United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.B., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Washington, DC, Employer 

__________________________________________ 

) 

) 

) 

) 

) 

) 

) 

) 

Docket No. 16-0884 

Issued: September 8, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On March 23, 2016 appellant filed a timely appeal from a January 6, 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.2

 

ISSUE 

The issue is whether appellant met his burden of proof to establish bilateral hip 

osteoarthritis as a result of factors of his federal employment. 

 1

 5 U.S.C. § 8101 et seq.

2

 The Board notes that appellant submitted additional evidence after OWCP rendered its January 6, 2016 decision. 

The Board’s jurisdiction is limited to reviewing the evidence that was before OWCP at the time of its final decision. 

Therefore, this additional evidence cannot be considered on appeal. 20 C.F.R. § 501.2(c)(1); Dennis E. Maddy, 47 

ECAB 259 (1995); James C. Campbell, 5 ECAB 35, 36 n.2 (1952). Appellant may submit this evidence to OWCP, 

together with a formal request for reconsideration, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R. § 10.606(b)(2). 
2

FACTUAL HISTORY 

On April 27, 2015 appellant, then a 62-year-old letter carrier, filed an occupational 

disease claim (Form CA-2) alleging that he developed bilateral hip arthritis as a result of his 

federal employment duties. He reported that he was a letter carrier for 36 years and worked in 

extreme cold, snow, rain, and heat reaching above 100 degrees for 10 to 12 hours a day, 6 days a 

week. Appellant stopped work on February 14, 2015. 

In a July 25, 2014 medical report, Dr. Kelly A. Martens, a Board-certified orthopedic 

surgeon, performed a right hip fluoroscopic-guided injection. 

In an August 22, 2014 medical report, Dr. Thorsten Sundberg, a Board-certified 

diagnostic radiologist, performed a right hip fluoroscopic-guided injection. 

In a March 11, 2015 operative report, Dr. Craig R. Faulks, a Board-certified orthopedic 

surgeon, performed right hip total arthroplasty. He noted that an x-ray of the right hip showed 

severe arthritis. 

By letter dated May 13, 2015, OWCP informed appellant that the evidence of record was 

insufficient to support his claim for bilateral hip arthritis. Appellant was advised of the medical 

and factual evidence needed and was afforded 30 days to submit additional evidence. In another 

letter of that same date, OWCP requested that the employing establishment provide further 

information pertaining to appellant’s occupational disease claim. 

In a May 11, 2015 disability certificate, Dr. Faulks reported that appellant was totally 

incapacitated from May 11 through August 11, 2015. 

In a May 26, 2015 report, Dr. Faulks reported that appellant presented after right hip total 

arthroplasty on March 11, 2015. He noted left hip arthritis as well as intermittent symptoms 

pertaining to the right knee. Dr. Faulks provided findings on physical examination and 

diagnosed severe bilateral hip osteoarthritis and status post right hip total arthroplasty. He also 

diagnosed partial right knee tear anterior cruciate ligament. Dr. Faulks reported that appellant’s 

bilateral hip arthritis was likely aggravated by his work as a letter carrier for the employing 

establishment. He noted that this could be considered an on-the-job injury or at least an 

aggravation. Dr. Faulks concluded that appellant would eventually need a left hip total 

arthroplasty and to follow up in two to three months. 

By decision dated June 16, 2015, OWCP denied appellant’s claim finding that the 

evidence of record failed to establish that the occupational exposure occurred as alleged. It noted 

that appellant had failed to establish fact of injury because he did not respond to the 

questionnaire provided in its May 13, 2015 development letter. 

On July 13, 2015 appellant requested an oral hearing before an OWCP hearing 

representative. In support of his claim, he resubmitted medical evidence previously of record. 

A hearing was held on October 21, 2015 where appellant testified in support of his claim. 

Appellant stated that his letter carrier duties required him to be on his feet 10 to 12 hours per day, 

lift up to 70 pounds, carry up to 35 pounds, and step in and out of his truck. He explained that 
3

his hip condition would improve when he was off work and worsen when returning to work. The 

record was held open for 30 days. 

In a November 17, 2015 medical report, Dr. Faulks reported that appellant underwent 

right hip total arthroplasty on March 11, 2015 and returned with improvement, but continued to 

experience pain in the left hip. He reported that appellant worked as a letter carrier since 1979. 

Dr. Faulks diagnosed bilateral hip arthritis and noted that appellant would likely need left total 

arthroplasty explaining that he did well after his right hip arthroplasty. He opined that his 

bilateral hip arthritis was caused by his occupation which involved quite a bit of activity, 

walking, and standing. Dr. Faulks concluded with a reasonable degree of medical certainty that 

appellant’s condition was job related. 

By decision dated January 6, 2016, OWCP’s hearing representative affirmed the June 16, 

2015 decision, as modified, finding that appellant had established that the occupational exposure 

occurred as alleged, but that the medical evidence failed to establish that his diagnosed condition 

was causally related to his accepted federal employment duties. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA 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 filed within the applicable 

time limitation, that an injury was sustained while in the performance of duty as alleged, and that 

any disability or specific condition for which compensation is claimed is causally related to the 

employment injury.3

 These are the essential elements of every compensation claim regardless of 

whether the claim is predicated on a traumatic injury or an occupational disease.4

In order to determine whether an employee actually sustained an injury in the 

performance of duty, OWCP begins with an analysis of whether fact of injury has been 

established. Generally, fact of injury consists of two components which must be considered in 

conjunction with one another. The first component to be established is that the employee 

actually experienced the employment incident which is alleged to have occurred.5

 The second 

component is whether the employment incident caused a personal injury and generally can be 

established only by medical evidence. 

To establish that an injury was sustained in the performance of duty in a claim for 

occupational disease, 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 

 3 Gary J. Watling, 52 ECAB 278 (2001); Elaine Pendleton, 40 ECAB 1143, 1154 (1989). 

4 Michael E. Smith, 50 ECAB 313 (1999). 

5 Elaine Pendleton, supra note 3. 
4

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.6 

To establish a causal relationship between the condition, as well as any attendant 

disability claimed and the employment event or incident, the employee must submit rationalized 

medical opinion evidence based on a complete factual and medical background, supporting such 

a causal relationship.7

 The opinion of the physician 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. This 

medical opinion must include an accurate history of the employee’s employment injury and must 

explain how the condition is related to the injury. The weight of medical evidence is determined 

by its reliability, its probative value, its convincing quality, the care of analysis manifested, and 

the medical rationale expressed in support of the physician’s opinion.8

ANALYSIS 

OWCP accepted that appellant engaged in repetitive activities in his employment duties 

as a letter carrier. It denied his claim, however, as the evidence failed to establish a causal 

relationship between those activities and his bilateral hip osteoarthritis. The Board finds that the 

medical evidence currently of record is insufficient to establish that appellant developed bilateral 

hip osteoarthritis causally related to factors of his federal employment as a letter carrier. 

In the medical report dated May 26, 2015, Dr. Faulks reported that appellant underwent 

right hip total arthroplasty on March 11, 2015. In this report, he diagnosed severe bilateral hip 

osteoarthritis and status post right hip total arthroplasty. Dr. Faulks opined that appellant’s 

bilateral hip osteoarthritis was likely aggravated by his work as a letter carrier and could be 

considered an on-the-job injury, or at least an aggravation. 

In his November 17, 2015 report, Dr. Faulks opined that appellant’s bilateral hip 

osteoarthritis was caused by his work as a letter carrier since 1979, which involved quite a bit of 

activity, walking, and standing. He concluded with a reasonable degree of medical certainty that 

his condition was job related. 

The Board finds that although Dr. Faulks supported causal relationship noting that 

appellant’s employment duties likely aggravated his bilateral hip arthritis, he did not provide 

medical rationale explaining the basis of his opinion.9

 While Dr. Faulks noted that appellant’s 

bilateral hip osteoarthritis was likely aggravated by his work as a letter carrier, he failed to 

discuss whether his preexisting condition had progressed beyond what might be expected from 

 6 See Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. Fish, 46 ECAB 276, 279 (1994). 

7 See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983). 

8 James Mack, 43 ECAB 321 (1991). 

9 See T.M., Docket No. 08-0975 (issued February 6, 2009) (a medical report is of limited probative value on the 

issue of causal relationship if it contains a solution which is unsupported by medical rationale). 
5

the natural progression of that condition.10 A well-rationalized opinion is particularly warranted 

when there is a history of preexisting condition.11 Dr. Faulks’ opinion on causation is deficient 

as he failed to explain why appellant’s current bilateral hip condition was not caused by a 

preexisting degenerative arthritic condition.12

Dr. Faulks also explained in his notes that appellant’s employment as a letter carrier since 

1979 involved quite a bit of activity, walking, and standing which caused his bilateral hip 

osteoarthritis.13 Again, his medical opinion report is deficient as he only generally described 

appellant’s work duties without a clear understanding of the number of hours per day spent 

performing each task and the frequency of other physical movements which appellant attributes 

to his injury. Without explaining how the movements involved in appellant’s employment duties 

caused or contributed to his diagnosed condition, his opinion on causal relationship is deficient 

as he failed to specifically address whether appellant’s employment activities had caused or 

aggravated a medical condition. 

Moreover, the medical opinion of Dr. Faulks is deficient as it is speculative and 

equivocal,14 as he qualified his medical opinion by noting that this “could be” an on-the-job 

injury and described an aggravations of injury as “likely.” As Dr. Faulks failed to provide a 

definite and well-rationalized opinion that appellant’s bilateral hip osteoarthritis was caused or 

aggravated by his occupational employment duties, his medical reports fail to establish that 

appellant’s injuries are a result of a work-related occupational exposure.15 

The remaining medical evidence is also insufficient to establish appellant’s claim. The 

reports of Dr. Sundberg and Dr. Martens only note administering a right hip fluoroscopic guided 

injection with no opinion on the cause of his injury or discussion of his federal employment 

duties. The Board has held that medical evidence that does not offer any opinion regarding the 

cause of an employee’s condition is of limited probative value.16 Thus, the reports of 

Dr. Sundberg and Dr. Martens are insufficient to establish appellant’s occupational exposure 

claim. 

In the instant case, the record lacks rationalized medical evidence establishing a causal 

relationship between appellant’s federal employment duties as a letter carrier and his diagnosed 

bilateral hip osteoarthritis. Thus, appellant has failed to meet his burden of proof.17

 10 R.E., Docket No. 14-868 (issued September 24, 2014). 

11 Supra note 9; Michael S. Mina, 57 ECAB 379 (2006). 

12 P.O., Docket No. 14-1675 (issued December 3, 2015). 

13 See Lee R. Haywood, 48 ECAB 145 (1996). 

14 T.V., Docket No. 16-0656 (issued July 27, 2016) (medical opinions which are speculative or equivocal in nature 

have little probative value). 

15 S.R., Docket No. 12-1098 (issued September 19, 2012). 

16 S.E., Docket No. 08-2214 (issued May 6, 2009); C.B., Docket No. 09-2027 (issued May 12, 2010).

17 R.M., Docket No. 11-1921 (issued April 10, 2012). 
6

CONCLUSION 

The Board finds that appellant did not meet his burden of proof to establish bilateral hip 

osteoarthritis causally related to factors of his federal employment. 

ORDER 

IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’ 

decision dated January 6, 2016 is affirmed. 

Issued: September 8, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board