United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.L., Appellant

and

U.S. POSTAL SERVICE, BROOKLYN 

PROCESSING & DISTRIBUTION CENTER, 

Brooklyn, NY, Employer

__________________________________________

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Docket No. 20-1162

Issued: October 7, 2021

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 May 15, 2020 appellant, through counsel, filed a timely appeal from an April 14, 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,followingthe April14, 2020 decision, OWCP receivedadditional 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 his burden of proof to establish that the acceptance 

of his claim should be expanded to include superior labrum anterior and posterior (SLAP) and

labral tears of the right shoulder, causally related to the accepted July 12, 2017 employment injury.

FACTUAL HISTORY

On July 12, 2017 appellant, then a 26-year-old clerk, filed a traumatic injury claim (Form 

CA-1) alleging that on that date he injured his right arm and back when he fell over an empty tray 

and hit a wall while in the performance of duty. He stopped work on that date.4 

In a July 12, 2017 supplemental statement, appellant indicated that he injured his right 

shoulder and arm when he fell. 

A July 25, 2017 magnetic resonance imaging (MRI) scan of appellant’s right shoulder 

revealed a suspected labral tear and a September 5, 2017 magnetic resonance arthrogram (MRA) 

of the right shoulder revealed an underlying labral tear and impingement and tendinosis of 

supraspinatus and long head biceps tendon. 

On October 23, 2017 OWCP accepted the claim for right shoulder strain and right shoulder 

contusion. 

In a November 6, 2017 report, Dr. Barbara Steele, a Board-certified orthopedic surgeon,

assessed right shoulder possible SLAP tear, possible anteroinferior labral tear, and pain and 

stiffness. 

On February 8, 2018 OWCP expanded its acceptance of the claim to include right shoulder 

tendinitis, strain of unspecified muscle, fascia and tendon at shoulder and upper arm, right arm, 

and right shoulder tendinitis. 

In a December 10, 2018 report, Dr. Imran Ashraf, an orthopedic surgeon, advised that 

appellant had fallen and injured his right shoulder, and that, despite extensive conservative 

measures, appellant continued to experience persistent right shoulder pain. He opined that 

arthroscopic surgery could alleviate appellant’s symptoms and requested authorization for right 

shoulder arthroscopic surgery. 

In a December 14, 2018 development letter, OWCP informed appellant that the evidence 

of record was insufficient to authorize the requested procedure, noting that the medical evidence 

submitted did not explain why the procedure was needed for the accepted conditions. It advised 

him of the type of evidence necessary to establish his claim, including an opinion supported by 

4 Appellant returned to full-duty work on July 20, 2017 and stopped work on August18, 2017. 
3

medical rationale, relating the requested procedure to the July 12, 2017 employment injury. 

OWCP afforded appellant 30 days to submit the necessary evidence.

A November 8, 2018 MRI scan of appellant’s right shoulder revealed a tear of the anterior 

and posterior labrum. 

On January 8, 2019 Dr. Ashraf again requested authorization for right shoulder 

arthroscopic surgery. 

In a January 11, 2019 report, Dr. Manuel Ceja, an internist, related that on July 12, 2017

appellant tripped and fell over an empty tray on the floor, hit his face on an electrical box on the 

wall, hit his right shoulder on the corner of the metal electrical box, and fell to the floor hitting his 

left hand and left knee. He noted a suspected labral tear on the July 25, 2017 MRI scan of the right 

shoulder and that the September 5, 2017 MRA of the right shoulder was consistent with labral tear,

impingement, and tendinosis. Dr. Ceja opined, “[i]t is within a certain degree of medical certainty 

that the history presented by the patient, the objective physical findings as well as the diagnosis 

rendered, is causally related to the injury the patient incurred on the specified date.” 

In a February 25, 2019 report, Dr. Ceja diagnosed strain of unspecified muscle, fascia, and 

tendon at shoulder and upper arm level, right arm, subsequent encounter, impingement syndrome 

of right shoulder, and unspecified sprain of right shoulder joint, subsequent encounter. 

On March 14, 2019 OWCP received a July 13, 2017 x-ray report of appellant’s right 

shoulder with negative findings. 

By decision dated March 26, 2019, OWCP denied expansion of the acceptance of 

appellant’s claim to include SLAP and labral tears of the right shoulder and the requested surgery. 

It found that the medical evidence of record was insufficient to establish causal relationship 

between the additional claimed conditions and the accepted July 12, 2017 employment injury. 

On April 2, 2019 appellant, through counsel, requested a telephonic hearing before a

representative of OWCP’s Branch of Hearings and Review

OWCP continued to receive additional medical evidence. On April 18, 2019 it received 

reports dated from July 12, 2017 to April 8, 2019, wherein Dr. Ceja diagnosed strain of unspecified 

muscle, fascia and tendon at shoulder and upper arm level, right arm and impingement syndrome 

of the right shoulder. Dr. Ceja added diagnoses of sprains of the right shoulder and rightshoulder 

joint as of appellant’s February 25, 2019 report. He again opined, “within a certain degree of 

medical certainty, that the history presented by [appellant], the objective physical findings as well 

as the diagnosis rendered is causally related to the injury [appellant] incurred on the specified 

date.” 

In a May 7, 2019 report, Dr. Ceja diagnosed strain of unspecified muscle, fascia, and 

tendon at shoulder and upper arm level, right arm, subsequent encounter. He also diagnosed 

impingement syndrome of the right shoulder, unspecified sprain of the right shoulder joint, 

subsequent encounter, other sprain of right shoulder joint, subsequent encounter, and right 

shoulder anterior and posterior labrum tears. Dr. Ceja concluded that the history of injury as 
4

presented by appellant and his physical examination findings established that appellant’s 

diagnosed conditions were causally related to the accepted injury. 

In a September 12, 2017 report, Dr. Steele, noted appellant’s history of injury and 

treatment, examined him and diagnosed a right shoulder possible inferior labral tear, possible 

SLAP tear, impingement and bursitis, pain, and stiffness. She opined that surgical intervention 

was warranted for the right shoulder as he had failed conservative measures. Dr. Steele also saw 

appellant on November 6 and December 11, 2017, and diagnosed right shoulder possible SLAP 

tear, possible anteroinferior labral tear, pain, and stiffness. 

In an October 29, 2018 report, Dr. Steele noted appellant’s history of injury and physical 

examination findings. She diagnosed right shoulder possible SLAP tear, possible anteroinferior 

labral tear, impingement and bursitis, pain, and stiffness. Regarding causation, Dr. Steele opined 

that “[t]he right shoulder condition happened because of the injury while at work on 

[July] 12, 2017.” She advised that due to the length of time since the injury and the fact that 

appellant had failed conservative measures, arthroscopic surgery was warranted for the right 

shoulder.

In a March 4, 2019 report, Dr. Ashraf diagnosed right shoulder anterior and posterior labral 

tears. He recommended right shoulder surgery. Dr. Ashraf also saw appellant on April 22, 2019 

and repeated his diagnosis. 

OWCP received a June 13, 2019 operative reports which related that appellant underwent 

a right shoulder arthroscopy, paralabral cyst decompression with labral takedown and repair, 

subacromial debridement, and decompression.

A hearing was held on June 28, 2019. By decision dated September 4, 2019, the hearing 

representative affirmed the March 26, 2019 decision, finding that the medical evidence of record 

was insufficient to support expansion of the acceptance of appellant’s claim to include SLAP and 

labral tears of the right shoulder.

On September 26, 2019 appellant requested reconsideration.

OWCP received copies of prior reports from Dr. Ceja and additional reports dated 

September 9, 14, and 30 and November 5, 2019. Dr. Ceja noted appellant’s history of injury and 

treatment, examined appellant and diagnosed strain of unspecified muscle, fascia and tendon at 

shoulder and upper arm level, right arm, subsequent encounter, impingement syndrome of right 

shoulder, pain in right shoulder, superior glenoid labrum lesion of right shoulder, subsequent 

encounter, other sprain of right shoulder joint, subsequent encounter, strain of muscle(s) and 

tendon(s) of the rotator cuff of right shoulder, subsequent encounter, right shoulder anterior and 

posterior labrum tears, and s/p right shoulder arthroscopy. He again opined, “It is within a certain 

degree of medical certainty, that the history presented by the patient, the objective physical 

findings as well as the diagnosis rendered is causally related to the injury the patient incurred on 

the specified date.” 

By decision dated December 23, 2019, OWCP denied modification of the September 4, 

2019 decision. 

In a December 2, 2019 report, Dr. Ceja noted that appellant tripped and fell over an empty 

tray on the floor, hit his right face on an electrical box on the wall, hit his right shoulder on the 
5

corner of the metal electrical box, and was “jolted forward.” He noted that appellant resigned from 

the employing establishment in April 2018, as appellant was unable to lift overhead, and began 

working as a bus driver. Dr. Ceja diagnosed strain of unspecified muscle, fascia and tendon at 

shoulder and upper arm level, right arm, subsequent encounter, impingement syndrome of right 

shoulder, pain in right shoulder, superior glenoid labrum lesion of right shoulder, subsequent 

encounter, other sprain of right shoulder joint, subsequent encounter, right shoulder anterior and 

posterior labrum tears, and right shoulder arthroscopy. He opined, “It is within a certain degree of 

medical certainty that the history presented, the objective findings and diagnoses were causally 

related to the injury appellant occurred on the specified date.” 

On April 6, 2020 appellant, through counsel, requested reconsideration and submitted 

additional medical evidence. 

In a March 27, 2020 report, Dr. Ceja repeated his previous findings. He opined that after 

reviewing appellant’s medical file, taking a complete history and performing physical 

examination, “there appears to be a cause and effect relationship between the injuries sustained 

and the work[-]related incident reported on July 12, 2019.” 

By decision dated April 14, 2020, OWCP denied modification of the December 23, 2019 

decision. 

LEGAL PRECEDENT

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 conditio n is 

causally related to the employment injury.5

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.6 A physician’s opinion on whether there is a causal relationship 

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

complete factual and medical background.7 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 employment injury.8

ANALYSIS

The Board finds that appellant has not met his burden of proof to expand the acceptance of 

his claim to include SLAP and labral tears of the right shoulder causally related to the accepted 

July 12, 2017 employment injury.

5

J.R., Docket No. 20-0292 (issued June 26, 2020); W.L., Docket No. 17-1965 (issued September 12, 2018); JajaK. 

Asaramo, 55 ECAB 200, 204 (2004).

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

7 F.A., Docket No. 20-1652 (issued May 21, 2021); M.V., Docket No. 18-0884 (issued December 28, 2018); 

Victor J. Woodhams, 41 ECAB 345, 352 (1989).

8

Id.
6

In support of his claim, appellant submitted a series of reports from Dr. Ceja, who opined 

that, “It is within a certain degree of medical certainty, that the history presented by the patient, 

the objective physical findings as well as the diagnosis rendered is causally related to the injury 

the patient incurred on the specified date.” He further opined that “there appears to be a cause and 

effect relationship between the injuries sustained and the work[-]related incident reported on 

July 12, 2019.” However, these reports merely provided a conclusory opinion regarding causal 

relationship. The Board has held that a medical opinion that is conclusory in nature is of limited 

probative value.

9

 Dr. Ceja did not explain with medical rationale how he concluded that 

appellant’s right shoulder anterior and posterior labrum tears were caused by the accepted 

incident.10 His reports are, therefore, insufficient to meet appellant’s burden of proof.

Dr. Ashraf provided reports dated December 10, 2018 and March 4, 2019, in which he

diagnosed right shoulder anterior and posterior labral tears and recommended right shoulder 

surgery. However, he merely provided a diagnosis and request for authorization for surgery and 

did not offer any opinion to explain how the diagnosed conditions resulted from the accepted 

July 12, 2017 employment injury. 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.

11

 Therefore, these reports are insufficient to establish appellant’s claim.12

Dr. Steele provided reports dated September 12 and November 6, 2017 and October 29, 

2018, in which she diagnosed right shoulder possible SLAP tear, possible anteroinferior labral 

tear, pain, and stiffness. The Board notes thatshe opined, “[t]he right shoulder condition happened 

because of the injury while at work on 07/12/2017.” However, as these reports are conclusory in 

nature and lack medical rationale, they are of limited probative value and insufficient to meet 

appellant’s burden of proof to establish his claim.13

OWCP also received a number of diagnostic reports. However, the Board has held that 

diagnostic tests, standing alone, lack probative value as they do not provide an opinion on causal 

relationship between diagnosed conditions, and an employment injury.

14

 Therefore, this evidence 

also is insufficient to establish appellant’s claim.

As appellant has not submitted any rationalized medical evidence establishing that the 

acceptance of his claim should be expanded to include SLAP and labral tears of the right shoulder, 

9 C.M., Docket No. 19-0360 (issued February 25, 2020); C.D., Docket No. 17-0292 (issued June19, 2008); Mary A. 

Ceglia, 55 ECAB 626 (2004).

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

R.D., Docket No. 18-1551 (issued March 1, 2019).

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

12 Id.

13 Supra note 9.

14 S.K., Docket No. 19-0272 (issued July 21, 2020); A.V., Docket No. 19-1575 (issued June 11, 2020).
7

causally related to the accepted July 12, 2017 employment injury, he has failed to meet his 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 his burden of proof to expand the acceptance of 

his claim to include SLAP and labral tears of the right shoulder causally related to the accepted 

July 12, 2017 employment injury.

ORDER

IT IS HEREBY ORDERED THAT the April 14, 2020 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: October 7, 2021

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