United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

P.C., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Lake Crystal, MN, Employer 

__________________________________________ 

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Docket No. 15-514 

Issued: June 3, 2015 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On January 5, 2015 appellant filed a timely appeal from a September 8, 2014 merit 

decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal 

Employees’ Compensation Act1

 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has 

jurisdiction over the merits of this case. 

ISSUE 

The issue is whether appellant met her burden of proof to establish that she sustained an 

occupational disease in the performance of duty. 

FACTUAL HISTORY 

On June 4, 2014 appellant, then a 54-year-old rural carrier, filed an occupational disease 

claim alleging that she injured her left arm in the performance of duty. She stated that she began 

to develop pain in her left triceps muscles and forearm as a result of driving her postal vehicle on 

 1

 5 U.S.C. § 8101 et seq. 
2

snow and ice covered roads. Appellant advised that she first became aware of her condition and 

its relation to her federal employment on December 12, 2013. She did not stop work. 

By letter dated June 17, 2014, OWCP notified appellant that evidence was insufficient to 

establish the claim because no medical evidence was received. It advised her of the type of 

medical evidence needed to establish her claim. 

An April 25, 2014 treatment plan from her healthcare provider noted that appellant had 

upper arm pain. It also noted that she was diagnosed with myalgia. 

In a June 30, 2014 report, Dr. Nathan Groebner, Board-certified in diagnostic radiology, 

advised that an x-ray of the left shoulder revealed no fracture or dislocation. He further advised 

that the glenohumeral joint was normal and there were mild hypertrophic changes in the 

acromioclavicular joint. 

In a July 1, 2014 report, Dr. Annette Schmit-Cline, a family medicine practitioner, 

advised that appellant complained of left shoulder pain since December 12, 2013. She noted that 

appellant’s injury was caused by driving on snow covered roads and holding mail packs for 

delivery. On physical examination, Dr. Schmit-Cline found that the neck, trapezial ridge, and 

bicipital groove showed no tenderness, but the posterior rotator cuff showed moderate 

tenderness. She noted that the left shoulder was normal with no gross deformity, erythema, 

edema, ecchymosis, atrophy, or fasciculation. Dr. Schmit-Cline advised that there was active 

abduction to 100 degrees and no impingement signs. She assessed rotator cuff tendinitis. 

A July 10, 2014 physical therapy report cosigned by Dr. Schmit-Cline was also 

submitted. It advised that appellant’s symptoms were caused by hazardous driving conditions 

including excess snow and ice. It noted that she had to drive from the passenger seat, but the 

steering wheel and brakes were on the driver’s side. It further noted that appellant’s symptoms 

improved as driving conditions improved. 

By decision dated September 8, 2014, OWCP denied appellant’s claim because medical 

evidence did not establish that the medical condition was caused by work-related events. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden to establish the essential 

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

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

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

disabilities and/or specific conditions for which compensation is claimed are causally related to 

the employment injury.2

 These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated upon a traumatic injury or an occupational disease.3

 2 Elaine Pendleton, 40 ECAB 1143 (1989). 

3 Victor J. Woodhams, 41 ECAB 345 (1989). 
3

Whether an employee actually sustained an injury in the performance of duty begins with 

an analysis of whether fact of injury has been established. To establish an occupational disease 

claim, an employee must submit: (1) a factual statement identifying employment factors alleged 

to have caused or contributed to the presence or occurrence of the disease or condition; 

(2) medical evidence establishing the presence or existence of the disease or condition for which 

compensation is claimed; and (3) medical evidence establishing that the diagnosed condition is 

causally related to the employment factors identified by the employee.4

 

Causal relationship is a medical issue and the evidence generally required to establish 

causal relationship is rationalized medical opinion evidence. Rationalized medical opinion 

evidence is generally required to establish causal relationship. The opinion of the physician must 

be based on a complete factual and medical background, must be one of reasonable medical 

certainty, and must be supported by medical rationale explaining the nature of the relationship 

between the diagnosed condition and the specific employment factors identified by the claimant.5 

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.6 

ANALYSIS 

Appellant claimed that she began experiencing left arm pain on December 12, 2013 while 

driving her postal vehicle on snow and ice covered roads. There is no dispute that she drove a 

vehicle as a part of her job and that she sometimes encountered difficult road conditions. 

However, the medical evidence is insufficient to establish that the medical condition was 

causally related to the accepted work conditions. 

Dr. Groebner’s June 30, 2014 report is of limited probative value as it does not support 

that factor of appellant’s employment caused or aggravated a diagnosed left arm condition. The 

Board has held that a report without an opinion as to causal relationship is of little probative 

value.7 The April 25, 2014 healthcare provider treatment plan is not probative medical evidence 

as there is no indication that it is from a physician.8

In her July 1, 2014 report, Dr. Schmit-Cline advised that appellant complained of left 

shoulder pain since December 12, 2013. She noted that appellant’s injury was caused by driving 

on snow covered roads and holding mail packs for delivery and assessed rotator cuff tendinitis. 

Although Dr. Schmit-Cline causally related appellant’s condition to the work events, she does 

not provide adequate medical rationale. She did not explain how driving on snow covered roads 

 4 R.H., 59 ECAB 382 (2008); Ernest St. Pierre, 51 ECAB 623 (2000). 

5 I.J., 59 ECAB 408 (2008); supra note 3. 

6

 James Mack, 43 ECAB 321 (1991). 

7 See Jaja K. Asaramo, 55 ECAB 200 (2004) (medical evidence that does not offer an opinion regarding the cause 

of an employee’s condition is of limited probative value on the issue of causal relationship). 

8 See Charley V.B. Harley, 2 ECAB 208, 211 (1949) (where the Board held that medical opinion, in general, can 

only be given by a qualified physician). 
4

caused or contributed to appellant’s diagnosed condition. As a result, Dr. Schmit-Cline’s report 

is insufficient to discharge appellant’s burden of proof. The July 10, 2014 physical therapy 

report signed by her also attributed appellant’s condition to hazardous driving conditions. 

Although this report explained that appellant was required to drive from the passenger side while 

the steering wheel and brakes were on the driver’s side, there is no medical rationale explaining 

how this caused or contributed to appellant’s rotator cuff tendinitis. 

Consequently, appellant has submitted insufficient medical evidence to establish her 

claim. As noted, causal relationship is a medical question that must be established by probative 

medical opinion from a physician.9

 The physician must accurately describe appellant’s work 

duties and medically explain the pathophysiological process by which these duties would have 

caused or aggravated her condition.10 Because appellant has not provided such medical opinion 

evidence in this case, she has failed to meet her burden of proof. 

Appellant may submit new evidence or argument as part of a formal written request for 

reconsideration to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) 

and 20 C.F.R. §§ 10.605 through 10.607. 

CONCLUSION 

The Board finds that appellant did not establish that she sustained an occupational disease 

caused by work-related events. 

 9 See supra note 5. 

10 Solomon Polen, 51 ECAB 341 (2000) (rationalized medical evidence must relate specific employment factors 

identified by the claimant to the claimant’s condition, with stated reasons by a physician). See also S.T., Docket 

No. 11-237 (issued September 9, 2011). 
5

ORDER 

IT IS HEREBY ORDERED THAT the September 8, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: June 3, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board