United States Department of Labor 

Employees’ Compensation Appeals Board 

_________________________________________ 

S.J., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Glen Dale, MD, Employer 

__________________________________________ 

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Docket No. 16-0545 

Issued: June 17, 2016 

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 February 2, 2016 appellant, through counsel, filed a timely appeal from a 

December 2, 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 met his burden of proof to establish an injury causally 

related to factors of his federal employment. 

FACTUAL HISTORY 

On October 4, 2013 appellant, then a 57-year-old letter carrier, filed an occupational 

disease claim (Form CA-2) alleging that he sustained osteoarthritis of the right hip due to 

                                                             1

 5 U.S.C. § 8101 et seq.
2

employment. He first became aware of the condition and its relation to his federal employment 

on April 11, 2012. Appellant stopped work on April 11, 2012. 

In an October 4, 2013 statement accompanying his claim, appellant advised that he had 

two torn medial meniscus and he was in need of a total right hip replacement. He explained that 

his physicians believed his hip condition was due to favoring both knees and putting stress on his 

hip. Appellant noted that his duties included collecting both residential and business mail, 

driving a two-ton vehicle which required that he enter and exit using three steps, one and a half 

feet from the ground, at least 100 times per day. On July 28, 2009 he tore his left knee medial 

meniscus and underwent arthroscopic surgery. Appellant advised that he returned to full-time 

work with light restrictions to include not much walking or steps. He explained that, after 

working approximately one year, when exiting his vehicle on April 11, 2012, his left knee gave 

out causing him to fall to the ground. After reporting the incident, appellant was able to finish 

work that day, but he did not work the next day due to right knee swelling.2

 

In an August 21, 2012 report, Dr. H.S. Pabla, a Board-certified orthopedic surgeon, noted 

that appellant complained of pain in the right knee. He indicated that appellant had a similar 

episode of symptoms on the contralateral side and was favoring both knees, placing more stress 

on the hip. Dr. Pabla provided results on examination and diagnosed internal derangement, right 

knee, torn, right medial meniscus, and pain in the right hip, as a result of the incident on 

April 11, 2012. 

In a September 17, 2013 report, Dr. Craig Thomas, a Board-certified orthopedic surgeon 

noted that appellant had been seen for right hip pain since 2012. He indicated that the pain was 

severe to the point that appellant was unable to walk without crutches. After an examination, 

Dr. Thomas diagnosed osteoarthritis of the hip. He recommended an advanced hip arthropathy. 

By letter dated October 25, 2013, OWCP informed appellant of the type of evidence 

needed to support his claim and requested that he submit such evidence within 30 days. 

In a November 11, 2013 response, appellant described his duties at work which included 

driving a two-ton vehicle, which required that he enter and exit three steps at least 100 times a 

day, 8 to 10 hours a day, 5 days a week. He related that he had no prior medical conditions 

concerning his hip. Appellant advised that his daily activities included preparing for work, 

returning home and attending to dinner, grooming, preparing for the next workday, watching 

television, and sleeping. He explained that his injuries from 2009 and April 2012 caused him to 

favor both of his knees and placed stress on his right hip. Appellant also indicated that he had 

not returned to work since April 11, 2012 and has received compensation since April 12, 2012. 

OWCP received several treatment notes. They included a September 9, 2013 note from 

Dr. Marc E. Rankin, a Board-certified orthopedic surgeon, who noted that appellant presented 

for a postoperative visit. He advised that appellant had right hip pain on a constant basis which 

he related began after he injured his right knee. Dr. Rankin advised that appellant had to use 

                                                             2

 The Board notes that appellant filed separate claims for his knee conditions which were accepted by OWCP for 

right knee internal derangement under claim number xxxxxx182 and left knee internal derangement and medial 

meniscus tear under claim number xxxxxx241. The present claim pertains only to the claimed hip condition. 
3

crutches to walk “because of the pain.” He provided examination results and diagnosed 

osteoarthritis not otherwise specified, status postoperative total knee replacement, and hip 

arthritis. Dr. Rankin recommended hip replacement surgery and indicated that it was possible 

that a portion of appellant’s right knee pain was in fact referred pain from the right hip. 

In an October 1, 2013 report, Dr. Thomas noted that appellant presented for preoperative 

history and physical for a primary total hip arthropathy. He diagnosed osteoarthritis of the hip. 

In an October 23, 2013 report, Dr. Thomas noted that appellant was approximately 12 days post 

total hip arthroplasty. He saw appellant again on October 30, 2013 and advised that the sutures 

were removed without incident. Dr. Thomas advised that the right hip surgical wound was 

completely healed with no drainage. He recommended physical therapy. 

By decision dated January 9, 2014, OWCP denied appellant’s claim. It found that the 

medical evidence of record did not demonstrate that the claimed medical condition was related to 

the accepted factors of his federal employment. 

On January 14, 2014 appellant’s counsel requested a telephonic hearing, which was held 

before an OWCP hearing representative on July 15, 2014. OWCP received copies of previously 

submitted reports. 

By decision dated September 9, 2014, the OWCP hearing representative affirmed the 

January 9, 2014 decision. 

On September 2, 2013 appellant’s counsel requested reconsideration. He submitted 

additional medical evidence. 

In a November 27, 2013 report, Dr. Thomas diagnosed osteoarthritis of the hip and 

advised that appellant was “still unable to perform his work duties secondary to lower extremity 

weakness following surgery. He continued to treat appellant and on January 8, 2014 placed him 

off work. Dr. Thomas advised in an October 8, 2014 report that appellant attend a work 

hardening program to determine his work ability. He opined that “to a reasonable degree of 

medical certainty that [appellant] had exacerbation of his arthritis secondary to his employment 

as a letter carrier.” 

In a December 9, 2013 report, Dr. Rankin advised that appellant had been seen for left 

knee and right knee pain. He diagnosed osteoarthritis of the knee and derangement of the 

posterior horn of the medial meniscus. Dr. Rankin indicated that once appellant had reached 

maximum medical improvement from the left knee, they would address any remaining right knee 

pain. In a January 23, 2014 report, he noted that appellant’s left knee pain was decreased 

significantly and appellant was ambulating for the first time in three years. Dr. Rankin examined 

appellant’s knees and repeated his diagnoses of osteoarthritis of the knee and derangement of the 

posterior horn of the medial meniscus. He advised that appellant had not reached maximum 

medical improvement and was not cleared for a return to work. Dr. Rankin continued to treat 

appellant on March 20, June 5, and October 22, 2014. OWCP also received diagnostic reports. 

By decision dated December 2, 2015, OWCP denied modification of its prior decision. It 

found that the medical evidence of record was insufficient to establish that appellant’s hip 

diagnosis or condition was caused or aggravated by the accepted work factors. 
4

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 FECA, that the claim was timely filed within the applicable time 

limitation period of FECA, that an injury was sustained 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 employment injury.3 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.4

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) 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 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, generally, is 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.5

ANALYSIS 

Appellant alleged that he developed a right hip condition while performing his work 

duties as a letter carrier. The evidence supports that he engaged in the described activities at 

work as part of his letter carrier duties. However, the Board finds that appellant submitted 

insufficient medical evidence to establish that his hip condition was caused or aggravated by 

these activities or any other specific factors of his federal employment. 

In support of his claim appellant submitted several reports from Drs. Pabla, Thomas and 

Rankin. However, the only physician who provided an opinion on causal relationship was 

Dr. Thomas. In an October 8, 2014 report, Dr. Thomas recommended that appellant attend a 

work hardening program to determine his work ability. He opined that “to a reasonable degree 

of medical certainty that he had exacerbation of his arthritis secondary to his employment as a 

letter carrier.” However, Dr. Thomas’ opinion is not rationalized as he did not explain how he 

                                                             3 Joe D. Cameron, 41 ECAB 153 (1989); Elaine Pendleton, 40 ECAB 1143, 1145 (1989). 

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

5 Id. 
5

arrived at his conclusion and did not specify the location of the arthritis. He did not explain what 

and how particular work duties caused or contributed to appellant’s diagnosed medical 

conditions. As noted above, part of appellant’s burden of proof includes the submission of 

rationalized medical opinion addressing whether there is a causal relationship between the 

claimant’s diagnosed condition and the implicated employment factors. This he has not done. 

Other medical evidence submitted by appellant does not offer an opinion on causal 

relationship. Consequently, these reports are of limited probative value.6

The Board has held that the mere fact that a condition manifests itself during a period of 

employment does not raise an inference that there is a causal relationship between the two.7

 

Neither the fact that the condition became apparent during a period of employment nor the belief 

that the condition was caused or aggravated by employment factors or incidents is sufficient to 

establish causal relationship.8

 Causal relationship must be substantiated by reasoned medical 

opinion evidence, which is appellant’s responsibility to submit. The Board finds that this report 

is insufficiently rationalized and is of limited probative value with regard to causal relationship. 

As there is no reasoned medical evidence explaining how appellant’s employment duties 

caused or aggravated a medical condition involving his hips, he has not met his burden of proof 

in establishing that he sustained an injury causally related to factors of his federal employment. 

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 has not met his burden of proof to establish an injury 

causally related to factors of his federal employment. 

                                                             6 Linda I. Sprague, 48 ECAB 386 (1997) (medical evidence that does not offer any opinion regarding the cause of 

an employee’s condition is of diminished probative value on the issue of causal relationship). 

7 See Joe T. Williams, 44 ECAB 518, 521 (1993). 

8 Id.
6

ORDER 

IT IS HEREBY ORDERED THAT the December 2, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: June 17, 2016 

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