United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.W., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Houston, TX, Employer

__________________________________________

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Docket No. 19-1747

Issued: September 2, 2020

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

CHRISTOPHER J. GODFREY, Deputy Chief Judge

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On August 19, 2019 appellant, through counsel, filed a timely appeal from a July 10, 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 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 July 10, 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 met his burden of proof to establish that the acceptance 

of his claim should be expanded to include additional cervical, lumbar, and shoulder conditions 

causally related to his accepted August 28, 2012 employment injury.

FACTUAL HISTORY

This case has previously been before the Board.4 The facts and circumstances as set forth 

in the Board’s prior decision are incorporated herein by reference. The relevant facts are as 

follows.

On August 31, 2012 appellant, then a 51-year-old transitional city carrier, filed a traumatic 

injury claim (Form CA-1) alleging that on August 28, 2012 he sustained a traumatic injury when 

he was involved in a motor vehicle accident while in the performance of duty. He stopped work 

on August 29, 2012.5 OWCP accepted his claim for cervical and lumbar sprains, and left shoulder 

strain. It paid continuation of pay (COP) from August 29 to October 12, 2012 and wage-loss 

compensation benefits on the periodic rolls effective April 29, 2013.

Appellant continued to receive medical treatment. In a September 29, 2014 report,

Dr. Louis Train, a Board-certified family practitioner, recounted that on August 28, 2012 appellant 

was driving at work when he was broadsided by another motor vehicle and sustained injuries to 

his neck, right arm, right thigh, and lower back. He noted that appellant’s claim was accepted for 

cervical and lumbar sprains. Dr. Train provided examination findings and requested that 

appellant’s claim be expanded to include internal derangement of both shoulders.

In a November 12, 2014 narrative report, Dr. Train explained that, based on appellant’s 

history, mechanism of injury, and previous examinations, appellant had depressive disorder and 

additional issues, including anxiety and chronic pain. He opined that these additional diagnoses 

were a direct result of appellant’s work-related injury. Dr. Train requested that appellant’s claim 

be expanded to include the diagnoses of psychogenic pain/chronic pain syndrome, major 

depressive disorder, and generalized anxiety disorder.

By decisions dated April 6 and 22, 2015, OWCP denied expansion of appellant’s claim to 

include bilateral shoulder internal derangement, psychogenic pain, chronic pain, chronic pain 

syndrome, and major depressive disorder, finding that the medical evidence of record was 

insufficient to establish that the additional conditions were caused or aggravated by his August 28, 

2012 employment injury.

On May 4, 2015 appellant requested a hearing before a representative of OWCP’s Branch 

of Hearings and Review, which was held on November 16, 2015. By decision dated February 1, 

2016, an OWCP hearing representative affirmed the April 22, 2015 decision.

On March 22, 2016 appellant filed an appeal with the Board.

 

4 Docket No. 16-0858 (issued April 3, 2017).

5 On October 18, 2012 appellant’s term appointment ended. 
3

By decision dated April 3, 2017, the Board affirmed OWCP’s February 1, 2016 decision, 

finding that appellant had not met his burden of proof to expand his claim to include the additional 

conditions of internal derangement of bilateral shoulders, psychogenic pain, chronic pain 

syndrome, and major depressive order as causally related to the accepted August 28, 2012 

employment injury.6

Following the Board’s decision, appellant, through counsel, requested reconsideration and 

submitted additional medical evidence.

Appellant submitted reports by Dr. Mical Samuelson Duvall, Board-certified in 

anesthesiology and pain management, dated January 4 and February 29, 2016 relative to his 

treatment for ongoing neck and lower back pain radiating down to his right leg. Dr. Duvall

reported cervical and lumbar spine examination findings and diagnosed lumbar and neck sprain, 

and lumbar pain.

OWCP also received reports by Dr. Charles Reinhardt, an osteopath specializing in 

anesthesiology. In a June 1, 2016 report, Dr. Reinhardt recounted that on August 28, 2012 

appellant was driving a postal vehicle when he was blindsided by another vehicle. He noted 

appellant’s accepted conditions of lumbar and cervical spine sprains and indicated that his claim 

should be expanded to include the condition of internal disc disruption. Dr. Reinhardt reviewed 

appellant’s diagnostic examinations and provided cervical and lumbar spine examination findings. 

He continued to provide reports dated October 11, 2016 to February 27, 2017, regarding his 

treatment of appellant for his cervical spine disc disease, lumbar disc disease, and depression.

In a July 26, 2016 psychological report, Dr. George P. Grimes, a clinical psychologist, 

described the August 28, 2012 employment injury and noted that appellant was treated for cervical 

and lumbar spine sprains. He noted that, due to increased pain levels, appellant was having 

difficulty performing certain physical activities, sleeping three to four hours due to nightmares and 

sleep disturbances, and experienced nervousness, agitation, decreased appetite, weight 

fluctuations, and headaches. Dr. Grimes conducted psychometric testing and a mental status 

examination. He reported that appellant suffered a work-related injury, resulting in psychosocial 

stressors including increased pain levels, physical limitations, and loss of function. Dr. Grimes 

diagnosed chronic pain disorder.

In a March 27, 2017 report, Dr. Reinhardt recounted appellant’s complaints of neck, 

lumbar, and right knee pain following a work-related motor vehicle. He reviewed the medical 

treatment history, including magnetic resonance imaging (MRI) studies of his cervical spine, 

lumbar spine, and right shoulder. Dr. Reinhardt diagnosed cervical spine disc disease, lumbar 

disease with bilateral radiculopathy, and right shoulder rotator cuff. He opined that appellant 

developed an occupational injury due to his duties of prolonged standing, walking, bending, 

stooping, lifting, pushing, pulling, reaching, twisting, and turning as a carrier. Dr. Reinhardt 

requested that appellant’s claim be expanded to include the additional conditions of spinal stenosis 

at C3-4, C4-5, and C5-6, cervical disc disease, lumbar disc disease, and lumbar spondylosis 

foramen stenosis.

 

6 Supra note 4.
4

Appellant also underwent diagnostic examination testing on March 13, 2017. A lumbar 

spine MRI scan report revealed lumbar spondylosis resulting in mild spinal canal and mild bilateral 

neural foramen stenosis at L2-3 and L3-4 and mild bilateral neural foramen stenosis at L4-5.

Dr. Reinhardt continued to submit medical reports dated May 1, 2017 to February 27, 2019

for follow-up evaluations of appellant’s cervical spine, lumbar spine, and bilateral shoulders. He 

also continued to refer to his March 2017 request to upgrade appellant’s claim to include spinal 

stenosis at C3-4, C4-5, and C5-6, cervical and lumbar disc disease, and lumbar spondylosis 

foramen stenosis. In an April 9, 2018 report, Dr. Reinhardt began to request that appellant’s claim 

be expanded to include the additional condition of right shoulder tear of the supraspinatus tendon. 

He also indicated that appellant had depression due to stress and lack of work. Dr. Reinhardt 

diagnosed cervical spine disc disease, depression, lumbar disc disease with bilateral radiculopathy, 

and right shoulder rotator cuff.

By decision dated April 3, 2019, OWCP denied modification of its prior decision denying 

expansion of appellant’s claim to include additional conditions.

Appellant underwent diagnostic examination on March 11, 2019. A lumbar spine MRI 

scan report showed L4-5 posterior central 3.5 mm disc protrusion and moderate central canal 

stenosis, L3-4 posterior central disc protrusion, L2-3 posterior left central disc protrusion, and 

multilevel foraminal stenosis with moderate left L2, moderate bilateral L3, and severe bilateral L4 

nerve root contact in the foraminal spaces. A cervical spine MRI scan report revealed C2-3 disc 

protrusion, C3-4 disc protrusion, C4-5 disc protrusion, C5-6 disc protrusion, and multilevel 

foraminal stenosis with severe contact on bilateral C4 and bilateral C5 nerve roots.

On April 22, 2019 appellant, through counsel, requested reconsideration.

Appellant submitted an April 15, 2019 report by Dr. Reinhardt in which he noted that 

appellant was seen for follow-up evaluation of his cervical, thoracic, and lumbar spine and 

shoulders. He discussed the most recent MRI scan results and reviewed previous examination 

findings. Dr. Reinhardt reported that appellant had cervical and lumbar disc disease with 

radiculopathy. He also indicated that appellant had depression because of stress and work. 

Dr. Reinhardt diagnosed cervical spine disc disease, depression, lumbar disc disease with bilateral 

radiculopathy, and right shoulder rotator cuff.

OWCP also received additional medical reports dated May 20 and June 17, 2019 by

Dr. Reinhardt regarding follow-up evaluation for appellant’s cervical, thoracic, and lumbar spine, 

and shoulders, which were substantially similar to his April 15, 2019 report.

By decision dated July 10, 2019, OWCP denied modification of the April 3, 2019 decision.

LEGAL PRECEDENT

When an employee claims that a condition not accepted or approved by OWCP was due to 

an employment injury, he or she bears the burden of proof to establish that the condition is causally 

related to the employment injury.7

 

7 R.J., Docket No. 17-1365 (issued May 8, 2019); Jaja K. Asaramo, 55 ECAB 200, 204 (2004).
5

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.8 A physician’s opinion on whether there is a causal relationship 

between the diagnosed condition and the implicated employment factor(s) must be based on a 

complete factual and medical background.9 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 

employment injury.

10

When an injury arises in the course of employment, every natural consequence that flows 

from that injury likewise arises out of the employment, unless it is the result of an independent 

intervening cause attributable to a claimant’s own intentional misconduct.11 Thus, a subsequent 

injury, be it an aggravation of the original injury or a new and distinct injury, is compensable if it 

is the direct and natural consequence of a compensable primary injury.12

ANALYSIS

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

should be expanded to include additional cervical, lumbar, shoulder, and psychological conditions 

causally related to his accepted August 28, 2012 employment injury.

Preliminary, the Board notes that it is unnecessary to consider the evidence appellant 

submitted prior to the issuance of OWCP’s February 1, 2016 merit decision. The Board previously 

considered this evidence in its April 3, 2017 merit decision.13 Findings made in prior Board 

decisions are res judicata absent further review by OWCP under section 8128 of FECA.14

In support of his claim, appellant submitted additional reports by Dr. Reinhardt dated 

June 1, 2016 to June 17, 2019. Dr. Reinhardt described the August 28, 2012 employment injury 

and indicated that appellant had cervical and lumbar disc disease with radiculopathy. He provided 

examination findings and diagnosed cervical spine disc disease, depression, lumbar disc disease 

with bilateral radiculopathy, and right shoulder rotator cuff tear. Dr. Reinhardt requested that 

appellant’s claim be expanded to include spinal stenosis at C3-4, C4-5, and C5-6, cervical disc

disease, lumbar disc disease, lumbar spondylosis with foramen stenosis, and right shoulder rotator 

cuff tear. Although Dr. Reinhardt opined that appellant’s claim should include additional cervical 

 

8 E.M., Docket No. 18-1599 (issued March 7, 2019); Robert G. Morris, 48 ECAB 238 (1996). 

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

10 Id.

11 See S.M., Docket No. 19-0397 (issued August 7, 2019); Mary Poller, 55 ECAB 483, 487 (2004); Arthur Larson 

& Lex K. Larson, The Law of Workers’ Compensation 10-1 (2006). 

12 A.T., Docket No. 18-1717 (issued May 10, 2019); Susanne W. Underwood (Randall L. Underwood), 53 ECAB 

139 (2001).

13 Supra note 4.

14 See E.B., Docket No. 17-1497 (issued March 19, 2019); K.K., Docket No. 17-1061 (issued July 25, 2018). The 

Board will, therefore, not review the evidence addressed in the prior appeal.
6

and lumbar conditions, he did not provide a rationalized medical explanation for his opinion.15 

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.16 Dr. Reinhardt’s reports, therefore, are insufficient to establish appellant’s 

claim.

In a July 26, 2016 report, Dr. Grimes described the August 28, 2012 employment injury 

and conducted a mental status examination. He diagnosed chronic pain disorder. Dr. Grimes 

opined that appellant suffered a work-related injury. He did not, however, explain how appellant 

developed chronic pain disorder as a result of his accepted injury. As noted above, 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.17 Dr. Grimes’ opinion is 

therefore insufficient to establish appellant’s claim.

Appellant was also treated by Dr. Duvall who provided cervical and lumbar spine 

examination findings in reports dated January 4 and February 29, 2016. Dr. Duvall diagnosed 

lumbar and neck sprain, and lumbar pain. These reports, however, do not provide an opinion on 

the cause of appellant’s cervical and lumbar conditions. Medical evidence that does not offer an 

opinion regarding the cause of an employee’s condition is of no probative value on the issue of 

causal relationship.18

OWCP also received diagnostic reports dated March 13, 2017 and March 11, 2019. 

However, diagnostic studies, standing alone, lack probative value as they do not address whether 

an employment incident caused the diagnosed condition.19 

The Board finds that the medical evidence of record is insufficient to establish causal 

relationship between the additional cervical, lumbar, and shoulder conditions and the accepted 

August 28, 2012 employment injury and, thus, appellant has not met his burden of proof to 

establish his claim.

On appeal counsel argues that OWCP’s decision is contrary to fact and law, but has not 

cited any basis for such assertion. 

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 and 20 C.F.R. 

§§ 10.605 through 10.607.

 

15 See R.N., Docket No. 19-0994 (issued November 7, 2019).

16 Y.D., Docket No. 16-1896 (issued February 10, 2017); C.M., Docket No. 14-0088 (issued April 18, 2014).

17 Id. 

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

19 F.S., Docket No. 19-0205 (issued June 19, 2019); A.B., Docket No. 17-0301 (issued May 19, 2017).
7

CONCLUSION

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

acceptance of his claim should be expanded to include additional cervical, lumbar, and shoulder 

conditions causally related to his accepted August 28, 2012 employment injury.

ORDER

IT IS HEREBY ORDERED THAT the July 10, 2019 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: September 2, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Christopher J. Godfrey, Deputy Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board