United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.R., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

San Francisco, CA, Employer 

__________________________________________ 

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Docket No. 14-544 

Issued: May 8, 2014 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

RICHARD J. DASCHBACH, Chief Judge 

MICHAEL E. GROOM, Alternate Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On January 13, 2014 appellant filed a timely appeal from an October 2, 2013 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 established that she sustained a right shoulder condition in 

the performance of duty. 

FACTUAL HISTORY 

On July 30, 2013 appellant, a 55-year-old city carrier, filed a Form CA-2 occupational 

disease claim, alleging that she developed a torn right rotator cuff condition causally related to 

employment factors. 

 1

 5 U.S.C. § 8101 et seq. 
2

In a July 19, 2013 Form CA-20 report, Dr. Brian T. Feeley, an orthopedic surgeon, 

diagnosed a rotator cuff tear as indicated by results of a magnetic resonance imaging (MRI) scan. 

He indicated that appellant did not sustain a specific injury but began experiencing shoulder pain 

in 2012. Dr. Feeley advised that it was possible that appellant’s work caused the tear or 

increased her symptoms. He scheduled her for surgery on September 10, 2013, imposed a lifting 

restriction of 15 pounds and placed her on disability for three months. Dr. Feeley checked a box 

indicating that the diagnosed condition was caused or aggravated by employment activity. 

On August 16, 2013 OWCP advised appellant that it required additional factual and 

medical evidence to determine whether she was eligible for compensation benefits. It asked her 

to submit a comprehensive report from her treating physician describing her symptoms and the 

medical reasons as to whether her claimed condition was causally related to her federal 

employment. OWCP requested that appellant submit this evidence within 30 days. 

In a July 23, 2013 report, Dr. Michael L. Cheng, a specialist in internal medicine, noted 

that appellant had complaint of chronic right shoulder pain and a right rotator cuff tear. He 

advised that she was planning to undergo orthopedic surgery to repair her right rotator cuff on 

September 10, 2013. 

A September 7, 2012 right shoulder magnetic resonance imaging (MRI) scan revealed 

supraspinatus tendinosis with a full-thickness tear of the anterior fibers; a high-grade 

intrasubstance tear within the critical zone; mild atrophy of the supraspinatus muscle; 

infraspinatus tendinosis with high-grade intra-substance tear with laminar extension proximally 

into the muscle fibers where there was an associated small intramuscular cyst; marked thickening 

and tendinosis of the subscapularis with at least partial tear of the superior fibers; severe 

tendinosis with partial tear of the biceps tendon with subluxation of the biceps tendon; 

degeneration and tear of the labrum and biceps tendon anchor; and a full thickness fissuring and 

cartilage loss along the inferior glenoid, with moderate-sized effusion. 

By decision dated October 2, 2013, OWCP denied appellant’s claim. It accepted that 

appellant performed duties as a letter carrier but found that she failed to submit sufficient 

medical evidence to establish that her claimed right shoulder condition was causally related to 

her work. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA2

 has the burden of establishing that 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 period of FECA, that an injury was sustained 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.3 These are the essential elements of each and every 

 2 Id.

3 Joe D. Cameron, 41 ECAB 153 (1989); Elaine Pendleton, 40 ECAB 1143 (1989). 
3

compensation claim regardless of whether the claim is predicated upon a traumatic injury or an 

occupational disease.4

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 medical evidence required to establish causal relationship is usually rationalized medical 

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.5

Appellant has the burden of establishing by the weight of the substantial, reliable and 

probative evidence, a causal relationship between her claimed right shoulder condition and her 

federal employment. This burden includes providing medical evidence from a physician who 

concludes that the disabling condition is causally related to employment factors and supports that 

conclusion with sound medical reasoning.6

ANALYSIS 

The Board finds that appellant failed to submit sufficient medical evidence to establish 

that her claimed right shoulder condition was related to factors of her employment. For this 

reason, she has not discharged her burden of proof. 

In support of her claimed condition, appellant submitted reports from Drs. Feeley and 

Cheng. The physicians advised that she had a right rotator cuff tear and was scheduled to have 

surgery on September 30, 2013. In a July 19, 2013 form report, Dr. Feeley listed a history that 

appellant began having shoulder pain in 2012 which was not attributable to a specific injury. He 

diagnosed a rotator cuff tear as shown by MRI scan. Dr. Feeley noted generally that her work 

could have caused the tear or increased her symptoms. He scheduled rotator cuff surgery for 

September 10, 2013, placed her on disability for three months and imposed a 15-pound lifting 

restriction. Dr. Feeley checked a box indicating that appellant’s diagnosed condition was caused 

or aggravated by an employment activity. In a July 23, 2013 report, Dr. Cheng advised that she 

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

5 Id.

6 See Nicolea Bruso, 33 ECAB 1138, 1140 (1982). 
4

had complaints of chronic right shoulder pain and diagnosed a right rotator cuff tear. He related 

that appellant had scheduled right rotator cuff repair surgery for September 10, 2013. 

Drs. Feeley and Cheng did not provide sufficient medical opinion addressing how 

appellant’s right shoulder condition or disability was causally related to her employment duties 

as a letter carrier. The weight of medical opinion is determined by the opportunity for and 

thoroughness of examination, the accuracy and completeness of physician’s knowledge of the 

facts of the case, the medical history provided, the care of analysis manifested and the medical 

rationale expressed in support of stated conclusions.7

 The physicians did not sufficiently 

describe appellant’s job duties or explain the medical process by which such duties would cause 

or contribute to a torn rotator cuff. The reports from Drs. Feeley and Cheng fail to explain how 

appellant’s diagnosed condition resulted from factors of her employment. They did not address 

the history of appellant’s shoulder conditions in any detail or how her work duties were 

competent to cause the current condition.8 The reports note that appellant had a right rotator cuff 

tear which required surgery; but do not attribute the diagnosed condition to appellant’s 

employment duties. The July 19, 2013 form report from Dr. Feeley that supported causal 

relationship with a checkmark is insufficient to establish the claim. The Board has held that 

without further explanation or rationale, a checked box is not sufficient to establish causation.9

An award of compensation may not be based on surmise, conjecture or speculation. 

Neither the fact that appellant’s conditions became apparent during a period of employment nor 

the belief that his conditions were caused, precipitated or aggravated by his employment is 

sufficient to establish causal relationship.10 Causal relationship must be established by 

rationalized medical opinion evidence and appellant failed to submit such evidence. 

OWCP advised appellant of the evidence required to establish her claim; however, she 

failed to submit such evidence. Consequently, appellant has not met her burden of proof in 

establishing that her claimed right shoulder condition was causally related to her employment. 

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 10.607.11

CONCLUSION 

The Board finds that appellant has failed to meet her burden of proof in establish that her 

claimed right shoulder condition was sustained in the performance of duty. 

 7 See Anna C. Leanza, 48 ECAB 115 (1996). 

8 William C. Thomas, 45 ECAB 591 (1994). 

9 Debra S. King, 44 ECAB 203 (1992); Salvatore Dante Roscello, 31 ECAB 247 (1979). 

10 See Anna C. Leanza, supra note 7. 

11 The Board notes that appellant submitted additional evidence to the record following OWCP’s October 2, 2013 

decision. The Board’s jurisdiction is limited to a review of evidence which was before OWCP at the time of its final 

review. 20 C.F.R. § 501(c). 
5

ORDER 

IT IS HEREBY ORDERED THAT the October 2, 2013 decision of the Office of 

Workers’ Compensation Programs be affirmed. 

Issued: May 8, 2014 

Washington, DC 

 

 Richard J. Daschbach, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Michael E. Groom, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board