United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

L.S., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Brooklyn, NY, Employer 

__________________________________________ 

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Docket No. 15-0779 

Issued: August 7, 2015 

Appearances: Case Submitted on the Record

Thomas R. Harkins, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On February 19, 2015 appellant, through counsel, filed a timely appeal from a 

December 3, 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 an occupational 

disease in the performance of duty. 

FACTUAL HISTORY 

On November 18, 2013 appellant worked as a 54-year-old city letter carrier. She filed an 

occupational disease claim alleging that she injured her knees in the performance of duty. 

Appellant advised that walking up and down stairs caused pain and swelling in both knees. She 

 1

 5 U.S.C. § 8101 et seq. 
2

became aware of her condition and its relation to her federal employment on July 8, 2013. 

Appellant stopped work on July 8, 2013 and returned on October 1, 2013. 

By letter dated December 16, 2013, OWCP notified appellant that evidence was 

insufficient to establish the claim. Appellant was instructed to complete a questionnaire 

establishing the factual element of her claim and advised of the type of medical evidence needed. 

In a December 30, 2013 medical note, Dr. Dante Trovato, a Board-certified orthopedic 

surgeon, advised that appellant was under his care for chondromalacia patella of both knees. He 

reported that she was undergoing physical therapy, but still had bilateral knee problems. 

In a December 30, 2013 statement, appellant advised that she had worked for the 

employing establishment for the past seven years. She noted that on June 15, 2013 she was 

reassigned to Queens, NY where, two weeks into her position, she began experiencing pain in 

both knees for which she sought treatment for during her third week. Appellant further noted 

that she stopped work at that time and returned on October 1, 2013. She stated that three days 

after returning to work her knees were swollen and painful. Appellant attributed her condition to 

climbing and descending stairs. She claimed that she did not engage in any sports or recreational 

activities outside of her federal employment and that she did not have any previous knee 

condition. Appellant requested reassignment back to the city. 

By decision dated February 27, 2014, OWCP denied the claim because medical evidence 

was insufficient to establish that a medical condition was diagnosed in relation to appellant’s 

work duties. 

By letter dated September 10, 2014, appellant’s counsel, requested reconsideration. He 

asserted that he was submitting a new medical report that was sufficient to discharge appellant’s 

burden of proof. 

In a July 7, 2014 report, Dr. Trovato advised that he began treating appellant on July 17, 

2013 for bilateral knee pain. He noted that she was experiencing pain and swelling in both knees 

upon ambulation exacerbated by walking up and down steps, kneeling, carrying heavy objects, 

and squatting. Dr. Trovato further noted seeing appellant on August 28, 2013 after a magnetic 

resonance imaging (MRI) scan report revealed patella femoral osteoarthritis with fraying of 

patella cartilage along the medial patella facet with a small adjacent flap tear. He diagnosed 

patella femoral syndrome and chondromalacia of both knees. Dr. Trovato opined that 

appellant’s condition was permanent and noted that she would have periods of intermittent pain 

and swelling exacerbated by prolonged walking, standing, carrying excessive weight, kneeling, 

and squatting. He asserted that her condition was causally related to her duties as a letter carrier. 

In a November 27, 2013 report, Dr. Trovato diagnosed left knee osteoarthritis as 

demonstrated by an x-ray, provided a series of injections, and found that appellant’s pain had 

moderately improved. A partially legible August 26, 2013 left knee MRI scan report was also 

submitted. 

By decision dated December 3, 2014, OWCP again denied appellant’s occupational 

disease claim finding that the medical evidence did not establish that the medical condition was 

causally related to factors of her employment. 
3

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

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 knee pain as a result of climbing up and 

down stairs. There is no dispute that she climbed stairs as a part of her job. However, the 

medical evidence is insufficient to establish that any medical condition was causally related to 

the accepted work conditions. 

In his July 7, 2014 report, Dr. Trovato diagnosed patella femoral syndrome and 

chondromalacia of both knees. He opined that appellant’s condition was permanent was 

exacerbated by prolonged walking, standing, carrying excessive weight, kneeling, and squatting. 

 2 Elaine Pendleton, 40 ECAB 1143 (1989). 

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

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). 
4

Dr. Trovato opined that her condition was causally related to her duties as a letter carrier. 

However, he did not provide any medical rationale to explain how these duties contributed to 

appellant’s condition. As noted, rationalized medical opinion evidence is generally required to 

establish causal relationship. Dr. Trovato’s report is insufficient to discharge appellant’s burden 

of proof. Other reports from Dr. Trovato, including his November 27 and December 30, 2013 

reports, do not address causal relationship.7

There is no other medical evidence of record addressing how appellant’s work factors 

caused or contributed to a diagnosed medical condition. 

On appeal appellant’s counsel asserts that appellant submitted evidence that was 

sufficient to establish the claim. As explained, the medical evidence is insufficient to establish 

that the work duties caused or contributed to appellant’s claimed condition. 

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 failed to establish an occupational disease caused by 

work-related events. 

 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). 
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ORDER 

IT IS HEREBY ORDERED THAT the December 3, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: August 7, 2015 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board