United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.S., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Tomball, TX, Employer

__________________________________________

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Docket No. 19-0641

Issued: November 8, 2019

Appearances: Case Submitted on the Record

Douglas Sughrue, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On January 28, 2019 appellant, through counsel, filed a timely appeal from an October 18, 

2018 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.

ISSUE

The issue is whether appellant has met her burden of proof to establish a cervical condition 

causally related to factors of her federal employment.

 

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

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 August 4, 2008 appellant, then a 42-year-old letter carrier, filed an occupational disease 

claim (Form CA-2), alleging that her preexisting pinched nerve developed into five herniated discs 

as a result of conducting her letter carrier duties while in the performance of duty. She first became 

aware of her condition and realized it was causally related to factors of her federal employment on 

December 19, 2006. Appellant did not stop work at that time.

By decision dated September 29, 2008, OWCP denied appellant’s claim on the grounds

that the evidence was insufficient to establish the events occurred, as alleged and, thus, the 

requirements had not been met to establish an injury as defined by FECA. Appellant requested a 

review of the written record.

By decision dated April 8, 2009, an OWCP hearing representative found that appellant had 

established the factual element of her claim, but affirmed the denial of the claim because she had 

not submitted sufficient medical evidence to establish causal relationship.

Appellant subsequently requested reconsideration and, by decisions dated July 27 and 

November 27, 2009, OWCP denied modification.

Appellant continued to request reconsideration. By decisions dated December 29, 2009 

and February 14, 2011, OWCP denied appellant’s requests for reconsideration, finding that the 

evidence submitted was insufficient to warrant reconsideration of the merits of her claim.

On July 26, 2011 appellant appealed to the Board. By an April 12, 2012 order, the Board 

set aside OWCP’s February 14, 2011 decision and remanded the case to OWCP for it to consider 

all evidence submitted at the time of the February 14, 2011 decision.4

By decisions dated August 7, 2012, October 2, 2013, and August 25, 2014, OWCP 

reviewed the merits of the claim, but denied modification. Appellant appealed to the Board. By 

decision dated September 22, 2015, the Board affirmed the August 25, 2014 OWCP decision,

finding the medical evidence of record insufficient to establish causal relationship.5 

On September 14, 2016 appellant, through counsel, requested reconsideration. By decision 

dated December 12, 2016, OWCP denied modification. On February 17, 2017 appellant, through 

counsel, appealed to the Board. By decision dated August 1, 2017, the Board affirmed the 

December 12, 2016 decision. 

 

3 Order Remanding Case, Docket No. 11-1749 (issued April 12, 2012); Docket No. 15-0622 (issued 

September 22, 2015); Docket No. 17-0755 (issued August 1, 2017).

4 Order Remanding Case, Docket No. 11-1749 (issued April 12, 2012).

5 Docket No. 15-0622 (issued September 22, 2015).
3

Appellant, through counsel, requested reconsideration on July 23, 2018.

In support of the request, OWCP received an August 31, 2016 x-ray of the cervical spine,

which revealed mild-to-moderate cervical spondylosis. Similarly, a magnetic resonance imaging 

(MRI) scan of the cervical spine on October 24, 2016 revealed degenerative changes at C2-3,

lateral spinal stenosis at C3-4, posterior disc protrusion at C4-5, and posterior disc osteophyte at 

C5-6.

Appellant was treated by Dr. Mayur Kanjia, a Board-certified anesthesiologist, from 

November 8, 2016 to May 16, 2017, for a three-month history of neck pain radiating into the 

bilateral arms and hands. Dr. Kanjia reported a history of lumbar radiculopathy and noted that 

appellant was status post laminectomy in 2010. He performed steroid injections at C5-6 and a 

spinal cord stimulator (SCS) implant.

Physical therapy notes dated December 7, 2016 to January 3, 2017 were also received.

In a letter dated September 18, 2017, Dr. Kanjia opined that appellant’s duties as a letter 

carrier, including repetitive bending, twisting, turning, walking, lifting, and carrying more than 10 

pounds daily, five to six days a week, for 8 to 10 hours a day, aggravated appellant’s preexisting 

disc herniations and aggravated scar tissue from the surgical fusion of 2010. He reported first 

treating appellant on November 8, 2016 after she underwent lumbar surgeries in 2008 and 2010. 

Dr. Kanjia noted that appellant underwent a cervical epidural injection on November 23, 2016 and 

reported improved symptoms, however, persistent lumbar postlaminectomy pain. On March 7, 

2017 appellant underwent a SCS trial with 99 percent pain relief.

On November 6, 2017 Dr. Kanjia indicated that appellant’s work duties of repetitive 

bending, twisting, turning, walking, lifting, and carrying more than 10 pounds on a daily basis,

five days a week, eight hours every day aggravated the preexisting disc herniations. He opined 

that, based on her history and physical examination, appellant’s signs and symptoms have 

drastically changed, which is indicative of increased nerve pinching after the aggravation. On 

November 29, 2017 Dr. Kanjia provided an amended statement and opined that appellant 

aggravated her preexisting disc herniation from forces required at work, which include repetitive 

bending, twisting, turning, walking, lifting, and carrying more than 10 pounds daily, five to six

days a week, for 8 to 10 hours a day. He advised that the force from the motion enlarged her 

herniation causing worsening symptoms.

In a February 20, 2018 letter, Dr. Kanjia opined that appellant’s preexisting condition prior 

to reaggravation was a postlaminectomy fusion, which was high risk for herniating discs above 

and below the surgery with enough force. He further opined that appellant’s work descriptions 

could cause a great amount of force across the spine to rupture discs.

By decision dated October 18, 2018, OWCP denied modification of its prior decision.
4

LEGAL PRECEDENT

An employee seeking benefits under FECA6 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 of FECA,7that 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.8 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.9

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit: (1) a factual statement identifying employment factors 

alleged to have caused or contributed to the presence or occurrence of the disease or condition; 

(2) medical evidence establishing the presence or existence of the disease or condition for which 

compensation is claimed; and (3) medical evidence establishing that the diagnosed condition is 

causally related to the identified employment factors.10

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.11 A physician’s opinion on whether there is causal relationship 

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

complete factual and medical background.12 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 factor(s).13

Where there is medical evidence of a preexisting condition involving the same part of the 

body as the claimed employment injury, the issue of causal relationship invariably requires inquiry 

into whether there was employment-related aggravation, acceleration, or precipitation of the 

underlying condition.14 Accordingly, the physician must provide a rationalized medical opinion,

 

6 Supra note 2.

7

J.P., Docket No. 19-0129 (issued April 26, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); Joe D. 

Cameron, 41 ECAB 153 (1989). 

8

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988). 

9 R.R., Docket No. 19-0048 (issued April 25, 2019); L.M., Docket No. 13-1402 (issued February 7, 2014); 

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

10 M.S., Docket No. 18-1554 (issued February 8, 2019); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

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

12 M.V., Docket No. 18-0884 (issued December 28, 2018); Victor J. Woodhams, supra note 10.

13 Id.

14 See Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013). 
5

which differentiates between the effects of the work-related injury or disease and the preexisting 

condition.15

ANALYSIS

The Board finds that this case is not in posture for decision.

Following the Board’s August 1, 2017 decision, appellant, through counsel, requested 

reconsideration and submitted additional medical evidence. In letters dated September 18 and 

November 6, 2017, Dr. Kanjia opined that repetitive bending, twisting, turning, walking, lifting,

and carrying more than 10 pounds daily, five to six days a week, for 8 to 10 hours a day required 

by a letter carrier aggravated appellant’s preexisting disc herniations and scar tissue from the 

surgical fusion from 2010. He reported that appellant’s symptoms drastically changed indicating 

more nerve pinching. Similarly, in a report dated November 29, 2017, Dr. Kanjia opined that she

aggravated her preexisting disc herniation from forces required at work, which include repetitive 

bending, twisting, turning, walking, lifting, and carrying more than 10 pounds daily, five to six

days a week, for 8 to 10 hours a day. He opined that the force from the motion enlarged her 

herniation causing increased symptoms. Likewise, in a February 20, 2018 letter, Dr. Kanjia 

described appellant’s work duties and opined that the duties could cause a great amount of force 

across the spine to rupture discs.

The Board finds that the medical opinion of Dr. Kanjia is based upon a complete factual 

history and medical background, is supported by reasonable medical certainty, and provides a 

sufficient level of medical rationale explaining the nature of the relationship between the diagnosed 

conditions and the accepted employment incident.16 While Dr. Kanjia’s reports are insufficiently 

rationalized to meet appellant’s burden of proof to establish her claim, they are sufficient to require 

OWCP to further develop the medical evidence and the case record.17

Proceedings under FECA are not adversarial in nature and OWCP is not a disinterested 

arbiter. While the claimant has the burden to establish entitlement to compensation, OWCP shares 

responsibility to see that justice is done.18 The nonadversarial policy of proceedings under FECA 

is reflected in OWCP’s regulations at section 10.121.19 On remand OWCP should refer appellant 

and the medical evidence of record to an appropriate specialist to obtain a rationalized opinion 

regarding whether she sustained a cervical condition causally related to the accepted employment 

incident.20 After such further development as OWCP deems necessary, it shall issue a de novo

decision.

 

15 Id. 

16 W.C., Docket No. 18-1386 (issued January 22, 2019).

17 C.W., Docket No. 19-0231 (issued July 15, 2019).

18 X.V., Docket No. 18-1360 (issued April 12, 2019); Jimmy A. Hammons, 51 ECAB 219 (1999).

19 20 C.F.R. § 10.121.

20 M.K., Docket No. 17-1140 (issued October 18, 2017).
6

CONCLUSION

The Board finds that the case is not in posture for decision.

ORDER

IT IS HEREBY ORDERED THAT the October 18, 2018 decision of the Office of 

Workers’ Compensation Programs is set aside and the case is remanded for further proceedings 

consistent with this decision of the Board.

Issued: November 8, 2019

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board