United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.S., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Lawrence, MA, Employer 

__________________________________________ 

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Docket No. 15-0619 

Issued: July 17, 2015 

Appearances: Case Submitted on the Record

Daniel B. 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 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On January 26, 2015 appellant, through counsel, filed a timely appeal from a January 8, 

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 this case. 

ISSUE 

The issue is whether appellant has met his burden of proof to establish an aggravation or 

acceleration of bilateral hip osteoarthritis causally related to his employment. 

FACTUAL HISTORY 

On March 20, 2012 appellant, then a 46-year-old letter carrier, filed an occupational 

disease claim (Form CA-2) alleging that he sustained a permanent acceleration of bilateral hip 

 1

 5 U.S.C. §§ 8101-8193. 
2

osteoarthritis in the performance of duty on or before January 12, 2012.2

 He attributed his 

condition to prolonged standing, walking, heavy lifting, lifting in awkward positions, carrying a 

mail satchel weighing 35 pounds, and climbing steps while working as a letter carrier from 

January 1, 1988 through 2009.3

 Appellant noted that, under File No. xxxxxx161, OWCP 

accepted a muscle pull in his right thigh sustained on January 5, 2006 when he slipped and fell 

on ice, striking the upper portion of his right leg. June 10, 2006 imaging studies to evaluate 

postinjury hip pain revealed degenerative arthritis of both hips.4

Appellant submitted medical evidence in support of his claim. On October 20, 2008 

Dr. Richard Choi, an attending Board-certified orthopedic surgeon, noted severely limited right 

hip motion. X-rays of the right hip showed significant degeneration, with a one- to twomillimeter joint space remaining.5

In a July 23, 2009 report, Dr. Ronald A. Marvin, an attending Board-certified orthopedic 

surgeon, noted worsening osteoarthritis of both hips, more severe on the right. He noted that 

appellant’s father also had early degenerative arthritis, indicating that appellant’s condition was 

“probably congenital.” Dr. Marvin recommended hip resurfacing. 

Dr. Daniel M. Ward, an attending Board-certified orthopedic surgeon, provided a 

September 15, 2009 report noting that x-rays showed the “fairly impressive” advancement of 

right hip osteoarthritis from February to August 2009. He performed a total right hip 

arthroplasty on January 11, 2010 and total left hip arthroplasty on January 20, 2010.6

In a January 12, 2012 report, Dr. David C. Morley, Jr., an attending Board-certified 

orthopedic surgeon, described appellant’s job duties, noted the January 5, 2006 injury, and 

reviewed medical records. He stated that appellant had “[n]o significant family illness.” 

Dr. Morley related appellant’s complaints of bilateral hip stiffness, swelling in both legs, chronic 

bone pain in both thighs, and difficulties with activities of daily living. On examination, he 

observed a nontender right hip with arthroplasty scar, tenderness to palpation over the left hip 

incision, and restricted motion of both hips in all planes.7 Dr. Morley opined that “repetitive 

heavy physical activities” at work caused increased stresses on appellant’s hips, contributing” to 

preexisting degenerative joint disease and failure of articular cartilage. He explained that as 

 2

 In a March 26, 2012 letter, the employing establishment asserted that the date of injury should be June 2006, 

when imaging studies should have made appellant aware of the possible relationship between work factors and 

osteoarthritis. 

3

 Appellant submitted a letter carrier position description, listing requirements of walking and climbing steps six 

or more hours a day, and lifting up to 70 pounds intermittently. 

4

 June 10, 2006 x-rays showed degenerative osteoarthritis of both hips, worse on the right. 

5

 August 21, 2008 x-rays showed advanced osteoarthritic changes in the right hip, with relatively advanced 

arthritis of the left hip. 

6

 In a July 21, 2010 report, Dr. Christine Dalrymple, an attending podiatrist, noted appellant’s history of bilateral 

hip replacements. 

7

 Dr. Morley noted that he obtained all range of motion measurements after appellant performed warm-up 

exercises. “All range of motion measurements were made three times with a goniometer with the highest 

measurement” recorded. 
3

there was “no history of traumatic incident involving his hips,” the “most likely cause of 

[appellant’s] condition was degenerative and causally related to the arduous physical duties of a 

letter carrier.” 

In an April 24, 2012 letter, OWCP advised appellant of the additional evidence needed to 

establish his claim, including postoperative reports, diagnostic test results, and a narrative report 

from Dr. Ward explaining how and why factors of his federal employment would have caused 

the claimed bilateral hip arthritis. It afforded him 30 days to submit additional evidence. In 

response, appellant submitted a May 2, 2012 letter explaining that he no longer received 

treatment from Dr. Ward, and had chosen Dr. Morley as his treating physician. He provided 

duplicate copies of his job description and Dr. Morley’s January 12, 2012 report. 

By decision dated June 20, 2012, OWCP denied appellant’s claim as causal relationship 

had not been established. It accepted that the identified work factors of walking, standing, 

lifting, carrying, and climbing occurred as alleged. OWCP found, however, that the medical 

reports of record were insufficient to establish that the accepted work factors caused or 

aggravated bilateral hip arthritis. It further found that the record was incomplete, as appellant 

failed to submit the postoperative reports and test results as requested on April 24, 2012. 

In a June 25, 2012 letter, counsel requested an oral hearing, held October 24, 2012. At 

the hearing, he contended that OWCP’s request for postoperative reports and test results was 

improper as there was no medical opinion explaining why they were relevant to establishing 

causal relationship. Counsel also contended that appellant’s physicians provided sufficient 

opinion, “based on a complete and accurate relevant medical history,” to establish causal 

relationship. 

After the hearing, counsel provided an October 24, 2012 memorandum reiterating that 

OWCP should not have requested that appellant submit postoperative reports and test results. He 

contended that OWCP should not have requested a report from Dr. Ward as he no longer treated 

appellant. Counsel noted that appellant only had to show that his federal employment 

contributed to the claimed condition. In an October 24, 2012 affidavit, appellant asserted that, 

other than his postal employment, his activities included driving to and attending his son’s sports 

activities, camping, playing catch, and breeding fish in several aquariums in his basement. 

By decision dated and finalized January 22, 2013, an OWCP hearing representative 

affirmed OWCP’s June 20, 2012 decision, finding that causal relationship had not been 

established. He found that Dr. Marvin opined that appellant’s hip arthritis was congenital, while 

Dr. Ward did not address its etiology. Dr. Morley inaccurately stated that appellant had no 

significant family illnesses, failing to address appellant’s father’s history of early degenerative 

hip osteoarthritis as noted by Dr. Marvin. The hearing representative therefore found that 

Dr. Morley’s opinion was of diminished probative value as it was based on an incomplete, 

inaccurate medical history. 

In an August 27, 2013 letter, counsel requested reconsideration. He submitted an 

August 23, 2013 report from Dr. Morley, stating that he did not mention the potential congenital 

nature of the arthritis as this was unrelated to the issue of causal relationship. Dr. Morley 

asserted that the hereditary component of osteoarthritis did not negate the contribution of work 

factors in accelerating the condition. He stated that the “repetitive stresses” of appellant’s job 
4

duties “hastened the progress of his arthritic disease much more so than someone with a 

sedentary occupation.” Dr. Morley noted that degenerative arthritis in the lower extremities was 

permanently progressive due to wear and tear forces with weight bearing. Appellant’s duties as a 

letter carrier caused “greater stresses on the lower extremity weight bearing joints” than in 

everyday life, accelerating the arthritic process that culminated in bilateral hip replacements. 

Counsel submitted statements from appellant’s wife and father, asserting that appellant’s 

duties as a letter carrier contributed to the development of bilateral hip arthritis because his 

symptoms began during his postal employment. 

In a November 8, 2013 letter, appellant’s supervisor noted that appellant no longer 

carried mail. During the time he did carry a mail satchel, it sometimes weighed less than 35 

pounds. 

By decision dated November 18, 2013, OWCP denied modification, finding that the 

additional evidence was insufficient to alter the January 22, 2013 decision. It found that 

Dr. Morley had not explained “how the underlying condition was accelerated or materially 

adversely affected by the employment activities.” Regarding the statements from appellant’s 

wife and father, OWCP noted that the fact that a condition manifests during a period of 

employment did not establish causal relationship between work factors and the claimed 

condition. 

In a November 5, 2014 letter, counsel requested reconsideration. He provided an 

October 30, 2014 report from Dr. Morley asserting that bending, kneeling, lifting, climbing and 

squatting at work caused the acceleration of appellant’s hip condition in 2009 as observed by 

Dr. Ward. Dr. Morley cited seven medical studies supporting the pathophysiologic 

interrelationship of work tasks and the chemical and biologic processes of degenerative lower 

extremity arthritis. He adopted the conclusions of these studies as applicable to appellant’s 

specific work tasks and clinical presentation. Dr. Morley asserted that this literature proved that 

appellant’s duties as a letter carrier contributed to the degeneration of his hips by creating joint 

stress that effaced articular surfaces. 

By decision dated January 8, 2015, OWCP denied modification on the grounds that the 

additional evidence was insufficient to establish causal relationship. It found that Dr. Morley 

had not provided sufficient rationale explaining how and why work factors caused or contributed 

to degenerative arthritis. Additionally, Dr. Morley did not discuss the impact of the preexisting 

osteoarthritis on appellant’s condition. OWCP further found that the citations to medical 

literature were of no probative medical value as they did not address appellant’s specific history, 

presentation, and work factors. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of establishing 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 filed within the applicable time 

limitation; that an injury was sustained while 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 
5

employment injury.8

 These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated on a traumatic injury or an occupational disease.9

An occupational disease is defined as a condition produced by the work environment 

over a period longer than a single workday or shift.10 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.11

ANALYSIS 

Appellant attributed the development of his bilateral hip osteoarthritis to repetitive 

standing, walking, stair-climbing, and lifting while delivering mail beginning in 1988. However, 

he had no lower extremity symptoms until after an accepted traumatic right upper leg injury on 

January 5, 2006, accepted under File No. xxxxxx161. Bilateral hip pain prompted him to seek 

medical care, resulting in the diagnosis of osteoarthritis. Dr. Marvin, an attending Boardcertified orthopedic surgeon, did not attribute the osteoarthritis to either the traumatic injury or 

repetitive activity over time. Rather, he opined on July 23, 2009 that appellant’s arthritis was 

“probably congenital” as appellant’s father also had early onset, severe osteoarthritis. Thus, the 

medical and factual evidence of record presents three possible mechanisms of causation: 

traumatic; congenital; and occupational activities. A complete discussion of appellant’s history 

would entail an analysis of each proposed etiology. 

Dr. Ward, an attending Board-certified orthopedic surgeon, noted on September 15, 2009 

that appellant’s bilateral hip osteoarthritis progressed significantly between February and 

August 2009. He performed bilateral hip arthroplasties in 2010. However, Dr. Ward did not 

 8 Joe D. Cameron, 41 ECAB 153 (1989). 

9 See Irene St. John, 50 ECAB 521 (1999); Michael E. Smith, 50 ECAB 313 (1999). 

10 20 C.F.R. § 10.5(q). 

11 Solomon Polen, 51 ECAB 341 (2000). 
6

explain how and why work factors, the traumatic injury, or a genetic predisposition influenced 

the development of the claimed condition. His opinion is therefore insufficient to establish 

causal relationship.12

Dr. Morley, an attending Board-certified orthopedic surgeon, submitted a January 12, 

2012 report noting both that appellant sustained a traumatic upper right leg injury on January 5, 

2006, and that appellant had no history of trauma to either hip. He also stated that appellant had 

“[n]o significant family illness,” indicating he was unaware that appellant’s father had early 

onset degenerative arthritis. The inaccurate, incomplete nature of the history upon which 

Dr. Morley relied significantly diminishes the probative value of his opinion. His equivocal 

statement that appellant’s duties as a letter carrier “most likely” caused the claimed osteoarthritis 

is therefore insufficient to meet appellant’s burden of proof.13 

Dr. Morley attempted to clarify his opinion in an August 23, 2013 report, asserting that 

he deliberately omitted appellant’s genetic history because any congenital cause was irrelevant in 

determining causal relationship. He noted on October 30, 2014 that the physical stresses of 

appellant’s job accelerated his condition in 2009, as observed by Dr. Ward. However, 

Dr. Morley did not explain in detail how the accepted work factors of walking, climbing, 

standing, bending, and squatting would aggravate or accelerate appellant’s osteoarthritis. The 

lack of medical rationale further diminishes the probative quality of his opinion.14

Dr. Morley cited medical literature on the effect of physically demanding occupations on 

the development of lower extremity osteoarthritis. However, the Board has held that medical 

texts and excerpts from publications are of no evidentiary value in establishing the causal 

relationship between a claimed condition and an employee’s federal employment as such 

materials are of general application and are not determinative of whether the specific condition 

claimed is related to the particular employment factors alleged by the employee.15 This material 

has probative value only to the extent that it is interpreted and cited by a physician rendering an 

opinion on the causal relationship between a condition and specified employment injury.16 

Dr. Morley cited the journal articles in support of load stress activities causing and accelerating 

degenerative osteoarthritis. He expressed his agreement with the research conclusions, but did 

not provide a complete explanation of how these mechanisms were present in appellant’s case. 

The Board, therefore, finds that the cited literature is of limited probative value and is 

insufficient on its own to establish causal relationship. However, as Dr. Morley’s opinion is also 

significantly diminished by its incomplete and inaccurate history, the relative weight of the cited 

medical literature is moot. 

 12 Id. 

13 Ricky S. Storms, 52 ECAB 349 (2001). 

14 Deborah L. Beatty, 54 ECAB 340 (2003). 

15 Gloria J. McPherson, 51 ECAB 441 (2000); William C. Bush, 40 ECAB 1064, 1075 (1989); N.B., Docket No. 

14-1702 (issued December 29, 2014); S.A., Docket No. 13-1551 (issued December 17, 2013). 

16 C.S., Docket No. 12-1169 (issued November 5, 2012); Harlan L. Soeten, 38 ECAB 566, 567 (1987). 
7

Appellant’s wife and father submitted statements supporting a causal relationship 

between appellant’s job duties and his bilateral hip arthritis. However, there is no evidence that 

either individual was a qualified physician under FECA. The Board has held that the statement 

of a layperson is not competent evidence on the issue of causal relationship.17 Therefore, their 

opinions are of no probative medical value. 

The Board notes that by letter dated April 24, 2012 OWCP advised appellant of the 

necessity of submitting her physician’s statement explaining how and why the accepted work 

factors would impact the claimed bilateral hip osteoarthritis. As appellant’s physicians did not 

provide such rationale, OWCP’s January 8, 2015 decision denying his claim is proper under the 

law and facts of the case. 

On appeal, counsel filed a brief which argues that OWCP erred by failing to obtain 

“medical opinion confirming or disputing” that of Dr. Morley. Dr. Morley’s reports, however, 

were of insufficient probative quality to warrant additional development. Counsel further 

contends that OWCP claims examiner was barred as a layperson from ruling on the probative 

value of Dr. Morley’s opinion without first obtaining a medical review of the evidence.18 

However, the Board notes that under section 8124 of FECA,19 OWCP shall determine and make 

findings of fact with respect to an award for or against payment of compensation. FECA’s 

implementing regulations further provide that an OWCP decision shall contain findings of fact 

and a statement of reasons.20 Therefore, counsel’s assertion that OWCP was prohibited from 

evaluating the probative value of Dr. Morley’s opinion is without merit. 

Counsel also argues that OWCP misstated the standard of causal relationship by finding 

that Dr. Morley failed to explain whether obesity or the aging process contributed to appellant’s 

arthritis. He argues that OWCP was effectively holding that work factors must be the exclusive 

cause of the claimed condition. Counsel cites to Board precedents on the axiomatic principle 

that causal relationship is established if work factors contributed to the claimed condition in any 

degree.21 Dr. Morley’s opinion was not based on a complete, accurate factual and medical 

history. An element of this omission is his failure to discuss other factors affecting appellant’s 

health, such as obesity and aging. The Board notes that there is no indication that OWCP 

properly found that it was necessary in this claim for the treating physician to identify and 

discuss all the medical history related to appellant’s hip condition. OWCP misinterpreted or 

misapplied the appropriate standard of causal relationship. 

 17 See James A. Long, 40 ECAB 538 (1989); Susan M. Biles, 40 ECAB 420 (1988). 

18 Counsel cited to Board precedents holding that a layperson’s opinion on the medical issue of causal 

relationship is of no probative value, including J.G., Docket No. 15-251 (issued April 13, 2015) and Gloria J. 

McPherson, 51 ECAB 441 (2000). 

19 5 U.S.C. § 8124. 

20 20 C.F.R. § 10.126. 

21 L.C., Docket No. 12-1949 (issued January 3, 2013); Rudy C. Sixta, Jr., 44 ECAB 727 (1990); Glenn C. 

Chasteen, 42 ECAB 493 (1991); Arnold Gustafson, 41 ECAB 131; Beth Chaput, 37 ECAB 158 (1985). 
8

Counsel also asserts that OWCP’s January 8, 2015 decision contained an “[i]mproper 

quote of law on citation of research.” He cited to Board precedents holding that medical tests are 

of little probative value in establishing causal relationship unless the physician applies the 

general principles discussed to the specific facts of the claimant’s case.22 However, the probative 

weight of this literature is moot because Dr. Morley’s opinion rests on an incomplete and 

inaccurate history. 

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. 

CONCLUSION 

The Board finds that appellant did not establish that he sustained an aggravation or 

acceleration of bilateral hip arthritis in the performance of duty. 

ORDER 

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ 

Compensation Programs dated January 8, 2015 is affirmed. 

Issued: July 17, 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 

 22 James Rogy, Jr., Docket No. 05-1247 (issued December 8, 2005); Ralph L. Streever, Docket No. 95-1454 

(issued August 6, 1997); Ruby I. Fish, 46 ECAB 276 (1994); Kathy Marshall (Dennis Marshall), 45 ECAB 827 

(1994); Edna C. Drinkwine, 10 ECAB 511 (1959).