United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

M.L., Appellant

and

U.S. POSTAL SERVICE, CARMEL 

MOUNTAIN POSTAL STORE POST OFFICE, 

San Diego, CA, Employer

__________________________________________

)

)

)

)

)

)

)

)

)

Docket No. 22-0808

Issued: October 25, 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On April 13, 2022 appellant filed a timely appeal from a January 11, 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.

ISSUE

The issue is whether appellant has met his burden of proof to establish a lumbar condition 

causally related to the accepted April 20, 2021 employment incident.

FACTUAL HISTORY

On May 25, 2021 appellant, then a 36-year-old city delivery specialist, filed a traumatic 

injury claim (Form CA-1) alleging that on April 20, 2021, he sustained a slipped L5 lumbar disc 

1

5 U.S.C. § 8101 et seq.
2

when he entered and seated himself in a postal vehicle while in the performance of duty. He 

stopped work on April 20, 2021. 

In a development letter dated June 2, 2021, OWCP informed appellant of the deficiencies 

of his claim. It advised him of the type of factual and medical evidence required and provided a 

questionnaire for his completion. OWCP afforded appellant 30 days to submit the necessary 

evidence. 

A duty status report (Form CA-17) dated June 16, 2021, containing an illegible signature, 

noted appellant’s work restrictions. 

By decision dated July 8, 2021, OWCP denied appellant’s claim, finding that the medical 

evidence of record was insufficient to establish causal relationship between his diagnosed medical 

conditions and the accepted April 20, 2021 employment incident. It concluded, therefore, that the 

requirements had not been met to establish an injury and/or medical condition causally related to 

the accepted employment incident.

On August 4, 2021 appellant requested reconsideration and submitted additional medical 

evidence. 

In a report dated June 1, 2021, Dr. Basimah Khulusi, Board-certified in physical medicine 

and rehabilitation, related that she had examined appellant for complaints of lower back pain. She

described appellant’s history of injury. On physical examination, Dr. Khulusi observed slow and 

guarded transitional movements with a non-antalgic gait. Range of motion demonstrated forward 

flexion to 45 degrees aggravating left lower lumbar pain. Dr. Khulusi diagnosed left sacroiliac 

joint sprain and lumbar sprain. She opined that appellant suffered a traumatic injury at work when 

he contorted his body to enter a space too small for his size, resulting in back and sacroiliac joint 

sprain, resulting in a displacement of a lumbar disc, causing radicular symptoms.

A magnetic resonance imaging (MRI) scan of appellant’s lumbar spine obtained on 

June 10, 2021 demonstrated mild bilateral neuroforaminal stenosis at L2-3; mild-to-moderate 

spinal canal stenosis, mild bilateral articular recess stenosis, and moderate bilateral neuroforaminal 

stenosis at L4-5; and severe spinal canal stenosis, severe bilateral subarticular recess stenosis, and 

moderate right/severe left neuroforaminal stenosis.

An electromyogram/nerve conduction velocity (EMG/NCV) study obtained on July 8, 

2021 demonstrated multi-root radiculopathy affecting left L4-5 and S1, and right L5-S1.

In a report dated August 3, 2021, Dr. Khulusi related that she had examined appellant for 

complaints of low back pain radiating into the left hip. She described the duties of appellant’s 

federal employment and history of injury. On physical examination, Dr. Khulusi noted that his 

transitional movements were slightly antalgic and range of motion of the back with forward flexion 

of 45 degrees aggravating pain. She reviewed diagnostic studies and diagnosed lumbar sprain, 

resultant lumbar disc displacement, and resultant lumbar radiculopathies. Dr. Khulusi opined, “On 

[April 20, 2021, appellant] was put out to deliver mail.[...] The [employing establishment] rented 

a van.[...] The proportions of the van were too small for [appellant’s] size. The entry to the van 

through the door was too narrow for his body. He did grab the handle to get into the van and had 

to contort his body and twist it to be able to go from outside the van to place his body into the seat. 
3

When [standing] outside the van on the ground, the top of the seat [came] up to about the level of 

half of his chest. So, when he was contorting his body to get into the small seat, he did end up 

twisting his low back and lifting the weight of his body to be able to place himself into the seat, 

causing excessive loading pressures on the lumbar spine area and in particular on the intradiscal 

spaces in the lumbar spine area. That ended up causing more displacement of the discs in h is low 

back, with the worst displacement happening at the L5-S1 level causing crowding of the space for 

the nerve roots and in particular causing severe left neural foraminal stenosis. That translated into 

pinching of the nerve roots as per the results of the EMG study that show that he had the worst 

radiculopathies at the bilateral L5-S1 levels worse on the left and at the left L4-5 level which 

coincides with [appellant’s] symptoms. Because of what I explained above, his injury has been 

caused by the activities on the job.”

By decision dated October 29, 2021, OWCP denied modification of its July 8, 2021 

decision. 

On January 4, 2022 appellant requested reconsideration. In support thereof, he submitted 

a December 27, 2021 report wherein Dr. Khulusi reiterated the explanation she provided in her 

August 3, 2021 report. Dr. Khulusi further explained how appellant’s body was placed at a 

mechanical disadvantage when trying to fit his frame into a too-small space. She explained that 

appellant loaded his lumbar spine area with excessive loading forces and pressures that ended up 

causing sprain and displacement of the discs of the lumbar spine. Dr. Khulusi supplied the 

definition of a sprain and explained that in appellant’s case, the spraining of the ligaments of his 

low back had resulted in enough weakness of the ligaments, together with increased pressure on 

the intradiscal space, which led to displacement of the discs, worst at L5-S1, resulting in lumbar 

radiculopathy. She diagnosed lumbar sprain, resultant lumbar disc displacement, and resultant 

lumbar radiculopathy.

By decision dated January 11, 2022, OWCP denied modification of its October 29, 2021 

decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA2 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,3that 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 

2

Id.

3 F.H., Docket No. 18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April26, 2019); JoeD. 

Cameron, 41 ECAB 153 (1989). 
4

employment injury.4 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.5

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 whether the 

employee 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 and 

can be established only by medical evidence.6 

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

condition and an employment incident is rationalized medical opinion evidence. 7 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.8

ANALYSIS

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

In a report dated August 3, 2021, following review of appellant’s diagnostic studies,

Dr. Khulusi diagnosed lumbar sprain, resultant lumbar disc displacement, and resultant lumbar 

radiculopathies. She opined, “On [April 20, 2021, appellant] was put out to deliver mail.[...] The 

[employing establishment] rented a van.[...] The proportions of the van were too small for 

[appellant’s] size. The entry to the van through the door was too narrow for his body. He did grab 

the handle to get into the van and had to contort his body and twist it to be able to go from outside 

the van to place his body into the seat. When [standing] outside the van on the ground, the top of 

the seat [came] up to about the level of half of his chest. So, when he was contorting his body to 

get into the small seat, he did end up twisting his low back and lifting the weight of his body to be 

able to place himself into the seat, causing excessive loading pressures on the lumbar spine area 

and in particular on the intradiscal spaces in the lumbar spine area. That ended up causing more 

displacement of the discs in his low back, with the worst displacement happening at the L5-S1 

level causing crowding of the space for the nerve roots and in particular causing severe left neural 

4 L.C., Docket No. 19-1301 (issued January 29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020); 

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

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

DeloresC.Ellyett, 41 ECAB 992 (1990).

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).

7

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).

8 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).
5

foraminal stenosis. That translated into pinching of the nerve roots as per the results of the EMG 

study that show that he had the worst radiculopathies at the bilateral L5-S1 levels worse on the left 

and at the left L4-L5 level which coincides with [appellant’s] symptoms. Because of what I 

explained above, his injury has been caused by the activities on the job.”

In a December 27, 2021 report, Dr. Khulusi explained how appellant’s body was placed at 

a mechanical disadvantage when trying to fit his frame into a too-small space. She explained that 

appellant loaded his lumbar spine area with excessive loading forces and pressures that ended up 

causing sprain and displacement of the discs of the lumbar spine. Dr. Khulusi further explained 

that in appellant’s case, the spraining of the ligaments of his low back had resulted in enough 

weakness of the ligaments, together with increased pressure on the intradiscal space, which led to 

displacement of the discs, worst at L5-S1, resulting in lumbar radiculopathy. She diagnosed 

lumbar sprain, resultant lumbar disc displacement, and resultant lumbar radiculopathy.

The Board finds that these reports of Dr. Khulusi are sufficient to require further 

development of the medical evidence. Dr. Khulusi provided a pathophysiological explanation of 

how the accepted employment incident caused appellant’s diagnosed conditions. The Board has 

long 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 is only that necessary to 

convince the adjudicator that the conclusion drawn is rational, sound, and logical.9 Although the 

August 3, and December 27, 2021 reports are insufficient to meet appellant’s burden of proof to 

establish the claim, they are sufficient to require OWCP to further develop the claim.10

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.11 It has an obligation to see that justice is done.12

On remand, OWCP shall refer appellant, along with the case record and a statement of 

accepted facts, to a specialist in the appropriate field of medicine for a rationalized opinion on

whether appellant’s diagnosed lumbar conditions are causally related to or aggravated by the 

accepted employment incident. If the physician opines that the diagnosed conditions are not 

causally related, he or she must explain with rationale how or why their opinion differs from that 

of Dr. Khulusi. After this and other such further development of the case record as deemed

necessary, OWCP shall issue a de novo decision.

9 B.C., Docket No. 20-0498 (issued August 27, 2020); W.M., Docket No. 17-1244 (issued November 7, 2017); 

Kenneth J. Deerman, 34 ECAB 641, 645 (1983) and cases cited therein.

10 See E.G., Docket No. 19-1296 (issued December 19, 2019).

11 Id. See also A.P., Docket No. 17-0813 (issued January3, 2018); Jimmy A. Hammons, 51 ECAB 219, 223 (1999).

12 S.M., Docket No. 19-1634 (issued August 25, 2020); see B.C., Docket No. 15-1853 (issued January 19, 2016); 

John J. Carlone, 41 ECAB 354 (1989).
6

CONCLUSION

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

ORDER

IT IS HEREBY ORDERED THAT the January 11, 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: October 25, 2022

Washington, DC

Patricia H. Fitzgerald, Deputy 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