United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.D., Appellant

and

DEPARTMENT OF HOMELAND SECURITY, 

TRANSPORTATION SECURITY 

ADMINISTRATION, Newark, NJ, Employer

__________________________________________

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Docket No. 23-0841

Issued: December 15, 2023

Appearances: Case Submitted on the Record

Michael D. Overman, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On June 2, 2023 appellant, through counsel, filed a timely appeal from a December 22, 

2022 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.

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

ISSUE

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

causally related to the accepted factors of her federal employment.

FACTUAL HISTORY

This case has previously been before the Board.3 The facts and circumstances of the case 

as set forth in the Board’s prior order and decision are incorporated herein by reference. The 

relevant facts are as follows.

On August 18, 2016 appellant, then a 54-year-old transportation security officer, filed an 

occupational disease claim (Form CA-2) alleging that she sustained an injury to her knees, hips, 

ankles, feet, and lower back due to factors of her federal employment, including lifting up to 70 

pounds, twisting, bending, squatting, walking, and standing. She noted that she first became aware 

of her claimed conditions on March 1, 2015 and realized their relation to her federal employment 

on July 5, 2016. Appellant stopped work on July 27, 2016.

By decision dated December 5, 2016, OWCP denied appellant’s claim, finding that the

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

medical conditions and the accepted factors of her federal employment.

On December 13, 2016 appellant, through counsel, requested an oral hearing before a

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

March 1, 2017. By decision dated April 4, 2017, OWCP’s hearing representative affirmed the 

December 5, 2016 decision.

On September 28, 2017 appellant, through counsel, appealed to the Board. By decision 

dated November 6, 2018, the Board affirmed the April 4, 2017 hearing decision, finding that 

appellant had not met her burden of proof to establish a medical condition causally related to the 

accepted factors of her federal employment.

OWCP continued to receive additional medical evidence following the April 4, 2017

decision.

The additional medical evidence included reports dated April 26, 2016 and March 15, 

May 4, July 18, and August 3, 2017 from Dr. Mark Filippone, a Board-certified physiatrist.

Dr. Filippone noted appellant’s complaints and her physical examination findings relative to the 

knees, hips, ankles, and lumbar spine. He continued to opine that she was totally disabled. In his 

May 4, 2017 treatment note, Dr. Filippone opined, ‘‘In my professional medical opinion all of 

[appellant’s] present problems are the direct and sole result of injuries sustained while working for 

the [employing establishment]. More than that, I cannot say.” In his August 3, 2017 treatment 

3 Order Remanding Case, Docket No. 20-0168 (issued March 5, 2021); Docket No. 17-2011 (issued 

November 6, 2018).
3

note, Dr. Filippone indicated that he believed that he had answered all of the questions posed by 

OWCP. 

In an August 8, 2017 report, Dr. Marc Cohen, a pain medicine specialist, noted appellant’s 

history of injury and treatment. He noted that she was obese, had difficulty with walking across 

the room, and had difficulty with right and left heel toe walking. Dr. Cohen diagnosed lumbar 

discogenic pain with referred radiculopathy. 

OWCP also received reports dated September 12and 19 and November 7 and 21, 2017and

May 15 and June 26, 2018, from Dr. Jahnna Levy, an osteopathic physician Board-certified in 

physical medicine and rehabilitation. Progress reports from this clinic by Dr. Dipan Patel, a Boardcertified anesthesiologist, dated August 21, 2017 and March 15, 2018 were also received. These 

reports related a history of injury that, in 2014, appellant injured her right foot on the job while 

sitting at a ticket counter when the leg of the chair broke causing her to fall backward, and her 

right foot struck the ground awkwardly. Appellant’s diagnoses were listed as osteoarthritis of the 

knee, pain in right knee, pain in unspecified knee, other intervertebral disc degeneration of 

lumbosacral region, low back pain, and lumbar radiculopathy. The physicians also indicated that 

her pain was exacerbated by work activities of bending and lifting. 

Treatment notes dated September 15, October 31, and December 12, 2017, and January 19 

and May 29, 2018, were also received from Dr. Neil Sinha, a specialist in pain management. On 

September 15, 2017 Dr. Sinha reported that appellant had undergone left L4-S1 lumbar 

transforaminal epidural steroid and lumbar epidurography for diagnoses of lumbar radiculopathy 

and lumbar herniated disc. 

Minesh Patel, a physician assistant, also submitted reports dated October 3, 2017 and

April 30, 2018.

On February 19, 2019 appellant, through counsel, requested reconsideration.

In a January 10, 2019 report, Dr. Filippone noted appellant’s history of injury and

preexisting conditions. He opined that her work as a transportation security officer since 

October 1, 2006 increased her vulnerability to trauma of the spinal canal and a fall off of a chair 

in June 2014, aggravated her previously damaged back, right foot and ankle, both knees, and left 

hip. Dr. Filippone further explained that these injuries caused the activation of chemical mediators 

to release from the cell bodies of the sensory neurons and nonneurogenic mediated release from 

tissue played a role in initiating the perpetuating of an inflammatory response as reflected in the 

April 26, 2015 electromyogram (EMG) studies. He concluded that the EMG studies revealed a 

left L5-S1 lumbosacral radiculopathy with partial denervation in muscles innervated by the mid 

and lower lumbar dorsal rami on the left. Dr. Filippone further related that appellant’s June 29, 

2016 magnetic resonance imaging (MRI)scan of the right knee was highly abnormal and provided 

evidence of multiple abnormalities which were some years in the process of developing, but which 

were totally consistent with the history of her work incidents in 2014 and 2016, as were the MRI 

scan studies of her left knee and left hip. 

OWCP also received a June 25, 2016 MRI scan of the lumbar spine and a June 29, 2016 

MRI scan of the knees. 
4

By decision dated May 20, 2019, OWCP denied modification of its prior decision. It noted

that the evidence on reconsideration consisted only of the January 10, 2019 report from

Dr. Filippone.

On October 29, 2019 appellant, through counsel, filed a timely appeal to the Board from 

the May 20, 2019 decision.

By decision dated March 5, 2021, the Board set aside the May 20, 2019 decision and 

remanded to the case to OWCP, finding that OWCP had not properly considered all of the evidence 

of record.

By decision dated May 14, 2021, OWCP again denied appellant’s claim, finding that the 

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

conditions and the accepted employment factors.

On May 26, 2021 appellant, through counsel,requested an oral hearing, which was held on 

September 9, 2021. 

By decision dated November 2, 2021, OWCP’s hearing representative affirmed the 

May 14, 2021 decision.

In a November 5, 2021 statement, appellant described her 2014 incident at work when she 

fell off a chair and injured her right foot; that in 2015 she began experiencing hip, knee, and ankle 

problems; and that in 2016 her pain increased due to her job duties which required bending and 

picking up bags up to 70 pounds and patting down passengers. She also noted a new injury in 

March 2021 when she was riding her mobile scooter in a warehouse club. Appellant alleged that 

this caused more pain in her hips, knees, and legs. Counsel also enclosed new medical evidence.

In a March 4, 2021 office note, Dr. Jaswinder Chauhan, a family medicine specialist, saw 

appellant for body aches and a sudden onset of pain. He related that she drove a motorized cart 

into a pole, jarring her. Dr. Chauhan noted that appellant reported abdominal pain, bilateral lower 

leg bruising, and bilateral hip and lower back pain. He also noted that she reported a history of a 

workers’ compensation injury to her knees. Dr. Chauhan examined appellant and diagnosed 

contusion of unspecified lower leg, initial encounter, uncomplicated, and myalgia, uncomplicated. 

Emergency room notes dated March 10, 2021, by Dr. Ryan S. Slife, an emergency 

medicine specialist, revealed that appellant was seen for bilateral hip and knee pain, following an 

injury at a warehouse club nine days prior. Appellant was sore in her hips and knees, but her knee 

pain was improving, and she had been ambulating. Dr. Silfe noted no other concerns or 

complaints, no numbness, or paresthesia, x-rays of the hip and pelvis revealed severe osteoarthritis,

and diagnosed minor trauma and right hip pain.

A March 10, 2021 x-ray of the right hip/pelvis, read by Dr. Lawrence R. Lough, Boardcertified in diagnostic radiology, revealed severe osteoarthritis and no demonstrable fracture.

OWCP also received a January 15, 2020 x-ray of the bilateral hip and pelvis read by

Dr. Evan Johnson, a radiologist, which revealed severe left hip osteoarthritis, and a September 9, 
5

2021 x-ray of the knees read by Dr. Mira Chakravarty, a Board-certified diagnostic radiologist,

which revealed right knee moderate bicompartmental degenerative changes.

With a letter dated October 27, 2021, counsel for appellant provided treatment notes from

Dr. Oladapo Babatunde, Board-certified in orthopedic surgery, dating from August 21, 2018 to 

October 11, 2021, which indicated that he performed her February 12, 2019 left knee arthroscopy, 

partial medial and lateral meniscectomy, chondroplasty, and major synovectomy. Dr. Babatunde

diagnosed bilateral knee osteoarthritis and opined that her weight was contributing to her knee 

pain. He recommended weight loss and a bariatric surgeon, home exercise, and antiinflammatories as needed. Dr. Babatunde noted that appellant’s symptoms improved following 

her left knee surgery.

On October 14, 2022 appellant, through counsel, requested reconsideration and enclosed 

an April 20, 2022 report from Dr. Babatunde.

In the April 20, 2022 report, Dr. Babatunde noted appellant’s history of injury and 

treatment and that she suffered a work injury in 2014 when she injured her right foot. He related 

that, when she returned to full-duty work, she had worsening pain to the bilateral knees, hips, and 

lumbar spine. Dr. Babatunde noted that appellant related her conditions to her physical work duties 

as a transportation security officer, including lifting up to 70 pounds, twisting, bending, standing,

and walking. He also noted that she reported two falls in 2019. Regarding causal relationship,

Dr. Babatunde opined that, based on the available information, “there is objective medical 

evidence to establish within a reasonable degree of medical certainty that there was a causal 

connection between [appellant’s] initial injuries, the required treatment including surgery to her 

left knee.”

By decision dated December 22, 2022, OWCP denied modification of the May 14, 2021 

decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA4 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,5that 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 

4

Supra note 2.

5

See S.F., Docket No. 23-0264 (July 5, 2023); F.H., Docket No.18-0869 (issued January 29, 2020); J.P., Docket 

No. 19-0129 (issued April 26, 2019); Joe D. Cameron, 41 ECAB 153 (1989).
6

employment injury.6 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.7

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

disease claim, a claimant must submit: (1) a factual statement identifying employment factors 

alleged to have caused or contributed to the presence or occurrence of the disease or condition; 

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

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

casually related to the identified employment factors.8

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.9 The opinion of the physician must be based upon a complete factual 

and medical background, 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 incident.10

In any case where 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.11

ANALYSIS

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

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

Preliminarily, the Board notes that findings made in prior Board decisions are res judicata

absent further merit review by OWCP under section 8128 of FECA.12 It is, therefore, unnecessary 

6 L.C., Docket No. 19-1301 (issued January 29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020);

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

7 P.A., Docket No. 18-0559 (issued January 29, 2020);K.M., Docket No. 15-1660 (issued September 16, 2016);

Delores C. Ellyett, 41 ECAB 992 (1990).

8 T.W., Docket No. 20-0767 (issued January 13, 2021); L.D., Docket No. 19-1301 (issued January 29, 2020);S.C., 

Docket No. 18-1242 (issued March 13, 2019).

9

I.J., Docket No. 19-1343 (issued February 26, 2020);T.H., 59 ECAB 388 (2008); Robert G. Morris, 48 ECAB 

238 (1996).

10 D.C., Docket No. 19-1093 (issued June 25, 2020); see Victor J. Woodhams,41 ECAB 345 (1989).

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

R.D., Docket No. 18-1551 (issued March 1, 2019).

12 A.A., Docket No. 20-1399 (issued March 10, 2021); Clinton E. Anthony, Jr., 49 ECAB 476 (1998).
7

for the Board to consider the evidence appellant submitted prior to the issuance of OWCP’s April 4, 

2017 merit decision, as the Board considered that evidence in its November 6, 2018 decision.13

In an August 8, 2017 report, Dr. Cohen diagnosed symptomatic lumbar discogenic pain 

with referred radiculopathy, but did not provide an opinion regarding causal relationship. The 

Board has held that medical evidence that does not offer an opinion regarding the cause of an 

employee’s condition is of no probative value on the issue of causal relationship.14 Thus, the Board 

finds that this report from Dr. Cohen is insufficient to establish appellant’s claim. 

Medical reports dated September 12 and 19 and November 7 and 21, 2017 and May 15 and 

June 26, 2018, from Dr. Levy;treatment notes dated September 15, October 31, and December 12, 

2017 and January 19 and May 29, 2018, from Dr. Sinha; and August 21, 2017 and March 15, 2018 

progress reports from Dr. Patel, noted that appellant had chief complaints of left ankle, left knee, 

left hip, and low back pain which began in 2014 following a work accident. Her diagnoses were

noted as osteoarthritis of the knee, other intervertebral disc degeneration of lumbosacral region, 

and lumbar radiculopathy. The Board notes that appellant filed an occupational disease claim, 

indicating that her alleged conditions began after 2015, she did not allege that her right foot injury 

in 2014 caused her multiple other conditions. These physicians also indicated that her pain was 

exacerbated by work activities of bending and lifting. The Board has held that pain is a symptom

and not a compensable medical diagnosis.

15

 The Board has also held that a report is of limited

probative value regarding causal relationship if it does not contain medical rationale explaining 

how a given medical condition was related to accepted employment factors. 16 As such, these 

reports did not provide the necessary medical rationale to establish that appellant’s accepted 

employment factors caused her diagnosed conditions. The Board finds that these reports lack 

probative value and are insufficient to establish the claim.

17

OWCP also received multiple reports from Dr. Filippone. In a May 4, 2017 treatment note,

Dr. Filippone opined, ‘‘In my professional medical opinion all of [appellant’s] present problems 

are the direct and sole result of injuries sustained while working for the [employing establishment]. 

More than that I cannot say.” However, he also failed to provide any medical rationale to support 

his opinion. The need for rationale is particularly important as appellant had prior injuries.18 In a 

January 10, 2019 report, Dr. Filippone noted her history of injury and preexisting conditions. He 

opined that appellant’s work as a transportation security officer since October 1, 2006 increased 

13 See R.B., Docket No. 22-0954 (issued December 29, 2022); M.S., Docket No. 20-1095 (issued March 29, 2022);

C.D., Docket No. 19-1973 (issued May 21, 2020); M.D., Docket No. 20-0007 (issued May 13, 2020).

14 S.J., Docket No. 19-0696 (issued August 23, 2019); M.C., Docket No. 18-0951 (issued January 7, 2019);L.B., 

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

15 K.B., Docket No. 21-0953 (issued October 12, 2022); G.L., Docket No. 18-1057 (issued April14, 2020); J.P., 59 

ECAB 178 (2007).

16 See K.K., Docket No. 22-0270 (issued February14, 2023); I.D., Docket No. 22-0848 (issued September 2, 2022);

V.T., Docket No. 18-0881 (issued November 19, 2018).

17 Id.

18 See R.B., Docket No. 19-1527 (issued July 20, 2020); R.S., Docket No. 19-1774 (issued April 3, 2020).
8

her vulnerability to trauma of the spinal canal and that her fall off of a chair in June 2014, 

aggravated her previously damaged back, right foot and ankle, both knees, and left hip. In 

attempting to explain the physiological mechanism of injury, Dr. Filippone indicated that these

injuries caused the activation of chemical mediators to release from the cell bodies of the sensory 

neurons and nonneurogenic mediated release from tissue played a role in initiating the perpetuating 

of an inflammatory response as reflected in the April 26, 2015 EMG studies, which evidenced a 

left L5-S1 lumbosacral radiculopathy with partial denervation in muscles innervated by the mid 

and lower lumbar dorsalrami on the left. While he provided a partial explanation as to how release 

of chemical mediators initiates an inflammatory response in soft tissue, he did not provide a 

pathophysiological explanation as to how appellant’s specific accepted employment factors either 

caused or contributed to the initiation of the chemical and neurologic response. The Board has 

held that a report is of limited probative value regarding causal relationship if it does not contain 

medical rationale explaining how a given medical condition was related to accepted employment 

factors.19 Dr. Filippone further related that appellant’s June 29, 2016 MRI scan of the right knee 

provided evidence of multiple abnormalities which were some years in the process of developing, 

but which were totally consistent with the history of her work incidents in 2014 and 2016, as were 

the MRI scan studies of her left knee and left hip. His opinion in this regard is conclusory. As 

previously noted, the Board has held that a medical report is of limited probative value on a given 

medical issue if it contains an opinion which is unsupported by medical rationale.20 Thus, these 

reports are insufficient to establish appellant’s claim.

Appellant also submitted several reports from Dr. Babatunde. In an April 20, 2022 report,

Dr. Babatunde opined that, “there is objective medical evidence to establish within a reasonable 

degree of medical certainty that there was a causal connection between [appellant’s] initial injuries, 

the required treatment including surgery to her left knee.” He noted that appellant related her 

conditions to her physical work duties, including lifting up to 70 pounds, twisting, bending, 

standing, and walking. In treatment notes dated August 21, 2018 to October 11, 2021,

Dr. Babatunde diagnosed bilateral knee osteoarthritis. While he indicated that “there is objective 

medical evidence” to establish causation between appellant’s diagnosed conditions and the 

accepted factors of her federal employment, his opinion is conclusory as he did not explain with 

rationale how her employment duties caused or contributed to her diagnosed medical conditions.21 

While Dr. Babatunde opined that her employment duties caused injuries that required knee 

surgery, he did not fully address her history and preexisting conditions and did not provide a 

rationalized medical opinion that differentiates between the work-related injury or disease and her 

other injuries and preexisting conditions.

22

 The need for rationale is particularly important since

he diagnosed bilateral knee osteoarthritis. As Dr. Babatunde did not provide the required 

19 See K.K., supranote 16; I.D., Docket No. 22-0848 (issued September 2, 2022);V.T., Docket No. 18-0881 (issued 

November 19, 2018).

20 A.K., Docket No. 21-0278 (issued July 12, 2021); J.A., Docket No. 20-1195 (issued February 3, 2021).

21 Id.

22 M.B., Docket No. 20-1275 (issued January 29, 2021); see R.D., supra note 11.
9

rationalized medical opinion explaining how appellant’s accepted employment factors caused her 

diagnosed conditions, his reports are insufficient to establish her claim.23

The Board further notes that a November 5, 2021 statement from appellant indicated that 

she was injured in March 2021, when she was riding her mobile scooter at a warehouse club. A

March 4, 2021 office note from Dr. Chauhan noted that she reported a history of a workers’

compensation injury to her knees; however, he described the injury that she sustained at a 

warehouse club and diagnosed contusion of unspecified lower leg, initial encounter, 

uncomplicated, and myalgia, uncomplicated. Emergency room notes dated March 10, 2021, from

Dr. Silfe, also described the injury at a warehouse club and diagnosed severe osteoarthritis and 

minor trauma. As these reports did not address the issue of causal relationship, they are no 

probative value and are, therefore, insufficient to establish appellant’s claim.

24

While OWCP received reports from Minesh Patel, a physician assistant, the Board has held 

that physician assistants are not considered physicians under FECA. 25

OWCP also received diagnostic studies. However, the Board has also held that diagnostic 

reports, standing alone, lack probative value on the issue of causal relationship as they do not 

provide an opinion as to whether the accepted employment incident caused a diagnosed 

condition.26 Consequently, this evidence is insufficient to establish appellant’s claim.

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

the diagnosed medical conditions and the accepted employment factors, 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.

CONCLUSION

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

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

23 Supra note 20. 

24 See M.G., Docket No. 22-1119 (issued November 15, 2022); L.B., Docket No. 18-0533 (issued August 27, 2018);

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

25 5 U.S.C. § 8101(2) 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, 20 

C.F.R. § 10.5(t). See supra note 11at Chapter 2.805.3a(1) (January 2013); see also M.F., Docket No. 19-1573 (issued 

March 16, 2020); N.B., Docket No. 19-0221 (issued July 15, 2019); 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).

26 W.L., Docket No. 20-1589 (issued August26, 2021); A.P., Docket No. 18-1690 (issued December 12, 2019).
10

ORDER

IT IS HEREBY ORDERED THAT the December 22, 2022 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: December 15, 2023

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board