United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

L.M., Executrix of the Estate of W.M., Appellant 

and 

DEPARTMENT OF THE ARMY, ARMY 

DEPOT, Corpus Christi, TX, Employer 

__________________________________________ 

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Docket No. 14-1677 

Issued: February 4, 2015 

Appearances: Oral Argument January 7, 2015 

Steve Maher, for the appellant 

No appearance, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

COLLEEN DUFFY KIKO, Judge 

PATRICIA HOWARD FITZGERALD, Judge 

JURISDICTION 

On July 29, 2014 appellant, through her representative, filed a timely appeal from a 

June 6, 2014 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 the employee established an injury causally related to exposure to 

chemicals or other substances in his federal employment. 

FACTUAL HISTORY 

The case has previously been before the Board on prior appeals. The employee filed four 

claims for compensation. An initial claim was filed on March 2, 1988 alleging that the employee 

developed fatigue, depression, a skin condition, rapid heartbeat, stress, and anxiety due to 

 1

 5 U.S.C. § 8101 et seq. 
2

exposure to Agent Orange (AO) in his federal employment as a helicopter mechanic and 

inspector. By decision dated March 31, 1992, the Board affirmed OWCP’s denial of the claim as 

being untimely filed.2

 On January 7, 2005 the employee filed an occupational disease claim 

alleging that he developed Type II diabetes and peripheral neuropathy as a result of chemical 

exposure while overhauling helicopters in his federal employment. By decision dated 

September 17, 2008, the Board affirmed an OWCP decision dated July 2, 2007, finding that the 

medical evidence was insufficient to establish that diabetes and peripheral neuropathy were 

causally related to any chemical exposure.3

In a decision dated August 27, 2012, the Board remanded the case for further 

development.4 The Board found that an October 5, 2010 report from Dr. A. Lee Guinn, a Boardcertified internist, was sufficient to require additional development of the evidence. By decision 

dated June 5, 2013, the Board again remanded the case.5

 The Board found that a conflict in the 

medical evidence existed under 5 U.S.C. § 8123(a) between Dr. Guinn and second opinion 

physicians Drs. Imawati Wong, a Board-certified oncologist, and Dr. Raye Bellinger, a Boardcertified internist. The issue was whether the employee had sustained colon cancer, diabetes, or 

peripheral neuropathy causally related to chemical exposure in his federal employment. OWCP 

was directed to prepare a detailed statement of accepted facts (SOAF) and refer the evidence to a 

referee physician to resolve the conflict. 

OWCP prepared a SOAF and selected Dr. Ernest Chiodo, a Board-certified internist, as a 

referee physician. In a report dated April 15, 2014, Dr. Chiodo indicated that he had reviewed 

the voluminous record in this case. He stated that the determination of whether an individual had 

developed a condition due to environmental exposure involved a three-step process: 

(1) consideration of the nature and extent of the exposure; (2) consideration of whether the 

exposure is known to cause the condition claimed; and (3) determination of specific causation in 

the case presented. Dr. Chiodo accepted that the employee may have had limited exposure to 

AO, and would have had exposure to solvents and fuels. As to step two, he indicated that he had 

reviewed extensive medical literature and found no support for an increased risk of colon cancer 

due to AO or exposure to solvents, fuels, or other chemicals as an aviation mechanic. With 

respect to diabetes and peripheral neuropathy, Dr. Chiodo noted that diabetes was a common 

condition and peripheral neuropathy a common complication of diabetes. He stated that it was 

not a credible claim that the employee first developed peripheral neuropathy and then later 

diabetes. Dr. Chiodo concluded: 

“In summary, the records reviewed do not support the assertion that more than a 

minimal exposure to [AO] [occurred] during his work at [the employing 

establishment]. However, even if he had a significant exposure to [AO], the peer 

reviewed medical literature does not support the assertion that [AO] causes colon 

cancer. Similarly, the peer reviewed medical literature does not support the 

 2

 Docket No. 91-1047 (issued March 31, 1992). 

3

 Docket No. 07-1911 (issued September 17, 2008). 

4

 Docket No. 11-2103 (issued August 27, 2012). 

5

 Docket No. 13-322 (issued June 5, 2013). 
3

assertion that work as an aviation mechanic with exposure to aviation fuels, 

solvents and chemicals typical of that occupation causes colon cancer. In 

addition, [the employee’s] diabetes and peripheral neuropathy are common 

conditions in the aging population in the United States [and] were not caused by 

any exposure he had to [AO] or to any solvents, fuels or chemicals encountered 

during his work as an aviation mechanic at [the employing establishment].” 

By decision dated June 6, 2014, OWCP denied the employee’s claim for compensation. 

It found the weight of the medical evidence was represented by Dr. Chiodo. 

LEGAL PRECEDENT 

A claimant seeking benefits under FECA6 has the burden of establishing the essential 

elements of his or her claim by the weight of the reliable, probative, and substantial evidence, 

including that an injury was sustained in the performance of duty as alleged and that any specific 

condition or disability claimed is causally related to the employment injury.7

 

To establish that an injury was sustained in the performance of duty, a claimant must 

submit: (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 diagnosed condition is causally related to the 

employment factors identified by the claimant.8

Causal relationship is a medical question that can generally be resolved only by 

rationalized medical opinion evidence.9 A physician’s opinion on the issue of whether there is a 

causal relationship between the claimant’s diagnosed condition and the implicated employment 

factors must be based on a complete factual and medical background of the claimant.10 

Additionally, in order to be considered rationalized, the opinion must be expressed in terms of a 

reasonable degree of medical certainty, and must be supported by medical rationale, explaining 

the nature of the relationship between the diagnosed condition and appellant’s specific 

employment factors.11 

It is well established that when a case is referred to an impartial medical specialist for the 

purpose of resolving a conflict, the opinion of such specialist, if sufficiently well rationalized and 

based on a proper factual and medical background, must be given special weight.12

 6

 5 U.S.C. §§ 8101-8193. 

7

 20 C.F.R. § 10.115(e), (f) (2005); see Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996). 

8 Ruby I. Fish, 46 ECAB 276, 279 (1994). 

9 See Robert G. Morris, 48 ECAB 238 (1996). 

10 Victor J. Woodhams, 41 ECAB 345, 352 (1989). 

11 Id. 

12 Harrison Combs, Jr., 45 ECAB 716, 727 (1994). 
4

ANALYSIS 

As the above history indicates, this case has undergone significant factual and medical 

development. The Board noted in the last appeal that the case presented complex factual and 

medical issues. OWCP was directed to prepare a detailed SOAF and refer the case for a referee 

opinion on the issues presented. 

In this regard, OWCP did prepare a detailed SOAF with respect to possible exposure to 

chemicals and other substances by the employee. The SOAF reviews evidence with respect to 

exposure to benzene, asbestos, chromium, epoxies, cleaning substances, dirt, sand, fumes, 

insecticides, as well as AO. It also discusses the employee’s duties as an aircraft mechanic and 

the time period he performed those duties. The Board also notes that Dr. Chiodo indicated in his 

April 15, 2014 report that he had reviewed the extensive evidence in the file. 

The Board finds that Dr. Chiodo had a detailed and accurate factual and medical 

background to provide the foundation for his opinion. As to the opinion itself, Dr. Chiodo 

explained the process he utilized in making a determination on causal relationship in this case. 

He accepted that the employee did have some exposure to AO and chemicals. Dr. Chiodo 

indicated that he reviewed extensive medical literature on exposure to AO and other chemicals 

and substances, with respect to an increased risk of colon cancer, diabetes or peripheral 

neuropathy. He provided an unequivocal opinion, based on the evidence of record and review of 

medical literature. Dr. Chiodo concluded that the employee did not have a diagnosed condition 

causally related to his federal employment. 

As explained above, an opinion of a referee physician is entitled to special weight if it is 

based on a complete background and is supported by medical rationale. The April 15, 2014 

report from Dr. Chiodo provides a rationalized medical opinion based on a complete 

background. The Board finds it is entitled to special weight and represents the weight of the 

evidence. 

On appeal, appellant’s representative has reiterated his arguments that the employee had 

greater exposure to chemicals and substances than acknowledged by OWCP. There is no 

definitive document or evidence that can provide an exact measurement of the employee’s 

exposure to all substances while in federal employment. This is a difficult issue and OWCP did 

provide a detailed review of the evidence in the SOAF. Again, Dr. Chiodo indicated that he had 

reviewed voluminous evidence in the record, and he did accept some exposure to AO and 

chemicals. The April 15, 2014 report was a careful and thorough report that addressed the issues 

presented. The purpose of a referee selection under 5 U.S.C. § 8123(a) is to resolve a conflict in 

the medical evidence. For the reasons stated, the Board finds that Dr. Chiodo resolved the 

medical issues presented in this case. 

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. 
5

CONCLUSION 

The Board finds that the employee has not established an injury causally related to 

exposure to chemicals or other substances in his federal employment. 

ORDER 

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

Compensation Programs dated June 6, 2014 is affirmed. 

Issued: February 4, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board