United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

R.S., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

El Centro, CA, Employer 

__________________________________________ 

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Docket No. 15-415 

Issued: May 15, 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 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On December 15, 2014 appellant filed a timely appeal of the September 17, 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 has met his burden of proof in establishing that he 

sustained an occupational disease in the performance of duty. 

FACTUAL HISTORY 

On August 8, 2014 appellant then a 55-year-old letter carrier, filed a Form CA-2, 

occupational disease claim for pain in his left knee. He alleged that he had a previous left knee 

injury in 2004 for which he underwent surgery and noted that recently his knee was swollen and 

 1

 5 U.S.C. §§ 8101-8193. 
2

painful. Appellant indicated that he was advised that continued walking would aggravate his 

knee condition. He realized his illness was caused or aggravated by his employment on 

July 31, 2014. Appellant did not stop work. 

In an August 11, 2014 letter, OWCP advised appellant to submit additional information 

including a comprehensive medical report from his treating physician which included a reasoned 

explanation as to how the specific work factors or incidents identified by appellant had 

contributed to his claimed injury. It also requested that appellant respond to a questionnaire to 

substantiate the factual elements of his claim. No additional evidence was received. 

In a September 17, 2014 decision, OWCP denied the claim because appellant did not 

submit sufficient evidence establishing that the injury or events occurred as alleged. It advised 

that he failed to provide a description of specific employment factors that contributed to his 

medical condition and also failed to submit medical evidence containing a medical diagnosis in 

connection with the injury or events. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of his or her claim. When an employee claims that he or she sustained an 

injury in the performance of duty, he or she must submit sufficient evidence to establish that he 

or she experienced a specific event, incident, or exposure occurring at the time, place, and in the 

manner alleged. Appellant must also establish that such event, incident, or exposure caused an 

injury.2

 

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) 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 

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 causal relationship is generally rationalized medical 

opinion evidence. Rationalized medical opinion evidence is medical evidence which includes a 

physician’s rationalized opinion on the issue of whether there is a causal relationship between the 

claimant’s diagnosed condition and the implicated employment factors. The opinion of the 

physician must be based on a complete factual and medical background of the claimant, must be 

one of reasonable medical certainty, and must be supported by medical rationale explaining the 

nature of the relationship between the diagnosed condition and the specific employment factors 

identified by the claimant.3

 2 See Walter D. Morehead, 31 ECAB 188, 194 (1979) (occupational disease or illness); Max Haber, 19 ECAB 

243, 247 (1967) (traumatic injury). See generally John J. Carlone, 41 ECAB 354 (1989); Elaine Pendleton, 40 

ECAB 1143 (1989). 

3 Solomon Polen, 51 ECAB 341 (2000). 
3

ANALYSIS 

Appellant alleged that his knee began to bother him, started to swell, and was painful. He 

noted having a previous left knee injury in 2004, for which he underwent surgery, and was 

advised that continued walking would aggravate his knee condition. 

The Board finds that there is no medical evidence of record to establish that the injury or 

events occurred as alleged. In a letter dated August 11, 2014, OWCP requested that appellant 

submit additional evidence in support of his claim, specifically a comprehensive medical report 

from his treating physician which included a reasoned explanation as to how the specific work 

factors or incidents identified by appellant had caused his claimed injury. It further requested 

that appellant answer a questionnaire to substantiate the factual allegations of his claim. 

However, no response was submitted prior to OWCP’s decision of September 17, 2014. 

As noted, part of appellant’s burden of proof includes the submission of rationalized 

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

a causal relationship between the employment and the diagnosed condition. The record contains 

no medical evidence. Because appellant has not submitted reasoned medical evidence 

explaining how and why his left knee condition was employment related, he has not met his 

burden of proof. 

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

causal relationship is rationalized medical evidence.4 An award of compensation may not be 

based on surmise, conjecture, or speculation. Neither the fact that appellant’s condition became 

apparent during a period of employment nor the belief that his condition was caused, 

precipitated, or aggravated by his employment is sufficient to establish causal relationship. 

Causal relationships must be established by rationalized medical opinion evidence.5 Appellant 

failed to submit such evidence, and OWCP therefore properly denied appellant’s claim for 

compensation. 

On appeal appellant disagreed with OWCP’s decision denying his claim for 

compensation. He explained that his supervisor submitted the claim before his doctor’s 

appointment was scheduled and this was an error. Appellant requested that his claim be 

reviewed with all the information. The record before the Board contains no medical evidence 

explaining how and why his left knee condition was employment related, and therefore he has 

not met his burden of proof.6

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. Therefore, he may submit doctors’ reports obtained 

from examinations after his supervisor submitted his claim. 

 4 Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000). 

5

 See Dennis M. Mascarenas, 49 ECAB 215 (1997). 

6

 With his request for an appeal, appellant submitted additional evidence. However, the Board may not consider 

new evidence on appeal; see 20 C.F.R. § 501.2(c). 
4

CONCLUSION 

The Board finds that appellant did not meet his burden of proof to establish that he 

sustained an occupational disease in the performance of duty. 

ORDER 

IT IS HEREBY ORDERED THAT the September 17, 2014 decision of Office of 

Workers’ Compensation Programs is affirmed. 

Issued: May 15, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board