United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.T., Appellant

and

U.S. POSTAL SERVICE, MILWAUKEE 

VEHICLE MAINTENANCE FACILITY, 

Milwaukee, WI, Employer

__________________________________________

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Docket No. 20-1486

Issued: March 16, 2021

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On August 6, 2020 appellant, through counsel, filed a timely appeal from a May 6, 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.3

 

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.

3 The Board notes that, following the May 6, 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

ISSUE

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

causally related to the accepted July 9, 2019 employment incident.

FACTUAL HISTORY

On July 10, 2019 appellant, then a 56-year-old body repairman, filed a traumatic injury 

claim (Form CA-1) alleging that on July 9, 2019 he pinched a nerve in his left shoulder when he 

lifted a long life vehicle (LLV) door while in the performance of duty. He stopped work on that 

date and returned to modified duty on July 10, 2019.

In a July 12, 2019 duty status form report (Form CA-17), Dr. Cindy Catania, an osteopath

Board-certified in family medicine, noted a July 9, 2019 date of injury. She reported clinical 

findings of left shoulder impingement syndrome and left upper back muscle spasm.

In a July 17, 2019 work excuse note, Cathleen Baumeister, a medical assistant, indicated 

that appellant had been treated in the office by Dr. Jonathan E. Campbell, a Board-certified 

orthopedic surgeon, and that she could return to work on July 18, 2019 with no restrictions.

In an October 17, 2019 development letter, OWCP informed appellant that, it had reopened 

his claim for consideration of the merits because he had filed a notice of recurrence (Form CA2a),

4

and that his claim would now be formally adjudicated. It advised him of the deficiencies of 

his claim, requested additional factual and medical evidence, and provided a questionnaire for his 

completion. OWCP afforded him 30 days to provide the necessary factual information and 

medical evidence.

In an October 23, 2019 note, Dr. Cameron Best, a Board-certified orthopedic surgeon, 

indicated that appellant was unable to work until his electromyography (EMG) study.

By decision dated November 27, 2019, OWCP denied appellant’s claim. It accepted that 

the July 9, 2019 incident occurred as alleged and that left shoulder and cervical conditions had 

been diagnosed; however, it denied his claim, finding that he had failed to establish causal 

relationship between the accepted employment incident and the diagnosed conditions.

Appellant subsequently submitted diagnostic testing reports. A July 12, 2019 left shoulder 

magnetic resonance imaging (MRI) scan revealed focal cortical irregularity of the acromion. A 

July 17, 2019 left shoulder x-ray examination report showed normal shoulder alignment and mild 

acromioclavicular degenerative changes. An October 17, 2019 cervical spine MRI scan

demonstrated no critical spinal canal stenosis and severe left foraminal stenosis at the C4-5 and 

C5-6 levels. An October 17, 2019 left shoulder MRI scan revealed marked supraspinatus and 

infraspinatus tendinosis with superimposed undersurface, multifocal labral tearing, focal 

delaminating cartilage disease in the anterior labrum, moderate acromioclavicular (AC) joint 

degenerative change with ganglion cyst formation, and mild teres minor atrophy.

 

4 On October 10, 2019 appellant filed a recurrence claim for disability from work commencing October 9, 2019 

due to his July 9, 2019 employment injury.
3

In a July 9, 2019 report, Dr. Catania indicated that appellant was treated for complaints of 

left shoulder and arm pain. She reported that the injury occurred when appellant lifted a sliding 

door off of an LLV to place it on the stand. Dr. Catania reported left shoulder examination findings 

of tenderness, pain, spasm, and decreased strength. Range of motion was full with hesitation. 

Dr. Catania diagnosed left shoulder strain.

Dr. Catania noted in a July 12, 2019 report that appellant was reevaluated for his injuries 

of left shoulder strain and left thoracic muscle spasm. She conducted an examination and noted 

diagnoses of left shoulder impingement syndrome, left shoulder muscle spasm, left shoulder acute 

pain, paresthesia and pain of the left extremity, and peripheral muscle fatigue.

In a July 17, 2019 report Dr. Campbell recounted appellant’s complaints of left shoulder 

pain and numbness that started on July 8, 2019. Upon physical examination of appellant’s left 

upper extremity, he observed negative “Hawkins Neer’s impingement test,” and negative 

O’Brien’s, speeds, and cross body adduction tests. Dr. Campbell diagnosed left forearm and hand 

numbness with possible ulnar neuritis.

In reports dated October 14 and 21, 2019, Dr. David K. DeDianous, Board-certified in 

physical medicine and rehabilitation, recounted appellant’s symptoms of middle back and left 

shoulder pain that began about one week ago. Upon examination of appellant’s cervical spine, he 

observed tenderness of right trapezius muscles. Cervical and bilateral shoulder range of motion 

were full. Dr. DeDianous assessed shoulder pain, left arm paresthesia, tendinitis, and cervical pain 

and radiculopathy.

In a November 11, 2019 letter, Dr. R.J. Hammett, a chiropractor, indicated that he was 

treating appellant for injuries sustained at work and that appellant remained off work. Appellant 

submitted chiropractic treatment notes dated October 29 through November 14, 2019.

A February 3, 2020 EMG and nerve conduction velocity (NCV) study were normal and 

the EMG revealed no signs of cervical radiculopathy.

On February 18, 2020 appellant requested reconsideration and submitted additional letters 

from Dr. Hammett.

In a December 3, 2019 letter, Dr. Hammett recounted that appellant was seen on 

October 20, 2019 for complaints of neck pain radiating into his arm and hand. He described that 

appellant was pushing a loaded mail container up a small incline when the container started to slip. 

Dr. Hammett discussed appellant’s examination findings and noted that a cervical spine x-ray 

evaluation showed demonstrated loss of cervical lordosis, degenerative disc spaces at C5-6 with 

osteophytic spurring, and flexion malposition at C5 and C6. He diagnosed vertebral subluxation 

complexes of C-1, C-5 with a loss of cervical lordosis, and cervical degenerative changes. In an 

undated addendum letter, Dr. Hammett noted that the injury was initially caused on July 9, 2019 

when lifting an LLV door onto sawhorses and flipping them over.

By decision dated May 6, 2020, OWCP denied modification of the November 27, 2019 

decision.
4

LEGAL PRECEDENT

An employee seeking benefits under FECA5 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,6that 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.7 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.8

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, OWCP must first determine whether fact of injury has been established.9 

There are two components involved in establishing fact of injury. 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.10 Second, the employee must submit evidence, in the form 

of probative medical evidence, to establish that the employment incident caused a personal 

injury.11

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.12 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.13 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.14

 

5 Supra note 2.

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

153 (1989). 

7

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

ECAB 312 (1988).

8 R.R., Docket No. 19-0048 (issued April 25, 2019); K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., 

Docket No. 13-1402 (issued February 7, 2014); Delores C. Ellyett, 41 ECAB 992 (1990).

9 D.B., Docket No. 18-1348 (issued January 4, 2019); S.P., 59 ECAB 184 (2007).

10 D.S., Docket No. 17-1422 (issued November 9, 2017); Bonnie A. Contreras, 57 ECAB 364 (2006).

11 B.M., Docket No. 17-0796 (issued July 5, 2018); David Apgar, 57 ECAB 137 (2005); John J. Carlone, 41 ECAB 

354 (1989).

12 See S.A., Docket No. 18-0399 (issued October 16, 2018); see also Robert G. Morris, 48 ECAB 238 (1996).

13 M.V., Docket No. 18-0884 (issued December 28, 2018); I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 

ECAB 345 (1989).

14 James Mack, 43 ECAB 321 (1991).
5

ANALYSIS

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

conditions causally related to the accepted July 9, 2019 employment incident.

Appellant submitted reports dated July 9 and 12, 2019 from Dr. Catania, who described the 

July 9, 2019 history of injury and provided examination findings. Dr. Catania diagnosed left 

shoulder impingement syndrome, left shoulder muscle spasm, left shoulder acute pain, paresthesia 

and pain of the left extremity, and peripheral muscle fatigue. She reported that the injury occurred 

when appellant lifted a sliding door off of an LLV to place it on the stand. The Board finds that, 

although Dr. Catania provided an opinion supporting causal relationship, she did not proffer 

sufficient medical rationale explaining how lifting an LLV door caused or contributed to 

appellant’s left shoulder condition. A medical report is of limited probative value on the issue of 

causal relationship if it contains a conclusion regarding causal relationship which is unsupported 

by medical rationale.15 Dr. Catania’s opinion is therefore insufficient to establish the claim.

In reports dated October 14 and 21, 2019, Dr. DeDianous noted cervical and bilateral 

shoulder examination findings. He assessed shoulder pain, tendinitis, and cervical pain and 

radiculopathy. Dr. DeDianous did not, however, offer 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 or disability is of no probative value on the issue of causal relationship.16 

As such, the Board finds that these reports are insufficient to establish appellant’s claim. Likewise,

Dr. Campbell’s July 17, 2019 report and Dr. Best’s October 23, 2019 work status note are 

insufficient to establish appellant’s claim as neither physician provided an opinion on the cause of 

appellant’s diagnosed conditions.17 

The record also contains treatment notes and letters dated November 11 through

December 3, 2019 from Dr. Hammett, a chiropractor, who provided an opinion on causal 

relationship. Under FECA the term physician includes chiropractors only to the extent that their 

reimbursable services are limited to treatment consisting of manual manipulation of the spine to 

correct a subluxation as demonstrated by x-ray to exist.18 OWCP’s regulations have defined 

subluxation as an incomplete dislocation, off-centering, misalignment, fixation or abnormal 

spacing of the vertebrae, which must be demonstrable on an x-ray film to an individual trained in 

the reading of x-rays.19 If the diagnosis of subluxation as demonstrated by x-ray is not established, 

the chiropractor is not a physician as defined under FECA and his or her report is of no probative 

 

15 J.W., Docket No. 18-0678 (issued March 3, 2020); V.T., Docket No. 18-0881 (issued November 19, 2018); T.M., 

Docket No. 08-0975 (February 6, 2009); S.E., Docket No. 08-2214 (issued May 6, 2009).

16 E.R., Docket No. 20-0880 (issued December 2, 2020); L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., 

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

17 Id. 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. See J.H., Docket No. 19-0838 (issued October 1, 2019); S.G., 

Docket No. 19-0041 (issued May 2, 2019).

18 5 U.S.C. § 8101(2). See J.D., Docket No. 19-1953 (issued January 11, 2021); T.T., Docket No. 18-0838 (issued 

September 19, 2019); Thomas W. Stevens, 50 ECAB 288 (1999).

19 20 C.F.R. § 10.5(bb).
6

value to the medical issue presented.20 While Dr. Hammett noted his review of a cervical spine xray evaluation, the diagnosis of subluxation is not established by an x-ray examination. As such,

Dr. Hammett is not considered a physician under FECA and his medical opinion does not 

constitute probative medical evidence.21

Appellant also submitted diagnostic testing reports, including the July 12, 2019 left

shoulder MRI scan report, July 17, 2019 left shoulder x-ray scan report, October 17, 2019 cervical 

spine and left shoulder MRI scan reports, and February 3, 2020 EMG study. The Board has held 

that reports of diagnostic tests, standing alone, lack probative value as they do not provide an 

opinion as to whether the accepted employment factors caused the diagnosed condition.22 For this 

reason, this evidence is not sufficient to meet his burden of proof. 

Additionally, OWCP received a July 17, 2019 work excuse note by Ms. Baumeister. The 

Board has held that a medical report may not be considered probative medical evidence if there is 

no indication that the person completing the report qualifies as a physician as defined in 5 U.S.C. 

§ 8101(2).23 Therefore, this report does not establish appellant’s claim.

As the medical evidence of record does not contain rationalized medical evidence 

establishing causal relationship between appellant’s diagnosed medical conditions and the 

accepted July 9, 2019 employment incident, the Board finds that appellant has not met his burden 

of proof.

On appeal counsel argues that OWCP’s decision was contrary to law and fact. As 

explained above, however, the medical evidence of record does not contain rationalized medical 

evidence establishing causal relationship. Accordingly, 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 medical

conditions causally related to the accepted July 9, 2019 employment incident.

 

20 A.C., Docket No. 19-1950 (issued May 27, 2020); R.P., Docket No. 18-0860 (issued December 4, 2018); Mary A. 

Ceglia, 55 ECAB 626 (2004); Jack B. Wood, 40 ECAB 95, 109 (1988).

21 L.G., Docket No. 19-1616 (issued March 10, 2020); R.D., Docket No. 19-1528 (issued January 17, 2020); see 

Jay K. Tomokiyo, 51 ECAB 361 (2000).

22 G.S., Docket No. 18-1696 (issued March 26, 2019); A.B., Docket No. 17-0301 (issued May 19, 2017).

23 Section 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.” 

5 U.S.C. § 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); 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); see C.B., Docket No. 09-2027 (issued May 12, 2010).
7

ORDER

IT IS HEREBY ORDERED THAT the May 6, 2020 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: March 16, 2021

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board