United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.S., Appellant

and

U.S. POSTAL SERVICE, BUDD LAKE POST 

OFFICE, Budd Lake, NJ, Employer

__________________________________________

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Docket No. 20-0305

Issued: November 16, 2022

Appearances: Case Submitted on the Record

Thomas R. Uliase, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On November 25, 2019 appellant, through counsel, filed a timely appeal from a June 27, 

2019 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.

ISSUES

The issues are: (1) whether appellant has met her burden of proof to establish disability 

from work for the period March 1 through 4, 2016 causally related to her accepted January 15, 

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

2016 employment injury; and (2) whether appellant has established that the acceptance of her 

claim should be expanded to include additional conditions causally related to the accepted 

January 15, 2016 employment injury.

FACTUAL HISTORY

On January 20, 2016 appellant, then a 50-year-old city carrier assistant, filed a traumatic 

injury claim (Form CA-1) alleging that on January 15, 2016 she sustained lower extremity injuries 

when an oncoming vehicle collided with her vehicle, striking the driver’s-side door, while in the 

performance of duty. She stopped work on January 16, 2016. 

In an attending physician’s report, Part B of an authorization for examination and/or 

treatment (Form CA-16) dated January 22, 2016, Dr. Gary J. Arvary, Board-certified in family 

medicine, noted appellant’s history of injury and diagnosed multiple contusions and hematoma 

and indicated that her condition was caused or aggravated by a motor vehicle accident (MVA) in 

a work vehicle. He indicated that appellant was totally disabled from work during the period

January 16 through February 8, 2016 and advised that she would be able to resume light work on 

February 8, 2016 with restrictions of no lifting over 20 pounds.

In a report dated February 11, 2016, Dr. Manik Singh, Board-certified in family practice 

and sports medicine, noted that appellant was injured on January 15, 2016 when she was involved 

in an MVA. Appellant had not returned to work since the injury and she noted intermittent pain 

in her left thigh, right knee, bilateral upper extremities, and the left side of her neck. Dr. Singh 

diagnosed right knee and left thigh pain, left hip trochanteric bursitis, and cervicalgia. He advised 

that appellant could return to work on February 11, 2016 and perform light duty with restrictions 

of no carrying, lifting, and/or pushing/pulling more than 15 pounds.

By decision dated March 2, 2016, OWCP denied appellant’s claim,finding that the medical 

evidence of record was insufficient to establish causal relationship between a diagnosed medical 

condition and the accepted January 15, 2016 employment incident. 

OWCP continued to receive medical evidence. In a report dated February 25, 2016,

Dr. Singh noted that appellant was seen in follow-up for persistent pain. On physical examination, 

he observed left paraspinal cervical tenderness, left hip tenderness to palpation at the trochanteric 

bursa with decreased range of motion and strength, diffuse tenderness to palpation of the right 

knee with decreased range of motion and strength. Dr. Singh recommended a return-to-work date 

of February 25, 2016 with the same restrictions he noted in his previous February 11, 2016 report.

In an attending physician’s report (Form CA-20) dated March 2, 2016, Dr. Daryl Kim, an 

internist, noted that appellant’s physical examination findings included myofascial tenderness, 

stiffness, and reduced range of motion. He diagnosed myofascial pain and fibromyalgia and 

checked a box marked “Yes” indicating that appellant’s fibromyalgia was aggravated by an MVA. 

Dr. Kim opined that appellant was totally disabled from work commencing January 15, 2016.

In a report dated March 3, 2016, Dr. Kim related that appellant had continued issues with 

her neck, right knee, and left thigh. He indicated that appellant had aggravated her fibromyalgia 

as a result of the MVA on January 15, 2016. Appellant described her fibromyalgia manifesting in
3

shoulder, hip, and lower back pain. On physical examination, Dr. Kim observed trigger points, 

soft tissue myofascial and muscle tenderness of the trunk and extremities, and generalized stiffness 

with decreased range of motion. He diagnosed fibromyalgia, myofascial pain, and insomnia.

Appellant’s treatment goal was noted as “improve symptoms and return to work.”

On March 4, 2016 appellant filed a claim for compensation (Form CA-7) for disability 

from work for the period March 1 through 4, 2016. 

On March 18, 2016 Dr. Kim treated appellant in follow-up for diagnoses of fibromyalgia, 

insomnia, and myofascial pain. On physical examination, he observed trigger points, soft tissue 

myofascial and muscle tenderness of the trunk and extremities, and generalized stiffness with 

decreased range of motion. Dr. Kim recommended follow up with physical therapy and a 

rheumatologist in order to improve symptoms and return to work.

Appellant, on March 28, 2016, requested a hearing before a representative of OWCP’s 

Branch of Hearings and Review. The hearing was held on June 23, 2016.

OWCP subsequently received a report dated June 1, 2016, wherein Dr. Arvary, noted that 

appellant had been diagnosed with fibromyalgia in 2012 and that, subsequent to the January 15, 

2016 MVA, her fibromyalgia symptoms had worsened, as she still experienced intermittent left 

thigh, right knee, and bilateral hip, arm, and leg pain. Dr. Arvary stated that appellant could not 

perform her activities of daily living without pain and exhaustion, which did not occur prior to the 

incident. He opined that as appellant described her symptoms as severe enough that it precluded 

her ability to function on a daily basis, it was unlikely that appellant would be employable.

By decision dated July 28, 2016, OWCP’s hearing representative affirmed the March 2, 

2016 decision.

On May 1, 2017 appellant, through counsel, requested reconsideration and submitted 

additional evidence.

In a report dated March 19, 2017, Dr. Arvary related that appellant’s preexisting conditions 

had been chronic but she was still able to work. He noted that when seen on March 3, 2017, it was 

apparent that appellant had been disabled since the MVA of January 15, 2016, as her neck and 

arms were in constant pain with paresthesias, and she had upper extremity weakness. Dr. Arvary 

opined that she could not return to work as she had limitations in sitting, walking, standing, lifting, 

and concentration; and she could not drive alone but for short distances due to her loss of 

concentration. He noted that appellant’s fibromyalgia had worsened since the January 15, 2016

incident. Dr. Arvary summarized medical reports from February 23, 2016. He explained that the 

first time he treated appellant was on October 20, 2016, at that time appellant complained of 

fatigue. Physical examination on that date indicated decreased neck range of motion, left neck 

tenderness, and bilateral grasp weakness. On December 30, 2016 appellant was seen by another 

provider in his office for follow up for the post-concussion syndrome diagnosis. She related that 

she had pain in every joint of her body and stated that she was unable to accomplish any activities 

of daily living. Dr. Arvary recommended physical therapy, but on January 25, 2017, appellant 

indicated to him that physical therapy had worsened her pain. He diagnosed depression, anxiety,

post-concussion syndrome, nonspecific inflammatory response of the hands, shoulders, 
4

supraclavicular areas, and sternoclavicular joint, memory loss, and insomnia. Dr. Arvary observed 

that tests included an electroencephalogram, which was negative. A bone scan performed on 

February 14, 2017 demonstrated degenerative changes in the shoulders, sternoclavicular joints, 

spine, and mildly symmetric periarticular activity in the joints of the hands bilaterally. Amagnetic 

resonance imaging scan of the brain was negative. Dr. Arvary noted that a previous x-ray of 

appellant’s cervical spine demonstrated multilevel disc space narrowing with associated anterior 

and posterior spurring resulting in mild bilateral neural foraminal narrowing at those levels. He 

opined that it was difficult to imagine that appellant’s motor vehicle incident did not aggravate this 

type of pathology. Dr. Arvary opined that the MVA on January 15, 2016had worsened appellant’s

preexisting conditions and had directly caused her inability to work since January 15, 2016. He

further opined that he could not render a prognosis on her ongoing care except for the fact that she 

remained unable to work or function at home normally due to her level of pain, loss of 

concentration, and lack of memory. Dr. Arvary concluded that appellant was totally disabled from

work as the MVA had aggravated preexisting conditions.

In a decision dated July 28, 2017, OWCP modified the prior decision to find that the 

medical evidence of record was sufficient to establish contusions of the left front wall of the thorax, 

left thigh, right hand, and right knee as causally related to the accepted employment injury. It

further found, however, that the medical evidence of record was insufficient to establish 

depression, anxiety, post-concussion syndrome, non-specific inflammatory response of the hands, 

shoulders, and supraclavicular areas and sternoclavicular joint, memory loss, insomnia, loss of 

ability to perform daily activities, spinal stenosis, cervicalgia, post-traumatic headache, dizziness, 

and aggravation of fibromyalgia as causally related to the accepted employment injury. OWCP

noted that Dr. Arvary had not explained how appellant’s aggravation of fibromyalgia was directly 

caused or aggravated by the January 15, 2016 incident. 

By decision dated July 31, 2017, OWCP formally accepted the conditions of contusions of 

the left front wall of the thorax, left thigh, right hand, and right knee as causally related to the 

accepted January 15, 2016 employment incident.

In a development letter dated July 31, 2017, OWCP informed appellant of the deficiencies 

of her claim for wage-loss compensation. It advised her of the type of medical evidence needed 

and afforded her 30 days to submit the necessary evidence.

In a letter dated August 9, 2017, counsel clarified that appellant had been off work 

continuously since January 15, 2016 and noted that additional CA-7 forms would be processed 

through the employing establishment. 

By decision dated September 1, 2017, OWCP denied appellant’s claim for compensation, 

finding that she had not established disability from work for the period March 1 through 4, 2016. 

On September 7, 2017 appellant, through counsel, requested a hearing before a 

representative of OWCP’s Branch of Hearings and Review. The hearing was held on 

February 27, 2018. 

By decision dated May 11, 2018, OWCP’s hearing representative affirmed the 

September 1, 2017 decision. 
5

On June 12, 2018 appellant, through counsel, requested reconsideration of the May 11, 

2018 decision. Attached to the request was an April 22, 2018 report from Dr. Arvary. Dr. Arvary 

noted that appellant was involved in an MVA on January 15, 2017 while working for the 

employing establishment and was not wearing a seatbelt. At the time of the incident, appellant 

lived and worked with chronic conditions that did not affect her life either personally or at work. 

Dr. Arvary stated that the force of the impact was so severe that it caused her body to be forcibly 

jolted inside the vehicle, which caused her chronic condition of fibromyalgia to worsen. He opined

that after the accident appellant was unable to complete any duties of her employment. Dr. Arvary

noted that she still experienced chronic pain in her neck, arms, right knee, right hand, and left leg, 

with paresthesias and weakness in her upper extremities. He opined that these symptoms stemmed 

from the vehicle being struck with such great force that caused appellant to be thrown into the 

steering wheel and for her leg to be stressed under the dashboard. Dr. Arvary also diagnosed postconcussion syndrome and attributed it to the contusion of the left frontal wall of her thorax, noting 

that she did not need to suffer direct head trauma to sustain the condition, as she struck the steering 

wheel, was thrust backwards in her seat, then again struck the steering wheel. He stated that, due 

to this motion, appellant sustained brain trauma without direct impact to her head, as the sudden 

jarring back and forth caused her brain to impact her skull. Dr. Arvary explained that while the 

injury did not appear on imaging studies, the resultant inflammatory changes resulted in 

neurological symptoms. He noted that appellant still suffered from chronic pain from her left 

thigh, right hand, and left knee contusions, which were chronic injuries due to her immune system 

causing chronic changes in those areas. Dr. Arvary opined that she would not ever be able to 

return to her preinjury position as city carrier assistant.

By decision dated June 27, 2019, OWCP denied modification of the May 11, 2018

decision.

3

 

LEGAL PRECEDENT -- ISSUE 1

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

essential elements of his or her claim, including that any disability for which compensation is 

claimed is causally related to the employment injury.4

Under FECA the term “disability” means the incapacity, because of an employment injury, 

to earn the wages that the employee was receiving at the time of injury.5 

The Board will not require OWCP to pay compensation for disability in the absence of 

medical evidence directly addressing the specific dates of disability for which compensation is 

3

It noted that the June 27, 2019 decision superseded a September 6, 2018decision. 

4

S.W., Docket No. 18-1529 (issued April 19, 2019); J.F., Docket No. 09-1061 (issued November 17, 2009); 

Kathryn Haggerty, 45 ECAB 383 (1994); Elaine Pendleton, 40 ECAB 1143 (1989); see also Nathaniel Milton, 37 

ECAB 712 (1986).

5

See B.K., Docket No. 18-0386 (issued September 14, 2018).
6

claimed. To do so, would essentially allow an employee to self-certify their disability and 

entitlement to compensation.6

ANALYSIS -- ISSUE 1

The Board finds that appellant has not met her burden of proof to establish disability from 

work for the period March 1 through 4, 2016 causally related to her accepted January 15, 2016 

employment injury.

Appellant was first seen following March 1, 2016 by Dr. Kim. In a Form CA-20 dated 

March 2, 2016, Dr. Kim noted diagnoses of myofascial pain and fibromyalgia and opined that 

appellant was totally disabled from work commencing January 15, 2016. In reports dated March 3 

and 18, 2016, Dr. Kim repeated his diagnoses and continued to opine that appellant was disabled 

from work. Medical evidence that does not address the specific claimed dates of disability are of 

no probative value.

7

 This evidence is therefore insufficient to establish appellant’s disability claim.

Dr. Arvary discussed appellant’s fibromyalgia condition in his June 1, 2016 report. In his 

March 19, 2017 and April 22, 2018 reports, he related that prior to the employment injury 

appellant’s preexisting conditions had been chronic, but had allowed her to work. He further 

reported that after appellant was seen on March 3, 2017 it was apparent that she had been disabled 

since the employment injury due to constant neck and arm pain, with paresthesias and weakness 

of her upper extremities. Dr. Arvary indicated that appellant could not return to work as she had 

limitations sitting, walking, standing, lifting and concentration. In his April 22, 2018 report, he

further explained that appellant’s fibromyalgia and her post-concussion syndrome would not allow 

her to return to her position as a city carrier assistant. The reports of Dr. Arvary did not provide a 

rationalized medical opinion explaining why appellant was disabled due to her accepted 

employment injury. The Board has held that a report is of limited probative value regarding causal 

relationship if it does not contain medical rationale explaining how the claimed disability was 

related to the employment injury.

8

 Thus, this evidence is also insufficient to establish the claim. 

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

appellant’s claimed disability and the accepted employment injury, the Board finds that appellant 

has not met her burden of proof.

6 B.M.,Docket No. 19-1075 (issued February 10, 2021); R.A., Docket No. 19-1752 (issued March 25, 2020); A.W., 

Docket No. 18-0589 (issued May 14, 2019); Fereidoon Kharabi, 52 ECAB 291 (2001).

7 E.B., Docket No. 19-1390 (issued May 7, 2020);K.D., Docket No. 19-0628 (issued November 5, 2019);A.T., 

Docket No. 19-0410 (issued August13, 2019).

8

See Y.D., Docket No. 16-1896 (issued February 10, 2017) (finding that a report is of limited probative value 

regarding causal relationship if it does not contain medical rationale explaining causal relationship between the 

accepted work factors and a diagnosed condition/disability).
7

LEGAL PRECEDENT -- ISSUE 2

When an employee claims that a condition not accepted or approved by OWCP was due to 

an employment injury, he or she bears the burden of proof to establish that the condition is causally 

related to the employment injury.9

To establish causal relationship between the condition as well as any additional conditions 

claimed and the employment injury, an employee must submit rationalized medical evidence. 10 

The opinion of the physician must be based on a complete factual and medical background of the 

claimant, 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 factors identified by the claimant.11

ANALYSIS -- ISSUE 2

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

acceptance of her claim should be expanded to include additional conditions causally related to 

the accepted January 15, 2016 employment injury.

In his reports, Dr. Arvary described that the force of the impact on January 15, 2016 was 

so severe that it caused appellant’s body to be forcibly jolted inside the vehicle, which caused her 

chronic condition of fibromyalgia to worsen. In this report he also further addressed appellant’s 

post-concussion syndrome and attributed it to her left frontal thorax contusion. Dr. Arvary

explained that appellant did not need direct head trauma to sustain the condition, as she struck the 

steering wheel, was thrust backwards, and then again struck the steering wheel. This motion 

caused brain trauma without direct impact and the resulting inflammatory changes resulted in 

neurologic symptoms. While Dr. Arvary attempted to explain a possible mechanism of injury for 

a concussion during the accepted incident, the contemporaneous medical evidence from 

March 2016 does not establish that appellant was treated for concussion at that time. The Board 

has previously explained that medical reports which contain an incorrect history of injury are of 

limited probative value.12 This evidence is therefore insufficient to establish expansion of the 

claim.

In Form CA-20 dated March 2, 2016, Dr. Kim noted that appellant’s physical examination 

findings included myofascial tenderness, stiffness, and reduced range of motion. He diagnosed 

9 V.S., Docket No. 19-1370 (issued November 30, 2020); M.M., Docket No. 19-0951 (issued October 24, 2019); 

Jaja K. Asaramo, 55 ECAB 200 (2004).

10 T.K., Docket No. 18-1239 (issued May 29, 2019); M.W., 57 ECAB 710 (2006); John D. Jackson, 55 ECAB 

465 (2004).

11 T.K., id.; I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345 (1989).

12 D.G., Docket No. 22-0109 (issued May 17, 2022); M.G., Docket No. 18-1616 (issued April9, 2020); see J.M., 

Docket No. 17-1002 (issued August22, 2017) (a medical opinion must reflect a correct history and offer a medically 

sound explanation by the physician of how the specific employment incident physiologically caused or aggravated the 

diagnosed conditions).
8

myofascial pain and fibromyalgia and checked a box marked “Yes” indicating that appellant’s 

fibromyalgia was aggravated by an MVA. In a report dated March 3, 2016, Dr. Kim related that 

appellant had continued issues with her neck, right knee, and left thigh. He indicated that appellant 

had aggravated her fibromyalgia as a result of the MVA on January 15, 2016. Appellant described 

her fibromyalgia manifesting in shoulder, hip, and lower back pain. On physical examination,

Dr. Kim observed trigger points, soft tissue myofascial and muscle tenderness of the trunk and 

extremities, and generalized stiffness with decreased range of motion. He diagnosed fibromyalgia, 

myofascial pain, and insomnia. Appellant’s treatment goal was noted as “improve symptoms and 

return to work.” On March 18, 2016 Dr. Kim treated appellant in follow up for diagnoses of 

fibromyalgia, insomnia, and myofascial pain. On physical examination, he observed trigger 

points, soft tissue myofascial and muscle tenderness of the trunk and extremities, and generalized 

stiffness with decreased range of motion. Dr. Kim recommended follow up with physical therapy 

and a rheumatologist in order to improve symptoms and return to work. However, these reports 

do not provide a rationalized medical opinion explaining how the accepted employment injury 

physiologically caused or aggravated appellant’s additional conditions.

13

 As such, the Board finds 

that this evidence is insufficient to establish expansion of the claim.

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

appellant’s additional conditions and the January 15, 2016 employment injury, the Board finds 

that appellant 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.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish disability from 

work for the period March 1 through 4, 2016 causally related to her accepted January 15, 2016 

employment injury. The Board further finds that appellant has not met her burden of proof to 

establish that the acceptance of her claim should be expanded to include additional conditions 

causally related to the accepted January 15, 2016 employment injury.

13 Id.
9

ORDER

IT IS HEREBY ORDERED THAT the June 27, 2019 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: November 16, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board