United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

P.C., Appellant

and

U.S. POSTAL SERVICE, JENKS POST 

OFFICE, Jenks, OK, Employer

__________________________________________

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Docket No. 22-0428

Issued: July 22, 2022

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

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On January 28, 2022 appellant, through counsel, filed a timely appeal from a January 4, 

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.

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 met her burden of proof to establish a medical condition 

causally related to the accepted September 13, 2018 employment incident.

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 decision are incorporated herein by reference. The relevant facts 

are as follows.

On September 18, 2018 appellant, then a 56-year-old rural carrier, filed a traumatic injury 

claim (Form CA-1) alleging that, on September 13, 2018,she lost her footing and fell to the ground 

on her left knee and elbow when delivering a package while in the performance of duty. She noted 

that she suffered an abrasion of the right knee and that her hip and back began hurting after the 

fall. On the reverse side of the claim form, the employing establishment controverted appellant’s 

claim, noting that she had complained of hip and back pain in the past and there was no evidence 

that the fall actually occurred. Appellant did not stop work.

OWCP received a series of medical reports in support of appellant’s claim. In a 

September 18, 2018, Dr. Mark Stephen Wilson, a specialist in pain medicine, noted appellant’s 

history of injury and diagnosed acute traumatic injury resulting in lumbosacral disc displacement 

with radiculopathy. He opined that her condition was causally related to the accepted 

September 13, 2018 employment incident.

By decision dated November 27, 2018, OWCP denied appellant’s traumatic injury claim, 

finding that, while the September 13, 2018 employment incident occurred as alleged, the medical 

evidence of record wasinsufficientto establish that her diagnosed conditions were causally related 

to the accepted employment incident.

On January 31, 2019 appellant requested reconsideration and submitted additional evidence

in support of her request.

By decision dated April 29, 2019, OWCP denied modification of the November 27, 2018 

decision.

On October 28, 2019 appellant, through counsel, requested reconsideration and submitted 

additional evidence in support of her request.

By decision dated January 24, 2020, OWCP denied modification of the April 29, 2019 

decision. 

On March 9, 2020 appellant, through counsel, appealed to the Board. By decision dated 

November 23, 2020, the Board affirmed OWCP’s January 24, 2020 decision finding that appellant 

3 Docket No. 20-0855 (issued November 23, 2020). 
3

did not meet her burden of proof to establish a medical condition causally related to the accepted 

September 13, 2018 employment incident.

4

OWCP subsequently received a report dated September 8, 2020, from Dr. Nicholas Keith 

Thompson, an osteopath Board-certified in family and sports medicine. Dr. Thompson noted that 

appellant had experienced left hip pain since September 13, 2018 when she fell while delivering a 

package. He diagnosed lumbar radiculopathy, lumbar degenerative disc disease, and left hip 

osteoarthritis.

OWCP also received supplemental reports from Dr. Wilson. In a report dated February 9, 

2021, Dr. Wilson noted appellant’s history regarding her alleged September 13, 2018 employment 

injury. He reviewed her diagnostic studies, and examination findings and thereafter diagnosed 

lumbosacral intervertebral disc disorders with L3-4, L4-5, L5-S1 radiculopathy, and L4 on L5 

spondylolisthesis, which he attributed to her September 13, 2018 slip and fall accident. Dr. Wilson

explained that slip and falls, such as falling down two steps experienced by appellant, was known 

to be a common cause of spinal injuries. He further explained that the impact from a fall causes 

intervertebral discs to become compressed, damaged, or slip out of place. According to

Dr. Wilson, the actual event, forces involved, and impact, determine the actual seriousness of an 

injury.

Dr. Wilson, in a June 15, 2021 report, diagnosed with L3-4, L4-5, and L5-S1 radiculopathy, 

lumbosacral radiculopathy, L4 on L5 spondylolisthesis, lift hip bursitis, left hip chondromalacia, 

and left hip muscle, fascia, and tendon injury. He reiterated his opinion regarding the cause of 

appellant’s lumbosacral injury. Dr. Wilson further added that appellant sustained an injury to her 

hip based on her MRI scan, which demonstrated tearing and injury of the muscle, fascia, and 

tendon. 

On August 11 and October 6, 2021 appellant, through counsel, filed requests for 

reconsideration. 

By decision dated January 4, 2022, OWCP denied modification. It found that the newly 

submitted medical evidence was conclusory and lacked any medical rationale. 

LEGAL PRECEDENT

An employee seeking benefits under FECA 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,

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that the claim was timely filed within the applicable 

time limitation period 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 

4

Id.

5 K.R., Docket No. 20-0995 (issued January 29, 2021); A.W., Docket No. 19-0327 (issued July 19, 2019); S.B., 

Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).
4

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.

7

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. The first component is that the 

employee must submit sufficient evidence to establish that he or she actually experienced the 

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

whether the employment incident caused a personal injury.

8

 

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

condition and an employment incident is rationalized medical opinion evidence.

9

 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.

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ANALYSIS

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

Initially, the Board notes that it is unnecessary to consider the evidence appellant submitted 

prior to the issuance of OWCP’s January 24, 2020 decision, which was considered by the Board 

in its November 23, 2020decision. Findings made in prior Board decisions are res judicata absent 

further merit review by OWCP under section 8128 of FECA.

11

In his February 9 and June 15, 2021 reports, Dr. Wilson also clarified reports previously 

submitted and considered, regarding appellant’s lumbosacral condition. He reviewed appellant’s 

diagnostic studies, and examination findings and thereafter diagnosed intervertebral disc disorders 

with L3-4, L4-5, and L5-S1 radiculopathy, lumbosacral radiculopathy, and L4 on L5 

spondylolisthesis, which he attributed to the accepted September 13, 2018 incident. Dr. Wilson

explained that slip and falls, such as falling down two steps experienced by appellant, was known 

6 L.L., Docket No. 21-0991 (issued Februa ry9, 2022); J.M., Docket No. 17-0284 (issued February 7, 2018);

R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 ECAB 312 (1988).

7

J.B., Docket No. 20-1566 (issued August 31, 2021); K.M., Docket No. 15-1660 (issued September 16, 2016);

L.M., Docket No. 13-1402 (issued February 7, 2014);DeloresC. Ellyett, 41 ECAB 992 (1990).

8 L.L., supra note 6; T.H., Docket No. 19-0599 (issued January 28, 2020); K.L., Docket No. 18-1029 (issued 

January 9, 2019); John J. Carlone, 41 ECAB 354 (1989).

9

S.S., Docket No. 19-0688 (issued January 24, 2020);A.M., Docket No. 18-1748 (issued April24, 2019); RobertG. 

Morris, 48 ECAB 238 (1996).

10 T.L., Docket No. 18-0778 (issued January 22, 2020); Y.S., Docket No. 18-0366 (issued January 22, 2020);

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

11 L.L., supra note 6; A.A., Docket No. 20-1399 (issued March 10, 2021); ClintonE. Anthony, Jr., 49 ECAB 

476 (1998).
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to be a common cause of spinal injuries. He further explained that the impact from such falls cause

intervertebral discs to become compressed, damaged, or slip out of place with the seriousness of 

the injury determined by the forces involved, impact, and the actual event. 

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

is not a disinterested arbiter. While the claimant has the burden to establish entitlement to 

compensation, OWCP shares responsibility in the development of the evidence and to see that 

justice is done.

12

 

The Board finds that, while Dr. Wilson’s February 9, and June 15, 2021 reports are not 

fully rationalized, they raise an uncontroverted inference that appellant’s lumbar conditions were 

causally related to the accepted September 13, 2018 employment incident.

13

 Although the reports

are insufficient to meet appellant’s burden of proof to establish her claim, they are sufficient to 

require OWCP to further develop the medical evidence.14

The case shall, therefore, be remanded 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 employment 

incident caused, contributed to, or aggravated the diagnosed lumbar conditions. If the physician 

opines that the diagnosed conditions are not causally related to the accepted September 13, 2018 

employment incident, he or she must explain with rationale how or why their opinion differs from 

that of Dr. Wilson. 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.

12 See M.S.,Docket No. 20-1095 (issued March 29, 2022); A.D., Docket No. 20-0758 (issued January 11, 2021);

C.R., Docket No. 20-0366 (issued December 11, 2020); John J. Carlone,supranote 8; Horace Langhorne, 29 ECAB 

820 (1978).

13 C.B., Docket No. 21-1291 (issued April28, 2022); C.G., Docket No. 20-1121 (issued February 11, 2021);A.G., 

Docket No. 20-0454 (issued October 29, 2020).

14 Id.
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ORDER

IT IS HEREBY ORDERED THAT the January 4, 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: July 22, 2022

Washington, DC

Alec J. Koromilas, 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