United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

H.E., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Detroit, MI, Employer

__________________________________________

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Docket No. 22-1129

Issued: December 16, 2022

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On July 18, 2022 appellant filed a timely appeal from a May 31, 2022 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 his burden of proof to establish a cervical condition 

causally related to the accepted factors of his federal employment.

1

5 U.S.C. § 8101 et seq.

2 The Board notes that followingthe May 31, 2022 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 evidence for 

the first time on appeal. Id.
2

FACTUAL HISTORY

On December 3, 2021 appellant, then a 54-year-old postal rural carrier, filed an 

occupational disease claim (Form CA-2) alleging that he sustained a herniated disc, spondylosis, 

and radiculopathy of the neck with numbness of the hand due to factors of his federal employment, 

including 30 years of repetitive twisting, turning his neck, bending, and looking into a back seat to 

find and lift parcels and mail. He noted that he first became aware of his conditions and their 

relationship to his federal employment on July 1, 2021. Appellant did not stop work. 

In support of his claim, appellant submitted medical evidence.

In an October 24, 2021 cervical spine magnetic resonance imaging (MRI) scan report,

Dr. Mohammad Asad, a Board-certified diagnostic radiologist, provided an impression of 

multilevel degenerative changes most prominent at C5-6 with large left placental disc herniation 

with mild superior migration causing severe left lateral recess narrowing and medial left foraminal 

encroachment with probable impingement of left C6 nerve root. He also provided an impression 

of severe left C3-4, moderate severe right C4-5, and mild bilateral C6-7 foraminal encroachment.

In a November 8, 2021 progress note, Dr. Douglas F. Geiger, an attending Board-certified 

orthopedic surgeon, noted appellant’s history of injury, reviewed medical records, discussed his 

findings on physical examination, and reviewed diagnostic tests. He provided an assessment of

cervical spondylosis with left upper extremity radiculopathy. Dr. Geiger recommended that 

appellant undergo an anterior cervical discectomy and fusion at C5-6 and C6-7.

In a work status form also dated November 8, 2021, Dr. Geiger opined that appellant’s 

cervical spine spondylosis and radiculopathy were caused by his job, which involved cumulative 

and repetitive microtrauma to the cervical spine.

OWCP, by development letter dated December 13, 2021, advised appellant of the type of 

factual and medical evidence needed to establish his claim and provided a questionnaire for his

completion. By separate development letter of even date, it requested additional information from 

the employing establishment, including comments from a knowledgeable supervisor regarding his

allegations. OWCP afforded both parties 30 days to respond.

In a December 21, 2021 e-mail, the employing establishment concurred with appellant’s 

description of his work duties. It related that his repetitive motions at work could have caused his 

neck, back, and shoulder conditions, and need for surgery.

In response to OWCP’s development letter, appellant submitted medical evidence.

In a September 30, 2021 cervical spine MRI scan report, Dr. Asad provided impressions

of no acute cervical spine abnormality; degenerative disc disease at C5-6 and C6-7; and severe 

right C4-5 and severe left C3-4 foraminal encroachment.

In a December 21, 2021 letter, Danielle Berthold, a nurse practitioner, noted that appellant 

underwent cervical spine fusion on that day, and advised that he would be off work for three 

months and return to work on or around March 21, 2022.
3

By decision dated March 2, 2022, OWCP denied appellant’s occupational disease claim, 

finding that he had not submitted rationalized medical evidence establishing causal relationship 

between his diagnosed medical conditions and the accepted factors of his federal employment. 

On March 15, 2022 appellant requested reconsideration and submitted additional medical 

evidence from Dr. Geiger. In a January 31, 2022 letter, Dr. Geiger reiterated appellant’s history 

of injury, reported his findings on physical examination, and reviewed diagnostic tests. He again 

diagnosed cervical spondylosis with left upper extremity radiculopathy. Dr. Geiger opined that 

appellant’s symptoms, diagnosis, and need for cervical spine surgery on December 21, 2021, were 

a direct result of his mail carrier occupation.

By decision dated May 31, 2022, OWCP denied modification of its March 2, 2022 

decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA3 has the burden of establishing 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 filed within the applicable time limitation,

that an injury was sustained while in the performance of duty as alleged, and that any disability 

and/or specific condition for which compensation is claimed are causally related to the 

employment injury.4 These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated on a traumatic injury or an occupational disease.5

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;6(2) medical evidence establishing the presence or existence of the disease or 

condition for which compensation is claimed;7 and (3) medical evidence establishing that the 

diagnosed condition is causally related to the employment factors identified by the claimant.8 

The medical evidence required to establish causal relationship is rationalized medical 

opinion evidence. The opinion of the physician must be based on a complete factual and medical 

background of the employee, must be one of reasonable 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 employee.9

3

Id.

 

4 C.S., Docket No. 08-1585 (issued March 3, 2009); Elaine Pendleton, 40 ECAB 1143 (1989).

 

5

S.P., 59 ECAB 184 (2007); Victor J. Woodhams, 41 ECAB 345 (1989); JoeD. Cameron, 41 ECAB 153 (1989).

6 Marlon Vera, 54 ECAB 834 (2003); Roger Williams, 52 ECAB 468 (2001).

7 MichaelR. Shaffer, 55 ECAB 386 (2004).

8 Beverly A. Spencer, 55 ECAB 501 (2004).

9

See J.R.,Docket No. 17-1781 (issued January 16, 2018); I.J., 59 ECAB 408 (2008).
4

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish a cervical 

condition causally related to the accepted factors of his federal employment.

In support of his claim, appellant submitted a series of reports from Dr. Geiger dated 

November 8, 2021 through January 31, 2022. In these reports, although Dr. Geiger supported 

causal relationship between factors of appellant’s employment and his diagnosed conditions, he

did not provide medical rationale in support of his opinion that appellant’s cervical spondylosis 

and radiculopathy were causally related to the accepted employment factors. The Board has 

previously held that mere conclusory statements, not fortified by explanation, are insufficient to 

establish causal relationship between employment factors and diagnosed conditions.10 Without 

further explanation as to how, physiologically, the movements involved in appellant’s employment 

duties caused or contributed to the diagnosed cervical conditions, his opinion on causal 

relationship is of limited probative value.11 As such, Dr. Geiger’s reports are insufficient to 

establish the claim.12

Appellant also submitted Dr. Asad’s September 30 and October 24, 2021 MRI scans of the 

cervical spine. The Board has held, however, that diagnostic studies, standing alone, lack 

probative value on the issue of causal relationship as they do not address whether the accepted 

employment factors caused the diagnosed conditions.

13

The record also contains a December 21, 2021 letter from nurse practitioner, Ms. Berthold. 

This letter does not constitute competent medical evidence because nurse practitioners are not 

considered physicians as defined under FECA. Consequently, their medical findings and/or 

opinions are of no probative value and will not suffice for purposes of establishing entitlement to 

compensation benefits.14

10 S.G., Docket No. 20-1179 (issued May3, 2022);N.M.,Docket No. 19-0258 (issued May 8, 2020); A.W.,Docket 

No. 19-1277 (issued January 3, 2020); V.S., Docket No. 19-0936 (issued October 7, 2019); M.S., Docket No. 19-0587 

(issued July 22, 2019); B.C.,Docket No. 18-1735 (issued April 23, 2019); N.M.,Docket No. 10-0283 (issued 

August 19, 2010).

11 Id.

 

12 S.G.; N.M.; A.W., id; J.H., Docket No. 19-0838 (issued October 1, 2019); D.M., Docket No. 19-0389 (issued 

July 16, 2019).

 

13 M.S.,Docket No. 22-0586 (issued July 12, 2022); M.T.,Docket No. 20-0184 (issued June24, 2022); J.K., Docket 

No. 20-0591 (issued August 12, 2020);see A.B., Docket No. 17-0301 (issued May 19, 2017).

 

14 Section 8101(2) of FECA provides as follows: “(2) physician 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); 20 C.F.R. § 10.5(t). See Federal (FECA) Procedure Manual, Part 2 -- Claims, 

Causal Relationship, Chapter 2.805.3a(1) (January 2013);see also S.R., Docket No. 22-0245 (issued July 18, 2022)

(nurse practitioners are not considered physicians as defined under FECA); R.L., Docket No. 19-0440 (issued July 8, 

2019) (nurse practitioners and physical therapists are not considered physicians under FECA).
5

As appellant has not submitted rationalized medical evidence to establish a cervical 

condition causally related to the accepted employment factors, he has not met his 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 his burden of proof to establish a cervical 

condition causally related to the accepted factors of his federal employment.

ORDER

IT IS HEREBY ORDERED THAT the May 31, 2022 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: December 16, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board