United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
K.T., Appellant
and
U.S. POSTAL SERVICE, PROCESSING &
DISTRIBUTION CENTER, Little Rock, AR,
Employer
__________________________________________

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

Docket No. 17-1717
Issued: March 27, 2018

Case Submitted on the Record

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

JURISDICTION
On August 3, 2017 appellant filed a timely appeal from a July 24, 2017 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 to
consider the merits of this case.2

1
2

5 U.S.C. § 8101 et seq.

The Board notes that OWCP received additional evidence following the July 24, 2017 decision. However, the
Board may only review evidence that was in the record at the time OWCP issued its final decision. Thus, the Board
is unable to review this evidence for the first time on appeal. See 20 C.F.R. § 501.2(c)(1); M.B., Docket No. 09-0176
(issued September 23, 2009); J.T., 59 ECAB 293 (2008); G.G., 58 ECAB 389 (2007); Donald R. Gervasi, 57 ECAB
281 (2005); Rosemary A. Kayes, 54 ECAB 373 (2003).

ISSUE
The issue is whether appellant met his burden of proof to establish an emotional condition
causally related to the accepted compensable factor of his federal employment.
FACTUAL HISTORY
On December 26, 2013 appellant, then a 47-year-old building maintenance mechanic, filed
a traumatic injury claim (Form CA-1)3 alleging that his placement on administrative leave on
May 16, 2012, and his termination of employment on August 17, 2012 aggravated his depression
and anxiety.4
In support of his claim, appellant submitted an arbitration decision dated August 1, 2013.
The arbitrator concluded that the employing establishment had just cause to discipline appellant,
but not to remove him from employment. The decision instructed that appellant’s removal be
reduced to a suspension. The arbitrator noted that appellant’s return to work was conditional and
based on his providing acceptable medical documentation regarding the resolution of his medical
issues.
On January 3, 2014 OWCP received a form, which was completed by a supervisor,
documenting the May 16, 2012 investigation. The supervisor related that appellant was not
completing his given work assignment and was, therefore, interviewed in a supervisor’s office
with a steward present. He was placed on administrative leave following the interview.
In a letter dated January 15, 2014, OWCP informed appellant that the evidence of record
was insufficient to establish his claim. It advised him of the type of medical and factual evidence
required to establish his claim and afforded him 30 days to provide the requested information.
In response, OWCP received statements from appellant, statements from managers and
coworkers, disciplinary action information, and appellant’s Equal Employment Opportunity
complaint of discrimination. It also received additional medical evidence.

3

On December 26, 2013 appellant also filed an occupational disease claim (Form CA-2), assigned File No.
xxxxxx005, referencing the dates April 2006 and May 16, 2012 as the dates he first became aware of his condition
and its relationship to factors of his federal employment. He noted that the April 2006 date was the original date of
injury. As to the May 16, 2012 date, he referenced the events he claimed on his Form CA-1 for the May 16, 2012
date.
4
The record contains evidence from another traumatic injury claim filed by appellant, assigned OWCP File No.
xxxxxx098. OWCP accepted appellant’s April 5, 2004 claim for adjustment disorder with mixed anxiety and
depressed mood. It denied appellant’s claim for a recurrence of disability (Form CA-2a) beginning May 16, 2012 as
it found appellant had alleged a new factor of employment, being placed on administrative leave for failure to follow
instructions. By decision dated October 9, 2014, the Board found that OWCP improperly denied appellant’s request
for a merit review as he had submitted relevant and pertinent new evidence. Docket No. 14-0613 (issued
October 9, 2014). Specifically, the Board found the arbitration decision constituted relevant and pertinent new
evidence as the arbitrator raised the issue of whether appellant’s recurrence of disability was due to an accepted
employment factor and not a new factor of employment. The Board noted that the arbitration decision also discussed
the issue of administrative error with respect to appellant’s removal by the employing establishment.

2

In an October 11, 2012 report, Dr. James M. Sims, a treating psychiatrist, noted that he had
been treating appellant since 2006 for anxiety and recurrent severe major depression with
psychotic behavior. He noted that appellant had major conflicts with his supervisor, which he
opined aggravated his condition. Dr. Sims noted that he had recommended that appellant retire on
disability, but appellant rejected his recommendation. He observed that appellant’s condition had
worsened over the past year due to increasing conflict with his supervisor, which aggravated his
depression and paranoia. Appellant had expressed his belief that his supervisor was attempting to
have him fired, which then occurred on August 17, 2012. Dr. Sims recommended appellant be
returned to work, but under a different supervisor.
In a September 16, 2013 report, Dr. Sims recommended that appellant be transferred to a
different supervisor due to the conflict with his current supervisor. He opined that appellant was
disabled from work due to his anxiety and major depression, recurrent episode, severe with
psychotic behavior. Dr. Sims observed that appellant’s past conflicts with his supervisor continued
to cause him stress, as he worried about possible future contact with this supervisor. An
October 31, 2013 progress note by Dr. Sims observed that appellant continued to be worried about
returning to work, was worried about the world situation, and was not sleeping well. He opined
that appellant was not ready to return to work.
By decision dated June 23, 2014, OWCP denied appellant’s claim, finding that he failed to
establish that his alleged emotional condition occurred in the performance of duty. Specifically,
it found that he had not established any compensable factors of employment. OWCP accepted that
appellant was sent home on administrative leave on May 16, 2012, but it found that this was not a
compensable factor of employment.
In a form dated July 10, 2014, appellant requested an oral hearing before an OWCP hearing
representative, which was held on February 17, 2015.
In an October 15, 2014 report, Dr. Phillip A. Tracy, a treating Board-certified family
physician, opined that appellant continued to be totally disabled from work due to his severe
recurrent deep depression and anxiety with psychotic features.
On October 30, 2014 Dr. Tracy opined that appellant’s depression and anxiety were
worsening and that he continued to be disabled from work. Appellant had related that he was
being forced out as the employing establishment cleared out his locker.
On March 13, 2015 OWCP received a September 9, 2013 note from Dr. Sims noting
appellant had not been released to return to work. Dr. Sims opined that appellant required a
supervisor who understood his anxiety and depression and was not biased.
In a March 24, 2015 report, Dr. Tracy opined that appellant remained disabled from work
due to his employment-related major depression with recurrent episodes, psychosis, and general
anxiety.
By decision dated May 7, 2015, an OWCP hearing representative affirmed the June 23,
2014 decision, as modified. She found appellant had established a compensable employment
factor with respect to administrative error when the employing establishment terminated his
employment. However, she denied the claim, finding that the medical evidence of record failed
3

to establish causal relationship between the accepted employment factor and the diagnosed
conditions.
On November 2, 2015 appellant requested reconsideration and submitted additional
medical evidence.
Dr. Sims detailed appellant’s treatment in progress notes covering the period January 6,
2011 to July 24, 2012. On May 29, 2012 he observed that appellant was very agitated due to
conflicts at work and expressed fear about returning to work. Dr. Sims noted that appellant
sounded paranoid and therefore he recommended that appellant not return to work. During a
June 18, 2012 session appellant requested a release to return to work, which Dr. Sims provided.
On June 26, 2012 Dr. Sims reported that appellant continued to experience problems at work. In
a July 10, 2012 session, appellant noted that he had been suspended from work. He expressed
concern that his supervisor was attempting to get him fired. On July 24, 2012 appellant came in
with a letter of removal from work, which he was very upset about. Dr. Sims noted that the events
of the past few months had caused a marked deterioration in appellant’s condition.
Dr. Tracy, in the August 27, 2012 report, observed that appellant had a deepening
depression and worsening paranoia due to a hostile work environment, which resulted in disability
from work.
In a September 10, 2012 report, Dr. Sims noted that appellant expressed concern that he
has been under undue observation and scrutiny for the past year by his supervisor. His diagnosis
included recurrent major depression with psychotic features. Dr. Sims explained that this
condition could vary in intensity and could recur at any time, particularly in times of stress. He
opined that appellant would not fully recover, but would be able to perform his job and function
adequately the majority of the time.
Dr. Sims, in an August 7, 2013 report, recommended that appellant be reassigned to a new
supervisor due to conflict with his current supervisor. He noted that the reassignment would avoid
his current stress-related anxiety caused by conflicts with his supervisor.
In a February 3, 2014 report, Dr. Sims detailed appellant’s medical history as well as his
history of injury. He noted that appellant’s recurrent depression and anxiety had been aggravated
by being sent home from work on May 16, 2012. As a result of the aggravation, caused by the
May 16, 2012 employment incident, appellant became totally disabled from work. Dr. Sims noted
that he recommended that appellant be reassigned to a different supervisor as appellant believed
his current supervisor created stress and conflict for him. He concluded that appellant was totally
disabled from May 16, 2012 and it was uncertain as to when appellant could return to work.
Dr. Tracy, in a March 24, 2015 report, indicated that appellant remained disabled due to
his work-related generalized anxiety and depression with recurrent severe episodes and mention
of psychosis. On July 27, 2015 he reported that appellant’s psychiatric condition was stable and
that appellant wanted to return to work.
On October 6, 2015 Dr. Tracy diagnosed unspecified anxiety, major depression with
severe recurrent episodes with psychosis, and mixed adjustment disorder with depressed mood.
He opined that these conditions had been aggravated by the hostile work environment and
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harassment appellant endured at work. Dr. Tracy further opined that OWCP should have accepted
an aggravation of his previously accepted work-related emotional condition. He concluded that
appellant was disabled from returning to work due to the accepted work-related conditions and his
continued stress concerning return to work. In October 28, 2015 progress report, Dr. Tracy opined
that appellant was currently disabled due to aggravation of his work-related condition caused by
the employing establishment’s administrative error. He noted that appellant could not work with
his harassers as it would impede his recovery from depression and anxiety.
By decision dated February 4, 2016, OWCP denied modification of its prior decision. It
found that the medical evidence appellant submitted failed to establish causal relationship between
the compensable factor of administrative error and his diagnosed conditions.5
Dr. Tracy, in an April 7, 2016 report, noted that he had treated appellant for his workrelated conditions for almost 10 years. During this time, he had consistently indicated on OWCP
forms that appellant’s interpersonal relationships were impacted by his psychiatric condition and
affected his ability to meet deadlines and receive supervision. Dr. Tracy concluded that appellant’s
disability as the result of his psychiatric conditions on and after May 16, 2012 was work related.
On May 18, 2016 Dr. Tracy noted that he had treated appellant for approximately 10 years
and was fully aware of the history appellant had with his supervisor. He opined that appellant
sustained a worsening of his psychiatric condition following his placement on administrative leave
on May 16, 2012. Dr. Tracy observed that appellant became depressed, withdrawn, and anxious
due to the stress and harassment he experienced at work. He opined that the July 17, 2012 removal
notice and the August 17, 2012 termination of appellant’s employment were directly responsible
for aggravating his mental conditions and causing his disability.
On September 26, 2016 appellant requested reconsideration.
On October 17, 2016 OWCP received an October 30, 2015 report from Dr. Tracy in which
he related that he had treated appellant for his work-related emotional condition for many years.
Dr. Tracy observed that appellant had been so mistreated by his two supervisors that he was afraid
to either look or talk to them. He opined that appellant’s anger, delusions, anxiety, and paranoia
had been aggravated by the daily harassment and hostility he endured from these two supervisors.
Dr. Tracy noted that the employing establishment’s administrative error in removing appellant
from his employment on May 16, 2012 increased appellant’s depression and made him anxious
about losing his job. He concluded that there was no doubt, but that the employing establishment’s
termination of appellant’s employment aggravated his accepted mental condition and contributed
to his disability.
Dr. Tracy, in an October 26, 2016 report, opined that appellant continued to be totally
disabled due to an accepted employment-related psychiatric condition, which included unspecified
anxiety disorder and major depressive disorder with severe recurrent episodes with psychotic

5

On March 15, 2016 OWCP received a notification of personnel action (SF-50) dated February 1, 2016 removing
appellant from the employing establishment based on appellant’s being in a leave without pay status for more than
one year. The form noted that appellant’s last day in pay status was June 17, 2012.

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features. He disagreed with OWCP’s characterization of appellant’s psychiatric condition as
preexisting and self-generated.
On October 27, 2016 OWCP received a May 29, 2012 report from Dr. Sims which noted
that appellant was seen for a follow-up examination. Dr. Sims observed that appellant was more
depressed, and had possible paranoid ideation, which were related to the accepted diagnosis of
recurrent major depression with psychotic features. He recommended that appellant remain off
work for two weeks to reduce his stress level.
On November 10, 2016 OWCP received Dr. Tracy’s October 22, 2014 report, which
diagnosed a worsening of appellant’s anxiety and depression and concluded that appellant
remained disabled from work. By report dated December 7, 2016, Dr. Tracy opined that appellant
was currently totally disabled from work in any capacity due to his psychiatric conditions from
work.
In a progress note dated December 20, 2016, D. Kenneth Counts, Ph.D., a treating clinical
psychologist, noted appellant’s history of depression and chronic pain. He diagnosed recurrent
severe major depression without psychotic features and unspecified anxiety disorder. In a
February 14, 2017 report, Dr. Counts noted that appellant had a long history of recurrent major
depressive disorder. He diagnosed severe recurrent-type major depressive disorder without
psychotic features. Dr. Counts opined that appellant was totally disabled from any type of work
and he did not anticipate any date of full or partial recovery even though appellant’s condition was
chronic and static.
By decision dated July 24, 2017, OWCP denied modification of its prior decision, finding
that the medical evidence of record was insufficient to establish causal relationship between the
diagnosed psychiatric conditions and the accepted compensable employment factor.
LEGAL PRECEDENT
To establish a claim for an emotional condition in the performance of duty, an employee
must submit: (1) medical evidence establishing that he has an emotional or psychiatric disorder;
(2) factual evidence identifying employment factors or incidents alleged to have caused or
contributed to his or her condition; and (3) rationalized medical opinion evidence establishing that
the identified compensable employment factors are causally related to his or her emotional
condition.6
Causal relationship is a medical issue and the medical evidence generally required to
establish causal relationship is rationalized medical opinion evidence.7 Rationalized medical
opinion evidence is medical evidence which includes a physician’s rationalized opinion on
whether there is causal relationship between the employee’s diagnosed condition and the

6

V.W., 58 ECAB 428 (2007); Donna Faye Cardwell, 41 ECAB 730 (1990).

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

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compensable employment factors.8 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.9
ANALYSIS
The Board finds that appellant has not met his burden of proof to establish that his
emotional condition was causally related to the accepted factor of his federal employment.10
While it is undisputed that appellant has anxiety and depression, the Board finds that the
medical evidence of record does not sufficiently establish a causal connection between the
accepted employment factor regarding error in the termination of his employment, and his
diagnosed emotional conditions.
In support of his claim appellant submitted numerous reports from Dr. Sims and Dr. Tracy
attributing appellant’s disability on and after May 16, 2012 to an aggravation of a preexisting
adjustment disorder with mixed anxiety and depression. Both physicians noted that these
conditions had been accepted under another claim and that the conditions had been aggravated by
appellant’s removal from employment by the employing establishment. Histories and examination
findings were provided by both physicians. However neither physician offered a medical
explanation as to how appellant’s emotional condition was caused by the accepted employment
factor.11 Although both Dr. Sims and Dr. Tracy supported causal relationship in their reports, they
did not provide sufficient medical rationale explaining how the termination of appellant’s
employment aggravated his preexisting adjustment disorder with mixed anxiety and depression.
The Board has held that reports which lack rationale are insufficient to meet appellant’s burden of
proof.12
Appellant also submitted a February 14, 2017 report from Dr. Counts, a treating clinical
psychologist, diagnosing severe recurrent major depressive disorder without psychotic features.
Dr. Counts did not offer any opinion on the cause of the diagnosed medical conditions. A medical
report that does not provide an opinion on causal relationship is of little probative value.13

8

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

9

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

10

See William P. George, 43 ECAB 1159, 1167 (1992).

11

See A.B., Docket No. 08-2508 (issued July 10, 2009).

12

Supra note 9.

13

See L.M., Docket No. 14-0973 (issued August 25, 2014).

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The Board finds that appellant has not submitted rationalized medical evidence establishing
that his claimed conditions were caused or aggravated by the accepted compensable employment
factor.14
On appeal appellant contends that his emotional condition was aggravated when the
employing establishment terminated his employment. As discussed above, OWCP accepted a
compensable factor of employment with respect to administrative error by the employing
establishment in terminating appellant’s employment. However, none of the medical evidence
appellant submitted contained sufficient rationale explaining how the compensable factor caused
or aggravated the diagnosed psychiatric conditions.
Appellant may submit new evidence or argument with a written request for reconsideration
to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R.
§§ 10.605 through 10.607.
CONCLUSION
The Board finds that appellant has not met his burden of proof to establish an emotional
condition causally related to the accepted compensable factor of his federal employment.

14

See supra note 10.

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ORDER
IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ Compensation
Programs dated July 24, 2017 is affirmed.
Issued: March 27, 2018
Washington, DC

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

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

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

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
T.H., Appellant
and
DEPARTMENT OF JUSTICE, BUREAU OF
PRISIONS, FEDERAL CORRECTIONAL
INSTITUTION, Salters, SC, Employer
__________________________________________

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

Docket No. 14-1866
Issued: January 20, 2015

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
ALEC J. KOROMILAS, Alternate Judge
JAMES A. HAYNES, Alternate Judge
JURISDICTION
On August 21, 2014 appellant filed a timely appeal from a March 13, 2014 merit decision
of the Office of Workers’ Compensation Programs. Pursuant to the Federal Employees’
Compensation Act1 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over
the merits of this case.
ISSUE
The issue is whether appellant met his burden of proof to establish that he sustained a
back injury on February 7, 2013 while in the performance of duty.
On appeal, appellant contends that a medical opinion of a treating physician is sufficient
to establish that he sustained an employment-related back injury. He also provides additional
evidence.

1

5 U.S.C. § 8101 et seq.

FACTUAL HISTORY
On February 7, 2013 appellant, then a 43-year-old correctional officer, filed a traumatic
injury claim alleging that he sustained a lower back injury that day when he twisted the wrong
way while dragging a bag of property which included books and legal material.
In a duty status report (Form CA-17) and an authorization for examination and treatment
(Form CA-16) dated February 7, 2013, Darlene W. Fludd, a family nurse practitioner, provided a
history that appellant was pulling a property bag that day when he twisted to the left and felt pain
in his left lower back. She listed a diagnosis of muscle strain and sprain. Ms. Fludd advised that
appellant could resume work with restrictions as of February 12, 2013. In a February 7, 2013
prescription, she ordered his medications. In a February 14, 2013 slip, Ms. Fludd excused
appellant from work through February 19, 2013.
A February 7, 2013 letter from the Williamsburg Regional Health Center which
contained an unknown signature stated that appellant was seen in the office that day. A request
was made to allow him to return to work with no restrictions on February 12, 2013.
In a March 6, 2013 letter, Dr. Henry Bowens, Jr., a Board-certified family practitioner,
advised that appellant could return to work with no restrictions on March 20, 2013.
On August 2, 2013 appellant filed a claim requesting leave buyback from February 9 to
March 20, 2013.
By letter dated September 16, 2013, OWCP indicated that, when appellant’s claim was
received, it appeared to be a minor injury that resulted in minimal or no lost time from work.
Because the employing establishment did not controvert continuation of pay or challenge the
case, payment of a limited amount of medical expenses was administratively approved. OWCP
reopened the claim for adjudication because it had received a claim for wage-loss compensation.
Thereafter, OWCP notified appellant of the deficiencies of his claim and afforded him 30
days to submit additional medical evidence. It also requested that the employing establishment
submit medical evidence, if appellant had been treated at its medical facility.
In an October 17, 2013 decision, OWCP accepted that the February 7, 2013 incident
occurred as alleged. It denied appellant’s claim and determined that the medical evidence did
not establish a causal relationship between his back condition and the accepted employment
incident. OWCP also denied appellant’s claim for leave buyback, finding that the medical
evidence failed to establish any disability during the claimed period.
On October 29, 2013 appellant requested a review of the written record by an OWCP
hearing representative and submitted medical evidence. In a March 6, 2013 progress note,
Dr. Bowens listed physical examination findings and discussed laboratory test results with
appellant. He advised that appellant had low back pain and excused him from work.
In a March 13, 2014 decision, an OWCP hearing representative affirmed the October 17,
2013 decision, finding that the medical evidence of record failed to establish that appellant’s
back injury was causally related to the accepted February 7, 2013 employment incident.
2

LEGAL PRECEDENT
An employee seeking benefits under FECA2 has the burden of proof to establish the
essential elements of his or her claim by the weight of the reliable, probative and substantial
evidence3 including that he or she sustained an injury in the performance of duty and that any
specific condition or disability for work for which he or she claims compensation is causally
related to that employment injury.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.5
There are two components involved in establishing the fact of injury. First, the employee must
submit sufficient evidence to establish that he or she actually experienced the employment
incident at the time, place, and in the manner alleged.6
The second component is whether the employment incident caused a personal injury and
generally can be established only by medical evidence.7 The evidence required to establish
causal relationship is rationalized medical opinion evidence, based upon complete factual and
medical background, showing a causal relationship between the claimed condition and the
identified factors.8 The belief of the claimant that a condition was caused or aggravated by the
employment is insufficient to establish a causal relationship.9
ANALYSIS
OWCP accepted that on February 7, 2013 appellant dragged a bag of property while in
the performance of duty. It found that the medical evidence failed to establish that he sustained a
back injury as a result of the accepted incident. The Board finds that appellant failed to provide
sufficient medical evidence to establish that he sustained a back injury causally related to the
accepted February 7, 2013 employment incident.
Dr. Bowen’s March 6, 2013 letter found that appellant could return to work with no
restrictions. In a progress note of even date, he determined that appellant had low back pain and
excused appellant from work. Dr. Bowen provided no rationale for his disability finding or
explains the discrepancy between his two reports. The Board has held that medical conclusions
2

Id. at §§ 8101-8193.

3

J.P., 59 ECAB 178 (2007); Joseph M. Whelan, 20 ECAB 55, 58 (1968).

4

G.T., 59 ECAB 447 (2008); Elaine Pendleton, 40 ECAB 1143, 1145 (1989).

5

S.P., 59 ECAB 184 (2007); Alvin V. Gadd, 57 ECAB 172 (2005).

6

Bonnie A. Contreras, 57 ECAB 364 (2006); Edward C. Lawrence, 19 ECAB 442 (1968).

7

John J. Carlone, 41 ECAB 354 (1989); see 5 U.S.C. § 8101(5) (injury defined); 20 C.F.R. §§ 10.5(ee), 10.5(q)
(traumatic injury and occupational disease defined, respectively).
8

Lourdes Harris, 45 ECAB 545 (1994); see Walter D. Morehead, 31 ECAB 188 (1979).

9

Kathryn Haggerty, 45 ECAB 383, 389 (1994).

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unsupported by rationale are of diminished probative value and insufficient to establish causal
relationship.10 Moreover, the Board has held that pain is generally considered a symptom, not a
firm medical diagnosis.11 Consequently, Dr. Bowen’s report and progress note are insufficient to
meet appellant’s burden of proof.
The February 7, 2013 CA-17 and CA-16 forms, and February 14, 2013 slip from
Ms. Fludd, a nurse practitioner, have no probative value in establishing appellant’s claim. The
Board has held that a nurse practitioner is not considered a physician as defined under FECA.12
The February 7, 2013 letter which contained an unknown signature is insufficient to
establish appellant’s claim. A report that is unsigned or bears an illegible signature lacks proper
identification and cannot be considered probative medical evidence.13
Therefore, the Board finds that there is insufficient medical evidence to establish that
appellant sustained a back injury causally related to the accepted February 7, 2013 employment
incident.
On appeal, appellant contended that Dr. Bowen’s medical opinion was sufficient to
establish that he sustained an employment-related back injury. As discussed, Dr. Bowen did not
provide a rationalized medical opinion explaining the causal relationship between appellant’s
back condition and resultant disability, and the accepted February 7, 2013 employment incident.
Also, on appeal appellant submitted new evidence. However, the Board has no
jurisdiction to review this evidence for the first time on appeal.14 Appellant may submit new
evidence or argument with a written request for reconsideration to OWCP within one year of this
merit decision, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R. §§ 10.605 through 10.607.
CONCLUSION
The Board finds that appellant has not met his burden of proof to establish that he
sustained a back injury on February 7, 2013 while in the performance of duty.

10

See Albert C. Brown, 52 ECAB 152 (2000).

11

Robert Broome, 55 ECAB 339 (2004); see also N.C., Docket No. 12-761 (issued November 1, 2012).

12

A.C., Docket No. 08-1453 (issued November 18, 2008). Under FECA, a 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).
13

Thomas L. Agee, 56 ECAB 465 (2005); Richard F. Williams, 55 ECAB 343 (2004).

14

See 20 C.F.R. § 501.2(c)(1); M.B., Docket No. 09-176 (issued September 23, 2009); J.T., 59 ECAB 293 (2008);
G.G., 58 ECAB 389 (2007); Donald R. Gervasi, 57 ECAB 281 (2005); Rosemary A. Kayes, 54 ECAB 373 (2003).

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ORDER
IT IS HEREBY ORDERED THAT the March 13, 2014 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: January 20, 2015
Washington, DC

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

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

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

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
D.M., Appellant
and
DEPARTMENT OF THE NAVY, MARINE
CORPS BASE, COMMUNICATION
STRATEGY (COMSTRAT) & OPERATIONS,
Quantico, VA, Employer
__________________________________________

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

Docket No. 21-1244
Issued: March 25, 2022

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Chief Judge
JANICE B. ASKIN, Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION
On August 17, 2021 appellant, through counsel, filed a timely appeal from a June 4, 2021
merit decision of the Office of Workers’ Compensation Programs (OWCP). 2 Pursuant to the

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

The Board notes that, following the June 4, 2021 decision, OWCP received additional evidence. However, the
Board’s Rules of Procedure provides: “The Board’s review of a case is limited to the evidence in the case record that
was before OWCP at the time of its final decision. Evidence not before OWCP will not be considered by the Board
for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this additional
evidence for the first time on appeal. Id.

Federal Employees’ Compensation Act3 (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 has met his burden of proof to establish a back condition
causally related to the accepted January 15, 2019 employment incident.
FACTUAL HISTORY
This case has previously been on appeal before the Board. 4 The facts, as set forth in the
Board’s prior order, are incorporated herein by reference. The relevant facts are as follows.
On January 18, 2019 appellant, then a 64-year-old head of training support, filed a
traumatic injury claim (Form CA-1) alleging that on January 15, 2019 he hit his head and injured
his back when he slipped on ice walking from a road to a walkway while in the performance of
duty. He stopped work on January 15, 2019.5
Dr. Vishal Bindal, a Board-certified neuroradiologist, examined appellant on January 15,
2019 and noted his history of injury. He diagnosed traumatic pain, as well as a history of chronic
back pain. Dr. Bindal reviewed x-rays and indicated no acute lumbar spine findings.
In a January 31, 2019 development letter, OWCP advised appellant of the deficiencies of
his claim. It requested additional factual and medical evidence from him and provided a
questionnaire for his completion. OWCP provided 30 days for a response.
In January 18 and 30, 2019 notes, Dr. Vipul Mangal, a Board-certified pain medicine
specialist, described appellant’s January 15, 2019 fall and diagnosed lumbar radiculopathy.
Dr. Yolanda Reid, a Board-certified family practitioner, examined appellant on
February 26, 2019 and diagnosed lumbar disc herniation and lumbar facet arthropathy. She noted
that appellant had experienced a fall one month ago and suffered moderate-to-severe back pain.
Dr. Reid found muscle weakness in the right lower extremity.
By decision dated March 19, 2019, OWCP denied appellant’s traumatic injury claim,
finding that he failed to submit medical evidence establishing a causal relationship between his
diagnosed conditions and his accepted January 15, 2019 employment incident.

3

5 U.S.C. § 8101 et seq.

4

Order Remanding Case, Docket No. 19-1929 (issued August 3, 2020).

5

The record reflects that appellant has a prior traumatic injury claim involving a back injury. On October 5, 2015
appellant, then a 61-year-old audio visual specialist, filed a traumatic injury claim (Form CA-1) alleging that on
September 4, 2015 he sustained lumbar back pain, muscle strain, hypertension, and a contusion after he fell on office
steps and slipped onto his back while in the performance of duty. He did not stop work. OWCP assigned OWCP File
No. xxxxxx897. It administratively combined the files for OWCP File Nos. xxxxxx897 and xxxxxx142 designating
the latter as the master file.

2

On March 26, 2019 appellant requested a review of the written record by a representative
of OWCP’s Branch of Hearings and Review.
In additional February 26, 2019 treatment notes, Dr. Reid described appellant’s history of
back pain beginning one month earlier and noted his fall on January 15, 2019. She noted that he
had a spinal stimulator for previously diagnosed lumbar disc herniation and facet disease. Dr. Reid
diagnosed lumbar disc herniation with myelopathy status post a blunt injury with a fall on ice. She
examined appellant on March 27, 2019 due to musculoskeletal pain following a fall at work and
diagnosed herniated lumbar intervertebral disc.
On March 12, 2019 appellant underwent a lumbar spine magnetic resonance imaging
(MRI) scan, which demonstrated a mild disc bulge at L4-5 with probable small superimposed
broad-based central protrusion and severe facet arthropathy.
On April 2, 2019 Dr. Thomas Raley, a Board-certified orthopedic surgeon, examined
appellant due to chronic low back pain with intermittent radiation to his lower extremities. He
noted the January 15, 2019 fall at work and findings on the March 12, 2019 MRI scan of mild disc
bulge at L4-S1with spinal nerve root compression or foraminal stenosis. Dr. Raley diagnosed
chronic pain syndrome and lumbar radiculopathy.
In an April 5, 2019 note, Dr. Reid diagnosed lumbar disc displacement and chronic pain.
She described an injury where appellant fell at work in January 2019.
On April 16, 2019 Dr. Teresa M. Kerge, a Board-certified physiatrist, examined appellant
due to back pain and noted that his condition was injury -related as he slipped and fell on ice at
work. She reviewed his March 12, 2019 MRI scan and diagnosed sacroiliitis.
By decision dated June 3, 2019, OWCP’s hearing representative affirmed the March 19,
2019 OWCP decision. Appellant appealed to the Board and in its August 3, 2020 order,6 the Board
set aside the June 3, 2019 decision and remanded the case, directing OWCP to combine appellant’s
claims under File Nos. xxxxxx142 and xxxxxx897 and issue a de novo decision.
In an April 1, 2019 note, Dr. Raley reported that appellant slipped on ice at work on
December 15, 2018 and had experienced pain since that fall. He diagnosed radiculopathy lumbar
region, spondylosis without myelopathy or radiculopathy lumbar region, and low back pain.
Dr. Raley noted that appellant had experienced low back pain and bilateral lowe r extremity pain
since his fall. On April 17, 2019 he diagnosed chronic pain syndrome, lumbar spondylosis without
myelopathy or radiculopathy, lumbar radiculopathy, and low back pain. Dr. Raley again noted
appellant’s fall at work on January 15, 2019. He further noted that appellant fell down a few stairs
at work on September 4, 2015 and landed on his back. Dr. Raley reviewed appellant’s
October 2015 lumbar MRI scan, which demonstrated L4-5 mild disc bulge and mild central canal
stenosis L5-S1 as well as his June 11, 2018 lumbar MRI scan, which demonstrated L4-5 and L5S1 facet hypertrophy and L4-5 degenerative disc disease. He diagnosed chronic pain syndrome

6

Supra note 4.

3

and radiculopathy of the lumbar region. Dr. Raley repeated his findings in notes dated May 15
through August 8, 2019.
On September 6 and October 4, 2019 Dr. Brian Lee, a Board-certified anesthesiologist,
noted appellant’s history of a January 15, 2019 fall on ice at work and reported that lumbar spine
surgery was scheduled for October 7, 2019. He diagnosed chronic pain syndrome, lumbar
spondylosis, lumbar radiculopathy, and low back pain. In a November 1, 2019 note, Dr. Lee
reported that the October 7, 2019 microdiscectomy had reduced appellant’s right leg radiating
pain.
By decision dated November 16, 2020, OWCP denied appellant’s traumatic injury claim,
finding that the evidence of record had not established that the employment incident occurred as
alleged. Therefore, it concluded that the requirements had not been met to establish an injury as
defined by FECA.
On November 20, 2020 appellant, through counsel, requested an oral hearing before a
representative of OWCP’s Branch of Hearings and Review.
In notes dated May 9, 2019 through November 4, 2020, Dr. Wahid Baqaie, a Boardcertified orthopedic surgeon, opined that appellant originally injured himself in a 2015 fall and
that he fell again at work on January 15, 2019 resulting in back pain. He diagnosed lumbar
spondylosis, spinal stenosis, degenerative lumbar disc, and lumbar back pain . Dr. Baqaie found
that appellant was status post L5-S1 laminotomy with no evidence of instability.
A hearing was conducted on March 22, 2021, wherein appellant described the January 15,
2019 employment incident and resulting medical treatment.
Following the oral hearing, Dr. Baqaie provided treatment notes dated July 3, 2019 through
February 10, 2021. He reported that appellant’s back symptoms developed suddenly and were
associated with falling on ice at work on January 15, 2019.
By decision dated June 4, 2021, OWCP’s hearing representative affirmed, as modified,
OWCP’s prior decision, finding that appellant had established that the January 15, 2019
employment incident occurred, as alleged, but determined that the medical evidence was
insufficient to establish causal relationship between the diagnosed back conditions and the
accepted January 15, 2019 employment incident.
LEGAL PRECEDENT
An employee seeking benefits under FECA 7 has the burden of proof to establish the
essential elements of his or her claim, including that the individual is an employee of the United
States within the meaning of FECA, that the claim was timely filed within the applicable time
limitation of FECA, 8 that an injury was sustained in the performance of duty, as alleged, and that
7

Supra note 3.

8

F.H., Docket No.18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued December 13, 2019);
Joe D. Cameron, 41 ECAB 153 (1989).

4

any disability or medical condition for which compensation is claimed is causally related to the
employment injury. 9 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. 10
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. The first component is that the
employee must submit sufficient evidence to establish that he or she actually experienced the
employment incident at the time and place, and in the manner alleged. The second component is
whether the employment incident caused a personal injury. 11
The evidence required to establish causal relationship is rationalized medical opinion
evidence.12 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
specific employment incident identified by the employee.13
ANALYSIS
The Board finds that appellant has not met his burden of proof to establish a back condition
causally related to the accepted January 15, 2019 employment incident.
OWCP received treatment notes from Dr. Reid dated February 26 through April 5, 2019 in
which she diagnosed lumbar disc displacement. Dr. Reid found that appellant experienced a blunt
injury when he fall on ice at work on January 15, 2019. On April 16, 2019 Dr. Kerge diagnosed
sacroiliitis and opined that this condition was work related as appellant slipped and fell on ice at
work. Dr. Baqaie provided treatment notes dated July 3, 2019 through February 10, 2021
diagnosing lumbar spondylosis, spinal stenosis, degenerative lumbar disc and reporting that
appellant’s back symptoms developed suddenly and were associated with falling on ice at work on
January 15, 2019.
While Drs. Reid, Kerge, and Baqaie attributed appellant’s diagnosed back conditions to his
accepted January 15, 2019 employment incident, neither physician provided medical reasoning

9

L.C., Docket No. 19-1301 (issued January 29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020);
James E. Chadden, Sr., 40 ECAB 312 (1988).
10

P.A., Docket No. 18-0559 (issued January 29, 2020); K.M., Docket No. 15-1660 (issued September 16, 2016);
Delores C. Ellyett, 41 ECAB 992 (1990).
11

T.H., Docket No. 19-0599 (issued January 28, 2020); K.L., Docket No. 18-1029 (issued January 9, 2019); John J.
Carlone, 41 ECAB 354 (1989).
12

S.S., Docket No. 19-0688 (issued January 24, 2020); A.M., Docket No. 18-1748 (issued April 24, 2019);
Robert G. Morris, 48 ECAB 238 (1996).
13

T.L., Docket No. 18-0778 (issued January 22, 2020); Y.S., Docket No. 18-0366 (issued January 22, 2020);
Victor J. Woodhams, 41 ECAB 345, 352 (1989).

5

explaining how or why the fall resulted in his diagnosed conditions. These reports are, therefore,
of limited probative value and insufficient to establish causal relationship. 14
In January 18 and 30, 2019 notes, Dr. Mangal described appellant’s January 15, 2019 fall
and diagnosed lumbar radiculopathy. Dr. Raley submitted a series of notes from April 1 through
August 8, 2019 in which he recounted the January 15, 2019 fall at work and diagnosed lumbar
radiculopathy. Similarly, in notes dated September 6 and October 4, 2019, Dr. Lee noted his
history of a January 15, 2019 fall on ice at work and diagnosed chronic pain synd rome, lumbar
spondylosis, lumbar radiculopathy. None of these physicians provided an opinion on the cause of
appellant’s condition. The Board has long held that medical evidence that does not offer an
opinion regarding the cause of an employee’s condition is of no probative value. 15 Therefore,
these reports are insufficient to establish appellant’s claim.
On January 15, 2019 Dr. Bindal noted appellant’s history of injury and diagnosed traumatic
pain as well as a history of chronic back pain. In a February 26, 2019 note, Dr. Reid found
appellant experienced back pain for one month following a fall. The Board has held that pain is a
description of a symptom, not a clear diagnosis of a medical condition.16 A medical report lacking
a firm diagnosis is of no probative value. 17 These reports are, therefore, also insufficient to
establish a diagnosed medical condition causally related to the accepted employment incident.
Appellant submitted an MRI scan dated March 12, 2019. The Board has held that
diagnostic tests, standing alone, lack probative value on the issue of causal relationship as they do
not address the relationship between the accepted employment factors and a diagnosed condition. 18
For this reason, the MRI scan is insufficient to meet appellant’s burden of proof.
As there is no medical evidence of record establishing that appellant’s diagnosed back
conditions were causally related to the accepted employment incident, the Board finds that
appellant has not met his burden of proof to establish a diagnosed medical condition causally
related to the accepted January 15, 2019 employment incident.
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.

14

J.N., Docket No. 21-0606 (issued November 23, 2021); T.W., Docket No. 20-0767 (issued January 13, 2021);
see H.A., Docket No. 18-1466 (issued August 23, 2019); L.R., Docket No. 16-0736 (issued September 2, 2016).
15

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

16

See E.S., Docket No. 21-0189 (issued November 16, 2021); C.S., Docket No. 20-1354 (issued January 29, 2021);
D.R., Docket No. 18-1408 (issued March 1, 2019); D.A., Docket No. 18-0783 (issued November 8, 2018).
17

L.T., Docket No. 20-0582 (issued November 15, 2021); E.S.; C.S., id.; J.P., Docket No. 20-0381 (issued July 28,
2020); R.L., Docket No. 20-0284 (issued June 30, 2020).
18

See W.M., Docket No. 19-1853 (issued May 13, 2020); L.F., Docket No. 19-1905 (issued April 10, 2020).

6

CONCLUSION
The Board finds that appellant has not met his burden of proof to establish a back condition
causally related to the accepted January 15, 2019 employment incident.
ORDER
IT IS HEREBY ORDERED THAT the June 4, 2021 decision of the Office of Workers’
Compensation Programs is affirmed.
Issued: March 25, 2022
Washington, DC

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

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

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

7


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
R.T., Appellant
and
DEPARTMENT OF VETERANS AFFAIRS,
GRAND JUNCTION VETERANS
ADMINISTRATION MEDICAL CENTER,
Grand Junction, CO, Employer
__________________________________________

)
)
)
)
)
)
)
)
)
)

Appearances:
John S. Evangelisti, Esq. for the appellant
Office of Solicitor, for the Director

Docket No. 11-1440
Issued: December 9, 2011

Case Submitted on the Record

DECISION AND ORDER
Before:
RICHARD J. DASCHBACH, Chief Judge
COLLEEN DUFFY KIKO, Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On June 3, 2011 appellant, through his attorney, filed a timely appeal of the
December 14, 2010 nonmerit decision1 of the Office of Workers’ Compensation Programs
(OWCP) denying his request for reconsideration.2 Because more than 180 days has elapsed
between the last merit decision dated September 14, 2010 and the filing of the appeal, the Board
lacks jurisdiction to review the merits of the case pursuant to the Federal Employees’
Compensation Act3 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3.

1

Appellant also appealed OWCP’s “decision” dated April 7, 2011. The Board notes that the case record does not
contain a decision issued on that date by OWCP.
2

Appellant, through his attorney, originally requested an oral argument before the Board but withdrew his request
on June 20, 2011.
3

5 U.S.C. § 8101 et seq.

ISSUE
The issue is whether OWCP properly denied appellant’s request for reconsideration
under 5 U.S.C. § 8128(a).
FACTUAL HISTORY
On November 11, 2009 appellant, then a 51-year-old diagnostic radiologic technologist,4
filed an occupational disease claim5 alleging that he sustained right hip disease as a result of
lifting and moving patients. In a November 11, 2009 narrative statement, he listed his work
duties which included lifting and transporting patients weighing 90 to 400 pounds, pushing and
pulling wheelchairs of various weights and sizes that contained patients, lifting equipment
weighing 50 to 1,000 pounds, reaching, reaching overhead, bending, squatting, stooping and
continuous walking, standing and sitting on hard floors. Appellant performed these activities 5
to 40 times a week.
In a December 16, 2009 letter, the employing establishment controverted appellant’s
claim, contending that the claimed employment duties did not cause his injury.
By decision dated February 16, 2010, OWCP denied appellant’s claim, finding that he
failed to submit any medical evidence establishing a causal relationship between his condition
and established employment duties.
On February 25, 2010 appellant, through counsel, requested an oral hearing.
In medical reports dated January 23 and February 20, 2002, Dr. Michael P. Dohm, a
Board-certified orthopedic surgeon, advised that appellant had right L5 spondylolysis, right hip
capsulitis and iliopsoas tendinitis with left footballer’s ankle and possibly capsulitis. Further
evaluation was recommended to rule out a femoral hernia. Appellant was feeling much better a
few weeks after receiving an iliopsoas injection.
A March 1, 2002 report from Dr. Mark C. Mountford, a Board-certified radiologist,
indicated that he administered a successful steroid injection.
In an April 22, 2003 report, Dr. James E. Maclean, a Board-certified radiologist, stated
that appellant received right hip steroid and marcaine injections.
Reports dated May 23, 2003 through March 12, 2008 from Dr. Jeffrey M. Nakano, a
Board-certified orthopedic surgeon, advised that appellant had right hip symptoms secondary to
4

Appellant last worked for the employing establishment on December 9, 2006 and was placed off its rolls on
February 12, 2007.
5

The Board has issued a decision regarding appellant’s prior claim under File No. xxxxxx305 which OWCP
accepted for displacement of a herniated disc at C6-7 and authorized an August 26, 2003 surgery. In a November 2,
2005 decision, the Board affirmed an OWCP decision dated September 28, 2004 which found that appellant
received an overpayment in the amount of $3,076.26 for which he was at fault. Docket No. 05-1090 (issued
November 2, 2005). The cervical claim is not currently before the Board and will not be addressed in this appeal.

2

moderate degenerative changes. Appellant’s symptoms may also have been caused by lumbar
radiculopathy, meralgia paresthetica or increased activity. His ankle symptoms were secondary
to anterior impingement. Dr. Nakano noted that appellant underwent right hip surface
replacement and advised that a subsequent x-ray demonstrated a satisfactory appearance of the
hip replacement.
In reports dated June 2, July 21 and August 28, 2006, Dr. Roy E. Erb, a Board-certified
radiologist, stated that he successfully treated appellant’s right hip degenerative joint disease,
synovitis and pain with injections.
An unsigned report dated September 20, 2006 noted appellant’s complaints of back,
knee, hip and ankle pain. Appellant received an injection in his hip.
In reports dated September 21, 2006, Dr. Cynthia M. Kelly, a Board-certified orthopedic
surgeon, advised that appellant had several right hip conditions, including degenerative disc
disease secondary to avascular necrosis (AVN). On December 13, 2006 she performed right
Birmingham hip arthroplasty with no complications to treat his right hip degenerative arthritis.
In reports dated March 19 to June 22, 2010, Dr. Kelly stated that she performed left Birmingham
hip arthroplasty to treat appellant’s left hip pain. Appellant was doing well post surgery and
could return to work at any point.
In a report dated November 15, 2006, Rhonda Haver, a physician’s assistant, stated that
appellant was scheduled to undergo total hip arthroplasty on December 13, 2006. Appellant
would be off work for a minimum of three weeks followed by an evaluation to determine his
ability to perform light-duty work.
Reports dated December 13, 2006 from Dr. Kim I. McMillin, a Board-certified
radiologist, stated that x-rays of appellant’s right hip showed right total hip arthroplasty.
Appellant submitted hospital laboratory tests results dated December 18, 2006.
In a December 20, 2006 note, W. Etenburn, a physician’s assistant, stated that appellant
was treated in a hospital emergency room for a headache and leg symptoms. Diagnostic test
results were normal. Appellant’s headache and leg symptoms had improved. In a January 25,
2007 report, B. Etenburn, a physician’s assistant, advised that appellant was status post right hip
resurface replacement. Appellant was unable to work for six weeks.
In a February 3, 2010 report, Dr. Christopher B. Ryan, a Board-certified physiatrist,
obtained a history of appellant’s right hip condition, medical treatment, employment background
and physical activities. He reviewed appellant’s description of his work duties at the employing
establishment. Dr. Ryan listed his findings on physical examination and advised that appellant
had right hip osteoarthritis. He opined that the diagnosed condition was causally related to
appellant’s work duties which accelerated the need for total hip arthroplasty. Dr. Ryan
concluded that appellant had 21 percent impairment of the right lower extremity under the
American Medical Association, Guides to the Evaluation of Permanent Impairment.
In a May 5, 2010 report, Dr. Barry A. Schoelch, a Board-certified radiologist, indicated
that a left hip x-ray revealed no fracture, subluxation or dislocation with only minimal joint space
3

narrowing. Also, on May 5, 2010 Dr. Zubeir N. Jaffer, a Board-certified radiologist, obtained a
history that appellant had undergone left hip resurfacing. He stated that a left hip x-ray
demonstrated postsurgical changes with skin staples and a surgical drain.
A document dated May 20, 2010 listed appellant’s medications. A February 23, 2010
information sheet listed the policies of Rocky Mountain Orthopedic Associates.
In a September 14, 2010 decision, OWCP’s hearing representative affirmed, as modified,
the February 16, 2010 decision to reflect that appellant performed the physical requirements of
his work duties for a lesser percentage of time than alleged. She, however, found that the
medical evidence did not establish that his right hip condition was causally related to the
established work duties.
By letter dated November 2, 2010, appellant, through counsel, requested reconsideration.
He submitted duplicate copies of Dr. Dohm’s January 23, 2002 report, Dr. Mountford’s March 1,
2002 report, Dr. Nakano’s May 23, 2003 to March 12, 2008 reports, Dr. Erb’s June 2 to
August 28, 2006 reports, the September 20, 2006 unsigned report, Dr. Kelly’s September 21,
2006 to June 22, 2010 reports, Ms. Havre’s November 15, 2006 report, Dr. McMillin’s
December 13, 2006 report, the December 20, 2006 through March 24, 2008 notes
of W. Etenburn and B. Etenburn, the February 23, 2010 information sheet from Rocky Mountain
Orthopedic Associates, Dr. Schoelch’s and Dr. Jaffer’s May 5, 2010 reports and the May 20,
2010 list of medications.
In a June 10, 2002 report, Dr. Larry D. Tice, a Board-certified neurosurgeon, advised that
based on a computerized tomography scan, lumbar puncture, cerebral angiogram and magnetic
resonance imaging (MRI) scan of the cervical spine and brain, appellant had subarachnoid
hemorrhage suspect and headaches.
In an April 22, 2003 report, Dr. Maclean administered a steroid and marcaine injection
into appellant’s right hip. Also, on April 22, 2003 Dr. Randall H. Gehl, a Board-certified
radiologist, advised that a cervical MRI scan demonstrated a slightly progressive right
interforaminal disco-osteophytic bulge at C6-7.
In a September 13, 2006 note, Dr. Nakano advised that an MRI scan revealed that
appellant had evidence of AVN.
In an October 21, 2010 report, Dr. Ryan reviewed appellant’s medical records, including
the notes of Dr. Dohm and Dr. Nakano regarding his worsening left ankle symptoms and right
hip pain and again concluded that appellant’s right hip condition and resultant surgery were
employment related. He stated that it was well accepted that pressure over an osteoarthritic joint
would accelerate the degeneration which occurred in appellant’s case. Standing, walking,
squatting and weighting the hip, such as transferring a patient or carrying heavy objects would
accelerate the wear and tear of an osteoarthritic joint. Dr. Ryan opined that appellant’s
preexisting symptoms at least accelerated the degenerative process. If appellant had a normal
hip then his described work duties would not necessarily contribute to his osteoarthritis.
However, Dr. Ryan stated that, once a patient became symptomatic and the diagnosis of
osteoarthritis was suggested, activities, such as those of appellant placed a greater load on his hip

4

joint, worsening the fissure and degenerating the articular cartilage. He advised that his left
ankle pain was not work related. Dr. Ryan noted Dr. Dohm’s finding that appellant’s
footballer’s ankle was sustained during a karate exercise. Although this condition was not work
related, appellant’s right leg would be weighted to take the weight off his left ankle which would
accelerate the wear and tear of his right hip, especially in performing his described work duties.
Dr. Ryan stated that the pathology incurred was “microtrauma.” The osteoarthritic cartilage
became damaged and could not repair itself; and the wearing down process occurred faster than
the body could rebuild the cartilage. Thus, Dr. Ryan concluded that the damage progressed to
destroy the joint and the total joint arthroplasty was the only remedy.
In a December 14, 2010 decision, OWCP denied appellant’s request for reconsideration,
finding that the evidence submitted was duplicative and repetitious in nature and not relevant to
the causal relation issue and, thus, insufficient to warrant a merit review of his claim.
LEGAL PRECEDENT
To require OWCP to reopen a case for merit review under section 8128 of FECA6 its
regulations provide that a claimant must: (1) show that OWCP erroneously applied or
interpreted a specific point of law; (2) advance a relevant legal argument not previously
considered by OWCP; or (3) constitute relevant and pertinent new evidence not previously
considered by OWCP.7 To be entitled to a merit review of OWCP’s decision denying or
terminating a benefit, a claimant also must file his or her application for review within one year
of the date of that decision.8 When a claimant fails to meet one of the above standards, OWCP
will deny the application for reconsideration without reopening the case for review of the merits.
ANALYSIS
In a November 2, 2010 request for reconsideration, appellant disagreed with OWCP’s
hearing representative’s September 14, 2010 decision, which found that he did not sustain a right
hip condition causally related to the established work duties. On December 14, 2010 OWCP
found that the evidence submitted by appellant was duplicative and repetitious in nature and not
relevant to the causal relation issue and, therefore, was insufficient to warrant further merit
review. In this regard, the Board finds that the resubmission of reports by Drs. Dohm,
Mountford, Nakano, Erb, Kelly, McMillin, Schoelch and Jaffer do not warrant a merit review.
As the Board has held, evidence which is repetitious or duplicative of that already in the case
record is of no evidentiary value in establishing a claim and does not constitute a basis for
reopening a case.9

6

5 U.S.C. §§ 8101-8193. Under section 8128 of FECA, the Secretary of Labor may review an award for or
against payment of compensation at anytime on her own motion or on application. 5 U.S.C. § 8128(a).
7

20 C.F.R. § 10.606(b)(1)-(2).

8

Id. at § 10.607(a).

9

See Eugene F. Butler, 36 ECAB 393 (1984).

5

The reports of the physician’s assistants do not constitute relevant and pertinent new
evidence as physician’s assistants are not physicians as defined in FECA.10 Similarly, the reports
of diagnostic tests conducted by Drs. Tice, Gehl and Nakano are also irrelevant in that they do
not address the threshold issue of the causal relationship between his alleged hip condition and
factors of his federal employment.
Appellant also submitted Dr. Ryan’s October 21, 2010 report. Although this evidence
reiterated Dr. Ryan’s February 3, 2010 opinion that appellant’s right hip osteoarthritis and
resultant surgery were due to his work duties, he provided medical rationale in support of his
conclusion. This medical evidence explains the causal relationship between the established
employment-related duties and the diagnosed condition and, thus, is relevant to the issue of
whether OWCP properly denied appellant’s claim for compensation. As such, Dr. Ryan’s
October 21, 2010 report constitutes relevant and pertinent new evidence not previously
considered and is sufficient to require OWCP to reopen appellant’s claim for consideration of the
merits.11 The Board finds, therefore, that OWCP improperly refused to reopen his case for
further review of the merits.
To obtain merit review, appellant is not required to submit evidence sufficient to establish
his claim. He need only provide evidence that is relevant and pertinent and not previously
considered by OWCP.12 Dr. Ryan’s report meets these requirements. The case will, therefore,
be remanded for consideration of his October 21, 2010 report. Following any further
development of the issue, OWCP shall issue an appropriate merit decision.
CONCLUSION
The Board finds that OWCP improperly refused to reopen appellant’s claim for further
review of the merits under 5 U.S.C. § 8128(a) in its December 14, 2010 decision.

10

5 U.S.C. § 8101(2).

11

Id. at § 10.606(b)(2).

12

Billy B. Scoles, 57 ECAB 258 (2005).

6

ORDER
IT IS HEREBY ORDERED THAT the December 14, 2010 decision of the Office of
Workers’ Compensation Programs is set aside. The case is remanded for further action
consistent with this decision of the Board.
Issued: December 9, 2011
Washington, DC

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

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

7


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
S.N., Appellant
and
DEPARTMENT OF VETERANS AFFAIRS,
HUNTER HOLMES MCGUIRE HOSPITAL,
Richmond, VA, Employer
__________________________________________

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

Docket No. 18-1627
Issued: May 15, 2019

Case Submitted on the Record

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

JURISDICTION
On August 27, 2018 appellant, through counsel, filed a timely appeal from a July 13, 2018
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.
ISSUE
The issue is whether appellant has met her burden of proof to establish medical conditions
causally related to the accepted September 28, 2016 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 September 30, 2016 appellant, then a 46-year-old nurse, filed a traumatic injury claim
(Form CA-1) alleging that she sustained an injury on September 28, 2016 when she slipped and
fell in a puddle of water while in the performance of duty. She noted that her right leg had split
before she landed on the floor. Appellant claimed injury to her left leg, left knee, right shoulder,
and back as well as a headache.
In a September 28, 2016 emergency department report, Dr. James R. Freeman, a
nephrologist Board-certified in internal medicine, noted that appellant reported slipping and falling
on water at work approximately 10 minutes prior. Appellant also noted that her legs did a split
and that she had hit her head on the wall. She complained of posterior neck and upper back pain
radiating to her right shoulder and bowel incontinence at time of injury. Appellant denied loss of
consciousness or loss of urinary control. She indicated that she was undergoing physical therapy
for a prior shoulder injury. X-rays did not demonstrate acute abnormalities of the cervical spine
or right shoulder, but revealed mild degenerative changes of the cervical spine and mild
osteoarthritis of the acromioclavicular joint. Appellant was provided a cervical collar and
prescribed Valium for muscle spasms/tremors.
In a September 30, 2016 employee health report, Dr. Sara Mears, Board-certified in
internal medicine and pediatrics, noted that appellant was seen following her September 28, 2016
emergency room visit. The history of injury was noted as a slip and fall on a puddle of water in
the main hallway of the employing establishment. Appellant indicated that she fell against the
wall and her legs split. She also noted undergoing physical therapy for her right shoulder.
Dr. Mears noted examination findings and diagnosed “fall with injury as stated.” In an October 3,
2016 note, she excused appellant from work for the period September 29 through
October 13, 2016.
In an October 12, 2016 letter, the employing establishment controverted the claim, alleging
that there were discrepancies regarding how the injury occurred and that the medical
documentation was deficient. It noted that appellant was receiving physical therapy for a
preexisting shoulder condition at the time of the claimed incident.
In a development letter dated October 17, 2016, OWCP advised appellant that the evidence
received to date was insufficient to establish her claim. It informed her of the type of factual and
medical evidence necessary to establish her claim and provided a questionnaire for her to complete.
OWCP afforded appellant 30 days to submit further evidence.
In an October 18, 2016 letter, the employing establishment continued to controvert the
claim. It alleged that there were inconsistencies as to how the injury occurred and the medical
evidence did not establish causal relationship.
OWCP subsequently received appellant’s October 24, 2016 response to its questions along
with copies of a September 28, 2016 right shoulder x-ray and computerized tomography (CT) head
and cervical spine reports, findings from which Dr. Freeman previously noted.
In an October 3, 2016 report, Dr. Mears reiterated the history of the September 28, 2016
work injury. She noted that appellant reported that her left leg went out from under her and that
she landed on her left knee, then hit her upper back/neck, and right shoulder. Dr. Mears noted that
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the emergency department CT scans of the head and neck and the right shoulder x-ray were all
negative for acute findings. She reported significant muscle spasms on examination. Dr. Mears
indicated that the fall resulted in an acute flare up of appellant’s chronic neck and back pain. She
noted that there were no neurologic deficits on examination, although appellant had chronic issues
with urinary urge incontinence. In an October 13, 2016 employing establishment work capacity
evaluation form, Dr. Mears provided restrictions, but indicated that appellant was temporarily
totally disabled for the period September 28 through November 10, 2016.
By decision dated November 18, 2016, OWCP denied appellant’s claim. It found that the
evidence submitted established that the September 28, 2016 incident occurred, as alleged, but the
medical evidence submitted was insufficient to establish that a medical condition was diagnosed
in connection with the employment incident. Thus, OWCP concluded, that the requirements had
not been met to establish an injury as defined by FECA.
OWCP subsequently received additional evidence. In a November 21, 2016 report,
Dr. Marion Herring, an orthopedic surgeon, noted that appellant was seen on October 31, 2016 for
a work-related injury to her right shoulder which she sustained on September 28, 2016 during a
slip and fall. He reported that a November 15, 2016 magnetic resonance imaging (MRI) scan of
the right shoulder revealed supraspinatus tendinopathy and a full-thickness nonretracted tear, mild
infraspinatus and long head of the biceps tendinopathy, mild glenohumeral osteoarthritis, and
moderate acromioclavicular joint degenerative changes. Dr. Herring noted that appellant was
working full duty. He provided examination findings and an impression of sprain of the right
rotator cuff capsule. Surgical options for the right shoulder were discussed, but appellant preferred
to postpone surgery until she retired in April 2017.
On December 8, 2016 appellant requested a review of the written record before an OWCP
hearing representative. She also submitted additional evidence.
In an October 4, 2016 report, Dr. Douglas Okay, a Board-certified family practitioner,
noted that appellant was injured on September 28, 2016 when she slipped and fell on a wet spot
and injured her upper back, shoulder, and knee. Appellant noted that she currently was in physical
therapy for a frozen shoulder. Dr. Okay indicated that the lumbar examination was essentially
normal with lumbosacral tenderness noted on both sides of the paraspinal area. Sensory
examination was also normal in both the left and right lower extremity. The lumbar spine x-ray
revealed L4-5 and L5-S1 degenerative disc disease and L3-4 anterolisthesis, but no acute findings.
Dr. Okay diagnosed degenerative disc disease of the lumbar spine and lumbosacral
spondylolisthesis.
In an October 31, 2016 report, Dr. Herring noted that the x-rays of appellant’s right
shoulder and cervical spine, as well at the CT of her head on the date of injury did not show
abnormalities. He reported that she felt that the injury exacerbated her prior shoulder condition.
Dr. Herring also reported that appellant had not been in recent treatment for the left knee, but that
she indicated that she had a lot of bruising and had pain from the muscle pull in her left thigh.
Appellant reported that her knee was improving. Dr. Herring reported examination findings and
took x-rays of her right shoulder and left knee. The right shoulder x-ray showed type 2 acromial
spur and the left knee x-ray showed bilateral spurring of lateral patella. Dr. Herring diagnosed
sprain of right rotator cuff capsule and left patellofemoral syndrome. He also reported that
appellant had left knee osteoarthritis. Dr. Herring referred her for a right shoulder MRI scan.
3

Diagnostic tests from November 15, 2016 were also submitted. The MRI scan of the
lumbar spine indicated disc herniations at L3-4, L4-5, and L5-6 with right L3, left L4, and bilateral
L5 nerve impingement. The MRI scan of the cervical spine indicated multilevel spondylosis of
the cervical spine with disc protrusions at C2-3, C3-4, and C4-5 abutting the ventral cord with no
nerve root compression, no acute fracture or subluxation or destructive bone lesion. The MRI scan
of the right joint of the upper extremity indicated supraspinatus tendinopathy and a full-thickness
nonretracted tear, mild infraspinatus and long head of the biceps tendinopathy, mild glenohumeral
osteoarthritis, and moderate acromioclavicular joint degenerative changes.
In a November 18, 2016 report, Dr. Warren B. Kirby, a Board-certified physiatrist, noted
that appellant had lumbar and cervical radicular symptoms associated with spondylosis, which
were complicated by morbid obesity. He noted that she indicated that the symptoms were related
to a workers’ compensation injury that occurred on September 28, 2016. Dr. Kirby provided
examination findings and noted the results of the cervical and lumbar spine MRI scans. He
diagnosed cervical spondylosis with radiculopathy, lumbar spondylosis with radiculopathy, and
morbid obesity. Additional upper extremity diagnostic testing was ordered.
In a December 19, 2016 report, Dr. Herring noted that examination of appellant’s right
shoulder revealed subacromial crepitation, external rotation and supraspinatus strength 4/5 with
positive Hawkins, Neer impingement, and Jobe’s tests. He also discussed her November 15, 2016
MRI scan of the right shoulder. Dr. Herring diagnosed right rotator cuff capsule sprain.
In a January 5, 2017 report, Dr. Kirby provided examination findings and discussed the
results of nerve conduction velocity studies of the bilateral upper extremities and an
electromyogram of the right upper extremity and cervical paraspinals. The electrodiagnostic
testing revealed mild bilateral median neuropathy at the wrist, consistent with prior successful
carpal tunnel releases with no evidence of active cervical radiculopathy. Dr. Kirby diagnosed right
and left median neuropathy, right shoulder pain, cervicalgia, and lumbar spondylosis with
radiculopathy. He opined that appellant’s shoulder issues were the main reason for her upper
extremity complaints.
By decision dated July 13, 2018, an OWCP hearing representative modified the prior
decision to find that the factual and medical components of fact of injury had been established.
However, she denied the claim, finding that the medical evidence of record failed to include a
rationalized opinion which explained how the diagnosed conditions were causally related to the
accepted September 28, 2016 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,3 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

3

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

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to the employment injury.4 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.5
To determine if an employee 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 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.6 The second component is whether the employment incident caused a personal injury.7
An employee may establish that an injury occurred in the performance of duty as alleged, but fail
to establish that the disability or specific condition for which compensation is being claimed is
causally related to the injury.8
Causal relationship is a medical question that requires rationalized medical opinion
evidence to resolve.9 A physician’s opinion on whether there is causal relationship between the
diagnosed condition and the implicated employment incident must be based on a complete factual
and medical background.10 Additionally, the physician’s opinion must be expressed in terms of a
reasonable degree of medical certainty, and must be supported by medical rationale, explaining
the nature of the relationship between the diagnosed condition and an employment incident.11
In a case where a preexisting condition involving the same part of the body is present and
the issue of causal relationship therefore involves aggravation, acceleration, or precipitation, the
physician must provide a rationalized medical opinion that differentiates between the effects of the
work-related injury or disease and the preexisting condition.12
ANALYSIS
The Board finds that appellant has not met her burden of proof to establish medical
conditions causally related to the accepted September 28, 2016 employment incident.
Appellant was initially treated by Dr. Freeman and Dr. Mears following the September 28,
2016 employment incident. While both physicians noted the history of the September 28, 2016
employment incident, neither physician provided a firm medical diagnosis. Dr. Freeman did not
4

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40
ECAB 312 (1988).
5
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).
6

See T.O., Docket No. 18-1012 (issued October 29, 2018); Elaine Pendleton, 40 ECAB 1143 (1989).

7

See T.O., id.; John J. Carlone, 41 ECAB 354 (1989).

8

See K.C., Docket No. 17-1693 (issued October 29, 2018); Shirley A. Temple, 48 ECAB 404, 407 (1997).

9

See K.C., id.; Robert G. Morris, 48 ECAB 238 (1996).

10

See K.C., supra note 8; Victor J. Woodhams, 41 ECAB 345, 352 (1989).

11

Id.

12

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

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diagnose a medical condition in connection to the accepted employment incident. In her
September 30, 2016 report, Dr. Mears assessed a fall with injury, but also failed to diagnose a
medical condition. In her October 3, 2016 report, she indicated that the fall resulted in an acute
flare up of appellant’s chronic neck and back pain. The Board has consistently held that pain is a
symptom, not a compensable medical diagnosis.13 Therefore these medical reports are insufficient
to establish appellant’s claim.
Dr. Kirby noted that appellant had a work-related injury to which she attributed her
symptoms. In his November 18, 2016 and January 6, 2017 reports, he diagnosed cervical
spondylosis with radiculopathy, lumbar spondylosis with radiculopathy, right and left median
neuropathy, right shoulder pain, and cervicalgia. However, Dr. Kirby did not provide an opinion
regarding the cause of the diagnosed conditions. Medical evidence that does not offer an opinion
regarding the cause of an employee’s condition is of no probative value on the issue of causal
relationship.14 These reports, therefore, are insufficient to establish appellant’s claim.
The reports from Dr. Herring and Dr. Okay are also insufficient to establish appellant’s
claim. Dr. Herring diagnosed sprain of right rotator cuff capsule and left patellofemoral syndrome
and indicated that it was a work-related injury. Dr. Okay diagnosed degenerative disc disease
lumbar spine and lumbosacral spondylolisthesis and noted that she had a work-related injury.
While Drs. Herring and Okay provided an accurate history of injury and firm medical diagnoses
in their respective reports, they each offered a conclusory statement on causal relationship and are
therefore of limited probative value.15 Without explaining how, physiologically, the employment
incident caused or contributed to the diagnosed conditions, their opinion on causal relationship are
insufficiently rationalized and of limited probative value.16 Such medical rationale is necessary in
this case as appellant’s medical findings reveal that she had chronic medical conditions prior to
her work injury and no physician distinguished between the effects of her preexisting conditions
and her work injury.17
The record also includes diagnostic reports. Diagnostic testing reports lack probative value
as they do not provide an opinion regarding the cause of the diagnosed conditions.18
The Board finds that because appellant has not submitted reasoned medical evidence
establishing a medical condition causally related to her accepted employment incident, she has not
met her burden of proof.

13

See B.B., Docket No. 18-1036 (issued December 31, 2018); C.F., Docket No. 08-1102 (issued October 10, 2008).

14

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

15

See B.B., Docket No. 18-1036 (issued December 31, 2018); B.W., Docket No. 16-1012 (issued October 21, 2016);
see also T.H., 59 ECAB 388 (2008).
16
See L.M., Docket No. 14-0973 (issued August 25, 2014); R.G., Docket No. 14-0113 (issued April 25, 2014);
K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-0548 (issued November 16, 2012).
17

See S.D., Docket No. 16-0999 (issued October 16, 2017).

18

S.H., Docket No. 17-1447 (issued January 11, 2018).

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On appeal counsel contends that OWCP’s July 13, 2018 decision is contrary to fact and
law. For the reasons set forth above, the Board finds that appellant has not met her burden of
proof.
Appellant may submit new evidence or argument with a written request for reconsideration
to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R.
§§ 10.605 through 10.607.
CONCLUSION
The Board finds that appellant has not met her burden of proof to establish medical
conditions causally related to the accepted September 28, 2016 employment incident.
ORDER
IT IS HEREBY ORDERED THAT the July 13, 2018 decision of the Office of Workers’
Compensation Programs is affirmed.
Issued: May 15, 2019
Washington, DC

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

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

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

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