United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.D., Appellant

and

U.S. POSTAL SERVICE, SOUTH DOWNEY 

POST OFFICE, Downey, CA, Employer

__________________________________________

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Docket No. 22-1006

Issued: December 5, 2022

Appearances: Case Submitted on the Record

Roxann M. Gonzalez, for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On June 21, 2022 appellant, through her representative, filed a timely appeal from a 

January 10, 2022 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 January 10, 2022 decision, OWCP receivedadditional evidence. However, 

the Board’s Rules of Procedureprovides: “ 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 

evidence for the first time on appeal. Id.
2

ISSUE

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

causally related to the accepted factors of her federal employment.

FACTUAL HISTORY

On January 27, 2020 appellant, then a 50-year-old city letter carrier, filed an occupational 

disease claim (Form CA-2) alleging that she had sustained a lower back injury as a result of her 

federal employment duties, including lifting, bending, unloading parcels, and bearing weight. She 

noted that she first became aware of her lower back condition and its relation to her federal 

employment on October 1, 2019.4

In a duty status report (Form CA-17) dated February 6, 2020, Dr. Edward Mittleman, a 

family medicine specialist, diagnosed lumbar/sacral disc radiculitis and noted that appellant had 

been advised that she could return to work on January 2, 2020 with restrictions. He had provided 

the same diagnosis on Forms CA-17 dated January 2 and March 5, 2020. 

In a development letter dated March 20, 2020, OWCP informed appellant of the 

deficiencies of her claim. It advised her of the type of medical and factual evidence necessary to 

establish her claim and afforded her 30 days to provide the necessary evidence. 

OWCP received a December 18, 2019 magnetic resonance imaging (MRI) scan of 

appellant’s lumbar spine. The appearance was noted to be worse compared to prior examination 

on October 19, 2016. 

In a report dated February 6, 2020, Dr. Mittleman diagnosed lumbar disc extrusion with 

radiculopathy, permanent aggravation of severe lumbar L5-S1 neural foraminal stenosis, and 

aggravation of lumbar spondylosis. He reviewed appellant’s employment duties and described 

them in detail. Dr. Mittleman noted that, while casing mail, she rotated her lumbar axial skeletal 

system bilaterally and extended it upward, placing significant force on the lumbar skeletal system. 

This also placed significant force on the joints of the lumbar spine, causing irritation to appellant’s

articular cartilage, which resulted in wear of bony structures and eventual osteoarthrosis, as 

documented in the December 18, 2019 MRI scan. Dr. Mittleman explained that filling trays of 

mail put significant force on her lumbar axial system. Afterward, appellant used a transportation 

device to load her postal vehicle, which involved significant twisting force of the lumbar spine, 

transmitting such force to both the joints and discs of the lumbar spine. In delivering mail, she

pushed and pulled a mail cart, which again placed significant forces on the structures of her lumbar 

spine. Dr. Mittleman opined that these repetitive activities that appellant had performed on a daily 

basis in the course of her employment produced significant changes within the structures of the 

lumbar spine, as documented by MRI scan. He stated that these changes were consistent with 

permanent aggravation, which was a continuing and irreversible change in the underlying lumbar 

4 Appellant previously filed a claim for traumatic injury (Form CA-1) on December 15, 2016 alleging that on 

September 19, 2016 she injured her lower back when she stepped into a pothole while delivering mail. OWCP 

assigned that claim OWCP File No. xxxxxx637. It denied the claim by decisions dated May 25, 2017 and July12, 

2018 as appellant had not established that she sustained an injury as defined by FECA. Appellant’s claims have not 

been administratively combined.
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condition. Dr. Mittleman opined that it was medically reasonable to infer a direct causal 

relationship between appellant’s lumbar symptoms and her employment duties as a city carrier. 

By decision dated April 27, 2020,OWCP denied appellant’s claim, finding that the medical 

evidence of record was insufficient to establish causal relationship between the diagnosed 

conditions and the accepted factors of her federal employment. 

Appellant subsequently submitted a series of CA-17 forms indicating diagnoses of lumbar 

disc radiculitis and recommending work restrictions, dated from April 8, 2020 through 

May 27, 2021. 

On April 6, 2021 appellant requested reconsideration. 

By decision dated July 6, 2021, OWCP denied modification of its April 27, 2020 decision. 

Appellant subsequently submitted a series of CA-17 forms indicating diagnoses of lumbar 

disc radiculitis and recommending work restrictions, dated July 1 through November 30, 2021. 

On December 15, 2021 appellant requested reconsideration. 

In support thereof, appellant submitted a December 14, 2021 report from Dr. Basimah 

Khulusi, a physician Board-certified in physical medicine and rehabilitation. Dr. Khulusi 

diagnosed lumbar extrusion with radiculopathy, permanent aggravation of severe L5 -S1 neural 

foraminal stenosis, and aggravation of lumbar spondylosis. He explained that appellant had 

performed repetitive lifting and carrying day after day, year after year, that caused repetitive 

spraining and straining of her low back structures. Continuing to stress these structures by 

continuing respective lifting and carrying caused increased pressure on the discs in the disc spaces 

and caused displacement of these discs at multiple levels of the lumbar spine as seen by the MRI 

scan study of December 18, 2019. 

By decision dated January 10, 2022, OWCP denied modification of its July 6, 2021 

decision. 

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 timely filed within the applicable 

time limitation of FECA, 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.6 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.

5

Id.

6 C.K., Docket No. 19-1549 (issued June 30, 2020); R.G., Docket No. 19-0233 (issued July 16, 2019); Elaine 

Pendleton, 40 ECAB 1143 (1989).
4

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.7

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.8 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 factors.9

ANALYSIS

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

The issue in the present case is whether appellant has established causal relationship 

between any diagnosed medical condition and the accepted factors of her federal employment. In 

his February 6, 2020 report, Dr. Mittleman diagnosed lumbar disc extrusion with radiculopathy, 

permanent aggravation of severe lumbar L5-S1 neural foraminal stenosis, and aggravation of 

lumbar spondylosis. He explained that, while casing mail, appellant rotated her lumbar axial 

skeletal system bilaterally and extended it upward, placing significant force on the lumbar skeletal 

system. This also placed significant force on the joints of the lumbar spine, causing irritation to 

appellant’s articular cartilage, which resulted in wear of bony structures and eventual 

osteoarthrosis, as documented in the December 18, 2019 MRI scan. Dr. Mittleman further

explained that filling trays of mail put significant force on her lumbar axial system. Afterward, 

appellant used a transportation device to load her postal vehicle, which involved significant 

twisting force of the lumbar spine, transmitting such force to both the joints and discs of the lumbar 

spine. In delivering mail, she pushed and pulled a mail cart, which again placed significant forces 

on the structures of her lumbar spine. Dr. Mittleman opined that these repetitive activities that 

appellant had performed on a daily basis in the course of her employment produced significant 

changes within the structures of the lumbar spine, as documented by MRI scan and that these 

changes were consistent with permanent aggravation, a continuing and irreversible change in the 

underlying lumbar condition. He opined that it was medically reasonable to infer a direct causal 

relationship between her lumbar symptoms duties of her employment as a city carrier.

It is well established that, proceedings under FECA are not adversarial in nature and, while 

appellant has the burden of proof to establish entitlement to compensation, OWCP shares 

7 L.D., Docket No. 19-1301 (issued January 29, 2020); S.C., Docket No. 18-1242 (issued March 13, 2019); Victor J. 

Woodhams, 41 ECAB 345, 352 (1989).

8

I.J., Docket No. 19-1343 (issued February 26, 2020); T.H., 59 ECAB 388 (2008); RobertG. Morris, 48 ECAB 

238 (1996).

9 D.J., Docket No. 19-1301 (issued January 29, 2020).
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responsibility in the development of the evidence.10 OWCP has an obligation to see that justice is 

done.11

The Board finds that Dr. Mittleman’s February 6, 2020 report, while not fully rationalized, 

is sufficient to require further development of the medical evidence. 12 On remand, OWCP shall 

refer appellant to a physician in the appropriate field of medicine, along with the case record and 

a statement of accepted facts, for an examination and a rationalized medical opinion as to whether 

the accepted employment factors either caused or aggravated a diagnosed medical condition.13 If 

the second opinion physician disagrees with the explanations provided by Dr. Mittleman, he or she 

must provide a fully-rationalized opinion explaining why the accepted employment factors are 

insufficient to have caused or aggravated a diagnosed medical condition. Following this and other 

such further development as deemed necessary, OWCP shall issue a de novo decision.14

CONCLUSION

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

10 See id. See also A.P., Docket No. 17-0813 (issued January 3, 2018); Jimmy A. Hammons, 51 ECAB 219, 

223 (1999).

11 See B.C., Docket No. 15-1853 (issued January 19, 2016); E.J., Docket No. 09-1481 (issued February 19, 2010); 

John J. Carlone, 41 ECAB 354 (1989).

12 Id.

13 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013); 

C.C., Docket No. 19-1631 (issued February 12, 2020).

14 On remand, OWCP should consider administratively combining any prior claims for compensation related to 

appellant’s back with the present claim.
6

ORDER

IT IS HEREBY ORDERED THAT the January 10, 2022 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: December 5, 2022

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board