United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.O., Appellant

and

U.S. POSTAL SERVICE, KILMER POST 

OFFICE, Edison, NJ, Employer

__________________________________________

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Docket No. 23-0834

Issued: December 18, 2023

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

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On May 24, 2023 appellant filed a timely appeal from a May 23, 2023 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 a cervical condition 

causally related to the accepted November 30, 2022 employment incident. 

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the May23, 2023 decision, appellant submitted additional evidence to OWCP.

However, the Board’s Rules of Procedures 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.
2

FACTUAL HISTORY

On December 28, 2022 appellant, then a 32-year-old city delivery specialist, filed a 

traumatic injury claim (Form CA-1) alleging that on November 30, 2022 she sustained a cervical 

disc herniation between C7 and T1 when she delivered multiple packages and felt a pull in her 

back while in the performance of duty, she indicated that the onset of pain came a few days later. 

She stopped work on December 14, 2022. 

In a neurological consultation report dated December 16, 2022, Dr. Kangmin D. Lee, a 

Board-certified neurological surgeon, indicated that appellant was evaluated for complaints of 

chest pain and numbness and weakness in her bilateral lower extremities. He indicated that a 

magnetic resonance imaging (MRI) scan demonstrated C7-T1 disc herniation with severe cord 

compromise. On physical examination, Dr. Lee observed decreased sensation in the bilateral 

lower extremities and positive cervical paraspinal tenderness. He recommended surgical 

decompression of appellant’s cervical spine. 

In work status notes dated December 27 and 29, 2022, Dr. Lee opined that appellant was 

unable to work. 

In a January 12, 2023 development letter, OWCP informed appellant of the deficiencies of

her claim. It advised her of the type of factual and medical evidence necessary to establish her 

claim and provided a questionnaire for her completion. OWCP afforded appellant 30 days to 

respond. 

OWCP received a work status note dated December 13, 2022 by James W. Burns, an 

advanced practice nurse, who indicated that appellant was treated in the emergency room and may 

return to work on December 16, 2022. 

Appellant submitted hospital records dated December 16 through 18, 2022, which 

indicated that she was admitted to the hospital and underwent an unauthorized spine surgery. 

By decision dated February 16, 2023, OWCP accepted that the November 30, 2022 

incident occurred as alleged, but denied the claim, finding that the medical evidence of record was 

insufficient to establish causal relationship between appellant’s diagnosed condition and the 

accepted November 30, 2022 employment incident. Therefore, it concluded that the requirements 

had not been met to establish an injury as defined by FECA. 

Appellant submitted an operative report dated December 16, 2022, which indicated that 

she underwent cervico-thoracic discectomy, decompression, and fusion surgery. The preoperative 

diagnosis noted large cervical thoracic disc herniation and spinal cord injury. 

OWCP received a progress note dated December 29, 2022 by Nicole Ayala, a family nurse 

practitioner, who indicated that appellant was evaluated for status-post cervical surgery performed 

on December 16, 2022. Ms. Ayala reported neurological examination of intact sensation of the 

bilateral lower extremities. She diagnosed status-post cervical spinal fusion and recommended 

that appellant not work. 
3

Appellant submitted a January 26, 2023 work status note by Dr. Lee who advised that she

be excused from work as she recently underwent a surgical procedure on December 16, 2022. 

In progress notes dated January 26 and March 9, 2023, Dr. Lee indicated that appellant 

reported improvement in her postoperative symptoms. On physical examination, he observed 

intact sensation to light touch in the upper and lower extremities and +4/5 motor examination in 

the lower extremities. Dr. Lee assessed status-post cervical spinal fusion. 

In a report dated March 10, 2023, Dr. Lee indicated that on November 30, 2022 appellant 

was lifting heavy boxes when she began to experience severe and aching neck pain. He recounted 

that on December 16, 2022 she presented to the emergency room for worsening neck pain, 

numbness in her entire body, and particular weakness in the lower extremities to the point that she 

could no longer ambulate. Dr. Lee reported that imaging revealed a large acute C7-T1 disc 

herniation with severe cord compromise and evidence of spinal cord injury. He indicated that 

appellant was taken to the operating room for emergency cervical thoracic decompression 

discectomy and fusion surgery. Dr. Lee opined that “to the best [of his] medical judgment the 

injury that occurred at work on November 30, 2022 is directly and causally related to [appellant’s]

disc herniation and subsequent spinal cord injury.” He explained that it was well known that 

cervical injuries can initially present with mild symptoms that progress over time. 

On May 19, 2023 appellant requested reconsideration. 

By decision dated May 23, 2023, OWCP denied modification of its February 16, 2023 

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 

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, OWCP must first determine whether fact of injury has been established. 

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

3

Id.

4 F.H., Docket No. 18-0869 (issued January 29, 2020); S.B., Docket No. 17-1779 (issued February 7, 2018); JoeD. 

Cameron, 41 ECAB 153 (1989). 

5 L.C., Docket No. 19-1301 (issued January 29, 2020); J.M., Docket No. 17-0284 (issued February 7, 2018); 

James E. Chadden, Sr., 40 ECAB 312 (1988).

6 P.A., Docket No. 18-0559 (issued January 29, 2020); K.M., Docket No. 15-1660 (issued September 16, 2016); 

L.M., Docket No. 13-1402 (issued February 7, 2014); Delores C. Ellyett, 41 ECAB 992 (1990).
4

the employment incident at the time, place, and in the manner alleged. Second, the employee must 

submit sufficient evidence to establish that the employment incident caused a personal injury. 7 

To establish causal relationship between a diagnosed condition, as well as any attendant 

disability claimed, and the accepted employment incident, the employee must submit 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 the specific employment incident identified by the employee. 9 

ANALYSIS

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

condition causally related to the accepted November 30, 2022 employment incident.

Appellant submitted reports by Dr. Lee dated December 16, 2022 through March 10, 2023 

wherein he indicated that a cervical MRI scan demonstrated a large C7-T1 disc herniation with 

severe cord compromise. Dr. Lee conducted spinal surgery on December 16, 2022. In a report 

dated March 10, 2023, he described the November 30, 2022 employment incident and the 

subsequent medical treatment that appellant had received. Dr. Lee opined that “to the best [of his] 

medical judgment the injury that occurred at work on November 30, 2022 is directly and causally 

related to her disc herniation and subsequent spinal cord injury.” He explained that it was well 

known for cervical injuries to initially present with mild symptoms that progress over time. 

Dr. Lee’s reports, however, are of limited probative value as he did not provide any medical 

explanation for how lifting boxes at work caused or contributed to appellant’s cervical injury. The 

Board has held that medical opinion evidence must offer a rationalized explanation of how the 

specific employment incident or work factors, physiologically caused injury. 10 Consequently,

Dr. Lee’s reports are insufficient to establish appellant’s claim.

The remaining records consist of a December 13, 2022 work status note by Mr. Burns, an 

advanced practice nurse, and a December 29, 2022 report by Ms. Ayala, a family nurse 

practitioner. However, certain healthcare providers such as nurses and nurse practitioners are not 

7 T.H., Docket No. 19-0599 (issued January 28, 2020); B.M., Docket No. 17-0796 (issued July 5, 2018); David 

Apgar, 57 ECAB 137 (2005); John J. Carlone, 41 ECAB 354 (1989).

8

S.S., Docket No. 19-0688 (issued January 24, 2020); S.A., Docket No. 18-0399 (issued October 16, 2018); see 

also Robert G. Morris, 48 ECAB 238 (1996).

9 T.L., Docket No. 18-0778 (issued January 22, 2020); C.F., Docket No. 18-0791 (issued February 26, 2019); M.V., 

Docket No. 18-0884 (issued December 28, 2018); I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 

345 (1989).

10 F.C., Docket No. 23-0132 (issued May 25, 2023); G.R., Docket No. 21-1196 (issued March 16, 2022); L.R., 

Docket No. 16-0736 (issued September 2, 2016); Douglas M. McQuaid, 52 ECAB 382 (2001).
5

considered physicians as defined under FECA.11 Therefore, these reports are insufficient to 

establish appellant’s claim. 

As the medical evidence of record is insufficient to establish a cervical condition causally

related to the accepted November 30, 2022 employment incident, the Board finds that appellant

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 a cervical 

condition causally related to the accepted November 30, 2022 employment incident. 

11 Section 8102(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. § 8102(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); DavidP. Sawchuk, 57 ECAB 316, 320 n.11 (2006) (lay 

individuals such as physician assistants, nurses, and physical therapists are not competent to render a medical opinion 

under FECA); see also B.D., Docket No. 22-0503 (issued September 27, 2022) (nurse practitioners are not considered 

physicians as defined under FECA and their medical findings and/or opinions will not suffice for purposes of 

establishing entitlement to FECA benefits); L.S., Docket No. 19-1231 (issued March 30, 2021) (a nurse practitioner 

is not considered a physician as defined under FECA).
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ORDER

IT IS HEREBY ORDERED THAT the May 23, 2023 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: December 18, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board