United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.D., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Ybor City, FL, Employer

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Docket No. 19-1528

Issued: January 17, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On July 10, 2019 appellant filed a timely appeal from a June 10, 2019 merit decision of the 

Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal Employees’

Compensation Act1(FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over 

the merits of this case.2

ISSUE

The issue is whether appellant has met his burden of proof to establish a medical condition 

causally related to the accepted April 13, 2019 employment incident.

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that appellant submitted additional evidence on appeal. 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

FACTUAL HISTORY

On April 13, 2019 appellant, then a 60-year-old city carrier, filed a traumatic injury claim 

(Form CA-1) alleging that, on that date, he was involved in a motor vehicle accident while in the 

performance of duty. He claimed that this resulted in neck and low back pain with radiculopathy, 

headache, pain in the mid-back and left shoulder, sleep disturbance, anxiety, and abrasion of the 

left leg.

The employing establishment issued an authorization for examination and medical

treatment (Form CA-16). In an April 16, 2019 attending physician’s report, Part B of the Form 

CA-16, a chiropractor with an illegible signature noted a history of injury that appellant was 

involved in a motor vehicle accident. The chiropractor provided examination findings and 

diagnosed chronic periodontitis, other cervical disc displacement, acute post-traumatic headache, 

sacroilitis not elsewhere classified, and pain in the thoracic spine. The chiropractor checked a box 

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

employment activity. He also indicated that appellant was totally disabled from work from 

April 15 through 22, 2019 and could resume regular work on April 22, 2019.

In an April 16, 2019 duty status report (Form CA-17), a chiropractor with an illegible 

signature reiterated appellant’s history of injury, the prior diagnoses, and opinion on causal 

relationship. The chiropractor provided an additional diagnosis of low back pain and noted that 

appellant was unable to perform his regular work duties.

OWCP, in a development letter dated May 1, 2019, advised appellant of the deficiencies 

of his claim, informed him of the type of medical and factual evidence needed, and provided a 

questionnaire for his completion. Appellant was afforded 30 days to submit the necessary 

evidence. 

In an April 13, 2019 report, Dr. Lindsay A. Freeman, an emergency medicine physician, 

noted a history of injury that on that date appellant was a restrained driver of a postal truck that 

was struck on the front passenger side by a sport utility vehicle. She discussed physical

examination findings and reviewed diagnostic test results. Dr. Freeman diagnosed neck pain, and 

acute pain of the left shoulder.

In a statement dated May 12, 2019, appellant responded to OWCP’s development 

questionnaire. He noted that he was headed to lunch in a postal van at approximately 12:15 p.m. 

at the time of the motor vehicle accident. Appellant reiterated that he sustained neck, back, left 

shoulder, left, left leg, and headache injuries as a result of the April 13, 2019 motor vehicle 

accident. He also claimed that he experienced pain in both knees, and a burning sensation and 

numbness in his legs, arms, hands, and feet resulting from the accident.

April 13, 2019 discharge instructions from Tampa General Hospital indicated that 

appellant was seen by Dr. Freeman on that date and was diagnosed with neck pain, and acute pain 

of the left shoulder, following a motor vehicle accident.

In an April 15, 2019 patient information form, appellant again attributed his neck, back, 

shoulders, and legs to the April 13, 2019 motor vehicle accident.
3

On April 18, 2019 Dr. Cecilio Torres-Ruiz, an internist, reported a history of injury that on 

April 13, 2019 appellant was a restrained driver of a vehicle that was struck on the front right side 

by another vehicle. He noted appellant’s chief complaints of pain in the cervical and lower back 

regions, left leg wound and pain, and recurrent headaches. Dr. Torres-Ruiz provided a review of

systems, and discussed findings on physical examination. He provided impressions of pain in the 

cervical, thoracic, and lumbar regions, left leg healed wound, and muscle spasm. Dr. Torres-Ruiz

opined that, based on appellant’s history and physical examination, his symptomatology was 

directly attributed to the aforementioned motor vehicle accident. He indicated that his subjective 

complaints correlated well with both the mode of injury and objective clinical findings.

Diagnostic testing reports dated April 24, 2019 were received from Dr. Heather Kahan, a 

Board-certified diagnostic radiologist. In an April 24, 2019 lumbar spine magnetic resonance 

imaging (MRI) scan, Dr. Kahan provided impressions of grade 1 retrolisthesis of L4 on L5, and a 

broad-based bulging annulus and dorsal osteophytic ridging related to the spondylolisthesis defect 

with compression on the thecal sac, disc desiccation, and moderate bilateral facet hypertrophy at 

the L4-5 level. She also provided an impression of a three-millimeter left posterolateral disc 

herniation extending into the left neural foramen with severe left-sided neural foraminal stenosis 

and compression on the exiting left L5 nerve root. Dr. Kahan indicated that the herniated disc 

material also compressed the left S1 nerve root. There was diffuse disc desiccation and asymmetric 

hypertrophy of the left facet joint. There was also a small right-sided facet effusion.

In an April 24, 2019 cervical spine MRI scan report, Dr. Kahan provided impressions of:

straightening and reversal of the normal cervical lordosis consistent with marked torticollis/

cervical strain; a two-millimeter (mm) posterior osteophyte/herniated disc complex with 

compression of the thecal sac, intervertebral disc space narrowing, dessiccation, and moderately 

severe left-sided neural foraminal stenosis at the C3-4 level; a one-to-two-mm broad-based diffuse 

posterior disc herniation with compression of the thecal sac and mild intervertebral disc space 

narrowing at the C4-5 level; less than one-mm focal right paracentral disc herniation with 

compression of thecal sac and visualization with a small annular tear/fissure at the C5-6 level; and 

a one-to-two-mm broad-based left posterolateral/foraminal disc herniation resulting in severe leftsided neural foraminal stenosis with intervertebral disc space narrowing and visualization of a 

small paracentral annual tear/fissure at the C6-7 level.

An April 15, 2019 diagnostic imaging report indicated that a cervical spine imaging study 

performed on that day revealed ligament laxity, grade 1 anterolisthesis upon flexion at C2-3, and 

grade 1 retrolisthesis upon extension at C4-5. The report also indicated that a lumbar spine 

imaging study performed on even date revealed a deficient high pelvis.

By decision dated June 10, 2019, OWCP accepted that the April 13, 2019 employment 

incident occurred as alleged, but denied the claim finding that the medical evidence submitted was 

insufficient to establish a diagnosed medical condition causally related to the accepted 

employment incident. It concluded, therefore, that the requirements had not been met to establish 

an injury as defined by FECA.
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LEGAL PRECEDENT

An employee seeking benefits under FECA3 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,4and that 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.5 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.6

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.7 There are 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 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment incident must be based on a 

complete factual and medical background.11 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.12

 

3 Supra note 1.

4 S.C., Docket No. 18-1242 (issued March 13, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 

ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

5 T.H., Docket No. 18-1736 (issued March 13, 2019); J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 

59 ECAB 427 (2008); James E. Chadden, Sr., 40 ECAB 312 (1988).

6 T.E., Docket No. 18-1595 (issued March 13, 2019); K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., 

Docket No. 13-1402 (issued February 7, 2014); Delores C. Ellyett, 41 ECAB 992 (1990).

7 S.S., Docket No. 18-1488 (issued March 11, 2019); T.H., 59 ECAB 388, 393-94 (2008).

8 E.M., Docket No. 18-1599 (issued March 7, 2019); Elaine Pendleton, 40 ECAB 1143 (1989).

9 E.M., id.; John J. Carlone, 41 ECAB 354 (1989).

10 S.S., supra note 7; Robert G. Morris, 48 ECAB 238 (1996).

11 C.F., Docket No. 18-0791 (issued February 26, 2019); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

12 Id.
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ANALYSIS

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

condition causally related to the accepted April 13, 2019 employment incident.

In an April 13, 2019 report, Dr. Freeman noted a history of the accepted April 13, 2019 

employment incident. She addressed physical examination findings and reviewed diagnostic test 

results. Dr. Freeman diagnosed motor vehicle collision, initial encounter, neck pain, and acute 

pain of the left shoulder. However, these reports do not contain a specific opinion as to the cause 

of the diagnosed conditions. 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 These reports therefore are insufficient to establish appellant’s claim. 

In an April 18, 2019 report, Dr. Torres-Ruiz noted a history of the accepted April 13, 2019 

employment incident. He discussed findings on physical examination and provided impressions 

of pain in the cervical, thoracic, and lumbar regions, left leg healed wound, and muscle spasm. 

Dr. Torres-Ruiz opined that, based on appellant’s history and physical examination, his 

symptomatology was directly attributable to the accepted work incident. He noted that his 

subjective complaints correlated well with the mechanism of injury and objective clinical findings. 

The Board has held that “pain” and “spasm” are symptoms and not diagnoses.14 As Dr. TorresRuiz did not diagnose an actual medical condition causing appellant’s symptoms, his report lacks 

probative value and is insufficient to establish appellant’s claim.

The April 16, 2019 reports from a chiropractor offered an opinion on causal relationship 

between appellant’s diagnosed periodontal, cervical, thoracic, and lumbar spine, headache, and 

pelvis conditions and the accepted April 13, 2019 employment incident. However, chiropractors 

are only considered physicians under FECA, and their reports considered medical evidence, to the 

extent that they treat spinal subluxations as demonstrated by x-ray to exist, 5 U.S.C. § 8101(2).15 

The Board finds that these submitted reports are of no probative value because the chiropractor 

did not treat spinal subluxations as demonstrated by x-ray to exist.

Appellant also submitted diagnostic testing reports dated April 15 and 24, 2019. The 

Board has held that diagnostic studies lack probative value as they do not address whether the 

 

13 A.L., Docket No. 18-1756 (issued April 15, 2019); K.E., Docket No. 18-1357 (issued March 26, 2019); L.B.,

Docket No. 18-0533 (issued August 27, 2018).

14 J.S., Docket No. 19-0863 (issued November 4, 2019); V.B., Docket No. 19-0643 (issued September 6, 2019).

15 Section 8101(2) of FECA provides that medical opinion, in general, can only be given by a qualified physician. 

This section defines a physician as surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, 

and osteopathic practitioners within the scope of their practice as defined by state law. 5 U.S.C. § 8101(2). Section 

8101(3) of FECA, which defines services and supplies, limits reimbursable chiropractic services to treatment 

consisting of manual manipulation of the spine to correct a subluxation as demonstrated by x-ray to exist and subject 

to regulation by the Secretary. 5 U.S.C. § 8101(3). See H.K., Docket No. 19-0429 (issued September 18, 2019); K.J., 

Docket No. 18-1520 (June 13, 2019); Thomas W. Stevens, 50 ECAB 288 (1999); George E. Williams, 44 ECAB 

530 (1993).
6

employment incident caused any of the diagnosed conditions.16 Such reports are therefore 

insufficient to establish appellant’s claim.

As there is no well-reasoned medical opinion establishing causal relationship, the Board 

finds that appellant has not met his burden of proof.17

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 10.607.18

CONCLUSION

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

condition causally related to the accepted April 13, 2019 employment incident.

 

16 See F.D., Docket No. 19-0932 (issued October 3, 2019); B.C., Docket No. 18-1735 (issued April 23, 2019); J.S.,

Docket No. 17-1039 (issued October 6, 2017).

17 See F.D., id.; D.N., Docket No. 19-0070 (issued May 10, 2019); R.B., Docket No. 18-1327 (issued 

December 31, 2018).

18 The Board notes that the employing establishment issued a Form CA-16. A completed Form CA-16 authorization 

may constitute a contract for payment of medical expenses to a medical facility or physician, when properly executed. 

The form creates a contractual obligation, which does not involve the employee directly, to pay for the cost of the 

examination or treatment regardless of the action taken on the claim. See 20 C.F.R. § 10.300(c); J.G., Docket No. 17-

1062 (issued February 13, 2018); Tracy P. Spillane, 54 ECAB 608 (2003).
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ORDER

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

Compensation Programs is affirmed.

Issued: January 17, 2020

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board