United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
A.S., Appellant
and
DEPARTMENT OF JUSTICE, MARSHALS
SERVICE, Covington, KY, Employer
__________________________________________

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Appearances:
Alan J. Shapiro, Esq., for the appellant1
Office of Solicitor, for the Director

Docket No. 17-0868
Issued: October 19, 2017

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
PATRICIA H. FITZGERALD, Deputy Chief Judge
ALEC J. KOROMILAS, Alternate Judge

JURISDICTION
On March 13, 2017 appellant, through counsel, filed a timely appeal from a January 30,
2017 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to
the Federal Employees’ Compensation Act2 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the
Board has jurisdiction to consider the merits of this case.
ISSUE
The issue is whether appellant met his burden of proof to establish a lumbar injury
causally related to the accepted May 15, 2015 employment incident.
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.

FACTUAL HISTORY
On May 18, 2015 appellant, then a 38-year-old deputy marshal, filed a traumatic injury
claim (Form CA-1), alleging that, on May 15, 2015, while lifting and carrying cases of
ammunition, he strained his groin area. He did not stop work.
Appellant was treated by Dr. Dean D. Skinner, a chiropractor, from May 18 to July 20,
2015, for low back pain. Dr. Skinner reported that he sustained a work injury on May 15, 2015
while he was lifting and carrying boxes of ammunition at work.
Dr. Onassis A. Caneris, a Board-certified neurologist, examined appellant on May 20,
2015 for right lower abdominal and right groin pain. Appellant reported an onset a year ago of
back pain that radiated to the inguinal area and posterior aspect of the hip. He was treated
conservatively, but continued to have refractory problematic pain which interfered with his
ability to work. Appellant related this pain to a work-related incident. Dr. Caneris noted
findings on examination of normal range of motion of the musculoskeletal spine, slightly
positive reverse straight leg raise on the right, intact motor strength in the upper and lower
extremities, intact sensation, and intact reflexes. He diagnosed lumbar spondylosis, degenerative
disc disease, and lumbar radiculopathy. Dr. Caneris recommended right-sided, two-level
transforaminal injections at L4 and L5 and stretching and stabilization of the quadratus and psoas
with L4 and L5 techniques.
Appellant was examined by Dr. G. Stephen Cleves, a Board-certified internist, on
May 22, 2015, for low back pain and stiffness with an onset of one month. Dr. Cleves noted
findings of decreased range of motion of the musculoskeletal spine. He diagnosed backache,
unspecified. In a June 10, 2015 addendum, Dr. Cleves noted that appellant had a history of
ongoing back pain and on May 15, 2015 he aggravated his back and pulled something in his
groin area while lifting boxes at work. He noted that appellant was scheduled for a steroid
injection.
By letter dated February 8, 2016, OWCP advised appellant of the type of evidence
needed to establish his claim, particularly requesting that he submit a physician’s reasoned
opinion addressing the relationship of his claimed condition and specific employment incident.
It requested that the physician’s opinion be based upon the history and date of injury he had
provided to the physician. OWCP noted that medical evidence must be submitted by a qualified
physician and notified appellant of the circumstances under which a chiropractor can be
considered a physician under FECA. Appellant did not submit additional evidence responsive to
the specific requests contained within OWCP’s development letter.
In a March 15, 2016 decision, OWCP denied appellant’s claim for compensation because
the medical evidence of record was insufficient to establish a medical condition causally related
to the accepted work incident.
On March 21, 2016 appellant through counsel requested a telephonic hearing which was
held on December 19, 2016.

2

On August 24, 2016 Dr. Mathew A. Hazzard, a Board-certified neurosurgeon, performed
a bilateral percutaneous sacroiliac joint fixation, intraoperative fluoroscopy, and intraoperative
neuromonitoring. He diagnosed bilateral sacroiliac joint fixation.
Appellant was treated by Dr. Neil Allen, a Board-certified neurologist, on November 9,
2016, for back pain. Dr. Allen reported that appellant had sustained a low back injury and groin
pain as a result of repetitive lifting and carrying boxes of ammunition. Appellant noted current
symptoms of right-sided back pain, groin pain, numbness and tingling down the right leg, and
hypersensitivity of the right foot. Dr. Allen noted appellant’s history was significant for a low
back injury in 2007, which was refractive to conservative measures and he eventually required a
lumbar fusion at L5-S1 in 2008. He diagnosed strain/sprain of the lumbar spine. Dr. Allen noted
the repetitive, forceful muscle contraction required to perform the task described by appellant on
May 15, 2015, resulted in the overstretching and microscopic tearing of the ligaments and
musculature of the lumbar spine resulting in the injury. He indicated that the surrounding soft
tissues react and became inflamed, painful and stiff, restricting both functional and mobility
within the affected area with radiating symptoms to the buttocks and thigh. Dr. Allen opined that
appellant’s injury resulting from the repetitive occupational trauma on May 15, 2015 was both
reasonable and expected based upon the mechanism described by appellant and the medical
records. Appellant also submitted physical therapy notes.
In a decision dated January 30, 2017, an OWCP hearing representative affirmed the
decision dated March 15, 2016.
LEGAL PRECEDENT
An employee seeking benefits under FECA3 has the burden of proof to establish 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 of FECA, that an injury was sustained in the performance of duty as alleged, and that
any disability and/or specific condition for which compensation is claimed is causally related to
the employment injury. These are the essential elements of each and every compensation claim
regardless of whether the claim is predicated upon a traumatic injury or an occupational disease.4
To determine whether a federal employee has sustained a traumatic injury in the
performance of duty, it first must be determined whether fact of injury has been established.
There are two components involved in establishing fact of injury. First, the employee must
submit sufficient evidence to establish that he actually experienced the employment incident at
the time, place, and in the manner alleged. Second, the employee must submit medical evidence
sufficient to establish that the employment incident caused a personal injury.5

3

Id.

4

Gary J. Watling, 52 ECAB 357 (2001).

5

T.H., 59 ECAB 388 (2008).

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Rationalized medical opinion evidence is generally required to establish causal
relationship. The opinion of the physician must be based on a complete factual and medical
background, must be one of reasonable medical certainty, and must be supported by medical
rationale explaining the nature of the relationship between the diagnosed condition and the
specific employment factors identified by the claimant.6
ANALYSIS
It is undisputed that on May 15, 2015 appellant was lifting and carrying cases of
ammunition. However, he has failed to submit sufficient medical evidence to establish that his
diagnosed medical condition is causally related to the May 15, 2015 employment incident.
Appellant was treated by Dr. Allen on November 9, 2016. He reported sustaining a low
back injury as a result of repetitive lifting and carrying boxes of ammunition. Dr. Allen noted
that appellant’s history was significant for a low back injury in 2007, which required a 2008
lumbar fusion of L5-S1. He diagnosed strain/sprain of the lumbar spine and opined that the
repetitive, forceful muscle contraction required to perform the task described by appellant on
May 15, 2015 resulted in the overstretching and microscopic tearing of the ligaments and
musculature of the lumbar spine. Dr. Allen indicated that appellant’s injury resulted from the
repetitive occupational trauma on May 15, 2015 was both reasonable and expected based upon
the mechanism described by appellant and the medical records. However, he merely repeated
the history of injury as reported by appellant without providing his own opinion explaining how
particular work activities on May 15, 2015 caused a diagnosed condition. To the extent that
Dr. Allen is providing his own opinion, he failed to provide sufficient rationale regarding the
causal relationship between appellant’s low back condition and the accepted work incident.7
Therefore, this report is insufficient to meet his burden of proof.
Similarly, in a report dated May 20, 2015, Dr. Caneris treated appellant for right lower
abdominal and right groin pain. Appellant reported a first onset of pain over a year earlier and
believed that his condition related to a work-related incident. Dr. Caneris diagnosed lumbar
spondylosis, degenerative disc disease, and lumbar radiculopathy. As with Dr. Allen,
Dr. Caneris also merely repeated the history of injury as reported by appellant without providing
his own opinion regarding whether his condition was work related. To the extent that
Dr. Caneris is providing his own opinion, he did not provide a rationalized opinion regarding the
causal relationship between appellant’s low back condition and the May 15, 2015 work
activities.8
Appellant submitted a May 22, 2015 report from Dr. Cleves who treated him for low
back pain and stiffness. Dr. Cleves diagnosed backache, unspecified. In an addendum note
dated June 10, 2015, he noted that appellant had a history of back pain that was ongoing and on
6

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

7

Franklin D. Haislah, 52 ECAB 457 (2001) (medical reports not containing rationale on causal relationship are
entitled to little probative value); Jimmie H. Duckett, 52 ECAB 332 (2001).
8

Id.

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May 15, 2015 he aggravated his back by pulling something in his groin area while lifting boxes
at work. The Board finds that, although Dr. Cleves supported causal relationship, he did not
provide medical rationale explaining the basis of his conclusory opinion that appellant’s back
condition was due to the factors of employment.9 Dr. Cleves did not explain the process by
which lifting boxes caused or aggravated the diagnosed conditions.10 Medical rationale is
particularly necessary given that appellant had a preexisting low back condition and underwent a
surgery in 2008. As the opinion of appellant’s physician regarding causal relationship was
conclusory and unexplained, it was insufficient to meet appellant’s burden of proof.11
Appellant submitted an August 24, 2016 operative report from Dr. Hazzard who
performed a bilateral percutaneous sacroiliac joint fixation, intraoperative fluoroscopy and
intraoperative neuromonitoring, and diagnosed bilateral sacroiliac joint fixation. Dr. Hazzard’s
notes are insufficient to establish the claim as he did not provide a history of injury12 or
specifically address whether appellant’s employment activities had caused or aggravated a
diagnosed medical condition.13
Appellant was initially treated by Dr. Skinner, a chiropractor from May 18 to July 20,
2015, for low back pain. He reported that he sustained a work injury on May 15, 2015 while he
was lifting and carrying boxes of ammunition while working. Section 8101(2) of FECA
provides that chiropractors are considered physicians “only to the extent that their reimbursable
services are limited to treatment consisting of manual manipulation of the spine to correct a
subluxation as demonstrated by x-ray to exist and subject to regulation by the Secretary.”14
Thus, where x-rays do not demonstrate a spinal subluxation, a chiropractor is not considered a
“physician,” and his or her reports cannot be considered as competent medical evidence under
FECA.15 Dr. Skinner is not considered a physician in this case as he did not diagnose a spinal
9

See T.M., Docket No. 08-0975 (issued February 6, 2009) (a medical report is of limited probative value on the
issue of causal relationship if it contains a conclusion regarding causal relationship which is unsupported by medical
rationale).
10

Id.

11

J.M., 58 ECAB 478 (2007) (where the Board found that appellant did not meet his burden of proof in
establishing a work-related right wrist condition where his physician provided only conclusory support for causal
relationship and did not identify any of the job duties appellant performed at the employing establishment which he
believed were responsible for appellant’s condition or explain how his work duties at the employing establishment
caused or contributed to his condition. Medical rationale was particularly necessary given that appellant injured his
wrist while lifting luggage in private employment. As the opinion of appellant’s physician regarding causal
relationship was conclusory and unexplained, it was insufficient to meet appellant’s burden of proof).
12

Frank Luis Rembisz, 52 ECAB 147 (2000).

13

A.D., 58 ECAB 149 (2006); Docket No. 06-1183 (issued November 14, 2006) (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).
5 U.S.C. § 8101(2); see also section 10.311 of the implementing federal regulations provides: “(c) A
chiropractor may interpret his or her x-rays to the same extent as any other physician. To be given any weight, the
medical report must state that x-rays support the finding of spinal subluxation. OWCP will not necessarily require
submittal of the x-ray, or a report of the x-ray, but the report must be available for submittal on request.”
14

15

See Susan M. Herman, 35 ECAB 669 (1984).

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subluxation demonstrated by x-ray. Thus, his opinion is not considered competent medical
evidence under FECA.
Appellant submitted physical therapy notes dated March 8, 2016. The Board has held
that treatment notes signed by a physical therapist, are not considered medical evidence as they
are not a physician under FECA16 and are not competent to render a medical opinion under
FECA. Thus, this evidence is not sufficient to meet appellant’s burden of proof.
Due to appellant’s history of prior injury and the lack of clarity between his claim for
groin pain and the development of additional back pain, OWCP properly requested further
medical evidence as to the specific history and date of his back conditions. As previously
discussed above, appellant failed to submit a narrative medical report containing a history of
injury and a physician’s opinion relative to same. The Board finds that he has failed to submit
sufficient medical evidence to establish that his accepted work incident on May 15, 2015 caused
or aggravated a diagnosed medical condition.
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 meet his burden of proof to establish a lumbar
injury causally related to the accepted May 15, 2015 employment incident.

16

See David P. Sawchuk, 57 ECAB 316 (2006) (lay individuals such as physician’s assistants, nurses and
physical therapists are not competent to render a medical opinion under FECA); 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).

6

ORDER
IT IS HEREBY ORDERED THAT the January 30, 2017 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: October 19, 2017
Washington, DC

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

Patricia H. Fitzgerald, Deputy Chief Judge
Employees’ Compensation Appeals Board

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

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
F.N., Appellant
and
DEPARTMENT OF VETERANS AFFAIRS,
VETERANS HEALTH ADMINISTRATION,
NEW JERSEY HEALTH CARE SYSTEM,
Lyons, NJ, Employer
__________________________________________

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Appearances:
Thomas R. Uliase, Esq., for the appellant1
Office of Solicitor, for the Director

Docket No. 16-0597
Issued: October 25, 2016

Case Submitted on the Record

DECISION AND ORDER
Before:
COLLEEN DUFFY KIKO, Judge
ALEC J. KOROMILAS, Alternate Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION
On February 9, 2016 appellant, through counsel, filed a timely appeal from a
November 10, 2015 merit decision of the Office of Workers’ Compensation Programs (OWCP).
Pursuant to the Federal Employees’ Compensation Act2 (FECA) and 20 C.F.R. §§ 501.2(c) and
501.3, the Board has jurisdiction over the merits of this case.

1

In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for
legal or other service performed on appeal before the Board is valid unless approved by the Board.
20 C.F.R. § 501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board.
Id. An attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor,
subject to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of
fees to a representative, prior to approval by the Board, may be reported to appropriate authorities for investigation.
2

5 U.S.C. § 8101 et seq.

ISSUE
The issue is whether appellant met her burden of proof to establish an emotional
condition causally related to factors of her federal employment.
On appeal counsel alleges that appellant has submitted sufficient factual and medical
evidence to substantiate her emotional condition claim.
FACTUAL HISTORY
On September 9, 2010 appellant, then a 75-year-old registered nurse, filed a recurrence
claim (Form CA-2a) alleging that she sustained an emotional condition in the performance of
duty on April 2, 2010.3 With her claim she attached a timeline of her emotional condition,
beginning in 1985. Appellant alleged that the employing establishment had retaliated against her
following the disposition of an accepted traumatic injury claim by issuing an “improper
proficiency report.” She alleged that she had been “blackballed” by a supervisor after the
disposition of her traumatic injury claim and that this supervisor had favored a family member in
promotion.
Appellant noted allegations of harassment. She explained that after requesting to be
reassigned to a psychiatry department in 1997, she had been assigned to a nursing home, that the
employing establishment was corrupt, and that various supervisors had harassed her. Appellant
stated that she had filed a grievance on January 6, 1999 regarding a proficiency report. She
noted that on February 14, 2008 she had received a letter from a finance officer regarding a
delinquent debt. Appellant stated that she had been harassed, assigned to a different shift, given
bogus letters of reprimand, her car vandalized, her locker trashed with empty liquor bottles, and
intimidated by supervisors upon reporting these events. She noted that she had been working at
the employing establishment for 32 years and suffered physical afflictions as a result of a
stressful work environment. Appellant quoted Thomas Jefferson and Honoré de Balzac. She
attached various documents regarding misconduct and abdication of responsibilities at her place
of employment, and stated that she had been retaliated against as a whistleblower.
By letter dated October 12, 2010, appellant stated that five levels of management had
bullied, harassed, and retaliated against her. She alleged that it was standard practice of the
employing establishment to attack decent, honest, and hard-working employees.
By letter dated December 2, 2010, OWCP notified appellant that, due to the
circumstances of her claim, it was not a recurrence, and would be adjudicated as a new
occupational disease claim.
3

Appellant had previously filed a traumatic injury claim (Form CA-1) on October 26, 1984 alleging emotional
stress occurring on October 1, 1984. OWCP file number xxxxxx715. A memorandum from the Director of the
employing establishment dated December 13, 1984 related that no improper actions had been taken by the
employing establishment following appellant’s report of alleged patient abuse. However appellant’s reassignment
back to ward 55-C was not reprisal, but was inappropriate, because patients and staff on that ward knew of
appellant’s allegation. This claim was accepted on April 26, 1989 for “temporary adjustment disorder” and
disability benefits were authorized for the period October 1, 1984 to March 24, 1985.

2

On January 18, 2011 OWCP advised appellant that she needed to submit additional
evidence in order to establish her claim. It noted that she had not submitted any evidence to
establish that the employing establishment had taken improper actions against her other than her
own statements. OWCP further requested that appellant submit a narrative medical report from a
psychiatrist or clinical psychologist in support of her claim. Appellant was afforded 30 days to
submit this evidence.
By letter dated February 14, 2011, appellant responded to OWCP, contending that her
claim was a recurrence of her previously accepted claim dated April 26, 1989. She stated, “A
stress claim had been filed in the original claim -- manifesting itself into many frank physical
disorders and it took many years to again cause my physical condition to deteriorate to the point
of being unable to continue working and realizing history had repeated itself without any new
factors.” Appellant noted that her work-related condition had been continuous over her career.
With her letter, appellant attached voluminous correspondence dealing with personnel
matters, allegations of patient abuse, grievances, and correspondence with her Congressman. In
a letter dated June 18, 1985, the Office of Special Counsel (OSC) had informed appellant that it
found no evidence of a retaliatory motive in promotion denial, performance evaluation, or denial
of workers’ compensation benefits. In a letter dated March 10, 1986, the OSC informed
appellant that it was unable to conclude that the employing establishment had engaged in
retaliation, and that the case had been closed.
By decision dated February 22, 2011, OWCP denied appellant’s claim for compensation.
It noted that her claim had been adjudicated as a new claim because new employment-related
incidents had been claimed. OWCP found that she had not submitted any medical evidence
containing a diagnosis related to her claim. It further noted an accepted event that was not a
factor of employment: a letter dated August 12, 2010 that was sent regarding an investigation of
intimidation and retaliation. OWCP noted that the fact that a letter was sent regarding an
investigation did not establish any wrongdoing on the part of the employing establishment. It
noted that allegations alone were not sufficient to establish a factual basis for an emotional
condition claim.
On March 18, 2011 appellant requested an oral hearing before an OWCP hearing
representative.
Appellant again submitted voluminous records of correspondence, received by OWCP on
June 28, 2011. By letter dated June 5, 2002, the employing establishment noted that she was
involved in a verbal altercation with another staff member, and had been reassigned to a tour of
duty during the day shift. In a letter dated June 19, 2002, the employing establishment
responded to a letter from appellant alleging improper and unethical conduct with regard to a
change in her tour of duty, stating that she needed to file a grievance.
On July 1, 2011 OWCP received an entire copy of the book “Aftermath: A War of
Memories” by Dr. Ronald M. Chase.

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In a report dated July 23, 2010, Dr. Ronald M. Chase diagnosed appellant with anxiety
disorder that may have taken on the proportions of post-traumatic stress disorder.4 He wrote:
“[Appellant’s] chronic mental condition should have been obvious to the staff at
[the employing establishment] since 1985. Her chronic anxiety symptoms, and
later her attendance record of physical illnesses, should have been recognized by
the risk management team and supervisor staff to offer Employee Assistance
Program consultation or psychiatric treatment. [Appellant’s] obsession with
righting the perceived wrongs of the system was met with antagonism rather than
seen as a plea for help. Her paranoid suspiciousness rose to a level of belief that
the hospital administration deliberately chose to torment her by refusing to
accommodate her and provide a safe working environment. It is my opinion
based on a review of my initial evaluation of the claimant on January 3, 1985;
Review of the Decision of the Hearing Representative, October 7, 1986;
conversation with claimant on July 21, 2010 that there is a definite causal
relationship of work[-]related emotional stressors (Axis IV of the DSM-IV:
harassment, retaliation by government for whistle blowing) and the development
of a diagnosable condition of Anxiety Disorder which has been continuously
present since 1984.”
The hearing was held on June 27, 2011. Appellant contended that her claim had been
improperly classified as a new occupational disease rather than a recurrence. She alleged that the
lack of the medical evidence in her case file was due to “some sort of something that is not
exactly above board.” The hearing representative told appellant that the hearing was not to
determine the employing establishment’s corruption, but as to whether she had established a
claim for a stress condition. She noted that appellant kept interrupting her and asked her to stop.
The hearing representative asked appellant whether any of her charges against the employing
establishment had been adjudicated in her favor. Appellant stated that there were several current
investigations. The hearing representative stated that just because she had spoken with the
Office of the Inspector General, that did not mean that her claims had been adjudicated in her
favor. Appellant noted that she had submitted the book to the record because it dealt with the
employing establishment and that some of the events depicted in the book were relevant to her
case, and that it had been written by her physician. She stated that she wanted to tell her whole
story before she retired.
The employing establishment sent a response to the transcript of the hearing on
July 19, 2011. It noted that she had not provided any factual evidence identifying employment
factors or incidents alleged to have caused an emotional condition. The employing establishment
noted that she had not provided rationalized medical evidence connecting her emotional
condition to an employment factor, and stated that her physician, Dr. Chase, was biased against
the employing establishment because he had been terminated by the employing establishment.
By decision dated August 17, 2011, the hearing representative remanded the case for a de
novo decision, because OWCP had not made sufficient findings of fact and had not addressed
4

Dr. Chase’s certification in a medical specialty could not be confirmed with the American Board of Medical
Specialties or the American Osteopathic Association.

4

each of the factors alleged to have contributed to appellant’s emotional condition. The hearing
representative noted that OWCP correctly adjudicated appellant’s claim as a new claim for
occupational disease.
By letter dated October 13, 2011, the employing establishment stated that every
allegation or concern brought forward by appellant had been investigated and found to be
without merit. It noted that she had not presented any specific or reliable evidence supporting
harassment or improper treatment. The employing establishment stated that appellant was not
known as a whistleblower and that she had not been “blackballed” from working in psychiatry.
It noted that there was no report that her locker had been trashed or vandalized. The employing
establishment stated that appellant’s psychological condition was a personal, self-generated
emotional reaction to administrative issues and, therefore, did not occur in the performance of
duty.
By letter dated October 13, 2011, a supervisor at the employing establishment noted that
appellant had reported numerous concerns related to patient care, that they had all been reviewed
externally and internally, and that they all had been found to be without merit. The supervisor
noted that appellant did not have claim status as a whistleblower. He further stated that he was
unaware of any “blackballing” of appellant in 1991. The supervisor noted that, with regard to
the “bogus” delinquent debt letter, the employing establishment was “unaware of the validity of
the negative adjectives allocated to this correspondence.” He stated that appellant had not been
harassed or reassigned based on any practice of uncovering issues with patient care, and that all
of her concerns about patient care had been fully reviewed. The supervisor noted that the
employing establishment was also unaware of any “bogus” letters of reprimand, and that there
had been no reporting of an incident of vandalizing of her locker.
In an e-mail dated October 14, 2011, a supervisor in the employing establishment stated
that he had no knowledge of a bogus delinquent debt assessed to appellant.
By decision dated December 15, 2011, OWCP denied appellant’s claim for
compensation. It noted that, while Dr. Chase had diagnosed appellant with anxiety disorder and
opined that it was work related, he had not described any specific work factors related to
appellant’s anxiety condition.
OWCP further stated that there was one accepted event that was a factor of employment:
appellant’s reassignment to a building in which she previously worked on October 1, 1984 was
inappropriate because her identity as the reporter of alleged abuse could have been revealed due
to the fact that she knew many patients and staff in that building. It noted, however, that this
accepted injury resolved no later than 1986, and her current claim was related to new
employment incidents occurring subsequent to 1986.
OWCP found that the following events were not compensable factors of employment:
(a) the employing establishment’s handling of her claim for a traumatic injury she suffered in
July 1979; (b) unsubstantiated perception of harassment by coworkers and supervisors when she
resisted any form of patient abuse; (c) unsubstantiated perception of being placed in physical
jeopardy on February 22, 1984; (d) unsubstantiated perception of harassment by a supervisor on
February 22, 1984 when the supervisor refused to supply additional support personnel to cope

5

with a combative patient; (e) unsubstantiated perception of harassment by a supervisor in
March 1984 who accused appellant of trying to cover up the events of February 22, 1984 by not
reporting it to a supervisor; (f) unsubstantiated perception of harassment, discrimination, and
demoralizing by a supervisor who on March 16, 1984 replaced her with another nurse who had
originally refused assignment to the unit and accused appellant of being a blackmailer;
(g) unsubstantiated perception of being ignored, debased, and intimidated by a supervisor who
on April 2, 1984 ignored appellant’s request for clarification of policy and standards regarding
refusal of emergency-duty assignments; (h) unsubstantiated perception of being placed in
physical jeopardy on July 8, 1984; (i) unsubstantiated perception of being ignored and
discriminated against by a supervisor on July 8, 1984 by replacement of a specially-trained male
nurse with a female nursing assistant although there was a patient in a threatening mood;
(j) unsubstantiated perception of being harassed and ignored by a supervisor who on July 9, 1984
refused to make a personal assessment of a potentially dangerous staffing shortage;
(k) unsubstantiated perception of harassment by a nursing service supervisor who on August 8,
1984 requested a clarification to a memorandum; (l) unsubstantiated perception of being ignored,
debased, and intimidated by a supervisor on August 8, 1984 when she issued a memorandum
regarding a clarification of policy and standards; (m) unsubstantiated perception of harassment
and intimidation by a supervisor who on August 9, 1984 prepared a memorandum of
misinformation clarification; (n) unsubstantiated perception of a hostile attitude by a coworker
on August 29, 1984; (o) unsubstantiated perception of being harassed, degraded, and threatened
by a supervisor who on August 29, 1984 questioned the events of that date even though a report
had been provided; (p) unsubstantiated perception of being harassed, degraded, and threated by a
supervisor who declined to meet with her and a union representative on September 5, 1984; (q)
unsubstantiated perception of a passive and condescending reception by a supervisor on
September 6, 1984; (r) unsubstantiated perception of being ignored by a supervisor from
September 10 through 30, 1984; (s) unsubstantiated perception of being reassigned to an unsafe
place of work on October 1, 1984; (t) unsubstantiated perception of being abused, intimidated,
harassed, threatened, belittled, oppressed, and humiliated by a supervisor on October 1, 1984
who announced to others that she should not be in a particular location because she had been
reassigned; (u) unsubstantiated perception of being placed in physical jeopardy by a supervisor
on October 2, 1984 because she was discouraged from associating with a patient who wished to
speak with her; (v) unsubstantiated perception of working under known hostile conditions on
October 2, 1984; (w) unsubstantiated perception of a the employing agency’s mishandling of her
October 1, 1984 traumatic injury claim under file number xxxxxx715; (x) unsubstantiated
perception of deliberate delay in informing her of the denial of additional leave without pay in
1985; (y) unsubstantiated perception of management at the employing establishment bullying
and retaliating against her when the employing establishment denied leave without pay status by
letter dated March 19, 1985, with a withdrawal of a grievance for unjustified absent without
leave status on May 12, 1985; (z) unsubstantiated perception of being harassed by a supervisor
who reassigned appellant to a nursing home after appellant requested to be reassigned to
psychiatry in 1997; (aa) unsubstantiated perception of being ignored by a supervisor and being
intimidated by the employing establishment when appellant claimed she reported that her car had
been vandalized and her locker had been trashed; (bb) unsubstantiated perception of improper
conduct of reassigning appellant to the day shift on July 7, 2002; (cc) unsubstantiated perception
of being harassed on April 14, 2003 when she was told that her approved vacation time had been
forgotten by accident; (dd) unsubstantiated perception of being discriminated against by a

6

supervisor when she did not receive an annual proficiency report for 1996 and 1997; (ee)
unsubstantiated perception of a proficiency report for 1996 being prepared and approved by
biased and antagonistic supervisory personnel; (ff) unsubstantiated perception of the employing
establishment’s mishandling of her December 10, 1997 traumatic injury claim under file number
xxxxxx504; (gg) unsubstantiated perception of being discriminated against when supervisors
inserted an unissued and “disapproved” proficiency report in her personnel file; (hh)
unsubstantiated perception of hostility and threats from a head nurse when appellant reported her
for ordering medication procedures contrary to the regulations; (ii) unsubstantiated perception of
other nurses taking action against appellant in a contrived and discriminatory manner; (jj)
unsubstantiated perception of management placing appellant at a risk of injury when they
reassigned her to a nursing home; (kk) unsubstantiated perception of management engaging in
improper, unethical, and prohibited personnel practices when her performance rating was
lowered in 1998; (ll) unsubstantiated perception of being scapegoated when management ignored
her report dated May 14, 2002 regarding an incident on April 30, 2002; (mm) unsubstantiated
perception of the nursing service trying to “blacken” her on July 8, 2002; (nn) unsubstantiated
perception of being retaliated against when she received a satisfactory rating without promotion
in 2003; (oo) unsubstantiated perception of the employing establishment’s mishandling of her
February 12, 2003 traumatic injury claim under file number xxxxxx261; and (pp)
unsubstantiated perception of harassment and discrimination by a supervisor who on July 10,
1984 provided her with misinformation in order to continue to harass appellant and compromise
her position. OWCP found that the following incidents were not supported by the evidence of
record and thus found that they did not occur: (a) the employing establishment’s “blackballing”
of appellant from ever working in psychiatry again after her traumatic injury claim of October 1,
1984 was approved; (b) appellant’s receiving bogus letters of reprimand, which were then
withdrawn; and (c) appellant’s receiving of a bogus and illegal finance offer from the employing
establishment. OWCP found that appellant’s claim should be rejected on the medical component
of “fact of injury” because the medical evidence did not support a condition in connection with
the specified accepted factor of employment.
On December 16, 2012 appellant requested reconsideration of OWCP’s December 15,
2011 decision.
On January 14, 2013 OWCP denied appellant’s request for reconsideration, noting that it
was untimely filed and that she failed to demonstrate clear evidence of error.
Appellant again requested reconsideration on November 20, 2012.
By decision dated July 1, 2013, OWCP denied appellant’s request for reconsideration,
noting that it was untimely filed and failed to demonstrate clear evidence of error.
By letter dated August 15, 2013, appellant, through counsel, appealed OWCP’s July 1,
2013 decision to the Board.
On February 7, 2014 the Board remanded the case to OWCP, finding that appellant had
demonstrated that her request for reconsideration that was found untimely by OWCP on
January 14, 2013 had actually been timely submitted. The Board noted that the one-year time

7

period expired on a weekend and appellant had until the following business day to file the
request for reconsideration. The Board set aside the decisions of January 14 and July 1, 2013.5
Appellant submitted a disciplinary Board decision dated May 19, 2014, in which all
charges against her for violating a policy regarding administration of IV fluid were sustained, but
the level of penalty was reduced. She also submitted a statement alleging additional factors of
employment alleged to have caused her emotional condition. These allegations included an
unusual level of job tension, employing establishment refusal to pay continuation of pay, an
employing establishment challenge to file number xxxxxx319, and denial of pay after Hurricane
Sandy.
On May 19, 2014 OWCP evaluated the merits of appellant’s case and affirmed its prior
decisions denying her claim for an emotional condition. It found that appellant’s new allegations
were unsubstantiated. With regard to the employing establishment’s challenge of file number
xxxxxx319, OWCP noted that the claim had formally been denied on August 22, 2011, and that
appellant had not exercised her appeal rights on that decision.
By letter dated July 23, 2014, appellant, through counsel, again requested
reconsideration. With her request for reconsideration, appellant attached a report from Dr. Chase
dated July 7, 2013. In this report, Dr. Chase noted that he had known appellant as a colleague
since 1983. He diagnosed appellant with an anxiety disorder and stated, “It is my opinion that
from the outset in 1985 [appellant] suffered from an anxiety disorder that was directly related to
her employment at [the employing establishment.]”
On August 25, 2014 Dr. Chase reviewed appellant’s history of allegations and stated that
“[The events alleged by appellant] were major life stressors for [appellant]. They contributed to
the formulation of the diagnosis -- [a]nxiety [d]isorder -- a recurring condition, a continuum,
satisfying the DSM Axis I and Axis IV diagnostic requirements of the previously submitted
reports by Dr. Chase.”
By decision dated November 10, 2015, OWCP found that appellant had established a
medical diagnosis related to her employment-related allegations, that of generalized anxiety.
However, it denied her claim on the basis that she had not established compensable factors of
employment, affirming its prior finding that appellant’s allegations were unsubstantiated or
administrative matters, and therefore outside the performance of duty. OWCP noted that these
allegations did not occur within the performance of duty related to her occupational illness claim
of April 2, 2010.
LEGAL PRECEDENT
Workers’ compensation law does not apply to each and every injury or illness that is
somehow related to an employee’s employment. There are situations where an injury or an
illness has some connection with the employment, but nevertheless does not come within the
concept or coverage of workers’ compensation. Where the disability results from an employee’s
emotional reaction to his or her regular or specially assigned duties or to a requirement imposed
5

Docket No. 13-1601 (issued February 7, 2014).

8

by the employment, the disability comes within the coverage of FECA.6 On the other hand, the
disability is not covered where it results from such factors as an employee’s fear of a reductionin-force or his or her frustration from not being permitted to work in a particular environment or
to hold a particular position.7
Administrative and personnel matters, although generally related to the employee’s
employment, are administrative functions of the employer rather than the regular or specially
assigned work duties of the employee and are not covered under FECA.8 However, the Board
has held that, where the evidence establishes error or abuse on the part of the employing
establishment in what would otherwise be an administrative matter, coverage will be afforded.9
In determining whether the employing establishment has erred or acted abusively, the Board will
examine the factual evidence of record to determine whether the employing establishment acted
reasonably.10
To the extent that disputes and incidents alleged as constituting harassment and
discrimination by supervisors and coworkers are established as occurring and arising from the
employee’s performance of his or her regular duties, these could constitute employment
factors.11 However, for harassment or discrimination to give rise to a compensable disability
under FECA, there must be evidence that harassment or discrimination did in fact occur. Mere
perceptions of harassment or discrimination are not compensable under FECA.12
An employee has the burden of establishing by the weight of the reliable, probative, and
substantial evidence that the condition for which he or she claims compensation was caused or
adversely affected by employment factors.13 This burden includes the submission of a detailed
description of the employment factors or conditions which he or she believes caused or adversely
affected a condition for which compensation is claimed and a rationalized medical opinion
relating the claimed condition to compensable employment factors.14
In cases involving emotional conditions, the Board has held that, when working
conditions are alleged as factors in causing a condition or disability, OWCP, as part of its
adjudicatory function, must make findings of fact regarding which working conditions are
6

Lillian Cutler, 28 ECAB 125 (1976).

7

Gregorio E. Conde, 52 ECAB 410 (2001).

8

Matilda R. Wyatt, 52 ECAB 421 (2001); Thomas D. McEuen, 41 ECAB 387 (1990), reaff’d on recon., 42
ECAB 556 (1991).
9

William H. Fortner, 49 ECAB 324 (1998).

10

Ruth S. Johnson, 46 ECAB 237 (1994).

11

David W. Shirey, 42 ECAB 783, 795-96 (1991).

12

Jack Hopkins, Jr., 42 ECAB 818, 827 (1991).

13

Pamela R. Rice, 38 ECAB 838, 841 (1987).

14

Effie O. Morris, 44 ECAB 470, 473-74 (1993).

9

deemed compensable factors of employment and are to be considered by a physician when
providing an opinion on causal relationship and which working conditions are not deemed
factors of employment and may not be considered.15 If an employee does implicate a factor of
employment, OWCP should then determine whether the evidence of record substantiates that
factor. When the matter asserted is a compensable factor of employment and the evidence of
record establishes the truth of the matter asserted, it must base its decision on an analysis of the
medical evidence.16
ANALYSIS
On September 9, 2010 appellant, then a 75-year-old registered nurse, filed a recurrence
claim alleging that she sustained an emotional condition in the performance of duty on
April 2, 2010. By letter dated December 2, 2010, OWCP notified appellant that due to the
circumstances of her claim, it was not a recurrence, and would be adjudicated as a new
occupational disease claim. By decision dated August 17, 2011, the hearing representative noted
that OWCP correctly adjudicated appellant’s claim as a new claim for occupational disease.
As an initial matter, the Board finds that appellant’s claim for compensation was
correctly adjudicated as a new claim for occupational disease. A recurrence of disability means
an inability to work after an employee has returned to work, caused by a spontaneous change in a
medical condition which resulted from a previous compensable injury or illness and without an
intervening injury or new exposure in the work environment.17 OWCP regulations define a
recurrence of medical condition as the documented need for further medical treatment after
release from treatment of the accepted condition when there is no work stoppage. Continued
treatment for the original condition is not considered a renewed need for medical care, nor is
examination without treatment.18
In her initial claim, appellant attached a timeline of series of events, which included
several alleged incidents that occurred after 1985, including (but not limited to) incidents in
1997, 1999, 2002, 2003, and 2008. On April 26, 1989 a claims examiner noted that appellant’s
workers’ compensation claim had been approved for a traumatic injury of “temporary adjustment
disorder,” and that all causally-related conditions had ceased as of March 25, 1985. As such, her
claim was not for a spontaneous change in her condition without an intervening alleged injury,
but included allegations of new factors causing an emotional condition after 1985. Therefore,
OWCP properly adjudicated her claim as a new claim for occupational disease.
In its November 10, 2015 decision, OWCP denied appellant’s claim because she had not
established any new compensable employment factors. The Board must, then, review whether
15

See Norma L. Blank, 43 ECAB 384, 389-90 (1992).

16

Id.

17

20 C.F.R. § 10.5(x); see S.F., 59 ECAB 525, 531 (2008). See 20 C.F.R. § 10.5(y) (defines recurrence of a
medical condition as a documented need for medical treatment after release from treatment for the accepted
condition).
18

Id. at § 10.5(y).

10

these alleged incidents and conditions of employment are covered factors under the terms of
FECA.
Appellant’s allegations do not pertain to her regular or specially assigned duties under
Rather, she alleged error, abuse, and retaliation in administrative matters and
Cutler.
harassment and discrimination on the part of her supervisors. The Board has found that
administrative and personnel matters, although generally related to the employee’s employment,
are administrative functions of the employer rather than the regular or specially assigned work
duties of the employee and are not covered under FECA. However, the Board has held that,
where the evidence establishes error or abuse on the part of the employing establishment in what
would otherwise be an administrative matter, coverage will be afforded.20
19

In its December 15, 2011 decision, OWCP found that 42 separate allegations of error,
abuse, and retaliation in administrative matters and/or harassment and discrimination on the part
of her supervisors were not compensable factors of employment, because the events had not been
substantiated. The Board notes that for each of these allegations, the only evidence in the case
record was appellant’s own statements. She did not provide documentation that many of her
charges against the employing establishment had been adjudicated in her favor. Investigations of
wrongdoing, stemming from these allegations, do not prove that the allegations actually
occurred. The book by Dr. Chase, dealing generally with problems at the employing
establishment, also does not prove appellant’s specific allegations.
In fact, evidence provided by appellant indicates that several of these investigations were
adjudicated against her allegations: in a letter dated June 18, 1985, the OSC had informed
appellant that it found no evidence of a retaliatory motive in promotion denial, performance
evaluation, or denial of workers’ compensation benefits. In a letter dated March 10, 1986, the
OSC informed appellant that it was unable to conclude that the employing establishment had
engaged in retaliation, and that the case had been closed.
Various supervisors and the employing establishment disputed several of appellant’s
allegations. By letter dated October 13, 2011, the employing establishment stated that every
allegation or concern brought forward by appellant had been investigated and found to be
without merit. It noted that she had not presented any specific or reliable evidence supporting
harassment or improper treatment. The employing establishment stated that appellant was not
known as a whistleblower and that she had not been “blackballed” from working in psychiatry.
It noted that there was no report that her locker had been trashed or vandalized. The employing
establishment stated that appellant’s psychological condition was a personal, self-generated
emotional reaction to administrative issues and, therefore, not in the performance of duty. By
letter dated October 13, 2011, a supervisor at the employing establishment noted that appellant
had reported numerous concerns related to patient care, that they had all been reviewed
externally and internally, and that they all had been found to be without merit. The supervisor
noted that appellant did not have claim status as a whistleblower. He further stated that he was
unaware of any “blackballing” of appellant in 1991. The supervisor noted that, with regard to
19

See supra note 2.

20

See supra notes 4 through 6.

11

the “bogus” delinquent debt letter, the employing establishment was “unaware of the validity of
the negative adjectives allocated to this correspondence.” He stated that appellant had not been
harassed or reassigned based on any practice of uncovering issues with patient care, and that all
of her concerns about patient care had been fully reviewed. The supervisor noted that the
employing establishment was also unaware of any “bogus” letters of reprimand, and that there
had been no reporting of an incident of vandalizing of her locker. In an e-mail dated October 14,
2011, a supervisor in the employing establishment stated that he had no knowledge of a bogus
delinquent debt assessed to appellant.
The Board finds that appellant failed to submit any evidence of error or abuse with
respect to each of her 42 allegations because they were unsubstantiated. Appellant’s remaining
allegations, including those found to have not occurred by OWCP, and the allegations evaluated
by OWCP in its May 19, 2014 decision, were also unsubstantiated by supporting evidence. She
did not submit evidence, such as a final complaint or grievance, which showed that the
employing establishment had committed wrongdoing with respect to any of these matters. Thus,
appellant has not established a compensable employment factor under FECA with respect to her
claims that supervisors committed error or abuse with respect to administrative matters, nor has
she established a compensable employment factor under FECA with respect to the claimed
harassment and discrimination.
For the foregoing reasons, appellant has not established any compensable employment
factors under FECA and, therefore, has not met her burden of proof to establish that she
sustained an emotional condition in the performance of duty.21
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 meet her burden of proof to establish an emotional
condition causally related to factors of her federal employment.

21

As appellant has not established any compensable employment factors, the Board need not consider the medical
evidence of record; see Margaret S. Krzycki, 43 ECAB 496, 502-03 (1992).

12

ORDER
IT IS HEREBY ORDERED THAT the November 10, 2015 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: October 25, 2016
Washington, DC

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

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

13


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
L.O., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Denham, LA, Employer
__________________________________________

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

Docket No. 15-1573
Issued: April 7, 2016

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
PATRICIA H. FITZGERALD, Deputy Chief Judge
ALEC J. KOROMILAS, Alternate Judge

JURISDICTION
On July 15, 2015 appellant filed a timely appeal from a June 9, 2015 merit decision of the
Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal Employees’
Compensation Act1 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over
the merits of this case.2
ISSUE
The issue is whether appellant met her burden of proof to establish a traumatic injury
causally related to the employment incident of April 28, 2015.

1
2

5 U.S.C. § 8101 et seq.

Appellant timely requested oral argument before the Board. By order dated March 3, 2016, the Board exercised
its discretion and denied appellant’s request for oral argument as the issue on appeal required an evaluation of the
medical evidence and could be adequately addressed in a decision based on review of the case record. Order
Denying Request for Oral Argument, Docket No. 15-1573 (issued March 3, 2016).

FACTUAL HISTORY
On May 2, 2015 appellant, then a 47-year-old rural carrier, filed a traumatic injury claim
(Form CA-1) alleging that she sustained an injury to her left shoulder and back as a result of
casing mail on April 28, 2015. A supervisor noted that, while appellant stated that she injured
herself lifting one magazine, the alleged injury did not coincide with her statement. Appellant
stopped work on April 28, 2015.
A Form CA-16, authorization for examination and/or treatment, was issued by the
employing establishment on April 28, 2015.3
Appellant submitted a report from John Knight, a certified physician’s assistant, dated
April 28, 2015.
By letter dated May 8, 2015, OWCP advised appellant that the evidence of record was
insufficient to support her claim and noted that it had received no medical evidence to support
her claim. Appellant was afforded 30 days to submit additional factual and medical evidence.
In a statement dated May 2, 2015, appellant described the incident alleged to have caused
her injury. She wrote, “I [appellant] came to work pick up and handful of flats laid them on my
case began to put them into the slots and then grabbed another piece of mail a flat and my back +
left shoulder started hurting in excruciating pain. [illegible] cannot lift above 45 degrees. Cannot
hold anything in my left hand.”
Appellant submitted another report from certified physician assistant John Knight dated
May 4, 2015.
There were several duty status reports submitted with illegible signatures including an
April 28, 2015 note which stated that appellant had shoulder sprain and recommended that
appellant return to work on April 28, 2015, with restrictions relating to her left arm. A second
report dated May 4, 2015 stated that appellant had shoulder sprain and recommended that
appellant return to work on May 4, 2015 with restrictions relating to her left arm.
In a duty status report dated May 12, 2015, Dr. Jimmy Guidry, Board-certified in
pediatrics, diagnosed appellant with a resolved left shoulder sprain. He advised that she could
return to full duty with no restrictions as of May 12, 2015.
Appellant submitted a third report from certified physician assistant Mr. Knight dated
May 12, 2015.
In an attending physician’s report dated April 28, 2015, a medical provider with an
illegible signature stated that appellant had a left shoulder sprain.
3

When the employing establishment properly executes a Form CA-16 which authorizes medical treatment as a
result of an employee’s claim for an employment-related injury, the Form CA-16 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. The period for which treatment is authorized by a Form CA-16 is limited to 60 days from
the date of issuance, unless terminated earlier by OWCP. See 20 C.F.R. § 10.300(c); Tracy P. Spillane, 54 ECAB
608, 610 (2003).

2

By decision dated June 9, 2015, OWCP denied appellant’s claim. It found that she had
not submitted sufficient medical evidence containing a diagnosis from a qualified physician,
noting that she had submitted evidence only from a physician assistant.
LEGAL PRECEDENT
An employee seeking benefits under FECA4 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 timely filed within the applicable time
limitation period of FECA, that an injury5 was sustained in the performance of duty as alleged,
and that any disability or medical condition for which compensation is claimed is causally
related to the employment injury.6
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.
A fact of injury determination is based on two elements. 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. 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. An employee may establish that the employment incident
occurred as alleged but fail to show that his or her condition relates to the employment incident.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
4

Supra at note 1.

5

OWCP’s regulations define a traumatic injury as a condition of the body caused by a specific event or incident,
or series of events of incidents, within a single workday or shift. Such condition must be caused by external force,
including stress or strain, which is identifiable as to time and place of occurrence and member or function of the
body affected. 20 C.F.R. § 10.5(ee).
6

T.H., 59 ECAB 388, 393 (2008); see Steven S. Saleh, 55 ECAB 169, 171-72 (2003); Elaine Pendleton, 40
ECAB 1143, 1145 (1989).
7

See Shirley A. Temple, 48 ECAB 404, 407 (1997); John J. Carlone 41 ECAB 354, 356-57 (1989).

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).

3

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
ANALYSIS
Appellant alleged that on April 28, 2015 she sustained an injury to her left shoulder and
arm as a result of casing mail. OWCP denied appellant’s claim, finding that appellant had not
established that she sustained a diagnosed medical condition in connection with the claimed
incident. The Board finds, however, that appellant has submitted sufficient medical evidence to
establish that she has been diagnosed with a medical condition that of left shoulder sprain, but
further finds that she has not submitted sufficient medical evidence to establish that the incident
of April 28, 2015 caused her injury.
In a duty status report dated May 12, 2015, Dr. Guidry, a Board-certified physician,
diagnosed appellant with a resolved left shoulder sprain. He, however, offered no opinion
regarding the cause of the diagnosed condition, as such his report is insufficient to establish
causal relationship between the accepted incident and the diagnosed condition. An award of
compensation may not be based on surmise, conjecture, or speculation. Neither, the fact that
appellant’s claimed condition became apparent during a period of employment nor her belief that
the condition was caused by her employment is sufficient to establish causal relationship.13
Because Dr. Guidry has not provided a medical opinion clearly explaining how the accepted
employment incident resulted in a medical diagnosis, his report does not meet appellant’s burden
of proof.14
OWCP also received reports from a physician assistant. However, under FECA, the
report of a nonphysician, including a physician assistant, does not constitute probative medical
evidence.15 Similarly reports bearing illegible signature do not constitute probative medical
evidence as it is unclear that they were prepared by a physician.16
Appellant has submitted insufficient medical evidence to establish that the incident of
April 28, 2015 caused or aggravated her left shoulder sprain. The record is devoid of a

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).

13

D.I., 59 ECAB 158 (2007); Ruth R. Price, 16 ECAB 688, 691 (1965).

14

See M.H., Docket No. 15-1670 (December 15, 2015).

15

5 U.S.C. 8102(2) of FECA provides that the term physician includes surgeons, podiatrists, dentists, clinical
psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined
by State law. 5 U.S.C. § 8101(2); 20 C.F.R. § 10.404; Roy L. Humphrey, 57 ECAB 238 (2005)
16

N.D., Docket No. 15-0027 (issued February 4, 2016).

4

rationalized opinion from a qualified physician on the issue of the causal relationship between
her diagnosis of shoulder sprain and the incident of April 28, 2015.
As such, the Board finds that appellant has failed to establish that she sustained a
traumatic injury in the performance of duty on April 28, 2015.
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 meet her burden of proof to establish a traumatic
injury causally related to the employment incident of April 28, 2015.
ORDER
IT IS HEREBY ORDERED THAT the decision of the Office of Workers’
Compensation Programs dated June 9, 2015 is affirmed, as modified.
Issued: April 7, 2016
Washington, DC

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

Patricia H. Fitzgerald, Deputy Chief Judge
Employees’ Compensation Appeals Board

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

5


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
P.A., Appellant
and
DEPARTMENT OF THE ARMY, FORT
MONROE, Fort Monroe, VA, Employer
__________________________________________

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Appearances:
Jonathan H. Walker, Esq., for the appellant
No appearance, for the Director

Docket No. 09-903
Issued: November 3, 2009

Oral Argument September 16, 2009

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

JURISDICTION
On February 23, 2009 appellant filed a timely appeal from decisions of the Office of
Workers’ Compensation Programs dated April 21 and December 31, 2008 denying his claim for
a recurrence of disability. 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 a recurrence of disability on October 4, 2005
causally related to his accepted lumbar sprain and strain.
FACTUAL HISTORY
On August 16, 2001 appellant, then a 34-year-old firefighter, filed a traumatic injury
claim for a back injury on July 10, 2001 when another employee ran into him during mandatory
physical training. The Office accepted his claim for a lumbar sprain and strain.
On July 18, 2001 Dr. Boyd W. Haynes, III, an attending Board-certified orthopedic
surgeon, stated that appellant began experiencing low back pain after another employee ran into
him during a basketball game on July 10, 2001. Findings on physical examination included

normal knee and ankle jerks and normal sensation to light touch in all dermatomal patterns.
Motor strength was not tested due to pain. Straight leg raising was negative. There was some
pain in the hamstring muscles. Dr. Haynes’ assessment was mechanical low back pain. On
August 9, 2001 he noted that a magnetic resonance imaging (MRI) scan did not show any
herniated discs. Dr. Haynes released appellant to light-duty work with restrictions. On
September 18, 2001 he released him to regular work.
On October 30, 2003 appellant was placed on light duty by a Dr. Leddy because of
hyperthyroidism. He returned to full duty on March 12, 2005 following surgery to rule out
cancer.
In an October 4, 2005 report, Dr. B. Joe Ordonez, a Board-certified neurosurgeon,
reviewed the medical history and provided findings on physical examination. He indicated that
appellant had experienced chronic lower back pain radiating to his groin and right thigh since his
July 10, 2001 accepted lumbar sprain and strain with intermittent acute exacerbations.
Appellant’s pain was worsened by prolonged sitting, bending or twisting. He could not walk
farther than two blocks without worsening back pain. Findings on physical examination
included decreased hip flexors and decreased quadriceps muscle extension secondary to low
back pain. Dr. Ordonez indicated that his review of a 2001 MRI scan was limited as it was on a
compact disc (CD) and the images were quite small. However, there appeared to be multiple
areas of degenerative disc changes from L2 to L4-5. Dr. Ordonez recommended a new MRI
scan of appellant’s lumbar spine and flexion-extension studies.
A February 1, 2006 MRI scan report revealed several levels of mild to moderate disc and
facet pathology, most prominent at L3-4 where the findings appeared chronic. On February 2,
2006 Dr. Ordonez noted that appellant had been doing fairly well but noticed a worsening of his
lower back with any increases in activity. He indicated that an MRI scan revealed a herniated
disc at L3-4.
On February 15, 2006 Dr. Bonnie J. Nock, a physiatrist, reviewed the medical history and
provided findings on physical examination. She diagnosed chronic low back pain since
appellant’s July 10, 2001 work-related lumbar strain and sprain, annular tears at L3-4 and L4-5,
right leg pain consistent with right L3 foraminal stenosis, groin pain consistent with sacroiliitis
and sacral dysfunction, asymptomatic foraminal stenosis on the left at L4 and Graves’ disease.
Dr. Nock recommended conservative treatment consisting of an epidural injection, medication
and physical therapy.
On March 8, 2006 appellant filed a claim for a recurrence of disability commencing
October 4, 2005 causally related to his accepted lumbar sprain and strain. The Office asked
appellant to provide additional information, including medical records relating to treatment for
his accepted lumbar sprain and strain since September 18, 2001, the date that he was released to
regular duty, and a medical report with a current diagnosis and a rationalized explanation as to
how appellant’s back condition on October 4, 2005 was causally related to his July 10, 2001
employment injury.
On July 5, 2006 Dr. Ordonez noted that appellant reported no improvement in his back
and lower right extremity pain. He referred him for advanced pain management treatment.

2

By decision dated June 7, 2007, the Office denied appellant’s claim for a recurrence of
disability, finding that the medical evidence failed to establish that his disability on October 4,
2005 was causally related to the July 10, 2001 accepted lumbar sprain and strain.
On January 22, 2008 appellant requested reconsideration and provided additional
evidence. A July 23, 2007 MRI scan report indicated degenerative changes producing mild
spinal stenosis at L3-4 and L4-5 with some noncritical foraminal narrowing and discogenic
marrow edema at some levels indicating active degenerative disc disease. In reports dated
July 5, August 8 and October 25, 2007, Dr. Ordonez indicated that appellant had progressively
worsening lower back pain with radiation primarily into his right lower extremity. An MRI scan
revealed a disc protrusion at L3-4 and L4-5. Flexion-extension studies revealed retrolisthesis at
L3 and L4 and fish mouthing (anterior widening of the disc space) at L4-5. Dr. Ordonez
recommended a surgical lumbar fusion following a worsening of appellant’s symptoms despite
adequate conservative measures. In a January 16, 2008 letter, he opined, based on appellant’s
history, that there was a causal relationship between his 2001 employment injury and his
subsequent back problems. Dr. Ordonez stated that appellant had a continuity of difficulties with
his back leading to the current proposed surgical intervention.
By decision dated January 25, 2008, the Office denied authorization for a lumbar spine
fusion at L3-S1 on the grounds that the medical evidence did not establish causal relationship
between the proposed surgery and his July 10, 2001 accepted lumbar sprain and strain.
By decision dated April 21, 2008, the Office denied modification of the June 7, 2007
decision.
On October 8, 2008 appellant requested reconsideration. In an April 21, 2008 operative
report, Dr. Ordonez described appellant’s back surgery on that date to relieve his lumbar
radiculopathy and mechanical back pain, including L3 through S1 laminectomy and bilateral
facetectomies and foraminotomies. In a September 3, 2008 affidavit, he noted that he had treated
appellant since 2005 for his back condition. Dr. Ordonez had reviewed medical records and
imaging studies and observed the pathological presentation of appellant’s lumbar spine while
performing back surgery on April 21, 2008. He found his physical presentation and subjective
history to be consistent with findings on physical examination. Dr. Ordonez noted that
appellant’s symptoms dissipated through conservative treatment after his July 10, 2001 back
injury but did not completely resolve, according to the history he provided, including his report
of symptoms over the course of time and by his pathological presentation on imaging studies and
at surgery. He stated that appellant’s back symptoms since 2001 waxed and waned with no
complete resolution and no intervening injury. The 2006 MRI scan revealed multilevel disc
pathology that had advanced since 2001 and which Dr. Ordonez attributed in principal part to the
2001 back strain. Dr. Ordonez opined that, based on the history of trauma, the objective medical
evidence and physical and surgical findings, the only reasonable medical conclusion was that the
2001 back injury was the precipitating trauma that caused appellant’s underlying condition to
become symptomatic and accelerated the progression of his disc pathology. He opined that
appellant’s disability and need for surgery in 2008 was the natural and unavoidable result of the
July 10, 2001 accepted back strain.
By decision dated December 31, 2008, the Office denied modification of the April 21,
2008 decision.
3

LEGAL PRECEDENT
A recurrence of disability means “an inability to work after an employee has returned to
work, caused by a spontaneous change in a medical condition which has resulted from a previous
injury or illness without an intervening injury or new exposure to the work environment that
caused the illness.”1 An employee who claims a recurrence of disability due to an accepted
employment-related injury has the burden of establishing by the weight of the substantial,
reliable and probative evidence that the disability for which he or she claims compensation is
causally related to the accepted injury. This burden of proof requires that an employee furnish
medical evidence from a physician who, on the basis of a complete and accurate factual and
medical history, concludes that the disabling condition is causally related to the employment
injury and supports that conclusion with sound reasoning.2 Where no such rationale is present,
medical evidence is of diminished probative value.3
ANALYSIS
Appellant has the burden to provide medical evidence establishing that he sustained a
recurrence of disability on October 4, 2005 causally related to his July 10, 2001 accepted lumbar
sprain and strain.
Dr. Haynes treated appellant following his July 10, 2001 employment-related lumbar
sprain and strain. On August 9, 2001 he noted that an MRI scan did not reveal any herniated
discs. On September 18, 2001 Dr. Haynes released appellant to return to regular work. There
are no medical reports of record between September 18, 2001 and October 4, 2005. There is no
record of bridging symptoms from the 2001 injury to the claimed 2005 recurrence of disability.
The record shows that appellant was on light duty beginning October 30, 2003 due to a thyroid
condition but he returned to full duty on March 12, 2005 following surgery. Medical evidence of
bridging symptoms between the recurrence and the accepted injury support the physician’s
conclusion regarding causal relationship.4
On October 4, 2005 Dr. Ordonez indicated that appellant had experienced chronic lower
back pain radiating to his groin and right thigh since his July 10, 2001 accepted lumbar sprain
and strain with intermittent acute exacerbations. Appellant’s pain was worsened by prolonged
sitting, bending or twisting. Findings on physical examination included decreased hip flexors
and decreased quadriceps muscle extension secondary to low back pain. Dr. Ordonez indicated
that his review of a 2001 MRI scan was limited secondary to it being on a CD and the images
being quite small. However, there appeared to be multiple areas of degenerative disc changes
from L2 to L4-5. On February 2, 2006 Dr. Ordonez noted that an MRI scan revealed a herniated
disc at L3-4. On July 5, 2006 he noted that appellant reported no improvement in his back and
lower right extremity pain. In reports dated July through October 2007, Dr. Ordonez indicated
that appellant had progressively worsening lower back pain with radiation primarily into his right
1

R.S., 58 ECAB ___ (Docket No. 06-1346, issued February 16, 2007); 20 C.F.R. § 10.5(x).

2

I.J., 59 ECAB ___ (Docket No. 07-2362, issued March 11, 2008); Nicolea Bruso, 33 ECAB 1138, 1140 (1982).

3

See Ronald C. Hand, 49 ECAB 113 (1957); see also Michael Stockert, 39 ECAB 1186, 1187-88 (1988).

4

Ricky S. Storms, 52 ECAB 349 (2001).

4

lower extremity. He recommended surgery. In a September 3, 2008 affidavit, Dr. Ordonez
noted that he had reviewed medical records and imaging studies. He observed the pathological
presentation of appellant’s lumbar spine while performing back surgery on April 21, 2008.
Dr. Ordonez found appellant’s physical presentation and subjective history to be consistent with
findings on physical examination. His symptoms dissipated through conservative treatment after
the July 10, 2001 lumbar sprain and strain but did not completely resolve, according to the
history appellant provided, including his report of symptoms over the course of time and by his
pathological presentation on imaging studies and at surgery. There was no intervening injury.
Dr. Ordonez opined that, based on appellant’s history of trauma, the objective medical evidence
and physical and surgical findings, the only reasonable medical conclusion was that the 2001
employment-related back strain injury was the precipitating trauma that caused appellant’s
underlying condition to become symptomatic and accelerated the progression of his disc
pathology. He opined that appellant’s disability and need for surgery in 2008 was the natural
and unavoidable result of the July 10, 2001 accepted back strain.
The Board finds that the reports of Dr. Ordonez are not sufficient to establish that
appellant sustained a recurrence of disability on October 4, 2005 causally related to his accepted
July 10, 2001 lumbar sprain and strain. Dr. Ordonez did not note in his reports that appellant
was on light duty for a year and a half between October 2003 and March 2005 due to a thyroid
condition. He did not address whether returning to full duty after a year and a half of light duty
had any effect on appellant’s back condition. Dr. Ordonez’s opinion regarding causal
relationship is not based on a complete and accurate factual and medical background. He did not
initially examine appellant until more than four years after the accepted July 10, 2001
employment-related lumbar sprain and strain. Dr. Ordonez did not provide a detailed and wellrationalized report explaining how the 2001 lumbar sprain and strain soft tissue injury resulted in
the degeneration of the lumbar spine noted in 2005. He noted that the 2001 MRI scan that he
reviewed was of poor quality. Therefore, it was difficult for Dr. Ordonez to compare the
progression of appellant’s lumbar spine pathology between 2001 and 2005. On August 9, 2001
Dr. Haynes noted that an MRI scan did not reveal any herniated discs. Because Dr. Ordonez
indicated that the 2001 MRI scan that he reviewed on disc was of poor quality, his opinion that
appellant had underlying spine pathology in 2001 which was accelerated by the lumbar sprain
and strain, is of diminished probative value. Due to these deficiencies, the reports of
Dr. Ordonez are not sufficient to establish that appellant sustained a recurrence of disability on
October 4, 2005 causally related to his July 10, 2001 employment-related lumbar sprain and
strain.
On February 15, 2006 Dr. Nock diagnosed chronic low back pain since appellant’s
July 10, 2001 work-related lumbar strain and sprain, annular tears at L3-4 and L4-5, right leg
pain consistent with right L3 foraminal stenosis, groin pain consistent with sacroiliitis and sacral
dysfunction and asymptomatic foraminal stensosis on the left at L4. However, she did not
express a rationalized opinion as to the cause of these lumbar spine conditions. The only
accepted condition in 2001 was a lumbar sprain and strain. Dr. Nock did not explain how the
lumbar spine pathology in 2006 was causally related to the July 10, 2001 employment injury.
Therefore, her report is not sufficient to establish that appellant sustained a work-related
recurrence of disability on October 4, 2005.
On appeal, appellant, through his attorney, argues that the July 10, 2001 employmentrelated lumbar sprain and strain resulted in prolonged chronic pain requiring surgery. Although
5

there are no medical reports of record regarding his back condition between his return to regular
work on September 18, 2002 and his claimed recurrence of disability on October 4, 2005, he
argues that his accepted lumbar sprain and strain never resolved. These arguments have been
considered and found to be without merit. Appellant further argues that the Office should have
obtained medical records from the employing establishment. The Office noted the claimant’s
burden to provide evidence establishing his claim. Appellant’s arguments on appeal are without
merit.
CONCLUSION
The Board finds that appellant failed to meet his burden of proof to establish that he had a
recurrence of disability on October 4, 2005 causally related to his July 10, 2001 accepted lumbar
sprain and strain.
ORDER
IT IS HEREBY ORDERED THAT the decisions of the Office of Workers’
Compensation Programs dated December 31 and April 21, 2008 are affirmed.
Issued: November 3, 2009
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

6


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
S.S., Appellant
and
DEPARTMENT OF HOMELAND SECURITY,
TRANSPORTATION SECURITY
ADMINISTRATION, O’HARE
INTERNATIONAL AIRPORT, Chicago, IL,
Employer
__________________________________________

)
)
)
)
)
)
)
)
)
)
)

Appearances:
Alan J. Shapiro, Esq., for the appellant1
Office of Solicitor, for the Director

Docket No. 19-0675
Issued: August 22, 2019

Case Submitted on the Record

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

JURISDICTION
On February 5, 2019 appellant, through counsel, filed a timely appeal from a January 2,
2019 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the
Federal Employees’ Compensation Act2 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board
has jurisdiction over the merits of this case.

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.

ISSUE
The issue is whether appellant has met his burden of proof to establish a right knee injury
causally related to the accepted February 11, 2018 employment incident.
FACTUAL HISTORY
On February 20, 2018 appellant, then a 24-year-old transportation security officer, filed a
traumatic injury claim (Form CA-1) alleging that on February 11, 2018 at 1:45 p.m. he sprained
his right knee when he tripped over a bin while in the performance of duty. On the reverse side of
the claim form appellant’s supervisor noted that he was not made aware of appellant’s injury until
a week after it occurred.3
On February 27, 2018 the employing establishment controverted appellant’s claim.
In support of his claim, appellant submitted medical evidence including a February 19,
2018 report from Dr. Patricia Ann Graham, a Board-certified internist, who diagnosed torn
cartilage and right knee sprain. In a March 1, 2018 report, Dr. Adam Yanke, a Board-certified
orthopedic surgeon, diagnosed right knee injury (possible meniscus tear or loose body). He noted
that appellant reported right knee pain following a February 11, 2018 injury with one locking
episode.
OWCP, in a March 6, 2018 development letter, noted that when appellant’s claim was first
received, it appeared to be a minor injury that resulted in minimal or no lost time from work. It
had administratively approved payment of a limited amount of medical expenses without formally
considering the merits of his claim. OWCP advised that it was now considering the merits. It
requested additional factual and medical evidence, and provided a questionnaire for his
completion. It afforded him 30 days to respond.
On March 8, 2018 the employing establishment provided appellant with an authorization
for examination and/or treatment (Form CA-16) authorizing medical treatment for appellant’s
alleged February 11, 2018 injury.
OWCP subsequently received a March 1, 2018 report wherein Dr. Yanke described
appellant’s employment incident as tripping on a bin at work on February 11, 2018 and then
experiencing a “weird sensation” in his right knee. Appellant began to experience pain, locking,
and swelling in his right knee over the course of the week following February 11, 2018. Dr. Yanke
diagnosed possible right knee medial meniscal tear.
Appellant responded to OWCP’s development questionnaire and asserted that he was not
completely sure when the tripping incident occurred, but that he only worked on the x-ray lane on
February 11 and 15, 2018. He again described the alleged employment incident as walking to the
front of the x-ray machine, stepping on a bin, and tripping. Appellant asserted that he stumbled,
but did not fall to the ground. He felt a “weird pop” in his right knee, with slight discomfort, but

3

Appellant resigned from the employing establishment effective April 17, 2018.

2

no immediate pain. Appellant picked up the bin and returned to his position. He denied that any
coworkers witnessed this incident or that he had stated that any coworkers were witnesses.
Dr. Yanke in a March 13, 2018 attending physician’s form report (Form CA-20) diagnosed
medial meniscal tear. He checked a box marked “yes” indicating that appellant’s condition was
caused or aggravated by the February 11, 2018 trip and fall at work, and further noted that
appellant had no symptoms prior to this incident.
By decision dated April 12, 2018, OWCP denied appellant’s traumatic injury claim,
finding that he had not established that the February 11, 2018 incident occurred as alleged. It
concluded that the requirements had not been met to establish an injury as defined by FECA.
On May 3, 2018 appellant, through counsel, requested an oral hearing before OWCP’s
hearing representative. OWCP subsequently received a March 15, 2018 note, wherein Dr. Yanke
diagnosed iliotibial band friction syndrome.
Appellant subsequently underwent a right knee magnetic resonance imaging (MRI) scan
which did not demonstrate a discrete tear in the medial meniscus, but was suspicious for a tiny tear
within the anterior root of the lateral meniscus.
A hearing was held on October 17, 2018.
By decision dated January 2, 2019, OWCP’s hearing representative modified the April 12,
2018 decision finding that appellant established that the injury of February 11, 2018 occurred, as
alleged. However, the claim remained denied as appellant had not established causal relationship
between appellant’s diagnosed condition and his accepted employment incident.
LEGAL PRECEDENT
An employee seeking benefits under FECA has the burden of proof to establish 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 timely filed within the applicable
time limitation period of FECA,4 that an injury was sustained in the performance of duty as alleged,
and that any disability or medical condition for which compensation is claimed is causally related
to the employment injury.5 These are the essential elements of each and every compensation claim,
regardless of whether the claim is predicated upon a traumatic injury or an occupational disease.6
To determine if an employee has sustained a traumatic injury in the performance of duty,
OWCP begins with an analysis of whether fact of injury has been established. Generally, fact of
4

S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB
153 (1989).
5

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40
ECAB 312 (1988).
6
K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014);
Delores C. Ellyett, 41 ECAB 992 (1990).

3

injury consists of two components that must be considered in conjunction with one another. The
first component is whether the employee actually experienced the employment incident that
allegedly occurred.7 The second component is whether the employment incident caused a personal
injury.8
Causal relationship is a medical issue and the medical evidence required to establish causal
relationship is rationalized medical opinion evidence. Rationalized medical opinion evidence is
medical evidence which includes a physician’s detailed opinion on whether there is causal
relationship between the employee’s diagnosed condition and the accepted employment incident.9
The opinion of the physician must be based on a complete factual and medical background, must
be one of reasonable medical certainty, and must be supported by medical rationale explaining the
nature of the relationship between the diagnosed condition and the specific employment incident.10
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 causal relationship.11
ANALYSIS
The Board finds that appellant has not met his burden of proof to establish a right knee
injury causally related to the accepted February 11, 2018 employment incident.
Dr. Graham, a Board-certified internist, diagnosed torn cartilage and right knee sprain, but
did not provide an opinion on the cause of this condition. In a March 15, 2018 note, Dr. Yanke
likewise did not provide any opinion on the cause of appellant’s diagnosed iliotibial band friction
syndrome. The Board has held that medical evidence that does not offer an opinion regarding the
cause of an employee’s condition is of no probative value on the issue of causal relationship.12
These reports, therefore, are insufficient to establish appellant’s claim.
On March 1, 2018 Dr. Yanke, diagnosed a right knee injury (possible meniscus tear or
loose body). He noted that appellant reported right knee pain following a February 11, 2018 injury
with one locking episode. Dr. Yanke did not provide a clear diagnosis and the fact that a condition
manifests itself during a period of employment is insufficient to establish causal relationship.

7

T.M., Docket No. 19-0380 (issued June 26, 2019); Elaine Pendleton, 40 ECAB 1143 (1989).

8

M.H., Docket No. 18-1737 (issued March 13, 2019); John J. Carlone, 41 ECAB 354 (1989).

9
C.B., Docket No. 18-0071 (issued May 13, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59
ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).
10

S.S., Docket No. 18-1488 (issued March 11, 2019).

11

J.L., Docket No. 18-1804 (issued April 12, 2019).

12

R.W., Docket No. 19-0010 (issued June 18, 2019); L.B., Docket No. 18-0533 (issued August 27, 2018).

4

Temporal relationship alone will not suffice.13 This report, therefore, is insufficient to establish
appellant’s claim.14
In a March 13, 2018 form report (Form CA-20), Dr. Yanke diagnosed medial meniscal
tear. He checked a box marked “yes” indicating that appellant’s condition was caused or
aggravated by the February 11, 2018 work incident. The Board has held that a physician’s opinion
on causal relationship which consists of checking “yes” to a form question, without explanation or
rationale, is of diminished probative value and is insufficient to establish a claim.15 Dr. Yanke
further noted that appellant had no symptoms prior to this fall. The Board has held that the fact
that a condition manifests itself during a period of employment is insufficient to establish causal
relationship. Temporal relationship alone will not suffice.16 Thus, the Board finds that this report
is insufficient to establish appellant’s burden of proof.
Finally, appellant has submitted an MRI scan in support of his claim. The Board has
explained that diagnostic studies lack probative value as they do not address whether the
employment incident caused any of the diagnosed conditions.17 These reports are therefore also
insufficient to establish appellant’s claim.
Causal relationship is a medical question that must be established by probative medical
opinion from a physician.18 As appellant has not submitted such medical evidence, the Board finds
that he has not met his burden of proof.19
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.

13

M.H., Docket No. 18-1737 (issued March 13, 2019); Daniel O. Vasquez, 57 ECAB 559 (2006).

14

M.B., Docket No. 18-0906 (issued November 21, 2018).

15

J.R., Docket No. 18-1679 (issued May 6, 2019); M.C., Docket No. 18-0361 (issued August 15, 2018); Calvin E.
King, Jr., 51 ECAB 394 (2000); see also Frederick E. Howard, Jr., 41 ECAB 843 (1990).
16

Supra note 13.

17

R.C., Docket No. 19-0376 (issued July 15, 2019).

18

T.K., Docket No. 18-1239 (issued May 29, 2019).

19

A properly completed CA-16 form 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. The period for which treatment is authorized by a Form CA-16 is limited to 60 days from the date of issuance,
unless terminated earlier by OWCP. 20 C.F.R. § 10.300(c); P.R., Docket No. 18-0737 (issued November 2, 2018);
N.M., Docket No. 17-1655 (issued January 24, 2018); Tracy P. Spillane, 54 ECAB 608 (2003).

5

CONCLUSION
The Board finds that appellant has not met his burden of proof to establish a right knee
injury causally related to the accepted February 11, 2018 employment incident.
ORDER
IT IS HEREBY ORDERED THAT the January 2, 2019 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: August 22, 2019
Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge
Employees’ Compensation Appeals Board

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

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

6