United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.P., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Manorville, NY, Employer

__________________________________________

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Docket No. 20-0161

Issued: October 23, 2020

Appearances: Case Submitted on the Record

Paul Kalker, Esq. for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Deputy Chief Judge

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On October 28, 2019 appellant, through counsel, filed a timely appeal from a September 5, 

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.

 

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 left upper 

extremity condition causally related to the accepted January 25, 2018 employment incident.

FACTUAL HISTORY

This case has previously been before the Board.3 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 January 25, 2018 appellant, then a 48-year-old rural carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on that same date he was reaching for a scanner from a seated 

position and felt a sudden sharp pop/pain in his left bicep and armpit area while in the performance 

of duty. He notified his supervisor, stopped work, and sought medical treatment on the date of 

injury.

In a development letter dated January 29, 2018, 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 required and afforded him 30 days to provide the necessary evidence. 

In support of his claim, appellant submitted a February 2, 2018 duty status report (Form 

CA-17), and February 7, 2018 attending physician’s report from Dr. John-Paul Blaber, Boardcertified in emergency medicine. Dr. Blaber diagnosed left bicep injury and left bicep ecchymosis, 

reporting that appellant injured his left bicep while reaching for a scanner at work. In a February 7, 

2018 form report, he additionally checked a box marked “Yes” indicating that the conditions were 

caused or aggravated by an employment activity. Dr. Blaber provided appellant restrictions, 

reported that he was totally disabled from work until further evaluation, and referred him to 

orthopedics for additional treatment. 

In a February 12, 2018 medical report, Dr. Michael Sileo, a Board-certified orthopedic 

surgeon, reported that appellant presented for evaluation of left arm pain following a January 25, 

2018 work-related injury. Appellant described a pop in his left bicep muscle while reaching for a 

tray at the level of the shoulder. Dr. Sileo reviewed left shoulder x-rays and recommended a 

magnetic resonance imaging (MRI) scan of the left shoulder to evaluate for a proximal biceps 

tendon rupture versus a possible rotator cuff tear. 

In a February 27, 2018 medical report, Dr. Sileo reviewed the results of the February 17, 

2018 left shoulder MRI scan which revealed a high-grade partial thickness tear of the rotator cuff,

as well as a more acute rupture of the long head bicep tendon. He opined that this injury was a 

direct and causal result of the work-related incident. Dr. Sileo placed appellant on temporary total 

disability and discussed surgery to repair the left shoulder. 

 

3 Order Remanding Case, Docket No. 19-0301 (issued August 21, 2019).
3

By decision dated March 8, 2018, OWCP denied appellant’s claim, finding that the medical 

evidence of record was insufficient to establish that the diagnosed left rotator cuff tear and left 

biceps tendon rupture were causally related to the accepted January 25, 2018 employment incident. 

In a March 9, 2018 narrative statement, appellant reported that on January 25, 2018, he was 

at work for approximately four and a half hours and had finished about one third of his route. He 

reached for a scanner from the dashboard cradle when his bicep popped and felt like it exploded. 

Appellant described experiencing great pain and called his postmaster to inform her that he had 

been injured. He reported no similar pain prior to this incident.

Medical and form reports dated February 2, 2018 were submitted from Dr. Blaber

documenting treatment at urgent care. Dr. Blaber reported that appellant injured his left bicep on 

January 25, 2018 while at work. Appellant stated that he was reaching for a scanner and felt a pop 

and pain in his left bicep radiating to his left shoulder. Dr. Blaber diagnosed unspecified injury of 

muscle, fascia, and tendon of other parts of biceps, left arm. Appellant was discharged with work 

restrictions and scheduled for an MRI scan of the left shoulder. 

A March 19, 2018 progress note, was also submitted from Richard Georges, a physician 

assistant, documenting a follow-up evaluation of the left shoulder.

On August 7, 2018 appellant, through counsel, requested reconsideration and submitted 

additional medical evidence. 

In a July 13, 2018 report, Dr. Sileo described the January 25, 2018 employment incident 

when appellant was reaching across the dashboard of his postal vehicle at the level of his shoulder 

and felt a pop in the shoulder and bicipital area, with sudden and severe pain radiating from the 

shoulder into the bicep musculature. He noted that this was associated with visible deformity of 

the bicep musculature and significant bruising and swelling. Dr. Sileo initially evaluated appellant 

on February 12, 2018 and a February 17, 2018 MRI scan of the left shoulder revealed evidence of 

rupture of the long head of the bicep, as well as a high-grade partial tear of the rotator cuff 

anteriorly (directly next to his bicep tendon rupture). He noted that no evidence of muscle atrophy 

was appreciated on his MRI scan, suggesting the findings were acute (new). Dr. Sileo also noted 

some tearing of the labral cartilage.

Dr. Sileo described appellant’s course of treatment and reported no previous history of left 

shoulder or bicep pain when he sustained a work-related injury on January 25, 2018. He opined 

that the work-related injury directly and causally resulted in a symptomatic left shoulder long head 

of the bicep tendon rupture and a high-grade partial tear of the rotator cuff. Dr. Sileo explained

that appellant struggled with persistent pain, and associated weakness of the shoulder, which was 

consistent with his objective MRI scan findings. Furthermore, the MRI scan findings showed no 

muscle atrophy (shrinking), which provided objective support suggesting the acute onset of his 

injury. Dr. Sileo recommended left shoulder arthroscopic repair and provided work restrictions 

for appellant, noting that his condition was permanent and would not improve without surgery.

By decision dated October 29, 2018, OWCP denied modification of the March 8, 2018 

decision. 

On November 20, 2018 appellant, through counsel, filed an appeal before the Board.
4

By order dated August 21, 2019, the Board set aside the October 29, 2018 decision finding

that it failed to acknowledge, reference, or analyze the July 13, 2018 report of Dr. Sileo.

4 The 

Board therefore remanded the case for full consideration of all the evidence that was of record at 

the time of the October 29, 2018 decision to be followed by a de novo decision.

On remand OWCP evaluated the evidence submitted and reviewed the merits of the case. 

By decision dated September 5, 2019, it denied the claim finding that the evidence of record was 

insufficient to establish that appellant’s diagnosed left shoulder and bicep conditions were causally 

related to the accepted January 25, 2018 employment incident. OWCP found that Dr. Sileo’s 

July 13, 2018 report, failed to provide a well-reasoned medical opinion regarding causal 

relationship. 

LEGAL PRECEDENT

An employee seeking benefits under FECA5 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 filed within the applicable time

limitation, that an injury was sustained while in the performance of duty as alleged, and that any 

disability or specific condition for which compensation is claimed are 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 on 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 

The medical evidence required to establish causal relationship between a claimed specific 

condition and an employment incident is rationalized medical opinion evidence. The opinion of 

the physician must be based on a complete factual and medical background, 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 employee.10 The weight of the medical evidence is determined by its reliability, its 

 

4

Id.

5 Supra note 2.

6 D.K., Docket No. 17-1186 (issued June 11, 2018); Gary J. Watling, 52 ECAB 278 (2001).

7 T.C., Docket No. 18-1498 (issued February 13, 2019); Michael E. Smith, 50 ECAB 313 (1999).

8

J.M., Docket No. 17-0284 (issued February 7, 2018); Elaine Pendleton, 40 ECAB 1143 (1989).

9 M.H., Docket No. 18-1737 (issued March 13, 2019); John J. Carlone, 41 ECAB 354 (1989). 

10 S.S., Docket No. 18-1488 (issued March 11, 2019). 
5

probative value, its convincing quality, the care of analysis manifested, and the medical rationale 

expressed in support of the physician’s opinion.11

ANALYSIS

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

extremity condition causally related to the accepted January 25, 2018 employment incident. 

Appellant submitted medical reports from Dr. Blaber dated February 2 to 7, 2018. 

Dr. Blaber discussed the history of injury when appellant injured his left bicep while reaching for 

a scanner at work. In a form report dated February 7, 2018, he diagnosed left bicep ecchymosis 

and left bicep injury in which he checked a box marked “Yes,” without further comment, indicating 

that the diagnosed conditions were caused or aggravated by the employment incident. The Board 

has held that when a physician’s opinion on causal relationship consists only of checking “Yes” to 

a form question, without explanation or rationale, that opinion is of diminished probative value 

and is insufficient to establish a claim.12 In the remainder of Dr. Blaber’s reports he did not offer 

an opinion as to causal relationship. 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.13 Dr. Blaber’s reports, therefore, are insufficient to establish appellant’s claim.

OWCP also received medical reports dated February 12 through July 13, 2018, from

Dr. Sileo. Dr. Sileo diagnosed left shoulder long head of the bicep tendon rupture and high-grade 

partial tear of the rotator cuff as evidenced on the February 17, 2018 left shoulder MRI scan, which 

he opined were causally related to the January 25, 2018 employment incident. The Board finds 

that the reports of Dr. Sileo are not well rationalized.14 While Dr. Sileo provided a firm medical 

diagnosis pertaining to the left shoulder and bicep, he failed to provide a sufficient explanation, 

based on medical rationale, on the cause of appellant’s conditions. Rather, he only generally noted

that the tendon rupture and rotator cuff tear were trauma-induced.15 The Board has held that 

medical evidence that does not offer supporting rationale regarding the cause of an employee’s 

condition is of limited probative value.16 Dr. Sileo’s general statement on causation failed to 

provide a sufficient explanation as to the mechanism of injury pertaining to this traumatic injury 

claim, namely, how reaching for a scanner from a seated position would cause ruptures and tears 

 

11 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 465 (2005).

12 M.G., Docket No. 18-1616 (issued April 9, 2020); Sedi L. Graham, 57 ECAB 494 (2006); D.D., 57 ECAB 

734 (2006).

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

14 R.C., Docket No. 19-0376 (issued July 15, 2019).

15 H.A., Docket No. 18-1466 (issued August 23, 2019).

16 See D.K., Docket No. 17-1549 (issued July 6, 2018).
6

to the left shoulder.17 Therefore, his medical opinion is of limited value and insufficient to 

establish his claim.

18

 

OWCP also received a February 17, 2018 MRI scan of the left shoulder. The Board has 

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

the employment incident caused any of the diagnosed conditions.19 Such reports are therefore 

insufficient to establish appellant’s claim.

The physician assistant notes of record are also of no probative value. Such healthcare 

providers are not considered “physician[s]” as defined under FECA.20 Consequently, their medical 

findings and/or opinions will not suffice for purposes of establishing entitlement to FECA 

benefits.21

As the record lacks rationalized medical evidence establishing causal relationship between 

the January 25, 2018 employment incident and appellant’s diagnosed left shoulder conditions the 

Board finds that appellant has not met his burden of proof.

Appellant may submit additional evidence or argument with a written request for 

reconsideration, to OWCP within one year of the Board’s 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 left upper 

extremity condition causally related to the accepted January 25, 2018 employment incident. 

 

17 See T.H., Docket No. 18-1736 (issued March 13, 2019); R.R., Docket No. 16-1901 (issued April 17, 2017).

18 C.M., Docket No. 19-0360 (issued February 21, 2020); see Mary A. Ceglia, 55 ECAB 626 (2004).

19 F.D., Docket No. 19-0932 (issued October 3, 2019).

20 5 U.S.C. § 8102(2) of FECA provides that the term physician includes surgeons, podiatrists, dentists, clinical 

psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined 

by State law. K.C., Docket No. 19-0834 (issued October 28, 2019); E.T., Docket No. 17-0265 (issued May 25, 2018) 

(physician assistants are not considered physicians under FECA).

21 N.B., Docket No. 19-0221 (issued July 15, 2019).
7

ORDER

IT IS HEREBY ORDERED THAT the September 5, 2019 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: October 23, 2020

Washington, DC

Christopher J. Godfrey, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board