United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

A.L., Appellant

and

U.S. POSTAL SERVICE, MORGAN 

PROCESSING & DISTRIBUTION CENTER, 

New York, NY, Employer

__________________________________________

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Docket No. 19-1122

Issued: January 7, 2020 

Appearances: Case Submitted on the Record

Alan J. Shapiro, for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

JANICE B. ASKIN, Judge

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On April 22, 2019 appellant, through counsel, filed a timely appeal from a March 26, 2019 

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 the 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 March 26, 2019 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 established diagnosed medical conditions causally 

related to the accepted December 19, 2017 employment incident.

FACTUAL HISTORY

On December 21, 2017 appellant, then a 78-year-old mail handler equipment operator, 

filed a traumatic injury claim (Form CA-1) alleging that on December 19, 2017 he experienced 

neck muscle spasms and low back, right shoulder, and arm pain with tingling when performing 

routine lifting, pushing, walking, and bending duties while in the performance of duty. He stopped 

work on December 20, 2017.

In a development letter dated February 9, 2018, OWCP informed appellant of the 

deficiencies of his claim. It advised him of the type of factual and medical evidence needed to 

establish his claim and provided a questionnaire for completion. Appellant was afforded 30 days

to submit the necessary evidence.

On March 10, 2018 OWCP received a statement from appellant in which he noted that he 

developed muscle spasms in his neck, lower back, right shoulder, and arm, with tingling into his 

right hand while he was at work on December 19, 2017. Appellant explained that on that day he 

was lifting flat trays of mail weighing 70 pounds or more from a conveyor, walking 10 paces or 

more, placing them in empty postal containers, and pushing and pulling the filled containers to 

their staging areas. He noted seeking treatment on December 21, 2017. In a January 18, 2018 

report, Dr. Danielle Stember, a Board-certified neurologist, noted that appellant was seen on that 

date for neck pain. She indicated that he could return to work with restrictions.

In a March 6, 2018 report, Dr. Stember noted that appellant had repetitively lifted trays of 

mail and complained of neck pain with numbness and tingling in his right arm. She indicated that 

he reported an exacerbation of neck pain at his follow-up appointment on December 21, 2017. 

Dr. Stember also noted that appellant had evidence of preexisting multi-level degenerative disease 

on the x-ray of the cervical spine obtained on June 28, 2017. She found degenerative changes at 

the T1 and T2 level of the spine which resulted in mild canal and severe bilateral foraminal 

stenosis. Dr. Stember opined that it was possible that the reported neck pain was exacerbated by 

activities at appellant’s job based on his report of events. 

In a March 6, 2018 attending physician’s report (Form CA-20), Dr. Stember noted the date 

of injury as December 19, 2017, and diagnosed exacerbation of cervical radiculopathy, with 

known chronic cervical degenerative disease. She checked a box marked “yes” in response to 

whether she believed the diagnosed condition was employment related. Dr. Stember also noted 

that appellant had severe degenerative disease of the cervical spine, as found on the January 11, 
3

2018 cervical spine magnetic resonance imaging (MRI) scan. She indicated that he was at risk of 

recurrent exacerbation of neck pain and/or cervical radiculopathy.

By decision dated March 16, 2018, OWCP denied appellant’s claim finding that the 

medical evidence of record was insufficient to establish a medical condition causally related to the 

accepted employment incident.

In a March 14, 2018 Form CA-20 report, Dr. Stember diagnosed exacerbation of cervical 

radiculopathy in setting of known chronic cervical degenerative disease. She again checked the 

box “yes” in response to whether she believed the diagnosed condition was employment related.

Dr. Stember indicated that appellant was partially disabled from December 21, 2017 to 

January 22, 2018.

On March 29, 2018 appellant, through counsel, requested a telephonic hearing before an 

OWCP hearing representative.

In a March 2, 2018 report, Dr. Theresa Pereguda, a Board-certified internist, noted that 

appellant was seen on August 3 and December 21, 2017, for complaints of neck and lower back

pain and numbness and tingling in the right arm. She noted appellant’s history of lifting trays of 

mail. Dr. Pereguda advised that a neurology note revealed chronic cervicalgia, but worsening 

radicular symptoms of paresthesia over the right upper extremity, and lateral aspect (C5-6 

distribution) with no accompanying weakness or sensory loss. She noted that a cervical spine MRI 

scan disclosed multi-level degenerative changes resulting in mild canal stenosis at C4-5 and 

multilevel bilateral foraminal stenosis. Dr. Pereguda diagnosed cervical spondylosis with 

radiculopathy and opined that it was “possible” that the condition was aggravated by appellant’s 

activity at work.

In a report dated July 27, 2018, Dr. Paul Ort, a Board-certified orthopedic surgeon, noted 

that appellant was under his care since June 28, 2017. He indicated that appellant had complaints

of bilateral knee pain for over three years and bilateral arthroscopic knee surgery. Dr. Ort opined 

that, within a reasonable degree of medical certainty, appellant’s work had aggravated his bilateral 

knee osteoarthritis.

Following a July 30, 2018 telephonic hearing, by decision dated September 20, 2018, 

OWCP’s hearing representative affirmed the March 16, 2018 decision. The hearing representative 

explained that the treating physicians had not provided a rationalized opinion as to causal 

relationship, nor did the medical record include objective diagnostic findings in support of the 

claim.

On December 28, 2018 appellant, through counsel, requested reconsideration and 

submitted new evidence. 

In a November 6, 2018 report, Dr. Steven S. Moalemi, Board-certified in physical 

medicine and rehabilitation, noted that appellant had a history of an injury on May 4, 2017, and an 

exacerbation on December 19, 2017, while performing his regular duties as a mail handler. He

noted that appellant’s duties included working 40 hours a week, repetitively lifting flat trays of 

mail weighing up to 70 pounds, and walking 10 or more paces to place the mail in postal containers. 

Dr. Moalemi diagnosed neck ascending aortic aneurysm, right shoulder sprain/osteoarthritis, 

exacerbation of cervical spine radiculopathy/osteoarthritis, exacerbation of lumbar spine
4

radiculopathy/osteoarthritis, exacerbation of thoracic spine sprain/osteoarthritis, exacerbation of 

right knee osteoarthritis with possible meniscus tear, exacerbation of left knee osteoarthritis with 

possible meniscus tear, exacerbation of bilateral foot hypertrophied bone and resolved bursitis, 

exacerbation of bilateral foot osteoarthritis, and peroneus brevis tendon tears of the feet. He opined 

that, within a reasonable degree of medical certainty, the exacerbation of appellant’s conditions 

resulted from his work activities.

OWCP also received additional diagnostic reports dated from June 7, 2017 to 

October 2, 2018. 

By decision dated March 26, 2019, OWCP denied modification of its September 20, 2018 

decision.

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

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

OWCP begins with an analysis of whether fact of injury has been established.8 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 generally requires rationalized medical 

opinion evidence to resolve the issue.11 A physician’s opinion on whether there is a causal 

relationship between the diagnosed condition and the implicated employment incident must be 

 

4

Id.

5

J.P., Docket No. 19-0129 (issued April 26, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); Joe D. 

Cameron, 41 ECAB 153 (1989).

6

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 R.R., Docket No. 19-0048 (issued April 25, 2019); L.M., Docket No. 13-1402 (issued February 7, 2014); 

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

8 E.M., Docket No. 18-1599 (issued March 7, 2019); T.H., 59 ECAB 388, 393-94 (2008).

9 L.T., Docket No. 18-1603 (issued February 21, 2019); Elaine Pendleton, 40 ECAB 1143 (1989).

10 B.M., Docket No. 17-0796 (issued July 5, 2018); John J. Carlone, 41 ECAB 354 (1989).

11 E.M., supra note 8; Robert G. Morris, 48 ECAB 238 (1996).
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based on a complete factual and medical background.12 Additionally, the physician’s opinion must 

be expressed in terms of a reasonable degree of medical certainty, and must be supported by 

medical rationale, explaining the nature of the relationship between the diagnosed condition and 

appellant’s specific employment incident.

13

In a 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.14

ANALYSIS

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

medical conditions causally related to the accepted December 19, 2017 employment incident.

Appellant submitted several reports from Dr. Stember, including a January 18, 2018 report 

which indicated that appellant was seen for pain and recommended work restrictions. However, 

this report is insufficient to establish the claim as the physician did not provide a diagnosis or 

history of injury,

15 or provide an opinion on the issue of causation.16

In a March 6, 2018 report, Dr. Stember noted the history of injury and found evidence of 

preexisting, multi-level degenerative disease of the spine. She opined that it was “possible” that 

the reported neck pain was exacerbated by activities at appellant’s job, as based on his report of 

injury. However, this report is speculative and therefore of limited probative value.17

Appellant also submitted March 6 and 14, 2018 CA-20 forms from Dr. Stember in which 

she diagnosed exacerbation of cervical radiculopathy in setting of known chronic cervical 

degenerative disease. Dr. Stember checked a box marked “yes” in response to whether she 

believed the diagnosed condition was employment related. The Board has held that when a 

physician’s opinion on causal relationship consists of checking “yes” to a form question, without 

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

to establish a claim.16 Therefore, Dr. Stember’s reports are insufficient to establish appellant’s 

claim. 

In a March 2, 2018 report, Dr. Pereguda diagnosed spondylosis with radiculopathy, 

cervical region, and opined that it was “possible” that the condition was aggravated by appellant’s 

 

12 M.V., Docket No. 18-0884 (issued December 28, 2018); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

13 Id.

14 J.F., Docket No. 19-0456 (issued July 12, 2019); Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal 

Relationship, Chapter 2.805.3e (January 2013).

15 See R.P., Docket No. 19-0743 (issued September 20, 2019); 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).

16 L.B., Docket No. 18-0533 (issued August 27, 2018); A.D., 58 ECAB 149 (2006).

17 See Frank Luis Rembisz, supra note 15.
6

activity at work. As previously noted, speculative opinions are of diminished probative value and 

insufficient to establish appellant’s claim.

18

In a report dated July 27, 2018, Dr. Ort indicated that appellant had complaints of bilateral 

knee pain for over three years and bilateral arthroscopic surgery to both knees. He opined that,

within a reasonable degree of medical certainty, appellant’s work aggravated his bilateral knee 

osteoarthritis. However, the Board finds that Dr. Ort did not provide medical rationale explaining 

the basis of his conclusory opinion regarding the causal relationship between appellant’s knee 

conditions and the December 19, 2017 employment incident. The Board has held that 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.

19

 Dr. Ort did not explain 

the physiologic process by which the lifting, pushing, walking, and bending at work would have 

caused or aggravated the diagnosed conditions, and why the diagnoses would not have been the 

result of preexisting conditions and thus his opinion is insufficient to establish the claim.

20

 

In a November 6, 2018 report, Dr. Moalemi noted the history of injury and appellant’s 

duties at work and provided physical examination findings. He diagnosed multiple conditions and 

opined that, within a reasonable degree of medical certainty, the exacerbation of appellant’s 

conditions resulted from his work activities. However, Dr. Moalemi did not provide rationale to 

support his opinion that the multiple diagnosed conditions were caused by appellant’s work 

activities. As his opinion regarding causal relationship was conclusory and unexplained, it was 

insufficient to establish appellant’s claim.21

OWCP also received diagnostic reports. However, diagnostic testing reports lack probative 

value on the issue of causal relationship as they do not provide an opinion regarding the cause of 

the diagnosed conditions.22

The Board finds that the evidence of record lacks rationalized medical evidence 

establishing causal relationship between appellant’s diagnosed medical conditions and the

accepted December 19, 2017 employment incident. Thus, appellant 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.

 

18 Id.

19 See T.M., Docket No. 08-0975 (issued February 6, 2009). 

20 See A.M., Docket No. 18-1538 (issued April 25, 2019); K.K., Docket No. 17-1061 (issued July 25, 2018).

21 See M.O., Docket No. 18-0229 (issued September 23, 2019); see T.M., supra note 19 (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).

22 Z.G., Docket No. 19-0967 (issued October 21, 2019); see L.M., Docket No. 14-0973 (issued August 25, 2014). 
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CONCLUSION

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

medical conditions causally related to the accepted December 19, 2017 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the March 26, 2019 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: January 7, 2020

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board