United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
A.W., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Romeo, MI, Employer
__________________________________________

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

Docket No. 19-0327
Issued: July 19, 2019

Case Submitted on the Record

DECISION AND ORDER
Before:
CHRISTOPHER J. GODFREY, Chief Judge
JANICE B. ASKIN, Judge
ALEC J. KOROMILAS, Alternate Judge

JURISDICTION
On November 26, 2018 appellant filed a timely appeal from a June 22, 2018 merit decision
and a September 26, 2018 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 this case.2
ISSUES
The issues are: (1) whether appellant has met her burden of proof to establish a right arm
condition causally related to the accepted April 30, 2018 employment incident; and (2) whether

1
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.

OWCP properly denied appellant’s request for reconsideration of the merits of her claim pursuant
to 5 U.S.C. § 8128(a).
FACTUAL HISTORY
On May 2, 2018 appellant, then a 33-year-old mail clerk, filed a traumatic injury claim
(Form CA-1) alleging that on April 30, 2018 she sustained a right arm condition after throwing
over a thousand parcels of mail while in the performance of duty. She stopped work on May 2,
2018 and returned to limited-duty work on May 3, 2018.
In a May 2, 2018 attending physician’s report (Form CA-20) Dr. Susan A. Bidigare, a
Board-certified family practitioner, reported that appellant was moving packages and felt pain in
her right shoulder and upper arm. She diagnosed a right shoulder strain and indicated by checking
a box marked “yes” that the condition was caused or aggravated by the described employment
activity. In an accompanying May 2, 2018 duty status report (Form CA-17) Dr. Bidigare
diagnosed a right shoulder strain due to an April 30, 2019 incident and indicated that appellant
could return to work on May 2, 2018 with restrictions.
In a May 4, 2018 report, Cherise A. Short, a certified physician assistant, diagnosed right
arm strain. She indicated that appellant was working modified activity and that such restricted
activity was in effect until the next physician visit. In another May 4, 2018 report, Ms. Short noted
a date of injury of April 30, 2018 and provided an assessment of right shoulder strain and strain of
the right trapezius muscle. This report was also countersigned by an osteopathic physician, but
the signature is illegible.
In a May 4, 2018 duty status report (Form CA-17) Dr. James W. Collins, a specialist in
emergency medicine, related that appellant’s cervical, trapezius, and right shoulder strains were
due to sorting parcels on April 30, 2018.
In a development letter dated May 14, 2018, OWCP informed appellant that the evidence
of record was insufficient to establish her traumatic injury claim. Appellant was advised of the
type of factual and medical evidence needed to establish her claim and was afforded 30 days to
submit the necessary evidence.
In response, OWCP received a May 10, 2018 offer of modified assignment and copies of
physical therapy reports dated from May 4 to 24, 2018.
OWCP also received a May 2, 2018 report from Dr. Bidigare. Dr. Bidigare related that
appellant’s injury occurred on April 30, 2018 while lifting and sorting packages while at work.
She noted examination findings and provided an assessment of right shoulder strain. Appellant
was placed on modified work activity and referred to physical therapy.
In a May 10, 2018 report, Dr. Collins noted appellant’s right shoulder examination findings
and provided an assessment of right shoulder strain and strain of her right trapezius muscle. He
also provided a May 10, 2018 work activity status report noting appellant’s work restrictions.

2

In a May 17, 2018 report, Dr. Zaid Hanoudi, a Board-certified family practitioner, noted
appellant’s April 30, 2018 date of injury and diagnosed a right shoulder strain and right trapezius
muscle strain. He recommended that appellant continue performing modified duty.
On May 24, 2018 Dr. Collins released appellant from care and advised that she could return
to full work activity.
By decision dated June 22, 2018, OWCP denied appellant’s claim finding that the medical
evidence of record was insufficient to establish that the diagnosed medical conditions were
causally related to the accepted employment incident.
On August 27, 2018 appellant requested reconsideration. Physical therapy reports were
received which summarized appellant’s May 2018 physical therapy sessions.
Appellant also resubmitted a number of reports, including a May 4, 2018 report from
Ms. Short, a May 10, 2018 report from Dr. Collins, and a May 17, 2018 report from Dr. Hanoudi.
By decision dated September 26, 2018, OWCP denied appellant’s request for
reconsideration.
LEGAL PRECEDENT -- ISSUE 1
An employee seeking benefits under FECA has the burden of proof to establish the
essential elements of his or her claim, including the fact that the individual is an employee of the
United States within the meaning of FECA,3 that the claim was filed within the applicable time
limitation, that an injury was sustained while in the performance of duty as alleged, and that any
disability or specific condition for which compensation is claimed is causally related to the
employment injury.4 These are the essential elements of every compensation claim regardless of
whether the claim is predicated on a traumatic injury or an occupational disease.5
In order to determine whether an employee actually sustained an injury in the performance
of duty, OWCP begins with an analysis of whether fact of injury has been established. Fact of
injury consists of two components which must be considered in conjunction with one another. The
first component to be established is that the employee actually experienced the employment

3

S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB
153 (1989).
4

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40
ECAB 312 (1988).
5
K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014);
Delores C. Ellyett, 41 ECAB 992 (1990).

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incident which is alleged to have occurred.6 The second component is whether the employment
incident caused a personal injury and generally can be established only by medical evidence.7
To establish 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 supporting such causal relationship.8 Causal relationship is a medical issue, and
the medical evidence required to establish causal relationship is rationalized medical evidence.9
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 employee.10 Neither the mere fact that a disease or condition
manifests itself during a period of employment, nor the belief that the disease or condition was
caused or aggravated by employment factors or incidents is sufficient to establish causal
relationship.11
ANALYSIS -- ISSUE 1
The Board finds that appellant has not met her burden of proof to establish a right arm
condition causally related to the accepted April 30, 2018 employment incident.
OWCP received May 2, 2018 reports from Dr. Bidigare, who diagnosed a right shoulder
strain due to the April 30, 2018 employment incident and placed appellant on modified work
activity. Dr. Bidigare indicated by checking a box marked “yes” on her Form CA-20 attending
physician’s report, that appellant’s injury was causally related to moving packages while in the
performance of duty. The Board has held that a physician’s opinion on causal relationship which
consists only of checking a box marked “yes” to a form question, without explanation or rationale,
is of diminished probative value and is insufficient to establish a claim.12 Dr. Bidigare provided
no medical rationale in any of her reports explaining how the accepted employment activity
caused, contributed to, or aggravated appellant’s diagnosed right shoulder strain. To be of
probative medical value, a medical opinion must explain how physiologically the movements

6

See P.F., Docket No. 18-0973 (issued January 22, 2019); see also Elaine Pendleton, 40 ECAB 1143 (1989).

7

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

8

J.L., Docket No. 18-0698 (issued November 5, 2018); I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB
465 (2005).
9

L.D., Docket No. 17-1581 (issued January 23, 2018); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

10

L.D., id.; see also Leslie C. Moore, 52 ECAB 132 (2000); Gary L. Fowler, 45 ECAB 365 (1994).

11

T.H., Docket No. 18-1736 (issued March 13, 2019); Dennis M. Mascarenas, 49 ECAB 215 (1997).

12
See M.D., Docket No. 18-0195 (issued September 13, 2018); M.W., Docket No. 17-1063 (issued
November 2, 2017).

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involved in the employment incident caused or contributed to the diagnosed conditions.13 As such,
Dr. Bidigare’s reports are insufficient to establish causal relationship.
Dr. Collins and Dr. Hanoudi diagnosed a right shoulder strain and a right trapezius muscle
strain and provided medical restrictions. While they reported an April 30, 2018 date of injury,
neither physician offered a history of the employment incident or an opinion regarding causal
relationship. The Board has held that medical evidence that does not offer an opinion regarding
the cause of an employee’s condition is of no probative value on the issue of causal relationship.14
As the reports of Dr. Collins and Dr. Hanoudi are deficient in this regard, their reports are of no
probative value and are insufficient to establish appellant’s claim.
Physical therapy reports and reports from a physician assistant, were also received. Certain
healthcare providers such as physician assistants and physical therapists are not considered
“physician[s]” as defined under FECA.15 Consequently, their medical findings and/or opinions
will not suffice for purposes of establishing entitlement to FECA benefits.16 If their findings and
opinions are countersigned by a physician, they can be considered probative evidence.17 A May 4,
2018 report from Ms. Short was countersigned by a physician, but the physician’s signature was
illegible. The Board has held that a report that bears an illegible signature cannot be considered
probative medical evidence because it lacks proper identification.18 Thus, this report has no
probative value.
Because the medical reports of record do not establish that the April 30, 2018 employment
incident caused a right arm condition, the evidence of record is insufficient to establish entitlement
to compensation under FECA.19 Accordingly, appellant has not met her burden of proof.
Appellant may submit new evidence or argument with a written request for reconsideration
to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R.
§§ 10.605 through 10.607.

13

D.B., Docket No. 18-1359 (issued May 14, 2019).

14

See W.M., Docket No. 19-0013 (issued April 11, 2019); L.B., Docket No. 18-0533 (issued August 27, 2018).

15

5 U.S.C. § 8102(2) of FECA provides as follows: (2) physician includes surgeons, podiatrists, dentists, clinical
psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined
by State law. See also Roy L. Humphrey, 57 ECAB 238 (2005); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006)
(lay individuals such as physician assistants, nurses, and physical therapists are not competent to render a medical
opinion under FECA); 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t). George H. Clark, 56 ECAB 162 (2004) (physician
assistant); Jane A. White, 34 ECAB 515, 518 (1983) (physical therapist).
16

See K.C., Docket No. 18-1330 (issued March 11, 2019); K.W., 59 ECAB 271, 279 (2007).

17

Id.

18

See K.C., supra note 16; R.M., 59 ECAB 690 (2008); D.D., 57 ECAB 734 (2006); Richard J. Charot, 43 ECAB
357 (1991).
19
See J.L., Docket No. 18-1804 (issued April 12, 2019); D.H., Docket No. 17-1913 (issued December 13, 2018);
see Linda I. Sprague, 48 ECAB 386 (1997).

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LEGAL PRECEDENT -- ISSUE 2
Section 8128(a) of FECA does not entitle a claimant to review of an OWCP decision as a
matter of right.20 OWCP has discretionary authority in this regard and has imposed certain
limitations in exercising its authority.21 One such limitation is that the request for reconsideration
must be received by OWCP within one year of the date of the decision for which review is sought.22
A timely application for reconsideration, including all supporting documents, must set forth
arguments and contain evidence that either: (1) shows that OWCP erroneously applied or
interpreted a specific point of law; (2) advances a relevant legal argument not previously
considered by OWCP; or (3) constitutes relevant and pertinent new evidence not previously
considered by OWCP.23 Section 10.608(b) of OWCP regulations provide that when an application
for reconsideration does not meet at least one of the three requirements enumerated under section
10.606(b)(3), OWCP will deny the application for reconsideration without reopening the case for
a review on the merits.24
ANALYSIS -- ISSUE 2
The Board finds that OWCP properly denied appellant’s request for reconsideration of the
merits of her claim pursuant to 5 U.S.C. § 8128(a).
In her timely application for reconsideration, appellant did not show that OWCP
erroneously applied or interpreted a specific point of law, nor did she advance a new and relevant
legal argument not previously considered.25 Consequently, she is not entitled to review of the
merits of her claim based on the first and second above-noted requirements under 20 C.F.R.
§ 10.606(b)(3).
Furthermore, appellant failed to submit relevant and pertinent new evidence in support of
her request for reconsideration.26 She submitted additional physical therapy reports. However,

20

This section provides in pertinent part: the Secretary of Labor may review an award for or against payment of
compensation at any time on his own motion or on application. 5 U.S.C. § 8128(a).
21

20 C.F.R. § 10.607.

22
Id. at § 10.607(a). For merit decisions issued on or after August 29, 2011, a request for reconsideration must be
received by OWCP within one year of OWCP’s decision for which review is sought. Federal (FECA) Procedure
Manual, Part 2 -- Claims, Reconsiderations, Chapter 2.1602.4 (February 2016). Timeliness is determined by the
document receipt date of the request for reconsideration as indicated by the received date in the integrated Federal
Employees Compensation System (iFECS). Chapter 2.1602.4b.
23

20 C.F.R. § 10.606(b)(3); J.B., Docket No. 18-1531 (issued April 11, 2019); D.K., 59 ECAB 141 (2007).

24

Id. at § 10.608; P.H., Docket No. 18-1020 (issued November 1, 2018); K.H., 59 ECAB 495 (2008).

25

R.R., Docket No. 18-1562 (issued February 22, 2019); Sherry A. Hunt, 49 ECAB 467 (1998).

26

See J.B., Docket No. 18-1531 (issued April 11, 2019); M.C., Docket No. 14-0021 (issued March 11, 2014).

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these reports were not countersigned by a physician and thus have no probative medical value.27
As the underlying issue is medical in nature,28 these reports are of no relevance to the issue of
causal relationship and do not establish a basis for reopening the case for merit review.29
OWCP also received duplicative reports from Dr. Collins, Dr. Hanoudi and Ms. Short.
Submitting evidence that repeats or duplicates evidence already in the case record does not
constitute a basis for reopening a case.30 Thus, appellant is also not entitled to a review of the
merits of her claim based on the third above-noted requirement under section 10.606(b)(3).31
The Board accordingly finds that appellant has not met any of the requirements of 20 C.F.R.
§ 10.606(b)(3). Pursuant to 20 C.F.R. § 10.608, OWCP properly denied merit review.
CONCLUSION
The Board finds that appellant has not met her burden of proof to establish a right arm
condition causally related to the accepted April 30, 2018 employment incident. The Board also
finds that OWCP properly denied appellant’s request for reconsideration of the merits of her claim
pursuant to 5 U.S.C. § 8128(a).

27

See K.J., Docket No. 16-0611 (issued May 13, 2016).

28
Id.; Carol A. Lyles, 57 ECAB 265 (2005) (causal relationship is a medical issue which must be resolved by
competent medical opinion).
29

Id.; Joseph A. Brown, Jr., 55 ECAB 542 (2004).

30

O.C., Docket No. 19-0106 (issued April 26, 2019).

31

H.H., Docket No. 18-1660 (issued March 14, 2019).

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ORDER
IT IS HEREBY ORDERED THAT the September 26 and June 22, 2018 decisions of the
Office of Workers’ Compensation Programs are affirmed.
Issued: July 19, 2019
Washington, DC

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

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

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

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
J.V., Appellant
and
DEPARTMENT OF AGRICULTURE, ANIMAL
& PLANT HEALTH INSPECTION SERVICE,
Fort Pierce, FL, Employer
__________________________________________

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Appearances:
Ronald Webster, Esq., for the appellant
Office of Solicitor, for the Director

Docket Nos. 14-624 &
14-1088
Issued: August 8, 2014

Case Submitted on the Record

DECISION AND ORDER
Before:
COLLEEN DUFFY KIKO, Judge
ALEC J. KOROMILAS, Alternate Judge
MICHAEL E. GROOM, Alternate Judge

JURISDICTION
On January 28, 2014 appellant, through his attorney, filed a timely appeal from a
November 26, 2013 merit decision of the Office of Workers’ Compensation Programs (OWCP).
This appeal was docketed as No. 14-624. On April 10, 2014 appellant filed a timely appeal of a
February 6, 2014 OWCP merit decision, docketed as No. 14-1088. 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 any employment-related disability during
the period December 21, 2012 to January 11, 2013.

1

5 U.S.C. § 8101 et seq.

FACTUAL HISTORY
On March 13, 2012 appellant, then a 60-year-old plant protection technician, filed a
traumatic injury claim (Form CA-1) alleging that on February 29, 2012 he sustained injuries in a
motor vehicle accident. The claim form states that he “swerved to avoid animal and ran into
canal.” In a March 1, 2012 letter, the employing establishment advised that, as of June 24, 2011,
appellant had been working under a one-year limited appointment. Appellant was limited to 180
days of work from June 24, 2011 to June 23, 2012 and, when injured, he had already worked 178
days, with his last scheduled day as March 2, 2012. He would then be in a nonpay status until
June 23, 2012, when he would either be rehired under the same one-year appointment, rehired
under a new appointment or terminated.
On April 17, 2012 OWCP accepted the claim for lumbosacral spondylosis without
myelopathy, lumbar spondylosis with myelopathy, herniated discs at C4-5, L4-5 and L5-S1,
cervical and lumbar sprains. The record indicates that appellant received compensation from
April 16 to October 20, 2012.
In a work capacity evaluation (Form OWCP-5c) dated September 17, 2012, Dr. Daniel
Husted, a Board-certified orthopedic surgeon, advised that appellant could work with a 30-pound
lifting restriction. By letter dated October 1, 2012, the employing establishment offered
appellant a 60-day job as a plant protection technician commencing October 22, 2012. It stated
that the job was set up to accommodate his 30-pound lifting restriction. Appellant accepted the
position and worked from October 22 to December 20, 2012.
On January 8, 2013 appellant filed a claim for compensation (Form CA-7) from
December 21 to 28, 2012. On February 1, 2013 he filed a Form CA-7 for the period
December 31, 2012 to January 11, 2013.
In a report dated January 30, 2013, Dr. Husted stated that appellant sustained work
injuries on February 29, 2012 with an aggravation sustained at work on October 24, 2012.2 He
agreed to allow appellant to work a 60-day, relatively light job with no lifting over 30 pounds
and allowing him to stretch every 45 minutes. On November 5, 2012 appellant had worsened
symptoms and needed a functional capacity evaluation and an epidural injection. He stated that a
magnetic resonance imaging (MRI) scan revealed a compression fracture and appellant should
not be involved in prolonged sitting, standing or bending. Dr. Husted stated that appellant
“certainly continues to be affected by this original diagnosis” and should be treated for those
conditions in the future and the October 24, 2012 incident was the type of incident that
aggravates an orthopedic condition.
In a report dated February 22, 2013, Dr. Husted provided results on examination and
stated that appellant was status post February 29, 2012 work injury. He noted an MRI scan
showed an L1 inferior endplate fracture, which was new and constituted a new injury.
By decision dated March 20, 2013, OWCP denied appellant’s claim for compensation
from December 21 to 28, 2012. It found that he worked in a temporary position when injured,
2

Claim File No. xxxxxx766.

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was brought back for a 60-day temporary position and was not terminated due to injury but
expiration of the temporary job.
Appellant requested a hearing before an OWCP hearing representative on April 9, 2013.
In a report dated April 10, 2013, Dr. Husted provided results on examination. He noted
that appellant continued to have residual low back pain, that was a combination of both the
compression fracture and stenosis and resulting in partial disability.
By decision dated May 3, 2013, OWCP denied the claim for compensation from
December 31, 2012 to January 11, 2013. It again found appellant’s work stoppage was not the
result of the employment injury but termination of a temporary job.
On May 21, 2012 appellant requested a hearing on this decision.
A hearing was held on August 13, 2013. Counsel argued that appellant was provided a
light-duty job that was withdrawn and he was entitled to compensation.
In a letter dated September 13, 2013, the employing establishment stated that appellant
had been on a term appointment that expired on June 24, 2011. Appellant was then on a
temporary one-year appointment, limited to 180 workdays, that would have ended regardless of a
work injury. The employing establishment stated the 60-day job was also a temporary job that
ended due to expiration of its term.
By decision dated November 26, 2013, an OWCP hearing representative affirmed the
March 20, 2013. He found that appellant’s work stoppage was due to the termination of a
temporary appointment rather than a medical disability.
A hearing was held on October 30, 2013 with respect to the May 3, 2013 decision.
By decision dated February 6, 2014, an OWCP hearing representative affirmed the
May 3, 2013 decision. She found that appellant did not submit sufficient medical evidence to
establish that he sustained any employment-related disability.
LEGAL PRECEDENT
An employee seeking benefits under FECA3 has the burden to establish the essential
elements of his or her claim, including that any disability or specific condition for which
compensation is claimed is causally related to the employment injury.4 The term disability is

3

5 U.S.C. §§ 8101-8193.

4

Kathryn Haggerty, 45 ECAB 383 (1994); Elaine Pendleton, 40 ECAB 1143 (1989).

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defined as the incapacity because of an employment injury to earn the wages the employee was
receiving at the time of the injury, i.e., a physical impairment resulting in loss of wage-earning
capacity.5
A claimant that has returned to a light-duty position may establish a recurrence of an
employment-related disability by showing either a change in the nature and extent of the
injury-related condition or a change in the nature and extent of the light-duty requirements.6 The
Board has recognized that for a permanent employee the withdrawal of a light-duty job may
establish a change in the nature and extent of the light-duty requirements.7 To establish a change
in the nature and extent of the injury-related condition, there must be probative medical evidence
of record. The evidence must include a medical opinion, based on a complete and accurate
factual and medical history and supported by sound medical reasoning, that the disabling
condition is causally related to employment factors.8
ANALYSIS
The record reflects that appellant was originally hired on a term appointment that expired
on June 24, 2011. Appellant was rehired on a one-year, limited appointment not to exceed 180
workdays. This appointment would expire on June 23, 2012. At the time of injury on
February 29, 2012, appellant was a temporary employee on a limited one-year contract. As of
October 22, 2012, he worked for 60 days on a temporary light-duty position. The position
expired and appellant filed claims for compensation commencing December 21, 2012.
There are circumstances where a permanent employee may establish a recurrence of
disability when a light-duty job is withdrawn and no longer available. When the employing
establishment has no modified job within the employment-related medical restrictions, then the
permanent employee may establish an employment-related disability. The present case involves
a temporary employee returning to a temporary light-duty position. As the Board noted in M.S.,9
when a temporary employee’s appointment expires, this does not itself establish a recurrence of
disability. Appellant was a temporary employee when injured and returned to a temporary
light-duty position. The expiration of the temporary light-duty job, due to the terms of the
appointment, does not itself establish any employment-related disability.10

5

20 C.F.R. § 10.5(f); see, e.g., Cheryl L. Decavitch, 50 ECAB 397 (1999) (where appellant had an injury but no
loss of wage-earning capacity).
6

Albert C. Brown, 52 ECAB 152 (2000); Mary A. Howard, 45 ECAB 646 (1994); Terry R. Hedman, 38 ECAB
222 (1986).
7

Jackie B. Wilson, 39 ECAB 915 (1988).

8

Maurissa Mack 50 ECAB 498 (1999).

9

Docket No. 11-1184 (issued December 12, 2011). In this case the employee was a temporary employee who
sustained an employment injury, returned to a light-duty position that expired at the end of the term appointment.
The Board found this did not constitute a withdrawal of light duty establishing a recurrence of disability.
10

See also Steven A. Anderson, 53 ECAB 367 (2002); Shelly A. Paolinetti, 52 ECAB 391 (2001).

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The issue is whether appellant submitted sufficient medical evidence to establish
disability for the claimed period causally related to the February 29, 2012 injury. In this regard,
the record contains reports from Dr. Husted regarding continuing treatment. Dr. Husted did not
specifically discuss the claimed period of disability of December 21, 2012 through
January 11, 2013. In addition, he noted that appellant sustained a new work injury on
October 24, 2012 and reported a compression fracture. This claim is not before the Board on the
current appeal. Dr. Husted refers generally to partial disability in his April 10, 2013 report due
to compression fracture and stenosis. Neither of those conditions has been accepted pursuant to
the current claim. As noted, a medical report must be based on a complete background and the
opinion supported by sound medical reasoning.
On appeal, appellant argues that the evidence shows that he had two serious accidents,
“both of which were limiting and both of which require the same orthopedic treatment.” He
argues that there was no basis for the denial of compensation following the end of his temporary
60-day position, which was not the date-of-injury position. The Board finds that appellant did
not establish disability commencing December 21, 2012 causally related to the
February 29, 2012 employment injury. The termination of appellant’s temporary employment
does not itself establish entitlement to compensation and the medical evidence of record is not
sufficient to establish causal relationship between any disability beginning December 21, 2012
and the February 29, 2012 employment injuries.
Appellant may submit new evidence or argument with a written request for
reconsideration to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a)
and 20 C.F.R. §§ 10.605 through 10.607.
CONCLUSION
The Board finds that appellant has not established an employment-related disability
during the period December 21, 2012 to January 11, 2013.

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ORDER
IT IS HEREBY ORDERED THAT the decisions of the Office of Workers’
Compensation Programs dated February 6, 2014 and November 26, 2013 are affirmed.
Issued: August 8, 2014
Washington, DC

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate 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
__________________________________________
M.M., Appellant
and
U.S. POSTAL SERVICE, POST OFFICE,
Boston, MA Employer
__________________________________________

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Appearances:
Jeffrey P. Zeelander, Esq., for the appellant
Office of Solicitor, for the Director

Docket No. 09-729
Issued: October 8, 2009

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Chief Judge
COLLEEN DUFFY KIKO, Judge
MICHAEL E. GROOM, Alternate Judge

JURISDICTION
On January 22, 2009 appellant, through her attorney, filed a timely appeal of the Office
of Workers’ Compensation Programs’ merit decision dated May 13, 2008 denying her left thumb
condition. Pursuant to 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over the
merits of this case.
ISSUE
The issue is whether appellant has met her burden of proof to establish that she developed
left thumb basal joint arthritis due to her federal employment.
FACTUAL HISTORY
On February 7, 2008 appellant, then a 45-year-old mail processing clerk, filed an
occupational disease claim alleging that she developed basal joint arthritis in her left hand thumb
and wrist due to throwing, lifting, loading and sorting mail as well as machine work.
Appellant submitted a narrative statement asserting that she used her left hand in
throwing mail on a nightly basis as well as grabbing, pinching, lifting and loading mail. She
returned to work in January 2007 and was required to sort mail by hand. Appellant stated that

her limitations required her to use her left hand only. She contended that her present condition
was a consequential injury but that no lost wages were claimed. Appellant requested medical
care as she had received disability retirement benefits. On January 28, 2008 her disability
retirement was approved. The Office of Personnel Management (OPM) found appellant disabled
for her position as a mail processor due to bilateral basal joint arthritis of the hand, thumb and
wrist. In a note dated January 9, 2008, Dr. Bruce M. Leslie, a Board-certified orthopedic
surgeon, noted that appellant had developed pain in the left thumb which she attributed to
overuse. He stated, “I suspect that [appellant] probably has arthritis in the left basal joint.”
In a letter dated April 1, 2008, the Office requested additional medical evidence from
appellant noting that Dr. Leslie did not provide a firm diagnosis of her condition or explain how
her employment caused her condition. Appellant submitted a factual statement dated April 28,
2008 and noted that she had informed Dr. Leslie that she was experiencing pain in her left hand.
By decision dated May 13, 2008, the Office denied appellant’s claim. It found that
appellant performed the described work duties but that the medical evidence was not sufficient to
establish that her condition was employment related.
On appeal, appellant’s attorney contends that she submitted sufficient medical evidence
to meet her burden of proof or to require additional development by the Office.
LEGAL PRECEDENT
An occupational disease or illness means a condition produced by the work environment
over a period longer than a single workday or shift.1 To establish that an injury was sustained in
the performance of duty in an occupational disease claim, a claimant must submit the following:
(1) medical evidence establishing the presence or existence of a disease or condition for which
compensation is claimed; (2) a factual statement identifying the 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
employment factors identified by the claimant. The medical opinion 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.2
ANALYSIS
Appellant alleged that she developed left thumb basal joint arthritis due to her
employment activities. The Office found that she performed lifting, throwing and sorting mail as
alleged. However, appellant failed to submit sufficient medical evidence to establish causal
relation.
The medical evidence consists solely of the January 9, 2008 treatment record of
Dr. Leslie, a Board-certified orthopedic surgeon, who noted that appellant had developed pain in
the left thumb which she attributed to overuse. He stated, “I suspect that [appellant] probably
1

20 C.F.R. § 10.5(q).

2

Solomon Polen, 51 ECAB 341, 343-44 (2000).

2

has arthritis in the left basal joint.” This report is not sufficient to meet appellant’s burden of
proof as Dr. Leslie failed to provide a firm diagnosis. Dr. Leslie’s opinion on whether appellant
has left thumb basal joint arthritis was concluded in speculative terms. He merely indicated that
he suspected this condition. Without a clear diagnosis, findings on physical examination and an
opinion addressing how appellant’s condition was caused or contributed to by her employment
activities, this report is insufficient to meet her burden of proof. The Board further notes that the
report is of diminished probative value. Before the Office is required to undertake additional
development of the medical evidence, a medical report must contain an accurate medical history
and factual background, a firm medical diagnosis and opinion that the employee’s condition is
related to the employment.3 The Board finds that the Office properly denied appellant’s claim.
CONCLUSION
Appellant failed to submit the necessary medical opinion evidence to establish that she
developed left thumb basal joint arthritis due to her employment.
ORDER
IT IS HEREBY ORDERED THAT the May 13, 2008 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: October 8, 2009
Washington, DC

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

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

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

3

See John J. Carlone, 41 ECAB 354, 358-60 (1989).

3


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
A.F., Appellant
and
U.S. POSTAL SERVICE, PROCESSING &
DISTRIBUTION CENTER, St. Louis, MO,
Employer
__________________________________________

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

Docket No. 20-0525
Issued: September 14, 2020

Case Submitted on the Record

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

JURISDICTION
On January 8, 2020 appellant filed a timely appeal from a November 25, 2019 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

1
2

5 U.S.C. § 8101 et seq.

The Board notes that following the November 25, 2019 decision, OWCP received additional evidence. However,
the Board’s Rules of Procedure provides: “The Board’s review of a case is limited to the evidence in the case record
that was before OWCP at the time of its final decision. Evidence not before OWCP will not be considered by the
Board for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this
additional evidence for the first time on appeal. Id.

ISSUE
The issue is whether appellant has met her burden of proof to establish an emotional
condition while in the performance of duty, as alleged.
FACTUAL HISTORY
On August 6, 2019 appellant, then a 56-year-old clerk, filed an occupational disease claim
(Form CA-2) alleging that she experienced chest pain, presyncope, and tachycardia as a result of
harassment from her supervisor. She explained: “supervisor aggravated me to a point(s) where
blood pressure/heartburn.” Appellant indicated that she first became aware of her condition and
realized its relationship to her federal employment on July 26, 2019. She stopped work on July 26,
2019 and returned on July 29, 2019.
OWCP received an employing establishment accident report form, which noted a date of
injury of July 26, 2019.
On July 26, 2019 appellant received medical treatment in the hospital emergency room
from Dr. Neil David McCormack, who specializes in emergency medicine. Discharge instruction
sheets noted diagnoses of chest pain, unspecified type, presyncope, and tachycardia.
In a July 26, 2019 hospital record, Dr. Cory Cheatham, an internist, related appellant’s
complaints of rapid heart rate, chest pain, and presyncope. He recounted that appellant was
working when she suddenly felt dizzy and started to have chest pain and palpitation. Appellant
had indicated that she was recently stressed at work. Dr. Almajali reviewed appellant’s history
and reported that an abnormal electrocardiogram (ECG) was suggestive of atrioventricular nodal
reentry tachycardia (AVNRT).
In an August 20, 2019 progress note, Dr. Ahmed A. Hussein, a Board-certified internist
who specializes in cardiology, related that appellant was initially treated in the hospital emergency
department on July 26, 2019 because of an episode of supraventricular tachycardia, likely
AVNRT, associated with dizziness and chest discomfort. Cardiovascular examination was
positive for palpitations. Dr. Hussein reported diagnosis of presyncope and recommended an
AVNRT ablation procedure. He provided a letter indicating that appellant was seen in cardiology
and was being scheduled for an ablation in the upcoming weeks.
In a development letter dated September 11, 2019, OWCP informed appellant that the
evidence of record was insufficient to establish her claim. It advised her of the type of medical
and factual evidence necessary to support her claim and provided a questionnaire for her
completion. In a similar letter of even date, OWCP requested additional information from the
employing establishment. It afforded both parties 30 days to submit the requested information.
On September 19, 2019 OWCP received an undated and unsigned completed development
questionnaire from the employing establishment. It indicated that on July 26, 2019 appellant’s
supervisor instructed her to report to the second floor to work on waste mail, which required
appellant to sit and finger through trays of mail.

2

In a September 20, 2019 letter and report, Dr. Carmel Boykin-Wright, a Board-certified
internist, related that appellant was seen for follow-up examination and cardiology consultation
due to syncope and supraventricular tachycardia. She noted that appellant had an abnormal ECG
and reported that appellant suffered from AVNRT.
In a September 20, 2019 response to OWCP’s development letter, appellant explained that
on July 26, 2019 she was working the 6:00 a.m. to 2:30 p.m. shift throwing mail in manual flats
when Supervisor C.H. came to the unit. She reported that C.H. first stared at her and then told her
to apply the dates on the cages behind her because they had no dates on them. Appellant asserted
that C.H. was supposed to perform that task as she was on limited light duty. She further alleged
that C.H. had been bullying and harassing her for over a year and that this incident was just another
attempt. Appellant explained that when she went to sit down in the room to start throwing mail
the room got dark, and when she got up and walked to the nearby telephone she felt her heart
beating fast. She related that she was brought to the second floor where a safety captain took her
vitals and put her on a breathing unit and she was eventually taken to the hospital emergency
department. Appellant also explained that she did not file the claim on time because she thought
that the paperwork was filed by C.H.
OWCP received additional hospital records, including a hospital billing statement dated
September 11, 2019.
In a July 26, 2019 emergency department note, Dr. Steven D. Elster, a Board-certified
internist who specializes in emergency medicine, recounted that appellant was standing up and
working at the employing establishment when she began to experience dizziness, chest pain, and
palpitations. Appellant noted that she had some recent stress due to difficulties with her supervisor
at work. Dr. Elster reviewed appellant’s history and conducted a physical examination. He
diagnosed chest pain with palpitations and admitted appellant for additional testing.
In a July 26, 2019 cardiology consultation note, Dr. Michael Peterson, a Board-certified
internist who specializes in cardiovascular disease and clinical cardiac electrophysiology,
indicated that appellant was evaluated for complaints of chest pain and elevated troponin.
Appellant related that she was at work around 8:00 a.m. when she began to experience chest pain
that lasted for two to three hours. Dr. Peterson provided examination findings and reviewed
appellant’s laboratory results and abnormal ECG findings.
In a September 19, 2019 letter, Dr. Nabil Ahmad, Board-certified in physical medicine and
rehabilitation and pain medicine, recommended that appellant be excused from work for 11
specific dates due to her current medical condition.
In an October 4, 2019 work status note, Dr. Ahmad related that appellant was seen in his
office that day and could return to work on October 7, 2019.
OWCP received a statement dated September 22, 2019 from appellant. Appellant reported
that she had a pending Equal Employment Opportunity Commission (EEOC) complaint against
Supervisor C.H. and that C.H. continued to harass and bully her. She asserted that the development
of her claimed condition all contributed to C.H. constantly harassing her. Appellant noted that she

3

did not have a history of coronary artery disease and that she first experienced cardiac symptoms
on July 25, 2019 after dealing with C.H. at work.
Appellant included a copy of an August 16, 2018 letter from the EEOC, which informed
appellant of the name of the investigator who was assigned to her claim.
In an October 30, 2019 letter, Dr. Hussein indicated that appellant was in need of a cardiac
procedure that was scheduled for November 6, 2019. He noted that she would need at least six
days of recovery time after the procedure and could return to work on November 12, 2019.
By decision dated November 25, 2019, OWCP denied appellant’s claim, finding that the
evidence of record was insufficient to establish that appellant actually experienced the alleged
employment factors. It explained that there was no evidence to corroborate that appellant was
bullied or harassed by her supervisor.
LEGAL PRECEDENT
To establish an emotional condition causally related to factors of his or her federal
employment, appellant must submit: (1) factual evidence identifying and supporting employment
factors or incidents alleged to have caused or contributed to his or her condition; (2) rationalized
medical evidence establishing that he or she has an emotional condition or psychiatric disorder;
and (3) rationalized medical opinion evidence establishing that his or her emotional condition is
causally related to the identified compensable employment factors.3
Workers’ compensation law does not apply to each and every injury or illness that is
somehow related to an employee’s employment.4 There are situations where an injury or illness
has some connection with the employment, but nevertheless does not come within the concept or
coverage under FECA.5 When disability results from an emotional reaction to regular or specially
assigned work duties or a requirement imposed by the employment, the disability is deemed
compensable.6 However, disability is not compensable when it results from factors such as an

3

G.R., Docket No. 18-0893 (issued November 21, 2018); George H. Clark, 56 ECAB 162 (2004); Kathleen D.
Walker, 42 ECAB 603 (1991).
4

L.Y., Docket No. 18-1619 (issued April 12, 2019); L.D., 58 ECAB 344 (2007).

5

W.F., Docket No. 17-0640 (issued December 7, 2018); David Apgar, 57 ECAB 137 (2005).

6

Pamela D. Casey, 57 ECAB 260, 263 (2005); Lillian Cutler, 28 ECAB 125, 129 (1976). In the case of Lillian
Cutler, the Board explained that there are distinctions as to the type of employment situations giving rise to a
compensable emotional condition under FECA. When an employee experiences emotional stress in carrying out his
or her employment duties, and the medical evidence establishes that the disability resulted from an emotional reaction
to such situation, the disability is generally regarded as due to an injury arising out of and in the course of employment.
This is true when the employee’s disability results from his or her emotional reaction to a special assignment or other
requirement imposed by the employing establishment, or by the nature of the work.6 On the other hand, when an
injury or illness results from an employee’s feelings of job insecurity per se, fear of a reduction-in-force or his or her
frustration from not being permitted to work in a particular environment, unhappiness with doing work, or frustration
in not given the work desired, or to hold a particular position, such injury or illness falls outside FECA’s coverage
because they are found not to have arisen out of employment.

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employee’s fear of reduction-in-force, or frustration from not being permitted to work in a
particular environment or to hold a particular position.7
For harassment or discrimination to give rise to a compensable disability under FECA,
there must be evidence which establishes that the acts alleged or implicated by the employee did,
in fact, occur.8 Mere perceptions of harassment or discrimination are not compensable under
FECA.9 A claimant must substantiate allegations of harassment or discrimination with probative
and reliable evidence.10 Unsubstantiated allegations of harassment or discrimination are not
determinative of whether such harassment or discrimination occurred.11
ANALYSIS
The Board finds that appellant has not met her burden of proof to establish an emotional
condition while in the performance of duty, as alleged.
Appellant alleged that on July 26, 2019 she experienced chest pain and palpitations as a
result of her supervisor, C.H., harassing and bullying her. As noted above, to establish a claim for
harassment under FECA, a claimant must substantiate allegations of harassment or discrimination
with probative and reliable evidence.12 In support of her claim, appellant submitted a letter
indicating that she had filed an EEOC complaint and had been assigned an investigator. The Board
notes, however, that the record does not contain a final EEO decision finding that the employing
establishment committed error or abuse.13 Appellant has not provided corroborating evidence to
establish that C.H. bullied and harassed her on July 26, 2019. Furthermore, the employing
establishment denied that such bullying and harassment occurred as alleged by appellant. As such,
the Board finds that she has not established harassment as a compensable factor of employment.14
Appellant, therefore, has not established any compensable employment factors under
FECA and, therefore, has not met her burden of proof to establish that she sustained an emotional
condition in the performance of duty. As such, the Board need not consider the medical evidence
of record.15

7

Lillian Cutler, id.

8

O.G., Docket No. 18-0350 (issued August 7, 2019); K.W., 59 ECAB 271 (2007).

9

A.E., Docket No. 18-1587 (issued March 13, 2019); M.D., 59 ECAB 211 (2007); Jack Hopkins, Jr., 42 ECAB
818, 827 (1991).
10

J.F., 59 ECAB 331 (2008); Robert Breeden, 57 ECAB 622 (2006).

11

T.Y., Docket No. 19-0654 (issued November 5, 2019); G.S., Docket No. 09-0764 (issued December 18, 2009).

12

Supra note 10.

13

R.B., Docket No. 19-1256 (issued July 28, 2020); J.E., Docket No. 17-1799 (issued March 7, 2018).

14

See G.M., Docket No. 17-1469 (issued April 2, 2018).

15

M.A., Docket No. 19-1017 (issued December 4, 2019); A.K., 58 ECAB 119 (2006).

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Appellant may submit new evidence or argument with a written request for reconsideration
to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R.
§§ 10.605 through 10.607.
CONCLUSION
The Board finds that appellant has not met her burden of proof to establish an emotional
condition while in the performance of duty, as alleged.
ORDER
IT IS HEREBY ORDERED THAT the November 25, 2019 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: September 14, 2020
Washington, DC

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

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

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

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United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
C.W., Appellant
and
DEPARTMENT OF THE AIR FORCE,
HEADQUARTERS AIR FORCE SPACE
COMMAND, El Segundo, CA, Employer
__________________________________________

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

Docket No. 18-0618
Issued: March 27, 2019

Case Submitted on the Record

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

JURISDICTION
On January 30, 2018 appellant, through counsel, filed a timely appeal from an October 3,
2017 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the
Federal Employees’ Compensation Act2 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board
has jurisdiction 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.

ISSUES
The issues are: (1) whether appellant has met her burden of proof to establish that
acceptance of her claim should be expanded to include the conditions of permanent aggravation of
right knee osteoarthritis and permanent aggravation of right lateral meniscus derangement as
causally related to the accepted June 20, 2011 employment injury; and (2) whether she has met her
burden of proof to establish permanent impairment of a scheduled member or function of the body
warranting a schedule award.
FACTUAL HISTORY
This case has previously been before the Board.3 The facts and circumstances as set forth
in the Board’s prior decision are incorporated herein by reference. The relevant facts are as
follows.
On June 20, 2011 appellant, then a 62-year-old budget technician, filed an occupational
disease claim (Form CA-2) alleging that she developed a right knee injury as a result of her federal
employment duties, which required rising from her desk, walking, and ascending and descending
stairs. She did not stop work. By decision dated December 7, 2012, OWCP accepted the claim
for temporary aggravation of right knee osteoarthritis and temporary aggravation of right lateral
meniscus derangement.
On February 25, 2013 appellant filed a claim for a schedule award (Form CA-7).
In a May 13, 2013 medical report, Dr. H. Daniel Maghen, a Board-certified orthopedic
surgeon, diagnosed osteoarthritis of the right knee and acute right knee tear of the lateral meniscus.
He recommended total knee arthroplasty.
In a May 13, 2013 report, Dr. John Carmel Norton, Board-certified in occupational
medicine, diagnosed osteoarthritis of the right knee and derangement of lateral meniscus. He
related that appellant had permanent work restrictions and reported that she had reached maximum
medical improvement (MMI) as of May 13, 2013.
OWCP referred appellant, a statement of accepted facts (SOAF), and the case record to
Dr. Richard A. Rogachefsky, a Board-certified orthopedic surgeon, for a second opinion
evaluation regarding appellant’s entitlement to a schedule award. In a report dated February 21,
2014, Dr. Rogachefsky reported that appellant was not compliant and did not participate
adequately in the physical examination. He further noted that, based on her work activities of
walking to a printer, rising from a desk, and walking to the elevators, he did not see work-related
causation for the bilateral knee conditions and bilateral degenerative arthritis. Dr. Rogachefsky
opined that these were nonwork-related diagnoses/injuries and preexisting conditions. He
explained that her conditions were not work related as appellant had not experienced acute events
and only claimed repetitive work had caused her injuries. As such, Dr. Rogachefsky determined
that a schedule award would not be appropriate.

3

Docket No. 16-0749 (issued August 26, 2016).

2

By decision dated April 17, 2014, OWCP denied appellant’s claim for a schedule award,
finding that the evidence submitted was insufficient to establish permanent impairment of a
scheduled member or function of the body. It noted that appellant had failed to adequately
participate in Dr. Rogachefsky’s physical examination and he had found no permanent impairment
causally related to her accepted employment injury.
On May 20, 2015 appellant filed another claim for a schedule award (Form CA-7).
In support of her claim, appellant submitted a June 3, 2015 impairment rating from
Dr. Mesfin Seyoum, a treating pediatric physician. Dr. Seyoum provided a detailed medical
history, reviewed appellant’s prior diagnostic and medical reports, and set forth findings on
physical examination. He diagnosed right lower leg osteoarthrosis, right lateral meniscus
derangement, chondromalacia patella, and marked genu valgum, which he opined were caused or
aggravated by her work-related injury. Dr. Seyoum reported that a January 21, 2013 right knee
magnetic resonance imaging (MRI) scan was positive for anterior cruciate and lateral collateral
ligament tears, lateral meniscus tears, and degenerative changes. In accordance with the sixth
edition of the American Medical Association, Guides to the Evaluation of Permanent Impairment
(A.M.A., Guides),4 he determined that MMI had been reached. Utilizing Table 16-3 of the
A.M.A., Guides, he classified the right knee cruciate and lateral collateral ligaments in class 2 and
calculated 22 percent permanent impairment of the right lower extremity.5
On August 11, 2015 appellant requested reconsideration of the April 17, 2014 schedule
award decision.
By decision dated November 2, 2015, OWCP denied appellant’s reconsideration request,
finding that it was untimely filed and failed to demonstrate clear evidence of error.
On March 7, 2016 appellant appealed to the Board. By decision dated August 26, 2016,
the Board set aside the November 2, 2015 decision, finding that OWCP improperly adjudicated
appellant’s schedule award claim as an untimely request for reconsideration under the clear
evidence of error standard and failed to issue an appropriate decision regarding appellant’s claim
for an increased schedule award.6 The Board remanded the case to OWCP to review and develop
the medical evidence and issue a de novo decision regarding appellant’s claim for a schedule
award.
On remand OWCP routed the case file, the SOAF, and a series of questions to Dr. David I.
Krohn, an OWCP district medical adviser (DMA) Board-certified in internal medicine, for the
purposes of determining whether appellant sustained a permanent aggravation of her right knee
conditions causally related to her accepted employment injury. It requested that Dr. Krohn discuss
whether she sustained permanent impairment of the right lower extremity warranting a schedule
award.
4

A.M.A., Guides (6th ed. 2009).

5

Id. at 510.

6

Supra note 3; see also E.T., Docket No. 13-1691 (issued September 25, 2013).

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In an October 28, 2016 report, Dr. Krohn reported that appellant’s chart was reviewed for
the purpose of determining whether her accepted work-related conditions of temporary
aggravation of right knee osteoarthritis and lateral meniscus derangement should be upgraded to
permanent conditions for the purposes of establishing a ratable impairment to her right lower
extremity. He reviewed the medical records and diagnostic testing, noting that the evidence of
record was insufficient to establish that appellant’s work activities caused permanent aggravation
of her right knee osteoarthritis and lateral meniscus degeneration. Dr. Krohn explained that
appellant’s underlying conditions were caused by genetic predisposition and would have occurred
with or without her employment activities which were relatively sedentary in nature. He noted
that meniscal degeneration did not represent a meniscal injury, but rather reflected the process of
joint degeneration that predisposes to arthritis. Dr. Krohn also noted that while the medical reports
of record demonstrated evidence of lateral meniscus degeneration, diagnostic studies revealed no
objective evidence of a definitive meniscal tear such that the acceptance of the claim should be
expanded to include permanent aggravation of right knee lateral meniscus derangement.
Appellant also submitted a September 22, 2016 medical report from Dr. Mark A.
Goldstein, an osteopathic physician. Dr. Goldstein reviewed diagnostic testing, provided findings
on physical examination, and diagnosed right knee osteoarthritis.
By decision dated December 19, 2016, OWCP denied appellant’s claim for a schedule
award as the evidence of record was insufficient to establish that she sustained permanent
impairment of a scheduled member or function of the body. It further found that the evidence of
record did not establish that her accepted conditions of temporary aggravation of right knee
osteoarthritis and right lateral meniscus derangement should be accepted as permanent conditions.
By letter received on December 29, 2016, appellant, through counsel, requested an oral
hearing before an OWCP hearing representative.
The hearing was held on June 19, 2017. During the hearing, appellant discussed her
employment duties, which entailed walking and ascending and descending stairs, totaling
approximately 1,000 steps daily. The record was held open for 30 days for submission of further
medical evidence.
Following the hearing, an August 16, 2017 medical report was received from Dr. Rathin
Nishikant Vora, Board-certified in internal medicine, who diagnosed right knee osteoarthritis.
By decision dated October 3, 2017, OWCP’s hearing representative affirmed the
December 19, 2016 decision with respect to the denial of the schedule award and denial of
expansion of the acceptance of the claim.
LEGAL PRECEDENT -- ISSUE 1
When an employee claims that a condition not accepted or approved by OWCP was due to
an employment injury, he or she bears the burden of proof to establish that the condition is causally
related to the employment injury.7 To establish causal relationship between the condition and the
7

O.S., Docket No. 18-1519 (issued February 7, 2019); Jaja K. Asaramo, 55 ECAB 200 (2004).

4

employment event or incident, the employee must submit rationalized medical opinion evidence
supporting such causal relationship.8 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. This medical
opinion must include an accurate history of the employee’s employment injury and must explain
how the condition is related to the injury. The weight of medical evidence is determined by its
reliability, its probative value, its convincing quality, the care of analysis manifested, and the
medical rationale expressed in support of the physician’s opinion.9 Neither the mere fact that a
disease or condition manifests itself during a period of employment, nor the belief that the disease
or condition was caused or aggravated by employment factors or incidents is sufficient to establish
causal relationship.10
ANALYSIS -- ISSUE 1
The Board finds that appellant has not met her burden of proof to establish that acceptance
of her claim should be expanded to include the conditions of permanent aggravation of
osteoarthritis and permanent aggravation of right lateral meniscus derangement as causally related
to her federal employment duties.11
In an October 28, 2016 report, Dr. Krohn, serving as a DMA, reviewed the medical records
and the SOAF and discussed appellant’s work-related conditions. He opined that appellant had
not sustained permanent aggravation of her right knee osteoarthritis and lateral meniscus
derangement warranting entitlement to a schedule award. Dr. Krohn explained that appellant’s
right knee osteoarthritis and meniscal degeneration developed as a result of genetic predisposition,
which were unrelated to her work activities. He noted that these conditions would have developed
with or without her employment activities, which were relatively sedentary in nature. Dr. Krohn
further explained that meniscal degeneration was a process of joint degeneration that predisposed
to arthritis.12 He opined that permanent impairment of right knee lateral meniscus derangement
should not be accepted as appellant’s right knee MRI scan studies failed to provide objective
evidence of a definitive meniscal tear, but rather only revealed lateral meniscus degeneration. The
Board notes that Dr. Krohn’s findings were supported by diagnostic studies of the right knee which
suggested a possible meniscal tear rather than a definitive tear.13 The Board finds his report to be
sufficiently detailed and well reasoned to establish that appellant sustained a temporary, rather

8

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

9

V.K., Docket No. 18-1005 (issued February 1, 2019); James Mack, 43 ECAB 321 (1991).

10

L.D., Docket No. 17-1581 (issued January 23, 2018); V.W., 58 ECAB 428 (2007).

11

T.K., Docket No. 16-1543 (issued March 13, 2017).

12

S.R., Docket No. 12-1098 (issued September 19, 2012).

13

A.H., Docket No. 18-0050 (issued March 26, 2018).

5

than a permanent, aggravation of her preexisting right knee osteoarthritis and lateral meniscus
degeneration.14
Dr. Rogachefsky’s February 21, 2014 second opinion report also fails to provide support
for a permanent aggravation of appellant’s right knee conditions. He opined that appellant’s
bilateral knee conditions and bilateral degenerative arthritis were nonwork-related diagnoses/
injuries and preexisting conditions. Dr. Rogachefsky explained that appellant had not experienced
acute events and the repetitive work activities of walking to a printer, rising from a desk, and
walking to the elevators would not have caused the bilateral knee conditions and degenerative
arthritis. Given the above, this opinion does not provide support for a work-related right knee
injury.15
OWCP received May 13, 2013 reports from Drs. Maghen and Norton. These reports do
not establish that the claim should be accepted for a work-related permanent aggravation of right
knee osteoarthritis and permanent aggravation of right lateral meniscus derangement.16 They
provided a diagnosis of right knee osteoarthritis and derangement of lateral meniscus, but they did
not provide a firm diagnosis of permanent aggravation of right knee osteoarthritis and derangement
of lateral meniscus. The reports also failed to provide an opinion on the cause of appellant’s
condition. The Board has held that the claimant must submit medical evidence providing a firm
diagnosis of a permanent impairment and must establish that the condition is employment
related.17 Additionally, medical evidence that does not offer an opinion regarding the cause of an
employee’s condition is of no probative value on the issue of causal relationship.18 Similarly,
Drs. Goldstein and Vora diagnosed right knee osteoarthritis, but provided no opinion as to whether
appellant’s accepted employment injury caused a permanent aggravation of appellant’s condition.
Therefore these reports have no probative value.19
OWCP also received a June 3, 2015 report from Dr. Seyoum who diagnosed right leg
osteoarthrosis, right lateral meniscus derangement, chondromalacia patella, and marked genu
valgum and opined that these conditions were caused or aggravated by appellant’s employment
injury. Dr. Seyoum did not explain, however, how appellant’s employment duties caused a
permanent aggravation of her right knee conditions. As Dr. Seyoum did not provide a medically
sound explanation of how the specific employment factors, physiologically, caused or aggravated

14

P.G., Docket No. 17-0900 (issued December 7, 2017).

15

G.M., Docket No. 15-1288 (issued September 18, 2015).

16
See L.M., Docket No. 14-973 (issued August 25, 2014); R.G., Docket No. 14-113 (issued April 25, 2014); K.M.,
Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-548 (issued November 16, 2012).
17

See Richard A. Bennett, Docket No. 92-1663 (issued September 27, 1993).

18

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

19

Id.

6

appellant’s right knee conditions, his reports are insufficient to establish expansion of the
acceptance of the claim.20
The Board therefore finds that appellant has not met her burden of proof to establish that
acceptance of her claim should be expanded to include additional conditions causally related to
the accepted factors of federal employment.21
Appellant may submit new evidence or argument with a written request for reconsideration
to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R.
§§ 10.605 through 10.607.
LEGAL PRECEDENT -- ISSUE 2
The schedule award provisions of FECA and its implementing regulations set forth the
number of weeks of compensation payable to employees sustaining permanent impairment from
loss or loss of use of scheduled members or functions of the body.22 However, FECA does not
specify the manner in which the percentage of loss shall be determined. For consistent results and
to ensure equal justice under the law to all claimants, good administrative practice necessitates the
use of a single set of tables so that there may be uniform standards applicable to all claimants.
Through its implementing regulations, OWCP adopted the A.M.A., Guides as the appropriate
standard for evaluating schedule losses.23
As of May 1, 2009, schedule awards are determined in accordance with the sixth edition
of the A.M.A., Guides (2009).24 The Board has approved the use by OWCP of the A.M.A., Guides
for the purpose of determining the percentage loss of use of a member of the body for schedule
award purposes.25
It is the claimant’s burden of proof to establish permanent impairment of the scheduled
member or function as a result of any employment injury.26 OWCP procedures provide that, to
support a schedule award, the file must contain competent medical evidence which shows that the
impairment has reached a permanent and fixed state and indicates the date on which this occurred

20

T.G., Docket No. 14-751 (issued October 20, 2014).

21

See T.M., Docket No. 18-1418 (issued February 7, 2019).

22

5 U.S.C. § 8107; 20 C.F.R. § 10.404.

23

20 C.F.R. § 10.404. See also Ronald R. Kraynak, 53 ECAB 130 (2001).

24

See Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims,
Chapter 2.808.6a (March 2017); see also Part 3 -- Medical, Schedule Awards, Chapter 3.700, Exhibit 1 (January 2010).
25

Isidoro Rivera, 12 ECAB 348 (1961).

26

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

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(date of MMI), describes the impairment in sufficient detail so that it can be visualized on review,
and computes the percentage of impairment in accordance with the A.M.A., Guides.27
OWCP’s procedures provide that, after obtaining all necessary medical evidence, the file
should be routed to an OWCP medical adviser for an opinion concerning the nature and percentage
of impairment in accordance with the A.M.A., Guides, with the medical adviser providing
rationale for the percentage of impairment specified.28
ANALYSIS -- ISSUE 2
The Board finds that appellant has not met her burden of proof to establish permanent
impairment of a scheduled member or function of the body warranting a schedule award.29
Dr. Krohn provided a well-reasoned report based on a proper factual and medical history
and included detailed findings and rationale supporting his opinion. In his October 28, 2016
report, he opined that appellant did not sustain a permanent aggravation of her right knee
osteoarthritis and lateral meniscus derangement warranting entitlement to a schedule award.
Dr. Krohn provided a detailed discussion explaining that appellant’s right knee osteoarthritis and
meniscal degeneration developed as a result of genetic predisposition which were unrelated to her
work activities. He provided support for his assertions based on objective clinical findings.
Dr. Krohn referenced a right knee MRI scan study, which did not provide support for a meniscus
tear, describing the meniscal degeneration as a process of joint degeneration that predisposed to
arthritis. As Dr. Krohn explained that appellant sustained a temporary rather than a permanent
aggravation of her preexisting right knee osteoarthritis and lateral meniscus degeneration, his
report establishes that she had no permanent impairment of a scheduled member or function of the
body warranting a schedule award.30
In support of her schedule award claim, appellant submitted a June 3, 2015 impairment
rating from Dr. Seyoum who opined that she sustained 22 percent permanent impairment of the
right lower extremity. The Board finds that the report of Dr. Seyoum is insufficient to establish
appellant’s schedule award claim.31 The Board notes that Dr. Seyoum based his impairment rating
on the diagnoses of right knee anterior cruciate and lateral collateral ligament tears, conditions
which has not been accepted as employment related.32 As such, his Dr. Seyoum’s opinion is
insufficient to overcome the weight accorded to DMA Dr. Krohn.

27

FECA Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, Chapter 2.808.5
(March 2017).
28

Id. at Chapter 2.808.6(e) (March 2017).

29

D.T., Docket No. 17-0102 (issued April 13, 2017).

30

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

31

K.S., Docket No. 15-1082 (issued April 18, 2017).

32

R.W., Docket No. 15-1121 (issued August 12, 2015).

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The other medical evidence submitted, including the reports of Drs. Goldstein and Vora,
do not address the issue of permanent impairment in conformance with the sixth edition of the
A.M.A., Guides and therefore lack probative value on the issue of permanent impairment.33 The
Board finds that appellant has not met her burden of proof to establish her schedule award claim.34
Appellant may request a schedule award or increased schedule award at any time based on
evidence of a new exposure or medical evidence showing progression of an employment-related
condition resulting in permanent impairment or increased impairment.
CONCLUSION
The Board finds that appellant has not met her burden of proof to establish that acceptance
of her claim should be expanded to include the conditions of permanent aggravation of right knee
osteoarthritis and permanent aggravation of right lateral meniscus derangement as causally related
to the accepted June 20, 2011 employment injury. The Board further finds that appellant has not
met her burden of proof to establish permanent impairment of a scheduled member or function of
the body warranting a schedule award.

33

See M.J., Docket No. 17-1776 (issued December 19, 2018).

34

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

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ORDER
IT IS HEREBY ORDERED THAT the October 3, 2017 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: March 27, 2019
Washington, DC

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

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

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

10


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
A.H., Appellant
and
U.S. POSTAL SERVICE, PROCESSING &
DISTRIBUTION CENTER, New York, NY,
Employer
__________________________________________

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

Docket No. 20-1211
Issued: April 30, 2021

Case Submitted on the Record

DECISION AND ORDER
Before:
ALEC J. KOROMILAS, Chief Judge
JANICE B. ASKIN, Judge
PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION
On May 26, 2020 appellant filed a timely appeal from a January 16, 2020 merit decision
of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal Employees’
Compensation Act1 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over
the merits of this case.2

1
2

5 U.S.C. § 8101 et seq.

The Board notes that, following the January 16, 2020 decision, OWCP received additional evidence. However,
the Board’s Rules of Procedure provides: “The Board’s review of a case is limited to the evidence in the case record
that was before OWCP at the time of its final decision. Evidence not before OWCP will not be considered by the
Board for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this
additional evidence for the first time on appeal. Id.

ISSUE
The issue is whether appellant has met her burden of proof to establish a recurrence of
disability, commencing September 28, 2019, causally related to the accepted November 30, 1989
employment injury.
FACTUAL HISTORY
On December 18, 1989 appellant, then a 45-year-old postal distribution clerk, filed a
traumatic injury claim (Form CA-1) alleging that on November 30, 1989 she sustained shoulder,
back, and leg injuries when a coworker accidentally pulled the chair she was sitting in out from
under her. OWCP accepted the claim for lumbago, bilateral ankle sprain, right leg strain, left
shoulder strain, and lumbar and lumbosacral strains. Appellant stopped work on the date of injury
and returned to a modified job working four hours per day on December 29, 1990, which was
subsequently increased to six hours per day on July 13, 2005.3 OWCP paid her wage-loss
compensation on the periodic rolls and the supplemental rolls.4
On October 2, 2019 appellant filed a notice of recurrence (Form CA-2a) alleging that she
sustained a recurrence of disability on September 27, 2019, with wage-loss commencing
September 28, 2019. She related that she had been confined to a wheelchair following the work
injury, that getting up to use the restroom caused back pain, and that her constant back pain had
worsened.
In support of her recurrence claim, appellant submitted a return-to-work form dated
September 28, 2019 from Dr. Yu-Shiuan Sun, a physician specializing in family medicine, who
certified that appellant was disabled from work due to back pain. He released her to return to work
on October 14, 2019.
In an October 12, 2019 return-to-work form, Dr. Sun noted that appellant had lower back
pain and noted an October 28, 2019 return-to-work date. On October 23, 2019 he completed
another return-to-work form and indicated that appellant was disabled due to lower back and lower
extremity pain and that she could return to work on November 18, 2019.
By development letter dated November 6, 2019, OWCP noted receipt of appellant’s claim
for a recurrence of disability due to a material change/worsening of the accepted work-related
condition. It also noted that she returned to part-time limited-duty work following her original
injury and continued to work until October 7, 2019, when she stopped work. OWCP related that
it appeared that appellant was claiming a material worsening/change of her accepted conditions
and it provided a definition of a recurrence of disability. Appellant was advised that she should
submit a narrative medical report from her physician that addressed why she could not perform
3
In OWCP File No. xxxxxx971, OWCP accepted that appellant sustained a cervical and lumbosacral ligament
sprains on October 19, 1998. OWCP File No. xxxxxx971 has been administratively combined with OWCP File No.
xxxxxx535, with the former serving as the master file. No medical development has occurred under OWCP File No.
xxxxxx971 since 2007.
4
OWCP issued a loss of wage-earning capacity (LWEC) determination on May 2, 2006, based upon appellant’s
actual earnings. In a February 4, 2011 decision, it found that she had met one of the criteria for modifying an LWEC,
as the original determination was based on a makeshift or odd lot job and was, therefore, issued in error.

2

her work duties, based upon objective medical findings, and why her current disability was
causally related to the accepted employment injury. She was afforded 30 days to submit the
necessary evidence.
On December 23, 2019 appellant filed a Form CA-2a for a recurrence of disability, alleging
that she had stopped work on December 12, 2019 due to the accepted November 30, 1989
employment injury.
In a letter dated January 9, 2020, Victoria Nunez, a social worker, related that appellant
had been admitted to a rehabilitation facility on December 28, 2019.
By decision dated January 16, 2020, OWCP denied appellant’s recurrence claim.
LEGAL PRECEDENT
A recurrence of disability means an inability to work after an employee has returned to
work, caused by a spontaneous change in a medical condition, which has resulted from a previous
injury or illness without an intervening injury or new exposure to the work environment that caused
the illness.5 This term also means an inability to work that takes place when a light-duty
assignment made specifically to accommodate an employee’s physical limitations due to her workrelated injury or illness is withdrawn (except when such withdrawal occurs for reasons of
misconduct, nonperformance of job duties, or a reduction-in-force) or when the physical
requirements of such an assignment are altered so that they exceed the established physical
limitations.6
When an employee who is disabled from the job he or she held when injured on account
of employment-related residuals returns to a limited-duty position or the medical evidence of
record establishes that he or she can perform the limited-duty position, the employee has the burden
of proof to establish by the weight of the reliable, probative, and substantial evidence a recurrence
of total disability and to show that he or she cannot perform such limited-duty work. As part of
this burden, the employee must show a change in the nature and extent of the injury-related
condition or a change in the nature and extent of the limited-duty job requirements.7 This burden
includes the necessity of furnishing evidence from a qualified physician who concludes, on the
basis of a complete and accurate factual and medical history, that for each period of disability
claimed, the disabling condition is causally related to the employment injury, and supports that
conclusion with medical reasoning. Where no such rationale is present, the medical evidence is
of diminished probative value.8

5
20 C.F.R. § 10.5(x); F.D., Docket No. 19-1637 (issued February 25, 2021); S.W., Docket No. 18-1489 (issued
June 25, 2019).
6

Id.

7

K.F., Docket No. 19-1846 (issued November 3, 2020) H.T., Docket No. 17-0209 (issued February 8, 2019);
Ronald A. Eldridge, 53 ECAB 218 (2001).
8
A.M., Docket No. 19-1870 (issued February 10, 2021); E.M., Docket No. 19-0251 (issued May 16, 2019); Mary A.
Ceglia, Docket No. 04-0113 (issued July 22, 2004).

3

ANALYSIS
The Board finds that appellant has not met her burden of proof to establish a recurrence of
disability, commencing September 28, 2019, causally related to the accepted November 30, 1989
employment injury.
Appellant has not alleged a change in her light-duty job requirements. Instead, she
attributed her inability to work to a change in the nature and extent of her employment-related
conditions. Appellant, therefore, has the burden of proof to provide medical evidence to establish
that she was disabled from work due to a worsening of her accepted work-related condition.9
In support of her claim, appellant submitted return-to-work forms dated September 28,
October 12 and 23, 2019 from Dr. Sun diagnosing lower back and lower extremity pain. Read
together these forms indicated that appellant was totally disabled from work until
November 18, 2019. Although Dr. Sun opined that appellant was totally disabled from work, his
opinion was conclusory in nature and failed to explain how the accepted back and lower extremity
conditions were responsible for appellant’s claimed disability and why she could not perform her
limited-duty assignment during the period claimed.10 OWCP advised appellant in the development
letter dated November 6, 2019 that she should submit a narrative report from her treating
physician, which explained why she was disabled based upon objective medical findings and
which explained why her current condition was a worsening of her accepted employment-related
conditions. The reports OWCP received from Dr. Sun merely related that appellant could not
return to work due to back and lower extremity pain.11 Moreover, Dr. Sun did not address whether
appellant’s current condition was a material worsening of her accepted employment conditions.
The Board has held that medical evidence that does not offer an opinion regarding the cause of an
employee’s disability is of no probative value on the issue of causal relationship.12 Therefore,
these form notes are insufficient to establish appellant’s recurrence of disability claim.
The Board also notes that OWCP received a letter from a social worker dated January 9,
2020, which related that appellant had been admitted to a short-term rehabilitation facility.
However, a social worker is not considered a physician as defined by FECA. Therefore, her report
does not constitute competent medical opinion evidence regarding the issue of disability and is
insufficient to establish the claim.13
As none of the medical evidence of record contains a rationalized medical explanation
establishing a recurrence of disability, commencing September 28, 2019, causally related to the

9

See K.F., Docket No. 19-1846 (issued November 4, 2020); J.P., Docket No. 18-1396 (issued January 23, 2020).

10

See S.K. Docket No. 18-1537 (issued June 20, 2019).

11

Pain is a symptom, not a medical diagnosis. I.M., Docket No. 19-1038 (issued January 23, 2020); Y.S., Docket
No. 18-0366 (issued January 22, 2020).
12

I.M., Docket No. 20-0980 (issued February 2, 2021); See L.B., Docket No. 18-0533 (issued August 27, 2018).

13
Section 8101(2) of FECA provides that 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 C.A., Docket No. 18-0824 (issued November 15, 2018).

4

accepted November 30, 1989 employment injury, the Board finds that appellant has not met her
burden of proof.
Appellant may submit new evidence or argument with a written request for reconsideration
to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R.
§§ 10.605 through 10.607.
CONCLUSION
The Board finds that appellant has not met her burden of proof to establish a recurrence of
disability, commencing September 28, 2019, causally related to the accepted November 30, 1989
employment injury.
ORDER
IT IS HEREBY ORDERED THAT the January 16, 2020 decision of the Office of
Workers’ Compensation Programs is affirmed.
Issued: April 30, 2021
Washington, DC

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

Janice B. Askin, Judge
Employees’ Compensation Appeals Board

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

5


United States Department of Labor
Employees’ Compensation Appeals Board
__________________________________________
L.R., Appellant
and
DEPARTMENT OF HOMELAND SECURITY,
TRANSPORTATION SECURITY
ADMINISTRATION, Anchorage, AK, Employer
__________________________________________

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

Docket No. 09-1419
Issued: January 20, 2010

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 May 18, 2009 appellant filed a timely appeal from an April 10, 2009 merit decision of
the Office of Workers’ Compensation Programs, denying her claim for compensation. Pursuant
to 20 C.F.R. §§ 501.2(c) and 501.3(e), the Board has jurisdiction over the April 10, 2009 merit
decision.
ISSUE
The issue is whether appellant has established an injury causally related to factors of her
federal employment as a security screener.
FACTUAL HISTORY
On March 2, 2009 appellant, then a 56-year-old security screener, filed an occupational
disease claim, alleging that she sustained back, left arm and shoulder conditions as a result of her
federal employment. By letter dated March 6, 2009, the Office requested that she submit
additional factual and medical evidence. In a narrative statement, appellant indicated that her job

required lifting and transferring luggage and boxes. She indicated she went for treatment on
February 10, 2009 due to severe pain.
With respect to medical evidence, appellant submitted notes and form reports (CA-17 and
CA-20) signed by a physician’s assistant. The record contains an unsigned report dated
February 24, 2009 containing the name of the physician’s assistant. Appellant also submitted
diagnostic tests, including cervical and left shoulder x-rays, and a cervical magnetic resonance
imaging (MRI) scan.
By decision dated April 10, 2009, the Office denied her compensation claim. It found
that the medical evidence was insufficient to establish the claim.
LEGAL PRECEDENT
A claimant seeking benefits under the Federal Employees’ Compensation Act1 has the
burden of establishing the essential elements of 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.2
To establish that an injury was sustained in the performance of duty, 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
employment factors identified by the claimant.3
Causal relationship is a medical question that can generally be resolved only by
rationalized medical opinion evidence.4 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 must be based on a complete factual and medical background of the claimant.5
Additionally, in order to be considered rationalized, the opinion must be expressed in terms of a
reasonable degree of medical certainty and must be supported by medical rationale, explaining
the nature of the relationship between the diagnosed condition and appellant’s specific
employment factors.6

1

5 U.S.C. §§ 8101-8193.

2

20 C.F.R. § 10.115(e), (f) (2005); see Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996).

3

Ruby I. Fish, 46 ECAB 276, 279 (1994).

4

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

5

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

6

Id.

2

ANALYSIS
In this case, appellant identified lifting and transferring luggage and boxes as
employment factors causing an injury. The Office accepted that she performed these activities.
The issue is whether there is probative medical evidence on causal relationship between a
diagnosed back, left arm or shoulder condition and the identified employment factors.
The evidence appellant submitted does not contain a rationalized medical opinion from a
physician. Under the Act, a physician includes, “surgeons, podiatrists, dentists, clinical
psychologists, optometrists, chiropractors and osteopathic practitioners within the scope of their
practice as defined by state law.”7 It is well established that medical evidence from a physician’s
assistant does not constitute competent medical evidence as a physician’s assistant is not a
physician under 5 U.S.C. § 8101(2).8 The reports from the physician’s assistant are therefore of
no probative value to appellant’s claim. The diagnostic studies do not provide an opinion on
causal relationship with employment.
On appeal, appellant stated that she was sending papers with different signatures. The
Board, however, is limited to the evidence that was before the Office at the time of the April 10,
2009 Office decision. The evidence before the Office did not contain a rationalized medical
opinion on causal relationship from a physician. Therefore, the Office properly denied the claim.
CONCLUSION
The Board finds the medical evidence is not sufficient to establish an injury causally
related to the identified employment activities.

7

5 U.S.C. § 8101(2). With regard to chiropractors, the term “physician” includes chiropractors “only to the
extent that their reimbursable services are limited to treatment consisting of manual manipulation of the spine to
correct a subluxation as demonstrated by x-ray to exist.” Id.
8

George H. Clark, 56 ECAB 162 (2004).

3

ORDER
IT IS HEREBY ORDERED THAT the decision of the Office of Workers’
Compensation Programs dated April 10, 2009 is affirmed.
Issued: January 20, 2010
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

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