United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.B., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Houston, TX, Employer 

__________________________________________ 

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Docket No. 16-1284 

Issued: February 14, 2017 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On June 3, 2016 appellant filed a timely appeal from a May 16, 2016 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 her burden of proof to establish a bilateral knee 

condition causally related to factors of her federal employment. 

FACTUAL HISTORY 

On October 9, 2015 appellant, then a 61-year-old retired customer services supervisor, 

filed an occupational disease claim (Form CA-2) alleging a bilateral knee condition due to 

 1

 5 U.S.C. § 8101 et seq. 
2

factors of her federal employment. She identified June 23, 2009 as the date she first became 

aware of her condition. 

In a narrative statement, appellant specified that she had retired on October 1, 2015 and 

prior to her retirement she worked as a supervisor which required constant walking to the 

window unit, parcel area, and box section and sometimes in the automated areas. She indicated 

that she performed these duties at least eight hours per day, five days per week. Appellant 

alleged that her federal duties affected both of her knees, right worse than left, and noted that she 

never had a problem with her knees prior to working for the employing establishment and had no 

hobbies that would have caused or aggravated her conditions. 

In a November 2, 2015 letter, OWCP notified appellant of the deficiencies of her claim 

and afforded her 30 days to submit additional evidence and respond to its inquiries. 

By decision dated December 3, 2015, OWCP denied the claim as the medical evidence of 

record failed to establish a diagnosis in connection with the alleged injury and/or events. 

On December 11, 2015 appellant requested a review of the written record by a 

representative of the Branch of Hearings and Review and submitted a November 19, 2015 

narrative statement indicating that her job as a supervisor required constant walking in order to 

check areas of responsibilities and also required her to bend and stoop in the performance of 

duty. 

In a September 15, 2015 report, Dr. Steven Inbody, a Board-certified neurologist, noted 

that appellant had been employed by the employing establishment as a supervisor for the past 35 

years and on or about June 23, 2009 she first became aware of an aggravation of a preexisting 

injury of the right knee and sustained a new injury to the left knee while performing her 

repetitive duties of walking, standing, stooping, and bending. He reported that appellant 

eventually underwent right knee total replacement surgery and in 2006 a right knee meniscal tear 

was noted and treated arthroscopically with medial collateral ligament tear also noted and 

repaired. As appellant continued to work on her feet with significant walking required, her pain 

evolved and required knee injections. Dr. Inbody noted that appellant’s pain continued to 

progress making activities at work difficult with end-of-the-day exacerbations to the point where 

she was unable to complete her activities of daily living at home with pain no longer responding 

to after-work rest. Appellant was scheduled for a total knee replacement on April 6, 2015 and 

had been going through gradual rehabilitation since. Dr. Inbody diagnosed bilateral internal 

derangement of the knees and opined that appellant’s condition was a result of the repetitive 

traumas she experienced in her federal employment which required walking throughout the day 

with prolonged standing and very little time to sit. 

On April 22, 2016 the employing establishment controverted appellant’s claim alleging 

that she did not walk or stand for eight hours per day and used a yard stick to measure the mail 

which required no bending or stooping. It noted that appellant’s job required two hours of 

intermittent walking and standing. The employing establishment submitted a position 

description and noted that appellant did not perform any physical exertion of lifting, pushing, 

pulling, bending, or stooping at work. 
3

By decision dated May 16, 2016, an OWCP hearing representative affirmed the 

December 3, 2015 decision, finding that the medical evidence of record established fact of 

injury, but failed to establish a causal relationship between appellant’s condition and factors of 

her federal employment. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA2

 has the burden of proof to establish 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 of FECA, and that an injury3

 was sustained in the performance 

of duty. These are the essential elements of each 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, an employee must submit the following: (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

Causal relationship is a medical issue and the medical evidence generally required to 

establish causal relationship is rationalized medical evidence. The opinion of the physician must 

be based on a complete factual and medical background of the employee, 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 employee.6

ANALYSIS 

The Board finds that appellant did not meet her burden of proof to establish that factors 

of her federal employment caused or aggravated her bilateral knee condition. Appellant 

identified the factors of employment that she believed caused the condition, including walking 

and standing while supervising areas at work, which OWCP accepted as factual. However, in 

order to establish a claim that she sustained an employment-related injury, she must also submit 

 2 Id.

3

 OWCP regulations define an occupational disease or illness as a condition produced by the work environment 

over a period longer than a single workday or shift. 20 C.F.R. § 10.5(q). 

4 See O.W., Docket No. 09-2110 (issued April 22, 2010); Ellen L. Noble, 55 ECAB 530 (2004). 

5 See D.R., Docket No. 09-1723 (issued May 20, 2010). 

6 See O.W., supra note 4. 
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rationalized medical evidence which explains how her medical condition was caused or 

aggravated by the accepted employment factors.7

In his September 15, 2015 report, Dr. Inbody diagnosed bilateral internal derangement of 

the knees and opined that appellant’s condition was a result of the repetitive traumas she 

experienced in her federal job which required walking throughout the day with prolonged 

standing and very little time to sit. He failed to provide a rationalized opinion explaining how 

factors of appellant’s federal employment, her walking and prolonged standing at work, caused 

or aggravated her bilateral knee condition. Dr. Inbody failed to provide an opinion adequately 

addressing how appellant’s history of knee issues, including a June 23, 2009 incident, caused or 

contributed to her bilateral internal knee derangement. The Board has held that medical opinions 

based on an incomplete history have diminished probative value.8

 Dr. Inbody noted that 

appellant’s condition occurred while she was at work, but such generalized statements do not 

establish causal relationship because they merely repeat appellant’s allegations and are 

unsupported by adequate medical rationale explaining how her physical activity at work actually 

caused or aggravated the diagnosed condition.9 The Board has held that the mere fact that 

appellant’s symptoms arise during a period of employment or produce symptoms revelatory of 

an underlying condition does not establish a causal relationship between appellant’s condition 

and her employment factors.10 Thus, the Board finds that Dr. Inbody’s report is insufficiently 

rationalized to establish that appellant’s condition was caused or aggravated by factors of her 

federal employment. 

On appeal, appellant contends that there was an error of fact or law and argues that her 

claim should have been approved based on the medical evidence she submitted. For the reasons 

set forth above, the Board finds appellant’s arguments are without merit. As appellant has not 

submitted any rationalized medical evidence to support her allegation that she sustained an injury 

causally related to the accepted employment factors, she failed to meet her burden of proof to 

establish a claim. 

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 her burden of proof to establish a bilateral 

knee condition causally related to factors of her federal employment. 

 7 See A.C., Docket No. 08-1453 (issued November 18, 2008). 

8 See 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). See also Douglas M. McQuaid, 52 ECAB 382 

(2001); N.H., Docket No. 13-849 (issued July 17, 2013). 

9 See K.W., Docket No. 10-98 (issued September 10, 2010). 

10 See Richard B. Cissel, 32 ECAB 1910, 1917 (1981); William Nimitz, Jr., 30 ECAB 567, 570 (1979). 
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ORDER 

IT IS HEREBY ORDERED THAT the May 16, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: February 14, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board