United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

P.C., Appellant

and

U.S. POSTAL SERVICE, JENKS POST 

OFFICE, Jenks, OK, Employer

__________________________________________

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Docket No. 20-0855

Issued: November 23, 2020

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On March 9, 2020 appellant, through counsel, filed a timely appeal from a January 24, 

2020 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 January 24, 2020 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 her burden of proof to establish a medical condition

causally related to the accepted September 13, 2018 employment incident.

FACTUAL HISTORY

On September 18, 2018 appellant, then a 56-year-old rural carrier, filed a traumatic injury 

claim (Form CA-1) alleging that, on September 13, 2018, she lost her footing and fell to the ground 

on her left knee and elbow while delivering a packing in the performance of duty. She noted that 

she suffered an abrasion of the right knee and that her hip and back began hurting after the fall. 

On the reverse side of the claim form, the employing establishment controverted appellant’s claim, 

noting that she had complained of hip and back pain in the past and there was no evidence that the 

fall actually occurred. Appellant did not stop work.

In a development letter dated September 21, 2018, OWCP informed appellant that the 

evidence of record was insufficient to establish her claim. It advised her of the type of factual and 

medical evidence needed and provided a questionnaire for her completion. OWCP afforded 

appellant 30 days to submit the necessary evidence. 

OWCP subsequently received a September 18, 2018 report from Dr. Mark Stephen Wilson, 

a specialist in pain management, who noted that, on September 13, 2018, appellant scraped her 

right knee and fell onto her arms while turning to leave a porch and falling off a step. He indicated 

that appellant had pain in her left lower back and hip that was most painful when walking, bending 

over, or standing from sitting. Dr. Wilson examined appellant and reviewed x-rays of her lumbar 

spine. He diagnosed acute traumatic injury resulting in lumbosacral disc displacement with 

radiculopathy and lumbar spine disc displacement with radiculopathy. Dr. Wilson opined that 

appellant’s conditions were causally connected to the September 13, 2018 employment incident. 

He recommended physical therapy treatment and listed appellant’s work restrictions. In an 

accompanying duty status report (Form CA-17), Dr. Wilson indicated that appellant was advised 

to resume work with restrictions.

On a September 26, 2018 Form CA-17, Dr. Wilson diagnosed complete rotator cuff tear

and indicated that appellant was advised to resume work with restrictions. 

In a letter dated October 10, 2018, the employing establishment controverted appellant’s 

claim, noting that she delayed seeking medical treatment and reporting the employment incident 

until after an interview with her supervisor discussing how she abandoned her work-related duties 

on September 13, 2018, the date of the employment incident. It further alleged that fact of injury 

and causal relationship had not been established. 

In a report dated October 17, 2018, Dr. Wilson noted that appellant experienced ongoing 

pain in her lower back and that she had not been working for the last few weeks. He indicated that 

appellant received a job offer, but felt that she could not perform the job duties. Dr. Wilson 

examined appellant and diagnosed acute traumatic injury resulting in lumbosacral disc 

displacement with radiculopathy and lumbar spine disc displacement with radiculopathy. He 

recommended physical therapy treatment and magnetic resonance imaging (MRI) scan studies of 
3

appellant’s lumbar spine. On an accompanying Form CA-17, Dr. Wilson diagnosed complete 

rotator cuff tear and indicated that appellant was not advised to resume work. 

On a November 15, 2018 Form CA-17, Dr. Aaron McGuire, an osteopathic physician 

specializing in physical medicine and rehabilitation, diagnosed complete rotator cuff tear and

indicated that appellant was not advised to resume work. 

By decision dated November 27, 2018, OWCP denied appellant’s traumatic injury claim, 

finding that, while the September 13, 2018 employment incident occurred as alleged, the medical 

evidence of record was insufficient to establish that her diagnosed conditions were causally related 

to the accepted employment incident. 

OWCP subsequently received a progress report from Dr. McGuire, dated 

November 15, 2018, which reviewed a November 13, 2018 MRI scan of appellant’s left hip and 

noted that it revealed modest deep soft tissue edema lateral to the left greater trochanter. 

Dr. McGuire diagnosed acute traumatic injury resulting in lumbosacral disc displacement with 

radiculopathy and lumbar spine disc displacement with radiculopathy. He indicated that appellant 

was temporarily, totally disabled from work at that time. 

On January 31, 2019 appellant requested reconsideration. 

In support of her request, appellant submitted an MRI scan of her lumbar spine, dated 

June 20, 2018, which revealed posterior disc protrusion and narrowing of the foramina at L4-5 and 

mild facet joint hypertrophy, modest disc bulging, and mild narrowing of the foramina at L2-3 and 

L3-4.

In Form CA-17 reports, dated September 13 through December 10, 2018, Dr. McGuire 

diagnosed rotator cuff tear and listed appellant’s work restrictions. 

In an October 1, 2018 report, Dr. Eun Ho Ko, a Board-certified family practitioner, noted 

that appellant fell while delivering a package two to three weeks ago. He indicated that appellant 

fell on a concrete floor while turning and losing her balance. Dr. Ko examined appellant and 

diagnosed chronic left-sided low back pain.

In an October 22, 2018 report, Dr. Ko noted that appellant had been placed on temporary 

total disability. He examined appellant and diagnosed chronic bilateral low back pain with leftsided sciatica. 

In Form CA-17 reports dated October 25 and November 26, 2018, Dr. McGuire diagnosed 

right knee sprain, left knee sprain, and intervertebral disc disorder of the lumbosacral region with 

radiculopathy. He indicated that appellant was advised to resume work with restrictions. 

A November 13, 2018 MRI scan of appellant’s left hip revealed modest deep soft tissue 

edema lateral to the left greater trochanter.

A November 21, 2018 MRI scan of appellant’s lumbar spine revealed degenerative disc 

disease of the lumbar spine and moderate bilateral neuroforaminal stenosis at L4-5. 
4

In a November 26, 2018 report, Dr. McGuire diagnosed intervertebral disc disorder of the 

lumbosacral region with radiculopathy and sacroiliitis. He indicated that appellant’s symptoms 

first appeared on September 13, 2018, and checked a box marked “Yes” indicating that appellant’s 

conditions were work related. Dr. McGuire noted that appellant had other orthopedic conditions 

affecting her bilateral shoulders. He indicated that appellant was totally disabled from work 

commencing September 13, 2018. 

In a November 29, 2018 report, Dr. Ko noted that appellant experienced continued low 

back pain. He examined appellant and diagnosed facet hypertrophy of the lumbar region and 

foraminal stenosis of the lumbar region. 

On January 22, 2019 appellant responded to OWCP’s development questionnaire. She 

noted that she fell due to missing a step. Appellant indicated that she had also fallen in May or 

June 2018. 

In a narrative statement dated January 25, 2019, appellant clarified that she initially fell on 

her right side before injuring her left knee. She asserted that any preexisting conditions that she 

had were attributable to injuries she had sustained while at work. Appellant noted that she 

experienced pain from her right foot to her back if she stepped incorrectly. She indicated that she 

could not carry more than a few pounds of mail in her right hand without experiencing pain in her 

back. Appellant also noted that she experienced back pain while leaning and sleeping. She stated 

that the employing establishment denied her a handicapped parking space and prohibited her from 

using a walker. Appellant indicated that she experienced constant pain and weakness in her back, 

legs, left hip, and knees since the employment incident. She noted that she had problems walking 

for longer periods of time. 

By decision dated April 29, 2019, OWCP denied modification of the November 27, 2018 

decision. 

On October 28, 2019 appellant, through counsel, requested reconsideration. 

OWCP subsequently received a May 6, 2019 report from Dr. Britney Else, a Boardcertified osteopathic physician specializing in sports medicine, who noted that appellant presented 

with left hip and lumbar pain. Dr. Else indicated that appellant fell while delivering a package on 

September 13, 2018, and had been experiencing increased pain since that time. She examined 

appellant and diagnosed lumbago, lumbar radiculopathy, and hip pain. 

In a June 10, 2019 report, Dr. Brian Lovelace, a Board-certified orthopedic surgeon, noted 

that appellant had been experiencing low back and leg pain since September 2018. He indicated 

that she experienced ongoing pain that radiated down her left leg. Dr. Lovelace examined 

appellant and diagnosed chronic left-sided low back pain with left-sided sciatica, left-sided 

lumbago with sciatica, other chronic pain, and lumbar radiculopathy. 

By decision dated January 24, 2020, OWCP denied modification of the April 29, 2019 

decision.
5

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 period 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 has sustained a traumatic injury in the performance of duty, 

OWCP begins with an analysis of whether fact of injury has been established. 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.8 The second component is whether the employment incident caused a personal injury.9

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.10 The opinion of the physician must be based on a complete factual 

and medical background of the claimant, 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 incident identified by the claimant.11

In a case in which 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.12

 

4 Supra note 2.

5 M.O., Docket No. 19-1398 (issued August 13, 2020); S.B., Docket No. 17-1779 (issued February 7, 2018); Joe D. 

Cameron, 41 ECAB 153 (1989).

6

J.R., Docket No. 20-0496 (issued August 13, 2020); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 ECAB 

312 (1988).

7 B.M., Docket No. 19-1341 (issued August 12, 2020); L.M., Docket No. 13-1402 (issued February 7, 2014); 

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

8 T.J., Docket No. 19-0461 (issued August 11, 2020); Elaine Pendleton, 40 ECAB 1143 (1989).

9 D.M., Docket No. 20-0386 (issued August 10, 2020); John J. Carlone, 41 ECAB 354 (1989).

10 A.R., Docket No. 19-0465 (issued August 10, 2020); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

11 W.L., Docket No. 19-1581 (issued August 5, 2020); Leslie C. Moore, 52 ECAB 132 (2000).

12 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013); 

C.C., Docket No. 19-1071 (issued August 26, 2020); V.W., Docket No. 19-1537 (issued May 13, 2020).
6

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a medical 

condition causally related to the accepted September 13, 2018 employment incident.

In support of her claim, appellant submitted a September 18, 2018 report, from Dr. Wilson 

who diagnosed acute traumatic injury resulting in lumbosacral disc displacement with 

radiculopathy and lumbar spine disc displacement with radiculopathy. Dr. Wilson opined that 

appellant’s conditions were causally connected to the accepted September 13, 2018 employment 

incident. While he supported causal relationship, Dr. Wilson offered only a conclusory statement 

devoid of medical rationale. He did not explain the medical mechanics of how the accepted 

employment incident of stepping and falling off a step was competent to cause appellant’s 

diagnosed conditions. The Board has held that a medical report is of limited probative value on a 

given medical issue if it contains an opinion which is unsupported by medical rationale.13 

Consequently, Dr. Wilson’s opinion is insufficient to meet appellant’s burden of proof to establish 

her claim.

Appellant also submitted Form CA-17 reports from Drs. Wilson and McGuire, dated 

September 18 through December 10, 2018. In these reports, Drs. Wilson and McGuire diagnosed 

rotator cuff tear and listed appellant’s work restrictions. Appellant also submitted Form CA-17 

reports, dated October 25 and November 26, 2018, from Dr. McGuire who diagnosed right knee 

sprain, left knee sprain, and intervertebral disc disorder of the lumbosacral region with 

radiculopathy. He indicated that appellant could resume work with restrictions. Drs. Wilson and 

McGuire, however, did not offer an opinion as to whether appellant’s diagnosed conditions were 

causally related to the employment incident in any of these Form CA-17 reports. The Board has 

held that 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.14 Accordingly, these reports 

are insufficient to establish appellant’s claim.

Similarly, appellant submitted multiple reports from physicians who did not offer an 

opinion on causal relationship. In October 1 and 22, 2018 reports, Dr. Ko diagnosed chronic leftsided low back pain and chronic bilateral low back pain with left-sided sciatica. In October 17 

and November 15, 2018 reports, Drs. Wilson and McGuire diagnosed acute traumatic injury 

resulting in lumbosacral disc displacement with radiculopathy and lumbar spine disc displacement 

with radiculopathy. On November 29, 2018 Dr. Ko diagnosed facet hypertrophy of the lumbar 

region and foraminal stenosis of the lumbar region. On May 6, 2019 Dr. Else diagnosed lumbago, 

lumbar radiculopathy, and hip pain. On June 10, 2019 Dr. Lovelace diagnosed chronic left-sided 

low back pain with left-sided sciatica, left-sided lumbago with sciatica, other chronic pain, and 

lumbar radiculopathy. The physicians offered no opinion as to whether appellant’s diagnosed 

conditions were causally related to the accepted employment incident in any of these reports. 

 

13 B.M., supra note 7.

14 L.B., Docket No. 19-1907 (issued August 14, 2020).
7

Accordingly, these reports are of no probative value on the issue of causal relationship and are 

insufficient to establish appellant’s claim.15

In a report dated November 26, 2018, Dr. McGuire diagnosed intervertebral disc disorder 

of the lumbosacral region with radiculopathy and sacroiliitis. He indicated that appellant’s 

symptoms first appeared on September 13, 2018 and checked a box marked “Yes” indicating that 

appellant’s conditions were work related. However, the Board has held that when a physician’s 

opinion on causal relationship consists only of checking a box marked “Yes” to a form question, 

without more by the way of medical rationale, that opinion is of limited probative value and is 

insufficient to establish causal relationship.16 As such, this report by Dr. McGuire is also 

insufficient to establish appellant’s claim.

Appellant submitted MRI scans of her lumbar spine, dated June 20 and November 21, 

2018, and an MRI scan of her left hip, dated November 13, 2018. The Board has held that 

diagnostic studies, standing alone, lack probative value on the issue of causal relationship as they 

do not provide an opinion as to whether the employment incident caused any of the diagnosed 

conditions.17 This evidence is therefore insufficient to establish appellant’s claim. 

As the medical evidence of record does not contain rationalized medical evidence 

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

September 13, 2018 employment incident, the Board finds that she has not met her 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 has not met her burden of proof to establish a medical 

condition causally related to the accepted September 13, 2018 employment incident.

 

15 L.B., id.

16 M.S., Docket No. 20-0437 (issued July 14, 2020).

17 C.B., Docket No. 20-0464 (issued July 21, 2020).
8

ORDER

IT IS HEREBY ORDERED THAT the January 24, 2020 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: November 23, 2020

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board