United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

M.M., Appellant

and

U.S. POSTAL SERVICE, RASPEBURG POST 

OFFICE, Baltimore, MD, Employer

__________________________________________

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Docket No. 19-1580

Issued: February 19, 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On July 19, 2019 appellant filed a timely appeal from a June 20, 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 her burden of proof to establish that her right 

sacroiliac joint condition was causally related to the accepted factors of her federal employment.

 

1 5 U.S.C. § 8101 et seq. 

2 The Board notes that, following the June 20, 2019 decision, OWCP received additional 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

FACTUAL HISTORY

On April 10, 2019 appellant, then a 33-year-old letter carrier, filed an occupational disease 

claim (Form CA-2) alleging that she developed a right hip condition due to constant reaching, 

twisting, and turning required to place mail into boxes when delivering to approximately 300 

houses on her route, while in the performance of duty. She indicated that she first became aware 

of her condition and its relationship to factors of her federal employment on February 11, 2019. 

Appellant stopped work on February 13, 2019.

In a development letter dated April 18, 2019, OWCP informed appellant that the evidence 

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

evidence needed and provided a questionnaire for her completion. In a separate letter of even date, 

OWCP requested additional information from the employing establishment regarding appellant’s 

claim. It afforded both parties 30 days to submit the requested information.

Thereafter, OWCP received a report dated February 12, 2019 from Susan Giscombe, a 

nurse practitioner, who related appellant’s complaints of having significant difficulties with the 

physical requirements of her job because of lower, right-sided back pain. Ms. Giscombe diagnosed 

lumbar strain and recommended that appellant’s duty status be updated to no driving. In an 

addendum report dated February 13, 2019, she noted that appellant could return to modified work 

on February 13, 2019 with occasional walking and standing, and with a 10-pound lifting, pushing, 

and pulling restriction.

In a February 26, 2019 report, Dr. Michael A. Randolph, a Board-certified specialist in 

internal medicine, noted that appellant experienced pain in the right posterior hip that was

aggravated by prolonged standing and sitting. He related that on approximately February 12, 2019 

appellant started to notice pain into her right hip, which occurred while she was working as a mail 

carrier. Dr. Randolph diagnosed appellant with a sprain of the sacroiliac joint. He opined that 

appellant was not advised to continue with her normal occupational tasks until the resolution of 

her symptoms. On March 14, 2019 Dr. Randolph related that appellant was seen in a follow up 

for chronic lower leg and possible S1 joint dysfunction attributed to her job as a mail carrier. He 

again diagnosed sacroiliac sprain. In an April 15, 2019 report, Dr. Randolph again diagnosed

sacroiliac joint sprain, and related that appellant experienced muscle spasm in the lumbar spine. 

He also indicated that she was still unable to work at that time.

On April 29, 2019 appellant responded to OWCP’s development questionnaire. She stated

that she began feeling right hip pain on February 11, 2019 while delivering on her mounted 

(vehicular) route. Appellant noted that, while on her mounted route, she performed twisting, 

turning, and reaching motions while sitting to deliver mail. She estimated that she averaged 300 

deliveries daily on her mounted route, which lasted three hours. Appellant indicated that she had 

been working her route for approximately seven months and had no prior injury or illness related 

to her right hip.

By decision dated June 20, 2019, OWCP denied appellant’s claim, finding that the medical 

evidence submitted was insufficient to establish causal relationship between her diagnosed medical 

conditions and the accepted factors of her federal employment.
3

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,4that 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 establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (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 issue and the medical evidence required to establish causal 

relationship is rationalized medical opinion evidence.8 The opinion of the physician must be based 

on a complete factual and medical background of the claimant, 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 identified by the claimant.

9

 

Neither the mere fact that a disease or condition manifests itself during a period of employment, 

nor the belief that the disease or condition was caused or aggravated by employment factors or 

incidents, is sufficient to establish causal relationship.10

 

3 Supra note 1.

4 S.P., Docket No. 19-0819 (issued January 10, 2020); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989).

5 M.C., Docket No. 19-1192 (issued January 6, 2020); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

6 20 C.F.R. § 10.115; D.O., Docket No. 19-1437 (issued January 2, 2020); L.M., Docket No. 13-1402 (issued 

February 7, 2014); Delores C. Ellyett, 41 ECAB 992 (1990).

7 See M.C., supra note 5; Roy L. Humphrey, 57 ECAB 238, 241 (2005); Victor J. Woodhams, 41 ECAB 345, 

352 (1989).

8 A.W., Docket No. 19-1277 (issued January 3, 2020); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

9 S.P., supra note 4; Leslie C. Moore, 52 ECAB 132 (2000).

10 A.W., supra note 8; Gary L. Fowler, 45 ECAB 365 (1994).
4

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish that her right

sacroiliac joint condition was causally related to the accepted factors of her federal employment.

In his February 26, 2019 report, Dr. Randolph discussed appellant’s complaints of right 

hip pain that she related were aggravated by prolonged standing and sitting. He related that her

symptoms began on approximately February 12, 2019 when she noticed right hip pain while 

delivering mail. Dr. Randolph diagnosed sprain of the sacroiliac joint. The Board has held that 

the mere fact that appellant’s symptoms arise during a period of employment or produce symptoms

revelatory of an underlying condition does not establish a causal relationship between a diagnosed

condition and employment factors.11 A medical opinion must provide an explanation of how 

specific employment factors physiologically caused or aggravated the diagnosed conditions.12 As

Dr. Randolph’s report did not contain a rationalized medical opinion regarding causal relationship, 

it is of limited probative value.13 

In his March 14, 2019 report, Dr. Randolph related that appellant’s sacroiliac joint 

dysfunction was attributed to her job as a mail carrier. Although Dr. Randolph supported causal

relationship, he did not provide medical rationale explaining the basis of his conclusory opinion 

regarding the causal relationship between appellant’s right hip sacroiliac joint dysfunction and the 

factors of her federal employment.14 As such, this report is of limited probative value. 

In an April 15, 2019 report, Dr. Randolph noted that appellant continued to experience

discomfort in the right hip and lower back. He diagnosed sprain of the sacroiliac joint, but failed 

to relate the sprain to the accepted factors of appellant’s federal employment. 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.15 The Board, therefore, finds 

that Dr. Randolph’s reports, which lack medical rationale regarding causal relationship, are

insufficient to establish appellant’s claim.

OWCP also received February 12 and 13, 2019 reports, wherein Ms. Giscombe, a nurse 

practitioner, diagnosed a lumbar strain. These reports are of no probative value because nurse 

 

11 A.B., Docket No. 19-0734 (issued August 22, 2019); see C.L., Docket No. 16-1078 (issued October 21, 2016); 

William Nimitz, Jr., 30 ECAB 567, 570 (1979).

12 See A.P., Docket No. 18-1690 (issued December 12, 2019). 

13 K.G., Docket No. 18-1598 (issued January 7, 2020); see A.B., Docket No. 16-1163 (issued September 8, 2017).

14 K.G., id.; See T.M., Docket No. 08-0975 (issued February 6, 2009) (a medical report is of limited probative value 

on the issue of causal relationship if it contains a conclusion regarding causal relationship which is unsupported by 

medical rationale).

15 S.P., supra note 4; M.C., supra note 5.
5

practitioners are not considered physicians under FECA.16 They are therefore insufficient to 

establish appellant’s claim.

As appellant has not submitted rationalized medical evidence explaining a causal 

relationship between her diagnosed medical conditions and the accepted factors of her federal 

employment, the Board finds that she has not met her 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 her burden of proof to establish that her right 

sacroiliac joint condition was causally related to the accepted factors of her federal employment.

 

16 Section 8101(2) of FECA provides that physicians “includes 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). See also S.J., Docket No. 19-0489 (issued January 13, 2020); David P. Sawchuk, 

57 ECAB 316, 320 n.11 (2006) (finding that lay individuals such as physician assistants, nurses, and physical 

therapists are not competent to render a medical opinion under FECA). See K.G., supra note 13 (a nurse practitioner 

is not considered a physician under FECA). 
6

ORDER

IT IS HEREBY ORDERED THAT the June 20, 2019 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: February 19, 2020

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board