United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.S., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE

CANAL STREET STATION, New York, NY, 

Employer

__________________________________________

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Docket No. 21-0051

Issued: September 2, 2021

Appearances: Case Submitted on the Record

Thomas S. Harkins, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On October 19, 2020 appellant, through counsel, filed a timely appeal from a May 5, 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.

 

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

ISSUES

The issues are: (1) whether appellant has met his burden of proof to expand the acceptance 

of his claim to include additional conditions as causally related to the accepted April 28, 2017 

employment injury; and (2) whether appellant has met his burden of proof to establish disability 

from work for the period beginning October 24, 2017 causally related to the accepted April 28, 

2017 employment injury.

FACTUAL HISTORY

On April 28, 2017 appellant, then a 65-year-old building equipment mechanic, filed a 

traumatic injury claim (Form CA-1) alleging that on that date he sustained a muscle strain when 

he was climbing down a ladder and lost his footing while in the performance of duty. He stopped 

work on April 28, 2017 and worked intermittently thereafter.

On April 28, 2017 appellant was treated in the emergency room by Dr. Omar Corujo 

Vazquez, a Board-certified emergency room physician, for back pain radiating down his legs that

developed after he twisted his back while descending a ladder at work. Dr. Vazquez diagnosed 

muscle strain and radicular pain. In a work excuse note of even date, he indicated that appellant 

was disabled from work through April 30, 2017.

Appellant was treated by Dr. Craig Capeci, a Board-certified orthopedist, on May 1, 2017

for a low back injury sustained at work when he was descending a ladder. Dr. Capeci diagnosed 

low back strain and spasm. 

On May 18, 2017 Dr. Martin Quirno, a Board-certified orthopedist, evaluated appellant for 

radiating low back pain. Appellant reported descending a ladder at work when he slipped. X-rays 

of the lumbar spine revealed mild degenerative disc disease at L5-S1 and L2-3 with no 

spondylolisthesis and no fractures. Dr. Quirno diagnosed low back pain status post work accident 

on April 28, 2017, bilateral lower extremity radiculopathy, and numbness and weakness slightly 

worse on the left. In a September 14, 2017 attending physician’s report (Form CA-20), Dr. Quirno 

recounted a history of the low back injury occurring on April 28, 2017. He diagnosed 

radiculopathy of the lumbar region. Dr. Quirno affirmed that the diagnosed conditions were 

caused or aggravated by the described employment incident. He noted that appellant was totally 

disabled from work from April 28, 2017 through February 27, 2018.

A magnetic resonance imaging (MRI) scan of the lumbar spine dated May 31, 2017 

revealed a medium size L4-5 posterolateral/foraminal disc herniation associated with moderate 

congenital and acquired spinal canal stenosis, mild-to-moderate left foraminal narrowing slightly 

compressing the left L4 nerve root, small left L5-S1 foraminal disc herniation, disc bulging and 

degenerative changes at remaining levels resulting in mild-to-moderate L2-3, and mild L3-4 

congenital and acquired spinal canal stenosis.

On June 8 and August 15, 2017 Dr. Syed Husain, a Board-certified physiatrist, treated 

appellant for low back and leg pain that developed when he was descending a ladder at work and 

slipped. Findings on examination revealed limited range of motion of the lumbar spine, tenderness 

to palpation over L3, L4, L5 facet joints bilaterally, slightly diminished sensation in the lower 
3

extremities, and positive straight leg test on the left. Dr. Husain diagnosed lumbar radicular pain 

and recommended a bilateral L4-5 and L5-S1 transforaminal epidural steroid injection and a back 

brace.

On December 1, 2017 OWCP accepted appellant’s claim for low back strain.

OWCP received additional evidence. On June 1, 2017 Dr. Quirno related that appellant 

continued to complain of low back pain with bilateral lower extremity radiculopathy and weakness 

after a fall from a ladder at work. He reviewed an MRI scan, which revealed bilateral recess 

stenosis at L4-5 with a large left disc bulge producing severe bilateral recess stenosis with severe 

foraminal stenosis at L4-5. Dr. Quirno diagnosed L4-5 severe bilateral recess stenosis and severe 

foraminal stenosis secondary to a large disc bulge. He recommended epidural injections and 

physical therapy.

In subsequent reports dated August 10 through October 26, 2017, Dr. Quirno noted that 

appellant presented with persistent lower back pain, progressive weakness, and lower extremity 

radiculopathy. Appellant reported that he did not begin treatment because OWCP had not 

approved his claim. 

In duty status reports (Form CA-17) dated December 22, 2017 and January 2, 2018,

Dr. Quirno noted clinical findings of low back pain. He noted the diagnosis due to injury was 

radiculopathy of the lumbar region and indicated that appellant could not work. Dr. Quirno treated 

appellant again on December 28, 2017 for significant weakness and radiculopathy on the left side. 

He noted that appellant began physical therapy. In a January 2, 2018 attending physician’s report 

(Form CA-20), Dr. Quirno noted a history of the low back injury occurring on April 28, 2017. He 

diagnosed radiculopathy of the lumbar region. Dr. Quirno affirmed by checking a box marked 

“Yes” indicating that the diagnosed conditions were caused or aggravated by the described 

employment incident. Dr. Quirno noted the period of total disability began on April 18, 2017.

On January 23 and February 1, 2018 appellant filed claims for compensation (Form CA-7) 

for work-related disability for the period commencing October 24, 2017.

In a development letter dated February 7, 2018, OWCP requested that appellant submit 

medical evidence to support disability during the period claimed causally related to the accepted 

April 28, 2017 employment injury. It afforded him 30 days to submit the requested evidence.

By decision dated February 22, 2018, OWCP denied expansion of the acceptance of 

appellant’s claim to include the additional conditions of lumbar radiculopathy, disc bulge at L4-5, 

foraminal stenosis at left L4-5, L4-5 bilateral recess stenosis, and lumbar spine stenosis. 

Appellant submitted additional evidence. On February 20, 2018 Dr. Quirno examined 

appellant who reported bilateral lower extremity radiculopathy and significant weakness. He

reported improvement with physical therapy.

By decision dated April 3, 2018, OWCP denied appellant’s claims for wage-loss 

compensation, finding that he had not established disability from work commencing October 24, 

2017 causally related to the accepted April 28, 2017 employment injury. 
4

Appellant continued to submit additional evidence. In a July 10, 2017 report, Dr. Jeffrey 

Benjamin, a Board-certified neurologist, treated appellant for low back pain radiating into the left 

lower extremity and left foot weakness. Appellant reported that on April 28, 2017 he was 

descending a vertical ladder and slipped injuring his back. Findings on examination revealed 

decreased bilateral grip strength, decreased light touch and pinprick in the distal right C7, left drop 

foot, and tenderness over the bilateral lumbar paraspinal musculature. Dr. Benjamin diagnosed 

lumbosacral radiculopathy, cervical radiculopathy, and carpal tunnel syndrome.

In a report dated February 6, 2018, Dr. Husain treated appellant, reporting good pain relief 

with physical therapy; however, appellant continued to have back pain radiating into the legs. He 

noted tenderness to palpation over the L3, L4, and L5 facet joints bilaterally and diminished 

sensation to light touch in the lower extremities. Dr. Husain diagnosed lumbar radiculopathy and 

recommended additional physical therapy and epidural injections.

On April 12, 2018 Dr. Quirno related treating appellant since May 18, 2017 for spinal 

stenosis, large disc bulge at L4-5, and partial foot drop. Appellant experienced improvement in 

his symptoms secondary to physical therapy. Dr. Quirno diagnosed lumbar sprain and severe 

spinal stenosis. On May 17 and August 16, 2018 appellant presented with left buttock pain and 

reported being assaulted in the subway two weeks prior, jolting his spine. X-rays revealed mild 

degenerative disc disease at L2-3, L3-4, and L4-5. Dr. Quirno diagnosed left buttock pain after an 

assault. On January 10, 2019 he again recommended physical therapy and epidural injections.

On February 18, 2019 appellant, through counsel, requested reconsideration on a 

February 22, 2018 decision concerning expansion of the acceptance of the claim.

On March 28, 2019 appellant requested reconsideration of the decision dated 

April 3, 2018.

By decision dated May 16, 2019, OWCP denied modification of both the February 22, 

2018 decision concerning expansion of the claim and the April 3, 2018 OWCP decision denying 

appellant’s claims for wage-loss compensation for disability from work commencing 

October 24, 2017.

Appellant continued to submit additional evidence. In a May 9, 2019 report, Dr. Quirno 

noted that appellant was assaulted on May 17, 2018 and developed significant back pain. He 

prescribed another trial of physical therapy and epidural injections. On May 30, 2019 Dr. Quirno

provided a summary of appellant’s treatment from May 18, 2017 through May 9, 2019. He

provided a history of injury of the April 28, 2017 work incident and an assault that occurred on 

May 17, 2018. Dr. Quirno noted that appellant did not have low back symptoms prior to the work 

accident on April 28, 2017. He opined that appellant developed left leg radiculopathy, back pain, 

and left partial foot drop, which resolved after physical therapy; however, these symptoms returned 

after he was assaulted on May 17, 2018. 

On April 21, 2020 appellant requested reconsideration. 

By decision dated May 5, 2020, OWCP denied modification of the May 16, 2019 decision.
5

LEGAL PRECEDENT -- ISSUE 1

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.3

To establish causal relationship between the condition as well as any additional conditions 

claimed and the employment injury, an employee must submit rationalized medical evidence. 4 

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 factors identified by the claimant.5

ANALYSIS -- ISSUE 1

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 conditions causally related to the 

accepted April 28, 2017 employment injury.

In reports dated May 18, 2017 through May 9, 2019, Dr. Quirno noted his treatment of 

appellant for low back pain and diagnosed additional conditions including: low back pain status 

post work accident on April 28, 2017 with bilateral lower extremity radiculopathy, numbness, and 

weakness in the left lower extremity; L4-5 severe bilateral recess stenosis and severe foraminal 

stenosis secondary to a large disc bulge; and partial foot drop.” In none of those reports, however, 

did Dr. Quirno provide an opinion regarding causal relationship between appellant’s additional 

diagnosed conditions and the accepted April 28, 2017 employment injury. The Board has held 

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

condition or disability is of no probative value on the issue of causal relationship.6 As such, this 

evidence is insufficient to establish expansion of the claim.

In Form CA-17 reports dated December 22, 2017 and January 2, 2018, Dr. Quirno noted 

that the diagnosis due to injury was radiculopathy of the lumbar region and indicated that appellant 

could not work. He opined that the diagnosed conditions were caused or aggravated by the 

described employment incident. Dr. Quirno, however, did not provide rationale explaining how 

appellant’s diagnosed conditions were caused or aggravated by the April 28, 2017 accepted 

employment injury. He did not explain how the mechanism of injury would have physiologically 

caused or aggravated the additional diagnosed conditions.7 As Dr. Quirno failed to provide 

 

3 M.M., Docket No. 19-0951 (issued October 24, 2019); Jaja K. Asaramo, 55 ECAB 200 (2004).

4 T.K., Docket No. 18-1239 (issued May 29, 2019); M.W., 57 ECAB 710 (2006); John D. Jackson, 55 ECAB 

465 (2004).

5 T.K., id.; I.J., 59 ECAB 408 (2008).

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

7

See F.H., Docket No. 18-1238 (issued January 18, 2019); J.R., Docket No. 18-0206 (issued October 15, 2018).
6

medical rationale in support of a causation finding, these reports are insufficient to meet appellant’s 

burden of proof.8

In Form CA-20 reports dated September 14, 2017 and January 2, 2018, Dr. Quirno 

diagnosed radiculopathy of the lumbar region and checked a box marked “Yes” indicating that the 

condition was caused or aggravated by an employment activity. The Board has held, however,

that an opinion on causal relationship with an affirmative check mark, without more by the way of 

medical rationale, is insufficient to establish the claim.

9

On May 30, 2019 Dr. Quirno provided a summary of appellant’s medical treatment through 

May 9, 2019 and a history of the April 28, 2017 employment incident and an assault that occurred 

on May 17, 2018. He noted that appellant did not have low back symptoms prior to the 

employment incident on April 28, 2017. The Board has held that an opinion that the employee 

was asymptomatic before the injury is insufficient, without supporting rationale, to establish causal 

relationship.10

Reports from Dr. Vazquez dated April 28, 2017 noted appellant’s treatment for radiating 

back pain. He diagnosed muscle strain and radicular pain and advised that appellant was disabled 

through April 30, 2017. Similarly, on May 1, 2017 Dr. Capeci treated appellant for a low back 

injury and diagnosed low back strain and spasm. Reports from Dr. Husain dated June 8 and 

August 15, 2017 and February 6, 2018, related treatment for low back and leg pain. Dr. Husain 

diagnosed lumbar radicular pain. Likewise, Dr. Benjamin treated appellant on July 10, 2017 for 

radiating low back pain and left foot weakness that developed on April 28, 2017. He diagnosed 

lumbosacral radiculopathy, cervical radiculopathy, and carpal tunnel syndrome. None of these 

physicians, however, provided an opinion regarding causal relationship between appellant’s 

additional diagnosed conditions and the accepted employment injury. As noted above, the Board 

has held that medical evidence that does not offer an opinion regarding the cause of an employee’s 

condition or disability is of no probative value on the issue of causal relationship.11 As such, these 

reports are insufficient to establish expansion of the claim.

Appellant submitted multiple diagnostic testing reports. The Board has held that diagnostic 

studies, standing alone, are of limited probative value as they do not address whether the 

employment injury caused any of the diagnosed conditions.12 

As the medical evidence of record is insufficient to establish causal relationship between 

appellant’s additional diagnosed conditions and the accepted employment injury, the Board finds 

that appellant has not met his burden of proof.

 

8 M.C.,Docket No. 18-0361 (issued August 15, 2018).

9

See D.S., Docket No. 21-0037 (issued May 27, 2021); Richard G. Chasse,Docket No. 99-1574 (issued 

June 27, 2000).

10 J.F., Docket No. 19-1694 (issued March 18, 2020); Kimper Lee, 45 ECAB 565 (1994).

11 Supra note 8.

12 J.P., Docket No. 19-0216 (issued December 13, 2019); A.B., Docket No. 17-0301 (issued May 19, 2017).
7

LEGAL PRECEDENT -- ISSUE 2

An employee seeking benefits under FECA13 has the burden of proof to establish the 

essential elements of his or her claim, including that any disability or specific condition for which 

compensation is claimed is causally related to the employment injury.14 For each period of 

disability claimed, the employee has the burden of proof to establish that he or she was disabled 

from work as a result of the accepted employment injury.15 Whether a particular injury causes an 

employee to become disabled from work, and the duration of that disability, are medical issues 

that must be proven by a preponderance of probative and reliable medical opinion evidence. 16

Under FECA, the term disability means an incapacity because of an employment injury, to 

earn the wages the employee was receiving at the time of the injury.17 When, however, the medical 

evidence establishes that the residuals or sequelae of an employment injury are such that, from a 

medical standpoint, prevent the employee from continuing in his or her employment, he or she is 

entitled to compensation for any loss of wages.18

To establish causal relationship between the disability claimed and the employment injury, 

an employee must submit rationalized medical evidence, based on a complete factual and medical 

background, supporting such causal relationship.19 The opinion of the physician 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 factors identified 

by the employee.20

ANALYSIS -- ISSUE 2

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

the period commencing October 24, 2017, causally related to his accepted April 28, 2017

employment injury.

 

13 Supra note 2.

14 See D.S., Docket No. 20-0638 (issued November 17, 2020); F.H., Docket No. 18-0160 (issued August 23, 2019); 

C.R., Docket No. 18-1805 (issued May 10, 2019); Kathryn Haggerty, 45 ECAB 383 (1994); Elaine Pendleton, 40 

ECAB 1143 (1989).

15 See M.B., Docket No. 18-1455 (issued March 11, 2019); D.W., Docket No. 18-0644 (issued November 15, 2018); 

Amelia S. Jefferson, 57 ECAB 183 (2005).

16 See 20 C.F.R. § 10.5(f); N.M., Docket No. 18-0939 (issued December 6, 2018).

17 Id. at § 10.5(f); Cheryl L. Decavitch, 50 ECAB 397 (1999).

18 See G.T., Docket No. 18-1369 (issued March 13, 2019); Merle J. Marceau, 53 ECAB 197 (2001).

19 See S.J., Docket No. 17-0828 (issued December 20, 2017); KathrynE. DeMarsh, 56 ECAB 677 (2005).

20 C.B.,Docket No. 18-0633 (issued November 16, 2018); Leslie C. Moore, 52 ECAB 132 (2000); Gary L. Fowler, 

45 ECAB 365 (1994).
8

In reports dated October 26 and December 28, 2017 and February 20, 2018, Dr. Quirno 

treated appellant for persistent lower back pain, progressive weakness, and bilateral lower 

extremity radiculopathy. Dr. Husain treated appellant on February 6, 2018 for back pain radiating 

into the legs and diagnosed lumbar radiculopathy. However, Drs. Quirno and Husain do not 

specifically address dates of disability or offer an opinion regarding appellant’s disability from 

work for the period commencing October 24, 2017.21 Accordingly, their reports are of no 

probative value and are insufficient to establish appellant’s claim for compensation.22

On April 12, 2018 Dr. Quirno related treating appellant since May 18, 2017 for spinal 

stenosis and large disc bulge at L4-5 and partial foot drop. He diagnosed lumbar sprain and severe 

spinal stenosis. While he provided a diagnoses of lumbar sprain, Dr. Quirno did not provide an 

opinion regarding appellant’s disability from work commencing October 24, 2017.23 Without a 

medical explanation, supported by objective findings, explaining why appellant was disabled on 

specific dates due to the accepted employment injury, appellant would be self-certifying 

disability.24 Thus, this report is of no probative value and insufficient to establish the claim. 

In Form CA-17 reports dated December 22, 2017 and January 2, 2018, Dr. Quirno noted 

the diagnosis due to injury of radiculopathy of the lumbar region and indicated that appellant could 

not work. Similarly, in a Form CA-20 report dated January 2, 2018, he diagnosed radiculopathy 

of the lumbar region. Dr. Quirno opined that the diagnosed conditions were caused or aggravated 

by the described employment incident. He noted that the period of total disability began on 

April 18, 2017. Dr. Quirno, however, did not otherwise provide an opinion on whether appellant 

was disabled from work during the claimed period due to his accepted employment injury. 

Accordingly, this report is of no probative value and is insufficient to establish appellant’s claim 

for compensation.25

In a May 30, 2019 report, Dr. Quirno provided a summary of appellant’s treatment from 

May 18, 2017 through May 9, 2019 and a history of the April 28, 2017 work incident and the 

assault that occurred on May 17, 2018. He noted that appellant did not have low back symptoms 

prior to the work accident on April 28, 2017 and thereafter developed left leg radiculopathy, back 

pain, and left partial foot drop. However, these reports are of no probative value because, despite 

the fact that Dr. Quirno mentioned an April 28, 2017 employment injury, he did not provide an 

opinion that appellant was disabled from work during the claimed period, beginning October 24, 

 

21 Supra note 8; see also WilliamA. Archer, 55 ECAB 674 (2004) (the Board will not require OWCP to pay 

compensation for disability in the absence of medical evidence directly addressing the specific dates of claimed 

disability).

22 See M.M., Docket No. 18-0817 (issued May 17, 2019); M.C.,Docket No. 16-1238 (issued January 26, 2017).

23 Supra note 21.

24 See B.K., Docket No. 18-386 (issued September 14, 2018); Amelia S. Jefferson, 57 ECAB 183 (2005); see also 

C.S.,Docket No. 17-1686 (issued February 5, 2019).

25 Supra note 21.
9

2017, causally related to the accepted April 28, 2017 lower back strain.26 Therefore, these reports

are insufficient to establish his claim.

In other reports dated May 17, 2018 through May 9, 2019, Dr. Quirno diagnosed left 

buttock pain after a May 17, 2018 subway incident. As these reports do not address the issue of 

disability stemming from the April 28, 2017 employment injury, they are of no probative value.27 

A July 10, 2017 report from Dr. Benjamin, predates the claimed period of disability and 

thus is not relevant to the specific period of disability claimed.28 Thus, this report is insufficient 

to establish appellant’s disability claims.

As the medical evidence of record is insufficient to establish disability from work 

commencing October 24, 2017 causally related to the accepted April 28, 2017 employment injury, 

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

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 conditions causally related to the 

accepted April 28, 2017 employment injury. The Board further finds that he has not met his burden 

of proof to establish disability from work for the period commencing October 24, 2017 causally 

related to his accepted April 28, 2017 employment injury.

 

26 Id.

27 Supra note 21.

28 See E.B., Docket No. 17-0875 (issued December 13, 2018); C.L., Docket No. 16-0004 (issued June14, 2016).
10

ORDER

IT IS HEREBY ORDERED THAT the May 5, 2020 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: September 2, 2021

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board