United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

L.H., Appellant

and

U.S. POSTAL SERVICE, FREEHOLD POST 

OFFICE, Freehold, NJ, Employer

__________________________________________

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Docket No. 21-0215

Issued: July 22, 2021

Appearances: Case Submitted on the Record

Russell T. Uliase, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On December 8, 2020 appellant, through counsel, filed a timely appeal from a July 9, 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

ISSUE

The issue is whether appellant has established a medical condition causally related to the 

accepted factors of her federal employment.

FACTUAL HISTORY

This case has previously been before the Board.3 The facts and circumstances of the case 

as set forth in the Board’s prior order are incorporated herein by reference. The relevant facts are 

as follows.

On July 11, 2016 appellant, then a 51-year-old rural carrier, filed an occupational disease 

claim (Form CA-2) alleging that she injured her back, legs, and hips due to factors of her federal 

employment, including bending, twisting, lifting up to 70 pounds, pushing, pulling, sitting, 

walking, turning, kneeling, squatting, reaching above and below her head, standing, leaning over, 

stepping up and down, carrying, and stretching.

4

 She noted that she first became aware of her 

condition on January 22, 2014 and realized its relationship to her employment on 

January 26, 2016. Appellant stopped work on January 26, 2016.

A February 25, 2014 lumbar magnetic resonance imaging (MRI) scan report showed spinal 

canal stenosis at L4-5 related to a diffuse disc bulge and prominent facet arthropathy.

In an April 2, 2014 report, Dr. Robert B. Grossman, a Board-certified orthopedic surgeon,

indicated that appellant was previously diagnosed with spinal stenosis and entrapment at L4-5. 

Upon physical examination, he observed tenderness at L4-5 and L5-S1 of the lumbar spine. 

Straight leg raise testing was positive. Dr. Grossman reported decreased knee reflex and no 

sensory losses. He opined that appellant’s injury was “directly related to overuse at work 

delivering mail on January 22, 2014.”

In notes dated April 30 and July 2, 2014, Dr. Grossman noted physical examination

findings of back and sacroiliac (SI) joint tenderness. He opined that appellant’s back injury was 

“directly related to back strains from doing two routes at the same time for the [employing 

establishment].”

In a January 19, 2016 report, Dr. Sandeep Rathi, Board-certified in physical medicine and 

rehabilitation and pain medicine, recounted appellant’s complaints of low back pain on the right 

side and significant muscle spasm. Upon physical examination, he observed tenderness to 

palpation over the right-sided lumbosacral paraspinal musculature and palpable spasm. Straight 

leg raise testing was negative. Dr. Rathi diagnosed lumbar intervertebral disc displacement.

In a January 20, 2016 report, Dr. Leslie Cauvin, an osteopath who specializes in internal 

medicine, indicated that appellant was seen for right-side back pain. He reviewed appellant’s 

 

3 Order Remanding Case, Docket No. 18-1777 (issued July 20, 2019).

4 The claim was assigned OWCP File No. xxxxxx373. Appellant previously filed a traumatic injury claim for a 

back injury related to a January 22, 2014 employment incident. OWCP assigned that claim OWCP File No. 

xxxxxx498 and accepted it for temporary aggravation of lumbosacral degenerative disc disease
3

history and provided examination findings. Dr. Cauvin diagnosed low back pain and left elbow 

sprain.

An April 1, 2016 lumbar spine MRI scan revealed multilevel degenerative disc disease, 

most prominent within the lower lumbar spine and disc protrusion at T11-12, L1-2, L2-3, L3-4, 

L4-5, and L5-S1.

On September 6, 2016 OWCP received a statement from appellant. Appellant noted that 

the date of the original traumatic injury, which resulted in her back condition, was 

January 22, 2014. She provided a detailed account of her employment duties, which included 

casing mail, sorting mail into trays, loading trays into carts or skids, signing and writing up all 

accountable items, pushing the cart or skid full of mail to the loading dock, driving her truck to the 

dock, loading her mail truck with mail, driving to her mail route, and delivering mail and packages. 

Appellant indicated that her duties required repetitive grabbing, pulling, twisting, rotating, 

bending, squatting or kneeling, lifting, reaching, and walking. 

In a September 22, 2016 development letter, OWCP informed appellant that the evidence 

of record was insufficient to establish her claim. It advised her of the type of medical and factual 

evidence necessary to support her claim and provided a questionnaire for her completion. OWCP 

afforded appellant 30 days to submit the necessary information. 

In reports dated August 2 and October 13, 2016, Dr. Rathi recounted appellant’s 

complaints of low back pain with radiation to the lower extremities. Upon examination of 

appellant’s lumbar spine, he observed tenderness to palpation of the lumbosacral paraspinal 

musculature. Straight leg raise testing produced pain in the low back and buttocks. Dr. Rathi 

diagnosed lumbosacral radiculopathy and lumbar intervertebral disc displacement. 

On October 20, 2016 OWCP received appellant’s response to its development letter. 

Appellant noted that her original back injury occurred on January 22, 2014 and that diagnostic 

testing showed that she had two herniated and/or bulging discs in her lower back. She indicated 

that her second work injury occurred in January 2016 and that a lumbar spine MRI scan revealed 

that she now had five herniated and/or bulging discs in her lumbar spine.

Appellant submitted additional reports by Dr. Grossman. In reports dated August 3 and 

October 5, 2016, Dr. Grossman indicated that appellant’s problems with her back and legs started 

in January 2014 and again in 2016 and was caused by her bending, twisting, and walking for work. 

He indicated that an MRI scan showed L2-3, L3-4, L4-5, and L5-S1 entrapment. Upon 

examination of appellant’s lumbar spine, Dr. Grossman observed back tenderness and entrapment. 

In the October 5, 2016 report, he assessed “spinal stenosis and degenerative spinal disease, all 

caused by two injuries at work.”

By decision dated November 14, 2016, OWCP denied appellant’s occupational disease 

claim, finding that the medical evidence of record was insufficient to establish that her diagnosed 

medical conditions were causally related to the accepted factors of her federal employment. 

On November 23, 2016 appellant, through counsel, requested a hearing before a 

representative of OWCP’s Branch of Hearings and Review, which was held on March 1, 2017.
4

Appellant submitted progress notes dated January 30 and March 6, 2014 from Dr. Anupam 

Sinha, an osteopath, regarding appellant’s medical treatment for “exacerbation of lumbar disc

herniation from work-related incident on January 22, 2014.” Dr. Sinha diagnosed L3-4, L4-5, and 

L5-S1 disc herniation and mild-to-moderate L4-5 stenosis.

OWCP received reports dated April 30 and October 26, 2015 by Dr. Grossman, who 

treated appellant for left knee pain. Dr. Grossman reported that examination findings revealed 

joint line tenderness and positive McMurray signs. He diagnosed arthritis and meniscal tear. 

Appellant continued to receive medical treatment from Dr. Rathi and submitted reports and 

procedure notes dated November 21, 2016 through January 19, 2017 regarding the treatment that 

she received for her lumbar radiculopathy and low back pain.

Appellant submitted reports dated March 7, 2016 through March 23, 2017 from

Dr. Grossman who noted the 2014 back injury and indicated that diagnostic testing had confirmed 

degenerative spine disease and five bulging discs. In reports dated January 11 and February 8, 

2017, Dr. Grossman assessed “protruding discs and degenerative spine disease related to the work 

that [appellant] has done for the last 32 years.” In reports dated January 24 and March 8, 2017, he

further indicated that the source of appellant’s problem began in 2014 when she had to carry an 

excessive amount of weight at work. Dr. Grossman recounted that appellant had been carrying 

large weights with a degenerative back for 30 some years and explained that appellant’s 

degenerative problems were accentuated by her working on hard floors, carrying, lifting, turning, 

and twisting. He reported that appellant’s back problems were directly related to being “forced to 

carry two bags of mail as a rural carrier back in 2014 and did so approximately 30 years.” In a 

March 23, 2017 narrative report, Dr. Grossman further indicated that appellant’s injury was made 

worse by what she had done for the previous 20 to 25 years.

By decision dated April 4, 2017, OWCP’s hearing representative affirmed the 

November 14, 2016 decision.

On February 5, 2018 appellant, through counsel, requested reconsideration.

OWCP received additional reports and procedure notes from Dr. Rathi dated May 1

through December 14, 2017 regarding the medical treatment that appellant received for her lumbar 

and right hip conditions.

In a narrative June 17, 2017 report, Dr. Grossman indicated that for 30 years appellant was 

required to work an average of 81⁄2 hours per day, 5 to 6 days per week, casing and delivering mail, 

which involved twisting, bending, stooping, and lifting. He opined that appellant’s medical 

problems were directly related to what she was required to do and the significant amount of work 

on her spine. Dr. Grossman explained that significant twisting, turning, and bending all day long 

for 31 years would disrupt anyone’s spine and hips. He concluded that appellant’s back and hip 

problems were directly related to her employment, which required twisting and turning exercises, 

moving large amounts of mail across the employing establishment floor, and moving that mail 

again in and out of her truck.
5

In a report dated August 17, 2017, Dr. Grossman reported that appellant continued to be 

symptomatic in her back and left lower extremity. He noted examination findings of positive 

straight leg raise testing and weakness in the dorsiflexion of the left foot.

In a December 12, 2017 report, Dr. Rathi noted appellant’s January 22, 2014 work-related 

injury and discussed the medical treatment that appellant had received, including diagnostic 

testing, epidural steroid injections, and nerve branch blocks. He reported that appellant’s 

diagnoses related to the January 22, 2014 work injury were lumbar facet joint syndrome bilaterally, 

annual tear at L3-4 and L4-5, and disc herniation at L4-5 and L5-S1. Dr. Rathi indicated that 

appellant suffered a permanent, work-related injury on January 22, 2014, which remained 

symptomatic after conservative treatment. He opined that appellant’s work duties for May 2014 

through January 2016 aggravated her injury.

In a January 8, 2018 narrative report, Dr. Grossman reiterated appellant’s employment 

duties as a rural carrier and indicated that this was a significant amount of work for anyone, but 

more problematic for appellant since her January 22, 2014 work injury. He noted that appellant 

returned to full duty in May 2014 and worked until she reinjured her back in January 2016 while 

in the performance of her duties. Dr. Grossman indicated that an April 1, 2016 lumbar MRI scan 

showed additional injuries to her back and clearly showed that returning back to work caused more 

damage to appellant’s lumbar spine. He reported that physical examination findings showed 

continued back pain and numbness and pain and weakness in her legs. Dr. Grossman concluded 

that appellant’s injuries were directly related to 30 plus years of employment, which involved 

twisting, turning, stooping, squatting, and lifting large amounts of mail across the floor and in and 

out of her truck.

In a May 4, 2018 decision, OWCP denied modification of the April 4, 2017 decision.

Appellant appealed to the Board. In a July 29, 2019 order, the Board set aside the May 4, 

2018 decision and remanded the case for OWCP to administratively combine the current claim 

with appellant’s previous lumbar claim under File No. xxxxxx498 followed by a de novo decision.5 

On August 15, 2019 OWCP administratively combined the claim files, with File No. xxxxxx498

serving as the master file.

By de novo decision dated October 22, 2019, OWCP denied appellant’s occupational 

disease claim, finding that the medical evidence of record was insufficient to establish a diagnosed 

medical condition causally related to the accepted factors of her federal employment.

On April 14, 2020 appellant, through counsel, requested reconsideration and submitted 

additional medical evidence.

In a March 30, 2020 report, Dr. Grossman described how the back consisted of disc spaces 

between vertebrae, which break and compress, causing irritation, as people become older. He 

indicated that for someone in appellant’s age group, the pressures of twisting, bending, and lifting 

increase the forces across the back. Dr. Grossman noted that appellant had two significant back 

injuries. He reported that a 2014 MRI scan showed irritation and the nucleus pulposus materials 

 

5 Order Remanding Case, Docket No. 18-1777 (issued July 29, 2019). 
6

pushing out against the C1-3 nerve roots. Dr. Grossman indicated that a second MRI scan 

completed after the 2016 injury revealed that discs were herniated at T11-12, L1-2, L2-3, L3-4, 

L4-5, and L5-S1. He noted that appellant’s lumbar spine had degenerated. Dr. Grossman opined 

that the degeneration was “related to the amount of weight she carried, lifted, and moved for 30

plus years and so the discs have degenerated throughout her back, putting pressure against her 

nerve.” He concluded that appellant’s lumbar condition was degenerated and related to her workrelated back injury.

By decision dated July 9, 2020, OWCP denied modification of its prior decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA6has the burden of proof to establish the 

essential elements of his or her claim, including 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 employment factors identified by the claimant.10 

Causal relationship is a medical issue and the medical evidence required to establish causal 

relationship is rationalized medical opinion evidence.11 The opinion of the physician must be 

based on a complete factual and medical background of the employee, must be one of reasonable 

medical certainty, and must be supported by medical rationale explaining the nature of the 

 

6

Id.

7 L.C., Docket No. 19-0724 (issued September 5, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 

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

8 D.W., Docket No. 18-1139 (issued May 21, 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).

9 D.W., id.; 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). 

10 S.C., Docket No. 18-1242 (issued March 13, 2019); R.H., 59 ECAB 382 (2008).

11 A.M., Docket No. 18-1748 (issued April 24, 2019); T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 

238 (1996).
7

relationship between the diagnosed condition and specific employment factors identified by the 

employee.12

In any case where a preexisting condition involving the same part of the body is present 

and the issue of causal relationship, therefore, involves aggravation, acceleration or precipitation, 

the physician must provide a rationalized medical opinion that differentiates between the effects 

of the work-related injury or disease and the preexisting condition.13

ANALYSIS

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

In support of her claim, appellant submitted a series of reports from Dr. Grossman. 

Dr. Grossman indicated that he had treated appellant for an accepted lumbar condition due to her 

January 22, 2014 employment injury. In reports dated August 3 and October 5, 2016, he indicated 

that appellant’s problems with her back and legs started in January 2014 and again in 2016 and 

was caused by her bending, twisting, and walking for work. Dr. Grossman provided examination 

findings and noted that diagnostic testing had confirmed degenerative spine disease and five 

bulging discs. In reports dated January 24 and March 8, 2017, he indicated that appellant had been 

carrying large weights with a degenerative back for 30 some years and explained that appellant’s 

degenerative problems were accentuated by her working on hard floors, carrying, lifting, turning, 

and twisting. In a June 17, 2017 narrative report, Dr. Grossman explained that significant twisting, 

turning, and bending all day long for 31 years would disrupt anyone’s spine and hips. He 

concluded that appellant’s back and hip problems were directly related to her employment, which 

required twisting and turning exercises, moving large amounts of mail across the post office floor,

and moving this mail again in and out of her truck. In a March 30, 2020 report, Dr. Grossman 

described how the back consisted of disc spaces between vertebrae, which break and compress, 

causing irritation, as people become older. He indicated that for someone in appellant’s age group, 

the pressures of twisting, bending, and lifting increased the forces across the back. Dr. Grossman 

opined that the degeneration was “related to the amount of weight she carried, lifting, and moved 

for 30 plus years and so the discs have degenerated throughout her back, putting pressure against 

her nerve.” 

The Board finds that Dr. Grossman provided an affirmative opinion on causal relationship, 

provided a complete factual history confirming the accepted employment factors, and accurately 

noted appellant’s medical history and course of treatment. The Board finds that, while

Dr. Grossman’s reports are not completely rationalized and are insufficient to meet appellant’s 

burden of proof to establish his occupational disease claim, they are consistent in indicating that 

 

12 M.L., Docket No. 18-1605 (issued February 26, 2019); M.V., Docket No. 18-0884 (issued December 28, 2018); 

I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

13 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013).
8

she sustained a medical condition due to the accepted factors of federal employment and are 

sufficient to require OWCP to further develop the medical evidence and the case record.14

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

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

responsibility in the development of the evidence to see that justice is done.15 

The Board will, therefore, remand the case for further development of the medical 

evidence. On remand OWCP shall prepare a statement of accepted facts and obtain a rationalized 

opinion from a physician in the appropriate field of medicine as to whether the accepted work 

factors caused or aggravated a diagnosed medical condition. If the referral physician opines that 

the diagnosed condition is not causally related to the accepted employment factors, he or she must 

explain with rationale how or why their opinion differs from that of appellant’s treating physicians. 

Following this and other such further development as deemed necessary, OWCP shall issue a de 

novo decision.

CONCLUSION

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

 

14 E.P., Docket No. 19-1703 (issued April 16, 2021); G.M., Docket No. 19-0657 (issued September 13, 2019); see 

also John J. Carlone, 41 ECAB 354 (1989); Horace Langhorne, 29 ECAB 820 (1978).

15 C.W., Docket No. 19-0322 (issued July 18, 2019); S.W., Docket No. 18-0119 (issued October 5, 2018); William J. 

Cantrell, 34 ECAB 1233 (1993).
9

ORDER

IT IS HEREBY ORDERED THAT the July 9, 2020 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: July 22, 2021

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board