United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

T.G., Appellant

and

U.S. POSTAL SERVICE, NETWORK 

DISTRIBUTION CENTER, Des Moines, IA, 

Employer

__________________________________________

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Docket No. 22-0244

Issued: September 30, 2022

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 December 9, 2021 appellant filed a timely appeal from a November 8, 2021 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.2

ISSUE

The issue is whether appellant has met her burden of proof to establish a recurrence of 

disability on April 5, 2021, causally related to her accepted December 8, 2018 employment injury.

1

5 U.S.C. § 8101 et seq.

2 The Board notes that, following the November 8, 2021 decision OWCP received additional evidence. 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

FACTUAL HISTORY

On December 9, 2018 appellant, then a 58-year-old mail handler, filed a traumatic injury 

claim (Form CA-1) alleging that on December 8, 2018 she was lifting two heavy parcels when she 

felt a sharp shooting pain in her lower back and down her left leg while in the performance of duty.

OWCP accepted her claim for sciatica, left side. 

Appellant accepted a modified-duty mail handler assignment on December 20, 2018. 

OWCP paid appellant wage-loss compensation on its supplemental rolls for intermittent 

disability commencing February 15, 2019.

In a March 25, 2021 report, Dr. Christian Ledet, a Board-certified anesthesiologist and pain 

medicine specialist, noted appellant’s chronic pain, long-term current use of opiate analgesic drug, 

long-term drug therapy, and radiculopathy due to lumbar intervertebral disc disorder.

An April 5, 2021 magnetic resonance imaging (MRI) scan read by Dr. Aaron C. Hurlbut, 

a Board-certified diagnostic radiologist, revealed findings of L1-3 mild-to-moderate bilateral facet 

arthropathy, L3-5 severe bilateral facet arthropathy, L4-5 left subarticular annular tear, and mild 

L3-4 neural foraminal stenosis.

Appellant stopped work on April 5, 2021.

In an April 8, 2021 report, Dr. Ledet noted appellant’s history of injury and medical 

treatment. He related that an MRI scan of appellant’s lumbar spine revealed degenerative changes 

and annular tears associated with neuritis and radiculopathy. Dr. Ledet diagnosed chronic pain 

and radiculopathy due to lumbar intervertebral disc disorder. He held appellant off work from 

April 5 through 9, 2021 and advised that she could return to work on Monday April 12, 2021.

In an April 16, 2021 disability certificate, Dr. Leona N. Holcomb, a family medicine 

specialist, held appellant off work from April 15 to May 15, 2021.

On April 29 and 30, 2021 appellant filed claims for compensation (Form CA-7) for

disability from work. 

In a May 3, 2021 development letter, OWCP noted that appellant was claiming disability 

from work due to a material change/worsening of her accepted work-related conditions and that 

the evidence submitted was insufficient to establish total disability. It advised her of the definition 

of recurrence of disability and the type of medical and factual evidence needed and provided a 

questionnaire for her completion. OWCP afforded appellant 30 days to submit the necessary 

evidence.

In an April 8, 2021 disability certificate, Dr. Ledet noted that appellant was off work from 

Monday, April 5 to Sunday, April 11, 2021, and could return to work on April 12, 2021, with no 

change in restrictions. 

In April 16, 2021 progress notes, Dr. Holcomb diagnosed acute left-sided low back pain 

with left-sided sciatica, and injury of back, subsequent encounter. In an April 16, 2021 disability 

certificate, she placed appellant off work from April 15 until May 15, 2021.
3

Appellant continued to file Form CA-7 claims for continuing disability from work.

In a May 14, 2021 disability certificate, Dr. Holcomb placed appellant off work for six

weeks due to her continued back pain.

In a June 3, 2021 response to OWCP’s development questionnaire, appellant related that 

her injury was ongoing and that she had not recovered. She explained that she had persistent pain,

some days worse than others. Appellant described her work activities and noted that they included 

bending stooping and walking while in discomfort. She related that on April 5, 2021 she could 

hardly move and it was “agony” just to get out of bed. 

In a June 11, 2021 disability certificate, Dr. Holcomb opined that appellant should not 

return to work until she obtained a second opinion evaluation from another pain specialist.

OWCP received a copy of the March 25 and April 8, 2021 reports from Dr. Ledet and 

physical therapy notes. 

By decision dated June 22, 2021, OWCP denied appellant’s claim for a recurrence of 

disability. It found that the medical evidence of record was insufficient to establish disability from 

work due to a material change or worsening of her accepted work-related conditions.

OWCP subsequently received additional evidence, including treatment notes dated 

June 10, 2021, wherein Dr. Ledet diagnosed chronic pain and radiculopathy due to intervertebral 

disc disorder.

In a June 25, 2021 report, Dr. Ledet provided a summary of appellant’s medical treatment. 

He noted that she was first seen on August 14, 2019 for lower extremity radiculopathy, which was 

consistent with appellant’s MRI scan which demonstrated degenerative changes and disc 

herniation at the L3-4 with associated stenosis at the neural foramina. Dr. Ledet described 

appellant’s treatment including epidural steroids in September and October 2019 with no 

substantial improvement. He noted that the April 5, 2021 MRI scan revealed severe facet 

arthropathy in the lumbar spine with L3-4 foraminal disc bulge and associated stenosis, and 

degenerative disc disease and facet arthropathy at L4-5 with “annular tear.” Dr. Ledet opined that 

appellant’s MRIscan findings were consistent with the pain and disability that appellant continued

to experience in the low back and left lower extremity and that it is understandable that she would 

have a great deal of difficulty with work activities that required bending, lifting, standing, or sitting 

for even short periods of time. He advised, “unfortunately, we do not have good treatments for 

this progressive degenerative process that you’re experiencing.”

OWCP received copies of prior reports and November 19, 2020 treatment notes from

Dr. Ledet. In this report, Dr. Ledet noted appellant’s radiculopathy due to lumbar intervertebral 

disc disorder, with an onset on August 14, 2019. 

In a July 20, 2021 report, Dr. Holcomb noted that appellant was seen for many months 

regarding her work injury and subsequent low back pain. She noted that appellant had tried several 

medications and was sent to a pain management specialist. Dr. Holcomb also noted that appellant 

had been treated with several epidural injections which were not helpful. She opined that appellant 

had an “ongoing issue and not a recurrence. Her low back pain is worsening.” Dr. Holcomb 

related that appellant described “the pain as excruciating. With any short episodes of activity such 

as sitting, walking, or standing, she is in severe pain. She finds more comfort only if she is laying 
4

down.” Dr. Holcomb opined that she could not predict how long appellant would be in pain and 

unable to work and held appellant off work for two months from July 20 through 

September 20, 2021.

On August 13, 2021 appellant requested reconsideration. In an August 13, 2021 letter, she 

noted that she was fine before her traumatic injury, that she had never recovered, and that she dealt 

with her injury on a daily basis. Appellant explained that she was offered a mod ified job on 

December 20, 2018, and she was still injured but “striving” to do her job. She indicated that her 

duties required standing, walking, bending, carrying, reaching, grasping, rewrapping, sitting and 

typing and that she would call in periodically on days that “weren’t so good.” Appellant related 

that on the morning of April 5, 2021 she was not doing anything different, but that she could barely 

move. She related that over a period of time, her injury had worsened, and she was limited in her 

activities and mobility in her daily life. Appellant described her treatment and drug therapies, 

noted that none of them worked, and indicated that surgery was not an option.

In support of her request for reconsideration, appellant submitted an August 6, 2021report,

wherein Dr. Holcomb related that appellant returned to work on December 9, 2018, as she was 

offered a modified job. She noted that appellant tried to perform that job, but found the activities 

worsened her original left sciatica, as well as her low back pain, and periodically took days off 

work due to pain and decreased mobility. Dr. Holcomb noted that on April 5, 2021 appellant could 

barely move while she was undergoing an MRl scan for further evaluation on her back pain. She 

related that appellant followed the prescribed testing, treatments, physical therapy, epidurals, and 

consultations, without improvement, and in fact experienced worsening of the pain and inability 

to function. Dr. Holcomb opined that appellant was no longer able to work and should apply for 

disability. 

By letters dated August 19 and September 27, 2021, OWCP referred appellant to the 

June 22, 2021 decision, which denied her claim for total disability from April 5, 2021 and 

continuing. It explained that no further action would be taken and she was to follow her appeal 

rights enclosed with that decision if she disagreed.

OWCP continued to receive Form CA-7 claims for continuing disability through 

October 22, 2021. 

By decision dated November 8, 2021, OWCP denied modification of its June 22, 2021 

decision.

LEGAL PRECEDENT

A recurrence of disability means an inability to work after an employee has returned to 

work, caused by a spontaneous change in a medical condition which resulted from a prev ious 

compensable injury or illness and without an intervening injury or new exposure in the work 

environment.3

OWCP’s procedures provide that a recurrence of disability includes a work stoppage 

caused by a spontaneous material change in the medical condition demonstrated by objective 

findings. That change must result from a previous injury or occupational illness rather than an 

3

20 C.F.R. §10.5(x); T.J., Docket No. 18-0831 (issued March 23, 2020).
5

intervening injury or new exposure to factors causing the original illness. It does not include a 

condition that results from a new injury, even if it involves the same part of the body previously 

injured.4

An employee who claims a recurrence of disability due to an accepted employment-related 

injury has the burden of proof to establish by the weight of the substantial, reliable, and probative 

evidence that the disability for which he or she claims compensation is causally related to the 

accepted injury. This burden of proof requires that a claimant furnish medical evidence from a 

physician who, on the basis of a complete and accurate factual and medical history, concludes that, 

for each period of disability claimed, the disabling condition is causally related to the employment 

injury, and supports that conclusion with medical reasoning.5 Where no such rationale is present, 

the medical evidence is of diminished probative value.6

ANALYSIS

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

disability on April 5, 2021, causally related to her accepted December 8, 2018 employment injury.

Appellant provided several reports from Dr. Ledet. In November 19, 2020 progress notes,

Dr. Ledet noted appellant’s diagnosis of radiculopathy due to lumbar intervertebral disc disorder. 

He related that this condition was onset on August 14, 2019. In a March 25, 2021 report, Dr. Ledet 

noted appellant’s chronic pain and diagnosed radiculopathy due to lumbar intervertebral disc 

disorder. In an April 8, 2021 report, he related appellant’s diagnoses and placed her off work from 

April 5 through 9, 2021. In an April 8, 2021 disability certificate, Dr. Ledet noted that appellant 

was off work from Monday, April 5 to Sunday, April 11, 2021. He also saw appellant on June 10, 

2021 and diagnosed chronic pain and radiculopathy due to intervertebral disc disorder. In a 

June 25, 2021 report, Dr. Ledet related that appellant was first seen on August 14, 2019 for lower 

extremity radiculopathy, which was consistent with appellant’s MRI scan which demonstrated 

degenerative changes and disc herniation at L3-4 with associated stenosis at the neural foramina. 

He noted that appellant’s April 5, 2021 MRI scan revealed severe facet arthropathy in the lumbar 

spine with L3-4 foraminal disc bulge and associated stenosis and degenerative disc disease and 

facet arthropathy at L4-5 with “annular tear.” Dr. Ledet opined that it was understandable that 

appellant would have a great deal of difficulty with work activities that required bending, lifting, 

standing, or sitting for even short periods of time. While Dr. Ledet found that appellant was 

disabled and placed her off work, he did not address whether the disability was causally related to 

the accepted employment injury of sciatica. 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 

4 Federal (FECA) Procedure Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.2 (June 2013); F.C., Docket 

No. 18-0334 (issued December 4, 2018).

5

J.D., Docket No. 18-0616 (issued January 11, 2019).

6 G.G., Docket No. 18-1788 (issued March 26, 2019).
6

value on the issue of causal relationship.7 This evidence is therefore of no probative value and 

insufficient to meet appellant’s burden of proof.8

Appellant also submitted several reports from Dr. Holcomb. In April 16, 2021 treatment 

notes, Dr. Holcomb diagnosed acute left-sided low back pain with left-sided sciatica, and injury 

of back, subsequent encounter. She provided April 16, May 14, and June 11, 2021 disability 

certificates and opined that appellant should not return to work. In a July 20, 2021 report,

Dr. Holcomb opined that appellant had an “ongoing issue and not a recurrence. Her low back pain 

is worsening.” She explained that appellant related that “the pain as excruciating.” In an August 6, 

2021 report, Dr. Holcomb opined that appellant was no longer able to work and should apply for 

disability. However, Dr. Holcomb did not provide 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.9 Dr Holcomb’s 

reports are therefore of no probative value and insufficient to meet appellant’s burden of proof to 

establish her disability claim.

The record also contains diagnostic reports. However, the Board has long held that 

diagnostic studies, standing alone, lack probative value as they do not address whether the 

employment injury caused any of the diagnosed conditions or associated disability. 10 For this 

reason, the Board finds that the diagnostic reports are insufficient to establish appellant’s disability 

claim.

OWCP also received May 13, 2021 physical therapy notes. Certain healthcare providers 

such as physical therapists, nurses, physician assistants, and social workers are not considered 

physicians as defined under FECA.11 Consequently, their medical findings and/or opinions will 

not suffice for purposes of establishing entitlement to FECA benefits.12

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

the claimed recurrence of disability and the accepted 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 and 20 C.F.R. §§ 10.605 through 10.607. 

7

See T.M., Docket No. 21-1310 (issued March 7, 2022); K.F., Docket No. 19-1846 (issued November 3, 2020); 

L.B., Docket No. 18-0533 (issued August27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

8

See D.B., Docket No. 21-0503 (issued August 24, 2021).

9

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

10 See T.W., Docket No. 20-1669 (issued May 6, 2021); J.S., Docket No. 17-1039 (issued October 6, 2017).

11 Section 8101(2) of FECA provides that the term 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 Federal (FECA) Procedure Manual, Part 2 -- Claims, 

Causal Relationship, Chapter 2.805.3a(1) (January 2013); DavidP. 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 also A.M., Docket No. 20-1575 (issued May 24, 2021) (physical therapists are not physicians as 

defined by FECA).

12 Id.
7

CONCLUSION

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

disability on April 5, 2021 causally related to her accepted December 8, 2018 employment injury.

ORDER

IT IS HEREBY ORDERED THAT the November 8, 2021 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: September 30, 2022

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