United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.M., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

San Juan, PR, Employer

__________________________________________

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Docket No. 21-0504

Issued: September 3, 2021

Appearances: Case Submitted on the Record

Alan J. Shapiro, 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 February 16, 2021 appellant, through counsel, filed a timely appeal from a February 3, 

2021 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 medical condition 

causally related to the accepted May 22, 2020 employment incident.

 

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

On June 19, 2020 appellant, then a 46-year-old postal vehicle maintenance operator, filed 

a traumatic injury claim (Form CA-1) alleging that on May 22, 2020 she suffered a right wrist 

injury when loading a vehicle while in the performance of duty. On the reverse side of the claim 

form, the employing establishment acknowledged that she was injured in the performance of duty. 

Appellant did not stop work. 

In support of her claim, appellant submitted a work excuse note, dated May 26, 2020, from

Dr. Nancy E. Alicea Valentin, a specialist in physical medicine and rehabilitation. Dr. Valentin 

noted diagnoses of thoracic radiculopathy, lumbosacral radiculopathy, right shoulder 

tenosynovitis, right forearm tenosynovitis, right wrist contracture, and thigh myositis. She 

indicated that appellant could return to work on June 8, 2020.

In a development letter dated June 23, 2020, 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. OWCP afforded appellant 30 

days to submit the necessary evidence. No additional evidence was received. 

By decision dated August 3, 2020, OWCP denied appellant’s claim, finding that the 

medical evidence of record was insufficient to establish causal relationship between appellant’s 

diagnosed conditions and the accepted May 22, 2020 employment incident. 

On August 17, 2020 appellant requested reconsideration and submitted a July 27, 2020 

report from Dr. Valentin. Dr. Valentin noted that appellant experienced bilateral wrist, hand, neck, 

back, and left shoulder pain after loading a platform plate onto the back of a work vehicle on 

May 22, 2020. She provided appellant’s medical history and physical examination findings. 

Dr. Valentin reviewed x-rays of appellant’s bilateral wrists, hands, shoulders, thoracic spine, and 

lumbosacral spine and diagnosed cervicodorsal myositis, lumbosacral myositis, cervical 

radiculitis, post-traumatic cervicodorsal back strain, right shoulder tenosynovitis, left shoulder 

tenosynovitis, right hand tenosynovitis, left hand tenosynovitis, right elbow tenosynovitis, and left 

elbow tenosynovitis. She opined that appellant’s conditions were causally related to the accepted 

employment incident. Dr. Valentin noted that appellant’s maneuvering created an axial load 

during the acceleration and deceleration motion, which caused increased intraspinal pressure along 

her intervertebral discs and associated spinal nerves at the cervical, thoracic, and lumbosacral 

levels. She indicated that appellant’s repetitive pushing, pulling, lifting, and carrying physic al 

loads and equipment led to additional excessive microcumulative disorder, which was aggravated 

by the employment incident. Dr. Valentin advised that appellant was unable to tolerate prolonged 

overhead reaching, managing heavy physical loads with both arms, and repetitive upper extremity 

movements. She opined that appellant had not reached maximum medical improvement (MMI).

On August 18, 2020 appellant, through counsel, requested a telephonic hearing before a 

representative of OWCP’s Branch of Hearings and Review, which was held on October 14, 2020. 

During the hearing, appellant described the employment incident and clarified that she experienced 

left shoulder and right wrist injuries. 
3

By decision dated November 19, 2020, OWCP’s hearing representative affirmed the 

August 3, 2020 decision, finding that the medical evidence of record did not provide a detailed 

discussion of appellant’s preexisting underlying conditions. 

On December 22, 2020 appellant, through counsel, requested reconsideration and 

submitted a November 9, 2020 report from Dr. Valentin. Dr. Valentin again provided appellant’s 

medical history and physical examination findings. She diagnosed cervicodorsal myositis, 

lumbosacral myositis, cervical radiculitis, post-traumatic cervicodorsal back strain, right shoulder 

tenosynovitis, left shoulder tenosynovitis, right hand tenosynovitis, left hand tenosynovitis, right 

elbow tenosynovitis, and left elbow tenosynovitis. Dr. Valentin opined that appellant’s conditions 

were related to the accepted employment incident. She noted that the employment incident caused 

appellant’s paravertebral muscle spasms along the cervicodorsal/lumbosacral spine region, which 

triggered vertebral compression due to contracting muscles and soft tissue swelling, leading to 

radicular symptoms secondary to nerve root irritation within the narrowed foramens. Dr. Valentin 

indicated that appellant’s maneuvering to prevent injury created an axial load during the 

acceleration and deceleration motion, which resulted in compression of the spinal nerves and 

overstretching of the spinal ligaments along the cervicodorsal/lumbosacral spine. She reported 

that this overstretching produced local inflammation reaction affecting pain and irritation of the 

muscular tissue and injured nerve roots. Dr. Valentin opined that rapid acceleration/deceleration 

with change in directional forces caused the cervicodorsal/lumbosacral muscles to strongly 

contract and shorten their lengths to stabilize appellant’s spine and prevent fracture or dislocation. 

She noted that these forces resulted in microscopic tearing of appellant’s shortened muscles, their 

associated tendons, and surrounding ligaments. Dr. Valentin also indicated that appellant’s 

maneuvering caused increased intraspinal pressure along her intervertebral discs and associated 

spinal nerves at the cervical, thoracic, and lumbosacral levels. She again reported that the 

employment incident aggravated appellant’s excessive microcumulative disorder and advised that 

appellant was unable to tolerate prolonged overhead reaching, managing heavy physical loads with 

both arms, and repetitive upper extremity movements. Dr. Valentin opined that appellant had not 

reached MMI. 

By decision dated February 3, 2021, OWCP denied modification of the November 19, 

2020 decision. 

LEGAL PRECEDENT

An employee seeking benefits under FECA3 has 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,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

 

3

Id.

4

S.O., Docket No. 21-0002 (issued April29, 2021); J.P., Docket No. 19-0129 (issued April26, 2019); Joe D. 

Cameron, 41 ECAB 153 (1989).
4

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 determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, it first must be determined whether fact of injury has been established. There 

are two components involved in establishing fact of injury. First, the employee must submit 

sufficient evidence to establish that he or she actually experienced the employment incident at the 

time, place and in the manner alleged. The second component is whether the employment incident 

caused a personal injury and can be established only by medical evidence.7

The medical evidence required to establish causal relationship between a claimed specific 

condition and an employment incident is rationalized medical opinion evidence.8 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 relationship between the diagnosed condition and specific employment factors 

identified by the employee.9

In a case in which 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.10

ANALYSIS

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

In support of her claim, appellant submitted reports from Dr. Valentin dated July 27 and 

November 9, 2020. Dr. Valentin diagnosed cervicodorsal myositis, lumbosacral myositis, cervical 

radiculitis, post-traumatic cervicodorsal back strain, right shoulder tenosynovitis, left shoulder 

tenosynovitis, right hand tenosynovitis, left hand tenosynovitis, right elbow tenosynovitis, and left 

elbow tenosynovitis and opined that appellant’s conditions were causally related to the accepted 

May 22, 2020 employment incident. She provided a pathophysiological explanation of how 

appellant’s maneuvering to prevent getting injured by a container created an axial load during the 

 

5 R.J., Docket No. 20-1630 (issued April27, 2021); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 ECAB 

312 (1988).

6

J.C., Docket No. 20-1584 (issued April23, 2021); L.M., Docket No. 13-1402 (issued February7, 2014); 

DeloresC. Ellyett, 41 ECAB 992 (1990).

7 K.M., Docket No. 21-0016 (issued April21, 2021); Elaine Pendleton, 40 ECAB 1143 (1989); John J. Carlone, 

41 ECAB 354 (1989).

8

J.B., Docket No. 21-0011 (issued April20, 2021); A.M., Docket No. 18-1748 (issued April24, 2019); Robert G. 

Morris, 48 ECAB 238 (1996).

9 P.C., Docket No. 20-0855 (issued November 23, 2020); Y.S., Docket No. 18-0366 (issued January 22, 2020); 

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

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

C.C., Docket No. 19-1071 (issued August26, 2020); V.W., Docket No. 19-1537 (issued May 13, 2020).
5

acceleration and deceleration motion, which resulted in compression of the spinal nerves and 

overstretching of the spinal ligaments along the cervicodorsal/lumbosacral spine. Dr. Valentin

noted that this overstretching produced local inflammation reaction affecting the muscular tissue 

and injured nerve roots. She opined that rapid acceleration/deceleration with change in directional 

forces caused the cervicodorsal/lumbosacral muscles to strongly contract and shorten their lengths 

to stabilize appellant’s spine and prevent fracture or dislocation. Dr. Valentin indicated that these 

forces resulted in microscopic tearing of appellant’s shortened muscles, their associated tendons, 

and surrounding ligaments. She explained that appellant’s maneuvering caused increased 

intraspinal pressure along her intervertebral discs and associated spinal nerves at the cervical, 

thoracic, and lumbosacral levels. Dr. Valentin also advised that appellant’s repetitive work duties 

caused her underlying excessive microcumulative disorder, which was aggravated by the 

employment incident.

The Board finds that, while Dr. Valentin’s report was not completely rationalized, it is 

sufficient to require further development of the medical evidence.11 Dr. Valentin accurately 

described the May 22, 2020 employment incident and provided an explanation as to how it resulted 

in his diagnosed conditions. Further, she is a Board-certified physician who is qualified in her 

field of medicine to render an opinion on causal relationship. The Board has held that it is 

unnecessary that the evidence of record in a case be so conclusive as to suggest causal connection 

beyond all possible doubt. Rather, the evidence required is only that necessary to convince the 

adjudicator that the conclusion drawn is rational, sound, and logical.12 Although Dr. Valentin’s 

opinion is insufficiently rationalized to establish causal relationship, it does raise an 

uncontroverted inference regarding causal relationship between the diagnosed condition and the 

accepted employment incident sufficient to require that OWCP further develop the medical 

evidence in the claim.13

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 

responsibility in the development of the evidence.14 OWCP has an obligation to see that justice is 

done.15

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

evidence. On remand OWCP shall refer appellant, a statement of accepted facts, and the medical 

record to a specialist in the appropriate field of medicine. The chosen physician shall conduct a 

physical examination and provide a rationalized medical opinion as to whether appellant’s 

diagnosed conditions are causally related to the accepted May 22, 2020 employment incident. If 

the physician opines that the diagnosed conditions are not causally related, he or she must explain 

 

11 See E.G., Docket No. 20-1184 (issued March 1, 2021).

12 W.M., Docket No. 17-1244 (issued November 7, 2017); E.M., Docket No. 11-1106 (issued December 28, 2011).

13 J.H., Docket No. 18-1637 (issued January 29, 2020); D.S., Docket No. 17-1359 (issued May 3, 2019); WilliamJ. 

Cantrell, 34 ECAB 1223 (1983).

14 See H.H., Docket No. 20-0839 (issued May 25, 2021); M.G., Docket No. 18-1310 (issued April16, 2019); 

Walter A. Fundinger, Jr., 37 ECAB 200, 204 (1985).

15 See A.C., Docket No. 20-1127 (issued May 19, 2021); C.M., Docket No. 17-1977 (issued January 29, 2019); 

WilliamJ. Cantrell, 34 ECAB 1233, 1237 (1983).
6

with rationale how or why the opinion differs from that of Dr. Valentin. 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.

ORDER

IT IS HEREBY ORDERED THAT the February 3, 2021 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: September 3, 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