United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.D., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Chadds Ford, PA, Employer 

__________________________________________ 

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Docket Nos. 13-2120 & 

14-33 

Issued: September 4, 2014 

Appearances: Case Submitted on the Record

Jeffrey P. Zeelander, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA HOWARD FITZGERALD, Judge 

MICHAEL E. GROOM, Alternate Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On September 16, 2013 appellant, through her attorney, filed a timely appeal from merit 

decisions of the Office of Workers’ Compensation Programs’ (OWCP) dated May 14, 2013 

terminating her compensation benefits and March 27 and July 9, 2013 denying her occupational 

disease claim. Pursuant to the Federal Employees’ Compensation Act1

 (FECA) and 20 C.F.R. 

§§ 501.2(c) and 501.3, the Board has jurisdiction over the merits of this case. 

ISSUES 

The issues are: (1) whether OWCP properly terminated appellant’s compensation 

benefits effective July 9, 2012 on the grounds that she no longer had any residuals or disability 

causally related to her accepted employment-related injury in OWCP File No. xxxxxx957; 

(2) whether appellant had any continuing employment-related residuals or disability after 

July 9, 2012 in OWCP File No. xxxxxx957; and (3) whether she established a left ankle injury 

causally related to factors of her federal employment in OWCP File No. xxxxxx886. 

On appeal, counsel contended that appellant’s claims under OWCP File Nos. xxxxxx957 

and xxxxxx886 be consolidated as they were duplicate claims. He asserted that they have the 

 1

 5 U.S.C. § 8101 et seq.
2

same date of awareness of the injury and factors of employment. Counsel further asserted that 

appellant filed the second claim because her work factors continued and she experienced pain 

and required additional surgery. 

FACTUAL HISTORY 

On January 8, 2010 appellant, then a 51-year-old regular rural carrier, filed an 

occupational disease claim (Form CA-2) under OWCP File No. xxxxxx957 alleging that she first 

became aware of her bilateral foot condition on January 1, 2007. She alleged that on 

September 6, 2009 she first realized that her condition was caused by her work duties, which 

included standing three to five hours a day and hopping out of a long-life vehicle (LLV) 30 times 

a day while delivering mail. Appellant’s regular work schedule was from 7:30 a.m. to 3:30 

p.m., Monday through Saturday. 

By letter dated April 21, 2010, OWCP accepted appellant’s claim for traumatic bilateral 

plantar fasciitis. It paid her total disability compensation benefits. 

On May 28, 2010 appellant stopped work. On June 2, 2010 she returned to full-duty 

work. Appellant again stopped work on July 3, 2010. On August 17, 2010 she underwent 

authorized partial release of the medical band of the plantar fascia of the left foot. On 

November 18, 2010 appellant returned to part-time limited-duty work, four hours a day. Her 

work hours increased to seven hours every other day commencing January 6, 2011. On 

February 10, 2011 appellant began performing limited-duty work eight hours a day every other 

day. 

By letter dated March 24, 2011, OWCP referred appellant, together with a statement of 

accepted facts and the medical record, to Dr. Robert A. Smith, a Board-certified orthopedic 

surgeon, for a second opinion to determine whether she had any employment-related residuals or 

disability. In an April 18, 2011 medical report, Dr. Smith diagnosed traumatic bilateral plantar 

fasciitis. He advised that, although appellant had pain in her feet, there were no objective test 

results to indicate that she had any ongoing plantar fascial problems and she had a good result 

from her left foot surgery. Dr. Smith concluded that appellant could continue performing fulltime regular-duty work. 

In an April 8, 2011 duty status report, Dr. Timothy Chen, a podiatrist, released appellant 

to return to full-time, full-duty work on that date. In reports dated May 18 and October 12, 2011, 

he diagnosed plantar fasciitis. 

An unsigned report dated February 22, 2012 contained the printed name of Dr. Andre O. 

Williams, a Board-certified anesthesiologist. The report noted appellant’s left ankle pain and 

provided essentially normal findings on physical examination with the exception of definite soft 

swelling along the tendon sheath inferior to the lateral mallalus which was only mildly tender to 

palpation. 

In a March 26, 2012 report, Dr. Scott M. Reich, a podiatrist, stated that on February 10, 

2012 appellant presented with bilateral left greater than right ankle pain. Appellant reported to 

Dr. Reich that her condition was caused by her mail carrier job which required her to 
3

continuously hop in and out of a truck. She further reported that the continuous physical aspects 

of her job exacerbated these symptoms. Dr. Reich noted that appellant currently presented with 

significant pain on palpation along her peroneal tendon, left greater than the right. He advised 

that a magnetic resonance imaging (MRI) scan showed tendinosis of the peroneus longus tendon 

with peritendinosis of the common peroneus tendon sheath of the left ankle. Dr. Reich 

recommended peroneal tendon debridement and repair. He concluded that the surgery would 

prevent appellant from working approximately six to eight weeks since she had physical work 

activities. 

By letter dated April 9, 2012, OWCP referred appellant, along with a statement of 

accepted facts and a list of questions, to Dr. Steven J. Valentino, a Board-certified orthopedic 

surgeon, for another second opinion.2

 The statement of accepted facts and list of questions noted 

the accepted condition of bilateral plantar fasciitis. Dr. Valentino was asked to address whether 

appellant continued to have residuals of this employment-related condition and to determine her 

work restrictions. 

In an April 17, 2012 report, Dr. Valentino reviewed a history of the accepted 

employment-related bilateral foot condition, and appellant’s medical treatment and work 

capacity. He also reviewed her medical records which included a February 13, 2012 MRI scan 

of the left ankle that showed tendinosis in the common peroneal tendon sheath without a tear, 

stress about the anterior aspect of the calcaneus and a normal image of the plantar fascia. 

Dr. Valentino noted appellant’s complaint of heel pain, worse on the left than on the right. On 

examination, he reported that she was able to walk normally. Appellant could heel/toe and squat 

and return without postural difficulty. She had a well-healed small scar consistent with her 

surgery and Dr. Valentino’s review of her records. On examination of the spine, Dr. Valentino 

reported full range of motion with all motion segments. Classic modified Spurling’s maneuvers, 

sitting spine, straight leg raising and prone stretch sitting were negative. On neurologic 

examination, Dr. Valentino found intact deep tendon reflexes, normal motor and sensory 

examinations, and no pathologic reflexes. On examination of the hips, knees, ankles and feet he 

found full range of motion. A Faber test was negative. On examination of the knees and ankles, 

Dr. Valentino found no synovitis, effusion or internal derangement. There was no tenderness 

with palpation of the peroneal tendon. Dr. Valentino reported a normal plantar examination as 

there was no tenderness over the incision site which was well healed and no abnormal findings 

on stretching of the plantar fascia bilaterally. The ankle had good stability and intact medial 

deltoid and lateral ligaments. An anterior drawers’ sign and stress testing were negative. 

Dr. Valentino diagnosed resolved plantar fasciitis. Upon his extensive evaluation and review of 

records, he agreed with the treatment of appellant’s work-related plantar fasciitis, including her 

surgery which resolved her plantar fasciitis symptoms. He advised that MRI scan findings of 

peroneal tendinosis were not related to either the work-related plantar fasciitis injury or resolved 

bilateral plantar fasciitis. Dr. Valentino opined that given this finding was not present early on 

and that appellant’s work-related bilateral plantar fasciitis had completely resolved, she had no 

complaints compatible with residuals of the condition. He concluded that she could perform 

full-time, full-duty work with no restrictions. Dr. Valentino further concluded that treatment 

related to appellant’s peroneal tendinitis was not related to her work injury or work duties. 

 2

 In a May 5, 2011 e-mail, OWCP advised an OWCP nurse that it was trying to obtain appellant’s release to fullduty, full-time work. 
4

In a May 14, 2012 report, Dr. Frank B. Sarlo, a Board-certified physiatrist, stated that the 

results of electromyogram and nerve conduction studies (EMG/NCS) were normal. 

On May 30, 2012 OWCP issued a notice of proposed termination of appellant’s wageloss compensation and medical benefits based on Dr. Valentino’s medical opinion. Appellant 

was advised that she had 30 days to submit additional evidence in response to the proposed 

termination. 

In a May 25, 2012 note, Dr. Reich advised that appellant could return to full-duty work as 

of May 21, 2012. He noted that she was tentatively scheduled to undergo left ankle surgery. In 

an attending physician’s report (Form CA-20) dated June 8, 2012, he diagnosed left peroneal 

tendinitis. Dr. Reich indicated with a checkmark that the diagnosed condition was caused or 

aggravated by an employment activity. He again noted appellant’s scheduled surgery and 

advised that she would be totally disabled from June 27 to August 27, 2012. She could resume 

work on August 27, 2012. 

On June 12, 2012 appellant filed a Form CA-2 and an undated narrative statement under 

OWCP File No. xxxxxx886. She first became aware of her peritendinosis on January 1, 2007. 

Appellant alleged that on September 6, 2009 she realized that her condition was caused or 

aggravated by essentially the same accepted factors of employment under OWCP File No. 

xxxxxx957. The record in OWCP File No. xxxxxx957 contained copies of Dr. Reich’s 

March 26, 2012 report, Dr. Valentino’s April 17, 2012 report and hospital records regarding the 

June 27, 2012 left ankle surgery. 

Hospital records indicate that on June 27, 2012 appellant was scheduled to undergo 

debridement of the peroneal tendon with exploration and topaz of the left foot. 

In a July 9, 2012 decision, under OWCP File No. xxxxxx957, OWCP terminated 

appellant’s wage-loss compensation and medical benefits effective that date. It found that the 

medical evidence submitted was insufficient to outweigh the weight accorded to Dr. Valentino’s 

opinion. 

By letter dated July 11, 2012, under OWCP File No. xxxxxx886, OWCP advised 

appellant that the evidence submitted was insufficient to establish her June 12, 2012 claim. It 

requested additional factual and medical evidence. OWCP also requested additional factual and 

medical evidence from the employing establishment regarding appellant’s allegations, a 

description of the physical requirements for her rural carrier position and her treatment at its 

medical facility. 

By letter dated April 10, 2013, appellant, through her attorney, requested reconsideration 

of the July 9, 2012 decision contending that an accompanying March 14, 2013 report from 

Dr. D. Scot Malay, a podiatrist, was supportive of her claim of residuals. Counsel requested that 

OWCP combine File Nos. xxxxxx957 and xxxxxx886 into one claim as they were duplicative 

and both cited January 1, 2007 as the date of awareness of the injury and September 6, 2009 as 

the date she related her condition to work. Appellant filed the second claim because the work 

factors continued and she had pain and was scheduled to undergo additional surgery. 

In the March 14, 2013 report, Dr. Malay obtained a history of the work-related bilateral 

foot condition and appellant’s medical treatment. He stated that as a mail carrier she had to stand 
5

and walk up to 10 hours a day. Appellant rated her pain as 5 to 7 on a 10-point scale. On 

physical examination, Dr. Malay reported normal findings. On neurological examination, he 

reported essentially normal findings with the exception of a faintly present bilateral Tinel’s sign 

posterior to the medial malleolus at the tibial nerve to percussion which radiated to the sole but 

not fully to the toes and without proximal radiation. Appellant’s stance and gait displayed a 

smooth, comfortable and self-selected cadence without early heel off and with normal appearing 

propulsion bilaterally with the exception of flexor stabilization digital contractures (hammering 

of the toes). In the open kinetic chain, the digits were fully relocating with push-up loading of 

the metatarsus bilaterally. Appellant reported pain in her tarsal tunnel and metatarsal ball in 

stance. Palpation and moderate deep pressure revealed tenderness in both tarsal tunnels and 

there was palpable and boggy edema localized to the peroneal tendon sheath as it coursed 

posterior and distal to the lateral malleolus only in the left leg and ankle. 

Dr. Malay assessed bilateral tarsal tunnel syndrome and metatarsalgia. He advised that 

appellant’s peroneal tendinitis appeared to be quiescent as it had evidently responded to therapy. 

Appellant did not have complex regional pain syndrome (CRPS), reflex sympathetic dystrophy 

(RSDS), (CRPS Type I) or causalgia (CRPS Type II) as she readily allowed examination and 

manipulation of her feet, showed no gross evidence of vasomotor instability (despite cigarette 

smoking) and did not display allodynia (pain due to nonnoxious stimuli) or hyperpathia (pain out 

of proportion to a stimulus) in either foot. Moreover, appellant did not appear to have 

rheumatoid arthritis or any other systemic arthropathy of an inflammatory nature even though a 

blood test displayed a low level rheumatoid factor. 

Dr. Malay suspected that this could be aggravating to appellant’s pedal and ankle 

conditions as it may have contributed to a low level of inflammation in her connective tissues 

(tendons, ligaments, bones and joints) that were slow to heal as compared to an individual 

without the presence of this autoantibody. He stated that cigarette smoking byproducts were also 

known to upregulate certain proinflammatory cytokines in patients with the rheumatoid factor 

present in their serum which could contribute to appellant’s foot and ankle pain. Furthermore, 

there was no objective evidence of tremor or muscle spasm during examination. Dr. Malay 

advised that appellant’s current pain and disability were the result of years of prolonged weightbearing work requirements, in particular long hours carrying mail and performing other standing 

work duties. The hyperpronating mechanics of her feet led to the development of chronic plantar 

fasciitis, followed by compensatory peroneal tendinitis as the peroneal tendon attempted to 

plantarflex the first ray to resist the progressive valgus deformation. Despite focal therapies 

aimed at resisting the hyperpronation-induced pes valgoplanus deformation (hindfoot pronation 

leading to flattening of her pedal arch), including foot orthoses and physical therapy, alteration of 

activities, anti-inflammatory and analgesic medications, and surgery, every time appellant 

resumed her weight-bearing duties she relapsed into the same foot and ankle pain, which was 

indicative of an inability of her tissues to stand up to the demands of her job despite her efforts to 

carry them out. Dr. Malay stated that the duration of time dedicated to recovery following her 

surgical treatments was appropriate since six weeks was typically enough time for soft tissue 

healing and the gradual resumption of physical activities. He concluded that appellant should 

satisfactorily improve within 6 to 12 more months of supportive therapy and sedentary duties 

that did not require more than one hour of continuous weight-bearing activity. 

In an undated report, Dr. Chen provided a history of his treatment of the accepted 

employment injury and appellant’s medical treatment and work capacity. He advised that she 
6

was currently able to work full time, five days a week with Monday and Sunday off for rest. The 

days off restriction would allow appellant’s foot and heel to recover. Appellant still required 

chronic pain control medication. Dr. Chen advised that the symptoms related to her heel would 

be recurrent and episodic in nature. From time to time, appellant would require time and days 

off as needed due to her level of discomfort. Resting her foot periodically was important to 

reduce pain and inflammation, thereby preventing her acute symptoms from progressing and 

lingering. 

In a July 19, 2012 report, Dr. Damian M. Andrisani, a Board-certified orthopedic 

surgeon, obtained a history of appellant’s bilateral lower extremities conditions. On physical 

examination, he reported essentially normal findings with the exception of pain over the anterior 

border of the tibia. Dr. Andrisani reviewed x-rays of the knees and legs which were normal. He 

noted that a May 11, 2012 bone scan demonstrated no abnormalities consistent with CRPS, but 

there was a suggestion of degenerative changes of the proximal tibula and fibular articulation. 

Dr. Andrisani further noted that the May 14, 2012 EMG/NCS were negative for any 

abnormalities of bilateral lower extremities. He diagnosed bilateral lower extremity leg pain and 

stated that appellant was three weeks status post left ankle surgery. Dr. Andrisani advised that 

the pain about the anterior aspect of her leg may be secondary to compensation of chronic 

peroneal tendinosis. He did not expect any improvement for at least several months following 

appellant’s surgery. 

An unsigned report dated July 27, 2012 contained the printed name of “Dr. Williams.” It 

stated that since appellant’s last visit on May 4, 2012 she had undergone surgery at the lateral 

malleolus on the left. Three to four weeks since the surgery she had made an excellent recovery 

and was satisfied with the outcome. Appellant continued to experience burning pain in the soles 

of both feet which she believed was due to ongoing plantar fasciitis. 

In a September 6, 2012 decision, under OWCP File No. xxxxxx886, OWCP denied 

appellant’s occupational disease claim. It found that Dr. Andrisani’s report was insufficient to 

establish that her current left ankle condition was causally related to her prior claim or that her 

regular carrier position caused peroneal tendinitis of the left ankle. OWCP further noted that 

Dr. Valentino’s report found no causal relationship between appellant’s accepted condition and 

peroneal tendinitis for which she underwent surgery on June 27, 2012 and her employment. On 

September 24, 2012 appellant requested an oral hearing before an OWCP hearing representative. 

By letter dated March 3, 2013, appellant’s attorney, again requested that OWCP combine 

appellant’s claims under File Nos. xxxxxx957 and xxxxxx886. 

In a March 27, 2013 decision, under OWCP File No. xxxxxx886, an OWCP hearing 

representative affirmed the September 6, 2012 decision. He found that OWCP properly 

adjudicated the claim as a new occupational disease. The factual and medical evidence 

supported the filing of a new occupational disease claim based on appellant’s renewed exposure 

to previously injurious work factors. The hearing representative found that she failed to submit 

rationalized medical evidence sufficient to establish that her left peroneal tendon condition was 

causally related to the established employment factors. In an April 10, 2013 letter, appellant’s 

attorney requested reconsideration and submitted Dr. Malay’s March 14, 2013 report. 
7

In an April 11, 2013 letter, OWCP denied appellant’s request to combine File Nos. 

xxxxxx957 and xxxxxx886. It noted that this request was previously addressed by the hearing 

representative’s March 27, 2013 decision under File No. xxxxxx886. The hearing representative 

stated that the factual and medical evidence supported that a new claim for an occupational 

condition should be filed based upon appellant’s renewed exposure to potentially injurious work 

factors. He also stated that the claim under File No. xxxxxx957 was accepted for traumatic 

bilateral plantar fasciitis while the claim under File No. xxxxxx886 sought compensation for left 

peroneal tendon. 

In a May 14, 2013 decision, OWCP denied modification of its termination decision. It 

found that the medical evidence submitted was insufficient to outweigh the weight accorded to 

Dr. Valentino’s April 17, 2012 report. 

In a July 9, 2013 decision, under OWCP File No. xxxxxx886, OWCP denied 

modification of the March 27, 2013 decision. It found that Dr. Malay’s report did not provide a 

sufficiently rationalized medical opinion based on an accurate factual background and objective 

test results to support his physical examination findings. 

LEGAL PRECEDENT -- ISSUE 1 

The United States shall pay compensation for the disability of an employee resulting 

from personal injury sustained while in the performance of duty.3

 Once OWCP accepts a claim, 

it has the burden of proof to justify termination or modification of compensation benefits.4

 After 

it has determined that an employee has disability causally related to federal employment, OWCP 

may not terminate compensation without establishing that the disability has ceased or that it is no 

longer related to the employment.5

ANALYSIS – ISSUE 1 

The Board finds that OWCP met its burden of proof to terminate appellant’s wage-loss 

compensation and medical benefits as of July 9, 2012. OWCP accepted that appellant sustained 

traumatic bilateral plantar fasciitis while in the performance of duty. As of February 10, 2011, 

appellant worked in a limited-duty position eight hours a day every other day. OWCP obtained a 

second opinion from Dr. Smith, a Board-certified orthopedic surgeon, who opined on April 18, 

2011 that appellant had no residuals of her accepted traumatic bilateral plantar fasciitis and that 

she could continue to perform her regular full-time work duties. 

OWCP found that another second opinion was necessary and referred appellant to 

Dr. Valentino to determine whether she could perform full-time, full-duty work with no 

restrictions. Dr. Valentino’s April 17, 2012 report reviewed a history of the accepted 

employment injury and appellant’s medical treatment which included her authorized 

August 2010 plantar surgery. He provided normal examination findings. Dr. Valentino found 

 3

 5 U.S.C. § 8102(a). 

4 Harold S. McGough, 36 ECAB 332 (1984). 

5 Jason C. Armstrong, 40 ECAB 907 (1989). 
8

that appellant could work normally and perform heel and toe squats and return without postural 

difficulty. He further found that she had a well-healed small scar consistent with her surgery and 

his review of her records. On examination of the spine, Dr. Valentino reported full range of 

motion and negative classic modified Spurling’s maneuvers, sitting spine, straight leg raising and 

prone stretch sitting. On neurologic examination, he reported intact deep tendon reflexes, normal 

motor and sensory examination and no pathologic reflexes. Regarding the hips, knees, ankle and 

feet, Dr. Valentino found no synovitis, effusion or internal derangement or tenderness with 

palpation of the peroneal tendon. He also found that the ankle had good stability and intact 

medial deltoid and lateral ligaments. Dr. Valentino further found that a plantar examination 

revealed no tenderness over the incision site which was well healed and no abnormal findings on 

stretching of the plantar fascia bilaterally. He reported that an anterior drawer sign and stress 

testing were negative. Dr. Valentino diagnosed resolved plantar fasciitis. 

Based upon his extensive evaluation and review of records, Dr. Valentino opined that 

surgery resolved appellant’s work-related plantar fasciitis symptoms. While he found that an 

MRI scan revealed peroneal tendinosis, he opined that this condition was not related to the 

accepted plantar fasciitis or resolved plantar fasciitis and that any treatment for the diagnosed 

condition was not related to her work injury or work duties. Dr. Valentino explained that, since 

this finding was not present early on and appellant’s work-related condition had completely 

resolved, she had no complaints compatible with residuals of the accepted condition. He 

concluded that she could perform full-time, full-duty work with no restrictions. 

The Board finds that Dr. Valentino’s report represents the weight of the medical evidence 

and that OWCP properly relied on his report in terminating appellant’s wage-loss compensation 

and medical benefits for the accepted condition on July 9, 2012. Dr. Valentino’s opinion is 

based on a proper factual and medical history as he reviewed the statements of accepted facts and 

appellant’s prior medical treatment. He also related his comprehensive examination findings in 

support of his opinion that appellant no longer had any residuals or disability causally related to 

the accepted traumatic bilateral plantar fasciitis. 

The remaining evidence submitted prior to the termination of compensation is 

insufficient to show that appellant had any remaining work-related residuals or disability. 

Dr. Chen’s April 8, 2011 duty status report found that appellant could return to full-time, fullduty work on that date. His subsequent reports addressed her plantar fasciitis and pain in her left 

heel and peroneal brevis tendon and disability for work on certain dates. The Board has 

generally held that pain is a symptom, rather than a firm medical diagnosis.6

 Moreover, 

Dr. Chen did not provide any opinion addressing whether appellant’s conditions and disability 

for work were causally related to the accepted employment injury. The Board has held that 

medical evidence that does not offer any opinion regarding the cause of an employee’s condition 

is of limited probative value on the issue of causal relationship.7

 

Dr. Reich’s March 26, 2012 report noted that when appellant was seen on February 10, 

2012 she reported that her job as a mail carrier which required her to continuously hop in and out 

 6 C.F., Docket No. 08-1102 (issued October 10, 2008). 

7 See K.W., 59 ECAB 271 (2007); A.D., 58 ECAB 149 (2006); Jaja K. Asaramo, 55 ECAB 200 (2004); 

Michael E. Smith, 50 ECAB 313 (1999). 
9

of her truck caused and exacerbated her bilateral left greater than right ankle pain. He diagnosed 

her current condition as tendinosis of the peroneus longus tendon with peritendinosis of the 

common peroneus tendon sheath of the left ankle based on an MRI scan. Dr. Reich 

recommended surgery to treat the diagnosed condition and advised that appellant would be 

unable to work approximately six to eight weeks following surgery due to her physical work 

activities. He merely repeated the history of injury as reported by appellant without providing 

his own opinion on whether her condition was work related. Dr. Reich failed to provide a 

rationalized opinion regarding the causal relationship between her left ankle condition and the 

factors of employment believed to have caused or contributed to such condition.8

 

In a June 8, 2012 Form CA-20, Dr. Reich indicated with a checkmark that appellant’s left 

peroneal tendinitis was caused or aggravated by an employment activity. He advised that she 

was scheduled to undergo left ankle surgery and would be totally disabled from June 27 to 

August 27, 2012. The Board has held that an opinion consisting of a physician’s checkmark is of 

diminished probative value without any explanation or rationale for the conclusion reached.9 

Dr. Reich did not adequately explain how the diagnosed condition or total disability was caused 

or contributed to by the accepted employment-related injury. In a May 25, 2012 note, he found 

that appellant could return to full-duty work as of May 21, 2012. Dr. Reich did not provide an 

opinion of whether appellant’s disability was related to the accepted work injury. 

Neither Dr. Sarlo’s EMG/NCS nor the hospital records related to appellant’s June 27, 

2012 left ankle surgery provided an opinion addressing whether she had any continuing residuals 

or disability due to the accepted work injury.10 

The Board finds that Dr. Valentino’s opinion that appellant had recovered from the 

employment injury represents the weight of the medical evidence and the additional medical 

evidence submitted is insufficient to create a conflict in opinion regarding whether she had 

continuing residuals or disability related to the accepted injury. Therefore, OWCP properly 

terminated appellant’s compensation effective July 9, 2012 based on Dr. Valentine’s opinion. 

LEGAL PRECEDENT -- ISSUE 2 

Once OWCP properly terminates appellant’s compensation benefits, the burden shifts to 

appellant to establish that she has continuing disability after that date related to her accepted 

injury.11 To establish a causal relationship between the condition as well as any attendant 

disability claimed and the employment injury, an employee must submit rationalized medical 

evidence based on a complete medical and factual background, supporting such a causal 

 8 Franklin D. Haislah, 52 ECAB 457 (2001) (medical reports not containing rationale on causal relationship are 

entitled to little probative value); Jimmie H. Duckett, 52 ECAB 332 (2001). 

9 D.D., 57 ECAB 734 (2006); Sedi L. Graham, 57 ECAB 494 (2006). 

10 See cases cited, supra note 7. 

11 See I.J., 59 ECAB 408 (2008); Franklin D. Haislah, supra note 8. 
10

relationship.12 Causal relationship is a medical issue and the medical evidence required to 

establish a causal relationship is rationalized medical evidence.13

ANALYSIS -- ISSUE 2 

The Board finds that appellant has not established that she has any continuing residuals or 

disability causally related to her work-related traumatic bilateral plantar fasciitis after 

July 9, 2012. 

After the termination of her wage-loss compensation and medical benefits on July 9, 

2012, appellant submitted a March 14, 2013 report from Dr. Malay. He found that appellant’s 

peroneal tendinitis appeared to be quiescent as it had responded to therapy. Dr. Malay further 

found that her bilateral tarsal tunnel syndrome, metatarsalgia and disability were causally related 

to factors of her employment. However, he did not find that appellant was disabled for work due 

to objective residuals of the accepted traumatic bilateral plantar fasciitis. Instead, Dr. Malay 

attributed her inability to work to bilateral tarsal tunnel syndrome and metatarsalgia, conditions 

not accepted as work related by OWCP. Further, he did not provide an opinion addressing 

whether appellant’s resolved peroneal tendinitis resulted from the accepted employment injury.14 

Moreover, Dr. Malay’s opinion on causal relationship is based on an inaccurate history of 

appellant’s established work factors. He stated that her job as a mail carrier required her to, 

among other things, walk up to 10 hours a day to deliver mail. OWCP, however, accepted that 

appellant’s work duties involved hopping out of a LLV 30 times a day to deliver mail. The 

Board notes that medical opinions must be based on a complete and accurate factual and medical 

background and medical opinions based on an incomplete or inaccurate history are of limited 

probative value.15 While Dr. Malay provides an opinion on causal relationship, he relates 

appellant’s injuries and disability to walking long hours, not driving and dismounting her LLV. 

For the stated reasons, the Board finds that his report is insufficient to meet appellant’s burden of 

proof. 

Dr. Andrisani’s July 19, 2012 report found that appellant had bilateral lower extremity 

leg pain and that she was status post left ankle surgery. He advised that the pain about the 

anterior aspect of her leg may be secondary to compensation of chronic peroneal tendinosis. As 

stated, pain is not a compensable medical diagnosis.16 Further, Dr. Andrisani did not provide 

any opinion addressing the causal relationship between appellant’s bilateral leg condition and the 

established work factors.17 The Board finds that his report is insufficient to establish appellant’s 

burden of proof. 

 12 Id. 

13 See Paul Foster, 56 ECAB 208 (2004); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000). 

14 See cases cited, supra note 7. 

15 J.R., Docket No. 12-1099 (issued November 7, 2012); Douglas M. McQuaid, 52 ECAB 382 (2001). 

16 C.F., supra note 6. 

17 See cases cited, supra note 7. 
11

Dr. Chen’s undated report provided a history of his treatment of the accepted 

employment injury and appellant’s medical treatment and noted her left heel pain. He advised 

that she could work full time, five days a week with two days off for rest and to allow for 

recovery of her left foot and heel condition, but did not explain how her condition and inability 

to work her regular schedule of six days a week were causally related to the accepted work 

injury. The Board again notes that pain is not a compensable medical diagnosis.18 Moreover, 

Dr. Chen’s opinion that appellant would require time and days off work in the future due to her 

recurrent and episodic heel symptoms to prevent the progression and lingering of her acute 

symptoms of pain and inflammation is based on a fear of future injury. It is well established that 

the possibility of future injury or disability is not a basis for payment of compensation.19 For the 

stated reasons, the Board finds that Dr. Chen’s report is insufficient to satisfy appellant’s burden 

of proof. 

None of the reports submitted by appellant after the termination of benefits included a 

rationalized opinion regarding the causal relationship between her current foot condition and 

disability and her accepted work-related condition. Consequently, appellant did not establish 

that she had any employment-related residuals or disability after July 9, 2012. 

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 3 -- OWCP FILE NO. xxxxxx886 

An employee seeking benefits under FECA20 has the burden of establishing the essential 

elements of his or her claim, including the fact that the individual is an employee of the United 

States within the meaning of FECA; that the claim was filed within the applicable time 

limitation; that an injury was sustained while in the performance of duty as alleged and that any 

disability and/or specific condition for which compensation is claimed are causally related to the 

employment injury.21 These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated on a traumatic injury or an occupational disease.22

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (1) medical evidence establishing the 

presence or existence of the disease or condition for which compensation is claimed; (2) a factual 

statement identifying 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 

employment factors identified by the claimant were the proximate cause of the condition for 

 18 See C.F., supra note 6. 

19 I.J., supra note 11; Gaeten F. Valenza, 39 ECAB 1349, 1356 (1988). 

20 5 U.S.C. §§ 8101-8193. 

21 C.S., Docket No. 08-1585 (issued March 3, 2009); Elaine Pendleton, 40 ECAB 1143 (1989). 

22 S.P., 59 ECAB 184 (2007); Victor J. Woodhams, 41 ECAB 345 (1989); Joe D. Cameron, 41 ECAB 

153 (1989). 
12

which compensation is claimed or, stated differently, medical evidence establishing that the 

diagnosed condition is causally related to the employment factors identified by the claimant. 

The medical evidence required to establish a causal relationship is rationalized medical opinion 

evidence. The opinion of the physician must be based on a complete factual and medical 

background of the employee, must be one of reasonable certainty, and must be supported by 

medial rationale explaining the nature of the relationship between the diagnosed condition and 

the specific employment factors identified by the employee.23 Neither the fact that appellant’s 

condition became apparent during a period of employment nor, his or her belief that the 

condition was caused by his or her employment is sufficient to establish a causal relationship.24

Proceedings under FECA are not adversarial in nature nor is OWCP a disinterested 

arbiter. While the claimant has the burden to establish his or her claim, OWCP also has a 

responsibility in the development of the evidence.25

ANALYSIS -- ISSUE 3 -- OWCP FILE NO. xxxxxx957 

The Board finds that this case is not in posture for decision as to whether appellant 

sustained a left ankle peritendinosis causally related to her federal employment. 

OWCP accepted appellant’s factors of federal employment as a rural letter carrier. It 

denied her occupational disease claim for a left ankle injury, however, finding that the weight of 

the medical evidence rested with Dr. Valentino, OWCP’s referral physician, who found that 

appellant’s left ankle condition was not causally related to the accepted employment factors. 

In the April 17, 2012 report, Dr. Valentino found that left ankle MRI scan findings of 

peroneal tendinosis were not related to either the work-related plantar fasciitis injury or resolved 

bilateral plantar fasciitis. He further found that appellant could perform full-duty work on a fulltime basis with no restrictions and that any treatment for her peroneal tendinitis was not related 

to her work injury or duties. The Board notes that the statement of accepted facts and list of 

questions forwarded to Dr. Valentino in OWCP File No. xxxxxx957 addressed the accepted 

bilateral plantar fasciitis condition. He was asked to provide an opinion on whether appellant 

continued to have residuals of this employment-related injury and identify her work restrictions. 

In the claim under OWCP File No. xxxxxx886, OWCP did not ask Dr. Valentino to address 

whether appellant’s peroneal tendinosis was causally related to her federal employment.26 His 

report only noted that this condition was not causally related to the accepted bilateral plantar 

fasciitis injury for which appellant filed a claim on January 8, 2010 and the work duties claimed 

to have caused this accepted injury. Dr. Valentino did not provide any medical opinion 

addressing the causal relationship between appellant’s peroneal tendinosis and the work duties 

she performed after her authorized August 17, 2010 left foot surgery, recovery and return to 

limited-duty work on February 10, 2011 through June 27, 2012, the date of her left ankle 

 23 I.J., supra note 11; Victor J. Woodhams, id. at 351-52.

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

25 See Claudia A. Dixon, 47 ECAB 168, 170 (1995). 

26 The Board notes the case record in OWCP File No. xxxxxx886 does not contain the statement of accepted facts 

and list of questions forwarded to Dr. Valentino in OWCP File No. xxxxxx957. 
13

surgery. The Board finds, therefore, that Dr. Valentino’s report is not dispositive on the issue of 

causal relationship. 

Once OWCP undertakes development of the record it must do a complete job in 

procuring medical evidence that will resolve the relevant issues in the case.27 When it selects a 

physician for an opinion on causal relationship, it has an obligation to secure, if necessary, 

clarification of the physician’s report and to have a proper evaluation made.28 Because it 

referred appellant to a second opinion physician, it has the responsibility to obtain a report that 

will resolve the issue of whether her left ankle condition was caused by her federal 

employment.29 Dr. Valentino did not provide a rationalized opinion on the cause of appellant’s 

left ankle condition. 

The case will be remanded to OWCP for further development of the medical evidence.30 

On remand, OWCP should prepare a new statement of accepted facts regarding appellant’s 

claimed work exposure through June 2012 and refer her to a physician in the appropriate field of 

medicine for a rationalized opinion on the causal relationship between her diagnosed left ankle 

condition and her employment duties.31 Following this and any other further development as it 

deems necessary, OWCP shall issue a de novo decision on appellant’s occupational disease 

claim.32

Counsel requested before OWCP and on appeal consolidation of the instant claim under 

File No. xxxxxx957 and appellant’s claim under File No. xxxxxx886 because they are duplicate 

claims due to the same date of awareness of the injury and factors of employment. Counsel 

further asserted that appellant filed the second claim because her work factors continued and she 

experienced pain and required more surgery. While OWCP procedures provide that cases should 

be doubled when a new injury case is reported for an employee who previously filed an injury 

claim for a similar condition or the same part of the body,33 appellant has identified a different 

foot injury in File No. xxxxxx957. As noted, the Board has directed separate further 

development of the medical record in File No. xxxxxx957. While the claims may be 

substantially similar in some respects, they do not appear to be identical. For the stated reasons, 

the Board finds that counsel’s arguments have not been established. 

 27 Phillip L. Barnes, 55 ECAB 426, 441 (2004); see also Virginia Richard (Lionel F. Richard), 53 ECAB 430, 

433 (2002); Dorothy L. Sidwell, 36 ECAB 699, 707 (1985); William J. Cantrell, 34 ECAB 1233, 1237 (1993). 

28 Alva L. Brothers, Jr., 32 ECAB 812 (1981). 

29 See Ramon K. Farrin, Jr., 39 ECAB 736 (1988). 

30 S.E., Docket 08-2243 (issued July 20, 2009). 

31 When a medical evaluation is made at its request, OWCP has the responsibility of obtaining a proper 

evaluation. Leonard Gray, 25 ECAB 147, 151 (1974). 

32 See P.K., Docket No. 08-2551 (issued June 2, 2009); see also Horace Langhorne, 29 ECAB 820, 822 (1978). 

33 See Federal (FECA) Procedure Manual, Part 2 -- Claims, File Maintenance and Management, Chapter 

2.400.8(c)(1) (February 2000). 
14

CONCLUSION 

The Board finds that OWCP properly terminated appellant’s compensation benefits 

effective July 9, 2012 on the grounds that she no longer had any residuals or disability causally 

related to her accepted employment-related injury. The Board further finds that appellant failed 

to establish that she had any continuing employment-related residuals or disability after 

July 9, 2012. Lastly, the Board finds that the case is not in posture for a decision as to whether 

appellant sustained a left ankle injury in the performance of duty. 

ORDER 

IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’ 

May 14, 2013 decision is affirmed and July 9 and March 27, 2013 decisions are set aside and the 

case is remanded for further consideration consistent with this decision. 

Issued: September 4, 2014 

Washington, DC 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 

 Michael E. Groom, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board