United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.T., Appellant

and

DEPARTMENT OF HOMELAND SECURITY, 

CUSTOMS & BORDER PROTECTION, 

Los Angeles, CA, Employer

__________________________________________

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Docket No. 20-0138

Issued: September 29, 2020

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Deputy Chief Judge

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On October 22, 2019 appellant, through counsel, filed a timely appeal from an August 19, 

2019 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 to consider 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 his burden of proof to establish a medical condition 

causally related to the accepted January 9, 2019 employment incident.

FACTUAL HISTORY

On January 10, 2019 appellant, then a 71-year-old law enforcement officer, filed a 

traumatic injury claim (Form CA-1) alleging that on January 9, 2019 he sustained injuries to his 

left shoulder, cervical spine, jaw, tongue, and low back as a result of being thrown on a mat during 

edged weapon defense training while in the performance of duty. He did not stop work at the time 

of injury.

In a development letter dated January 25, 2019, OWCP notified appellant of the 

deficiencies of his claim and provided a questionnaire for his completion. It afforded him 30 days 

to respond.

Appellant subsequently submitted a January 10, 2019 report by Dr. Max Lebow, Boardcertified in both emergency and occupational medicine, which noted the history of a January 9, 

2019 injury. He obtained lumbar x-rays demonstrating possible degenerative changes. Dr. Lebow 

assessed acute jaw pain, acute abrasion of the oral cavity, acute neck strain, acute left shoulder 

strain, and acute lumbar strain.

In reports dated January 18 and 25, 2019, Dr. Pedram Kohan, a Board-certified internist, 

diagnosed jaw pain; abrasion of oral cavity; strain of muscle, fascia, and tendon at the neck and 

low back; and left shoulder strain. He released appellant to modified-duty work effective 

January 10, 2019 with restrictions pertaining to the lumbar spine.3

In reports dated from January 28 to February 5, 2019, Dr. Hovsep Babayan, Board-certified 

in family practice, noted that, on January 9, 2019, appellant sustained injuries to his neck, left 

shoulder, jaw, tongue, and lower back during training. He diagnosed left shoulder, neck, and low 

back strains. Dr. Babayan noted work restrictions limiting lifting, pulling, and pushing with the 

left shoulder. 

In a February 15, 2019 report, Dr. Amos Ladouceur, a neurosurgeon, noted appellant’s 

account of sustaining neck, left shoulder, jaw, tongue, and low back injuries while at work during 

training on January 9 2019.

In a February 22, 2019 report, Dr. Lebow noted appellant’s account of January 9, 2019 

neck, left shoulder, jaw, tongue, and lower back injuries sustained at work. He diagnosed neck, 

left shoulder, and low back strains. Dr. Lebow provided work restrictions for the left shoulder.

By decision dated February 28, 2019, OWCP accepted that the January 9, 2019 

employment incident occurred as alleged, but denied the claim finding that the medical evidence 

 

3 Appellant participated in physical therapy treatments from January 23 to February 24, 2019. 
3

of record was insufficient to establish that the diagnosed medical conditions were causally related 

to the accepted employment incident.

On June 7, 2019 appellant requested reconsideration and submitted additional evidence.

In a February 22, 2019 request for authorization of a left shoulder imaging study,

Dr. Lebow noted that appellant was unable to function normally and the “severe pain, resulting 

from this work-related injury,” prohibited him from returning to full duty at work. In a March 8, 

2019 report, he noted that a March 4, 2019 magnetic resonance imaging (MRI) scan of the left 

shoulder demonstrated a full-thickness tear of the supraspinatus tendon with medial dislocation of 

the biceps tendon and effusion.4 Dr. Lebow renewed restrictions for the left shoulder in reports 

through April 1, 2019.5

Dr. Babayan noted in a March 25, 2019 report that appellant’s left shoulder pain remained 

severe. He restricted appellant from using his left shoulder at work. 

In April 10 and 17, 2019 reports, Dr. Enrico Melson, Board-certified in public health and 

preventive medicine, noted appellant’s account of being thrown to the floor during a training 

exercise at work on January 9, 2019, causing tongue and jaw injuries, left shoulder pain, left-sided 

neck pain, and lumbar pain. He opined that the March 4, 2019 MRI scan showed significant 

pathology reasonably consistent with the mechanism and history of injury. 

In April 24, 2019 reports, Dr. Lebow noted that, on January 9, 2019, appellant “sustained 

an injury when he was thrown to the floor during a training exercise. His initial injuries included 

jaw pain, contusion of his oral cavity, cervical strain, left shoulder pain and strain, and back strain.” 

Dr. Lebow opined that based on the mechanism of injury, appellant’s “current state of disability, 

and his positive MRI,” there was a “direct causal connection between the diagnosed condition of 

joint derangement of the left shoulder” and the January 9, 2019 employment incident. He

diagnosed a full-thickness tear of the left supraspinatus tendon with tendon retraction. Dr. Lebow

emphasized that there was a “direct causal relationship between [appellant’s] left shoulder injury 

and his job duties” at the employing establishment.

In May 15, 2019 report, Dr. Melson noted that appellant had retired from the employing 

establishment and was awaiting surgical repair of the left rotator cuff tear. 

By decision dated August 19, 2019, OWCP denied modification of the prior decision.

 

4

January 10, 2019 x-rays showed no significant bony abnormality of the left shoulder. A March 4, 2019 MRI scan 

of left shoulder showed a full-thickness tear of the supraspinatus tendon with 1.5 cm tendon retraction and mild atrophy 

of the supraspinatus musculature, tendinopathy of the infraspinatus tendon, minimal cystic changes of the humeral 

head, medial dislocation of the long head of the biceps tendon with probable associated disruption of the 

coracohumeral ligament of the superior glenohumeral ligament, effusion of the subacromial/subdeltoid bursa.

5 Appellant also provided physical therapy treatment notes dated from February 7 to March 11, 2019. 
4

LEGAL PRECEDENT

An employee seeking benefits under FECA6 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, that the claim was timely filed within the applicable 

time limitation of FECA,7that 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.8 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.9 

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.10 Generally, fact of 

injury consists of two components that must be considered in conjunction with one another. The 

first component is whether the employee actually experienced the employment incident that 

allegedly occurred.11 The second component is whether the employment incident caused a 

personal injury.12

Causal relationship is a medical issue and 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 claimant, 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.13

ANALYSIS

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

conditions causally related to the accepted January 9, 2019 employment incident.

 

6 Supra note 2.

7

J.P., Docket No. 19-0129 (issued April 26, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); Joe D. 

Cameron, 41 ECAB 153 (1989).

8

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

9 R.R., Docket No. 19-0048 (issued April 25, 2019); L.M., Docket No. 13-1402 (issued February 7, 2014); 

Delores C. Ellyett, 41 ECAB 992 (1990).

10 Y.D., Docket No. 19-1200 (issued April 6, 2020); S.S., Docket No. 18-1488 (issued March 11, 2019); T.H., 59 

ECAB 388 (2008).

11 M.O., Docket No. 19-1398 (issued August 13, 2020); E.M., Docket No. 18-1599 (issued March 7, 2019); 

Bonnie A. Contreras, 57 ECAB 364 (2006).

12 Id.

13 M.O., supra note 11; see Y.D., supra note 10; S.S., supra note 10; H.B., Docket No. 18-0781 (issued 

September 5, 2018).
5

OWCP received multiple reports from treating physicians Drs. Babayan, Kohan, 

Ladouceur, and Melson in which they opined that the accepted January 9, 2019 employment 

incident had caused appellant’s resolved cervical spine, jaw, oral cavity, and lumbar injuries, as 

well as his ongoing left shoulder condition. However, these physicians did not provide medical 

rationale explaining how or why the accepted employment incident would have caused the 

diagnosed conditions. The Board has held that a report is of limited probative value regarding 

causal relationship if it does not contain medical rationale explaining how a given medical 

condition was related to employment factors.14 

Dr. Lebow first examined appellant on January 10, 2019, the day following the accepted 

January 9, 2019 employment incident. He diagnosed acute jaw pain, abrasion of the oral cavity, 

neck strain, left shoulder strain, and lumbar strain. In his report dated April 24, 2019, Dr. Lebow 

opined that the mechanism of the January 9, 2019 training incident was competent to cause joint 

derangement of the left shoulder with supraspinatus tendon tear as demonstrated by the March 4, 

2019 MRI scan. While he consistently attributed these diagnoses to the accepted incident, he did 

not provide medical reasoning explaining how that incident caused appellant’s cervical, lumbar, 

and oral cavity conditions. As noted above, the Board has held that a report is of limited probative 

value regarding causal relationship if it does not contain medical rationale explaining how a given 

medical condition/disability was related to employment factors.15 Dr. Lebow’s opinion is 

therefore insufficient to establish appellant’s claim.

Finally, appellant submitted results from diagnostic testing. 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 employment incident caused any of the diagnosed conditions.16 

These reports are therefore insufficient to establish the claim.

As appellant has not submitted rationalized medical evidence sufficient to establish an 

injury causally related to the accepted employment incident, the Board finds that he has not met 

his burden of proof.

On appeal counsel contends that the medical evidence of record is sufficient to establish 

the claim and that OWCP’s August 19, 2019 decision was “not rationalized.” As explained above, 

the Board finds the medical evidence of record is insufficient to establish causal relationship 

between the accepted January 9, 2019 employment incident and the diagnosed conditions. 

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.

 

14 See Y.D., Docket No. 16-1896 (issued February 10, 2017) (finding that a report is of limited probative value 

regarding causal relationship if it does not contain medical rationale explaining the relationship between work factors 

and a diagnosed condition).

15 Id. 

16 M.J., Docket No. 19-1287 (issued January 13, 2020); see J.S., Docket No. 17-1039 (issued October 6, 2017).
6

CONCLUSION

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

condition causally related to the accepted January 9, 2019 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the August 19, 2019 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: September 29, 2020

Washington, DC

Christopher J. Godfrey, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board