United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

O.R., Appellant

and

DEPARTMENT OF HOMELAND SECURITY,

TRANSPORTATION SECURITY 

ADMINISTRATION, Miami, FL, Employer

__________________________________________

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Docket No. 20-1518

Issued: November 17, 2022

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On August 14, 2020 appellant filed a timely appeal from an August 3, 2020 merit decision 

of the Office of Workers’Compensation Programs (OWCP).1 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 his burden of proof to establish a lumbar condition

causally related to the accepted December 9, 2014 employment incident.

1 Appellant also timely appealed from decisions issued under other OWCP file numbers. The Board will adjudicate 

those appeals separately.

2

5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

This case has been previously before the Board.3 The facts and circumstances as set forth 

in the Board’s prior order are incorporated herein by reference. The relevant facts are set forth 

below.

On October 2, 2018 appellant, then a 35-year-old transportation security officer, filed a 

traumatic injury claim (Form CA-1) alleging that on December 9, 2014 he aggravated his lumbar 

spine as a result of repetitively lifting, dragging and pushing oversized and heavy bags while in 

the performance of duty.4 He explained that his workload was increased in the baggage area during 

the holiday season. Appellant did not stop work.

In a January 2, 2014 medical note, Dr. Katzman, a Board-certified orthopedic surgeon,

recommended light-duty desk work. He diagnosed right leg sciatica and a herniated disc at L5-

S1.

In a February 26, 2014 medical report, Dr. Jonathan Hyde, a Board-certified orthopedic 

surgeon, diagnosed lumbosacral disc degeneration and thoracic/lumbosacral neuritis/radiculitis 

and recommended that appellant undergo an electromyography (EMG) scan for further evaluation. 

In a medical form of even date, he provided work restrictions. In a subsequent March 14, 2014 

medical report, Dr. Hyde scheduled appellant to undergo a laminectomy procedure to treat his 

condition.

In an April 1, 2014 operative report, Dr. Hyde performed a right inferior L5 

hemilaminectomy, a right S1 anterior hemilaminectomy, a S1 foraminectomy, a partial 

facetectomy for L5 nerve root, and a lysis of adhesions with excision of disc herniation at L5-S1 

to treat appellant’s condition.

In an April 15, 2014 medical report, Diana Martinez, a physician assistant, evaluated 

appellant two weeks after his surgical procedure and noted his progression with healing. She held 

him off of work and recommended that he follow up with Dr. Hyde in one month.

In a subsequent May 16, 2014 medical report, Dr. Hyde evaluated appellant following his 

surgical procedure and noted his improved condition. In a June 20, 2014 medical report, he 

referred appellant to physical therapy.

3 Order Granting Motion to Reverse, Docket No. 19-1234 (issued June 23, 2020).

4 The Board notes that appellant has a previously accepted July 2, 2013 traumatic injury claim for a lumbar back 

sprain and herniated lumbar disc at L5-S1 under OWCP File No. xxxxxx033. Appellant also previously filed an 

occupational disease claim (Form CA-2) for an emotional condition under OWCP File No. xxxxxx667, which was 

formally denied on July 20, 2015. On May 12, 2017 appellant filed a traumatic injury claim alleging that he injured 

his low back and right knee on August 6, 2014 under OWCP File No. xxxxxx404. OWCP formally denied this claim 

on July 9, 2018. On February8, 2018 it accepted a subsequent traumatic injury claim for aggravation of the L5-S1 

herniated lumbar disc under OWCP File No. xxxxxx403. 
3

Appellant submitted physical therapy reports dated from June 24 to August 11, 2014. In a 

July 18, 2014 medical report, Ms. Martinez noted appellant’s improvement with physical therapy 

and recommended that he continue to work limited duty.

In an August 22, 2014 medical report, Dr. Hyde evaluated appellant after an April 1, 2014 

lumbar laminectomy/discectomy procedure. In his August 22, 2014 report, he determined that 

appellant had seven percent permanent impairment based on the Uniform Permanent Impairment 

Rating Guide.

In an October 6, 2014 medical form, Dr. Hyde determined that appellant reached maximum 

medical improvement (MMI) on August 22, 2014 and determined that he had seven percent 

permanent impairment of his spine based on the sixth edition of the American Medical 

Association, Guides to the Evaluation of Permanent Impairment (A.M.A., Guides).5

In a December 9, 2014 form report, appellant asserted that he sustained an emotional 

condition directly related to the chronic lower back pain and right leg cramping after demanding 

days of heavy lifting at work. He related that the pain made it difficult for him to sleep and that 

his supervisor was harassing him with false accusations.

In medical reports dated December 10, 2014 and January 23, 2015, appellant informed

Dr. Hyde that he had returned to work, but still experienced pain in his right leg. Dr. Hyde referred 

him for another magnetic resonance imaging (MRI) scan for further evaluation of his symptoms.

In medical reports dated from April 6 to 14, 2015, Dr. Manuel Carril, a chiropractor, 

evaluated appellant for right knee pain. Appellant informed him that he injured his right knee 

while rehabilitating from his April 1, 2014 surgical procedure. Dr. Carril diagnosed a knee sprain 

and knee joint pain and performed a mobilizing spinal adjustment.

In an April 23, 2015 diagnostic report, Dr. Michael Thorpe, a Board-certified diagnostic 

radiologist, performed an MRI scan of appellant’s right knee, finding a 1.2 centimeter cartilage 

defect in the trochlea and joint effusion.

In an October 5, 2015 medical report, Dr. Jesse Shaw, a Board-certified orthopedic 

surgeon, reviewed appellant’s history of medical treatment relating to the April 22, 2013 

employment injury. He diagnosed right quadriceps muscle weakness and atrophy and opined that 

the condition was due to appellant’s April 22, 2013 lumbar spine injury that led to nonphysiological altered gait mechanics and his right knee symptoms.

In a November 6, 2015 medical report, Dr. Hyde diagnosed other intervertebral disc 

displacement, lumbar region. He observed that appellant was evaluated by Dr. Shaw for his right 

knee symptoms and noted that he would defer to her findings for any impairment or restrictions.

5 A.M.A., Guides(6th ed. 2009).
4

In a November 13, 2015 medical report, Dr. Hyde reviewed a November 12, 2015 MRI 

scan of appellant’s lumbar spine and opined that his right knee pain was not a direct consequence 

of his herniated disc or spine surgery.

In medical reports dated February 15 and March 30, 2016 medical report, Dr. Shaw 

diagnosed unspecified right joint effusion, unspecified right muscle wasting and atrophy, right 

muscle weakness, a sprain of the right knee and lumbar region radiculopathy. She ordered another 

MRI scan of his right knee.

In a March 31, 2016 diagnostic report, Dr. Jonathan Luchs, a Board-certified radiologist,

performed an MRI scan of appellant’s right knee, finding a joint effusion and no definitive internal 

derangement or fracture.

In an April 5, 2016 medical report, Dr. Samy Bishai, a Board-certified orthopedic surgeon, 

reviewed appellant’s history of lower back and right knee pain beginning after the April 22, 2013 

employment incident. He explained that appellant aggravated his condition on May 14, 2013 when 

he was pulling luggage. On review of appellant’s medical records and evaluation Dr. Bishai 

diagnosed a herniated lumbar disc at L5-S1 with right-sided radiculopathy, L5 nerve root and lysis 

of adhesions with excisions of disc herniation at L5-S1 and slight atrophy of the vastus medialis 

right knee joint. She opined that appellant’s vastus medialis atrophy was not related to his right 

knee joint, but rather related to his May 14, 2013 back injury.

In medical reports dated from April 15 to July 19, 2016, Dr. Mark Fishman, a Boardcertified physiatrist, diagnosed lumbar disc degeneration, lumbosacral spondylosis, lumbar 

stenosis, lumbosacral post-laminectomy syndrome and lumbar myofascial pain syndrome. He 

advised that appellant complete his functional capacity evaluation (FCE) and continue his home 

exercises.

In a March 3, 2017 medical report, Dr. Caio Goncalves, Board-certified in emergency 

medicine, evaluated appellant for his complaints of low back pain. Appellant informed him that 

the onset of his pain began two days prior at work when he was lifting and bending. Dr. Goncalves 

diagnosed a back strain and provided a back strain information sheet.

In a March 27, 2017 medical report, Dr. Katzman reviewed appellant’s history of injury in 

relation to his April 22, 2013 employment injury. On review of diagnostic studies and evaluation, 

he diagnosed low back pain and radicular right leg radiculitis and recommended work restrictions 

for appellant to follow.

In an April 4, 2017 diagnostic report, Dr. Brian Young, a Board-certified radiologist, 

performed an MRI scan of appellant’s lumbar spine and diagnosed a T12-L1 disc herniation, L3-

4 and L4-5 disc bulges with mild central stenosis and a L5-S1 disc bulge noted with enhancing 

soft tissue off the posterior disc space margin.

In an April 10, 2017 medical report, Dr. Katzman reviewed appellant’s MRI scan and 

diagnosed low back pain and disc herniation at L5-S1. He provided updated work restrictions.

In a June 14, 2017 medical report, Dr. Bishai clarified her April 5, 2016 medical opinion, 

explaining that appellant’s May 14, 2013 injury was an aggravation of his April 22, 2013 injury 
5

and caused the development of his radiculopathy. She noted that the atrophy to the vastus medialis 

was related to the compression of a nerve root secondary to his back condition, and not related to 

his right knee injury as a primary injury. Dr. Bishai further noted appellant’s employment duties 

and opined that his constant kneeling to check oversized luggage may have contributed to his right 

knee problems.

In a June 16, 2017 medical report, Dr. Katzman diagnosed a residual herniated disc at L5-

S1 and residual back pain status post lumbar laminectomy. He opined that appellant could return 

to work with modified duty.

In an October 26, 2017 medical report, Dr. Sami Zaki, Board-certified in family medicine, 

evaluated appellant for back pain, which he noted began the day prior while he was performing 

house chores. He informed her that his chronic back pain first began in 2013 while lifting at work 

and that he underwent surgery in 2014 to treat the symptoms related to his condition. Dr. Zaki 

diagnosed chronic back pain with an acute exacerbation.

In an undated statement, Dr. Shaw reviewed the history of appellant’s physical therapy 

reports in which he began to feel pain in his right knee after performing lunges. He opined that 

appellant would not have been suited to perform his job functions as of October 5, 2015 and stated 

that proper restrictions were needed in order for his knee to heal correctly.

In medical reports dated November 2 and December 7, 2017, Dr. Katzman evaluated 

appellant for low back pain and left buttock pain and noted his previous diagnosis of a disc 

herniation in relation to an April 22, 2013 employment injury. He diagnosed low back pain, 

lumbar radiculitis and left leg sciatica/gluteal pain. Dr. Katzman advised that appellant undergo 

physical therapy and recommended work restrictions for him to follow.

In a January 16, 2018 medical report, Dr. Christopher Brown, a Board-certified orthopedic 

surgeon, noted that he first injured his back in the April 2013 employment incident and later 

aggravated the injury in a subsequent May 13, 2013 injury when he was pushing luggage at work. 

He stated that the disc herniation was caused by the April 22, 2013 employment injury.

Appellant submitted physical therapy reports dated from January 4 to March 2, 2018 in 

which he was treated for his complaints of low back pain.

In a March 5, 2018 medical report, Dr. Katzman noted that the pain in appellant’s leftsided back and buttock had significantly improved. He observed that an updated MRI scan 

demonstrated worsening disc desiccation and collapse at the L5-S1 segment with epidural fibrosis, 

junctional facet synovitis and foraminal narrowing. Dr. Katzman diagnosed low back pain, lumbar 

disc desiccation, degeneration and disc displacement at the L5-S1 segment with bilateral foraminal 

narrowing, L4-L5 facet synovitis and foraminal narrowing and left lumbar radiculitis. He opined 

that, due to appellant’s April 22, 2013 disc injury, he underwent a degenerative process that is 

worsening at the L5-S1 segment. Dr. Katzman explained that, due to the collapse and worsening 

degenerative changes, his injury caused degenerative cascade to the disc at L5-S1. He offered that 

due to a loss of mobility at the desiccated disc additional stress was placed on the adjacent segment, 

causing lumbar facet synovitis.
6

In an April 12, 2018 medical report, Dr. Clinton Bush, a Board-certified orthopedic 

surgeon serving as an OWCP second opinion physician, reviewed the statement of accepted facts 

(SOAF), history of injury, and medical evidence of record. He noted appellant’s diagnoses of a 

disc herniation and right L5-S1 radiculopathy accepted as associated with the April 22, 2013 

employment injury. Dr. Bush explained that appellant’s quadriceps muscle would not be affected 

by his spinal injury and opined that the medical evidence of record did not support that his right 

knee injury was related to his documented lumbar conditions.

In a May 10, 2018 medical report, Dr. Katzman reevaluated appellant for an April 22, 2013 

work-related lifting injury. He noted that, as a result of his injury, appellant sustained an injury at 

the L5-S1 level and underwent a right-sided L5-S1 hemilaminectomy. Dr. Katzman then 

developed left-sided sciatica on October 26, 2017. He opined that the reaggravation of his back 

was directly related to the April 22, 2013 employment injury. Dr. Katzman noted that, in spite of 

physical therapy, appellant’s left-sided sciatica and low back persisted and also reviewed an 

April 11, 2017 MRI scan of his lumbar spine that showed a worsening of the disc desiccation and 

collapse at L5-S1 segment with epidural fibrosis, junctional facet synovitis and foraminal 

narrowing. He diagnosed low back pain, lumbar disc desiccation, degeneration of disc 

displacement at L5-S1 with foraminal narrowing, L4-L5 facet synovitis and foraminal narrowing,

and left lumbar radiculitis with left-sided lumbar sciatica.

In a May 18, 2018 diagnostic report, Dr. Alex Alonso, a Board-certified radiologist, 

performed an MRI scan of appellant’s lumbosacral spine. He noted that appellant was 

experiencing lower back pain after an April 26, 2018 motor vehicle accident. Dr. Alonso noted 

disc bulges at L3-4 and L4-5 and disc herniation at T12-L1 and L5-S1.

In a June 4, 2018 medical report, Dr. Liam McCarthy, a Board-certified physiatrist, 

evaluated appellant for lower back pain and reviewed the results of his May 18, 2018 MRI scan. 

He noted that appellant was scheduled to undergo an EMG scan; however, the nerve conduction 

machine was not functioning properly. Dr. McCarthy suggested that he return to his orthopedic 

surgeon to discuss treatment option.

In a June 18, 2018 diagnostic report, Dr. Alonso performed an MRI scan of appellant’s 

lumbar spine, finding broad-based posterior disc bulges at L3-4 and L4-5 and disc herniation at 

T12-L1 and L5-S1.

In an August 1, 2018 medical report, appellant visited Dr. McCarthy seeking 

recommendations for his left T12-L1 disc herniation, L5-S1 disc herniation and left groin pain. 

Dr. McCarthy diagnosed low back pain, left groin pain and left T12-L1 disc herniation 

paracentrally without significant stenosis worsening at L5-S1.

In an August 3, 2018 medical report, Dr. Katzman reviewed appellant’s treatment for low 

back pain and his recovery from a facet block he received on May 29, 2018. He noted the previous 

diagnosis of a strain of the midback and a low back strain and further diagnosed low back pain, 

status post left facet block, L5-S1.

In an August 21, 2018 e-mail, appellant provided a statement of facts relating to a 

December 10, 2014 employment injury. He explained that he underwent hemilaminectomy
7

surgery on April 1, 2014 and participated in physical therapy from June 24 to August 11, 2014. 

On August 25, 2014 appellant related that, despite never reaching the employing establishment’s

goal of lifting 70 pounds repeatedly and suffering a right knee injury, he was told he reached MMI

and was cleared to return to work full duty. On December 10, 2014 he suffered a lumbar sprain 

due to an increased workload of frequent bending, stooping, kneeling, dragging and lifting items 

that weighed up to 70 pounds. The injury was never reviewed by the physician who performed 

his surgery or reported to OWCP.

6

 On July 6, 2016 appellant was removed from work after being 

denied reasonable accommodations and being unable to perform the full scope of his employment 

duties. He concluded by recounting the history of treatment he received through OWCP for his 

pain related to his lumbar condition.

In medical reports dated August 17 and August 24, 2018, Dr. Katzman recounted 

appellant’s history of treatment related to an April 22, 2013 back injury and a subsequent 

laminectomy and discectomy at L5-S1, as well as lidocaine injections, to treat his injury. On 

evaluation he diagnosed facetogenic back pain, L5-S1 facet disease and lumbar disc displacement 

at L5-S1. Dr. Katzman reviewed past documentation from appellant and opined that his pain was 

facetogenic and was not new, but recurrent. He recommended permanent work restrictions for 

appellant to follow.

Appellant submitted physical therapy reports dated from September 18 to 28, 2018 in 

which Cynthia Gonzalez, a physical therapist, evaluated appellant for his continuing lumbar pain 

and recommended that he undergo three weeks of physical therapy.

In a development letter dated October 9, 2018, OWCP made note of appellant’s four 

previous claims.

7

 It provided a questionnaire for his completion seeking information about the 

claimed employment incident alleged to have caused or contributed to his medical condition and 

requested a medical report from his attending physician explaining how and why his federal 

employment caused, contributed to, or aggravated his medical condition. OWCP afforded 

appellant 30 days to submit the requested information.

In a March 7, 2016 medical report, Dr. Stephen Wender, a Board-certified arthroscopic 

surgeon, evaluated appellant for low back pain related to an April 22, 2013 employment injury in 

which he was required to repeatedly lift suitcases weighing up to 70 pounds. He recounted 

appellant’s history of medical treatment, including physical therapy and an April 1, 2014 surgical 

procedure to treat his diagnosed lumbar conditions. On examination and review of appellant’s 

medical and diagnostic reports, Dr. Wender opined that he had reached MMI and sustained 10 

percent permanent impairment.

In a May 29, 2018 medical report, Dr. David Arroyo, Board-certified in family medicine, 

evaluated appellant for back pain and lumbar pain that began four days prior when he was lifting 

approximately 25-pound boxes of paper at work. He diagnosed a strain of the mid-back and a low 

6 Appellant explained that, shortly after the December 9, 2014 employment injury, he was suspended and 

wrongfully terminated from employment after filing a discrimination complaint against a supervisor who refused to 

allow him to report his injury. His termination was eventually overturned, and he was reinstated on August 27, 2015.

7

Supra note 4.
8

back strain and provided a series of informational fact sheets on back strains with instructions for 

stretches to perform during home care to treat appellant’s symptoms.

In physical therapy reports dated from October 1 to 16, 2018, Ms. Gonzalez discharged 

appellant from physical therapy treatment.

In response to OWCP’s questionnaire, appellant submitted a November 26, 2018 statement 

where he explained that his injury occurred at the baggage area and after his injury he went to the 

emergency room as he could not bend down or pick up items.

In a medical report of even date, Dominick Caracciolo, a physician assistant, evaluated 

appellant after the completion of his physical therapy plan of care for his low back pain. He 

diagnosed low back pain, myofascial tenderness, a lumbar disc displacement at L5 -S1 and 

facetogenic myofascial pain.

By decision dated December 12, 2018, OWCP denied appellant’s traumatic injury claim, 

finding that it had not been filed within the applicable time limits of 5 U.S.C. § 8122. It noted that 

his claimed injury occurred on December 9, 2014 and he did not file his claim until October 2, 

2018, which was more than three years later.

On December 17, 2018 appellant requested a telephonic hearing before a representative of 

OWCP’s Branch of Hearings and Review. In an attached letter of even date, he asserted that his 

claim was timely filed and included a signed December 12, 2014 acknowledgment from his 

immediate supervisor showing that he reported an injury on December 10, 2014. Appellant also 

argued that his claim was mistakenly treated as a recurrence of a previously filed claim and that 

this misconception interfered with the proper resolution of his claim.

Appellant also submitted a December 4, 2015 affidavit from an Equal Employment

Opportunity (EEO) complaint he filed alleging harassment and discrimination based on a disability 

from his supervisor.

In a March 27, 2017 medical report, Dr. Katzman reviewed appellant’s history of treatment 

for his lumbar condition including Dr. Hyde’s April 1, 2014 surgical procedure performed to treat 

his condition. He diagnosed low back pain, radicular right leg radiculitis status post right L5 -S1 

hemilaminectomy with partial facetectomy at L5 and lysis of adhesins with excision of disc 

herniation at L5-S1.

In a February 11, 2019 medical report, Dr. Katzman evaluated appellant during a followup appointment with regard to his April 22, 2013 employment injury. He diagnosed low back 

pain, myofascial tenderness, a lumbar disc displacement at L5-S1 and facetogenic back pain.

A telephonic hearing was held on March 18, 2019. Appellant alleged that his claim 

examiner mistakenly kept his most recent injury as a recurrence under OWCP File No. xxxxxx033 

instead of treating his injury as a new claim. He also explained that he completed a separate form 

for his alleged December 9, 2014 injury and left it with the employing establishment.

In a March 25, 2019 letter, appellant attached a copy of his December 9, 2014 employee 

statement to his workplace injury form and explained that, after his supervisor refused to complete
9

the proper Form CA-1 for his December 9, 2014 injury, he filed the harassment complaint against 

him and the employing establishment.

By decision dated April 25, 2019, OWCP’s hearing representative affirmed the 

December 12, 2018 decision.

On May 14, 2019 appellant appealed to the Board.

In medical reports dated June 27 and August 2, 2019, Dr. Katzman evaluated appellant for 

left-sided low back pain related to his April 22, 2013 employment injury. He diagnosed 

facetogenic low back pain, prescribed anti-inflammatory medication, and referred appellant to 

physical therapy to treat his condition.

In a motion to reverse dated December 4, 2019, the Director of OWCP requested that the 

Board reverse OWCP’s April 25, 2019 decision and find that appellant’s claim was timely filed. 

He reasoned that appellant submitted sufficient evidence demonstrating that his supervisors had 

reasonable notice that he had an on-the-job injury and, thus, satisfying the test for actual 

knowledge. The Director of OWCP asserted that, given that this information was received by 

appellant’s supervisors within the 30-day statutory time frame, appellant’s claim was timely filed.

In an April 28, 2020 medical report, Dr. Katzman evaluated appellant for left-sided back 

pain in relation to his April 22, 2013 employment injury. He diagnosed left-sided low back pain 

and prescribed additional medications for appellant to use.

By order dated June 23, 2020,8the Board granted the Director of OWCP’s motion and 

reversed OWCP’s April 25, 2019 decision, finding that appellant’s claim was timely filed. It also 

ordered that the present case file be administratively combined with appellant’s previous claims in 

OWCP File Nos. xxxxxx033, xxxxxx403 and xxxxxx404.

By decision dated August 3, 2020, OWCP denied appellant’s traumatic injury claim, 

finding that the medical evidence of record was insufficient to establish that his diagnosed lumbar 

condition was causally related to the accepted December 9, 2014 employment incident.

LEGAL PRECEDENT

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of his or her claim, including the fact 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 period of FECA,9that 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.10 These are the essential elements of each and every 

8

Supra note 3.

9

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

153 (1989).

10 L.S., Docket No. 19-1769 (issued July 10, 2020); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).
10

compensation claim, regardless of whether the claim is predicated upon a traumatic injury or an 

occupational disease.11

To determine if an employee has sustained a traumatic injury in the performance of duty, 

OWCP begins with an analysis of whether fact of injury has been established. Fact of injury 

consists of two components that must be considered in conjunction with one another. The first 

component is whether the employee actually experienced the employment incident that allegedly 

occurred.12 The second component is whether the employment incident caused a personal injury.13

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.14 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factor(s) must be based on a 

complete factual and medical background.15 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 factor(s).16

In a case in which a preexisting condition involving the same part of the body is present 

and the issue of causal relationship, therefore, involves aggravation, acceleration, or precipitation, 

the physician must provide a rationalized medical opinion that differentiates between the effects 

of the work-related injury or disease and the preexisting condition.17

ANALYSIS

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

condition causally related to the accepted December 9, 2014 employment incident.

In his medical reports dated from March 27, 2017 to August 3, 2018, Dr. Katzman 

reviewed appellant’s treatment for low back pain and provided work restrictions. He diagnosed 

low back pain, radicular right leg radiculitis status post right L5-S1 hemilaminectomy with partial 

facetectomy at L5 and lysis of adhesions with excision of disc herniation at L5-S1. The Board has 

held, however, that medical evidence that does not offer an opinion regarding the cause of an 

11 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).

12 B.P., Docket No. 16-1549 (issued January 18, 2017); Elaine Pendleton, 40 ECAB 1143 (1989).

13 M.H., Docket No. 18-1737 (issued March 13, 2019); John J. Carlone, 41 ECAB 354 (1989).

14 T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 238 (1996).

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

16 B.C., Docket No. 20-0221 (issued July 10, 2020); Leslie C. Moore, 52 ECAB 132 (2000).

17 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013); 

K.R., Docket No. 21-0822 (issued June28, 2022); V.W., Docket No. 19-1537 (issued May 13, 2020); N.C., Docket 

No. 19-1191 (issued December 19, 2019); R.D., Docket No. 18-1551 (issued March 1, 2019).
11

employee’s condition is of no probative value on the issue of causal relationship.18 For this reason

Dr. Katzman’s medical reports are insufficient to meet appellant’s burden of proof.

Similarly, in medical reports dated from December 10, 2014 to November 6, 2015,

Dr. Hyde evaluated appellant for low back pain related to his diagnosis of intervertebral disc 

displacement, lumbar region. However, as stated above, 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.19 For this reason, Dr. Hyde’s medical reports are insufficient to establish 

appellant’s burden of proof.

Additionally, appellant submitted medical reports dated from April 15, 2016 to August 1, 

2018 where Drs. Fishman and McCarthy provided treatment relating to diagnoses of lumbar disc 

degeneration, lumbosacral spondylosis, lumbar stenosis, lumbosacral post-laminectomy 

syndrome, lumbar myofascial pain syndrome, low back pain, left groin pain and left T12-L1 disc 

herniation paracentrally without significant stenosis worsening at L5-S1. As Drs. Fishman and 

McCarthy did not offer an opinion regarding the cause of appellant’s condition, their medical 

evidence is also of no probative value on the issue of causal relationship. 20

Appellant submitted diagnostic reports dated April 4, 2017 and June 18, 2018 from 

Drs. Young and Alonso, respectively. The Board has held, however, that diagnostic test reports,

standing alone, lack probative value as they do not provide an opinion on causal relationship 

between an employment incident and a diagnosed condition. 21 For this reason, the diagnostic 

reports are insufficient to meet appellant’s burden of proof.

Appellant also provided physical therapy reports dated from January 4 to October 16, 2018 

signed by a physical therapist, and a November 26, 2018 medical report signed by a physician 

assistant. Certain healthcare providers such as physical therapists, nurses, physician assistants, 

and social workers are not considered physicians as defined under FECA. 22 Consequently, their 

medical findings and/or opinions will not suffice for purposes of establishing entitlement to FECA 

benefits.

In a series of reports dated from April 6 to 14, 2015, Dr. Carril, a chiropractor, indicated 

that he treated appellant for right knee pain. The Board notes that section 8101(2) of FECA23

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

19 Id.

20 Id.

21 W.M., Docket No. 19-1853 (issued May 13, 2020); L.F., Docket No. 19-1905 (issued April10, 2020).

22 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); M.F.,Docket No. 17-1973 (issued December 31, 2018); K.W., 59 

ECAB 271, 279 (2007); 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). 

23 Supra note 2.
12

provides that the term physician, as used therein, 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 and subject to regulation by the Secretary.24 

OWCP’s implementing federal regulation at 20 C.F.R. § 10.5(bb) defines subluxation as an 

incomplete dislocation, off-centering, misalignment, fixation or abnormal spacing of the vertebrae 

which must be demonstrated on x-ray. As these reports do not diagnose a subluxation as 

demonstrated by x-ray, they do not constitute probative medical evidence.25

As appellant has not submitted rationalized medical evidence establishing a lumbar 

condition causally related to the accepted December 9, 2014 employment incident, the Board finds 

that he has not met his burden of proof to establish his claim.

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 lumbar 

condition causally related to the accepted December 9, 2014 employment incident.

24 Id.; 20 C.F.R. § 10.311.

25 T.H., Docket No. 17-0833 (issued September 7, 2017); Robert H. St. Onge, 43 ECAB 1169 (1992).
13

ORDER

IT IS HEREBY ORDERED THAT the August 3, 2020 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: November 17, 2022

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board