United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

D.S., Appellant

and

DEPARTMENT OF JUSTICE, BUREAU OF 

PRISONS, THE METROPOLITAN 

CORRECTIONAL CENTER, NEW YORK, 

New York, NY, Employer

__________________________________________

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Docket No. 22-0323

Issued: September 26, 2022

Appearances: Case Submitted on the Record

Shannon Bravo, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On December 30, 2021 appellant filed a timely appeal from an October 8, 2021 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 over the merits of this case.3

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.

 

3 The Board notes that, following the October 8, 2021 decision, appellant submitted additional evidence to 

OWCP. However, the Board’s Rules of Procedureprovides: “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. Id.
2

ISSUE

The issue is whether appellant has met his burden of proof to expand the acceptance of his 

claim to include additional conditions causally related to the accepted May 5, 2020 employment 

injury.

FACTUAL HISTORY

On May 6, 2020 appellant, then a 47-year-old correctional officer, filed a traumatic injury 

claim (Form CA-1) alleging that on May 5, 2020 he sustained neck and back injuries when he 

passed through a check point at work and his vehicle came to a violent stop while in the 

performance of duty. OWCP assigned the claim OWCP File No. xxxxxx817.4

In a report dated May 27, 2020, Dr. Allen Wilkins, a Board-certified physiatrist, discussed 

appellant’s reporting of a “May 6, 2020” employment incident when a steel security gate 

malfunctioned and lifted his vehicle off the pavement. Appellant complained of neck, lower back, 

and bilateral leg pain due to the incident. Dr. Wilkins detailed the findings of the physical 

examination, including a positive Spurling’s test demonstrating cervical radicular pain. He noted 

that examination of the right shoulder revealed no swelling, atrophy, or tenderness. Dr. Wilkins 

diagnosed cervical spine ligaments sprain; injury of muscle, fascia, and tendon of the lower back; 

and lumbar radiculopathy.

In a June 6, 2020 attending physician’s report (Form CA-20), Dr. Wilkins referenced the 

malfunctioning of the security gate on an unspecified date. He diagnosed cervical spine strain and 

low back injury. Dr. Wilkins checked a “Yes” box indicating that appellant’s conditions were 

related to the reported employment activity and provided the notation, “injuries caused by impact 

of vehicle with pavement [and] steel barricade.” He found total disability from May 6 through 

June 24, 2020. 

By decision dated July 28, 2020, OWCP denied appellant’s claim, finding that he had not 

submitted sufficient factual evidence to establish that the injury arose during the course of 

employment and within the scope of compensable work factors.

On August 3, 2020 appellant requested a telephone hearing before a representative of 

OWCP’s Branch of Hearings and Review. A telephone hearing was held on October 5, 2020.

Appellant submitted additional medical evidence, including June 10 and July 15, 2020 

reports from Dr. Wilkins who again indicated that appellant complained of neck, lower back, and 

bilateral leg pain due to a May 6, 2020 employment incident. He diagnosed cervical spine 

ligaments sprain; injury of muscle, fascia, and tendon of the lower back; and lumbar radiculopathy.

In a July 17, 2020 report, Dr. Howard M. Baruch, a Board-certified orthopedic surgeon, 

discussed the May 5, 2020 employment incident and diagnosed lumbago and cervicalgia.

 

4 Appellant filed claims for other employment injuries, including a claim for a September 12, 2013 back injury,

which OWCP denied, assignedOWCP File No. xxxxxx675; a claim for a June 20, 2017 low back injury,which OWCP 

denied, assigned OWCP File No. xxxxxx569; and a September 20, 2019 injury OWCP accepted for left wrist 

sprain/contusion and left carpal tunnel syndrome, assigned OWCP File No. xxxxxx512. OWCP administratively 

combined OWCP File Nos. xxxxxx675, xxxxxx817, xxxxxx569, and xxxxxx512, and designated the latter as the 

master file.
3

In an undated Form CA-20, Dr. Wilkins referenced the malfunctioning of the steel security 

gate as occurring on May 5, 2020. He diagnosed cervical spine ligaments sprain; injury of muscle, 

fascia, and tendon of the lower back; and lumbar radiculopathy. Dr. Wilkins checked a “Yes” box 

indicating that the diagnosed conditions were related to the reported employment activity. 

By decision dated December 18, 2020, OWCP’s hearing representative set aside OWCP’s

July 28, 2020 decision and remanded the case for further development of the factual evidence. 

After such development, OWCP issued a January 15, 2021 decision in which it denied 

appellant’s claim for a May 5, 2020 employment injury, finding that he had not submitted 

sufficient factual evidence to establish that the injury arose during the course of employment and 

within the scope of compensable work factors.

OWCP then referred appellant, along with a statement of accepted facts (SOAF) and a 

series of questions, for a second opinion examination with Dr. Robert DeFalco, Jr., a Boardcertified orthopedic surgeon. It requested that he address whether appellant had work-related 

disability and residuals. In a December 10, 2020 report, Dr. DeFalco diagnosed right shoulder 

strain, resolved, cervical strain, resolved, and disc bulges at L3-4, L4-5 and L5-S1, as seen on a 

magnetic resonance imaging (MRI) scan of the lumbar spine.

Appellant submitted a June 10, 2021 report in which Dr. Wilkins indicated that appellant 

complained of neck, lower back, and bilateral leg pain due to a May 6, 2020 employment incident. 

Dr. Wilkins diagnosed cervical spine ligaments sprain; injury of muscle, fascia, and tendon of the 

lower back; and lumbar radiculopathy.

By decision dated May 14, 2021, OWCP vacated its January 15, 2021 decision and 

accepted appellant’s claim for a lumbar radiculopathy and resolved sprain of cervical spine 

ligaments.

5

 In this decision, it also determined that appellant failed to establish a right shoulder 

strain and disc bulges at L3-4/L5-S1 as employment related.

On June 7, 2021 appellant, through counsel, requested a review of the written record by a 

representative of OWCP’s Branch of Hearings and Review in connection with the May 14, 2021 

decision, which denied his claim for acceptance of additional conditions causally related to the 

accepted May 5, 2020 employment injury. Counsel argued that the acceptance of appellant’s claim 

should be expanded to include several additional conditions, including a right shoulder strain and 

disc bulges at L3-4/L5-S1.

Appellant submitted additional medical evidence. In a May 10, 2021 report, Dr. Chris E. 

Thomas, a Board-certified physiatrist, referenced the May 5, 2020 accident and diagnosed lumbar 

radiculopathy and low back pain.

In a June 19, 2021 report, Dr. Wilkins diagnosed cervical spine ligaments sprain; injury of 

muscle, fascia, and tendon of the lower back; and lumbar radiculopathy. In an August 14, 2021 

report, he diagnosed cervical spine ligaments sprain; injury of muscle, fascia, and tendon of the 

lower back; lumbar radiculopathy; and injury of right rotator cuff muscle or tendon. 

 

5 OWCP paid appellant wage-loss compensation for disability on the supplemental rolls, on a retroactive basis, 

commencing June 20, 2020, and on the periodic rolls, commencing October 10, 2021.
4

In an August 5, 2021 report, Dr. Wesam Mohamed, a Board-certified orthopedic surgeon, 

referenced the May 5, 2020 employment incident. He diagnosed lumbar sprain/strain; possible 

lumbar radiculopathy versus lumbar facet syndrome versus lumbar discogenic pain; possible 

coccyx pain; and possible lumbar myofascial pain with trigger point. Dr. Mohamed indicated that 

these diagnoses were “related to work injury.”

Following a preliminary review, by decision dated August 19, 2021, OWCP’s hearing 

representative set aside the May 14, 2021 decision and remanded the case to OWCP for further 

development of the question as to whether the acceptance of appellant’s claim should be expanded 

to include a right shoulder strain, disc bulges at L3-4/L5-S1, or some other previously unaccepted 

condition causally related to the May 5, 2020 employment injury, to be followed by a de novo

decision.

By decision dated August 27, 2021, OWCP provided further discussion of the medical 

evidence submitted by appellant and determined that appellant’s claim for a May 5, 2020 

employment injury was only accepted for a lumbar radiculopathy and resolved sprain of cervical 

spine ligaments. Thereby, it determined that appellant failed to establish that the acceptance of his 

claim should be expanded to include additional conditions causally related to the accepted May 5, 

2020 employment injury.6

By decision dated October 8, 2021, OWCP determined that appellant’s claim for a May 5, 

2020 employment injury was only accepted for a lumbar radiculopathy and resolved sprain of 

cervical spine ligaments, and that appellant failed to establish that expansion of the acceptance of 

his claim should include additional conditions causally related to the accepted May 5, 2020 

employment injury. 

LEGAL PRECEDENT

When an employee claims that, a condition not accepted or approved by OWCP was due 

to an employment injury, he or she bears the burden of proof to establish that the condition is 

causally related to the employment injury.7 The medical evidence required to establish causal 

relationship between a specific condition, and the employment injury 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 factors identified by the claimant.8

6 On September 17, 2021 appellant, through counsel, requested a review of the written record by a representative 

of OWCP’s Branch of Hearing and Review. In an October 7, 2021 informational letter, OWCP advised appellant that 

the case was not in posture for a review of the written record.

7

J.R., Docket No. 20-0292 (issued June 26, 2020); W.L., Docket No. 17-1965 (issued September 12, 2018); V.B., 

Docket No. 12-0599 (issued October 2, 2012); JajaK. Asaramo, 55 ECAB 200, 204 (2004). 

 

8

See E.J., Docket No. 09-1481 (issued February19, 2010).
5

ANALYSIS

The Board finds that appellant has not met his burden of proof to expand the acceptance of 

his claim to include additional conditions causally related to the accepted May 5, 2020 

employment injury.

Appellant submitted a June 6, 2020 Form CA-20 in which Dr. Wilkins referenced the 

malfunctioning of the steel security gate on an unspecified date. He diagnosed cervical spine strain 

and low back injury. Dr. Wilkins checked a “Yes” box indicating that the diagnosed conditions 

were related to the reported employment activity and provided the notation, “injuries caused by 

impact of vehicle with pavement and steel barricade.” He found total disability from May 6 

through June 24, 2020. In an undated Form CA-20 received by OWCP on September 16, 2020,

Dr. Wilkins referenced the malfunctioning of the steel security gate as occurring on May 5, 2020. 

He diagnosed cervical spine ligaments sprain; injury of muscle, fascia, and tendon of the lower 

back; and lumbar radiculopathy. Dr. Wilkins checked a “Yes” box indicating that the diagnosed 

conditions were related to the reported employment activity. 

Appellant’s burden of proof regarding his expansion claim includes the necessity of 

furnishing an affirmative opinion from a physician who supports his or her conclusion with sound 

medical reasoning.9 In the above-noted reports, Dr. Wilkins diagnosed some medical conditions,

which OWCP had not accepted as related to the May 5, 2020 employment incident. However, he 

failed to provide sufficient rationale for his opinion on causal relationship. The Board has held that 

when a physician’s opinion on causal relationship consists only of checking “Yes” to a form 

question, without more by the way of medical rationale, that opinion is of limited probative value 

and is insufficient to establish causal relationship.10 As such, these reports of Dr. Wilkins are 

insufficient to establish appellant’s expansion claim.

Appellant submitted an August 5, 2021 report from Dr. Mohamed who referenced the 

May 5, 2020 employment incident. Dr. Mohamed diagnosed lumbar sprain/strain; possible 

lumbar radiculopathy versus lumbar facet syndrome versus lumbar discogenic pain; possible 

coccyx pain; and possible lumbar myofascial pain with trigger point. He indicated that these 

diagnoses were “related to [the] work injury.” The Board notes that this report is of limited 

probative value regarding appellant’s expansion claim. Although Dr. Mohamed provided an

opinion on causal relationship, he failed to provide medical rationale in support of that opinion. 

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/level of disability 

has an employment-related cause.11 Therefore, this report is insufficient to establish appellant’s 

expansion claim. 

Appellant submitted reports, dated May 27, June 10, and July 15, 2020, and April 17 and 

June 19, 2021, in which Dr. Wilkinsreferenced a “May 6, 2020” malfunctioning of a steel security 

gate and diagnosed cervical spine ligaments sprain; injury of muscle, fascia, and tendon of the 

lower back; and lumbar radiculopathy. In an August 14, 2021 report, Dr. Wilkins diagnosed 

cervical spine ligaments sprain; injury of muscle, fascia, and tendon of the lower back; lumbar 

 

9

J.A., Docket No. 18-1586 (issued April9, 2019); Lillian M. Jones, 34 ECAB 379, 381 (1982).

 10 Id.

11 See T.T., Docket No. 18-1054 (issued April8, 2020); Y.D., Docket No. 16-1896 (issued February 10, 2017).
6

radiculopathy; and injury of right rotator cuff muscle or tendon. In a July 17, 2020 report,

Dr. Baruch discussed the May 5, 2020 employment incident and diagnosed lumbago, cervicalgia, 

lumbar pain, and cervical pain. In a May 10, 2021 report, Dr. Thomas referenced the May 5, 2020 

employment incident and diagnosed lumbar radiculopathy and low back pain.

The Board finds that these reports are of no probative value regarding appellant’s 

expansion claim. Although some of the reports reference the accepted May 5, 2020 employment 

incident and contain diagnosesthat have not been accepted by OWCP, the reports do not contain 

an opinion that the conditions are causally related to the accepted employment incident. The Board 

has held that medical evidence which does not offer an opinion regarding the cause of an 

employee’s condition is of no probative value on the issue of causal relationship.

12

 Therefore, 

these reports are insufficient to establish appellant’s claim.

As appellant has not submitted rationalized medical evidence establishing causal relationship

between his claimed additional work-related conditions and the accepted May 5, 2020 employment 

injury, he has not met his burden of proof regarding his expansion claim.

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 expand the acceptance of 

his claim to include additional conditions causally related to the accepted May 5, 2020 

employment injury.

12 See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).
7

ORDER

IT IS HEREBY ORDERED THAT the October 8, 2021 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: September 26, 2022

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board