United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

L.F., Appellant 

and 

DEPARTMENT OF LABOR, MINE SAFETY & 

HEALTH ADMINISTRATION, 

Mount Hope, WV, Employer 

__________________________________________ 

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Docket No. 14-1144 

Issued: August 14, 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 

COLLEEN DUFFY KIKO, Judge 

JURISDICTION 

On April 21, 2014 appellant filed a timely appeal of a March 19, 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 to 

consider the merits of the case.2

ISSUE 

The issue is whether appellant has met her burden of proof to establish an antibiotic 

resistant staph infection due to exposures during her federal employment. 

 1

 5 U.S.C. § 8101 et seq.

2

 Appellant filed a timely request for oral argument, pursuant to 20 C.F.R. § 501.5(b). After exercising its 

discretion pursuant to 20 C.F.R. § 501.5(a) the Board, by a July 10, 2015 order, denied appellant’s request because it 

could adequately address appellant’s contentions based on a review of the case record. Order Denying Request for 

Oral Argument, Docket No. 14-1144 (issued July 10, 2015). 
2

FACTUAL HISTORY 

On January 24, 2013 appellant, then a 59-year-old mine safety and health assistant, filed 

an occupational disease alleging that she had developed methicillin-resistant staphylococcus 

aureus or multidrug resistant staphylococcus aureus (MRSA) in the employing establishment 

field office. OWCP requested additional factual and medical evidence in support of her claim by 

letter dated January 31, 2013. 

Appellant completed a statement in support of her claim noting that an inspector in her 

office had MRSA and did not follow good hygiene. After the inspector’s retirement, the 

employing establishment used “our normal cleaning lady” to disinfect the facility. On March 30, 

2012 the employing establishment promised disinfectants and hand sanitizers which did not 

appear. On April 4, 2012 appellant was diagnosed with MRSA. She noted that she was an 

insulin-dependent diabetic and should have been informed of special precautions. Appellant 

stated that the infection had weakened her immune system and that she currently had an infection 

in her kidney and urinary tract that was antibiotic resistant. She also submitted excerpts from 

Mine Safety and Health Talks. 

Appellant also responded to OWCP’s request for factual information on February 20, 

2013 stating that she was exposed to MRSA throughout the Princeton field office. She noted 

that files traveled to and from the infected agent’s desk, to the supervisor’s office, and onto her 

desk. Appellant stated that she shared office areas with the infected coworker including the copy 

room, copier, inspectors floor, file cabinets, inspectors workstations, entry, and shoe removal 

area. She noted that it was her job to aid supervisors and inspectors with their paperwork. 

Appellant described the progression of her infection, which she alleged had weakened her 

immune system resulting in kidney and urinary tract infections. 

The employing establishment responded and stated that an employee, now retired was 

diagnosed with MRSA and worked for approximately one year and two months in the office with 

the disease. He reported his condition to his coworkers. The employing establishment noted that 

appellant operates commonly used equipment such as fax and copy machines on a daily basis 

and shared some office space and equipment with the infected coworker for approximately one 

year and two months. It stated that the infected employee used disinfecting wipes and sprays as 

well as hand sanitizer. The building was cleaned with special instructions on MRSA. 

In a report dated March 13, 2013, Dr. Richard Shorter, an osteopath, stated that appellant 

was treated on March 30, April 4, and May 7, 2012 for an abscess of the right labial area. The 

culture was positive for MRSA and the diagnosis was a skin abscess of the right inguinal fold. 

Dr. Shorter stated that exposure to MRSA was increasingly common and could have been 

transmitted to appellant’s skin from any number of surfaces that she might have touched. He 

concluded that an exact etiology would be impossible to determine. Appellant’s tests were 

negative for MRSA on May 25, 2012. Dr. Shorter noted that she had a long standing history of 

type 1 diabetes mellitus, which was not optimally controlled and that as such she might have 

increased susceptibility to infection. He concluded, “Given the high prevalence of MRSA in the 

community setting it would be impossible to determine the source of [appellant’s] infection.” 

Dr. Shorter noted that appellant had a coworker with MRSA, but stated that exposure was likely 

in any public setting such as a retail store, hospital, or office building. 
3

By decision dated March 28, 2013, OWCP denied appellant’s claim finding that the 

medical evidence had not established a causal relationship between her employment exposure 

and her infection. 

Appellant requested an oral hearing before an OWCP hearing representative on 

April 23, 2013. In her testimony at the oral hearing held on September 12, 2013, she stated that 

the employing establishment had not informed her of the active infection in the workplace 

through the coworker. Appellant stated that she was directed to organize the office, dispose of 

papers, and clean the infected coworker’s work area. She described her coworker’s actions 

stating, “He would come in with sores and pop them and scratch them and never wash his hands 

or never even try to cover up the areas.” Appellant noted that her coworker retired in 

December 2012. She was diagnosed with MRSA on March 4, 2013. 

By decision dated November 26, 2013, the hearing representative found that the medical 

evidence was insufficient to support a causal relationship between appellant’s diagnosed MRSA 

infection and her workplace exposure. 

Following the hearing representative’s decision, Dr. Shorter submitted an additional 

report dated September 25, 2013. He again stated that it would be impossible to definitively 

determine the source of appellant’s infection. Dr. Shorter noted again that MRSA was quite 

common in the community and that she could have been exposed to the bacteria in any public 

setting. He then stated, “However, given that [appellant] had a known exposure to MRSA in the 

workplace for a prolonged period of time and given that this is the only known source of 

exposure, this would be the most likely source of her infection.” Appellant requested 

reconsideration based on this report on December 12, 2013. 

By decision dated March 19, 2014, OWCP reviewed Dr. Shorter’s report and denied 

modification of the prior decisions. 

LEGAL PRECEDENT 

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 

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 evidence required to establish causal relationship is rationalized medical opinion 

evidence, based upon a complete factual and medical background, showing a causal relationship 

between the claimed condition, and identified factors. The belief of a claimant that a condition 

was caused or aggravated by the employment is insufficient to establish causal relation.3

 In 

addition, in order to be considered rationalized, the medical opinion must be expressed in terms 

 3 Lourdes Harris, 45 ECAB 545, 547 (1994). 
4

of a reasonable degree of medical certainty and must be supported by medical reasoning 

explaining the nature of the relationship between the diagnosed condition and appellant’s 

specific employment factors.4

ANALYSIS 

Appellant filed an occupational disease claim for an abscess in her inguinal area as 

causally related to her federal employment. She attributed her MRSA infection to exposures for 

a period exceeding a year to a coworker with the infection. Appellant described the shared office 

space and documents with the infected coworker. The employing establishment supported her 

allegations. 

OWCP denied appellant’s claim as the medical evidence had not established that her 

infection resulted from her accepted employment exposures. Dr. Shorter first examined her on 

March 30, 2012 for an abscess, which cultured positive for MRSA. He diagnosed skin abscess 

of the right inguinal fold. Dr. Shorter concluded that an exact etiology of appellant’s exposure 

would be impossible to determine. He noted that she had a coworker with MRSA, but noted that 

exposure was likely in any public setting such as a retail store, hospital, or office building. The 

report does not support appellant’s claim that her MRSA infection was the result of employment 

exposures. Dr. Shorter suggested that she could have contracted the bacteria in any public 

building. He submitted an additional report dated September 25, 2013 and again opined that it 

would be impossible to definitively determine the source of appellant’s infection. Dr. Shorter 

again noted that she has been exposed to the MRSA bacteria in any public setting. He 

concluded, “However, given that [appellant] had a known exposure to MRSA in the workplace 

for a prolonged period of time and given that this is the only known source of exposure, this 

would be the most likely source of her infection.” 

The September 25, 2013 report of Dr. Shorter is of limited probative value in establishing 

that appellant’s diagnosed occupational disease is related to her employment. Dr. Shorter did not 

explain how or why he believed that she developed MRSA due to her employment exposure. He 

merely indicated that there was a possible connection as it was the only known exposure. 

Dr. Shorter continued to emphasize that MRSA was common in the community and that 

appellant had other exposure sources.5

 Without medical opinion evidence addressing the 

mechanics by which her exposure to papers and equipment used in common with her infected 

coworker would have resulted in the diagnosed condition and offering a clear opinion that this 

exposure was the cause of her disease process, this report is insufficient to meet her burden of 

proof. 

The Board finds that appellant has not submitted the necessary medical opinion evidence 

to meet burden of proof to establish a causal relationship between her workplace exposure and 

her diagnosis of MRSA. 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. 

 4 C.W., Docket No. 11-754 (issued October 18, 2011). 

5 C.S., Docket No. 13-203 (issued April 24, 2014). 
5

CONCLUSION 

The Board finds that appellant not met her burden of proof in establishing that she 

developed an antibiotic staph infection due to exposures during her federal employment. 

ORDER 

IT IS HEREBY ORDERED THAT the March 19, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: August 14, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board