United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.B., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Park Place, TX, Employer

__________________________________________

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Docket No. 20-1602

Issued: May 26, 2021

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

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On September 8, 2020 appellant filed a timely appeal from March 20 and August 17, 2020

merit decisions 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 his burden of proof to establish a left inguinal hernia 

condition causally related to the accepted September 19, 2019 employment incident.

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following the August 17, 2020 decision, appellant submitted additional evidence to OWCP. 

However, the Board’s Rules of Procedure 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. Id.
2

FACTUAL HISTORY

On September 23, 2019 appellant, then a 59-year-old automotive technician, filed a 

traumatic injury claim (Form CA-1) alleging that on September 19, 2019 when pushing a truck 

out of a stall he felt pain in the lower left abdomen while in the performance of duty. He stopped 

work on September 23, 2019 and worked intermittently thereafter.

On September 20, 2019 appellant was treated by Dr. Mitzi T. Jimenez, a Board-certified 

family practitioner, who diagnosed left inguinal hernia and referred him to a surgeon. In a work 

status note of even date she released appellant to light duty. On October 11, 2019 Dr. Jimenez 

indicated that appellant was unable to work because he could not lift any weight.

In a narrative statement dated September 23, 2019, appellant related that on September 19, 

2019 he was pushing a long life vehicle (LLV) when he felt pain in his lower abdomen and later 

developed a bump in that area. He sought medical care and was diagnosed with an inguinal hernia. 

In an October 7, 2019 development letter, OWCP informed appellant of the deficiencies of 

his claim. It advised him of the medical evidence necessary to establish a claim and attached a 

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

evidence.

In an October 17, 2019 response to OWCP’s development letter, appellant reported that on 

September 19, 2019 he was assisting a coworker, S.C., pushing an LLV out of a stall when he lost 

his footing, felt abdomen pain, and fell on his left knee. He indicated that he did not sustain any 

other injury between the date of the injury and the date first reported. Appellant’s pain increased 

over time and he felt a bump in his lower left groin area and sought treatment from Dr. Jimenez. 

In a witness statement dated October 17, 2019, S.C. reported that on September 19, 2019 

appellant assisted him in pushing a vehicle out of his bay when he fell onto one knee.

OWCP subsequently received a duty status report (Form CA-17) from Dr. Jorge Guerrero, 

a Board-certified family practitioner, dated October 31, 2019, who noted clinical findings of tender 

left inguinal hernia and checked a box marked “Yes” that the diagnosis was due to injury. 

Dr. Guerrero noted that appellant was unable to return to work.

By decision dated November 15, 2019, OWCP denied appellant’s traumatic injury claim 

finding that the medical evidence submitted was insufficient to establish causal relationship 

between his diagnosed condition and the accepted September 19, 2019 employment incident. 

In excuse notes for work/school dated October 31 and November 29, 2019, Dr. Guerrero 

treated appellant and indicated that surgery was pending and it was unknown when he would be 

returning to work. In a November 29, 2019 follow-up visit, he related that on September 19, 2019 

appellant was pushing the bumper of an automobile and felt a pop in the left inguinal area and 

subsequently noticed a large bulge. Appellant was examined on October 31, 2019 and diagnosed 

with large left inguinal bulging mass, a widened left inguinal canal, and traumatic hernia. Physical 

examination was unchanged and he was referred for an inguinal evaluation for possible hernia 

repair. 
3

On December 2, 2019 appellant requested an oral hearing before a representative of

OWCP’s Branch of Hearings and Review regarding the decision dated November 15, 2019. The 

hearing was held on February 11, 2020. 

In a January 27, 2020 report, Dr. Paul E. Kobza, an osteopath, treated appellant for an 

injury sustained at work when he was pushing a car and felt severe pain and a pulling sensation in 

his groin. Examination revealed tenderness over the left groin and testicle, forced Valsalva 

maneuver displayed positive hernia wave present on the left, and digital palpation of the left 

epididymal areas were positive for pain. Dr. Kobza diagnosed left unilateral inguinal hernia 

without obstruction or gangrene. He recommended left inguinal hernia repair with mesh 

reinforcement. In physician’s preoperative orders, Dr. Kobza diagnosed left inguinal hernia. In 

accompanying Form CA-17 reports dated January 27 and March 2, 2020, he noted the diagnoses 

due to injury was left inguinal hernia and advised that appellant could return to work with 

restrictions on January 28, 2020. In notes dated January 27 and March 2, 2020, Dr. Kobza

determined that appellant was incapacitated from doing his regular work duties and would have a 

10-pound lifting restriction until surgery.

By decision dated March 20, 2020, the hearing representative affirmed the decision dated 

November 15, 2019. 

OWCP subsequently received medical evidence previously of record. In a December 30, 

2019 note, Dr. Guerrero related a history of the September 19, 2019 work incident and diagnosed 

large left inguinal bulging mass, a widened left inguinal canal, and traumatic hernia. Physical 

examination was unchanged and he referred appellant for an inguinal evaluation for possible hernia 

repair. In a Form CA-17 dated January 2, 2020, Dr. Guerrero noted clinical findings of a tender 

left inguinal hernia and noted affirmatively “Yes” that the diagnosis was due to injury. He noted 

that appellant was unable to return to work. 

On March 2, 2020 Dr. Kobza treated appellant for a left inguinal hernia that developed 

after pushing a car at work. Examination revealed tenderness over the left groin and testicle, forced 

Valsalva maneuver displayed positive hernia wave present on the left, and digital palpation of the 

left epididymal areas was positive for pain. Dr. Kobza diagnosed left unilateral inguinal hernia 

without obstruction or gangrene and recommended a left inguinal hernia repair. He evaluated 

appellant again on April 6 and May 7, 2020 and appellant reported no change in his symptoms. 

Dr. Kobza reported that appellant was injured at work after pushing a car with the brakes engaged. 

He diagnosed left inguinal. In a July 9, 2020 report, Dr. Kobza noted tenderness to palpation over 

the left testicle, forced Valsalva maneuver revealed positive hernia wave present on the left, and 

pain with palpation of the left epididymal area. He diagnosed left inguinal hernia and advised that 

appellant was awaiting authorization for surgery. Dr. Kobza returned appellant to light duty. Form 

CA-17 reports from Dr. Kobza dated April 6 and May 7, 2020 noted clinical findings and diagnosis 

of left inguinal hernia due to injury. Similarly, a Form CA-17 report dated August 10, 2020 noted 

clinical findings of left inguinal hernia and advised that appellant could not work. In notes dated 

May 7 and August 10, 2020, Dr. Kobza opined that appellant was incapacitated from performing

his regular work duties and would have a 10-pound lifting restriction until surgery. 

On May 19, 2020 appellant requested reconsideration.
4

By decision dated August 17, 2020, OWCP denied modification of the prior decision dated 

March 20, 2020.

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, it first must be determined whether fact of injury has been established. 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. Second, the employee must 

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

The medical evidence required to establish a causal relationship is 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 

specific employment incident identified by the employee.9

ANALYSIS

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

hernia condition causally related to the accepted September 19, 2019 employment incident.

 

3 Supra note 1.

4 F.H., Docket No. 18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April 26, 2019); Joe D. 

Cameron, 41 ECAB 153 (1989).

5 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).

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

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

7 T.J., Docket No. 19-0461 (issued August 11, 2020); K.L., Docket No. 18-1029 (issued January 9, 2019); John J. 

Carlone, 41 ECAB 354 (1989).

8 S.S., Docket No. 19-0688 (issued January 24, 2020); A.M., Docket No. 18-1748 (issued April 24, 2019); Robert G. 

Morris, 48 ECAB 238 (1996).

9 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

In reports dated January 27 and March 2, 2020, Dr. Kobza treated appellant for an injury 

sustained at work when he was pushing a car and felt severe pain and a pulling sensation in his 

groin. He diagnosed left unilateral inguinal hernia without obstruction or gangrene and 

recommended surgery. Dr. Kobza evaluated appellant again on April 6 and May 7, 2020 and 

diagnosed left inguinal hernia. He reported that appellant was injured at work after straining while 

pushing a car with the brakes engaged. While Dr. Kobza provided affirmative opinions, which 

supported causal relationship, he did not offer a rationalized medical explanation in any of these 

reports to support his opinion. Medical evidence that provides a conclusion, but does not offer a 

rationalized medical explanation regarding the cause of an employee’s condition is of limited 

probative value on the issue of causal relationship.10

In Form CA-17 reports dated January 27, March 2, April 6, and May 7, 2020, Dr. Kobza 

noted clinical findings of left inguinal hernia and indicated that the left inguinal hernia was due to 

injury. In a Form CA-17 dated August 10, 2020, he noted clinical findings of left inguinal hernia 

and indicated that appellant could not return to work. However, Dr. Kobza did not specifically 

relate the diagnosed conditions to the accepted September 19, 2019 employment incident. As 

noted above, the Board has held that medical evidence that does not offer an opinion regarding the 

cause of a diagnosed condition is of no probative value on the issue of causal relationship.11 

Therefore, the Board finds that these reports are insufficient to establish appellant’s burden of 

proof.

In notes dated January 27, March 2, May 7, and August 10, 2020, Dr. Kobza opined that 

appellant was incapacitated from doing his regular work duties and would have a 10-pound lifting 

restriction until surgery. Similarly, in a July 9, 2020 report, he diagnosed left inguinal hernia and 

advised that appellant was awaiting authorization for surgery and could return to light duty. As 

these notes do not address causation, they are of no probative value and insufficient to meet 

appellant’s burden of proof.12

Reports from Dr. Guerrero dated November 29 and December 30, 2019 related that on 

September 19, 2019 appellant was pushing the bumper of an automobile and felt a pop in the left 

inguinal area and subsequently noticed a large bulge. Appellant was examined on October 31, 

2019 and diagnosed with large left inguinal bulging mass, a widened left inguinal canal, and 

traumatic hernia. The Board has held that the mere fact that symptoms arise during a period of 

employment or produce symptoms revelatory of an underlying condition does not establish a 

causal relationship between a diagnosed condition and employment factors.13 A medical opinion 

 

10 C.V., Docket No. 18-1106 (issued March 20, 2019); M.E., Docket No. 18-0330 (issued September 14, 2018); 

A.D., 58 ECAB 149 (2006).

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

12 See id. 

13 A.S., Docket No. 19-1955 (issued April 9, 2020).
6

must provide an explanation of how the specific employment incident or employment factors 

physiologically caused or aggravated the diagnosed conditions.14

In Form CA-17 reports dated October 31, 2019 and January 2, 2020, Dr. Guerrero noted 

clinical findings of left inguinal hernia and indicated that appellant was unable to return to work. 

In response to a question as to whether the diagnoses was due to injury, he responded affirmatively 

noting “Yes,” without further comment. The Board has held that when a physician’s opinion on 

causal relationship consists only of noting “Yes” to a form question, without explanation or 

rationale, that opinion is of limited probative value regarding causal relationship.15

In excuses for work/school dated October 31 and November 29, 2019, Dr. Guerrero treated 

appellant and indicated that surgery was pending and it was unknown when he would be returning 

to work. As these notes do not address causation, they are of no probative value and insufficient 

to meet appellant’s burden of proof.16

In a September 20, 2019 report, Dr. Jimenez diagnosed left inguinal hernia and referred 

appellant to a surgeon. In a work status note of even date, he released appellant to light duty. On 

October 11, 2019 he indicated that appellant was unable to work because he could not lift any 

weight. The Board has held that medical reports are of no probative value if they do not provide 

an opinion regarding the cause of the employee’s condition or disability.17

As appellant has not submitted rationalized medical evidence sufficient to establish that his 

diagnosed medical condition was caused or aggravated by the accepted September 19, 2019 

employment incident, the Board finds that he has not met his burden of proof.18

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 establish a left inguinal 

hernia condition causally related to the accepted September 19, 2019 employment incident.

 

14 G.L., Docket No. 18-1057 (issued April 14, 2020).

15 M.G., Docket No. 18-1616 (issued April 9, 2020); Sedi L. Graham, 57 ECAB 494 (2006); D.D., 57 ECAB 

734 (2006).

16 See supra note 13.

17 Id.

18 See T.J., Docket No. 19-1339 (issued March 4, 2020); F.D., Docket No. 19-0932 (issued October 3, 2019); D.N.,

Docket No. 19-0070 (issued May 10, 2019); R.B., Docket No. 18-1327 (issued December 31, 2018).
7

ORDER

IT IS HEREBY ORDERED THAT the August 17 and March 20, 2020 decisions of the 

Office of Workers’ Compensation Programs are affirmed.

Issued: May 26, 2021

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board