr. Szymanski provided medical diagnoses, but failed to 

provide an opinion on the issue of causal relationship. The Board has held that medical evidence 

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

value on the issue of causal relationship.10 Thus, this evidence is also insufficient to establish 

appellant’s burden of proof.

Upon noting the symptoms and appellant’s work requirements, Dr. Krishnashastry opined 

that carrying the satchel along the right shoulder could be adding to a lot of strain to the back and 

be precipitating the symptoms of back pain. She also related his low back pain to an incident when 

appellant tried to get out of a truck at work. OWCP has not accepted a truck incident in this case. 

The Board finds that Dr. Krishnashastry’s opinion regarding the cause of appellant’s lumbar spine 

 

6 See D.R., Docket No. 09-1723 (issued May 20, 2010). See also Roy L. Humphrey, 57 ECAB 238, 241 (2005); 

Ruby I. Fish, 46 ECAB 276, 279 (1994); Victor J. Woodhams, 41 ECAB 345 (1989).

7 D.L., Docket No. 18-1007 (issued November 28, 2018); R.H., 59 ECAB 382 (2008); Ernest St. Pierre, 51 ECAB 

623 (2000).

8 D.L., id.; I.J., 59 ECAB 408 (2008); Victor J. Woodhams, supra note 6.

9 A.C., Docket No. 08-1453 (issued November 18, 2008).

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

condition and exacerbation is speculative and equivocal in nature.11 To be of probative value, a 

physician’s opinion on causal relationship must be one of reasonable medical certainty.12

In his reports, Dr. Kim indicated that appellant was a mail carrier who started to have 

significant back pain around December 1, 2015 which he felt was related to carrying heavy mail 

bags and packages. However, he failed to provide sufficient medical rationale to support his 

opinion that appellant’s lifting, carrying, pushing, pulling, bending, stooping, and twisting at work 

caused or aggravated his L4-5 disc herniation with lateral recess stenosis condition. The Board 

has held that a report is of limited probative value regarding causal relationship if it does not 

contain medical rationale explaining how a given medical condition/disability was related to 

employment factors.13 Dr. Kim did not otherwise sufficiently explain why he had concluded that 

carrying a satchel and lifting mail and packages at work was sufficient to have caused or 

contributed to the diagnosed condition. Thus, the Board finds that the report from Dr. Kim is 

insufficient to establish that causal relationship.

In his February 19, 2018 report, Dr. Allen indicated that he had reviewed appellant’s 

medical record in order to establish whether a causal relationship exists between his lumbar spine 

condition(s) and occupational exposure on and prior to November 15, 2015. He opined that 

appellant’s case should be updated to include aggravation of intervertebral disc disorders with 

radiculopathy, lumbar region, and other spondylosis with radiculopathy, lumbar region. Dr. Allen 

explained that appellant’s underlying degenerative conditions combined with the repetitive 

occupation related microtrauma on and before November 15, 2015 contributed to the manifestation 

of a symptomatic lumbar facet syndrome. He noted that appellant’s regular duties required him to 

repetitively lift from the ground and/or about the shoulder, both activities requiring forceful lumbar 

extension, over time stressing the joints of the spine, more so than what would be expected to 

perform daily activities. Dr. Allen concluded that appellant’s lumbar spine conditions were 

aggravated by and became symptomatic as a direct result of repetitive occupational-related trauma. 

The Board finds that Dr. Allen has not provided sufficient medical rationale explaining how 

carrying a satchel and lifting mail and packages at work either caused or contributed to appellant’s 

diagnosed conditions. Dr. Allen’s opinion was based, in part, on temporal correlation. However, 

the Board has held that neither the mere fact that a disease or condition manifests itself during a 

period of employment, nor the belief that the disease or condition was caused or aggravated by 

employment factors is sufficient to establish causal relationship.14 Dr. Allen did not otherwise 

sufficiently explain why he had concluded that appellant’s employment factors caused or 

contributed to the diagnosed conditions. Thus, the Board finds that the report from Dr. Allen is

also insufficient to establish that appellant sustained an employment-related injury.

Appellant submitted evidence from a nurse practitioner and a physician assistant. The 

Board has held, however, that medical reports signed solely by a nurse practitioner or physician 

 

11 Medical opinions that are speculative or equivocal in character are of little probative value. See Kathy A. Kelley, 

55 ECAB 206 (2004).

12 See Beverly R. Jones, 55 ECAB 411 (2004).

13 See Y.D., Docket No. 16-1896 (issued February 10, 2017).

14 Id.
7

assistant are of no probative value as such health care providers are not considered physicians as 

defined under FECA and are therefore not competent to provide medical opinions.15 

Consequently, this evidence is also insufficient to establish appellant’s claim.

As appellant has not submitted rationalized medical evidence sufficient to establish that he 

sustained a lumbar spine injury causally related to the accepted employment factors, he has not 

met his burden of proof to establish the 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 lumbar spine

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

 

15 See David P. Sawchuk, 57 ECAB 316, 320 n.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). E.T., Docket No. 17-0265 (issued 

May 25, 2018) (physician assistants are not considered physicians under FECA); S.J., Docket No. 17-0783, n2. (issued 

April 9, 2018) (nurse practitioners are not considered physicians under FECA).
8

ORDER

IT IS HEREBY ORDERED THAT the May 1, 2018 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: March 15, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board