United States Department of Labor

Employees’ Compensation Appeals Board

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A.M., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Reno, NV, Employer

__________________________________________

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Docket No. 22-0322

Issued: November 17, 2022

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

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On December 30, 2021 appellant filed a timely appeal from an October 21, 2021 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.

ISSUE

The issue is whether appellant has met his burden of proof to establish a recurrence of the 

need for medical treatment, commencing January 2, 2021, causally related to the accepted

September 17, 2002 employment injury.

FACTUAL HISTORY

On September 17, 2002 appellant, then a 54-year-old letter carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on that date he injured his lower back when carrying a heavy 

package through a door while in the performance of duty. He explained that his back was struck 

1

5 U.S.C. § 8101 et seq.
2

by the door handle as the door was closing.

2

 Appellant did not stop work. OWCP accepted the 

claim for lumbosacral strain, thoracic strain, and lumbar region contusion. It subsequently 

expanded the acceptance of the claim to include aggravation of cervical, thoracic, and lumbar 

spondylosis without myelopathy; and cervical and thoracolumbar intervertebral disc degeneration. 

Appellant retired from the employing establishment in 2003. 

In a November 14, 2006 report, Dr. Christopher Twombly, a Board-certified physiatrist, 

related that appellant was seen for a follow up of chronic mechanical low back pain with lumbar 

spondylosis. He noted diagnoses of chronic mechanical low back pain, lumbar and thoracic 

spondylosis, myofascial pain, and possible mild disc versus facet pain. Dr. Twombly noted that 

appellant was doing well and did not need further treatment, but would follow up on an as-needed 

basis. 

On April 17, 2021 appellant filed a notice of recurrence (Form CA-2a) alleging that he 

sustained a recurrence of the need for medical treatment, commencing January 2, 2021, causally 

related to his spinal conditions. He noted that he had experienced recurring episodes of pain 

throughout the years, which were controlled through exercise and rest, but that he had misstepped

and his pain had been constant for two months. 

Appellant submitted an attending physician’s report (Form CA-20) dated January 28, 2003 

from Dr. Forrest Burke, a specialist in physical medicine and rehabilitation. Dr. Burke noted a

September 17, 2002 date of injury and diagnosed cervical, lumbar and thoracic spondylosis.

In a development letter dated April 19, 2021, OWCP informed appellant of the deficiencies 

of his recurrence claim. It requested that he submit additional evidence in support of his claim, 

including a physician’s opinion supported by a medical explanation as to the relationship between 

his current need for medical treatment and the accepted employment conditions. OWCP also 

provided a questionnaire for appellant’s completion, which posed questions regarding his medical 

treatment. It afforded appellant 30 days to respond.

OWCP subsequently received a March 1, 2021 report, wherein Dr. John Reyher, an 

osteopathic physician Board-certified in physical medicine and rehabilitation, noted that 

appellant’s pain began on September 17, 2002 when he performed heavy lifting and carrying, and 

that his pain was aggravated when his back was struck by a heavy door. Appellant had also related 

that approximately six weeks prior he had been hunting and hiking for a few hours when he tripped 

over a sagebrush and fell, but experienced no pain at the time of the fall. However, two weeks 

later, he noticed increased lower back pain radiating into his left lower extremity. Dr. Reyher 

reviewed a November 30, 2002 lumbar magnetic resonance imaging scan and noted that 

examination findings for appellant’s low back included positive left straight leg raising and pain 

with extension. He diagnosed other lumbar intervertebral disc degeneration, lower back muscle, 

fascia and tendon strain, and lumbar radiculopathy. Dr. Reyher concluded that appellant had 

2 OWCP assigned OWCP File No. xxxxxx418 to the current claim. Appellant has a prior claim for a traumatic 

injury (Form CA-1 alleging that on October 18, 2001 he injured his lower back while loading mail. OWCP accepted 

the claim for lumbosacral strain and assigned OWCP File No. xxxxxx277. On February 5, 2003 appellant filed an 

occupational disease claim (Form CA-2) alleging that his federal employment duties aggravated his spinal disc 

degeneration. OWCP accepted the claim for cervical and thoracic or thoracolumbar intervertebral disc degeneration 

and assigned OWCP File No. xxxxxx331. On June 18, 2003 OWCP administratively combined OWCP File Nos. 

xxxxxx277, xxxxxx331, and xxxxxx418, with the latter designated as the master file. 
3

chronic low back pain and lower extremity radicular pain, which was secondary to an industrial 

injury.

By decision dated July 7, 2021, OWCP denied appellant’s recurrence claim, finding that 

the medical evidence of record was insufficient to establish a recurrence of the need for medical 

treatment due to a worsening of his accepted employment injuries. It found there was no medical 

evidence to support that the claimed recurrence was due to the accepted September 17, 2002

employment injury.

On July 28, 2021 appellant requested a review of the written record by a representative of 

OWCP’s Branch of Hearings and Review. 

By decision dated October 21, 2021, OWCP’s hearing representative affirmed the July 7, 

2021 OWCP decision. 

LEGAL PRECEDENT

The United States shall furnish to an employee who is injured while in the performance of 

duty the services, appliances, and supplies prescribed or recommended by a qualified physician 

that the Secretary of Labor considers likely to cure, give relief, reduce the degree or the period of 

any disability, or aid in lessening the amount of any monthly compensation.3

A recurrence of a medical condition means a documented need for further medical 

treatment after release from treatment for the accepted condition or injury when there is no 

accompanying work stoppage.4 An employee has the burden of proof to establish that he or she 

sustained a recurrence of a medical condition that is causally related to his or her accepted 

employment injury without intervening cause.5

If a claim for recurrence of medical condition is made more than 90 days after release from 

medical care, a claimant is responsible for submitting a medical report supporting a causal 

relationship between the employee’s current condition and the original injury in order to meet his 

or her burden.

6

 To meet this burden, the employee must submit medical evidence from a physician 

who, on the basis of a complete and accurate factual and medical history, supports that the 

3

5 U.S.C. § 8103(a).

4

20 C.F.R. § 10.5(y).

5 R.B., Docket No. 22-0980 (issued October 18, 2022); B.B., Docket No. 21-1358 (issued May 11, 2022); S.P., 

Docket No. 19-0573 (issued May 6, 2021); M.P., Docket No. 19-0161 (issued August 16, 2019); E.R., Docket No. 

18-0202 (issued June5, 2018).

6 Federal (FECA) Procedural Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.4(b) (June 2013); see also

M.F., Docket No. 21-1221 (issued March 28, 2022); J.M., Docket No. 09-2041 (issued May 6, 2010).
4

condition is causally related and supports his or her conclusion with sound medical rationale.

7

 

Where no such rationale is present, medical evidence is of diminished probative value.

8

ANALYSIS

The Board finds that appellant has not met his burden of to establish a recurrence of the 

need for medical treatment, commencing January 2, 2021, causally related to the accepted 

September 17, 2002 employment injury.

In a March 1, 2021 report, Dr. Reyher noted the history of appellant’s September 17, 2002 

employment injury. He also noted that appellant related a history that approximately six weeks 

prior to his report, appellant had tripped over sagebrush and fallen. Appellant had related that he 

had not experienced pain at the time of the fall, but two weeks later, he noticed an increase of

lower back pain radiating into his left lower extremity. Dr. Reyher reported low back examination

findings of positive left straight leg raising and pain with extension. He diagnosed other lumbar 

intervertebral disc degeneration, lower back muscle, fascia and tendon strain, and lumbar 

radiculopathy. Dr. Reyher indicated that appellant had chronic low back pain and left lower 

extremity radicular pain secondary to an industrial injury. The Board has held that a medical 

opinion is of limited value if it is conclusory in nature.9 Dr. Reyher concluded that appellant 

sustained a recurrence of the need for medical treatment, but he did not explain how or why the 

accepted conditions for which appellant last received treatment in November 2006, resulted in the 

need for further medical treatment commencing January 2, 2021.

10

 The need for rationale in is 

particularly important since Dr. Reyher noted that appellant had an intervening fall in 2021.11 

In a Form CA-20 dated January 28, 2003, Dr. Burke noted a September 17, 2002 date of 

injury and diagnosed cervical, lumbar and thoracic spondylosis. However, as this report predates 

the claimed recurrence of the need for medical treatment, it is of no probative value on the issue 

of causal relationship.12

As appellant has not submitted medical evidence sufficient to establish a recurrence of the 

need for medical treatment causally related to his accepted September 17, 2002 employment 

injury, the Board finds that he has not met his burden of proof.

7

S.P., supra note 5; A.C., Docket No. 17-0521 (issued April 24, 2018); O.H., Docket No. 15-0778 (issued 

June 25, 2015).

8 M.F., supra note 6; M.P., supranote 5; Michael Stockert, 39 ECAB 1186 (1988).

9

See R.B., Docket No. 19-1527 (issued July 20, 2020); R.S., Docket No. 19-1774 (issued April3, 2020).

10 K.B., Docket No. 21-1038 (issued February 28, 2022); R.C., Docket No. 20-1321 (issued July 7, 2021); J.S., 

Docket No. 0764 (issued January21, 2021).

11 Supra note 9.

12 V.N., Docket No. 16-1427 (issued December 13, 2016).
5

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 recurrence of 

the need for medical treatment, commencing January 2, 2021, causally related to the accepted 

September 17, 2002 employment injury.

ORDER

IT IS HEREBY ORDERED THAT the October 21, 2021 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: November 17, 2022

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board