United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

Q.G., Appellant 

and 

DEPARTMENT OF HOMELAND SECURITY, 

TRANSPORTATION SECURITY 

ADMINISTRATION, Long Beach, CA, Employer 

__________________________________________ 

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Docket No. 13-2016 

Issued: March 14, 2014 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

RICHARD J. DASCHBACH, Chief Judge 

PATRICIA HOWARD FITZGERALD, Judge 

MICHAEL E. GROOM, Alternate Judge 

JURISDICTION 

On September 3, 2013 appellant, through his attorney, filed a timely appeal from a 

May 6, 2013 merit decision of the Office of Workers’ Compensation Programs (OWCP), which 

denied his claim. 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 his burden of proof to establish that he sustained a 

hernia causally related to factors of his federal employment. 

FACTUAL HISTORY 

On May 18, 2012 appellant, then a 37-year-old transportation security officer, filed an 

occupational disease claim alleging a hernia in the performance of duty. He was directed to load 

 1

 5 U.S.C. § 8101 et seq. 
2

two machines on a ramp and was subjected to stress and strain while loading the machines. 

Appellant became aware of his condition and realized that it was caused or aggravated by his 

employment on May 16, 2012. 

By letters dated May 31, 2012, appellant was advised to submit additional factual and 

medical evidence to support his claim for benefits. 

In a June 22, 2012 report, Dr. Brian Minkus, Board-certified in family medicine and an 

osteopath, noted that appellant was seen for left pelvis and groin pain on May 14, 2012. 

Appellant related that the pain occurred with prolonged standing and heavy lifting at work. 

Dr. Minkus noted that appellant received a physical examination prior to his employment and did 

not exhibit signs of a hernia. His examination revealed a left inguinal hernia, Dr. Minkus saw 

appellant on June 18, 2012 and that there was no change in the left inguinal hernia. He advised 

appellant to continue to avoid heavy lifting, strenuous physical activities and prolonged standing 

until the hernia was repaired and he had fully recovered. Dr. Minkus completed disability 

certificates placing appellant on restricted duties at work. 

In a June 21, 2012 statement, appellant noted that his hernia occurred when he was asked 

by a supervisor to load two baggage machines. As he was loading heavy bags from conveyor 

belt onto the two machines, he twisted, turned and bent his body. Appellant explained that he 

picked up a heavy bag and felt a pull in his lower groin/abdomen region and assumed it was a 

pulled muscle. 

In a July 3, 2012 statement, Cathy Bridges, the employer’s administrative officer, noted 

appellant’s allegations and discussed his duties and the requirements of his various positions. 

She advised that lifting was not a requirement in his job and that he had not worked in the 

checked baggage area since December 4, 2011. Ms. Bridges provided a copy of appellant’s 

May 18, 2012 workplace injury statement and photographs of the checked baggage area. 

In an August 14, 2012 statement, appellant described his duties and the physical 

requirements of the position. OWCP received witness statements from coworkers confirming 

that appellant and others lifted bags on the ramps in the course of their duties. It also received 

photographs of the loading ramp, with baggage. 

In a letter dated September 5, 2012, James Tiampo, the employer’s assistant federal 

security director for screening, noted that appellant had previously been a physical education 

teacher/assistant and track coach. He reviewed the statements of appellant’s coworkers and 

asserted that there was no need to lift baggage but confirmed that, occasionally, there was a need 

to lift baggage. Mr. Tiampo also provided statements from managers and coworkers. 

In an October 18, 2012 decision, OWCP denied appellant’s claim. It accepted that he 

lifted baggage but found that the medical evidence did not establish that the claimed hernia was 

related to his work duties. 

On November 5, 2012 appellant’s representative requested a telephonic hearing, which 

was held on February 15, 2013. At the hearing, appellant denied having a hernia before 

May 2012. He explained that his duties required lifting, twisting and bending to load baggage of 

varying weight into two machines. Appellant experienced intermittent pain in the course of his 
3

duties but it did not subside after a few days and continued to worsen. He continued to have pain 

after changing positions and sought medical treatment in May 2012. Appellant’s representative 

argued that Dr. Minkus’ December 26, 2012 report supported causal relationship. Appellant 

noted that he did not have surgery and stopped work on October 30, 2012, when the employing 

establishment informed him that there was no work available within his medical restrictions. 

In a December 26, 2012 form report, Dr. Minkus noted that appellant was engaged in 

lifting at work and experienced left testicle pain. He diagnosed a left inguinal hernia. 

Dr. Minkus addressed casual relation by ascribing to the statement: “the facts of injury are the 

direct and proximate cause of the diagnosis that I cited above. This is based upon a reasonable 

medical probability. There may be other causes for this medical problem, but one of the causes 

is clearly the activities of work described [by appellant] and described above.” 

In a March 21, 2013 statement, Mr. Tiampo again explained the details of the checked 

baggage area and emphasized that it was designed to minimize physical transportation, loading 

and lifting of bags that needed to be screened. Occasionally, a need would arise such that it 

would be necessary for an employee to physically move bags. In a March 22, 2013 statement, 

Mr. Tiampo confirmed that employees did occasionally lift baggage. 

By decision dated May 6, 2013, an OWCP hearing representative affirmed the 

October 18, 2012 decision. She found that appellant did not submit sufficient medical evidence 

addressing causal relation. 

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 timely filed within the applicable time 

limitation period, 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.4

 To establish fact of injury in 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.5

 2

 Elaine Pendleton, 40 ECAB 1143 (1989). 

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

4 See S.P., 59 ECAB 184, 188 (2007). 

5 See R.R., Docket No. 08-2010 (issued April 3, 2009); Roy L. Humphrey, 57 ECAB 238, 241 (2005). 
4

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.6

ANALYSIS 

The record establishes that appellant’s job entailed screening passengers and lifting 

baggage and such pushing, bending and twisting as was necessary to send baggage through the 

screening machine. He was diagnosed with a left inguinal hernia. The Board finds that the 

medical evidence is insufficient to establish that his employment duties caused or contributed to 

the diagnosed hernia. 

In a June 22, 2012 report, Dr. Minkus, noted that appellant was seen for left pelvis and 

groin pain arising on May 14, 2012. He diagnosed a left inguinal hernia. Appellant related that 

the pain occurred with prolonged standing and heavy lifting at work. Dr. Minkus noted that a 

physical examination prior to appellant’s employment did not exhibit signs of a hernia. The 

Board finds that he did not offer a rationalized opinion on causal relation other than to note that 

appellant had pain that occurred while loading baggage at work. The Board has found that 

because an employee is asymptomatic before an employment injury is insufficient, without 

supporting medical rationale, to establish causal relationship.7 Dr. Minkus did not describe the 

process by which appellant’s job duties were competent to cause or aggravate the diagnosed 

hernia. 

In a December 26, 2012 form report, Dr. Minkus provided brief written responses to 

several questions. He noted that appellant was engaged in lifting at work and experienced left 

testicle pain. Dr. Minkus diagnosed a left inguinal hernia. He ascribed to the form statement 

concerning causal relationship that “the facts of injury are the direct and proximate cause of the 

diagnosis that I cited above. This is based upon a reasonable medical probability. There may be 

other causes for this medical problem, but one of the causes is clearly the activities of work 

described [by appellant] and described above.” The Board notes that Dr. Minkus’ response on 

the form fails to adequately explain how the specific job duties identified by appellant caused or 

contributed to his hernia. Dr. Minkus did not explain the pathophysiological process by which 

lifting bags or bending and twisting at work, would cause the diagnosed hernia. The Board has 

long held that medical opinions not containing rationale on causal relation are of diminished 

probative value.8

 

As Dr. Minkus failed to provide a rationalized medical opinion explaining how the 

diagnosed hernia was related to specific job duties, appellant failed to establish that his hernia is 

causally related to his federal employment. 

 6 I.J., 59 ECAB 408 (2008); Woodhams, supra note 3. 

7 Thomas Petrylak, 39 ECAB 276 (1987). 

8 Carolyn F. Allen, 47 ECAB 240 (1995). 
5

On appeal, appellant’s representative argued that appellant met his burden of proof as the 

evidence was sufficient on causal relation. The Board notes that causal relationship is a medical 

issue and the evidence generally required to establish causal relationship is rationalized medical 

opinion evidence.9

 The medical evidence must include rationale explaining how the physician 

reached the conclusion he or she is supporting.10 OWCP’s procedures recognize that, with 

certain clear-cut traumatic injuries, such as a fall from a scaffold resulting in a broken arm, the 

record may require only an affirmative statement by a physician to establish causal 

relationship.11 This occupational disease claim is not a situation with an injury that can be 

identified on visual inspection or a clear-cut traumatic injury requiring only an affirmative 

statement.12 Dr. Minkus did not provide rationale for his opinion on causal relationship. 

Appellant may submit evidence or argument with a written request for reconsideration 

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 he 

sustained a hernia causally related to factors of his employment. 

 9 Y.J., Docket No. 08-1167 (issued October 7, 2008). 

10 See also T.M., Docket No. 08-975 (2009) (a physician’s opinion on causal relationship between a claimant’s 

disability and an employment injury is not conclusive simply because it is rendered by a physician; the physician 

must provide rationale for the opinion reached and where no such rationale is present, the medical opinion is of 

diminished probative value); Beverly A. Spencer, 55 ECAB 501 (2004). 

11 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3(d) (January 2013). 

12 See A.S., Docket No. 07-141 (issued March 27, 2007). 
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ORDER 

IT IS HEREBY ORDERED THAT the May 6, 2013 decision of the Office of Workers’ 

Compensation Programs is affirmed. 

Issued: March 14, 2014 

Washington, DC 

 

 Richard J. Daschbach, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 

 Michael E. Groom, Alternate Judge 

 Employees’ Compensation Appeals Board