United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
M.M., Appellant
and
DEPARTMENT OF VETERANS AFFAIRS,
VETERANS HEALTH ADMINISTRATION,
MINNEAPOLIS VA MEDICAL CENTER,
Minneapolis, MN, Employer
__________________________________________

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

Docket No. 21-1159
Issued: March 7, 2022

Case Submitted on the Record

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

JURISDICTION
On June 7, 2021 appellant, through counsel, filed a timely appeal from a May 26, 2021
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.

1

ISSUE
The issue is whether appellant has met his burden of proof to establish a right elbow
condition causally related to the accepted March 2, 2020 employment incident.
FACTUAL HISTORY
On March 4, 2020 appellant, then a 48-year-old supply technician, filed a traumatic injury
claim (Form CA-1) alleging that on March 2, 2020 he was maneuvering a cart, which was difficult
to push and steer, when he experienced a shooting pain from his elbow to his fingers, while in the
performance of duty. He stopped work on March 2, 2020 and returned to work on March 4, 2020.
On the reverse side of the claim form appellant’s supervisor acknowledged that appellant was
injured while in the performance of duty.
Appellant submitted a form dated March 6, 2020 from Dr. Fardows Omar Salim, a family
medicine specialist, who noted a March 2, 2020 date of injury and provided work restrictions.
OWCP also received an imaging report dated March 10, 2020 from Dr. Kyle Shipley, a
Board-certified diagnostic radiologist, which related an impression of mild distal biceps and
common extensor tendinopathy.
Appellant submitted a work capacity form dated March 11, 2020 from Dr. Elizabeth
Moorhead, a Board-certified internist. Dr. Moorhead related that appellant was injured on
March 2, 2020 and diagnosed right ulnar neuropathy and right lateral epicondylitis. He noted
appellant’s work restrictions and limited him to four hours of work a day.
In a development letter dated March 23, 2020, OWCP informed appellant of the
deficiencies of his claim. It informed him of the type of factual and medical evidence needed and
provided him with a questionnaire. OWCP afforded appellant 30 days to submit the necessary
evidence.
In response, appellant submitted a medical report dated March 4, 2020 from Dr. Salim.
Dr. Salim related that appellant was pushing and steering a crash cart with bad wheels at work and
reinjured his right elbow. She related that appellant had previously injured the same elbow at work
in April 2019 when he struck his elbow on metal shelving.3 Dr. Salim provided an assessment of
right elbow pain and noted that there concern regarding a fracture versus a nerve injury; therefore,
appellant would undergo an x-ray and magnetic resonance imaging (MRI) scan.
By decision dated May 6, 2020, OWCP accepted that the March 2, 2020 employment
incident occurred, as alleged. However, it denied appellant’s claim, finding that he had not
submitted medical evidence containing a medical diagnosis in connection with his accepted

3

Appellant has a prior claim under OWCP File No. xxxxxx929 alleging that on April 11, 2019 he was stocking a
storeroom, lifting heavy boxes and putting them on shelves, when he struck his elbow against the metal shelves.
OWCP denied that claim by decisions dated August 29 and December 17, 2019. Appellant’s claims have not been
administratively combined by OWCP.

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employment incident. It concluded, therefore, that the requirements had not been met to establish
an injury as defined by FECA.
On April 13, 2021 appellant, through counsel, requested reconsideration of OWCP’s
May 6, 2020.
In a letter dated March 30, 2021, Dr. Moorhead related that, on April 11, 2019, appellant
was carrying boxes when he struck the posterior side of his elbow on a shelf. She noted that an
electromyogram (EMG) performed on September 3, 2019 showed a mild right ulnar sensory
mononeuropathy, and an MRI scan performed on December 9, 2019 showed mild lateral
epicondylitis. Dr. Moorhead diagnosed lateral epicondylitis, ulnar neuropathy, and right elbow
pain.
By decision dated May 26, 2021, OWCP modified its May 6, 2020 decision and found that
appellant had established a diagnosed medical condition, but denied appellant’s claim as causal
relationship had not been established between the diagnosed right elbow condition and the
accepted employment incident.
LEGAL PRECEDENT
An employee seeking benefits under FECA 4 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, 5 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. 6 These are the essential elements of each and every compensation claim,
regardless of whether the claim is predicated upon a traumatic injury or an occupational disease.7
To 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. 8

4

Supra note 2.

5

F.H., Docket No.18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April 26, 2019); Joe D.
Cameron, 41 ECAB 153 (1989).
6

L.C., Docket No. 19-1301 (issued January 29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020);
James E. Chadden, Sr., 40 ECAB 312 (1988).
7

P.A., Docket No. 18-0559 (issued January 29, 2020); K.M., Docket No. 15-1660 (issued September 16, 2016);
Delores C. Ellyett, 41 ECAB 992 (1990).
8

T.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).

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The medical evidence required to establish a causal relationship between a claimed specific
condition and an employment incident is rationalized medical opinion evidence. 9 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 factors
identified by the employee. 10
ANALYSIS
The Board finds that appellant has not met his burden of proof to establish a right elbow
condition causally related to the accepted March 2, 2020 employment incident.
Appellant was initially seen by Dr. Salim on March 4, 2020 who related appellant’s history
of the alleged March 2, 2020 injury, and noted that appellant had previously injured his right elbow
at work in April 2019 when he struck his elbow on metal shelving. Dr. Salim assessed right elbow
pain. The Board has held that pain is a description of a symptom, not a firm diagnosis of a medical
condition.11 Moreover, Dr. Salim did not provide an opinion with regard to causal relationship.
In a form report dated March 6, 2021, she noted appellant’s work restrictions, but again did not
provide a firm diagnosis or an opinion regarding causal relationship. The Board has held that a
medical report lacking a firm diagnosis or an opinion on causal relationship is of no probative
value.12 As such, these reports are insufficient to meet appellant’s burden of proof.
In a report dated March 11, 2020, Dr. Moorhead related that appellant was injured on
March 2, 2020. She diagnosed right ulnar neuropathy and right lateral epicondylitis. However,
Dr. Moorhead merely repeated the history of injury as reported by appellant without providing her
own opinion regarding whether appellant’s condition was work related. OWCP also received a
March 30, 2021 report wherein Dr. Moorhead related that on April 11, 2019 appellant was
carrying boxes when he struck the posterior side of his elbow on a shelf. Dr. Moorhead related
diagnoses of lateral epicondylitis, ulnar neuropathy, but did not provide an opinion on causal
relationship. As noted, the Board has held that a medical report lacking an opinion on causal
relationship is of no probative value. 13 As such, this evidence is also insufficient to establish the
claim.

9

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).
10

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).
11

D.R., Docket No. 18-1408 (issued March 1, 2019); D.A., Docket No. 18-0783 (issued November 8, 2018).

12

See J.P., Docket No. 20-0381 (issued July 28, 2020); R.L., Docket No. 20-0284 (issued June 30, 2020); L.B.,
Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).
13

Id.

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Appellant also submitted diagnostic studies. The Board has long held that diagnostic
studies, standing alone, lack probative value on the issue of causal relationship as they do not
address whether the employment incident caused a diagnosed condition. 14
As the medical evidence of record is insufficient to establish causal relationship between a
diagnosed right elbow condition and the accepted employment incident, the Board finds that
appellant has not met his 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. 15
CONCLUSION
The Board finds that appellant has not met his burden of proof to establish a right elbow
condition causally related to the March 2, 2020 employment incident.
ORDER
IT IS HEREBY ORDERED THAT the May 26, 2021 decision of the Office of Workers’
Compensation Programs is affirmed.
Issued: March 7, 2022
Washington, DC

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

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

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

14

J.P., Docket No. 19-0216 (issued December 13, 2019); A.B., Docket No. 17-0301 (issued May 19, 2017).

15

Upon return of the case record, OWCP should consider administratively combining this case record with the prior
record for OWCP File No. xxxxxx929.

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
M.S., Appellant
and
U.S. POSTAL SERVICE, PROCESSING &
DISTRIBUTION CENTER, Springfield, OR,
Employer
__________________________________________

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

Docket No. 18-1554
Issued: February 8, 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 August 10, 2018 appellant filed a timely appeal from an April 17, 2018 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 has met his burden of proof to establish an occupational
disease in the performance of duty.

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2

5 U.S.C. § 8101 et seq.

The Board notes that appellant submitted additional evidence on appeal. 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.

FACTUAL HISTORY
On September 21, 2017 appellant, then a 65-year-old building equipment mechanic, filed
an occupational disease claim (Form CA-2) for an unspecified injury or condition. He alleged that
he was injured as a result of performing repetitive work including changing overhead lighting,
pulling wires through conduits, and climbing ladders and steps while carrying heavy equipment in
the performance of duty. Appellant noted that he first became aware of his condition on March 1,
2017 and realized its relation to his federal employment on March 8, 2017. He did not stop work.
An accident report form prepared by R.E., manager of maintenance, dated September 18,
2017, noted that appellant was hired on November 8, 1997. R.E. advised that, due to several years
of replacing light ballasts, pulling wires through conduits, and other tasks in the performance of
his maintenance job, appellant developed repetitive motion injuries to both shoulder, both knees,
and his left ring finger.
In a statement dated September 20, 2017, appellant reported working for the employing
establishment for 20 years. He noted that his job required kneeling while working on sinks, drains,
repairing pallet jacks, tilters, compressors, air conditioners (roof top units), climbing and
descending stairs, and carrying motors and fans for 36 roof top units. As a result, appellant’s knees
have locked up, given out, and become weaker. He indicated that in 2004 he had right shoulder
surgery and in 2017 the condition returned and was now affecting both shoulders. Appellant
reported that both shoulders catch when raising his hands above his head to work on ballasts for
lighting, while pulling 200 feet of water and air hoses across the roof to clean the roof top units
and while pulling heavy wires and cables through conduits for new or relocated power for
machines.
In a development letter dated September 29, 2017, OWCP advised appellant of the type of
factual and medical evidence needed to establish his claim, including a detailed description and
factual corroboration of the identified work factors, and a report from his physician explaining
how and why those tasks would cause the claimed injuries. It also requested that he respond to a
questionnaire to substantiate the factual elements of his claim. OWCP afforded appellant 30 days
to provide the requested information. No further information was received by OWCP.
By decision dated October 30, 2017, OWCP denied appellant’s claim, finding that the
evidence of record was insufficient to establish that the injury or events occurred as alleged. It
noted that appellant did not respond to OWCP’s development letter of September 29, 2017.
On November 29, 2017 appellant requested a review of the written record by an OWCP
hearing representative. In support of his request, he submitted an October 26, 2017 statement,
indicating that an ultrasound of his left shoulder revealed a tear. On October 30, 3017 appellant
reported this injury to his supervisor.
Appellant also submitted a report by Dr. Brick A. Lantz, a Board-certified orthopedist, of
his treatment of appellant on November 13, 2017. Dr. Lantz noted that an ultrasound of the right
shoulder revealed a ruptured long head of the biceps with probable partial thickness tearing of the
supraspinatus and that the ultrasound of the left shoulder revealed subluxed biceps and tearing of
the subscapularis superiorly. He advised that based on the x-rays and ultrasound reports he
recommended surgical intervention. Appellant reported that his past work activities were a
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significant factor in developing his shoulder problems. Dr. Lantz also indicated that there was a
significant component of degeneration in the tendons.
By decision dated April 17, 2018, an OWCP hearing representative affirmed the
October 30, 2017 decision.
LEGAL PRECEDENT
A claimant seeking benefits under FECA3 has the burden of proof to establish the essential
elements of his or her claim by the weight of the reliable, probative and substantial evidence,
including that an injury was sustained in the performance of duty as alleged, and that any specific
condition or disability claimed is causally related to the employment injury.4
To establish that an injury was sustained in the performance of duty in an occupational
disease claim, a claimant must submit: (1) medical evidence establishing the presence or existence
of the disease or condition for which compensation is claimed; (2) a factual statement identifying
employment factors alleged to have caused or contributed to the presence or occurrence of the
disease or condition; and (3) medical evidence establishing that the diagnosed condition is causally
related to the identified employment factors.5
An injury does not have to be confirmed by an eyewitness in order to establish the fact that
an employee sustained an injury while in the performance of duty. However, the employee’s
statements must be consistent with the surrounding facts and circumstances and his or her
subsequent course of action.6 Such circumstances as late notification of injury, lack of
confirmation of injury, continuing to work without apparent difficulty following the alleged injury
and failure to obtain medical treatment may cast doubt on an employee’s statements in determining
whether he or she had established a prima facie claim for compensation. However, an employee’s
statement alleging that an injury occurred at a given time and in a given manner is of great
probative value and will stand unless refuted by strong and persuasive evidence.7
Causal relationship is a medical question, which requires rationalized medical opinion
evidence to resolve the issue.8 A physician’s opinion on whether there is causal relationship
between the diagnosed condition and the implicated employment factors must be based on a
complete factual and medical background.9 Additionally, the physician’s opinion must be
expressed in terms of a reasonable degree of medical certainty, and must be supported by medical

3

Supra note 1.

4

20 C.F.R. § 10.115(e), (f); see Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996).

5

Victor J. Woodhams, 41 ECAB 345, 352 (1989).

6

See B.B., Docket No. 12-0165 (issued July 26, 2012); Mary Jo Coppolino, 43 ECAB 988 (1992).

7

Id.

8

See Robert G. Morris, 48 ECAB 238 (1996).

9

Supra note 5.

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rationale, explaining the nature of the relationship between the diagnosed condition and appellant’s
specific employment factors.10
ANALYSIS
OWCP denied appellant’s claim because he failed to establish that the claimed work events
occurred as alleged. The evidence of record supports that his job duties required performing
repetitive overhead tasks including installing ballasts for lighting, pulling water and air hoses
across the roof to clean the roof top units, pulling heavy wires and cables through conduits for new
or relocated power for machines, kneeling while working on sinks, drains, repairing pallet jacks,
tilters, compressors, and air conditioners (roof top units), climbing and descending stairs, and
carrying motors and fans from 36 roof top units. Specifically, appellant’s manager, R.E. indicated
in an accident report dated September 18, 2017, that on September 13, 2017, appellant was
performing the regular duties required of his position including replacing light ballasts, pulling
wire through conduits, and other tasks involved in the performance of his maintenance job. He
further noted that after several years of performing his job duties he developed repetitive motion
injuries to both shoulder, both knees, and left ring finger. On September 29, 2017 OWCP
requested that the employing establishment provide comments from a knowledgeable supervisor
on the accuracy of statements provided on the CA-2; however, no additional evidence was
submitted. The Board finds that the evidence is undisputed that appellant was performing his work
duties as a building equipment mechanic which included performing repetitive activities using
both shoulders and knees.
The Board further finds, however, appellant failed to submit sufficient medical evidence
sufficient to establish that his diagnosed medical conditions are causally related to specific factors
of his federal employment.
Appellant submitted a November 13, 2017 report from Dr. Lantz who noted the results of
an ultrasound of the right shoulder revealed a ruptured long head of the biceps with probable partial
thickness tearing of the supraspinatus. Dr. Lantz noted the ultrasound of the left shoulder revealed
subluxed biceps and tearing of the subscapularis superiorly. He advised that based on the x-rays
and ultrasound reports he recommended surgical intervention. Appellant reported that his past
work activities were a significant factor in developing his shoulder problems. Dr. Lantz indicated
that there was a significant component of degeneration in the tendons. However, this report is
insufficient to establish the claim as he 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 he is providing his own opinion, Dr. Lantz failed to provide a rationalized
opinion regarding the causal relationship between appellant’s bilateral shoulder condition and
accepted factors of his federal employment.11 Additionally, he attributed appellant’s shoulder
condition to a “significant component of degeneration.”

10

Id.

11
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).

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As there is no rationalized medical evidence of record explaining how appellant’s
employment duties caused or aggravated a medical condition involving his bilateral shoulders, the
Board finds that he has not met his burden of proof.
On appeal appellant contends that he submitted sufficient medical evidence to support that
he developed bilateral shoulder conditions due to performing repetitive duties at work over 20
years. As noted above, the medical evidence of record contains insufficient rationale to meet
appellant’s burden of proof to establish causal relationship.
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 established factors of his federal employment. However,
appellant has not met his burden of proof to establish an occupational disease causally related to
the accepted factors of his federal employment.
ORDER
IT IS HEREBY ORDERED THAT the April 17, 2018 decision of the Office of Workers’
Compensation Programs is affirmed as modified.
Issued: February 8, 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

5


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
R.R., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
New Orleans, LA, Employer
__________________________________________

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Appearances:
Bettye L. Richardson, for the appellant
Office of Solicitor, for the Director

Docket No. 09-1829
Issued: December 7, 2009

Case Submitted on the Record

DECISION AND ORDER
Before:
DAVID S. GERSON, Judge
COLLEEN DUFFY KIKO, Judge
MICHAEL E. GROOM, Alternate Judge

JURISDICTION
On July 13, 2009 appellant filed a timely appeal from the May 14, 2009 nonmerit
decision of the Office of Workers’ Compensation Programs denying review of his claim on the
grounds that his reconsideration request was not timely filed and failed to establish clear
evidence of error. Because more than one year has elapsed between the January 3, 2008 merit
decision of the Office and the filing of this appeal on July 13, 2009, the Board lacks jurisdiction
to review the merits of appellant’s claim pursuant to 20 C.F.R. §§ 501.2 and 501.3.1
ISSUE
The issue is whether the Office properly refused to reopen appellant’s claim for further
review of the merits on the grounds that his request was untimely filed and failed to demonstrate
clear evidence of error.

1

Appellant requested an oral argument before the Board in connection with his appeal. In an October 20, 2009
order, the Board denied appellant’s request for an oral argument.

FACTUAL HISTORY
This is the sixth appeal in this case. On May 11, 2000 the Board found that the Office
properly denied appellant’s request for a hearing under section 8124 of the Federal Employees’
Compensation Act in its September 22, 1998 decision.2 On June 18, 2003 the Board found that
the Office properly determined that appellant’s June 11, 2000 request for reconsideration was
untimely filed and did not establish clear evidence of error.3 On September 11, 2006 the Board
found that the Office’s November 25, 2005 decision properly denied appellant’s February 18,
2005 request for reconsideration decision as untimely.4 However, the Office did not address his
argument that he had timely filed a hearing request on August 21, 1997. The Board remanded
the case to the Office for further review. On June 18, 2007 the Board affirmed the Office’s
November 20, 2006 decision, which denied appellant’s request for a hearing. However, the
Board set aside a September 29, 2006 merit decision, as the Office did not address appellant’s
contention that he timely filed a request for a hearing on August 21, 1997. The case was
remanded to the Office to address his evidence and argument.5 On January 2, 2009 the Board
affirmed as modified the Office’s January 3, 2008 decision to reflect that, while appellant
established a compensable work factor, the medical evidence of record was insufficient to
establish that his stroke on January 13, 1997 was causally related to his federal employment.6
The findings of fact and conclusions of law from the prior decisions are hereby incorporated by
reference.
In a letter dated March 30, 2009, appellant requested reconsideration. He advised that he
previously requested reconsideration on December 31, 2008 and had submitted evidence from
his neuropsychologist and a CA-7 claim for compensation. Appellant indicated that he was
submitting a February 17, 2009 report from Dr. M. Shahidul Islam, a Board-certified
psychiatrist; witness statements from Coworkers Lonza Bigam dated March 10, 1997, Dwight
Reeve dated January 23, 2009 and Robert Valentine dated February 7, 2009; a seven-page
description of mail handler duties; an eight-page copy of the Congressional Code of Ethics for
Government Service; and the Board’s decision of January 2, 2009. The Office received a
December 19, 2006 report from Dr. Islam, numerous material from 1997 and 1998 pertaining to
return to work issues, grievances filed with the Equal Employment Opportunity Commission and
a copy of the Board’s January 2, 2009 decision. The record does not contain other documents
referenced in appellant’s March 30, 2009 letter. The record does contain evidence submitted
after the Office’s January 3, 2008 merit decision.

2

Docket No. 99-602 (issued May 11, 2000).

3

Docket No. 02-695 (issued June 18, 2003).

4

Docket No. 06-767 (issued September 11, 2006).

5

Docket No. 07-405 (issued June 18, 2007). On February 28, 2007 the Board issued an order dismissing appeal
in Docket No. 07-870. The Board noted two appeals were docketed for one Office file number and allowed Docket
No. 07-405 to proceed. Docket No. 07-870 (issued February 28, 2007).
6

Docket No. 08-1122 (issued January 2, 2009).

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By decision dated May 14, 2009, the Office denied appellant’s request for
reconsideration on the grounds that it was not timely filed within one year of the Office’s
January 3, 2008 decision and the evidence did not establish clear evidence of error in the 2008
decision.
On appeal, appellant contends he timely filed a request for reconsideration.
LEGAL PRECEDENT
The Act7 provides that the Office may review an award for or against compensation upon
application by an employee (or his or her representative) who receives an adverse decision. The
employee may obtain this relief through a request to the district Office. The request, along with
the supporting statements and evidence, is called the application for reconsideration.8 To be
entitled to a merit review of an Office decision denying or terminating a benefit, a claimant must
file his or her application for review within one year of the date of that decision.9 The Board has
found that the imposition of the one-year limitation does not constitute an abuse of the
discretionary authority granted the Office under section 8128(a) of the Act.10
Section 10.607(b) of the Office’s regulations states that the Office will consider an
untimely application for reconsideration only if it demonstrates clear evidence of error by the
Office in its most recent merit decision. The reconsideration request must establish that the
Office’s decision was, on its face, erroneous.11
ANALYSIS
The Board previously reviewed the merits of this claim in a January 2, 2009 decision. A
merit decision of the Board extends the one-year period to request reconsideration of a
final decision before the Office.12
Appellant’s request for reconsideration was dated
March 30, 2009.13 As this request was filed within one year after the Board’s merit decision, it is
timely.
As appellant filed a timely request for reconsideration, the Office improperly evaluated
his request for reconsideration pursuant to the clear evidence of error standard. The case will
therefore be remanded to the Office for a decision regarding whether the evidence submitted
7

5 U.S.C. § 8101 et seq.

8

20 C.F.R. § 10.605.

9

Id. at § 10.607(a).

10

5 U.S.C. § 8128(a); Leon D. Faidley, Jr., 41 ECAB 104 (1989).

11

20 C.F.R. § 10.607(b); D.E., 59 ECAB ___ (Docket No. 07-2334, issued April 11, 2008).

12

Howard Y. Miyashiro, 51 ECAB 253 (1999); Veletta C. Coleman, 48 ECAB 367 (1997); Federal (FECA)
Procedure Manual, Part 2 -- Claims, Reconsiderations, Chapter 2.1602.3b (January 2004).
13

Although appellant asserted on appeal that he had filed a request for reconsideration on December 31, 2008, a
review of the record does not support this contention.

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with the March 30, 2009 request for reconsideration was sufficient to warrant a review of the
merits of appellant’s claim under the standard for timely requests for reconsideration at 20
C.F.R. § 10.606(b).
CONCLUSION
The Board finds that appellant filed a timely request for reconsideration. Accordingly,
this case must therefore be remanded to the Office for an appropriate decision consistent with
this opinion.
ORDER
IT IS HEREBY ORDERED THAT the May 14, 2009 decision of the Office of
Workers’ Compensation Programs is set aside and the case remanded for further proceedings
consistent with the above opinion.
Issued: December 7, 2009
Washington, DC

David S. Gerson, Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

4


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
A.L., Appellant
and
DEPARTMENT OF HOMELAND SECURITY,
CUSTOMS & BORDER PROTECTION,
Madawaska, ME, Employer
__________________________________________

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

Docket No. 15-1418
Issued: October 8, 2015

Case Submitted on the Record

DECISION AND ORDER
Before:
COLLEEN DUFFY KIKO, Judge
JAMES A. HAYNES, Alternate Judge
VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION
On June 16, 2015 appellant filed a timely appeal from a January 12, 2015 merit decision
and a March 9, 2015 nonmerit 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 the case.2
ISSUES
The issues are: (1) whether appellant met his burden of proof to establish a traumatic
injury in the performance of duty; and (2) whether OWCP properly denied appellant’s request
for reconsideration without a merit review of his claim pursuant to 5 U.S.C. § 8128(a).

1
2

5 U.S.C. § 8101 et seq.

Appellant submitted new evidence on appeal. The Board is precluded from considering the evidence as it was
not before OWCP at the time of its decision. 20 C.F.R. § 501.2(c)(1).

FACTUAL HISTORY
On September 7, 2014 appellant, then a 51-year-old customs officer, filed a traumatic
injury claim (Form CA-1), alleging that on September 7, 2014 he injured his right forearm
during a secondary vehicle inspection. He contended that, while reaching into the bed of a
pickup truck, “something sprang” on his forearm causing pain. Appellant did not stop work.
The employing establishment issued a Form CA-16 on September 12, 2014 to provide
necessary medical treatment. The attending physician’s side of the form report was undated.
Brad Schmeling, a physician assistant, diagnosed muscle strain and checked a box “yes” that the
condition was caused or aggravated by appellant’s employment. Mr. Schmeling related that
appellant developed pain while moving a tire in the back of a pickup truck. He further noted that
x-rays of the right elbow were negative for fracture and that appellant could return to light duty
immediately.
Appellant was seen by Dr. Walter Doerfler, a Board-certified family practitioner. In a
report of September 12, 2014, he was discharged with instructions for care of a ligamentous
strain and muscle strain and was provided work restrictions through September 16, 2014.
A September 16, 2014 referral form from Heather Stevens, a nurse practitioner,
diagnosed appellant with epicondylitis and referred him for physical therapy. The record
contains several reports from a physical therapist documenting appellant’s treatment.
In a December 10, 2014 letter, OWCP informed appellant that the evidence of record did
not establish his claim. It requested that he provide a medical report with a physician’s
explanation of how employment caused or aggravated a medical condition. OWCP specified
that medical evidence must be submitted by a qualified physician, and that nurse practitioners
and physician assistants were not considered physicians under FECA.
On January 12, 2015 OWCP denied appellant’s claim finding that appellant had failed to
provide a medical report containing a physician’s opinion, supported by a medical explanation,
as to how work factors caused or aggravated a diagnosed condition.
Appellant requested reconsideration on February 6, 2015. In a statement, he maintained
that he suffered a work-related injury on September 7, 2014.
OWCP received a physical therapist reports, dated September 23, October 3, 27, and 29,
and November 5, 2014. It also received documents previously of record.
On March 9, 2015 OWCP denied appellant’s request for reconsideration finding that the
evidence was insufficient to warrant merit review.
LEGAL PRECEDENT -- ISSUE 1
An employee seeking compensation under FECA must establish the essential elements of
his or her claim by the weight of reliable, probative, and substantial evidence,3 including that he
3

J.P., 59 ECAB 178 (2007); Joseph M. Whelan, 20 ECAB 55, 57 (1968).

2

or she is an employee within the meaning of FECA and that he or she filed his or her claim
within the applicable time limitation.4 The employee must also establish that he sustained an
injury in the performance of duty as alleged and that his disability for work, if any, was causally
related to the employment injury.5
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 evidence, in the
form of medical evidence, to establish that the employment incident caused a personal injury.6
Causal relationship is a medical issue and the evidence generally required to establish
causal relationship is rationalized medical opinion evidence. Rationalized medical opinion must
include a physician’s opinion on the issue of whether there is a causal relationship between the
claimant’s diagnosed condition and the implicated employment factors. 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.7
ANALYSIS -- ISSUE 1
OWCP accepted that appellant reached into a truck to move a tire on September 7, 2014.
The Board finds, however, that appellant has not offered medical evidence establishing that a
diagnosed condition caused or aggravated his employment incident.
In a September 12, 2014 report, Dr. Doerfler discharged appellant with care instructions
for ligamentous strain and muscle strain. However, he did not provide any opinion on the cause
of appellant’s condition. Medical evidence that does not provide any opinion regarding the
cause of an employee’s condition is of limited probative value on the issue of causal
relationship.8

4

R.C., 59 ECAB 427 (2008).

5

Id.; Elaine Pendleton, 40 ECAB 1143, 1145 (1989).

6

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

7

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

8

Jaja K. Asaramo, 55 ECAB 200 (2004).

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Appellant also submitted evidence from a nurse practitioner, physical therapist, and
physician assistant. This evidence is insufficient to establish appellant’s claim as the persons
completing the reports do not qualify as physicians under FECA.9
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.
LEGAL PRECEDENT -- ISSUE 2
To require OWCP to reopen a case for merit review under section 8128(a) of FECA,
OWCP 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.10 Where the request for reconsideration fails to meet at least one of these
standards, OWCP will deny the application for reconsideration without reopening the case for
review of the merits.11
ANALYSIS -- ISSUE 2
OWCP denied appellant’s traumatic injury claim, finding that the medical evidence did
not establish a diagnosed condition causally related to his employment. Appellant requested
reconsideration and on March 9, 2015 OWCP denied appellant’s reconsideration request.
The Board finds that OWCP correctly denied appellant’s reconsideration request. In
support of his request, appellant submitted that he had suffered a work-related injury on
September 7, 2014. He did not, however, advance a relevant legal argument not previously
considered, or show that OWCP erroneously applied or interpreted a specific point of law.
Appellant submitted several physical therapy reports which were previously of record.
These reports are not medical evidence as they were prepared by a physical therapist and they do
not constitute probative medical evidence.12
Other documents submitted with the
reconsideration request are not relevant because they were previously considered by OWCP.13

9

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). See
L.B., Docket No. 13-1253 (issued September 18, 2013) (physicians assistants, physical therapists, and nurse
practitioners do not qualify as physicians under FECA and, therefore, their medical reports do not qualify as
probative medical evidence, unless such medical reports are countersigned by a physician).
10

20 C.F.R. § 10.606(b)(3); see J.M., Docket No. 09-218 (issued July 24, 2009).

11

Id. at § 10.608(b); see K.H., 59 ECAB 495, 499 (2008).

12

See supra note 9.

13

See J.A., Docket No. 14-1719 (issued December 5, 2014) (material which is duplicative of that already
contained in the case record does not constitute a basis for reopening a case).

4

On appeal appellant maintains he submitted the proper documentation to OWCP. As
explained, the evidence submitted by appellant is insufficient
CONCLUSION
The Board finds that appellant did not meet his burden of proof to establish a medical
condition causally related to his employment. The Board also finds that OWCP properly denied
appellant’s request for reconsideration.
ORDER
IT IS HEREBY ORDERED THAT the March 9 and January 12, 2015 decisions of the
Office of Workers’ Compensation Programs are affirmed.
Issued: October 8, 2015
Washington, DC

Colleen Duffy Kiko, Judge
Employees' Compensation Appeals Board

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

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

5


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
S.B., Appellant
and
DEPARTMENT OF THE INTERIOR, BUREAU
OF INDIAN AFFAIRS, Sault Saint Marie, MI,
Employer
__________________________________________

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

Docket No. 08-662
Issued: August 26, 2008

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Chief Judge
DAVID S. GERSON, Judge
MICHAEL E. GROOM, Alternate Judge

JURISDICTION
On December 18, 2007 appellant filed a timely appeal of an August 24, 2007 decision of
the Office of Workers’ Compensation Programs, which suspended his compensation benefits
effective September 2, 2007 based on his failure to attend a second opinion medical examination.
He also appealed from an October 22, 2007 decision, which suspended his compensation
benefits based on his failure to submit a Form CA-1032, as required. Pursuant to 20 C.F.R.
§§ 501.2(c) and 501.3(d)(2), the Board has jurisdiction to review the merits of the case.
ISSUES
The issues are: (1) whether the Office properly suspended appellant’s compensation
benefits effective September 2, 2007, under 5 U.S.C. § 8123(d), on the grounds that he failed to
submit to a scheduled medical examination; and (2) whether the Office properly suspended
appellant’s compensation benefits for failure to submit a CA-1032 form when requested.

FACTUAL HISTORY
On August 2, 1989 appellant, then a 22-year-old emergency firefighter, sustained injury
when he was struck by a rock on the right knee causing him to fall on his right side. The Office
accepted his claim for a right patella subluxation and patella chondromalacia with surgery in
1990. Appellant stopped work on August 2, 1989 and did not return. The Office paid
appropriate wage-loss compensation and medical benefits. In a decision dated September 2,
1994, the Board affirmed an Office decision reducing his compensation benefits under section
8113(b) based on appellant’s failure to cooperate with vocational rehabilitation.1 The facts of the
case, as set forth in the prior decision, are incorporated herein by reference.
By letter dated March 19, 2007, the Office advised appellant that a second opinion
medical evaluation was necessary and that he would be made aware of the details by separate
notice.2 By letter dated June 25, 2007, it informed appellant that it contracted out the scheduling
of medical evaluations and that he would be contacted by the contract company once it
rescheduled his appointment.
By letter dated June 27, 2007, appellant was informed by QTC Medical Associates
(QTC) that an appointment for a second opinion examination was scheduled for August 8, 2007
with Dr. A. Creig MacArthur, a Board-certified orthopedic surgeon. The notice indicated that
there would be no charge to appellant to attend this examination.
On August 9, 2007 appellant contacted QTC to advise that he could not make his second
opinion appointment because he had received a telephone call which required him to go to Idaho.
He did not advise how long he would be gone or provide any contact information in Idaho.
On August 10, 2007 the Office issued a notice of proposed suspension of compensation
based on his failure to attend the August 8, 2007 medical appointment. Appellant was provided
14 days in which to submit a valid reason for failing to submit the scheduled examination. If he
did not show good cause, his entitlement to compensation would be suspended under 5 U.S.C.
§ 8123(d) until he attended and cooperated fully with the examination. Although appellant
contacted QTC and advised that he was required to go to Idaho, the circumstances of his
departure were not sufficiently explained.
On August 15, 2007 the Office sent appellant a Form CA-1032 to complete pertaining to
his receipt of compensation. He was asked to report any employment, volunteer work, and status
of dependents and receipt of any other federal benefits or payments. Appellant was advised to
return the statement within 30 days, otherwise his benefits would be suspended in accordance
with 20 C.F.R. § 10.528.

1

45 ECAB 902 (1994).

2

Appellant was initially referred for evaluation with Dr. Alfred C. Lotman, a Board-certified orthopedic surgeon.
However, as he was in the process of relocating to Utah, notice of the appointment was not received in a timely
manner.

2

By decision dated August 24, 2007, the Office finalized the August 10, 2007 notice of
proposed suspension of compensation under 5 U.S.C. § 8123(d) effective September 2, 2007. It
was noted that appellant failed to attend an examination and did not provide information to
support his nonattendance.3
By letter dated September 18, 2007, the Office informed appellant that he had not
responded to the CA-1032 form request for earnings and dependency information. It advised
appellant that if he did not complete and return the form within 30 days of the date of the letter,
his compensation benefits would be suspended as provided at 20 C.F.R. § 10.528. Appellant did
not respond.
By decision dated October 22, 2007, the Office suspended appellant’s compensation
benefits as of October 28, 2007 based on his failure to report earnings and employment
information as required. It noted that, if appellant completed and returned an enclosed copy of
the CA-1032 form, his compensation benefits would be restored retroactively to October 28,
2007 provided that he complied with the attendance of the second opinion examination.
LEGAL PRECEDENT -- ISSUE 1
Section 8123 of the Federal Employees’ Compensation Act authorizes the Office to
require an employee, who claims disability as a result of federal employment, to undergo a
physical examination as it deems necessary.4 The determination of the need for an examination,
the type of examination and choice of locale and the choice of medical examiners are matters
within the province and discretion of the Office.5 The Office’s federal regulations, at section
10.320, provide that a claimant must submit to examination by a qualified physician as often and
at such time and place as the Office considers reasonably necessary.6 Section 8123(d) of the Act
and section 10.323 of the Office’s regulations provide that if an employee refuses to submit to or
obstructs a directed medical examination his or her compensation is suspended until the refusal
or obstruction ceases.7 However, before the Office may invoke these provisions, the employee is
provided a period of 14 days within which to present in writing his or her reasons for the refusal
or obstruction.8 If good cause for the refusal or obstruction is not established, entitlement to
compensation is suspended in accordance with section 8123(d) of the Act.9
3

Following issuance of this decision, appellant submitted a September 11, 2007 letter addressing the suspension
of his benefits under section 8123(d). The Board notes that, as the Office did not consider this evidence, it may not
be reviewed by the Board for the first time on appeal. See 20 C.F.R. § 501.2(c).
4

5 U.S.C. § 8123(a).

5

S.B., 58 ECAB ___ (Docket No. 06-1838, issued January 11, 2007); James C. Talbert, 42 ECAB 974 (1991).

6

20 C.F.R. § 10.320; see Dana D. Hudson, 57 ECAB 298 (2006).

7

5 U.S.C. § 8123(d); 20 C.F.R. § 10.323. See Sharon Handy, 57 ECAB 446 (2006).

8

Federal (FECA) Procedure Manual, Part 2 -- Claims, Developing and Evaluating Medical Evidence, Chapter
2.810.14(d) (July 2000).
9

Id.; see Scott R. Walsh, 56 ECAB 353 (2005); Raymond C. Dickison, 48 ECAB 646 (1997).

3

ANALYSIS -- ISSUE 1
On June 27, 2007 appellant was advised that a second opinion medical examination was
scheduled for August 8, 2007. The record reflects that he did not attend the appointment.
However, on August 9, 2007, appellant contacted QTC to advise that he had received a telephone
call that required him to go to Idaho. No other information for his failure to attend the medical
examination was provided. On August 10, 2007 the Office properly advised appellant of his
failure to attend the August 8, 2007 medical appointment and provided 14 days to submit a valid
reason for his failure to attend. No timely response was forthcoming.10 By decision dated
August 24, 2007, the Office suspended his compensation benefits, effective September 2, 2007,
pursuant to section 8123(d) of the Act.11
Appellant’s refusal to submit to the scheduled medical examination warrants suspension
of compensation unless he can establish good cause for his failure to attend.12 On August 10,
2007 the Office allowed appellant 14 days to provide a valid reason for failing to submit to the
examination. Appellant was properly informed that if he did not show good cause, his
entitlement to compensation would be suspended until he fully cooperated with the examination.
As noted, he did not file a timely response. Therefore, he did not establish good cause for not
attending the scheduled medical examination and the Office properly suspended his benefits.
LEGAL PRECEDENT -- ISSUE 2
Under section 10.528 of the Office’s implement federal regulations, an employee in
receipt of compensation benefits must complete an affidavit as to any work or activity indicating
an ability to work which the employee has performed for the prior 15 months.13 If an employee
who is required to file such a report fails to do so within 30 days of the date of the request, his or
her right to compensation for wage loss is suspended until the Office receives the requested
report. At that time, the Office will reinstate compensation retroactive to the date of suspension
if the employee remains entitled to compensation.14
ANALYSIS -- ISSUE 2
On August 15, 2007 the Office requested that appellant complete and return an CA-1032
form concerning the status of his employment and any dependents. The record reflects that the
Office’s letter was properly addressed and sent to appellant’s residence. Appellant did not return
a completed CA-1032 form to the Office within the time period allowed. As he failed to
complete and return the form to the Office, it properly suspended his wage-loss compensation
pursuant to the implementing federal regulations.
10

See supra note 3.

11

5 U.S.C. § 8123(d); 20 C.F.R. § 10.323.

12

See supra note 6.

13

20 C.F.R. § 10.528.

14

Id.; see also 20 C.F.R. § 10.525; Robert A. Robbins, Docket No. 05-728 (issued July 15, 2005).

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On appeal, appellant contends that he was not provided a notice of appeal rights as an
attachment to the September 2, 2007 decision or a response to his September 11, 2007 letter,
which he contends served as an exercise of his appellate rights. The Board notes that the record
contains a copy of the September 2, 2007 decision complete with an attached notice of appeal
rights. The evidence therefore does not support his contention that he was not properly apprised
of his appellate rights by the Office. As noted, his September 11, 2007 letter is new evidence
which may not be reviewed by the Board for the first time on appeal.
CONCLUSION
The Board finds that the Office properly suspended appellant’s compensation benefits
effective September 2, 2007 based on his failure to submit to a scheduled medical examination.
The Board also finds that the Office properly suspended appellant’s compensation benefits based
on his failure to timely submit a completed CA-1032 form when requested.
ORDER
IT IS HEREBY ORDERED THAT the decisions of the Office of Workers’
Compensation Programs dated October 22 and August 24, 2007 are affirmed.
Issued: August 26, 2008
Washington, DC

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

David S. Gerson, Judge
Employees’ Compensation Appeals Board

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

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
T.N., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
South Hackensack, NJ, Employer
__________________________________________

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Appearances:
James D. Muirhead, Esq., for the appellant
Office of Solicitor, for the Director

Docket No. 14-1733
Issued: December 2, 2014

Case Submitted on the Record

DECISION AND ORDER
Before:
COLLEEN DUFFY KIKO, Judge
MICHAEL E. GROOM, Alternate Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On August 6, 2014 appellant, through his attorney, filed a timely appeal from a June 2,
2014 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to
the Federal Employees’ Compensation Act1 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the
Board has jurisdiction over the merits of this case.
ISSUE
The issue is whether appellant sustained an injury on October 16, 2012 in the
performance of duty.
FACTUAL HISTORY
On October 26, 2012 appellant, then a 51-year-old city carrier, filed a traumatic injury
claim alleging that on October 16, 2012 he sprained his lower back pushing two hampers onto a

1

5 U.S.C. § 8101 et seq.

lift.2 He stopped work on October 16, 2012. The employing establishment controverted the
claim, contending that appellant had a prior unreported injury to his back, but did not know when
the injury occurred.3
By letter dated November 6, 2012, OWCP requested that appellant submit additional
factual and medical information, including a detailed report from his attending physician
addressing the causal relationship between any diagnosed condition and the October 16, 2012
work incident. No response was received.
In a decision dated December 7, 2012, OWCP denied appellant’s claim. It found that he
did not establish that the October 16, 2012 work incident occurred as alleged.
In a report dated October 22, 2012, Dr. Robert Greenblum, a Board-certified orthopedic
surgeon, found tenderness of the right paravertebral muscles especially at S1 on the right and
reduced spinal motion with intact motor strength and sensation. He diagnosed lumbar strain and
right sacroiliitis. Dr. Greenblum recommended physical therapy. In a disability certificate dated
October 22, 2012, he diagnosed acute lumbar strain and found that appellant should not work.
In a report dated November 13, 2012, Dr. Greenblum discussed appellant’s complaints of
continued low back pain radiated into his lower right extremity. He diagnosed persistent lumbar
strain and sacroiliitis and radiculitis on the right side. In a disability certificate dated
November 13, 2012, Dr. Greenblum found that appellant could not work.
A November 15, 2012 magnetic resonance imaging (MRI) scan study showed a disc
bulge at L4-5 “with [a] concomitant right foraminal herniated disc compressing the right L4
nerve,” disc space narrowing and desiccation and a disc bulge at L5-S1 with endplate
hypertrophic changes.
In a disability certificate dated November 27, 2012, Dr. Greenblum diagnosed acute
lumbar strain, lumbar radiculitis and a herniated disc. He found that appellant was disabled from
employment. In a narrative report dated November 27, 2012, Dr. Greenblum evaluated appellant
for continued complaints of low back discomfort with right leg pain. He noted that the
November 15, 2012 MRI scan study revealed a right foraminal L4-5 herniated disc with right L4
nerve root compression. Dr. Greenblum diagnosed an L4-5 herniated disc with compression on
the right at L4, lumbar strain, right sacroiliitis and right lumbar radiculitis.
On December 17, 2012 appellant, through his attorney, requested a telephone hearing
before an OWCP hearing representative. At the March 12, 2013 hearing, appellant described the
October 16, 2012 work incident. He related that he did not initially inform Dr. Greenblum that
he had sustained an injury on the job because he believed that he needed medical approval.
Appellant sought medical treatment on October 16, 2012 from an urgent care facility. He noted
having received prior treatment for a back condition. The hearing representative advised

2

Appellant referred to the hampers as “pumpkins.”

3

The employing establishment submitted statements regarding the October 16, 2012 incident.

2

appellant that he should submit a medical report discussing any prior back condition and the
October 16, 2012 work incident.
By decision dated May 30, 2013, the hearing representative affirmed the December 7,
2012 decision, as modified. She found that appellant established that the October 16, 2012 work
incident occurred as alleged. The hearing representative determined, however, that he had not
submitted sufficient medical evidence to establish his back condition was causally related to the
employment incident.
In a report dated June 26, 2013, Dr. Mark J. Ruoff, a Board-certified orthopedic surgeon,
related that in his February 27 and June 12, 2013 reports he obtained a history of appellant
sustaining an injury in October 2012 “sliding a mailbag into the back of a truck.” He specified
that the correct “mechanism of injury that occurred on October 16, 2012 was that he was moving
heavy hampers of mail between the mail truck and the loading dock. In fact, he was moving
hampers of mail onto a truck lift and then onto the truck.”
On August 7, 2013 appellant, through his attorney, requested reconsideration.
In a decision dated October 8, 2013, OWCP denied appellant’s request for
reconsideration. It found that he did not submit evidence or raise an argument sufficient to
warrant reopening the case for further review of the merits under 5 U.S.C. § 8128. It determined
that Dr. Ruoff’s June 26, 2013 report did not provide an opinion on causal relationship and thus
did not address the relevant issue.
On March 6, 2014 appellant, through his attorney, again requested reconsideration. He
submitted a June 12, 2013 report from Dr. Ruoff, who related that he had treated appellant since
February 27, 2013 for an injury at work in October 2012 that occurred when he experienced
significant pain sliding a mailbag into his truck. Dr. Ruoff noted that an MRI scan study showed
a disc herniation at L4-5. He advised that appellant was disabled following his injury. Dr. Ruoff
stated, “It is my opinion, based on his history provided and current symptomatology, that his
current condition is related to the injury of October 2012.”
By decision dated June 2, 2014, OWCP denied modification of its May 30, 2013
decision.
On appeal appellant’s attorney contends that the medical reports from Dr. Ruoff and from
Dr. Greenblum are sufficient to meet his burden of proof.
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 filed within the applicable time
limitation; that an injury was sustained while in the performance of duty as alleged; and that any
disability and/or specific condition for which compensation is claimed are causally related to the
4

5 U.S.C. § 8101 et seq.

3

employment injury.5 These are the essential elements of each and every compensation claim
regardless of whether the claim is predicated on a traumatic injury or an occupational disease.6
To determine whether an employee sustained a traumatic injury in the performance of
duty, OWCP must determine whether “fact of injury” is established. First, an employee has the
burden of demonstrating the occurrence of an injury at the time, place and in the manner alleged,
by a preponderance of the reliable, probative and substantial evidence.7 Second, the employee
must submit sufficient evidence, generally only in the form of medical evidence, to establish a
causal relationship between the employment incident and the alleged disability and/or condition
for which compensation is claimed.8 An employee may establish that the employment incident
occurred as alleged, but fail to show that his or her disability and/or condition relates to the
employment incident.9
ANALYSIS
Appellant alleged that he injured his lower back pushing two hampers onto a lift. OWCP
accepted that the October 16, 2012 incident occurred at the time, place and in the manner
alleged. The issue, consequently, is whether the medical evidence establishes that he sustained a
low back injury as a result of this incident.
The Board finds that appellant has not established that the October 16, 2012 employment
incident resulted in an injury. The determination of whether an employment incident caused an
injury is generally established by medical evidence.10
On October 22, 2012 Dr. Greenblum found tenderness of the right paravertebral muscles
and loss of spinal motion. He diagnosed lumbar strain and right sacroiliitis. On November 13,
2012 Dr. Greenblum diagnosed persistent lumbar strain and right-sided sacroiliitis and
radiculitis. In a report dated November 27, 2012, he noted that an MRI scan study showed a
right foraminal herniated disc at L4-5 with nerve root compression on the right at L4. In
disability certificates dated October 22 to November 27, 2012, Dr. Greenblum found that
appellant was disabled from employment. The Board finds, however, that Dr. Greenblum did
not address causation. Medical evidence that does not offer any opinion regarding the cause of
an employee’s condition is of limited probative value on the issue of causal relationship.11

5

Alvin V. Gadd, 57 ECAB 172 (2005); Anthony P. Silva, 55 ECAB 179 (2003).

6

See Elizabeth H. Kramm (Leonard O. Kramm), 57 ECAB 117 (2005); Ellen L. Noble, 55 ECAB 530 (2004).

7

David Apgar, 57 ECAB 137 (2005); Delphyne L. Glover, 51 ECAB 146 (1999).

8

Gary J. Watling, 52 ECAB 278 (2001); Shirley A. Temple, 48 ECAB 404, 407 (1997).

9

Id.

10

Lois E. Culver (Clair L. Culver), 53 ECAB 412 (2002).

11

K.W., 59 ECAB 271 (2007); A.D., 58 ECAB 149 (2006).

4

In the report dated June 12, 2013, Dr. Ruoff stated that he initially evaluated appellant on
February 27, 2013 for back pain that began after he slid a mailbag onto his truck in
October 2012. He diagnosed a herniated disc at L4-5 as demonstrated by MRI scan study.
Dr. Ruoff opined that appellant’s current condition arose from the October 2012 work incident
based on his history and symptoms. On June 26, 2013 he clarified the history of injury as
appellant injuring his back on October 16, 2012 moving mail hampers between a mail truck and
the loading dock. Dr. Ruoff, however, did not adequately explain his conclusion that the
herniated disc arose from the October 16, 2012 employment incident other than to generally note
that it was consistent with the history and symptoms. A physician must provide an opinion on
whether the employment incident described caused or contributed to the claimant’s diagnosed
medical condition and support that opinion with medical reasoning to demonstrate that the
conclusion reached is sound, logical and rationale.12 Further, Dr. Ruoff did not discuss
appellant’s history of prior back condition. Medical conclusions based on an incomplete factual
history are of diminished probative value.13
On appeal counsel argues that the medical reports of Drs. Greenblum and Ruoff are
sufficient to meet appellant’s burden to establish an employment injury on October 16, 2012. As
discussed, however, Dr. Greenblum did not address causation and Dr. Ruoff did not provide
sufficient rationale for his conclusion; consequently, their reports are of diminished probative
value. An award of compensation may not be based on surmise, conjecture, speculation or upon
appellant’s own belief that there is a causal relationship between his claimed condition and his
employment.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 and
20 C.F.R. §§ 10.605 through 10.607.
CONCLUSION
The Board finds that appellant has not established that he sustained an injury on
October 16, 2012 in the performance of duty.

12

John W. Montoya, 54 ECAB 306 (2003).

13

See M.W., 57 ECAB 710 (2006).

14

D.E., 58 ECAB 448 (2007); George H. Clark, 56 ECAB 162 (2004); Patricia J. Glenn, 53 ECAB 159 (2001).

5

ORDER
IT IS HEREBY ORDERED THAT the June 2, 2014 decision of the Office of Workers’
Compensation Programs is affirmed.
Issued: December 2, 2014
Washington, DC

Colleen Duffy Kiko, 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
__________________________________________
N.D., Appellant
and
DEPARTMENT OF THE ARMY, ARMY CORP
OF ENGINEERS, Louisville, KY, Employer
__________________________________________

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

Docket No. 13-515
Issued: May 15, 2013

Case Submitted on the Record

DECISION AND ORDER
Before:
PATRICIA HOWARD FITZGERALD, Judge
ALEC J. KOROMILAS, Alternate Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION
On December 27, 2012 appellant filed a timely appeal from a decision of the Office of
Workers’ Compensation Programs (OWCP) dated September 26, 2012. Pursuant to the Federal
Employees’ Compensation Act1 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has
jurisdiction over the merits of this case.
ISSUE
The issue is whether appellant has established that he sustained an aggravation of his
preexisting sacroiliac joint dysfunction condition on January 26, 2012.
FACTUAL HISTORY
On January 26, 2012 appellant, a 62-year-old lock and dam operator, filed a claim for
benefits, alleging that he injured his lower back while picking up large electrical cables. He
submitted several form reports from Brad Hutchins, a physician’s assistant, which noted
1

5 U.S.C. § 8101 et seq.

complaints of back pain on examination and indicated that he had sacroiliac (SI) joint
dysfunction.
By letter to appellant dated February 8, 2012, OWCP advised him that it required
additional factual and medical evidence to determine whether he was eligible for compensation
benefits. It asked him to submit a comprehensive medical report from his treating physician
describing his symptoms and the medical reasons for his condition, and an opinion as to whether
his claimed condition was causally related to the alleged January 26, 2012 work incident.
In a Form CA-20 co-signed by Dr. Ted Davies, a specialist in neurosurgery, it was
indicated that appellant had tenderness in his lower back. Dr. Davies related that appellant
injured his lower back on January 26, 2012 while picking up electrical cables and diagnosed
lumbar disc displacement and SI joint dysfunction. He checked a box indicating that the
condition found was caused or aggravated by an employment activity.
By decision dated March 19, 2012, OWCP denied appellant’s claim, finding that he failed
to submit sufficient medical evidence in support of his claim that sustained an aggravation of his
preexisting SI joint dysfunction condition on January 26, 2012.
On April 18, 2012 appellant requested an oral hearing, which was held on
August 10, 2012. He stated at the hearing that he initially injured his lower back in 2007 and
that he reinjured his back on January 26, 2012.2
In reports dated May 9 and July 1, 2011, received by OWCP on April 3, 2012,
Dr. Monte E. Rummelman, Board-certified in physical medicine and rehabilitation, noted
complaints of lower back pain and found that appellant had left S1 joint dysfunction. He stated
that a lumbar magnetic resonance imaging (MRI) scan indicated L5-S1 disc protrusion.
In a January 26, 2012 Form CA-20 co-signed by Dr. Davies, it was indicated that
appellant had experienced pain while bending over to pick up electrical cables on
January 26, 2012. He checked a box indicating that the condition found was caused or
aggravated by an employment activity.
By decision dated September 26, 2012, an OWCP hearing representative affirmed the
March 19, 2012 decision.
LEGAL PRECEDENT
An employee seeking benefits under FECA3 has the burden of establishing that 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
2

The hearing representative noted that appellant had accepted two other OWCP claims: claim number
xxxxxx326, for a February 17, 2003 slip and fall, which OWCP accepted for lumbar strain, cervical strain and left
hip strain; and claim number xxxxxx905, for an April 9, 2007 injury sustained when he bent over to move electric
cable, which OWCP accepted for displacement of lumbar intervertebral disc without myelopathy.
3

5 U.S.C. §§ 8101-8193.

2

time limitation period 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 are
causally related 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 whether a federal employee has sustained a traumatic injury in the
performance of duty, it must first be determined whether a “fact of injury” has been established.
First, the employee must submit sufficient evidence to establish that he or she actually experienced
the employment incident at the time, place and in the manner alleged.6 Second, the employee must
submit sufficient evidence, generally only in the form of medical evidence, to establish that the
employment incident caused a personal injury.7
The Board has held that the mere fact that a condition manifests itself during a period of
employment does not raise an inference that there is a causal relationship between the two.8
An award of compensation may not be based on surmise, conjecture or speculation.
Neither, the fact that appellant’s condition became apparent during a period of employment nor
the belief that his condition was caused, precipitated or aggravated by his employment is
sufficient to establish causal relationship.9 Causal relationship must be established by
rationalized medical opinion evidence and appellant failed to submit such evidence.
ANALYSIS
It is uncontested that appellant experienced back pain while picking up electrical cables on
January 26, 2012. The question of whether an employment incident caused a personal injury can
only be established by probative medical evidence.10 Appellant has not submitted rationalized,
probative medical evidence to establish that the January 26, 2012 employment incident caused a
personal injury and that the work accident would have been competent to cause the claimed injury.
Appellant submitted reports from Drs. Davies and Rummelman. The weight of medical
opinion is determined by the opportunity for and thoroughness of examination, the accuracy and
completeness of a physician’s knowledge of the facts of the case, the medical history provided,
the care of analysis manifested and the medical rationale expressed in support of stated

4

Joe D. Cameron, 41 ECAB 153 (1989); Elaine Pendleton, 40 ECAB 1143 (1989).

5

Victor J. Woodhams, 41 ECAB 345 (1989).

6

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

7

Id. For a definition of the term “injury,” see 20 C.F.R. § 10.5(ee).

8

See Joe T. Williams, 44 ECAB 518, 521 (1993).

9

Id.

10

Carlone, supra note 6.

3

conclusions.11 Appellant did not provide a report from a physician which presented a diagnosis
of appellant’s condition and sufficiently addressed how this condition was causally related to the
January 26, 2012 work incident. The medical reports from Dr. Davies did not explain how
medically appellant would have sustained an aggravation of his preexisting sacroiliac joint
dysfunction condition while picking up electrical cables on January 26, 2012. He merely cosigned form reports from a physician’s assistant which indicated causal relationship with a
checkmark and offered no medical explanation of their opinions.12 Thus Dr. Davies’ opinion
regarding causal relationship is of limited probative value in that he did not provide adequate
medical rationale in support of his conclusions.13 He did not adequately describe appellant’s
accident or how the accident would have caused the claimed condition. The May and June 2011
reports from Dr. Rummelman are of limited probative value because they predate the alleged
January 26, 2012 work incident.
Appellant has also submitted reports and notes signed by a nurse practitioner and a
physician’s assistant. Because healthcare providers such as nurses, acupuncturists, physicians’
assistants and physical therapists are not considered “physicians” under FECA, their reports and
opinions do not constitute competent medical evidence to establish a medical condition,
disability or causal relationship.14 Therefore, the reports signed by the nurse practitioner and
physical therapist do not constitute competent medical evidence and are insufficient to satisfy
appellant’s burden. There is, therefore, no rationalized evidence in the record that appellant’s
low back injury was work related. Therefore, appellant failed to provide a medical report from a
physician that explains how the work incident of January 26, 2012 caused or contributed to the
claimed aggravation of his preexisting SI joint dysfunction condition.
OWCP advised appellant of the evidence required to establish his claim; however,
appellant failed to submit such evidence. Appellant did not provide a medical opinion which
describes or explains the medical process through which the January 26, 2012 work accident
would have caused the claimed injury. Accordingly, he did not establish that he sustained an
aggravation of his preexisting SI joint dysfunction condition in the performance of duty. OWCP
properly denied appellant’s claim for compensation.
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.

11

See Anna C. Leanza, 48 ECAB 115 (1996).

12

See Calvin E. King, 51 ECAB 394, 400 (2000) (numerous form reports from a physician who checked a “yes”
box indicating a causal relationship between appellant’s spinal stenosis and his employment had little probative
value absent supporting rationale and were insufficient to establish causation).
13

William C. Thomas, 45 ECAB 591 (1994).

14

5 U.S.C. § 8101(2); see also G.G., 58 ECAB 389 (2007); Jerre R. Rinehart, 45 ECAB 518 (1994); Barbara J.
Williams, 40 ECAB 649 (1989); Jan A. White, 34 ECAB 515 (1983).

4

CONCLUSION
The Board finds that appellant has failed to establish that he sustained an aggravation of
his preexisting SI joint dysfunction condition on January 26, 2012.
ORDER
IT IS HEREBY ORDERED THAT the September 26, 2012 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: May 15, 2013
Washington, DC

Patricia Howard Fitzgerald, Judge
Employees’ Compensation Appeals Board

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

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

5


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
H.L., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Westport, CT, Employer
__________________________________________

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

Docket No. 10-2011
Issued: June 23, 2011

Case Submitted on the Record

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

JURISDICTION
On August 3, 2010 appellant filed a timely appeal from a July 15, 2010 merit decision of
the Office of Workers’ Compensation Programs denying his claim. Pursuant to the Federal
Employees’ Compensation Act1 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 his burden of proof to establish that he sustained
an occupational disease in the performance of duty.
FACTUAL HISTORY
On January 6, 2009 appellant, then a 37-year-old mail carrier, filed an occupational
disease claim alleging that he sustained a work-related injury due to his federal employment on
or before December 15, 2008. He did not describe the specific nature of his injury, but indicated
1

5 U.S.C. § 8101 et seq.

that he had surgery for a torn ligament in his left hand and his left wrist did not get better.
Appellant denied any nonemployment cause of his conditions. The employing establishment
noted that he had been out of work since June 2008.
In a December 15, 2008 report, Dr. David B. Brown, a Board-certified orthopedic
surgeon, stated that appellant was followed for a June 6, 2008 work-related injury. He noted
appellant’s complaints of ongoing neck pain with a sense of radiation to the shoulders and upper
arms. A December 9, 2008 electromyogram (EMG) of both arms was remarkable for cervical
radiculopathy involving C5 and C6, right side more severe than left. Dr. Brown noted
moderately severe median neuropathy of the wrist, right equal to left. He stated that a
December 3, 2008 magnetic resonance imaging (MRI) scan of the lumbar spine was negative.
Dr. Brown assessed right cervical radiculopathy and bilateral carpal tunnel symptomatology. A
consultation with a neurosurgeon was recommended.
In a January 13, 2009 letter, the Office advised appellant that it was unable to determine
whether he was eligible for benefits under the Act as he failed to state what work duties caused
or aggravated his condition or identify the medical condition he was claiming. It noted that
Dr. Brown appeared to relate an injury that occurred prior to the date claimed. Appellant was
requested to provide additional factual and medical evidence, including a rationalized opinion
from his physician explaining how work activities caused a claimed condition. The Office also
requested the employing establishment to provide a description of his work duties.
In a January 20, 2009 letter, the employing establishment questioned how appellant’s
carpal tunnel condition arising on or about December 15, 2008 could be related to work as he
had not worked since June 2008 due to a different injury.
By decision dated February 27, 2009, the Office denied appellant’s finding that he failed
to provide a statement identifying specific employment factors or conditions he felt caused or
contributed to a claimed condition.
On March 18, 2009 appellant requested an oral hearing which was held on
September 29, 2009. He testified that he had injured his neck and also had a lot of pain in his
hands. Appellant stated that the physicians did not know the cause of his pain but that a
December 9, 2008 EMG showed that he had carpal tunnel syndrome in both hands. His hand
symptoms began before he was treated for a torn ligament in the left hand. Appellant worked
sorting mail for about 17-1/2 years which involved repetitive motion, lifting and grabbing and
holding. He felt his work duties were responsible for his carpal tunnel condition. Appellant
noted that his neck condition was a work-related injury that occurred on June 6, 2008 and that he
had neck surgery on March 12, 2009.2 A copy of his March 12, 2009 surgical report for his
cervical disc herniation at C4-C5, C5-C6 and C6-C7 was submitted to the record.
At the hearing appellant submitted a December 9, 2008 EMG report, which found
moderately severe median neuropathy at both the right and left wrist; a copy of Dr. Brown’s
December 15, 2008 report, previously of record and two September 23, 2009 reports from
Dr. Craig G. Gunderson, a Board-certified internist, who noted that appellant was seeking
2

The claim for the June 6, 2008 injury is not before the Board on the present appeal.

2

workers’ compensation for carpal tunnel syndrome and reported bilateral hand symptoms of
cramping, swelling and joint discomfort. A nerve conduction study of October 2008 showed
bilateral “moderately severe” median neuropathy (carpal tunnel syndrome). Dr. Gunderson
stated that appellant attributed his hand and wrists symptoms to the repetitive motion of his
work. Appellant reported that he worked as a letter carrier for 17 years, which included sorting
mail daily for two to four hours a day and involved constantly picking up letters and sorting them
into mail slots. Dr. Gunderson noted that the October 2008 nerve conduction study showed
bilateral “moderately severe” carpal tunnel syndrome.
In an October 21, 2009 statement, appellant detailed his job duties. He concluded that his
repetitive work activity over many years led to his bilateral carpal tunnel syndrome.
In a December 15, 2009 decision, an Office hearing representative affirmed the denial of
the claim to find that the medical evidence did not establish that the claimed bilateral carpal
tunnel syndrome was causally related to appellant’s work duties.
Appellant requested reconsideration and submitted copies of material previously of
record. He submitted a copy of a December 23, 2009 EMG study, noting moderate to severe left
cubital tunnel syndrome and mild bilateral carpal tunnel syndrome; an undated statement; a
February 25, 2010 written inquiry from his congressman and a March 4, 2010 Office response to
the congressman; medical reports regarding a June 1, 2006 injury3; a January 10, 2010 letter
from a union representative; a May 12, 2010 treatment note from an occupational therapist and a
May 12, 2010 cervical spine x-ray report.
In a November 2, 2009 report, Dr. Thomas P. Moran, a Board-certified orthopedic
surgeon, treated appellant for de Quervain’s tendinitis following a June 1, 2006 work injury. He
stated that Dr. Brown had performed a de Quervain’s release and that appellant also had a
previous cervical fusion. Dr. Moran advised that appellant recently complained of hand
numbness and that a recent EMG was consistent with moderately severe carpal tunnel syndrome.
He opined that appellant’s bilateral carpal tunnel syndrome was “likely work related.” In a
January 15, 2010 report, Dr. Moran noted findings and listed an impression of advanced cubital
tunnel syndrome and mild carpal tunnel syndrome. He opined both conditions were work related
and should be addressed surgically.
By decision dated July 15, 2010, the Office denied modification of its previous decision.
LEGAL PRECEDENT
An employee seeking benefits under the Act4 has the burden of establishing the essential
elements of his or her claim including the fact that the individual is an employee of the United
States within the meaning of the Act, that the claim was filed within the applicable time
3

This claim number xxxxxx018, was accepted for left radial styloid tenosynovitis or de Quervain’s disease.
Matters regarding this claim are subject to a separate appeal that is proceeding before the Board. Docket
No. 10-2073.
4

5 U.S.C. §§ 8101-8193.

3

limitation of the Act, 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 are 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 occupational disease.5
To establish that an injury was sustained in the performance of duty in a claim for
occupational disease, an employee must submit: (1) a factual statement identifying employment
factors alleged to have caused or contributed to the presence or occurrence of the disease or
condition; (2) medical evidence establishing the presence or existence of the disease or condition
for which compensation is claimed; and (3) medical evidence establishing that the diagnosed
condition is causally related to the employment factors identified by the employee.6
To establish a causal relationship between the condition, as well as any attendant
disability, claimed and the employment event or incident, the employee must submit rationalized
medical opinion evidence, based on a complete factual and medical background, supporting such
a causal relationship.7 Rationalized medical opinion evidence is medical evidence which
includes a physician’s rationalized opinion on the issue of whether there is a causal relationship
between the claimant’s diagnosed condition and the implicated employment factors. The
opinion of the physician must be based on a complete factual and medical background of the
claimant, must be one of reasonable medical certainty and must be supported by medical
rationale explaining the nature of the relationship between the diagnosed condition and the
specific employment factors identified by the claimant.8 The weight of medical evidence is
determined by its reliability, its probative value, its convincing quality, the care of analysis
manifested and the medical rationale expressed in support of the physician’s opinion.9
ANALYSIS
The Board finds that appellant did not meet his burden of proof to establish that
employment factors caused or aggravated his claimed bilateral carpal tunnel syndrome.
Dr. Brown provided an assessment of right cervical radiculopathy and bilateral carpal
tunnel symptomatology. As he appeared to relate these conditions to a June 6, 2008 workrelated injury, his opinion has limited probative value in establishing appellant’s claim for a
condition arising on or about December 15, 2008. Additionally, Dr. Brown offered no rationale
for his opinion on causal relationship to explain how particular work factors caused or

5

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

6

See Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. Fish, 46 ECAB 276, 279 (1994).

7

Id.

8

Leslie C. Moore, 52 ECAB 132 (2000).

9

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).

4

aggravated his bilateral carpal tunnel syndrome. Where no such rationale is present, the medical
opinion is of diminished probative value.10
The record contains two September 23, 2009 reports from Dr. Gunderson, which note
that appellant has bilateral “moderately severe” carpal tunnel syndrome based on an
October 2008 nerve conduction study. However, in both reports, Dr. Gunderson did not offer a
specific opinion regarding the cause of appellant’s condition. The Board has long held that
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.11 While
Dr. Gunderson noted in one report that appellant attributes his condition to the repetitive motion
of his sorting duties, he did not offer his own opinion on the causal relationship of appellant’s
diagnosed condition. Therefore, his reports are insufficient to meet appellant’s burden of proof.
In a November 2, 2009 report, Dr. Moran found moderately severe carpal tunnel
syndrome that he noted to be “likely work related.” In his January 15, 2010 report, he provided
an impression of advanced cubital tunnel syndrome and mild carpal tunnel syndrome. Dr. Moran
opined that both conditions were work related. However, his opinion on causal relationship is of
limited probative value in that he did not offer or provide medical rationale in which he
explained how particular work factors caused or aggravated the diagnosed conditions.
Dr. Moran did not describe appellant’s work duties or indicate any knowledge of such duties
such that it could have been the cause of appellant’s diagnosed conditions. Thus, his report is
insufficient to support appellant’s claim.
The remaining medical evidence of record, including reports of MRI scans, x-rays and
other diagnostic tests, which do not contain an opinion on causal relationship, are insufficient to
establish that appellant’s bilateral carpal tunnel syndrome is causally related to employment
factors.
Appellant expressed his belief that his bilateral carpal tunnel condition was related to his
work duties of sorting mail. The Board has held that the mere fact that a condition manifests
itself during a period of employment does not raise an inference that there is a causal relationship
between the two.12 Neither the fact that the condition became apparent during a period of
employment nor the belief that the condition was caused or aggravated by employment factors or
incidents, is sufficient to establish causal relationship.13 Causal relationship must be
substantiated by reasoned medical opinion evidence, which it is appellant’s responsibility to
submit.
As there is no probative, rationalized medical evidence addressing how appellant’s
claimed carpal tunnel condition was caused or aggravated by his employment, he has not met his
burden of proof to establish his claim.
10

T.M., Docket No. 08-975 (issued February 6, 2009).

11

Michael Smith, 50 ECAB 313 (1999).

12

See Joe T. Williams, 44 ECAB 518, 521 (1993).

13

Id.

5

On appeal, appellant contends that the medical evidence has established that he sustained
an injury in the performance of duty. For reasons stated, the Board finds that the evidence is
insufficient to establish that he sustained an injury in the performance of duty causally related to
factors of his federal employment.
CONCLUSION
The Board finds that appellant had failed to establish that he sustained bilateral carpal
tunnel syndrome causally related to factors of his federal employment.
ORDER
IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’
decision dated July 15, 2010 is affirmed.
Issued: June 23, 2011
Washington, DC

Alec J. Koromilas, Judge
Employees’ Compensation Appeals Board

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

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

6