United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

W.R., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE,

Minneapolis, MN, Employer

__________________________________________

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Docket No. 21-0928

Issued: January 26, 2022

Appearances: Case Submitted on the Record

Andrew Douglas, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 2, 2021 appellant filed a timely appeal from an April 2, 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.

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 her burden of proof to establish a medical condition 

causally related to the accepted factors of her federal employment.

FACTUAL HISTORY

On December 9, 2019 appellant, then a 57-year-old rural carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on November 22, 2019 she strained her right upper back while in 

the performance of duty. She stopped work on November 26, 2019.

In a December 9, 2019 development letter, OWCP informed appellant that it had received 

no evidence in support of her claim. It advised her of the type of factual and medical evidence 

necessary and provided a questionnaire for her completion. OWCP afforded appellant 30 days to 

respond.

OWCP thereafter received various notes by Dr. Farzana Quraishi, a Board-certified family 

medicine specialist, recommending that appellant remain off work from November 26, 2019 

through January 27, 2020. Dr. Quraishi provided diagnoses of cervical radiculopathy and thoracic 

pain.

In a December 27, 2019 response to OWCP’s development questionnaire, appellant noted

that for the past few years she had been handling an increased load of heavier packages. She 

related that on November 22, 2019 she pulled and lifted large, heavy packages out of her delivery 

vehicle. The next day, appellant woke up with pain between her shoulder blades, radiating up to 

her head, across her shoulder blade, and down her right arm with numbness and tingling in her 

right hand. She noted that her job duties included lifting, pulling, and carrying large heavy 

packages, and that she had not engaged in any activity at home which would have otherwise caused 

her injury. Appellant clarified that the claimed condition was an occupational disease and not a 

traumatic injury.

By decision dated January 10, 2020, OWCP accepted that the employment factors had 

occurred as alleged, but denied the claim, finding that the evidence of record failed to establish 

that appellant’s diagnosed conditions were causally related to the accepted factors of her federal 

employment.

OWCP continued to receive evidence, including a note by an unknown healthcare provider 

recommending that appellant remain off work until April 1, 2020.

On June 24, 2020 appellant, through counsel, requested reconsideration of OWCP’s 

January 10, 2020 decision. In support of the request, she submitted various medical records 

including a December 20, 2019 report by Dr. John A. Cragg, a Board-certified orthopedic surgeon, 

who noted that she related a history of lifting at work for the past 20 years followed by development 

of sudden pain in her shoulder blades, the right side of her arm, and tingling into her right arm.

Dr. Cragg performed a physical examination and documented right intrascapular pain at T2-3, 

posterior trapezial pain, positive Spurling’s sign, and pain with axial compression. He also

reviewed x-rays and diagnosed cervical and thoracic pain suggestive of cervical disc and facet 
3

injury, possible right C6 or C7 radiculopathy, and mild thoracic outlet-type symptoms. Dr. Cragg

recommended that appellant undergo magnetic resonance imaging (MRI) scan studies, and opined 

that the conditions he diagnosed appeared to be caused by heavy lifting, pushing, pulling, and 

reaching activities at work.

A report of cervical MRI scan dated January 2, 2020 revealed a disc protrusion at C7-T1 

on the right, which was causing severe right foraminal stenosis.

In a follow-up report of even date, Dr. Cragg recommended that appellant consider an 

epidural steroid injection at C7-T1, which she declined. He opined that she was unable to return

to full-duty work and that turning her neck continually and reaching in the back seat of her postal 

vehicle for packages with her right arm caused a C7-T1 right-sided disc herniation with nerve root 

compression.

In a follow-up report dated January 21, 2020, Dr. Cragg noted that appellant continued to 

have a positive Spurling’s sign on the right with intrinsic weakness and right-sided posterior 

scapular pain. He diagnosed right C7-T1 disc herniation with right arm nerve root compression 

and indicated that the condition appeared to be work related by history. Dr. Cragg recommended 

that she remain off work through March 2, 2020 and noted that she may require surgery. In 

subsequent notes dated February 27 and March 30, 2020, he continued to recommend that 

appellant remain off work.

In a May 18, 2020 narrative letter to appellant’s counsel, Dr. Cragg reiterated appellant’s 

history of repetitive reaching and lifting at work for the past 20 years, and that her workload had 

increased over the last three years. He diagnosed C7-T1 lateral recess stenosis with disc protrusion

and indicated that she had no history of a preexisting injury or any outside activity, which would

have aggravated her neck. On that basis, Dr. Cragg opined that her diagnosed medical conditions 

were caused by driving, pushing, pulling, and lifting heavy packages at work for the past 20 years.

In a May 19, 2020 medical report, Dr. Corey Cronrath, a Board-certified occupational and 

aerospace medicine specialist, noted that appellant indicated that her job duties included sorting 

mail, loading her vehicle for two hours per day, lifting up to 70 pounds, and driving and delivering 

mail for six hours per day over a route that covers 115 miles. He also noted that she owned a bar. 

Dr. Cronrath performed a physical examination and diagnosed appellant with work-related 

cervical radiculopathy. He indicated that he relied upon medical literature, which suggested that 

manual material handling and sedentary work are associated with increased neck pain and cervical 

disc herniation, work involving sitting for more than 85 percent of the workday significantly 

increased the risk for neck pain, and that the main factor for cervical disc herniation was age, not 

physical activity. Dr. Cronrath explained that appellant was at increased risk for a cervical disc 

herniation due to her age and gender, but opined that her work duties for the past 20 years including 

reaching, lifting, pushing, pulling, prolonged sitting, frequent cervical flexion and repetitive 

motion of the arms also contributed to her cervical radiculopathy.

In a follow-up medical report dated May 26, 2020, Dr. Cragg again noted appellant’s 

history of carrying and reaching to perform her work duties for the past 20 years. He recommended 

that she remain off work until July 15, 2020, and opined that she would likely not be able to return 
4

to work in her previous job. Dr. Cragg diagnosed C7-T1 disc herniation with right-sided radicular 

pain with headaches, which he opined was work related.

By decision dated September 22, 2020, OWCPdenied modification of itsJanuary 10, 2020

decision.

OWCP continued to receive evidence. Reports of x-rays of the cervical spine dated 

November 26, 2019 revealed mild lower cervical and upper thoracic spine disc degeneration.

In follow-up visit reports dated July 13 and September 15, 2020, Dr. Cragg diagnosed C7-

T1 disc herniation, which he opined was work related. He continued to recommend that appellant 

remain off work.

On February 9, 2021 appellant, through counsel, requested reconsideration of the 

September 22, 2020 decision. In support of her request, she attached a statement indicating that 

she owns 40 acres of wild land that does not require any maintenance, and that she is the co-owner 

of a bar, but does not engage in any associated work other than making decisions, writing checks, 

and socializing with customers.

In further support of her request, appellant submitted a December 22, 2020 narrative letter 

by Dr. Cragg who reiterated that age and gender are nonwork-related risk factors for appellant’s 

diagnosed conditions, but that driving, manual material handling, frequent flexion of the cervical 

spine, and frequent use of the hands and upper extremities are also risk factors for her diagnosed 

medical conditions. Dr. Cragg opined that the work-related factors accelerated the onset of the 

cervical disc herniation with radiculopathy and cited to the medical literature mentioned in his 

May 19, 2020 report.

By decision dated April 2, 2021, OWCP denied modification of its September 22, 2020

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 

3

Id.

4 F.H., Docket No.18-0869 (issued January29, 2020); J.P., Docket No. 19-0129 (issued April26, 2019); JoeD. 

Cameron, 41 ECAB 153 (1989). 
5

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 establish that an injury was sustained in the performance of duty in an occupational 

disease claim, an employee must submit the following: (1) a factual statement identifying 

employment factors alleged to have caused or contributed to the presence or occurrence o f the 

disease or condition; (2) medical evidence establishing the presence or existence of the disease or 

condition for which compensation is claimed; and (3) medical evidence establishing that the 

diagnosed condition is causally related to the employment factors identified by the employee. 7

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.8 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factors must be based on a 

complete factual and medical background.9 Additionally, the physician’s opinion must be 

expressed in terms of a reasonable degree of medical certainty, and must be supported by medical 

rationale explaining the nature of the relationship between the diagnosed condition and appellant’s 

specific employment factors.10

ANALYSIS

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

condition causally related to the accepted factors of her federal employment.

The Board preliminarily notes that appellant originally alleged that she sustained a 

traumatic injury to her right upper back while in the performance of duty on November 22, 2019. 

As noted above, in response to OWCP’s questionnaire, appellant clarified that she was claiming 

an occupational disease due to various repetitive job duties. Therefore, OWCP properly 

adjudicated appellant’s claim as one for an occupational disease rather than a traumatic injury.

11

 

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 R.G., Docket No. 19-0233 (issued July 16, 2019). See also Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. 

Fish, 46 ECAB 276, 279 (1994); Victor J. Woodhams, 41 ECAB 345 (1989).

8 A.K., Docket No. 21-0278 (issued July 12, 2021); T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 

238 (1996).

9 M.V., Docket No. 18-0884 (issued December 28, 2018).

10 Id.; Victor Woodhams, supra note 7.

11 Section 10.5(q) of OWCP’s regulations provides, “Occupational disease or illness means a condition produced 

by the work environment over a period longer than a single workday or shift.” (Emphasisin the original.) 20 C.F.R. 

§ 10.5(q).
6

In his December 20, 2019 and January 21, and May 18 and 26, 2020 reports, Dr. Cragg 

opined that driving, pushing, pulling, and lifting heavy packages while in the performance of duty

caused a C7-T1 disc herniation with right-sided nerve root compression. In his January 2, 2020 

report, he opined that the condition was caused by her turning her neck continually and reaching 

in the back seat of her postal vehicle for packages with her right arm. While his reports supported 

causal relationship, Dr. Cragg did not provide a pathophysiological explanation of how the 

accepted factors of appellant’s federal employment were competent to cause her 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 accepted employment factors.12 Consequently, the opinions of Dr. Cragg are insufficient 

to meet appellant’s burden of proof to establish her claim.

Dr. Cronrath, in his May 19 and December 22, 2020 reports, likewise provided a 

conclusory opinion that appellant’s work duties for the past 20 years including reaching, lifting, 

pushing, pulling, prolonged sitting, frequent cervical flexion and repetitive motion of the arms 

contributed to her cervical radiculopathy. He indicated that he relied on medical literature to form 

his opinion, which he indicated suggested a correlation between age, gender, sedentary work and 

material handling with cervical disc herniation. However, Dr. Cronrath did not provide medical 

rationale explaining how the accepted factors of appellant’s employment caused the diagnosed 

medical conditions.13 Therefore, Dr. Cronrath’s reports are also insufficient to meet her burden of 

proof to establish her claim.

In her various work notes, Dr. Quraishi provided a diagnosis of cervical radiculopathy, but 

did not provide an opinion on causation. 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 Therefore, Dr. Quraishi’s notes are also insufficient to establish 

appellant’s claim.

The remaining evidence of record consists of various diagnostic study reports. The Board 

has held that diagnostic studies, standing alone, lack probative value as they do not address whether 

the employment factors caused any of the diagnosed conditions.15 As such, this evidence is 

insufficient to establish appellant’s claim.

As the medical evidence of record is insufficient to establish causal relationship between 

appellant’s diagnosed medical conditions and the accepted factors of her federal employment, the 

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

12 J.W., Docket No. 18-0678 (issued March 3, 2020); G.R., Docket No. 19-0940 (issued December 20, 2019); D.L., 

Docket No. 19-0900 (issued October 28, 2019); see also V.T., Docket No. 18-0881 (issued November 19, 2018); Y.D., 

Docket No. 16-1896 (issued February 10, 2017); T.M., Docket No. 08-975 (issued February 6, 2009); S.E., Docket 

No. 08-2214 (issued May 6, 2009).

13 Id.; see also S.M., Docket No. 21-0149 (issued June 21, 2021).

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

15 V.L., Docket No. 20-0884 (issued February 12, 2021); R.C., Docket No. 19-0376 (issued July 15, 2019).
7

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 medical 

condition causally related to the accepted factors of her federal employment.

ORDER

IT IS HEREBY ORDERED THAT the April 2, 2021 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: January 26, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board