United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
E.R., Appellant
and
U.S. POSTAL SERVICE, MCGAHEYSVILLE
POST OFFICE, McGaheysville, VA, Employer
__________________________________________

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Appearances:
Appellant, pro se
Office of Solicitor, for the Director

Docket No. 21-0133
Issued: November 15, 2021

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Chief Judge
PATRICIA H. FITZGERALD, Alternate Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION
On November 3, 2020 appellant filed a timely appeal from a September 24, 2020 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
ISSUES
The issues are: (1) whether OWCP properly determined that appellant received an
overpayment of compensation in the amount of $89,478.37 for the period May 25, 2015 through
August 15, 2020, for which she was not at fault, as she concurrently received Social Security
1
2

5 U.S.C. § 8101 et seq.

The Board notes that, following the September 24, 2020 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
evidence for the first time on appeal. Id.

Administration (SSA) age-related retirement benefits and FECA wage-loss compensation without
appropriate offset; (2) whether OWCP properly denied waiver of recovery of the overpayment;
and (3) whether OWCP properly required recovery of the overpayment by deducting $516.06 from
appellant’s continuing compensation payments every 28 days.
FACTUAL HISTORY
On March 24, 2015 appellant, then a 67-year-old rural carrier, filed a traumatic injury claim
(Form CA-1) alleging that on March 13, 2015 she injured her right shoulder when she stepped
onto a mail tub and fell onto her right side while in the performance of duty. Her supervisor noted
on the claim form that her retirement coverage was under the Federal Employees Retirement
System (FERS). OWCP accepted appellant’s claim for a complete rupture of the right rotator cuff.
It paid her wage-loss compensation on the supplemental rolls commencing May 25, 2015 and on
the periodic rolls commencing May 31, 2015.
On August 3, 2020 OWCP provided SSA with a FERS/SSA dual benefits calculation form.
It listed the computation period as March 13, 2015 to the present.
On August 5, 2020 SSA completed the FERS/SSA dual benefit calculation worksheet and
provided appellant’s SSA age-related retirement benefit rates with FERS and without FERS from
January 2015 through December 2019. SSA indicated that: beginning January 2015, appellant’s
SSA rate with FERS was $1,846.20 and without FERS was $483.40; beginning January 2016,
appellant’s SSA rate with FERS was $1,864.20 and without FERS was $483.40; beginning
December 2016, appellant’s SSA rate with FERS $1,869.70 and without FERS was $484.80;
beginning January 2017, appellant’s SSA rate with FERS was $1,879.30 and without FERS was
$484.80; beginning December 2017, appellant’s SSA rate with FERS was $1,916.80 and without
FERS was $494.40; beginning January 2018, appellant’s SSA rate with FERS was $1,921.00 and
without FERS was $494.40; beginning December 2018, appellant’s SSA rate with FERS was
$1,974.70 and without FERS was $508.20; beginning December 2019, appellant’s SSA rate with
FERS $2,006.20 and without FERS was $516.30.
In an August 5, 2020 letter, OWCP advised appellant that it had found that she was
receiving both FECA wage-loss compensation and SSA age-related retirement benefits without an
appropriate offset, resulting in a prohibited dual benefit. It noted that her FECA compensation
payments “must be adjusted for the FERS portion of SSA benefits.”
An August 5, 2020 OWCP periodic disability payment plate for the period July 19 through
August 15, 2020 indicated in the comments section that OWCP adjusted appellant’s FECA wageloss compensation by her “FERS offset.”
OWCP completed a FERS offset overpayment calculations worksheet on August 5, 2020.
It determined the 28-day FERS offset amount for the days in each period and computed a total
overpayment of $89,478.37. This form indicated that: from May 25 through November 30, 2015,
appellant received an overpayment of compensation in the amount of $ 8,536.22; from December 1
through 31, 2015 appellant received an overpayment of compensation in the amount of $1,392.75;
from December 1, 2016 through November 30, 2017 appellant received an overpayment of
compensation in the amount of $15,249.49; from December 1 through 31, 2016 appellant received

2

an overpayment of compensation in the amount of $ 1,415.34; from January 1 through
November 30, 2017, appellant received an overpayment of compensation in the amount of
$15,354.82; from December 1 through 31, 2017, appellant received an overpayment of
compensation in the amount of $1,453.66; from January 1 through November 11, 2018, appellant
received an overpayment of compensation in the amount of $15,708.28; from December 1, 2018
through November 30, 2019, appellant received an overpayment of compensation in the amount
of $17,646.35; and from December 1, 2019 through August 15, 2020, appellant received an
overpayment of compensation in the amount of $12,721.45.
On August 12, 2020 OWCP notified appellant of its preliminary overpayment
determination that she received an overpayment of compensation in the amount of $89,478.37 as
she had received FECA wage-loss compensation for the period May 25, 2015 through August 15,
2020 that had not been reduced by the portion of her SSA age -related retirement benefits
attributable to her federal service, and that this portion of her SSA benefit was a prohibited dual
benefit. It further advised her of its preliminary determination that she was without fault in the
creation of the overpayment. OWCP requested that appellant complete the enclosed overpayment
recovery questionnaire (Form OWCP-20) and submit supporting financial documentation
including copies of income tax returns, bank account statements, bills and canceled checks, pay
slips, and any other records, which support income and expenses. Additionally, it provided
appellant with an overpayment action request form and notified her that, within 30 days of the date
of the letter, she could request a telephone conference, a final decision based on the written
evidence, or a prerecoupment hearing.
In a completed Form OWCP-20 dated September 7, 2020, appellant advised that her
monthly income, including her husband’s income, totaled $3,540.00. She further advised that her
ordinary monthly expenses totaled $2,805.46 and her monthly bank and credit card debt totaled
approximately $1,154.02. Appellant listed available funds as including a $3,249.65 checking
account balance, a $584.98 savings account balance, and a $3,500.00 transfer from a separate bank
account. She indicated that she had $172,185.90 in an individual retirement account and
$57,975.99 in a thrift savings plan account. Appellant stated that she had informed OWCP that
she was receiving SSA benefits, and that if she had known that payments to her were incorrect,
she would not have accepted them. She stated that the overpayment was not her fault, and she
indicated that she wanted to return to full-duty work, but her physicians prevented her from doing
so.
By decision dated September 24, 2020, OWCP finalized its preliminary overpayment
determination that appellant had received an overpayment of compensation in the amount of
$89,478.37 because the SSA/FERS offset was not applied to FECA wage-loss compensation
payments for the period May 25, 2015 through August 15, 2020. It further found that she was
without fault in the creation of the overpayment, but denied waiver of recovery of the overpayment,
because the evidence submitted did not suggest that she would suffer severe financial hardship in
repaying the debt, and it did not receive supporting financial documentation. OWCP concluded,
therefore, that repayment would not defeat the purpose of FECA or be against good equity and
conscience. It required recovery of the overpayment by deducting $ 516.06 from appellant’s
continuing compensation payments beginning October 11, 2020.

3

LEGAL PRECEDENT -- ISSUE 1
Section 8102 of FECA provides that the United States shall pay compensation for the
disability of an employee resulting from personal injury sustained while in the performance of
duty.3 Section 8116 limits the right of an employee to receive compensation. While an employee
is receiving compensation, he or she may not receive salary, pay, or remuneration of any type from
the United States. 4
Section 10.421(d) of the implementing regulations requires that OWCP reduce the amount
of compensation by the amount of SSA age-related retirement benefits that are attributable to
federal service of the employee. 5 FECA Bulletin No. 97-09 provides that FECA benefits have to
be adjusted for the FERS portion of SSA benefits because the portion of the SSA benefit earned
as a federal employee is part of the FERS retirement package, and the receipt of FECA benefits
and federal retirement concurrently is a prohibited dual benefit. 6
ANALYSIS -- ISSUE 1
The Board finds that fact of overpayment has been established.
Beginning on May 25, 2015, appellant received FECA wage-loss compensation while she
continued to receive age-related retirement benefits from SSA. As noted, a claimant cannot receive
concurrent compensation for wage loss and SSA age-related retirement benefits attributable to
federal service for the same period. 7 The fact of overpayment is therefore established.
The Board further finds, however, that the case is not in posture for decision regarding the
amount of the overpayment. The Board notes that OWCP improperly calculated appellant’s
overpayment for the period May 25, 2015 through August 15, 2020. An August 5, 2020 OWCP
periodic disability payment plate for the period July 19 through August 15, 2020 indicated that
OWCP adjusted her FECA compensation payment by her FERS offset. Consequently, the SSA
benefits appellant received beginning July 19, 2020 were not dual benefits and should not have
been included in the overpayment calculation.
On remand, OWCP shall determine the exact amount of the overpayment of compensation
and the correct dates during which the overpayment occurred. It shall then issue a new preliminary
overpayment determination with an overpayment action request form, an overpayment recovery
questionnaire, and instructions for appellant to provide supporting financial information. After

3

5 U.S.C. § 8102(a).

4

Id. at § 8116.

5

20 C.F.R. § 10.421(d); see L.W., Docket No. 19-0787 (issued October 23, 2019); S.M., Docket No. 17-1802
(issued August 20, 2018).
6

FECA Bulletin No. 97-09 (February 3, 1997); see also N.B., Docket No. 18-0795 (issued January 4, 2019).

7

5 U.S.C. § 8116(d)(2); J.T., Docket No. 18-1791 (issued May 17, 2019).

4

this and other such further development as deemed necessary, OWCP shall issue a de novo
decision.8
CONCLUSION
The Board finds that fact of overpayment has been established. The Board further finds
that this case is not in posture for decision regarding the period and amount of the overpayment.
ORDER
IT IS HEREBY ORDERED THAT the September 24, 2020 decision of the Office of
Workers’ Compensation Programs is affirmed in part and set aside in part, and this case is
remanded for further proceedings consistent with this decision of the Board.
Issued: November 15, 2021
Washington, DC

Alec J. Koromilas, Chief Judge
Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge
Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge
Employees’ Compensation Appeals Board

8

In light of the Board’s disposition of Issue 1, the Issues of 2 and 3 are rendered moot.

5


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
D.I., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Birmingham, AL, Employer
__________________________________________

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)
)

Appearances:
Alan Shapiro, Esq., for the appellant
Office of Solicitor, for the Director

Docket No. 11-317
Issued: December 12, 2011

Case Submitted on the Record

DECISION AND ORDER
Before:
RICHARD J. DASCHBACH, Chief Judge
ALEC J. KOROMILAS, Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On November 22, 2010 appellant, through his attorney, filed a timely appeal from an
October 25, 2010 merit decision of the Office of Workers’ Compensation Programs (OWCP)
denying his traumatic injury claim. 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.
ISSUE
The issue is whether appellant met his burden of proof to establish that he sustained a
lower back injury in the performance of duty on November 19, 2009.
FACTUAL HISTORY
On November 28, 2009 appellant, then a 56-year-old city carrier, filed a traumatic injury
claim (Form CA-1) alleging that on November 19, 2009 he sustained a lower back injury when
1

5 U.S.C. § 8101 et seq.

he was parking the post office long life vehicle (LLV) and bumped the curve. He did not stop
work and first received medical care on November 20, 2009. Appellant notified his supervisor
on November 28, 2009. The employing establishment controverted the claim alleging that he
was not in the performance of duty.
In a November 20, 2009 discharge summary, Dr. Dan Spangler, a treating physician,
reported that appellant was treated on an emergency basis for back pain.
By letter dated December 9, 2009, OWCP informed appellant that the evidence of record
was insufficient to support his claim. Appellant was advised of the medical and factual evidence
needed and was directed to submit it within 30 days.
In a November 20, 2009 emergency room report, Dr. Spangler reported that appellant
complained of low back pain. Appellant stated that he ran into a curb with his truck on
November 19, 2009. Dr. Spangler diagnosed chronic back pain.
In a December 18, 2009 medical report, Dr. Joel D. Pickett, Board-certified in
neurological surgery, reported that appellant ran his truck into a curb in November 2009 and
complained of intense lower back pain, as well as pain radiating down his legs since the date of
the incident. He noted that appellant was neurologically intact and recommended a magnetic
resonance imaging (MRI) scan to rule out an acute disc herniation or other acute change.
By decision dated January 12, 2010, OWCP denied appellant’s claim on the grounds that
the evidence was insufficient to establish that he sustained an injury. It found that the incident
occurred as alleged; however, that the evidence failed to provide a firm medical diagnosis which
could be reasonably attributed to the accepted employment incident.
On January 19, 2010 appellant, through his attorney, requested an oral hearing before an
OWCP hearing examiner.
In support of his request, appellant submitted a claim for compensation (Form CA-7)
requesting leave without pay for the period dated December 18, 2009 to January 9, 2010.
At the August 11, 2010 hearing, appellant testified that he was a postal employee for 18
years and sustained a herniated disc injury while at work on October 19, 2006, which resulted in
permanent disability limitation, claim File No. xxxxxx541. He was receiving ongoing treatment
for that injury, contemporaneous with his accident on November 19, 2009. Appellant stated that
he filed a recurrence of his previous injury, which was denied by OWCP, but also filed a new
claim because this accident caused his back to hurt again. He also testified that Dr. Pickett
diagnosed him with an exacerbation of herniated disc. OWCP’s hearing representative noted
that the medical evidence of record only provided a diagnosis of pain and advised appellant as to
the necessary medical evidence needed. The record was held open for 30 days.
By decision dated October 25, 2010, OWCP’s hearing representative affirmed OWCP’s
January 12, 2010 decision. The hearing representative noted that the medical evidence of record

2

did not provide a diagnosis other than back pain and appellant failed to submit additional
medical evidence after the August 11, 2010 hearing.2
LEGAL PRECEDENT
An employee seeking benefits under FECA has the burden of establishing 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 filed within the applicable time
limitation; that an injury was sustained while in the performance of duty as alleged and that any
disability or specific condition for which compensation is claimed are causally related to the
employment injury.3 These are the essential elements of each and every compensation claim
regardless of whether the claim is predicated on a traumatic injury or occupational disease.4
In order to determine whether an employee actually sustained an injury in the
performance of duty, OWCP begins with an analysis of whether fact of injury has been
established. Generally, fact of injury consists of two components which must be considered in
conjunction with one another. The first component to be established is that the employee
actually experienced the employment incident which is alleged to have occurred.5 The second
component is whether the employment incident caused a personal injury and generally can be
established only by medical evidence.
To establish a causal relationship between the condition, as well as any attendant
disability claimed and the employment event or incident, the employee must submit rationalized
medical opinion evidence based on a complete factual and medical background, supporting such
a causal relationship.6 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
2

OWCP’s hearing representative reported that appellant had filed 14 injury claims since April 25, 2003, 6 of
which were related to his back and lower extremity. On April 25, 2003 appellant sustained a lower back injury
when twisting to exit his truck. The claim was accepted for lumbar sprain, File No. xxxxxx266. On May 30, 2003
appellant filed a second traumatic injury claim when he experienced back pain while walking down stairs. The
claim was accepted by OWCP, File No. xxxxxx722. On May 20, 2004 appellant filed a claim for injury to his lower
back when picking up a tub of mail. The claim was accepted by OWCP, File No. xxxxxx315. On October 24, 2005
appellant filed a claim for injuring his lower back when loading mail into a truck. The claim was accepted for
lumbar strain, File No. xxxxxx256. On August 2, 2006 appellant filed a traumatic injury claim for injuring his back
while exiting his truck. The claim was denied by OWCP, File No. xxxxxx029. On October 19, 2006 appellant filed
a traumatic injury claim for injuring his lower back when he twisted his back to avoid rolls of carpet falling on him
when picking up mail. OWCP accepted the claim for lumbar strain which was later expanded to include herniated
disc at L3-4, File No. xxxxxx541. Appellant missed time from work, returned with permanent restrictions and was
given a modified position. On November 19, 2009 he claimed a recurrence of disability, File No. xxxxxx541 which
was subsequently denied by OWCP.
3

Gary J. Watling, 52 ECAB 278 (2001); Elaine Pendleton, 40 ECAB 1143, 1154 (1989).

4

Michael E. Smith, 50 ECAB 313 (1999).

5

Elaine Pendleton, 40 ECAB 1143 (1989).

6

See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983).

3

condition and the specific employment factors identified by the claimant. This medical opinion
must include an accurate history of the employee’s employment injury and must explain how the
condition is related to the injury. The weight of medical evidence is determined by its reliability,
its probative value, its convincing quality, the care of analysis manifested and the medical
rationale expressed in support of the physician’s opinion.7
ANALYSIS
The evidence establishes that the November 19, 2009 incident occurred as alleged when
appellant was driving an LLV and bumped it into the curb. The issue, therefore, is whether he
submitted sufficient medical evidence to establish that the employment incident caused a lower
back injury. The Board finds that appellant did not submit sufficient medical evidence to support
that he sustained a lower back injury causally related to the November 19, 2009 employment
incident.8 The medical evidence is deficient on two grounds: (1) it fails to provide a firm
diagnosis; and (2) there is no narrative opinion on causal relationship between a diagnosed
condition and the employment incident.
In a November 20, 2009 report, Dr. Spangler reported that appellant was treated on an
emergency basis for back pain when he ran into a curb with his truck on November 19, 2009. He
diagnosed chronic back pain. Pain, however, is a symptom, not a compensable medical
diagnosis.9 Dr. Spangler did not provide any kind of diagnosis or detail regarding appellant’s
medical condition. It becomes almost impossible to establish causal connection in appellant’s
claim because the physician has not identified a medical condition. Thus, Dr. Spangler’s
medical notes do not constitute probative medical evidence because they fail to provide a clear
diagnosis and do not adequately explain the cause of appellant’s injury.10
In a December 18, 2009 medical report, Dr. Pickett reported that appellant complained of
intense lower back pain, as well as pain radiating down his legs when he ran his truck into a curb
in November 2009. He noted that appellant was neurologically intact and recommended an MRI
scan to rule out an acute disc herniation or other acute change.
The Board finds that the opinion of Dr. Pickett is not well rationalized. Dr. Pickett did
not explain how the November 19, 2009 employment incident contributed to or caused
appellant’s lower back injury. He provided no medical history regarding appellant’s prior back
injuries and did not describe, explain or diagnose appellant’s medical condition. Dr. Pickett
failed to provide a firm medical diagnosis and made no mention of an exacerbation of appellant’s
herniated disc other than to recommend an MRI scan to rule out disc herniation. It becomes
almost impossible to establish causal connection in appellant’s claim because the physician has
not identified a medical condition.

7

James Mack, 43 ECAB 321 (1991).

8

See Robert Broome, 55 ECAB 339 (2004).

9

Id.

10

Ceferino L. Gonzales, 32 ECAB 1591 (1981).

4

Medical evidence that does not offer any opinion regarding the cause of an employee’s
condition is of limited probative value on the issue of causal relationship.11 The opinion of a
physician supporting causal relationship must rest on a complete factual and medical background
supported by affirmative evidence, address the specific factual and medical evidence of record
and provide medical rationale explaining the nature of the relationship between the diagnosed
condition and the established incident or factor of employment.12 Thus, Dr. Pickett’s medical
report is insufficient to establish appellant’s burden of proof.
At the August 11, 2010 hearing appellant testified that Dr. Pickett diagnosed him with an
exacerbation of herniated disc. The record was held open for 30 days after the hearing but
appellant failed to submit any medical evidence. Appellant’s honest belief that work caused his
medical problem is not in question. Belief, however sincerely held, does not constitute the
medical evidence necessary to establish causal relationship. In the instant case, the record is
without rationalized medical evidence from a physician establishing a diagnosed medical
condition causally related to the accepted November 19, 2009 employment incident. Thus,
appellant has failed to establish his burden of proof.
CONCLUSION
The Board finds that appellant did not meet his burden of proof to establish that he
sustained a traumatic injury on November 19, 2009 in the performance of duty.

11

C.B., Docket No. 09-2027 (issued May 12, 2010); S.E., Docket No. 08-2214 (issued May 6, 2009).

12

See Lee R. Haywood, 48 ECAB 145 (1996).

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ORDER
IT IS HEREBY ORDERED THAT the October 25, 2010 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: December 12, 2011
Washington, DC

Richard J. Daschbach, Chief Judge
Employees’ Compensation Appeals Board

Alec J. Koromilas, Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board

6


United States Department of Labor
Employees’ Compensation Appeals Board
___________________________________________
)
)
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and
)
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U.S. POSTAL SERVICE, POST OFFICE,
)
Little Rock, AK, Employer
)
___________________________________________ )
R.G., Appellant

Appearances:
Appellant, pro se
Office of Solicitor, for the Director

Docket No. 07-507
Issued: May 15, 2007

Case Submitted on the Record

DECISION AND ORDER
Before:
DAVID S. GERSON, Judge
MICHAEL E. GROOM, Alternate Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On December 14, 2006 appellant filed a timely appeal from the Office of Workers’
Compensation Programs’ decision dated October 23, 2006 which found that she did not sustain
an injury in the performance of duty. Pursuant to 20 C.F.R. §§ 501.2(c) and 501.3(d)(2), the
Board has jurisdiction over the merits of this case.
ISSUE
The issue is whether appellant met her burden of proof in establishing that she sustained
an injury in the performance of duty on August 24, 2006.
FACTUAL HISTORY
On August 25, 2006 appellant, then a 46-year-old rural carrier, filed a traumatic injury
claim (Form CA-1). On August 24, 2006 before loading her vehicle, she went to the restroom
and noticed a large knot near her navel. Appellant was diagnosed on August 24, 2006 with an
“incisional hernia due to lifting.” The employing establishment controverted the claim.
Appellant stopped work on August 24, 2006.

In an August 24, 2006 disability certificate, from a physician whose signature is illegible,
appellant was placed off work until surgery on August 28, 2006 with the possibility of being off
work for two to three weeks afterwards. The Office also received discharge instructions related
to treatment for repair of a laparoscopic hernia.
By letter dated September 18, 2006, the Office advised appellant that additional factual
and medical evidence was needed. Appellant was requested to provide dates of examination and
treatment, a history of injury given by her to a physician, a detailed description of any findings,
the results of all x-rays and laboratory tests, a diagnosis and course of treatment followed and a
physician’s opinion supported by a medical explanation as to how the reported work incident
caused the claimed injury. The Office explained that the physician’s opinion was crucial to her
claim and allotted her 30 days to submit the requested information.
In an August 28, 2006 operative report, Dr. John S. Lambert, a Board-certified surgeon,
conducted a laparoscopic repair of an incisional hernia. The August 31, 2006 discharge noted
that appellant was given instructions with regard to care for her procedure and recommended a
follow-up appointment on September 8, 2006. The Office also received test results dated
August 24, 2006. Treatment notes related to the August 28, 2006 hernia repair, which are partly
illegible, referenced a January 2006 hernia. The August 24, 2006 note indicated that appellant
telephoned in on August 23, 2006 noting a fist-sized swelling to the left umbilicus.
The Office also received a September 5, 2006 attending physician’s report from a
physician whose signature is illegible. The report indicated that appellant underwent
laparoscopic repair of an incisional hernia on August 28, 2006. The physician checked the box
“yes” in response to whether he believed the condition was caused or aggravated by an
employment activity.
In an October 10, 2006 statement, an employing establishment injury compensation
specialist controverted the claim. She challenged appellant’s statement and referenced the
August 24, 2006 treatment note, which indicated that appellant had called a healthcare provider’s
office on August 23, 2006, the day prior to the alleged August 24, 2006 incident.
By decision dated October 23, 2006, the Office denied appellant’s claim on the grounds
that she did not establish an injury as alleged. The Office found that the medical evidence was
insufficient to establish that appellant’s condition was caused by her employment duties.
LEGAL PRECEDENT
An employee seeking benefits under the Federal Employees’ Compensation Act1 has the
burden of establishing 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 the Act, that the claim
was timely filed within the applicable time limitation period of the Act2 and that an injury was

1

5 U.S.C. §§ 8101-8193.

2

Joe D. Cameron, 41 ECAB 153 (1989).

2

sustained in the performance of duty.3 These are the essential elements of each compensation
claim, regardless of whether the claim is predicated upon a traumatic injury or an occupational
disease.4
To determine whether a federal employee has sustained a traumatic injury in the
performance of duty, it must first be determined whether a “fact of injury” has been established.
First, the employee must submit sufficient evidence to establish that he or she actually
experienced the employment incident at the time, place and in the manner alleged.5 Second, the
employee must submit sufficient evidence, generally only in the form of medical evidence, to
establish that the employment incident caused a personal injury.6
ANALYSIS
Appellant alleged that she was casing mail and loading her vehicle on August 24, 2006
and noticed a large knot on the left side near her navel. There is no dispute that appellant was
casing mail and loading her vehicle on August 24, 2006. The Office found that the first
component of fact of injury, the claimed incident, occurred as alleged.
However, the medical evidence is insufficient to establish that the employment incident
caused an injury. The medical reports of record do not establish that casing mail and loading her
vehicle on August 24, 2006 caused or contributed to the diagnosed hernia condition. The
medical evidence contains no firm diagnosis, no rationale and no explanation of the mechanism
of injury.
Appellant provided reports from Dr. Lambert, who performed surgery on
August 28, 2006. Dr. Lambert did not address whether any factors of appellant’s employment
caused her hernia condition. Consequently, the Board finds that this evidence is insufficient to
establish appellant’s claim.7 The Office also received the second page of a September 5, 2006
attending physician’s report, from a physician whose signature is illegible. The physician
checked the box “yes” in response to whether he believed the condition was caused or
aggravated by an employment activity. However, the checking of a box “yes” in a form report,
without additional explanation or rationale, is not sufficient to establish causal relationship.8 In
3

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

4

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

5

John J. Carlone, 41 ECAB 354 (1989).

6

Id.

7

To meet his or her burden of proof in establishing an injury in the performance of duty, a claimant must submit
medical evidence on causal relationship between a diagnosed injury and the employment incident. The Board has
held that medical evidence must be in the form of a reasoned opinion by a qualified physician based on a complete
and accurate factual and medical history. Thomas L. Agee, 56 ECAB ___ (Docket No. 05-335, issued
April 19, 2005).
8

Calvin E. King, 51 ECAB 394 (2000); Linda Thompson, 51 ECAB 694 (2000).

3

the present case, there is no reasoned medical evidence from a physician explaining how and
why the employment activities on August 24, 2006 caused or aggravated appellant’s hernia
condition.
Other reports submitted by appellant did not diagnose a specific condition or specifically
address causal relationship.
For these reasons, appellant has not established that the August 24, 2006 employment
incident caused or aggravated a specific injury.
CONCLUSION
The Board finds that appellant has not met her burden of proof in establishing that she
sustained an injury in the performance of duty.
ORDER
IT IS HEREBY ORDERED THAT the October 23, 2006 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: May 15, 2007
Washington, DC

David S. Gerson, Judge
Employees’ Compensation Appeals Board

Michael E. Groom, Alternate Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board

4


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
J.L., Appellant
and
DEPARTMENT OF THE NAVY, NAVAL
FACILITIES ENGINEERING COMMAND
STATIONS, Philadelphia, PA, Employer
__________________________________________

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Appearances:
Richard A. Daniels, for the appellant
Office of Solicitor, for the Director

Docket No. 14-2015
Issued: March 18, 2015

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
COLLEEN DUFFY KIKO, Judge
PATRICIA HOWARD FITZGERALD, Judge

JURISDICTION
On September 18, 2014 appellant, through his representative, filed a timely appeal from a
July 10, 2014 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.
ISSUE
The issue is whether appellant has established left lower extremity permanent impairment
due to his work-related injuries.
FACTUAL HISTORY
This case has previously been before the Board. In an April 21, 2014 decision, the Board
set aside OWCP’s January 16, 2013 schedule award decision and remanded the case to refer
1

5 U.S.C. § 8101 et seq.

appellant to an appropriate medical specialist for examination and an opinion on permanent
impairment. The findings and facts as set forth in the prior decisions are hereby incorporated by
reference.2
In support of his schedule award claim, appellant submitted an April 9, 2013 medical
report from Dr. David Weiss, a Doctor of Osteopathic Medicine. In his report, Dr. Weiss
reported that appellant’s January 10, 2002 work-related injury was the cause of the subjective
and objective findings. He referred to Table 2 of The Guides Newsletter, Rating Spinal Nerve
Extremity Impairment, to determine class 1 moderate sensory deficit left L5 nerve root and
calculated a net adjustment of five percent impairment.3 Dr. Weiss then assigned class 1
moderate sensory deficit left S1 nerve root and calculated a net adjustment of three percent
impairment.4 Using the sixth edition of the American Medical Association, Guides to the
Evaluation of Permanent Impairment (A.M.A., Guides),5 he combined the two values to
determine that appellant was entitled to eight percent impairment of the left lower extremity.
On June 14, 2013 OWCP referred the case file, statement of accepted facts, and
Dr. Weiss’ April 9, 2013 report to Dr. Morley Slutsky, Board-certified in occupational medicine,
serving as OWCP district medical adviser (DMA) to review the records and provide an opinion
regarding permanent functional loss of the affected lower extremity.
In a June 13, 2013 report, Dr. Slutsky found no ratable deficits and no lower extremity
impairments secondary to the accepted conditions. He noted that an impairment rating was
performed by Dr. Weiss on February 29, 2012 which found sensory deficits in the L3 and L4
distribution and assigned ratings based upon those issues. Appellant was reevaluated by
Dr. Weiss on April 9, 2013, at which time the examination revealed decreased sensation in the
L5 and S1 dermatomes and normal lower extremity motor strength. Dr. Slutsky noted that
Dr. Weiss’ clinical findings were considerably different than the majority of physicians who
evaluated appellant since 2002, who found no significant sensory, motor, or reflex changes in the
lower extremities. Additionally, appellant had undergone diagnostic testing, which included
lumbar magnetic resonance imaging (MRI) scans and computerized tomography (CT) scans, the
results of which were not consistent with involvement of nerve roots at the L5-S1 levels.
Dr. Slutsky found that Dr. Weiss’ findings were inconsistent and could not be explained by
diagnostic testing. He further found that there were no reliable or valid, ratable lower extremity
deficits upon which to base impairment calculations. Dr. Slutsky noted that, while appellant’s
tests supported left sided L2 involvement, neither the A.M.A., Guides nor The Guides Newsletter

2

Docket No. 13-2124 (issued April 21, 2014). On January 10, 2002 appellant, then a 43-year-old heavy mobile
equipment mechanic filed a traumatic injury claim alleging that he sustained a back injury when lifting and turning a
rim from a crane tire weighing approximately 300 pounds. By decision dated March 22, 2002, OWCP accepted the
claim for lumbosacral strain. It subsequently expanded the acceptance to include displacement of lumbosacral disc
without myelopathy.
3

Table 2, The Guides Newsletter, (6th ed. July/August 2009).

4

Id.

5

A.M.A., Guides (2009).

2

allowed for ratings of this nerve root and that there were no clinical findings in the lower
extremities to support deficits at this level.
By decision dated July 16, 2013, OWCP affirmed the June 3, 2013 decision finding that
the evidence failed to establish a permanent impairment to a member or function of the body. It
noted that the weight of medical opinion rested with the report of Dr. Slutsky serving as OWCP
DMA.
As previously noted, by decision dated April 21, 2014, the Board set aside OWCP’s
July 16, 2013 decision and remanded the case to refer appellant to an appropriate medical
specialist for examination and opinion on permanent impairment.
On June 13, 2014 OWCP referred appellant, a statement of accepted facts, and the case
file to Dr. Balazs B. Somogyi, a Board-certified orthopedic surgeon, for a second opinion
examination and opinion regarding permanent impairment of the lower extremities.
In a June 18, 2014 medical report, Dr. Somogyi documented a history of the employment
incident, reviewed prior medical and diagnostic reports, and provided findings on physical
examination. He reported that appellant rated his pain level from 0 (no pain) to 10 (excruciating
pain) at 3 to 4. Regional examination revealed no gross deformity or obvious abnormality.
Range of motion of the lumbosacral segment revealed forward flexion performed to mid tibia
level with pain, extension was 20 degrees and painful, lateral flexion was 30 degrees bilaterally
with minimal discomfort, and rotation movements were full and painless. Dr. Somogyi noted no
range of motion limitation of the upper or lower extremities and no palpatory findings. He noted
that objective findings also were negative. He stated that the Spurling test was negative, straight
leg raising examination was bilaterally negative, Homan’s sign and Febere’s tests were
unrevealing, and no abnormal reflex patterns were identified. With respect to neurological
examination, Dr. Somogyi stated that motor, sensory, and deep tendon reflexes were normal.
Dr. Somogyi opined that maximum medical improvement (MMI) was reached on June 1,
2004 based on the date of examination by Dr. Joel N. Abramovitz, a Board-certified
neurosurgeon. He noted that appellant’s objective complaints were related to lower back pain
and accentuated by range of motion maneuvers and prolonged sitting. The diagnostic entities
included history of lumbosacral sprain and strain, status post previous hemilaminectomy and
discectomy of the lumbar spine, and chronic lower back syndrome. As such, appellant’s
diagnosis was related to low back impairment. Dr. Somogyi stated that no definite impairment
related to the lower extremity was identified. Based on the sixth edition of the A.M.A., Guides
and The Guides Newsletter, he opined that there was no evidence of spinal nerve extremity
impairment and no impairment related to the affected extremities.6
OWCP routed Dr. Somogyi’s report and the case file to Dr. Slutsky, serving as the DMA,
for review and a determination on whether appellant sustained a permanent partial impairment of
the lower extremities and on the date of MMI.

6

Supra notes 3 and 5.

3

In a June 26, 2014 report, Dr. Slutsky opined that, based on the A.M.A., Guides and The
Guides Newsletter, there was no basis for a lower extremity impairment related to the accepted
low back conditions.7 He noted review of Dr. Somogyi’s June 13, 2014 second opinion
examination who also found no lower extremity sensory, motor, or reflex deficits related to the
lumbar spine.
The DMA noted that Dr. Weiss’ February 29, 2012 examination found sensory deficits in
the L3 and L4 distribution and assigned ratings based upon those issues. Appellant was
reevaluated by Dr. Weiss on April 9, 2013. The examination revealed decreased sensation in the
L5 and S1 dermatomes and normal lower extremity motor strength. Dr. Slutsky repeated his
assertion that Dr. Weiss’ clinical findings were considerably different than the majority of
physicians who had evaluated appellant since 2002 and found no significant sensory, motor, or
reflex changes in the lower extremities. Additionally, appellant had undergone diagnostic testing
including lumbar MRI and CT scans, the results of which were not consistent with involvement
of nerve roots at the L5-S1 levels. Dr. Slutsky noted that electromyogram (EMG) testing also
demonstrated no evidence of lower extremity radiculopathy. He concluded that there were no
reliable or valid, ratable lower extremity deficits upon which to base impairment calculations.
By decision dated July 10, 2014, OWCP denied appellant’s claim for a schedule award
finding that the evidence failed to establish a permanent impairment to a member or function of
the body.
LEGAL PRECEDENT
The schedule award provision of FECA and its implementing regulations set forth the
number of weeks of compensation payable to employees sustaining permanent impairment from
loss or loss of use of scheduled members or functions of the body.8 However, FECA does not
specify the manner in which the percentage of loss shall be determined. For consistent results
and to ensure equal justice under the law to all claimants, good administrative practice
necessitates the use of a single set of tables so that there may be uniform standards applicable to
all claimants. The A.M.A., Guides (6th ed. 2009) has been adopted by the implementing
regulations as the appropriate standard for evaluating schedule losses.9
It is the claimant’s burden to establish that he or she has sustained a permanent
impairment of the scheduled member or function as a result of any employment injury.10 OWCP
procedures provide that, to support a schedule award, the file must contain competent medical
evidence which shows that the impairment has reached a permanent and fixed state and indicates
the date on which this occurred (date of MMI), describes the impairment in sufficient detail so

7

Id.

8

5 U.S.C. § 8107; 20 C.F.R. § 10.404.

9

K.H., Docket No. 09-341 (issued December 30, 2011). For decisions issued after May 1, 2009, the sixth edition
will be applied. B.M., Docket No. 09-2231 (issued May 14, 2010).
10

Tammy L. Meehan, 53 ECAB 229 (2001).

4

that it can be visualized on review and computes the percentage of impairment in accordance
with the A.M.A., Guides.11
Although the A.M.A., Guides includes guidelines for estimating impairment due to
disorders of the spine, a schedule award is not payable under FECA for injury to the spine.12 In
1960, amendments to FECA modified the schedule award provisions to provide for an award for
permanent impairment to a member of the body covered by the schedule regardless of whether
the cause of the impairment originated in a scheduled or nonscheduled member. Therefore, as
the schedule award provisions of FECA include the extremities, a claimant may be entitled to a
schedule award for permanent impairment to an extremity even though the cause of the
impairment originated in the spine.13
The sixth edition of the A.M.A., Guides does not provide a separate mechanism for rating
spinal nerve injuries as extremity impairment.14 For peripheral nerve impairments to the upper
or lower extremities resulting from spinal injuries, OWCP procedures indicate that The Guides
Newsletter, Rating Spinal Nerve Extremity Impairment using the edition July/August 2009
edition is to be applied.15 FECA approved methodology is premised on evidence of
radiculopathy affecting the upper and/or lower extremities.16
In addressing lower extremity impairments, due to peripheral or spinal nerve root
involvement, the sixth edition requires identifying the impairment class for the diagnosed
condition Class of Diagnosis (CDX), which is then adjusted by grade modifiers based on
Functional History (GMFH) and if electrodiagnostic testing were done, Clinical Studies
(GMCS).17 The net adjustment formula is (GMFH - CDX) + (GMCS - CDX).18
ANALYSIS
OWCP accepted appellant’s claim for lumbosacral strain and displacement of
lumbosacral disc without myelopathy. The issue is whether appellant sustained a permanent
impairment as a result of his employment-related work injuries. The Board finds that he has not
submitted sufficient evidence to establish that, as a result of his employment injury, he sustained

11

Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims,
Chapter 2.808.5 (February 2013).
12

Pamela J. Darling, 49 ECAB 286 (1998).

13

Thomas J. Engelhart, 50 ECAB 319 (1999).

14

Supra note 12. FECA Manual, Part 3 -- Medical, Schedule Awards, Chapter 3.700, Exhibit 4 (January 2010).

15

See G.N., Docket No. 10-850 (issued November 12, 2010); see also Federal (FECA) Procedure Manual, id. at
Exhibit 1, note 5 (January 2010). The Guides Newsletter is included as Exhibit 4.
16

Federal (FECA) Procedure Manual, supra note 11 at Chapter 2.808.5c(3).

17

A.M.A., Guides 533.

18

Id. at 521.

5

any permanent impairment to a scheduled member such that he would be entitled to a schedule
award.19
The Board previously remanded this case specifically to obtain a second opinion as to
whether appellant had a peripheral nerve impairment of the lower extremities which originated
from the accepted lumbar injury. On remand, OWCP referred appellant to Dr. Somogyi for a
second opinion examination regarding the nature and extent of his injuries and a determination
on whether appellant sustained a permanent partial impairment of the lower extremities.
In the June 18, 2014 medical report, Dr. Somogyi documented a history of the
employment incident, reviewed prior medical and diagnostic reports, and provided findings on
physical examination. He noted no range of motion limitation of the upper or lower extremities
and no palpatory findings. Dr. Somogyi further stated that objective findings also were negative.
He explained that the Spurling test was negative, straight leg raising examination was bilaterally
negative, Homan’s sign and Febere’s tests were unrevealing, and no abnormal reflex patterns
were identified. With respect to the neurological examination, Dr. Somogyi stated that motor,
sensory, and deep tendon reflexes were normal. Using objective examination findings, review of
diagnostic studies, and appellant’s subjective complaints, Dr. Somogyi stated that no definite
impairment related to the lower extremity was identified. Based on the sixth edition of the
A.M.A., Guides, Dr. Somogyi opined that there was no evidence of spinal nerve extremity
impairment and no impairment related to the affected extremities.20 He concluded that MMI was
reached on June 1, 2004. The Board finds that the report of Dr. Somogyi was thorough and well
rationalized.
Dr. Slutsky, serving as the DMA, reviewed Dr. Somogyi’s report and agreed that there
was no basis for a lower extremity impairment related to the accepted low back conditions. He
noted that Dr. Somogyi’s examination also found no lower extremity sensory, motor, or reflex
deficits related to the lumbar spine. This supported Dr. Slutsky’s prior assertion that Dr. Weiss’
clinical findings were considerably different than the majority of physicians who evaluated
appellant since 2002 who found no significant sensory, motor, or reflex changes in the lower
extremities. Additionally, appellant had undergone diagnostic testing including lumbar MRI and
CT scans, the results of which were not consistent with involvement of nerve roots at the L5-S1
levels. Dr. Slutsky noted that EMG testing also demonstrated no evidence of lower extremity
radiculopathy. He concluded that there were no reliable or valid, ratable lower extremity deficits
upon which to base impairment calculations in accordance with the A.M.A., Guides.21
The Board finds that appellant has failed to establish a compensable permanent
impairment of the lower extremities. Dr. Slutsky reviewed appellant’s history of injury, the
medical record, and the statement of accepted facts. Utilizing Dr. Somogyi’s most recent
June 13, 2014 examination, a history of injury, and review of the diagnostic testing, he found no
impairment related to the lower extremities. The DMA provided support for his argument
19

W.R., Docket No. 13-492 (issued June 26, 2013).

20

Supra note 6.

21

Id.

6

stating that Dr. Somogyi’s examination revealed no lower extremity sensory, motor, or reflex
deficits related to the lumbar spine. As previously noted, FECA does not allow for permanent
impairment ratings of the back without evidence of extremity impairment.22 The reports of
Dr. Somogyi and Dr. Slutsky establish that appellant had no impairment of the left lower
extremity. Thus, the Board finds that OWCP properly denied appellant’s claim for a schedule
award.23
On appeal, counsel for appellant argues that Dr. Somogyi failed to provide a rationalized
opinion that appellant did not sustain any impairment related to his accepted injuries. The Board
notes that any lack of explanation that may exist in the second opinion report was cured by
Dr. Slutsky who thoroughly reviewed the medical record and examination findings and provided
medical rationale that appellant had no impairment related to the lower extremities. The Board
also rejects counsel’s argument that the second opinion report is deficient because Dr. Somogyi
did not conduct a Semmes-Weinstein monofilament test.24 The Board notes that Dr. Somogyi’s
examination findings and diagnostic testing provided no evidence for lower extremity
impairment. Moreover, Dr. Slutsky reviewed the Semmes-Weinstein monofilament test findings
provided in Dr. Weiss’ report, as well as the medical evidence of record and Dr. Somogyi’s
examination, to determine that appellant did not sustain any impairment to the lower extremity.
Counsel for appellant further argues that, at the very least, there is a conflict in medical
evidence because Dr. Weiss provided a well-reasoned opinion for eight percent impairment of
the left lower extremity. The Board is not persuaded by this argument. While Dr. Weiss made
proper reference to the A.M.A., Guides when calculating appellant’s left lower extremity
impairment, his opinion is not supported by the medical evidence of record or the most recent
physical examination findings on June 13, 2014.25
It is appellant’s burden of proof to establish a permanent impairment of a scheduled
member as a result of an employment injury.26 He has not met his burden of proof and thus
OWCP properly denied his schedule award claim.27
Appellant may request a schedule award or increased schedule award based on evidence
of a new exposure or medical evidence showing progression of an employment-related condition
resulting in permanent impairment or increased impairment.
22

Supra note 16.

23

M.J., Docket No. 13-598 (issued May 8, 2013).

24

E.W., Docket No. 12-772 (issued June 13, 2013) (appellant’s attending physician disputed the findings of
OWCP’s impartial medical examiner (IME) arguing that the IME failed to conduct the Semmes-Weinstein
monofilament test. The Board found that appellant failed to establish any impairment to the left lower extremity and
the weight of the medical evidence rested with the referee physician). See also F.L., Docket No. 10-1125 (issued
December 21, 2010).
25

E.J., Docket No. 12-1948 (issued June 5, 2013).

26

See supra note 10.

27

L.F., Docket No. 10-343 (issued November 29, 2010); V.W., Docket No. 09-2026 (issued February 16, 2010).

7

CONCLUSION
The Board finds that appellant has not established a left lower extremity permanent
impairment, due to his employment injuries.
ORDER
IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’
decision dated July 10, 2014 is affirmed.
Issued: March 18, 2015
Washington, DC

Christopher J. Godfrey, Chief Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

Patricia Howard Fitzgerald, Judge
Employees’ Compensation Appeals Board

8


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
H.A., Appellant
and
DEPARTMENT OF DEFENSE, PENTAGON,
Washington, DC, Employer
__________________________________________

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Appearances:
Appellant, pro se
Office of Solicitor, for the Director

Docket No. 07-996
Issued: December 27, 2007

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Chief Judge
MICHAEL E. GROOM, Alternate Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On February 9, 2007 appellant filed an appeal of a February 1, 2007 decision of the
Office of Workers’ Compensation Programs approving the purchase of a twin-sized adjustable
bed but denying purchase of a king-sized bed. Pursuant to 20 C.F.R. §§ 501.2(c) and 501.3, the
Board has jurisdiction over the merits of the claim.
ISSUE
The issue is whether the Office properly denied appellant’s request for a king-sized
adjustable bed. On appeal, appellant asserts that the Office erred by approving a twin-sized
hospital bed as he desired a king-sized bed for his wife’s personal convenience.
FACTUAL HISTORY
The Office accepted that on June 19, 1991 appellant, then a 31-year-old police officer,
sustained a right cervical strain and cervical disc rupture while lifting a casket at a funeral. He
returned to regular duty on July 2, 1991. The Office later accepted contusions of the right hip,
coccyx and lumbar spine sustained when he slipped and fell on a metal ramp. The Office

authorized a C4-5 anterior discectomy and fusion performed on May 28, 1992 and a C5-6 fusion
on October 14, 1992. He received compensation for periods of temporary total disability.1
In a July 23, 2001 report, Dr. Michael Kuo, an attending Board-certified physiatrist,
prescribed a hospital bed. He explained that the accepted cervical condition with radiculopathy
prevented appellant from lying flat in a standard bed. In an August 17, 2001 letter, the Office
authorized the purchase of a dual king-sized electric hospital bed. The Office reimbursed
appellant $3,699.00 for two Royal Twin Extra Long Adjustable Beds with pillow top
mattresses.2
On May 9, 2005 appellant underwent an anterior discectomy and decompression with
fixation from C3 to C6, authorized by the Office. In September 2006 he relocated from the
Metropolitan Washington area to North Carolina.
Dr. Christopher R. Brown, an attending Board-certified orthopedic surgeon, performed a
cervical laminoplasty with graft and plate on December 4, 2006. The Office approved the
procedure.
In a December 19, 2006 slip, Dr. Brown prescribed an “adjustable air mattress bed.” He
checked a box indicating that “product selection [was] permitted.” Appellant advised the Office
that he desired a king-sized Select Comfort “sleep number” bed at a cost of $7,205.61.
In a January 11, 2007 letter, the Office requested that Dr. Brown provide a medical
opinion explaining why appellant required a king-sized adjustable bed.
In a January 16, 2007 chart note, Dr. Brown noted that appellant had been “trying to get a
special bed; he is having a hard time sleeping in the cramped bed” he then used.
In a January 23, 2007 letter, Dr. Brown noted that appellant underwent a recent posterior
cervical laminoplasty and had difficulty rising to a standing position. Dr. Brown recommended
“an adjustable bed that allows the head of the bed as well as the foot of the bed to be raised and
lowered. This would help [appellant] be more ambulatory and it would also help him recover
from his surgery. Due to his myelopathy, he has a hard time getting in and out of a bed that is
not adjustable.”
By decision dated February 1, 2007, the Office authorized the purchase of a Twin XL
Precision Comfort Adjustable Foundation bed with a twin mattress, manufactured by Select
Comfort. The Office authorized the full purchase price of $1,973.80 and applicable set-up
charges. The Office denied appellant’s request for two Twin XL foundations and a king-sized
1

In July 1998, appellant began work at the Government Printing Office as a uniformed police officer. The Office
accepted recurrences of disability commencing April 2, 1992, January 1, 2002, August 11, 2003 and April 4, 2006.
2

By decision dated March 22, 2004, the Office denied appellant’s request to purchase an elliptical trainer. On
March 29, 2004 the Office approved a one-year health club membership. By decision dated May 25, 2005, the
Office granted appellant a schedule award for an 18 percent permanent impairment of the left upper extremity and a
10 percent impairment of the right upper extremity. The period of the award ran from April 26, 2005 to
December 28, 2006.

2

mattress. The Office explained that, according to its procedures at Chapter 2.0810-15(b), a
claimant who wanted an item more elaborate than needed for his or her own use, such as a
queen-sized bed and not a twin-sized bed, was responsible for any costs beyond those for the
basic item.
LEGAL PRECEDENT
Section 8103 of the Federal Employees’ Compensation Act3 provides that the United
States shall furnish to an employee who is injured while in the performance of duty, the services,
appliances and supplies prescribed or recommended by a qualified physician, which the Office
considers likely to cure, give relief, reduce the degree or the period of disability, or aid in
lessening the amount of the monthly compensation.4 In interpreting section 8103, the Board has
recognized that the Office has broad discretion in approving services provided under the Act.
The only limitation on the Office’s authority is that of reasonableness.5 Abuse of discretion is
generally shown through proof of manifest error, clearly unreasonable exercise of judgment or
actions taken which are contrary to both logic and probable deductions from established facts. It
is not enough to merely show that the evidence could be construed so as to produce a contrary
factual conclusion.6
In order to be entitled to reimbursement for medical expenses, a claimant must establish
that the expenditures were incurred for treatment of the effects of an employment-related injury.7
This burden of proof includes providing supporting rationalized medical evidence.8 The Office’s
procedure manual discusses requests for equipment prescribed for treatment, such as hospital
beds.9 The Office must evaluate the pertinent information received from the claimant and his
physician and determine whether the equipment is necessary to treat the effects of the workrelated injury and that its use will be consistent with the claimant’s restrictions and safety.10 The
Office’s procedures provide that, if a claimant requests special medical equipment or furnishings
and desires an item more elaborate than that prescribed, he or she is responsible for all costs
above that of the basic item.11

3

5 U.S.C. §§ 8101-8193.

4

5 U.S.C. § 8103; see Thomas W. Stevens, 50 ECAB 288 (1999).

5

Mira R. Adams, 48 ECAB 504 (1997).

6

Daniel J. Perea, 42 ECAB 214 (1990).

7

Cathy B. Mullin, 51 ECAB 331 (2000).

8

Id.

9

Federal (FECA) Procedure Manual, Part 2 -- Claims, Developing and Evaluating Medical Evidence, Health
Facility Membership and Special Equipment, Chapter 2.810.15.b (October 2005).
10

Id. at Chapter 2.810.15.a(1) (October 2005).

11

Id. at Chapter 2.810.15.a(2)(b) (October 2005).

3

ANALYSIS
The Office accepted that appellant sustained ruptured cervical discs requiring multiple
surgeries. Based on the prescription of Dr. Brown, an attending Board-certified orthopedic
surgeon, the Office authorized the purchase of a twin-sized adjustable bed. Appellant has the
burden of proof to establish that the Office abused its discretion by denying reimbursement for
the king-sized adjustable bed he desired.
Appellant advised the Office that he wanted a king-sized adjustable bed costing
$7,205.61. The Office requested that Dr. Brown to explain why the accepted injuries
necessitated a bed with those specifications. In a January 23, 2007 letter, Dr. Brown explained
that appellant had difficulty getting in and out of a standard flat bed and rising to a standing
position. He therefore required a bed that allowed the head and foot of the bed to be raised or
lowered. Such a bed would assist appellant in remaining ambulatory and recovering from
surgery. However, Dr. Brown did not opine that a king-sized bed was necessary to cure or give
relief to appellant’s accepted neck condition or to lessen the period of disability or amount of
compensation. Dr. Brown stated in a January 16, 2007 chart note that appellant’s present bed
was “cramped” but did not address the size of the bed or if appellant required a larger bed.
Therefore, in its February 1, 2007 decision, the Office authorized a twin-sized bed meeting
Dr. Brown’s specifications. The Office found that, according to its procedures, appellant would
be responsible for any costs above that for a twin-sized bed as his desire for a more elaborate bed
was unrelated to the treatment or relief of the accepted condition.
Dr. Brown’s reports do not contain medical rationale explaining why appellant required a
king-sized bed. He did not explain why appellant’s post-surgical condition required a king-sized
hospital bed to cure, give relief, lesson the period of disability or amount of monthly
compensation. The Board has held that, in the absence of medical rationale explaining how and
why a claimant required a king-sized hospital bed, the Office properly authorized a twin-sized
hospital bed.12 In the absence of such rationale, Dr. Brown’s opinion is thus insufficient to meet
appellant’s burden of proof.13
The Office properly denied authorization for payment for a king-sized hospital bed. Such
denial did not constitute an abuse of discretion.
CONCLUSION
The Board finds that the Office properly denied reimbursement of a king-sized adjustable
bed as the medical evidence did not support the need for a bed larger than the twin-sized bed
authorized by the Office.

12

Lee Haywood, Docket Nos. 03-727 and 03-1005 (issued March 30, 2005).

13

Deborah L. Beatty, 54 ECAB 340 (2003).

4

ORDER
IT IS HEREBY ORDERED THAT the decision of the Office of Workers’
Compensation Programs dated February 1, 2007 is affirmed.
Issued: December 27, 2007
Washington, DC

Alec J. Koromilas, Chief Judge
Employees’ Compensation Appeals Board

Michael E. Groom, Alternate Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board

5


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
M.L., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Minneapolis, MN, Employer
__________________________________________

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Appearances:
Appellant, pro se
Office of Solicitor, for the Director

Docket No. 14-1128
Issued: September 17, 2014

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
COLLEEN DUFFY KIKO, Judge
PATRICIA HOWARD FITZGERALD, Judge

JURISDICTION
On April 17, 2014 appellant filed a timely appeal from a March 26, 2014 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.
ISSUE
The issue in this case is whether appellant met her burden of proof to establish a
traumatic injury in the performance of duty on June 22, 2013.
FACTUAL HISTORY
On August 3, 2013 appellant, then a 64-year-old retail clerk (SSA), filed a traumatic
injury claim (Form CA-1) alleging that on June 22, 2013 she injured her lower back while
transferring a delivery point sequence (DPS) tray to a cart. She did not stop work. The
1

5 U.S.C. § 8101 et seq.

employing establishment controverted continuation of pay, noting that appellant’s claim was not
filed within 30 days of the alleged date of injury.
By letter dated August 14, 2013, OWCP informed appellant of the evidence needed to
support her claim and sent her a questionnaire for completion.
On August 20, 2013 Dr. Kathy H. Brandli, Board-certified in family medicine, assessed
appellant with low back pain radiating to the left leg. She noted that appellant had pain in her
left buttocks down to her knee since an injury at work on June 22, 2013, and prescribed aspirin,
ibuprofen and Tylenol. Dr. Brandli referred appellant for a magnetic resonance imaging (MRI)
scan of her lumbar spine. In another report of the same date, she noted that appellant told her she
was unloading a tray from one cart to another cart, leaned forward to grab a tray and move it to
another nearby location, and that during the process of moving one of these trays, she felt a
crunching sensation in the lower back. While it was not painful immediately, the next day
appellant began to experience more severe pain in the back of the left upper leg/hamstring
region. She worked the next day. On examination, Dr. Brandli noted that appellant was able to
ambulate without assistance and could move from the chair to the examination table without
difficulty. She noted tenderness at the L4 level of the spine and mild-left sacroiliac joint
tenderness. On straight-leg-raising, Dr. Brandli noted exacerbation of hamstring and back
discomfort, with elevation to approximately 70 degrees. She assessed appellant with low back
pain radiating to the left leg, suspicious for disc herniation and nerve impingement, with
symptoms ongoing for over eight weeks.
In a duty status report dated August 21, 2013, Dr. Brandli assessed appellant with lower
back pain radiating to the left leg and recommended work restrictions of carrying no more than
10 pounds continuously or 20 pounds intermittently.
In an undated statement received by OWCP on August 27, 2013, appellant stated that she
was off work for two weeks after the injury, and that this absence was the reason she had not
reported her injury within 30 days. Appellant noted that her injury occurred when she was
transferring a tray of DPS mail from one cart to another. The immediate effect of her injury was
a crackling sensation in her lower back. Appellant stated that she had not sustained any injury
since that time, and that on the day after her injury, she began to feel pain in her left thigh to her
knee, which she treated with over-the-counter pain medication. She noted that she did not have
any similar disability or symptoms before this injury.
Appellant submitted an undated witness statement in support of her claim. H.W., a
coworker, noted that on June 22, 2013 appellant and she were distributing mail to carriers at the
employing establishment. As they moved DPS letter trays from cart to cart, appellant gave a
small cry and exclaimed, “Oh, my back. I just felt a crackling sensation in my back.”
In a diagnostic report dated August 28, 2013, Dr. Phyllis J. Noss, a Board-certified
radiologist, examined the results of an MRI scan of appellant’s lumbar spine. She noted a 2.3
centimeter area of high signal in the L4 vertebral body, which was probably a hemangioma.
There was a tiny foci of high signal in the S1 segment of the sacrum and L3, which most likely
represented lipomata. At L5-S1, the disc height was preserved, and Dr. Noss noted an annular
tear posterior to the left of the midline without disc herniation. She observed a moderately

2

severe hypertrophy of the facet joints and ligamentum flavum bilaterally. An annular tear was
also observed at L4-5, which was posterior laterally on the left, with no disc herniation.
Dr. Noss noted moderately severe degenerative change in the facet joints bilaterally with marked
bilateral hypertrophy of the ligamentum flavum. At L3-4, there was mild circumferential
bulging of the disc annulus with no herniation, with the same moderately severe degenerative
changes. At L2-3, there was a one millimeter anterolisthesis due to ligamentous laxity in the
facet joints and mild circumferential bulging of the disc annulus, with the same moderately
severe degenerative changes. At L1-2, Dr. Noss noted mild degenerative change in the facet
joints and slight hypertrophy of the ligamentum flavum, with normal disc appearance.
By decision dated September 18, 2013, OWCP denied appellant’s claim on the grounds
that appellant did not establish a causal relationship between her condition and the incident of
June 22, 2013.
On October 12, 2013 appellant requested a review of the written record by the Branch of
Hearings and Review.
In a memorandum addressed to OWCP dated October 8, 2013, Dr. Brandli stated that
appellant sustained an injury at work on June 22, 2013, which caused pain development into the
left lower back, buttock region and into the left leg. She noted that appellant had no prior history
of lower back pain or radicular pain until her injury at work on June 22, 2013. Dr. Brandli stated
that her notation from August 20, 2013 clearly outlined the history and report of a work-related
injury. She noted that appellant continued to complain of pain and that her MRI scan
demonstrated the presence of bulging discs. Dr. Brandli observed that the disc bulging “certainly
could have been caused by her work injury on [June 22, 2013].” She explained, “As already
stated, patient had no prior history of back pain or radicular symptoms until she sustained her
injury at work, therefore it is in my opinion that her current symptoms are caused/aggravated by
the injury that occurred at work.” Dr. Brandli noted that appellant would benefit from physical
therapy and a recommendation on whether she should have epidural steroid or facet injections.
She noted that appellant was very frustrated with her workers’ compensation claim, and agreed
that she had been unjustly denied. Dr. Brandli asked OWCP to reconsider its denial as her
symptoms were directly related to an injury sustained at work.
On March 26, 2014 the hearing representative affirmed the decision dated September 18,
2013, denying appellant’s claim on the grounds that she had not established a causal relationship
between her condition and the incident of June 22, 2013.
LEGAL PRECEDENT
An employee seeking benefits under FECA2 has the burden of establishing 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 filed within the applicable time
limitation; that an injury was sustained while in the performance of duty as alleged and that any
disability and/or specific condition for which compensation is claimed are causally related to the
2

5 U.S.C. § 8101 et seq.

3

employment injury.3 These are the essential elements of each and every compensation claim
regardless of whether the claim is predicated on a traumatic injury or an occupational disease.4
To determine whether a federal employee has sustained a traumatic injury in the
performance of duty it must first be determined whether a fact of injury has been established.5
First, the employee must submit sufficient evidence to establish that he or she actually
experienced the employment incident at the time, place and in the manner alleged.6 Second, the
employee must submit sufficient evidence, generally only in the form of medical evidence, to
establish that the employment incident caused a personal injury.7
The claimant has the burden of establishing by the weight of reliable, probative and
substantial evidence that the condition for which compensation is sought is causally related to a
specific employment incident or to specific conditions of employment.8 An award of
compensation may not be based on appellant’s belief of causal relationship. Neither the mere
fact that a disease or condition manifests itself during a period of employment nor the belief that
the disease or condition was caused or aggravated by employment factors or incidents is
sufficient to establish a causal relationship.9
Causal relationship is a medical issue and the medical evidence generally required to
establish causal relationship is rationalized medical opinion evidence.10 Rationalized medical
opinion evidence is medical evidence which includes a physician’s rationalized opinion on
whether there is a causal relationship between the employee’s diagnosed condition and
compensable employment factors.11 The opinion of the physician must be based on a complete
factual and medical background of the employee, 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 employee.12

3

C.S., Docket No. 08-1585 (issued March 3, 2009); Bonnie A. Contreras, 57 ECAB 364, 366 (2006).

4

S.P., 59 ECAB 184, 188 (2007); Joe D. Cameron, 41 ECAB 153, 157 (1989).

5

B.F., Docket No. 09-60 (issued March 17, 2009); Bonnie A. Contreras, supra note 3 at n.5.

6

D.B., 58 ECAB 464, 466 (2007); David Apgar, 57 ECAB 137, 140 (2005).

7

C.B., Docket No. 08-1583 (issued December 9, 2008); D.G., 59 ECAB 734, 737 (2008); Bonnie A. Contreras,
supra note 3 at n.5.
8

Roma A. Mortenson-Kindschi, 57 ECAB 418, 428 n.37 (2006); Katherine J. Friday, 47 ECAB 591, 594 (1996).

9

P.K., Docket No. 08-2551 (issued June 2, 2009); Dennis M. Mascarenas, 49 ECAB 215, 218 (1997).

10

Y.J., Docket No. 08-1167 (issued October 7, 2008); A.D., 58 ECAB 149, 155-56 (2006); D Wayne Avila, 57
ECAB 642, 649 (2006).
11

J.J., Docket No. 09-27 (issued February 10, 2009); Michael S. Mina, 57 ECAB 379, 384 (2006).

12

I.J., 59 ECAB 408, 415 (2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

4

ANALYSIS
The Board finds that the evidence established that on June 22, 2013, appellant lifted and
moved trays of mail at work. However, the Board finds that the medical evidence submitted by
appellant is insufficient to establish that this incident caused or aggravated a medical condition.
On October 8, 2013, Dr. Brandli stated that appellant sustained an injury at work on
June 22, 2013, which caused pain development into the left lower back, buttock region, and into
the left leg. She noted that appellant continued to complain of pain and that her MRI scan
demonstrated the presence of bulging discs. Dr. Brandli observed that the disc bulging “certainly
could have been caused by her work injury on [June 22, 2013].” She explained, “As already
stated, patient had no prior history of back pain or radicular symptoms until she sustained her
injury at work, therefore it is in my opinion that her current symptoms are caused or aggravated
by the injury that occurred at work.”
The Board finds that Dr. Brandli’s report lacks sufficient detailed medical rationale to
discharge appellant’s burden of proof that she sustained a work-related injury on June 22, 2013.
The opinion that appellant’s bulging disc “certainly could have been caused” by appellant’s
June 22, 2013 incident is speculative in nature.13 Furthermore, Dr. Brandli stated that the
rationale for her opinion that appellant’s current condition was caused or aggravated by the
incident of June 22, 2013 was that appellant had no prior history of back pain or radicular
symptoms. As noted above, neither the mere fact that a disease or condition manifests itself
during a period of employment nor the belief that the disease or condition was caused or
aggravated by employment factors or incidents is sufficient to establish a causal relationship.14
She did not offer any explanation of the mechanics of the incident and resulting injury, including
the objective findings of the MRI scan dated August 28, 2013 apart from bulging discs. Without
a detailed medical report describing the employment incident in detail and noting,
physiologically, how and why appellant sustained a lumbar condition as a result of the June 22,
2013 incident, Dr. Brandli’s opinion is not sufficient to meet appellant’s burden of proof.15
The diagnostic study of August 28, 2013 and the duty status report of August 21, 2013 do
not address the cause of any diagnosed condition. Similarly, Dr. Brandli’s August 20, 2013
reports contain a history of injury, but no clear opinion on the causal relationship between
appellant’s condition and the traumatic incident. Medical evidence that does not offer any
opinion regarding the cause of an employee’s condition is of limited probative value on the issue
of causal relationship.16 Hence, this evidence is insufficient to meet appellant’s burden of proof.
Medical evidence submitted to support a claim for compensation should reflect a correct
history, and the physician should offer a medically sound explanation of how the claimed work

13

See W.F., Docket No. 14-673 (issued July 9, 2014).

14

Supra note 9.

15

See D.L., Docket No. 13-1226 (issued August 22, 2013).

16

Willie M. Miller, 53 ECAB 697, 701 (2002).

5

event caused or aggravated the claimed condition.17 Dr. Brandli, the only physician who
discussed causal relationship, did not do so. Therefore, appellant did not meet her burden of
proof to establish that she sustained a traumatic injury on June 22, 2013.
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 did not establish that she sustained an employment-related
injury on June 22, 2013.
ORDER
IT IS HEREBY ORDERED THAT the March 26, 2014 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: September 17, 2014
Washington, DC

Christopher J. Godfrey, Chief Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

Patricia Howard Fitzgerald, Judge
Employees’ Compensation Appeals Board

17

D.D., Docket No. 13-1517 (issued April 14, 2014).

6


United States Department of Labor
Employees’ Compensation Appeals Board
____________________________________________
M.W., Appellant
and
DEPARTMENT OF THE ARMY, EISENHOWER
ARMY MEDICAL CENTER, Fort Gordon, GA,
Employer
____________________________________________
Appearances:
Appellant, pro se
Office of Solicitor, for the Director

)
)
)
)
)
)
)
)
)

Docket No. 07-1163
Issued: September 6, 2007

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Chief Judge
DAVID S. GERSON, Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On March 27, 2007 appellant filed a timely appeal from the Office of Workers’
Compensation Programs’ merit decision dated March 12, 2007 which denied her occupational
disease claim. Pursuant to 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 sustained an occupational disease in the performance of
duty.
FACTUAL HISTORY
On January 31, 2007 appellant, then a 53-year-old file clerk filed an occupational disease
claim alleging that she sustained back pain, pain in the hands, carpal tunnel, and tendinitis of the
right thumb and wrist and sinus infections as a result of her employment.

On February 5, 2007 the Office requested additional factual and medical information
from appellant. She responded by submitting a description of her conditions and her own
statement relating her conditions to her employment duties. The Office thereafter received
unsigned medical reports from Orthopedic Associates of Augusta, P.A. and other unidentifiable
medical notes pertaining to appellant’s office visits on November 2, 9, 13 and 30, and
December 15, 2006, as well as January 2 and 30, and February 2, 2007. In a November 2, 2006
report, appellant was diagnosed with multiple joint arthritis and right carpal tunnel syndrome by
Dr. Paul J. Herzwum, a treating physician. The December 15, 2006 report diagnosed synovitis
right thumb.1
The Office also received an allergy work-up dated September 22, 2006. In a
November 10, 2006 magnetic resonance imaging (MRI) scan report, Dr. Jose Bauza, Boardcertified in diagnostic radiology, diagnosed minimal degenerative disc disease at L4-5 towards
the right side. On October 10, 2006 an electromyography was performed by Dr. Ranjit Sethi,
Board-certified in neurology, who diagnosed carpal tunnel syndrome of Grade 3.
On March 12, 2007 the Office denied appellant’s claim on the grounds that the medical
evidence failed to demonstrate that the claimed medical condition resulted from the accepted
work factors.
LEGAL PRECEDENT
An employee seeking benefits under the Federal Employees’ Compensation Act has the
burden of establishing the essential elements of his or her claim by the weight of the reliable,
probative and substantial evidence, including the fact that the individual is an “employee of the
United States” within the meaning of the Act and that the claim was timely filed within the
applicable time limitation period of the Act, that an injury was sustained in the performance of
duty as alleged and that any disability or specific condition for which compensation is claimed is
causally related to the employment injury.2
To establish that an injury was sustained in the performance of duty in an occupational
disease claim, a claimant must submit the following: (1) medical evidence establishing the
presence or existence of the disease or condition for which compensation is claimed; (2) a factual
statement identifying the factors alleged to have caused or contributed to the presence or
occurrence of the disease or condition; and (3) medical evidence establishing that the factors
identified by the claimant were the proximate cause of the condition for which compensation is
claimed, or stated differently, medical evidence establishing that the diagnosed condition is
causally related to the factors identified by the claimant.3

1

The author of this report cannot be identified.

2

Anthony P. Silva, 55 ECAB 179 (2003).

3

Elizabeth H. Cram (Leonard O. Cram), 57 ECAB ___ (Docket No. 05-715, issued October 6, 2005).

2

ANALYSIS
Appellant alleged that her back, hand and sinus conditions were causally related to
factors of her federal employment. The Board finds that she has submitted insufficient medical
evidence to establish that any of her conditions were caused or aggravated by her federal
employment.
The medical evidence demonstrates only that appellant has degenerative disc disease at
the L4-5 and carpal tunnel syndrome. The allergy work-up does not contain a diagnosis. None
of the reports for office visits from November 2, 2006 to February 2, 2007 identify the person(s)
who examined appellant or who authored the reports. Absent any evidence to the contrary it
cannot be assumed that the author of these reports was a physician. The Board notes that such
reports are not considered medical evidence as an unknown person cannot be considered a
physician under the Act.4 Reports that are not from physicians are of no probative medical value
to the claim.5 In order to qualify a medical opinion, the opinions must be from a physician under
the Act.6 While appellant was diagnosed with degenerative disc disease and carpal tunnel there
is no evidence that these conditions are causally related to her employment factors. To establish
causal relationship, appellant must submit a physician’s report in which the physician reviews
the employment factors identified by appellant as causing his condition and taking these factors
into consideration as well as findings upon examination, state whether the employment injury
caused or aggravated the diagnosed conditions and present medical rationale in support of his or
her opinion.7 No such physician’s report was submitted. Dr. Bauza’s MRI scan report merely
diagnosed degenerative disc disease and failed to offer any opinion as to the cause. Dr. Sethi’s
report diagnosed carpal tunnel but did not opine as to the cause of appellant’s condition.
Medical evidence which does not offer any opinion regarding the cause of an employee’s
condition is of limited probative value on the issue of causal relationship.8 A medical opinion on
causal relation is required to establish that an injury was sustained in the performance of duty.
Neither the mere fact that a disease or condition manifests itself during a period of
employment, nor appellant’s own belief that the disease or condition was caused or aggravated
by employment factors is sufficient to establish causal relationship.9

4

See 5 U.S.C. § 8101(2) (this subsection defines a “physician as surgeons, podiatrists, dentists, clinical
psychologists, optometrists, chiropractors and osteopathic practitioners within the scope of their practice as defined
by State law.”); see also Charley V.B. Harley, 2 ECAB 208, 211 (1949) (where the Board has held that a medical
opinion, in general, can only be given by a qualified physician).
5

See Jack B. Wood, 40 ECAB 95, 109 (1988).

6

See 5 U.S.C. § 8101(2). Nurses are not physicians under the Act and are not competent to render a medical
opinion. See Vincent Holmes, 53 ECAB 468 (2002).
7

Calvin E. King, 51 ECAB 394 (2000).

8

Michael E. Smith, 50 ECAB 313 (1999).

9

Richard L. Barnes, 55 ECAB 426 (2004).

3

Appellant has failed to submit medical evidence to establish causal relationship and,
therefore, has failed to discharge her burden of proof to establish that she sustained a condition
due to factors of her federal employment.
CONCLUSION
Appellant has not met her burden of proof to establish that she sustained an occupational
disease in the performance of duty.
ORDER
IT IS HEREBY ORDERED THAT the March 12, 2007 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: September 6, 2007
Washington, DC

Alec J. Koromilas, Chief Judge
Employees’ Compensation Appeals Board

David S. Gerson, Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board

4