United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

M.O., Appellant

and

U.S. POSTAL SERVICE, FORT POINT POST 

OFFICE, Boston, MA, Employer

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Docket No. 22-1035

Issued: March 22, 2023

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On June 28, 2022 appellant filed a timely appeal from a June 9, 2022 merit decision 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.

ISSUE

The issue is whether appellant has met his burden of proof to establish a medical condition 

causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On April 20, 2022 appellant, then a 54-year-old express mail service clerk, filed an 

occupational disease claim (Form CA-2) alleging that he sustained a left-sided sciatic nerve or 

piriformis strain due to factors of his federal employment. He stated that on March 15, 2022 he 

1

5 U.S.C. § 8101 et seq.
2

injured his lower back and left hip, but thought it was a minor injury at the time, but it worsened 

while at work on April 1, 2022. Appellant called in sick on April 2, 2022 and attempted to work 

on April 3, 2022, but experienced extreme pain while walking and sought treatment at a hospital 

emergency department. On the reverse side of the claim form, the employing establishment noted 

that he stopped work on April 1, 2022 and returned to work on April 15, 2022. 

In an April 3, 2022 report, Dr. Brian P. Lyngaas, Board-certified in emergency medicine, 

held appellant off work through April 6, 2022. OWCP also received an April 6, 2022 work status 

form report by Dr. Jeffrey Vogel, Board-certified in occupational medicine, who returned 

appellant to modified-dutywork effective that day,with no squatting, no climbing stairs or ladders, 

lifting limited to 25 pounds, and standing, walking, and bending limited to five hours. 

In an April 6, 2022 work slip Phyllis Cicchetti, a registered nurse, noted that appellant had 

been seen at an occupational health clinic that day for a March 15, 2022 work-related injury. 

In an April 13, 2022 work status form report, Dr. Elizabeth Kwo, Board-certified in 

occupational medicine, renewed Dr. Vogel’s restrictions through April 26, 2022. 

In a development letter dated May 5, 2022, OWCP informed appellant of the deficiencies 

of his claim. It advised him of the type of factual and medical evidence required and provided a 

questionnaire for his completion. OWCP afforded appellant 30 days to respond.

In response, appellant submitted a May 25, 2022 statement asserting that his work duties 

required him to lift and carry heavy packages and sort them at a fast pace, which required frequent 

bending and stretching. He indicated that his work unit had been short staffed at times, leading to 

more work for the employees present. Appellant recounted that, on March 15, 2022 at 

approximately the midpoint of his shift, he experienced left-sided lumbar pain that increased over 

the following two days, which were scheduled days off. His symptoms subsided by approximately 

April 20, 2022 and he felt “pretty much back to normal.” 

In an April 3, 2022 report, received by OWCP on May 31, 2022 Dr. Sophie M. MonnierSerov, Board-certified in emergency medicine, recounted that appellant experienced the onset of 

left-sided hip and buttock pain while lifting boxes at work two weeks prior. Appellant had a history 

of prior episodes of more medially-located back pain, usually improved after applying ice. On 

examination, Dr. Monnier-Serov observed tenderness to palpation of the left paralumbar region, 

left lateral hip and left buttock, and an antalgic gait. She noted that x-rays of the pelvis and left 

hip demonstrated no obvious fracture and ordered computerized tomography (CT) scans. 

Dr. Monnier-Serov referred appellant to Dr. Lyngaas. 

In an April 3, 2022 report received by OWCP on May 31, 2022, Dr. Lyngaas noted that 

appellant complained of left buttock pain and had an antalgic gait. He noted that appellant would 

undergo imaging studies to check for occult lumbar spine or pelvic fracture. Dr. Lyngaas

prescribed stretching exercises. 

In an April 6, 2022 report received by OWCP on May 31, 2022, Dr. Vogel recounted 

appellant’s history of the onset of pain in the left buttock region,with sharp pain along the posterior 

aspect of the left leg above the knee, after lifting a heavy box two weeks previously. He noted that 

x-rays and a CT scan demonstrated degenerative changes, but were negative for other pathologies. 
3

On examination, Dr. Vogel observed tenderness to palpation with pinpoint pain in the gluteal 

region and gluteus medius on the left, and a negative straight leg raising test. He diagnosed a 

gluteal strain. Dr. Vogel recommended conservative medical care and modified-duty work.

In an April 13, 2022 report, Dr. Kwo recounted that appellant had lifted a heavy box at 

work three weeks previously and experienced the onset of left buttock pain, with sharp pain that 

migrated from the lateral aspect of the left buttock to the posterior left leg above the posterior 

aspect of the knee. Imaging studies demonstrated degenerative changes. On examination,

Dr. Kwo observed tenderness to palpation of the gluteal region/gluteus medius on the left, pinpoint 

pain with palpation, a negative straight leg raising test, full motion of the left hip, and full strength 

in all extremities. She diagnosed a gluteal strain. Dr. Kwo recommended conservative medical 

treatment and returned appellant to restricted duty.

By decision dated June 9, 2022, OWCP denied appellant’s occupational disease claim, 

finding that the medical evidence of record was insufficient to establish a medical condition 

causally related to the accepted employment factors. It concluded, therefore, that the requirements 

had not been met to establish an injury or condition due to the accepted employment factors.

LEGAL PRECEDENT

An employee seeking benefits under FECA2 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,3that 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.4 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.5

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

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

employment factors alleged to have caused or contributed to the presence or oc currence of the 

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

2

Id.

3

See J.K., Docket No. 20-0527 (issued May 24, 2022); J.C., Docket No. 20-0882 (issued June23, 2021); S.B., 

Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

4

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

Chadden, Sr., 40 ECAB 312 (1988).

5 R.R., Docket No. 19-0048 (issued April25, 2019); 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).
4

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

diagnosed condition is causally related to the identified employment factors.6

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve.7 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 the specific employment factor(s) identified by the employee.8 The weight of the 

medical evidence is determined by its reliability, its probative value, its convincing quality, the 

care of analysis manifested, and the medical rationale expressed in support of the physician’s 

opinion.9

ANALYSIS

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

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

Dr. Lyngaas, in reports dated April 3, 2022, described appellant’s symptoms and 

prescribed stretching exercises. Dr. Monnier-Serov, in an April 3, 2022 report, described an 

occupational lifting incident that occurred two weeks previously, reviewed imaging studies, and 

noted findings on examination. However, neither physician provided an opinion on causal 

relationship. Therefore, their reports are of no probative value and are insufficient to establish

appellant’s claim.

10

 

Dr. Vogel, in reports dated April 6, 2022, described appellant’s pain symptoms, noted 

findings on examination, and diagnosed a gluteal strain. Dr. Kwo, in April 13, 2022 reports, 

indicated an awareness of the accepted employment factors, recounted appellant’s pain symptoms, 

and diagnosed a gluteal strain. Although Dr. Vogel and Dr. Kwo provided a medical diagnosis, 

neither physician offered an opinion on causal relationship. The Board has held that medical 

evidence that does not offer an opinion regarding the cause of an employee’s condition is of no 

6 T.M., Docket No. 20-1460 (issued December 20, 2022); 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).

7

See J.K., supra note 3;S.A., Docket No. 18-0399 (issued October 16, 2018); see also RobertG. Morris, 48 ECAB 

238 (1996).

8

S.B., Docket No. 21-0646 (issued July 22, 2022); M.V., Docket No. 18-0884 (issued December 28, 2018); I.J., 59 

ECAB 408 (2008);Victor J. Woodhams, supra note 6.

9

J.K., supra note 3; J.C., supra note 3; James Mack, 43 ECAB 321 (1991).

10 S.B., supra note 8; J.D., Docket No. 21-1422 (issued May 24, 2022); S.J., Docket No. 19-0696 (issued August 23, 

2019); M.C., Docket No. 18-0951 (issued January 7, 2019);L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., 

Docket No. 17-1549 (issued July 6, 2018).
5

probative value on the issue of causal relationship.11 For this reason, this medical evidence is 

insufficient to meet appellant’s burden of proof.

OWCP also received an April 6, 2022 work slip by Ms. Cicchetti, a registered nurse. This 

report, however, does not constitute competent medical evidence. The Board has held that nurses 

are not considered physicians as defined under FECA and are, therefore, not competent to offer 

medical opinions.

12

 

As the medical evidence of record is insufficient to establish a medical condition causally 

related to the accepted March 15, 2022 employment incident, the Board finds that appellant has 

not met his 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.

CONCLUSION

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

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

11 Id.

12 Section 8102(2) of FECA provides as follows: (2) physician includes surgeons, podiatrists, dentists, clinical 

psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined 

by State law. 5 U.S.C. § 8102(2); 20 C.F.R. § 10.5(t). See Federal (FECA) Procedure Manual, Part 2 -- Claims,

Causal Relationship, Chapter 2.805.3a(1) (January 2013); 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).
6

ORDER

IT IS HEREBY ORDERED THAT the June 9, 2022 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: March 22, 2023

Washington, DC

Patricia H. Fitzgerald, Deputy 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