United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

A.L., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

New York, NY, Employer 

__________________________________________ 

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Docket No. 16-0278 

Issued: March 21, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On December 1, 2015 appellant filed a timely appeal of a July 24, 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 merit decision in the case. 

ISSUE 

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

disease in the performance of duty. 

FACTUAL HISTORY 

On March 20, 2015 appellant then a 26-year-old city carrier, filed an occupational disease 

claim (Form CA-2), alleging that he developed bilateral knee pain as a result of repeatedly 

climbing stairs while carrying packages and pushing heavy carts while in the performance of 

 1

 5 U.S.C. § 8101 et seq. 
2

duty. He first became aware of his condition on February 5, 2015 and realized that it was 

causally related to his employment on February 28, 2015. Appellant did not stop work. 

Appellant submitted a narrative statement dated April 4, 2015 and explained that his 

bilateral knee pain began on February 5, 2015. He noted that his position required the use of a 

pushcart to deliver his mail route and repetitive climbing in and out of his mail truck with 

packages weighing up to 10 pounds. Appellant believed that his work duties caused his bilateral 

knee pain. He noted never having a prior knee injury. 

Appellant submitted a treatment report from Dr. Muhammad Shahid, a Board-certified 

internist, dated February 23, 2015, who treated him in the emergency room. Dr. Shahid provided 

restrictions of limited lifting of heavy packages and pushing heavy carts for three days. He noted 

appellant’s current medications and referred him for physical therapy. Appellant submitted a 

note from Dr. Sewon Lee, a Board-certified physiatrist, dated March 10, 2015, who provided a 

summary of appellant’s current medications. Dr. Lee recommended physical therapy for four 

weeks. In an undated referral form he diagnosed right knee pain and referred appellant for 

physical therapy. Appellant submitted a report from Dr. Dustin Pardo, a Board-certified 

internist, dated February 13, 2015 who diagnosed right knee pain. Dr. Pardo recommended an 

oral analgesic and physical therapy. Appellant submitted an undated referral form from 

Dr. Pardo for physical therapy. He was treated by Dr. Daniel Tsukanov, a Board-certified 

internist, on April 7, 2015, for a knee condition. Dr. Tsukanov noted that appellant would 

require physical therapy. 

By letter dated June 10, 2015, OWCP advised appellant of the type of evidence needed to 

establish his claim, particularly requesting that he submit a physician’s reasoned opinion 

addressing the relationship of his claimed condition and specific employment factors. 

By questionnaire dated June 18, 2015, appellant noted performing work activities six 

days a week for 8 to 14 hours. He noted that he was not involved in any activities or sports. 

Appellant was treated by an unidentified health care provider on June 9, 2015 for a right knee 

condition. The health care provider diagnosed bilateral patellofemoral syndrome, possible right 

quadriceps tendinopathy, knee pain, asthma, and allergic rhinitis. Appellant was referred for 

physical therapy and injections into the knee joint. In an undated report, the unidentified health 

care provider noted evaluating appellant on March 10, April 7, and June 9 and 15, 2015 for 

bilateral knee pain. He noted that appellant was treated with physical therapy and injections in 

the knee joint. Appellant was instructed to avoid strenuous activity such as prolonged kneeling 

and continuous stair negotiation until his symptoms improve. The health care provider 

diagnosed patellofemoral pain syndrome, knee pain, asthma, and allergic rhinitis. 

In a decision dated July 24, 2015, OWCP denied the claim because the medical evidence 

was insufficient to establish that a medical condition was diagnosed in connection with the 

claimed event or work factors. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of his claim. When an employee claims that he or she sustained an injury in 
3

the performance of duty, he or she must submit sufficient evidence to establish that he or she 

experienced a specific event, incident or exposure occurring at the time, place, and in the manner 

alleged. Appellant must also establish that such event, incident or exposure caused an injury.2 

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 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.3

ANALYSIS 

It is not disputed that appellant’s work duties as a city carrier included repetitively 

climbing stairs with packages and pushing carts. It is also not disputed that he was diagnosed 

with bilateral patellofemoral syndrome, possible right quadriceps tendinopathy, and right knee 

pain. However, appellant has not submitted sufficient medical evidence to establish that his 

diagnosed medical conditions were causally related to the employment factors. On June 10, 

2015 OWCP advised him of the type of medical evidence needed to establish his claim. 

However, appellant has not submitted sufficient medical evidence to establish that any of these 

conditions are causally related to specific employment factors or conditions. 

Appellant submitted a report from Dr. Shahid dated February 23, 2015, who 

recommended restrictions of limited lifting of heavy packages and pushing heavy carts for three 

days. Dr. Shahid referred appellant for physical therapy. On March 10, 2015 Dr. Lee provided a 

summary of appellant’s current medications and recommended physical therapy and diagnosed 

right knee pain. Similarly, a February 13, 2015 note from Dr. Pardo diagnosed right knee pain, 

recommended an oral analgesic, and referred appellant for physical therapy. Likewise, in an 

April 7, 2015 report, Dr. Tsukanov noted treating appellant for a knee condition which would 

require physical therapy. However, these reports are insufficient to establish the claim as they do 

 2 See Walter D. Morehead, 31 ECAB 188, 194 (1979) (occupational disease or illness); Max Haber, 19 ECAB 

243, 247 (1967) (traumatic injury). See generally John J. Carlone, 41 ECAB 354 (1989); Elaine Pendleton, 40 

ECAB 1143 (1989). 

3 Solomon Polen, 51 ECAB 341 (2000). 
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not provide a history of injury4

 or specifically address whether appellant’s employment activities 

had caused or aggravated the diagnosed medical conditions.5

 

Appellant was treated by an unidentified health care provider on June 9, 2015, March 10, 

April 7, June 9, and 15, 2015 for bilateral knee pain. There is no evidence that these reports 

from unidentified health care providers are signed by a physician. Medical documents not 

signed by a physician and lacking proper identification are not probative medical evidence and 

are not sufficient to establish appellant’s claim. The Board has held that medical reports lacking 

proper identification do not constitute probative medical evidence.6

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 meet his burden of proof to establish that his 

claimed condition was causally related to his employment. 

 4 Frank Luis Rembisz, 52 ECAB 147 (2000) (medical opinions based on an incomplete history or which are 

speculative or equivocal in character have little probative value). 

5 A.D., 58 ECAB 149 Docket No. 06-1183 (issued November 14, 2006) (medical evidence which does not offer 

any opinion regarding the cause of an employee’s condition is of limited probative value on the issue of causal 

relationship). 

6 See R.M., 59 ECAB 690 (2008); Bradford L. Sullivan, 33 ECAB 1568 (1982) (where the Board held that a 

medical report may not be considered as probative medical evidence if there is no indication that the person 

completing the report qualifies as a “physician” as defined in FECA). 
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ORDER 

IT IS HEREBY ORDERED THAT the July 24, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: March 21, 2016 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board