United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

E.C., Appellant

and

U.S. POSTAL SERVICE, BUSHWICK 

STATION, Brooklyn, NY, Employer

__________________________________________

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Docket No. 22-0604

Issued: September 30, 2022

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On March 18, 2022 appellant, through counsel, filed a timely appeal from a January 25, 

2022 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 lumbar or bilateral 

hand conditions causally related to the accepted June 8, 2021 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 June 9, 2021 appellant, then a 43-year-old city carrier, filed a traumatic injury claim 

(Form CA-1) alleging that on that day she injured her lower back and experienced right and left 

hand pain and cramping and could not move after she bent down to pick up a bucket of flats while 

in the performance of duty. On the reverse side of the claim form, D.M., a supervisor, controverted 

appellant’s claim, contending that she did not use proper lifting techniques. She noted that 

appellant’s legs were straight, and she did not bend over. D.M. indicated that appellant stopped 

work on the date of injury and has not returned. 

In an accompanying letter dated June 9, 2021, appellant related that she had cased 10 

bundles of books as instructed by a supervisor and when she bent down to pick up a heavy bucket 

her back went out and she dropped the bucket and screamed. She noted that she asked a coworker

to call for an ambulance because she was unable to move or stand up straight. Appellant further 

noted that another supervisor called for an ambulance and when it arrived, she was placed into a 

wheelchair and escorted out of the office by emergency medical service personnel.

Appellant was treated on June 8, 2021 by Dr. Shannon Pickup, Board-certified emergency 

medicine specialist, who provided an impression of lower back and hand pain.

OWCP subsequently received additional medical evidence. In letters dated June 10 and

July 1, 2021, Dr. Marc Cohen, an attending pain medicine specialist, opined that appellant was 

disabled and unable to return to work from June 10 to July 15, 2021.

In a development letter dated July 16, 2021, OWCP advised appellant of the deficiencies 

in her claim. It requested that appellant submit additional factual and medical evidence and 

provided a questionnaire for her completion. In a separate development letter of even date, it

requested that the employing establishment provide additional information, including a statement

from an official superior regarding its safety regulation for lifting techniques, enforcement of the 

regulation, and what disciplinary action was taken against employees for violation of the 

regulation, and witness statements from employees addressing the circumstances of the claimed 

injury and their knowledge of the lifting regulation. OWCPafforded both parties30 days to submit 

the necessary evidence.

OWCP subsequently received additional medical evidence from Dr. Cohen. In a July 13, 

2021 duty status report (Form CA-17), Dr. Cohen noted that appellant related a history of an injury 

to her back on June 8, 2021, indicating that her back gave out and she could not move. He 

diagnosed lumbar radiculopathy due to injury. Dr. Cohen advised that appellant could not return 

to work and listed her work restrictions.

In a July 15, 2021 letter, Dr. Cohen advised that appellant was disabled and unable to return 

to work from July 15 through September 15, 2021.

OWCP also received an additional Form CA-17 dated July 16, 2021 from Dr. Cohen in 

which he noted that appellant was examined on July 15, 2021, and reiterated appellant’s history of 

injury on June 8, 2021, his prior diagnosis of lumbar radiculopathy due to injury, and opinion that 

appellant could not return to work.
3

By letter dated August 3, 2021, the employing establishment responded to OWCP’s 

development letter. It provided e-mails dated July 30, 2021 and undated statements from D.M. 

who indicated that she witnessed appellantfailing to use proper lifting techniques on June 8, 2021. 

D.M. noted that appellant stood with her knees straight as she bent to lift a half-full bucket. She

also noted that she did not ask for assistance. D.M. related that every new employee received

training on proper lifting techniques. She submitted a document which outlined proper lifting 

techniques for all postal employees. 

On August 10, 2021 appellant responded to OWCP’s development letter. She noted the 

dates she received medical treatment and her diagnosis of lumbar radiculopathy.

OWCP, by decision dated September 3, 2021, accepted that the June 8, 2021 employment 

incident occurred as alleged, but denied appellant’s claim, finding that she had not provided 

rationalized medical evidence supporting causal relationship between her accepted employment 

incident and her diagnosed medical conditions.

On September 25, 2021 appellant requested reconsideration.

Thereafter, OWCP received reports dated June 30 and July 28, 2021 from Dr. Raz 

Winiarsky, a Board-certified orthopedic surgeon. Dr. Winiarsky, noted a history of the accepted 

June 8, 2021 employment incident and appellant’s complaint of left hand pain. He discussed 

examination findings and provided an assessment of left upper limb carpal tunnel syndrome (CTS).

Dr. Winiarsky found that appellant’s injuries, current disability from work, and need for treatment 

were causally related to the accepted employment incident.

OWCP also received medical evidence from Dr. Steven Horowitz, a Board-certified 

physiatrist and an interventional pain management specialist. In reports dated August 17 and 

September 15, 2021, Dr. Horowitz noted a history of the accepted June 8, 2021 employment 

history and appellant’s complaint of low back pain. He provided examination findings and 

diagnosed low back pain, lumbar radiculopathy, and lumbar spondylolisthesis without myelopathy 

or radiculopathy. Dr. Horowitz opined that appellant’s injuries, current disability from work, and 

need for treatment were causally related to the accepted employment incident.

In a September 15, 2021 letter, Dr. Horowitz continued to note that appellant was disabled 

and unable to return to work. He indicated that she was unable to work from September 15 to 

October 26, 2021.

Dr. Michael Horowitz, a Board-certified general and hand surgeon, in an August 18, 2021 

report, related a history of the June 8, 2021 employment incident. He noted appellant’s complaint 

of left-hand numbness and tingling. Dr. Horowitz reported examination findings and provided 

assessments of CTS, bilateral upper limbs. Based on appellant’s history and the development of 

her worsening symptoms and progression of her symptoms during her work activities, he 

concluded that these symptoms were directly causally related to her employment at the employing 

establishment. 

A September 1, 2021 lumbar spine magnetic resonance imaging (MRI) scan report from

Dr. Michael Greene, a Board-certified diagnostic radiologist, provided an impression of a posterior 

central focal herniation causing impingement upon the anterior thecal sac and left neural foramen

at the L4-L5 level and contact with the anterior bilateral L5 nerve roots. Dr. Greene also provided 
4

an impression of a posterior central focal herniation causing impingement upon the anterior thecal 

sac and bilateral neural foramina at the L5-S1 level and contact with the anterior bilateral S1 nerve 

roots.

By decision dated October 15, 2021, OWCP denied modification of the September 25, 

2021 decision. 

On October 26, 2021 appellant requested reconsideration. In support of her request, she

submitted an October 26, 2021 medical report from Dr. Steven Horowitz in which he reiterated 

his prior diagnoses of low back pain, lumbar radiculopathy, and lumbar spondylolisthesis without 

myelopathy or radiculopathy and his opinion on causal relationship.

OWCP, by decision date January 25, 2022, denied modification of the October 15, 2021 

decision.

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. There 

are two components involved in establishing fact of injury. The first component is that the 

employee must submit sufficient evidence to establish that he or she 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.7

3

Id.

4 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).

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); 

DeloresC. Ellyett, 41 ECAB 992 (1990).

7 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). 
5

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

condition and an employment incident 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 factors 

identified by the employee.9

ANALYSIS

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

bilateral hand conditions causally related to the accepted June 8, 2021 employment incident.

In support of her claim, appellant submitted Dr. Pickup’s June 8, 2021 report in which she 

provided an impression of lower back and hand pain. The Board has held that pain is a symptom 

and not a compensable medical diagnosis.10 For this reason, Dr. Pickup’s report is insufficient to 

establish appellant’s claim. 

Appellant also submitted reports dated June 30 and July 28, 2021 from Dr. Winiarsky. 

Dr. Winiarsky provided an assessment of left upper limb CTS. He opined that appellant’s 

condition, current disability from work, and need for treatment were causally related to the June 8, 

2021 employment incident. While Dr. Winiarsky provided an affirmative opinion suggestive of 

causal relationship, he failed to provide medical rationale explaining the basis of his opinion. 

Without explaining, physiologically, how the specific employment incident or employment factors 

caused or aggravated the diagnosed condition, Dr. Winiarsky’s opinion on causal relationship is 

of limited probative value and insufficient to establish appellant’s claim.11

In his July 13 and 16, 2021 CA-17 form reports, Dr. Cohen diagnosed lumbar 

radiculopathy due to the June 8, 2021 employment incident and found that appellant was totally 

disabled from work, but did not explain how the accepted employment incident ph ysiologically 

caused appellant’s diagnosed condition and disability.12 Dr. Cohen’s remaining June 10 and July 1 

and 15, 2021 reports found that appellant was totally disabled from work for the period June 10 

through September 15, 2021, but do not address the issue of causal relationship. The Board has 

held that medical evidence that does not offer an opinion regarding the cause of an employee’s 

8

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).

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).

10 See B.T., Docket No. 22-0022 (issued May 23, 2022); S.L., Docket No. 19-1536 (issued June 26, 2020); D.Y., 

Docket No. 20-0112 (issued June 25, 2020).

11 See B.T., id.; J.G., Docket No. 21-1334 (issued May 18, 2022); C.W., Docket No. 21-1204 (issued March 11, 

2022); A.W., Docket No. 19-0327 (issued July 19, 2019); M.D., Docket No. 18-0195 (issued September 13, 2018); 

Jimmie H. Duckett, 52 ECAB 332 (2001).

12 Id.
6

condition is of no probative value on the issue of causal relationship. 13 For these reasons, the 

Board finds that Dr. Cohen’s reports are insufficient to establish appellant’s claim.

Similarly, Dr. Steven Horowitz, in his August 17, September 15, and October 26, 2021 

reports, diagnosed low back pain, lumbar radiculopathy, and lumbar spondylolisthesis without 

myelopathy or radiculopathy, and opined that appellant’s diagnosed conditions, continued

disability from work, and need for further treatment were causally related to the June 8, 2021 

employment incident. However, he failed to offermedical rationale explaining how bending down 

to pick up a heavy bucket of flats either caused or aggravated appellant’s diagnosed conditions. 

As previously noted, a medical opinion should offer a medically-sound explanation of how the 

specific employment incident physiologically caused the diagnosed condition. 14 Dr. Horowitz’

remaining September 15, 2021 report found that appellant was totally disabled from work for the 

period September 15 through October 26, 2021. However, his report did not contain a history of 

injury, a medical diagnosis, or an opinion regarding causal relationship. As this report does not 

offer an opinion regarding the cause of an employee’s condition it is of no probative value.15 For 

these reasons, the Board finds that Dr. Horowitz’ reports are insufficient to establish appellant’s 

claim.

Dr. Michael Horowitz, in an August 18, 2021 report, opined that appellant’s bilateral upper 

limb CTS was directly causally related to her employment. Although he indicated that appellant’s 

bilateral CTS was work related, he failed to provide medical rationale explaining how the June 8, 

2021 employment incident physiologically caused the diagnosed condition. As such, the Board 

finds that Dr. Horowitz’ opinion on causal relationship is of limited probative value and 

insufficient to establish appellant’s claim.16

Appellant submitted Dr. Greene’s September 1, 2021 lumbar spine MRI scan report. The 

Board has held that diagnostic studies, standing alone, are of limited probative value as they do 

not address whether the employment incident caused any of the diagnosed conditions. 17

As appellant has not submitted rationalized medical evidence to establish lumbar or 

bilateral hand conditions causally related to the accepted June 8, 2021 employment incident, the 

Board finds that she has not met her burden of proof.

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.

13 J.H., Docket No. 20-1414 (issued April5, 2022); S.W., Docket No. 19-1579 (issued October 9, 2020); L.B., 

Docket No. 18-0533 (issued August27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

14 Id.

15 Id.

16 See supra note 10.

17 J.G., Docket No. 21-1334 (issued May 18, 2022); J.P.,Docket No. 19-0216 (issued December 13, 2019); A.B.,

Docket No. 17-0301 (issued May 19, 2017).
7

CONCLUSION

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

bilateral hand conditions causally related to the accepted June 8, 2021 employment incident.

ORDER

IT IS HEREBY ORDERED THAT the January 25, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: September 30, 2022

Washington, DC

Alec J. Koromilas, 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