United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

T.W., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Cleveland, OH, Employer 

__________________________________________ 

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Docket No. 15-1603 

Issued: October 20, 2015 

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 July 20, 2015 appellant filed a timely appeal of a March 25, 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.2

ISSUE 

The issue is whether appellant has met her burden of proof to establish that her current 

left knee condition is causally related to factors of her federal employment. 

 1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that appellant submitted additional evidence to the record following OWCP’s March 25, 2015 

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

review. 20 C.F.R. § 501(c)(1). 
2

FACTUAL HISTORY 

On January 28, 2015 appellant, a 44-year-old letter carrier, filed an occupational disease 

claim (Form CA-2) for benefits, alleging that she developed a left knee condition causally related 

to employment factors of walking, climbing up and down stairs, and standing while casing mail. 

She noted that she first became aware of her condition and that it was caused or aggravated by 

her employment on September 18, 2014. Appellant did not stop work. In a supplemental 

statement, also dated January 28, 2015, she noted that she had sustained a previous left knee 

injury on October 9, 2002, which was diagnosed as left knee lateral ligament strain. 

The record indicates that OWCP accepted that appellant sustained a traumatic injury to 

her left knee on October 19, 2002,3

 but that an August 2011 occupational disease claim in 

OWCP File No. xxxxxx542 was denied. 

On February 11, 2015 OWCP advised appellant that it required factual and medical 

evidence to determine whether she was eligible for compensation benefits. It asked her to submit 

a comprehensive report from a treating physician describing her diagnosed condition, and an 

opinion as to whether her claimed condition was causally related to her federal employment. 

OWCP requested that appellant submit this evidence within 30 days. 

In a March 5, 2015 report, Dr. Robert M. Fumich, a Board-certified orthopedic surgeon 

and appellant’s treating physician, provided a summary of treatment notes which he had 

compiled on a monthly basis from October 2014 to March 2015. He advised that appellant had 

been experiencing left knee pain since 2002, when she injured her left knee at work. Dr. Fumich 

noted that she underwent left knee surgery in December 2011, but continued to be symptomatic 

with pain in the patellofemoral joint and lateral joint line. He noted that on examination 

appellant had patellofemoral clicking and crunching, with lateral tenderness and that she 

underwent x-ray tests which showed varus with decreased medial joint space and some 

patellofemoral arthritic change. Dr. Fumich informed her that she might require knee 

replacement surgery. In his notes dated December 16, 2014, January 20, February 17, and 

March 5, 2015 he advised that appellant was still experiencing continuing left knee pain and 

symptoms and was awaiting approval for left knee arthroscopy. 

In a second March 5, 2015 narrative report, Dr. Fumich noted that appellant had 

sustained a left knee injury in October 2002 when she stepped backward off of stairs while 

delivering mail; a dog approached her and she turned and twisted, injuring her left knee. 

Following this injury appellant returned to limited duty for three years. She experienced 

recurrent pain and in December 2011 had an arthroscopic procedure. Dr. Fumich related that, 

after the surgery, appellant continued to have left knee problems. He noted that he first treated 

her on October 7, 2014 at which time she had patellofemoral clicking and crunching with lateral 

joint tenderness, some varus, and prolapse instability to valgus. Dr. Fumich advised that 

appellant continued carrying the mail on a full route, on full duty. He opined that she had a 

continued lateral meniscal tear and patellofemoral chondromalacia and required a repeat 

arthroscopy due to her continued, ongoing symptomatology. Dr. Fumich noted that, obviously 

 3

 Appellant’s claim for a left knee condition was assigned claim number xxxxxx332. 
3

with a bad knee, the continued walking of a mail route was contributory to aggravating the 

previous injury. He opined that there was a direct causal relationship between the symptomatic 

left knee and an internal derangement, most likely representing patellofemoral chondromalacia 

and a lateral meniscal tear, and the injury of September 18, 2014. 

By decision dated March 25, 2015, OWCP denied the claim, finding that appellant failed 

to submit medical evidence establishing that she sustained a left knee condition in the 

performance of duty. The decision noted that her 2011 left knee surgery had not been accepted 

as causally related to her federal employment. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA4 has the burden of establishing that 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, 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.5

 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.6

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 is usually rationalized medical 

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, either by direct cause or aggravation, and 

the specific employment factors identified by the claimant.7

 4

 5 U.S.C. §§ 8101-8193. 

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

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

7 Id. See also E.T., Docket No. 15-687 (issued June 19, 2015). 
4

ANALYSIS 

Appellant has explained and the records supports that she had a prior left knee injury on 

October 19, 2002 which was accepted for left knee ligament strain and that continued walking, 

climbing up and down stairs, and standing while casing mail caused her current left knee 

condition. 

In the instant case, appellant has failed to submit any medical opinion containing a 

rationalized, probative report which sufficiently relates her current claimed left knee condition 

was caused or aggravated by factors of her employment. The medical evidence of record does 

not sufficiently identify which employment duties are alleged to have caused her current left 

knee condition or sufficiently explain how these factors would result in causing her current 

condition. For this reason, appellant has not discharged her burden of proof to establish her 

claim that these conditions were sustained in the performance of duty. 

In addition to appellant’s accepted October 19, 2002 left knee ligament strain, the record 

indicates that she underwent a left knee procedure in 2011 which was not authorized by OWCP. 

In support of her claim that her current left knee condition was caused by factors of her federal 

employment, appellant submitted March 5, 2015 reports from Dr. Fumich. Dr. Fumich advised 

that she underwent a left knee arthroscopy in December 2011 and continued to experience pain 

in the patellofemoral joint and lateral joint line, he did not acknowledge, however, that this 

procedure in 2011 was not accepted as due to an employment injury. He advised that appellant 

underwent x-ray tests which indicated varus with decreased medial joint space and some 

patellofemoral arthritic change in the left knee. Dr. Fumich recommended that she undergo 

additional left knee arthroscopy surgery in light of her continued, ongoing symptomatology. 

Dr. Fumich opined that appellant’s duties of walking a mail route contributed to and 

aggravated her previous injury. He found that there was a direct causal relationship between the 

symptomatic left knee and an internal derangement, most likely representing patellofemoral 

chondromalacia and a lateral meniscal tear, and the injury of September 18, 2014. Dr. Fumich’s 

reports, however, did not provide a probative, rationalized medical opinion that the claimed 

condition was causally related to employment factors. His opinion on causal relationship is of 

limited probative value as it does not contain any medical rationale how or why appellant’s 

claimed left knee condition was currently caused or aggravated by factors of employment, 

especially in light of the fact that her 2011 claim for recurrence of her 2002 left knee injury was 

not accepted.8

 

The weight of medical opinion is determined by the opportunity for and thoroughness of 

examination, the accuracy and completeness of a physician’s knowledge of the facts of the case, 

the medical history provided, the care of analysis manifested, and the medical rationale 

expressed in support of stated conclusions.9

 Dr. Fumich did not sufficiently describe appellant’s 

job duties or explain the medical process through which such duties would have been competent 

to cause the current claimed condition. His opinion is of limited probative value as it does not 

 8 William C. Thomas, 45 ECAB 591 (1994). 

9 See Anna C. Leanza, 48 ECAB 115 (1996). 
5

contain any medical rationale explaining how her job duties physiologically caused the 

diagnosed left knee condition. Dr. Fumich’s reports thus did not constitute adequate medical 

evidence to establish that appellant’s claimed left knee condition was causally related to her 

employment. 

An award of compensation may not be based on surmise, conjecture, or speculation. 

Neither the fact that appellant’s condition became apparent during a period of employment nor 

the belief that her condition was caused, precipitated, or aggravated by her employment is 

sufficient to establish causal relationship.10 Causal relationship must be established by 

rationalized medical opinion evidence and she failed to submit such evidence. 

OWCP advised appellant of the evidence required to establish her claim. However, 

appellant failed to submit such evidence. Consequently, she has not met her burden of proof in 

establishing that her claimed left knee condition was causally related to her 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 failed to meet her burden of proof to establish that her 

current left knee condition is causally related to factors of her federal employment. 

 10 Id.
6

ORDER 

IT IS HEREBY ORDERED THAT the March 25, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: October 20, 2015 

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