United States Department of Labor

Employees’ Compensation Appeals Board

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R.A., Appellant

and

DEPARTMENT OF TRANSPORTATION, 

FEDERAL AVIATION ADMINISTRATION, 

Greensboro, NC, Employer

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Docket No. 19-0650

Issued: January 15, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On January 29, 2019 appellant filed a timely appeal from a December 11, 2018 merit 

decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal 

Employees’ Compensation Act1(FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has 

jurisdiction over the merits of this case.

ISSUE

The issue is whether appellant has met his burden of proof to establish cervical and thoracic 

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

FACTUAL HISTORY

On April 7, 2016 appellant, then a 55-year-old airways transportation systems specialist, 

filed an occupational disease claim (Form CA-2) alleging that he developed pain in his neck, 

 

1 5 U.S.C. § 8101 et seq.
2

shoulders, and knees due to factors of his federal employment including a two-day work project 

that required bending, kneeling, lifting, attaching hardware, long hours on his feet, and many trips 

up and down stairs. He noted that he first started to experience aches and pains following the first 

day of the project. Appellant indicated that he first became aware of his condition and realized its 

relationship to his federal employment on April 7, 2016.

In an attached statement, appellant noted that the work project occurred from April 5 to 6, 

2016 and that it required approximately six hours of continuous labor that put abnormal stress and 

strain on his body. He indicated that he was suffering from pain in his neck, shoulders, and knees 

and that he had severe pain in his right knee. Appellant reported that he had previously experienced 

neck, shoulder, and knee pain after special projects that had required extensive physical endurance, 

but the pain had significantly increased after the most recent project. He also noted that he had a 

previously accepted traumatic injury claim under OWCP File No. xxxxxx060.2

In an April 12, 2016 development letter, OWCP informed appellant that the evidence of 

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

evidence necessary to support his claim and provided a questionnaire for completion. In a separate 

letter of even date, OWCP requested that the employing establishment provide additional 

information regarding appellant’s alleged injury, including comments from a knowledgeable 

supervisor on the accuracy of his statements and explaining any points of disagreement. It afforded 

both parties 30 days to submit the requested evidence. No response was received.

By decision dated June 23, 2016, OWCP denied appellant’s occupational disease claim. It 

accepted his duties as described, but denied his claim because no medical evidence was submitted 

to establish a medical diagnosis causally related to the accepted employment factors. OWCP 

concluded, therefore, that the requirements had not been met to establish an injury as defined by 

FECA. 

On July 27, 2017 appellant requested reconsideration. 

Appellant submitted a series of reports dated May 26 to July 16, 2016 by Dr. Edward 

Boudreau, a chiropractor. In a May 26, 2016 narrative report, Dr. Boudreau related appellant’s 

complaints of pain in his neck, shoulders, and upper back, stiffness, and decreased range of motion. 

He indicated that appellant had informed him that he had neck problems since April 7, 2016 after 

performing a project at work. In subsequent office visit notes, Dr. Boudreau provided examination 

findings and reported diagnoses of lumbar region subluxation (segmental dysfunction), lumbar 

facet syndrome, cervicobrachial syndrome, cervical disc degeneration, cervical region 

subluxation, head region subluxation, thoracic region subluxation, and myalgia. 

A May 27, 2016 x-ray report of appellant’s cervical spine revealed levo-scoliosis, moderate 

disc thinning at C4-5, C5-6, and C6-7, and rotational malpositions at the following levels: C2, C7, 

 

2 On August 9, 2013 appellant filed a traumatic injury claim (Form CA-1) alleging that on August 7, 2013 he 

experienced pain in his shoulder, neck, knee, and left foot as a result of climbing a tower while in the performance of 

duty. OWCP accepted this claim for medical benefits and is currently closed and has not been administratively 

combined with this file. 
3

T1, T2, and T3. Dr. Boudreau reported that appellant displayed signs of disc degeneration at C4-5, 

C5-6, and C6-7. 

In a February 10, 2017 letter, Dr. Boudreau indicated that appellant was initially seen in 

his office on May 26, 2016 for complaints of neck and upper back pain following a work-related 

project that required heavy lifting and a substantial amount of overhead activity. He noted, “this 

would seem like a reasonable mechanism of injury for his presenting complaints.” Dr. Boudreau 

diagnosed cervicobrachial syndrome, cervical disc degeneration, cervical region subluxation, head 

region subluxation, and thoracic region subluxation. He indicated that these subluxations were 

noted on his x-ray report and listed under “rotational malpositions.”

In a February 22, 2017 narrative report, Dr. Stephen Meyers, a Board-certified family 

practitioner, indicated that appellant had been his patient for nearly 12 years and had intermittently 

sought treatment for neck and back pain related to a January 2008 motor vehicle accident. He 

recounted that appellant sought a written statement from him regarding his current neck and 

shoulder pain due to a work-related injury. Dr. Meyers noted that he did not immediately evaluate 

appellant, but related that appellant had informed him that on April 7, 2016 he was performing 

unusually physical labor. He reported that appellant subsequently underwent chiropractic and 

physical therapy treatment and that he had reviewed those treatment notes. Dr. Meyers noted 

examination findings of significant limitation in range of motion of appellant’s neck. He indicated 

that appellant’s degree of pain and need to seek treatment dramatically escalated after the reported 

date of injury. Dr. Meyers opined that it was “highly likely” that appellant’s current pain was 

caused, or at least greatly aggravated by, the unusual work that he reported performing on 

April 7, 2016. 

In a completed questionnaire dated February 23, 2017, appellant responded to OWCP’s 

development letter. He believed that the activities which led to his condition were eight hours of 

hard labor that occurred over two days. Appellant described the duties as removing rotten deck 

boards, carrying heavy material up and down stairs, lifting and handling of deck material, and 

removal and reattachment of hardware. 

In a February 23, 2017 narrative statement, appellant also indicated that he was submitting 

two letters which addressed OWCP’s request for additional information. He explained that he was 

very optimistic that the chiropractic treatment would resolve his issues, which was why he waited 

to seek treatment from a general physician. Appellant alleged that Dr. Boudreau properly 

documented and diagnosed the subluxation issue. 

By decision dated March 23, 2017, OWCP modified its June 23, 2016 decision denying 

appellant’s claim. It noted that the medical evidence of record in fact provided medical diagnoses 

of cervical region subluxation, head region subluxation, and thoracic region subluxation. OWCP, 

however, continued to deny appellant’s claim because the evidence of record was insufficient to 

establish causal relationship between his diagnosed conditions and the accepted factors of his 

federal employment.

On June 28, 2017 appellant requested reconsideration. 
4

Appellant submitted a letter by Dr. Meyers, dated April 19, 2017, which is substantially 

similar to his February 22, 2017 letter. Dr. Meyers described the claimed April 7, 2016 

employment injury and the subsequent chiropractic treatment that appellant received. He opined 

that appellant’s “current pain predicament” was caused by the unusual work that he reportedly 

performed on April 7, 2016. 

In a May 9, 2017 letter, Dr. Boudreau reiterated that appellant first presented in his office 

on May 26, 2016 with complaints of neck and upper back pain that began on April 7, 2016. He 

explained that, considering the degree of pain that appellant experienced after the reported injury, 

it was his opinion that the unusually physical work that appellant performed on April 7, 2016 was 

the cause of his neck and upper back pain. 

By decision dated August 23, 2017, OWCP denied modification of the March 23, 2017 

decision. 

On October 17, 2017 appellant requested reconsideration. 

In an October 4, 2017 letter, Dr. Boudreau clarified that appellant reported that his neck 

and upper back pain began on April 5, 2016 while working on a two-day project. He noted that 

the work required unusually physical activity, including heavy lifting and a substantial amount of 

overhead activity. Dr. Boudreau explained that, considering the degree of pain that he experienced 

after the reported injury, it was his opinion that the unusually physical work performed on April 5 

and 6, 2016 caused appellant’s neck and upper back pain. 

By decision dated January 5, 2018, OWCP denied modification of its August 23, 2017 

decision. 

On September 13, 2018 appellant requested reconsideration. 

In a September 12, 2018 letter, Dr. Boudreau described the type of work that appellant 

performed on April 5 and 6, 2016. He reported that intense physical labor can lead to microtrauma to the connective tissue, resulting in hypertonicity, trigger points, inflammation, and pain. 

Dr. Boudreau explained that connective tissue attached to the vertebrae can, therefore, disarticulate 

the vertebrae, resulting in subluxation. He indicated that appellant was treated in his office for 

vertebral subluxations and connective tissue micro-trauma (myalgia, hypertonicity, and trigger 

points). Dr. Boudreau concluded that the unusually physical work that appellant performed on 

April 5 and 6, 2016 was the cause of his neck and upper back pain. 

In a December 11, 2018 decision, OWCP denied modification of the January 5, 2018 

decision.

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 

 

3 Supra note 1.
5

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 

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 this case is not in posture for a decision. 

Appellant submitted a series of reports and letters dated May 26, 2016 to September 12, 

2018 by Dr. Boudreau, a chiropractor. Dr. Boudreau provided a May 27, 2016 x-ray report which 

 

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

153 (1989). 

5

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

ECAB 312 (1988).

6 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).

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 April 24, 2019); T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 

238 (1996).

9 M.V., Docket No. 18-0884 (issued December 28, 2018); 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); see 

M.S., Docket No. 19-0913 (issued November 25, 2019); R.D., Docket No. 18-1551 (issued March 1, 2019).
6

demonstrated rotational malpositions at C2, C7, T1, T2, and T3. Section 8101(2) of FECA11

provides that the term physician, as used therein, includes chiropractors only to the extent that their 

reimbursable services are limited to treatment consisting of manual manipulation of the spine to 

correct subluxation, as demonstrated by x-ray to exist and subject to regulations by the Secretary.12 

As Dr. Boudreau diagnosed subluxation based on a May 27, 2016 x-ray report, he is a qualified 

physician under FECA and his opinion constitutes competent medical evidence.13

In his initial May 26, 2016 report, Dr. Boudreau related that on April 7, 2016 appellant had 

completed a two-day work project that required heavy lifting and a substantial amount of overhead 

activity and experienced neck, shoulder, and upper back pain. In subsequent examination notes, 

he reported diagnoses of cervicobrachial syndrome, cervical disc degeneration, cervical region 

subluxation, head region subluxation, and thoracic region subluxation. In letters dated May 9 and 

October 4, 2017, Dr. Boudreau opined that, considering the degree of pain that appellant 

experienced, the unusually physical work that appellant performed on April 5 and 6, 2016 was the 

cause of his neck and upper back pain. In a September 12, 2018 letter, he provided further 

explanation noting that “intense physical labor can lead to micro-trauma to the connective tissue, 

resulting in hypertonicity, trigger points, inflammation, and pain.” Dr. Boudreau further explained 

that this connective tissue and disarticulation of the vertebra could lead to subluxation, which is a 

diagnosed condition in this claim. He concluded that the unusually physical work that appellant 

performed on April 5 and 6, 2016 caused appellant’s neck and upper back pain.

Proceedings under FECA are not adversarial in nature, nor is OWCP a disinterested arbiter. 

While it is appellant’s burden of proof to establish the claim, OWCP shares responsibility in the 

development of the evidence.14 It has the obligation to see that justice is done.15 The Board will, 

therefore, remand the case to OWCP for further development of the medical evidence. 

On remand OWCP shall refer appellant, a statement of accepted facts, and the medical evidence 

of record to an appropriate Board-certified physician. The chosen physician shall provide a 

rationalized opinion on the issue of whether the diagnosed conditions are causally related to the 

accepted factors of appellant’s federal employment, giving consideration to the opinion of

Dr. Boudreau. Following this and any other further development as deemed necessary, OWCP 

shall issue a de novo decision on appellant’s claim.

CONCLUSION

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

 

11 5 U.S.C. § 8101(2).

12 See 20 C.F.R. § 10.311; R.H., Docket No. 18-1544 (issued March 4, 2019); M.B., Docket No. 17-1378 (issued 

December 13, 2018).

13 Id.; see also Jay K. Tomokiyo, 51 ECAB 361 (2000).

14 C.W., Docket No. 19-0231 (issued July 15, 2019); D.G., Docket No. 15-0702 (issued August 27, 

2015); Donald R. Gervasi, 57 ECAB 281, 286 (2005); William J. Cantrell, 34 ECAB 1233, 1237 (1983).

15 Id.
7

ORDER

IT IS HEREBY ORDERED THAT the December 11, 2018 merit 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: January 15, 2020

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board