United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

M.M., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Jackson, MS, Employer

__________________________________________

)

)

)

)

)

)

)

)

Docket No. 20-1649

Issued: January 4, 2023

Appearances: Case Submitted on the Record

Bob Waller, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On September 21, 2020 appellant, through counsel, filed a timely appeal from an April 21, 

2020 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.

ISSUE

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

causally related to the accepted August 13, 2018 employment incident.

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

FACTUAL HISTORY

On September 21, 2018 appellant, then a 56-year-old clerk, filed a traumatic injury claim 

(Form CA-1) alleging that on August 13, 20183 she experienced pain in her lower back, radiating

down her left leg after picking up sacks of mail to move from the floor to a table. She stopped 

work on August 31, 2018 and returned to work on September 18, 2018. 

In a September 28, 2018 development letter, OWCP informed appellant of the deficiencies

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

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

days to submit the necessary evidence. 

In medical reports dated September 28 to October 5, 2018, Dr. Charles Mobley, a 

chiropractor, related that on August 31, 2018 appellantinjured her back whenlifting a sack of mail 

at work and described the symptoms that followed. On evaluation, Dr. Mobley diagnosed 

segmental and somatic dysfunction of the lumbar region, segmental and somatic dysfunction of 

the pelvic region, a muscle strain of the fascia and tendon of the lower back, unspecified neuralgia 

and neuritis, as well as myalgia. In his October 1, 2018 medical report and an attached medical 

note, he advised that appellant was unable to return to work at the time. In his October 5, 2018 

report, Dr. Mobley observed that she actually injured her back on August 13, 2018, but used 

August 31, 2018 on her report as it was the date the report was filled out. He suggested that 

appellant see him two times a week for treatment of her conditions. 

In an October 5, 2018 attending physician’s report (Form CA-20), Dr. Mobley related 

appellant’s history of injury and diagnosed a lumbosacral strain. He checked a box marked “Yes”

to indicate his opinion that her condition was caused or aggravated by her federal employment and 

made suggestions concerning the treatment for her condition. 

In response to OWCP’s development questionnaire, appellant submitted an October 9, 

2018 statement wherein she provided further details regarding the alleged employment incident. 

She explained that the sacks of mail that she lifted that day weighed between 60 and 70 pounds 

and she identified the coworkers who she spoke to regarding her injury. Appellant stated that she 

had no previous injuries or prior symptoms related to her low back pain and also detailed her 

history of treatment and provided notes from Dr. Mobley’s September 28, 2018 medical 

evaluation. 

In a report dated October 9, 2018, appellant informed Dr. Mobley that she was still 

experiencing mild pain in her back and left thigh. Dr. Mobley detailed his treatment of her back 

symptoms and advised that she remain off work. 

In duty status reports (Form CA-17) dated October 9 and 11, 2018, Dr. Mobley diagnosed 

a lumbosacral sprain/strain and identified August 31, 2018 as the date of injury. He also provided 

work restrictions. 

3 Appellant’s claim form noted August 31, 2018 as the date of injury; however, the record indicates that August 13, 

2018 is the correct date of injury.
3

In an October 12, 2018 medical report, appellant informed Dr. Mobley that she was now 

experiencing pain in her right buttocks rather than her left. Dr. Mobley stated that there may be 

some lumbar disc involvement and recommended that she perform no bending or lifting. 

In an October 15, 2018 medical report, Dr. Michael Patterson, a Board-certified orthopedic 

surgeon, evaluated appellant for a lifting injury she experienced at work when she was lifting bags 

of mail from the floor to a counter. On review of an x-ray of her lumbar spine, he diagnosed low 

back pain, mechanical back pain, and bilateral leg pain. Dr. Patterson recommended that appellant 

undergo a magnetic resonance imaging (MRI) scan for further evaluation. In a medical note of 

even date, he advised that she was unable to work. 

By decision dated November 2, 2018, OWCP denied appellant’s traumatic injury claim, 

finding that the medical evidence of record was insufficient to establish a diagnosis in connection 

with the accepted employment incident. It concluded, therefore, that the requirements had not 

been met to establish an injury as defined under FECA. 

On November 26, 2018 appellant requested reconsideration of OWCP’s November 2, 2018 

decision. 

In a November 16, 2018 diagnostic report, Dr. Ashwin Prabhu, Board-certified in internal 

medicine, conducted an MRI scan of appellant’s lumbar spine, finding mild degenerative changes, 

predominantly characterized by facet atrophy as well as a tiny left foraminal disc extrusion at L2-3. 

In a November 20, 2018 medical note, Dr. Patterson provided an addendum to his previous 

report, stating that the MRI scan of appellant’s lumbar spine showed no evidence of a tumor or 

infection and no areas of severe compression of the neurological structures. 

By decision dated January 23, 2019, OWCP affirmed its November 2, 2018 decision. 

On April 30, 2019 appellant requested reconsideration of OWCP’s January 23, 2019 

decision. 

By decision dated May 14, 2019, OWCP denied appellant’s request for reconsideration of 

the merits of her claim. 

On August 27, 2019 appellant, through counsel, requested reconsideration of OWCP’s 

January 23, 2019 decision. 

OWCP subsequently received an August 20, 2018 report, wherein Susan Sullivan, a 

registered nurse, noted that appellant visited the emergency department with complaints of back 

pain. Ms. Sullivan related that appellant’s symptoms began a week prior when she picked up 

something heavy at work. In a diagnostic report of even date, Dr. Richard Hosch, a diagnostic 

radiologist, performed an x-ray of appellant’s lumbar spine, observing no acute radiographic 

abnormality of the lumbar spine. 

On November 26, 2018 Dr. Patterson referred appellant to physical therapy for treatment 

of her intervertebral disc disorder with radiculopathy. In a report of even date, Jack Douglas, a 

physical therapist, provided a plan of care for her physical therapy treatment. 
4

In a December 28, 2018 diagnostic report, Dr. Price Halford, a Board-certified radiologist, 

performed an x-ray scan of appellant’s right shoulder, finding degenerative change in the right 

acromioclavicular joint. In a separate diagnostic report of even date, he performed an x-ray of her 

cervical spine, noting mild lower cervical spondylosis with no evidence of instability. 

Appellant submitted physical therapy notes dated November 26, 2018 through January 4, 

2019 in which Mr. Douglas detailed his treatment related to her lumbar condition. 

In a January 10, 2019 medical report, Clif Davis, a physician assistant, evaluated appellant 

for low back pain and observed diagnoses of lumbar region other intervertebral disc degeneration 

and cervical region radiculopathy. He advised that she could return to full-duty work on 

January 14, 2019. 

In an April 16, 2019 medical report, Dr. Bradley Hall, a Board-certified neurosurgeon, 

diagnosed chronic left-sided low back pain without sciatica, lumbar spondylosis, lumbar 

degenerative disc disease, lumbar radiculopathy, and lumbar disc displacement without 

myelopathy. Appellant informed him of her August 2018 employment injury in which she 

experienced left-sided back pain after lifting heavy boxes and that she was subsequently held out 

of work from September 2018 to January 2019. 

In a May 21, 2019 medical report, Dr. Barbara Barnard, Board-certified in physical 

medicine and rehabilitation, evaluated appellant for worsening back pain she first experienced at

work during August 2018 while lifting a sack. She noted diagnoses of lumbar degenerative disc 

disease, a lumbar herniated nucleus pulposus, and lumbar radicular pain. In a subsequent June 5, 

2019 medical report, Dr. Barnard noted that she administered an epidural steroid injection to treat 

appellant’s symptoms related to appellant’s lumbar conditions. 

In a June 6, 2019 note, Tammy Stringer, a medical assistant, related that appellant 

experienced 80 percent pain relief following her injection. 

In a June 25, 2019 medical report, Dr. Barnard related appellant’s complaint that she still 

experienced pain and that squatting and bending at work worsened her pain. She diagnosed lumbar 

degenerative disc disease, a lumbar herniated nucleus pulposus, and lumbar radicular pain. 

In a September 24, 2019 medical report, Dr. Barnard observed that appellant was still 

experiencing pain in her back. She diagnosed lumbar degenerative disc disease, lumbar herniated 

nucleus pulposus, lumbar radicular pain, and weakness of both lower extremities. Dr. Barnard

advised that appellant undergo an MRI scan and a left lumbar medial branch block procedure. 

On October 2, 2019 Dr. Barnard performed a lumbar medial branch nerve block procedure 

in order to treat appellant’s diagnosed lumbar degenerative disc disease, lumbar radicular pain,

and lumbar spondylosis without myelopathy. 

In an October 10, 2019 diagnostic report, Dr. Richard McCarthy, a Board-certified 

radiologist, performed an x-ray scan of appellant’s lumbar spine, finding degenerative changes,

and osteoporosis. 

On October 23, 2019 Dr. Barnard performed a L2, L3, L4, and L5 medial branch 

radiofrequency ablations to treat appellant’s lumbar spondylosis without myelopathy. 
5

By decision dated November 22, 2019, OWCP modified its January 23, 2019 decision to 

find that appellant met her burden of proof to establish the diagnosed condition of mild lumbar 

degenerative disc disease in connection with the accepted August 31, 2018 employment incident. 

The claim remained denied, however, because the medical evidence of record was insufficient to 

establish causal relationship between her diagnosed lumbar condition and the accepted August 13, 

2018 employment incident. 

On January 30, 2020 appellant, through counsel, requested reconsideration of OWCP’s 

November 22, 2019 decision. 

In a December 31, 2019 medical report, appellant informed Dr. Barnard that she was 

experiencing 80 to 90 percent relief from her back pain. Dr. Barnard recounted the history of the 

August 13, 2018 employment incident and diagnosed a lumbar herniated nucleus pulposus and 

lumbar spondylosis. She also observed that appellant was still experiencing difficulties at work 

related to her conditions. 

By decision dated April 21, 2020, OWCP affirmed its November 22, 2019 decision. 

LEGAL PRECEDENT

An employee seeking benefits under FECA 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 period 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 it must first be determined whether fact of injury has been established. 7 First, 

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

employment incident at the time, place, and in the manner alleged.8 Second, the employee must 

submit sufficient evidence to establish that the employment incident caused a personal injury. 9

4

S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989).

5

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

ECAB 312 (1988).

6 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); 

DeloresC. Ellyett, 41 ECAB 992 (1990).

7 D.B., Docket No. 18-1348 (issued January 4, 2019); T.H., 59 ECAB 388, 393-94 (2008).

8 D.S., Docket No. 17-1422 (issued November 9, 2017); Elaine Pendleton, 40 ECAB 1143 (1989).

9 B.M., Docket No. 17-0796 (issued July 5, 2018); JohnJ. Carlone, 41 ECAB 354 (1989).
6

To establish causal relationship between the condition, as well as any attendant disability 

claimed and the employment event or incident, the employee must submit rationalized medical 

opinion evidence sufficient to establish such causal relationship. 10 The opinion of the physician 

must be based on a complete factual and medical background, 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. 11 

ANALYSIS

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

condition causally related to the accepted August 13, 2018 employment incident.

In his October 15, 2018 medical report, Dr. Patterson observed that appellant sustained an

injury at work when she was lifting bags of mail from the floor to a counter. On examination, he 

diagnosed low back pain, mechanical back pain, and bilateral leg pain. The Board has held that 

medical evidence that 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 Dr. Patterson’s report, therefore, is 

insufficient to establish appellant’s claim.

Dr. Patterson’s remaining medical evidence consisted of a November 20, 2018 addendum 

in which he provided that an MRI scan of appellant’s lumbar spine revealed no evidence of a tumor 

or infection and no areas of severe compression of the neurological structures. As noted above, 

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

employee’s condition is of no probative value on the issue of causal relationship.13 For this reason,

Dr. Patterson’s remaining medical evidence is insufficient to meet appellant’s burden of proof.

Similarly, in medical reports dated from May 21 to December 31, 2019, Dr. Barnard 

diagnosed lumbar degenerative disc disease, a lumbar herniated nucleus pulposus, and lumbar 

radicular pain. She administered an epidural steroid injection and performed a nerve block 

procedure and L2, L3, L4, and L5 medial branch radiofrequency ablation procedures on October 2 

and 23, 2018, respectively. Dr. Barnard also provided progress updates on appellant’s symptoms 

related to her lumbar conditions. As stated above, the Board has held that medical evidence that 

does not offer an opinion regarding the cause of an employee’s condition is of no probative value 

on the issue of causal relationship.14 For this reason, Dr. Barnard’s medical evidence is insufficient 

to meet appellant’s burden of proof.

In Dr. Hall’s April 16, 2019 report, he diagnosed chronic left-sided low back pain without 

sciatica, lumbar spondylosis, lumbar degenerative disc disease, lumbar radiculopathy, and lumbar 

disc displacement without myelopathy. As stated previously, medical evidence that does not offer 

10 K.V., Docket No. 18-0723 (issued November 9, 2018).

11 I.J., 59 ECAB 408 (2008).

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

13 Id. 

14 Id.
7

an opinion regarding the cause of an employee’s condition is of no probative value on the issue of 

causal relationship.15 For this reason, Dr. Hall’s April 16, 2019 medical report is insufficient to 

meet appellant’s burden of proof.

Appellant submitted a series of diagnostic reports dated from August 20, 2018 to 

October 10, 2019 from Drs. Hosch, Prabhu, Halford, and McCarthy where she underwent x-ray 

and MRI scans of her lumbar spine. The Board has held, however, that diagnostic tests, standing 

alone, lack probative value on the issue of causal relationship as they do not address the 

relationship between accepted employment factors and a diagnosed condition.16 For this reason, 

these diagnostic reports are insufficient to meet appellant’s burden of proof.

Appellant also provided medical reports dated from September 28 to October 12, 2018 

from Dr. Mobley, a chiropractor. However, this evidence does not constitute probative medical 

evidence as a chiropractor is only considered a physician for purposes of FECA if he or she 

diagnoses subluxation based upon x-ray evidence.17 As Dr. Mobley did not diagnose a spinal 

subluxation based upon x-ray evidence, he is not considered a physician as defined under FECA 

and his reports do not constitute competent medical evidence.18

The remaining medical evidence consist of reports dated from August 20, 2018 to 

January 10, 2019 signed by a nurse practitioner, physician assistant, and physical therapist. The 

Board has consistently held that certain healthcare providers such as physician assistants, 

registered nurses, physical therapists, and social workers are not considered physicians as defined 

under FECA.19 Consequently, their medical findings and/or opinions will not suffice for purposes 

of establishing entitlement to FECA benefits.20

As appellant has not submitted rationalized medical evidence establishing that her lumbar 

conditions are causally related to the accepted August 13, 2018 employment incident, the Board 

finds that she has not met her burden of proof to establish her claim.

15 Id.

16 W.M.,Docket No. 19-1853 (issued May 13, 2020); L.F., Docket No. 19-1905 (issued April10, 2020).

17 Section 8101(2) of FECA provides that the term physician include chiropractors only if the treatment consists of 

manual manipulation of the spine to correct a subluxation as demonstrated by x-ray to exist. 5 U.S.C. § 8101(2). See 

T.T., Docket No. 18-0838 (issued September 19, 2019); Thomas W. Stevens, 50 ECAB 288 (1999); GeorgeE. 

Williams, 44 ECAB 530 (1993).

18 C.S., Docket No. 19-1279 (issued December 30, 2019).

19 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t).

20 Id. at § 8101(2) of FECA provides that physician “includes surgeons, podiatrists, dentists, clinical psychologists, 

optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by State law.”

Id. at § 8101(2); 20 C.F.R. § 10.5(t). See also Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal 

Relationship, Chapter 2.805.3a(1) (January 2013). See also T.W., Docket No. 19-1412 (issued February 3, 2020); 

K.W., 59 ECAB 271, 279 (2007); David P. 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); D.H.,Docket 

No. 18-0072 (issued January 21, 2020) (physical therapists are not considered physicians under FECA).
8

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 lumbar 

condition causally related to the accepted August 13, 2018 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the April 21, 2020 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: January 4, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board