United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

R.B., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Baltimore, MD, Employer 

__________________________________________ 

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Docket No. 15-1703 

Issued: November 20, 2015 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On August 10, 2015 appellant, through counsel, filed a timely appeal from a March 26, 

2015 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 the case. 

ISSUE 

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

condition in the performance of duty causally related to factors of her federal employment. 

FACTUAL HISTORY 

This case has previously been before the Board. In a decision dated December 12, 2014, 

the Board set aside a December 12, 2013 OWCP decision finding that the medical evidence was 

insufficient to establish that appellant sustained an emotional condition causally related to a 

 1

 5 U.S.C. § 8101 et seq. 
2

compensable work factor.2 The Board determined that a December 2, 2013 report from 

Dr. Christiane Tellefsen, a Board-certified psychiatrist, was insufficient to resolve the issue of 

whether appellant sustained an emotional condition as a result of the compensable employment 

factors. The Board remanded the case for OWCP to obtain a supplemental report from 

Dr. Tellefsen. The facts and circumstances as set forth in the prior decision are incorporated by 

reference. The facts relevant to the instant appeal will be set forth. 

In her initial report dated December 2, 2013, Dr. Tellefsen discussed appellant’s assertion 

that she sustained osteoarthritis of the knees as a result of her work duties. She also noted that 

she had a history of gastrointestinal issues resulting in a hospitalization in September 2012 and 

esophageal surgery in December 2012. Appellant alleged that John Cox, her supervisor, flirted 

with her and then harassed her after she told him to stop his inappropriate behavior. She had 

difficulty finishing her route because of her knee condition. Appellant’s route increased from 

800 mailboxes to 1,000 mailboxes and she received disciplinary action for taking too much time 

to deliver mail. Dr. Tellefsen diagnosed an adjustment disorder with anxiety, psychological 

factors affecting a physical condition, and achalasia. She found that appellant attributed many of 

her physical symptoms to stress beginning in 2011. Dr. Tellefsen indicated that the statement of 

accepted facts (SOAF) conflicted with appellant’s account of her work situation as it found that 

Mr. Cox did not harass her or treat her unfairly. She attributed appellant’s adjustment disorder to 

“adjusting to the work stress from a harassing boss, or the work stress from her worsening 

physical condition leading to deteriorating work performance, and thus negative attention from 

her boss.” Dr. Tellefsen opined that if appellant’s knee condition was related to employment 

then “conceivably her work stress would be a complication of the arthritis.” 

After the Board’s December 12, 2014 decision remanding the case, OWCP requested that 

Dr. Tellefsen clarify whether appellant experienced an emotional condition due to the 

compensable work factors. It advised that a condition was compensable if work factors 

contributed in any way to the condition. 

In a supplemental report dated February 26, 2015, Dr. Tellefsen again reviewed the 

SOAF and noted that appellant had work limitations from nonemployment-related arthritis of 

both knees. She related: 

“My understanding of the information in the SOAF is that her knee arthritis is not 

an accepted condition and that [the employing establishment] does not 

acknowledge that any harassment occurred. [Appellant], on the other hand, 

reports that her job delivering mail, with, at some point, a markedly increased 

workload, led to the worsening of her knee pain. She said that this, in turn, led to 

emotional distress when she was not able to complete her job as efficiently as she 

had been able to prior to developing the arthritis. [Appellant] also reported that, 

 2

 Docket No. 14-1043 (issued December 12, 2014). On April 6, 2012 appellant, then a 50-year-old letter carrier, 

filed an occupational disease claim alleging that she sustained depression, stress, and headaches due to factors of her 

federal employment. She stopped work on March 26, 2012. The Board determined that OWCP properly accepted 

as compensable work factors that she was unable to complete her route in eight hours beginning in September 2011 

and that she continued to work overtime after the employing establishment reduced her route in March 2012 because 

of her knee condition. 
3

in part, as a result of this diminished efficiency related to the knee pain, she was 

harassed by her supervisor. She had a separate issue with the supervisor 

involving retaliation for rebuffed sexual harassment. That was not even 

mentioned in the SOAF. 

“In the summer of 2012 [appellant] developed symptoms of depression, what I 

ultimately diagnosed as [a]djustment [d]isorder, in relation to all of these events 

and the worsening pain and disability from her knees. 

“As I stated in my original report, without verification from the [employing 

establishment] that these stressful events were work related, I am unable to 

formally connect her subsequent [a]djustment [d]isorder with her work. I do 

think it is clear that a large part of her emotional distress stems from her 

worsening physical condition and impairment from her osteoarthritis. That 

arthritis, however, is not an accepted condition. Therefore, whatever psychiatric 

fallout she had from this would also not be an accepted condition. Therefore, 

there is no medical evidence that an accepted work factor contributed in any way 

to her condition.” 

Dr. Tellefsen indicated that appellant’s condition “was further complicated by what 

appears to be a possibly unrelated gastrointestinal disorder for which she ultimately required 

surgery later in 2012.” She concluded that the adjustment disorder was not related to the 

compensable employment factors. 

By decision dated March 26, 2015, OWCP denied modification of its October 5, 2012 

decision. It found that Dr. Tellefsen’s opinion represented the weight of the evidence and 

demonstrated that appellant did not have a diagnosed condition as a result of the compensable 

work factors. 

LEGAL PRECEDENT 

Workers’ compensation law does not apply to each and every injury or illness that is 

somehow related to an employee’s employment. There are situations where an injury or an 

illness has some connection with the employment but nevertheless does not come within the 

concept or coverage of workers’ compensation. Where the disability results from an employee’s 

emotional reaction to his or her regular or specially assigned duties or to a requirement imposed 

by the employment, the disability comes within the coverage of FECA.3 On the other hand, the 

disability is not covered where it results from such factors as an employee’s fear of a reductionin-force, or his or her frustration from not being permitted to work in a particular environment, or 

to hold a particular position.4

In cases involving emotional conditions, the Board has held that, when working 

conditions are alleged as factors in causing a condition or disability, OWCP, as part of its 

 3

 5 U.S.C. § 8101 et seq.; Trudy A. Scott, 52 ECAB 309 (2001); Lillian Cutler, 28 ECAB 125 (1976). 

4 Gregorio E. Conde, 52 ECAB 410 (2001). 
4

adjudicatory function, must make findings of fact regarding which working conditions are 

deemed compensable factors of employment and are to be considered by a physician when 

providing an opinion on causal relationship and which working conditions are not deemed 

factors of employment and may not be considered.5

 If a claimant does implicate a factor of 

employment, OWCP should then determine whether the evidence of record substantiates that 

factor. When the matter asserted is a compensable factor of employment and the evidence of 

record establishes the truth of the matter asserted, OWCP must base its decision on an analysis of 

the medical evidence.6

 

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

establish causal relationship is rationalized medical opinion evidence.7 The opinion of the 

physician must be based on a complete factual and medical background of the claimant,8 must be 

one of reasonable medical certainty9

 explaining the nature of the relationship between the 

diagnosed condition and the specific employment factors identified by the claimant.10

ANALYSIS 

On prior appeal, the Board found that appellant had established as compensable work 

factors that she was unable to complete her route in eight hours following a September 2011 

route change and that, after the employing establishment reduced her route in March 2012 due to 

her bilateral knee osteoarthritis, she still had to work overtime multiple evenings a week to 

complete her route. The Board found that the December 2, 2013 report from Dr. Tellefsen was 

insufficient to resolve the issue of whether appellant sustained an emotional condition. Upon 

remand, OWCP specifically requested that the physician address whether compensable work 

factors contributed in any way to her condition. Based on Dr. Tellefsen’s February 26, 2015 

supplemental report, it denied appellant’s emotional condition claim. 

The Board finds that Dr. Tellefsen’s opinion is sufficiently well rationalized to establish 

that appellant did not sustain an emotional condition as a result of the accepted compensable 

work factors. In her initial report dated December 2, 2013, Dr. Tellefsen discussed the history of 

injury and the factors to which appellant attributed her condition. She diagnosed an adjustment 

disorder with anxiety largely due to physical symptoms beginning in 2011 and harassment by her 

supervisor. Dr. Tellefsen found that appellant’s adjustment disorder resulted from either 

harassment or a declining physical condition causing decreased work performance. In a 

supplemental report dated February 26, 2015, she noted that appellant attributed her stress to an 

increase in knee pain such that she was unable to adequately perform her work duties as well as 

harassment by her supervisor, Mr. Cox, due to her worsening work performance. Appellant also 

 5 Dennis J. Balogh, 52 ECAB 232 (2001). 

6 Id.

7 John J. Montoya, 54 ECAB 306 (2003). 

8 Tomas Martinez, 54 ECAB 623 (2003); Gary J. Watling, 52 ECAB 278 (2001). 

9 Supra note 7. 

10 Judy C. Rogers, 54 ECAB 693 (2003). 
5

related that Mr. Cox sexually harassed her and retaliated against her when she objected to the 

harassment. Dr. Tellefsen attributed the majority of her emotional symptoms to her increased 

knee osteoarthritis, which she noted was not accepted as employment related. She also indicated 

that appellant experienced a gastrointestinal disorder. Dr. Tellefsen determined that her 

adjustment disorder was unrelated to the compensable work factors. In reaching her conclusions, 

she thoroughly discussed the statement of accepted facts as well as appellant’s description of the 

work factors to which she attributed her stress-related condition. Dr. Tellefsen explained that her 

condition resulted from stress as a result of a decline in her physical condition due to 

nonemployment-related osteoarthritis. Her report is detailed, well rationalized and based on an 

accurate factual background; consequently, it represents the weight of the evidence.11 Appellant, 

therefore, has not met her burden of proof to establish an emotional condition as a result of the 

compensable work factors. 

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 and 

20 C.F.R. §§ 10.605 through 10.607. 

CONCLUSION 

The Board finds that appellant has not met her burden of proof to establish an emotional 

condition in the performance of duty causally related to factors of her federal employment. 

 11 See G.G., Docket No. 15-0985 (issued August 21, 2015); B.O., Docket No. 15-0385 (issued August 19, 2015). 
6

ORDER 

IT IS HEREBY ORDERED THAT the March 26, 2015 merit decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: November 20, 2015 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board