United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

P.N., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Houma, LA, Employer

__________________________________________

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Docket No. 22-0794

Issued: October 20, 2023

Appearances: Case Submitted on the Record

Alan J. Shapiro, 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

JANICE B. ASKIN, Judge

JURISDICTION

On April 27, 2022 appellant, through counsel, filed a timely appeal from an April 11, 2022

merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the 

Federal Employees’ Compensation Act

2

(FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board 

has jurisdiction over the merits of this case.3

1

In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for legal 

or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. § 501.9(e). 

No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An attorney or 

representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject to fine or 

imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation.

2

5 U.S.C. § 8101 et seq.

3 The Board notes that, following the April11, 2022 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

ISSUE

The issue is whether appellant has met her burden of proof to expand the acceptance of her 

claim to include a right shoulder condition as causally related to the accepted December 24, 2014 

employment injury.

FACTUAL HISTORY

On December 29, 2014 appellant, then a 61-year-old clerk, filed a traumatic injury claim 

(Form CA-1) alleging that on December 24, 2014 she injured her left lower leg while in the 

performance of duty. She noted that she was unloading a dispatch vehicle when a wire cage rolled 

into her and pushed her against a large container. Appellant stopped work on the date of injury.

On January 26, 2015 OWCP accepted her claim for an open wound of the left knee, leg, and ankle 

without complications. It thereafter expanded the acceptance of appellant’s claim to include

sprains of the left knee and lower leg, tear of the left medial meniscus, and strain of muscle and 

tendon of the peroneal muscle group of the left lower leg. OWCPpaid her wage-loss compensation 

on the supplemental rolls, effective December 24, 2014 and on the periodic rolls, effective 

April 5, 2015.

On June 25, 2015 appellant underwent OWCP-authorized surgery to repair a tear of the

peroneal brevis tendon in the left ankle performed by Dr. Michael LaSalle, a Board-certified 

orthopedic surgeon. 

In a report dated May 31, 2016, Dr. Lisa Lee-Alevizon, a Board-certified family physician 

and acupuncturist, noted that appellant related complaints of low back, left leg, and right shoulder 

pain, which she attributed to the December 24, 2014 employment incident. She performed a 

physical examination, which revealed pain and spams throughout the back and right shoulder and 

pain in the left lateral ankle. Dr. Lee-Alevizon diagnosed low back and left leg pain, bilateral 

sciatica, muscle spasm, and low back and right shoulder strains. 

Appellant underwent physical therapy and acupuncture treatments to the right shoulder, 

low back, and left leg with Dr. Lee-Alevizon from May 31, 2016 through April 17, 2017. 

In a report dated February 15, 2017, Dr. LaSalle noted that appellant had chronic swelling 

in the left lateral ankle, which he opined was permanent. He also noted that she related complaints 

of pain in the right shoulder, which she attributed to the December 24, 2014 employment incident. 

In a report dated May 15, 2017, Dr. LaSalle opined that appellant had reached maximum 

medical improvement relative to her left ankle condition. He noted that she again related 

complaints in the right shoulder. 

A report of magnetic resonance imagining (MRI) scan of the right shoulder dated May 25, 

2018, revealed a partial thickness interstitial tear at the confluence of the supraspinatus and 

infraspinatus tendons medial to the footplate, bursitis, and mild acromioclavicular (AC) joint 

arthropathy. 

In a medical report dated May 30, 2018, Dr. Brett E. Casey, Board-certified in orthopedic 

surgery, noted that appellant related complaints of stiffness and pain in the neck and right shoulder. 
3

He reviewed the May 25, 2018 MRI scan and performed a physical examination, where he 

observed reduced range of motion in the neck and right shoulder and positive Spurling’s, Speed, 

Neer’s, Hawkins’, and O’Brien’stests. Dr. Casey diagnosed neck and right shoulder pain, cervical 

disc displacement, arthrosis of the right AC joint, and impingement syndrome of the right shoulder. 

On April 10, 2019 appellant, through counsel, requested that her claim be expanded to 

include a right shoulder strain. 

By letter dated May 10, 2019, OWCP advised counsel that the evidence was insufficient 

to expand the claim to include a right shoulder condition, but that it would refer appellant for a 

second opinion evaluation. 

In a letter dated July 10, 2020, Dr. Kyle J. Guidry, Board-certified in family medicine, 

diagnosed left leg pain, ruptured left ankle tendon, a right rotator cuff tear, and neck and back pain. 

He opined that these conditions were caused by the December 24, 20144injury.

5

On September 13, 2021 OWCP referred appellant, along with the medical record, a SOAF 

and a series of questions, to Dr. Simon Finger, a Board-certified orthopedic surgeon, for a second 

opinion examination. It requested that he provide an opinion regarding whether she sustained a 

right shoulder injury causally related to her accepted December 14, 2014 employment injury. 

In an October 21, 2021 report, Dr. Finger advised that he had reviewed the SOAF and the 

medical evidence of record. On physical examination he observed mild shoulder impingement on 

the right with grossly intact rotator cuffs. Dr. Finger determined that appellant did not sustain a 

right shoulder injury related to her accepted December 24, 2014 employment injury. He noted 

that the May 25, 2018 right shoulder MRI scan showed a partial thickness tear, but that he did not 

believe that it would require surgery. Dr. Finger opined that the partial thickness rotator cuff tear 

was not related to the accepted employment incident and noted “I see no evidence in the medical 

record or on physical exam[ination] that a right shoulder injury was connected to the work injury 

on [December 24, 2014].” 

By decision dated November 19, 2021, OWCP denied expansion of the acceptance of 

appellant’s claim to include a right shoulder condition as causally related to her accepted 

December 24, 2014 employment injury. 

On December 1, 2021 appellant, through counsel, requested a telephonic hearing before a 

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

4 Dr. Guidry’s report indicateda date of injury of December 22, 2014; however, this appears to be a typographical 

error as the case record establishes that the date of injury was December 24, 2014.

5 On November 2, 2020 OWCP referred appellant, along with the medical record, a statement of accepted facts 

(SOAF) and a series of questions, for a second opinion examination and evaluation with Dr.Christopher Cenac, Sr., 

a Board-certified orthopedic surgeon. It requested that he determine whether she had any remaining residuals and 

disability due to her accepted December 24, 2014 employment injury. In a December 3, 2020 report, Dr. Cenac 

provided his physical examination findings and determined that appellant had no evidence of any continuing residuals 

from the accepted December 24, 2014 employment injury. On May 10, 2021 OWCP requested clarification from him

as to whether appellant sustained an injury to her right shoulder as a result of the accepted December 24, 2014 

employment incident. No further reports were received from Dr. Cenac. 
4

March 8, 2022. During the hearing, appellant testified that she believed that she injured her right 

shoulder during the incident on December 24, 2014 because she was “smashed like a pancake”

against the containers. 

By decision dated April 11, 2022, OWCP’s hearing representative affirmed OWCP’s 

November 19, 2021 decision. 

LEGAL PRECEDENT

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.

6

 As part of this burden, he or she must present 

rationalized medical opinion evidence, based on a complete factual and medical background, 

establishing causal relationship.7 The opinion of the physician 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 employment injury.8

ANALYSIS

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

of her claim to include a right shoulder condition as causally related to the accepted December 24, 

2014 employment injury.

In his July 10, 2020 letter, Dr. Guidry diagnosed a right rotator cuff tear, and opined that it 

was caused by the December 24, 2014 employment incident. While he attributed appellant’s right 

shoulder condition to her accepted employment incident, he did not offer medical rationale 

explaining how the accepted employment incident caused the diagnosed right shoulder condition. 

The Board has held that medical evidence that provides a conclusion, but does not offer a 

rationalized medical explanation regarding the cause of an employee’s condition is of limited 

probative value on the issue of causal relationship.9 Dr. Guidry’s letter, therefore, is insufficient 

to establish expansion of the claim.

In reports dated May 31, 2016 through April 17, 2017, Dr. Lee-Alevizon noted that 

appellant complained of right shoulder pain, which appellant attributed to her December 24, 2014 

employment incident. In reports dated February 15 and May 15, 2017, Dr. LaSalle noted that 

appellant attributed her right shoulder pain to the December 24, 2014 employment incident.

Dr. Casey, in his report dated May 30, 2018, diagnosed right shoulder pain and impingement. 

However, none of reports contain an opinion as to whether appellant’s diagnosed right shoulder 

condition was causally related to her accepted employment incident. The Board has held that 

6

J.R., Docket No. 20-0292 (issued June 26, 2020); W.L., Docket No. 17-1965 (issued September 12, 2018); V.B., 

Docket No. 12-0599 (issued October 2, 2012); Jaja K. Asaramo, 55 ECAB 200, 204 (2004).

7 F.A., Docket No. 20-1652 (issued May 21, 2021); E.M., Docket No. 18-1599 (issued March 7, 2019); Victor J. 

Woodhams, 41 ECAB 345 (1989).

8 M.M., Docket No. 20-1557 (issued November 3, 2021); M.V., Docket No. 18-0884 (issued December 28, 2018).

9

See S.D., Docket No. 21-0085 (issued August9, 2021); see also M.B., Docket No. 19-1655 (issued April7, 2020).
5

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. 10 As such, this evidence is also 

insufficient to establish expansion of the claim.

OWCP also received a report of MRI scan of the right shoulder dated May 25, 2018. The 

Board has held, however, that diagnostic studies, standing alone, lack probative value as they do 

not provide an opinion on causal relationship between an employment injury, and a diagnosed 

condition.11

In an October 21, 2021 second opinion evaluation, Dr. Finger opined that appellant’s right 

shoulder condition was not causally related to the accepted December 24, 2014 employment 

incident. As his report was well-reasoned and based on a complete and accurate history, the Board 

finds that it constitutes the weight of the medical evidence.

As the medical evidence of record is insufficient to establish that the acceptance of the 

claim should be expanded to include a right shoulder condition causally related to the accepted 

December 24, 2014 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 expand the acceptance 

of her claim to include a right shoulder condition as causally related to her accepted employment 

injury.12

10 S.L., Docket No. 23-0152 (issued May 16, 2023); L.B., Docket No. 18-0533 (issued August27, 2018); see D.K., 

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

11 M.E., Docket No. 18-0940 (issued June 11, 2019); V.J., Docket No. 17-0358 (issued July 24, 2018); John W. 

Montoya, 54 ECAB 306 (2003).

12 The Board notes that the employing establishment issued a Form CA-16, dated December 24, 2014. A completed 

Form CA-16 authorization may constitute a contract for payment of medical expenses to a medical facility or 

physician, when properly executed. The form creates a contractual obligation, which does not involve the employee 

directly, to pay for the cost of the examination or treatment regardless of the action taken on the claim. See 20 C.F.R. 

§ 10.300(c); V.S., Docket No. 20-1034 (issued November 25, 2020); J.G., Docket No. 17-1062 (issued February 13, 

2018); Tracy P. Spillane, 54 ECAB 608 (2003).
6

ORDER

IT IS HEREBY ORDERED THAT the April 11, 2022 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: October 20, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board