United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

P.J., Appellant 

and 

DEPARTMENT OF HOMELAND SECURITY, 

AIR MARSHAL SERVICE, 

Brooklyn Heights, OH, Employer 

__________________________________________ 

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Docket No. 17-0722 

Issued: August 1, 2017 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

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 13, 2017 appellant, through counsel, filed a timely appeal from a January 6, 

2017 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to 

the Federal Employees’ Compensation Act2

 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the 

Board has jurisdiction to consider the merits of this case. 

 1

 In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for 

legal or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. 

§ 501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An 

attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject 

to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation. 

2

 5 U.S.C. § 8101 et seq. 
2

ISSUE 

The issue is whether appellant met his burden of proof to establish a right shoulder injury 

causally related to the accepted March 26, 2008 employment incident. 

FACTUAL HISTORY 

On March 26, 2008 appellant, then a 36-year-old federal air marshal, filed a traumatic 

injury claim (Form CA-1) alleging that, on that day, he injured his right shoulder while 

performing pull-ups. 

In an April 7, 2008 authorization for examination and treatment (Form CA-16), J.H., an 

authorizing official, noted an injury date of March 26, 2008 for appellant’s right shoulder injury. 

He approved treatment for the effects of the diagnosed condition. 

In an April 7, 2008 attending physician’s report (Form CA-16) Part B, Dr. Larry K. Lika, 

a treating osteopath Board-certified in orthopedic surgery, diagnosed bicipital tendinitis. He 

described the injury as occurring while appellant was performing pull-ups and heard a pop in the 

right shoulder. Dr. Lika checked a box marked “yes” to the question of whether the diagnosed 

condition had been caused or aggravated by the alleged employment activity. 

Dr. Lika, in an April 7, 2008 duty status report (Form CA-17), noted an injury date of 

March 26, 2008, a diagnosis of bicipital tendinitis, and that appellant could return to work that 

day with no restrictions. 

On April 7, 2008 Dr. Lika conducted a physical examination of appellant. He noted that 

appellant related hearing his right shoulder pop while doing pull-ups for his fitness examination. 

Appellant’s physical examination revealed tenderness on palpation along the biceps tendon long 

head, positive impingement sign, no swelling, and negative Jibe’s sign. Dr. Lika diagnosed right 

shoulder bicipital tendinitis. 

Further documentation was not received in the record until 2016. On January 19, 2016 

appellant filed a claim for a schedule award (Form CA-7). 

By letter dated January 20, 2016, OWCP acknowledged receipt of appellant’s claim for a 

schedule award, but advised that no action could be taken on his claim as the March 26, 2008 

traumatic claim had never been adjudicated. 

By letter dated January 25, 2016, OWCP informed appellant that the evidence of record 

was insufficient to establish his traumatic injury claim. It advised him regarding the required 

medical and factual evidence and afforded him 30 days to provide this information. 

In response to OWCP’s request, appellant submitted physical therapy notes for the period 

August 8, 2014 to April 3, 2015. OWCP also received the following evidence. 

A January 8, 2015 surgical report from Dr. Alan D. Davis, a treating Board-certified 

orthopedic surgeon, noted a preoperative diagnosis of possible right rotator cuff tear and 
3

acromioclavicular impingement pain. He performed a right shoulder arthroscopy with distal 

clavicle excision and acromioplasty surgery. 

On February 13, March 13, and April 10, 2015 Dr. Davis noted that appellant was seen 

for postoperative follow-up. Physical examination findings were provided and diagnoses of right 

shoulder impingement, rotator cuff tear, and acromioclavicular impingement pain. Dr. Davis 

released appellant to return to work with restrictions on February 13 and March 13, 2015 and to 

full duty with no restrictions on April 10, 2015. 

In February 21, 2016 report, Dr. Joseph Deveau, a treating Board-certified family 

medicine physician, noted the dates he had seen appellant and the history of injury, and provided 

examination findings. He, based on review of an October 17, 2014 magnetic resonance imaging 

(MRI) scan, diagnosed right shoulder partial supraspinatus and infraspinatus tendon tears, and 

acromioclavicular supraspinatus tendon impingement with degenerative changes. Dr. Deveau 

opined that the pull-ups appellant performed in March 2008 were a direct cause of his shoulder 

tendon tears and the limitations in his right shoulder. 

By decision dated March 4, 2016, OWCP denied appellant’s claim. It found that the 

evidence of record established that the March 26, 2008 incident occurred as alleged, but denied 

the claim as the medical evidence failed to establish that the diagnosed condition was causally 

related to the accepted March 26, 2008 employment incident. 

On March 14, 2016 appellant, through counsel requested a telephonic hearing before an 

OWCP hearing representative, which was held on November 14, 2016. 

Subsequent to the hearing appellant submitted a February 10, 2009 right knee MRI scan 

and November 2, 2011 progress notes from Dr. Lika regarding right knee and right index finger 

complaints. 

By decision dated January 6, 2017, the hearing representative affirmed the March 4, 2016 

denial of appellant’s claim. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA3

 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 and/or specific condition for which compensation is claimed are causally related to the 

employment injury.4

 These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated on a traumatic injury or an occupational disease.5

 

 3 Id. 

4 C.S., Docket No. 08-1585 (issued March 3, 2009); Bonnie A. Contreras, 57 ECAB 364 (2006). 

5 S.P., 59 ECAB 184 (2007); Joe D. Cameron, 41 ECAB 153 (1989). 
4

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty it must first be determined whether a fact of injury has been established.6

 

First, the employee must submit sufficient evidence to establish that he actually experienced the 

employment incident at the time, place, and in the manner alleged.7

 Second, the employee must 

submit sufficient evidence, generally only in the form of medical evidence, to establish that the 

employment incident caused a personal injury.8

 

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

establish causal relationship is rationalized medical opinion evidence.9

 Rationalized medical 

opinion evidence is medical evidence which includes a physician’s rationalized opinion on 

whether there is causal relationship between the employee’s diagnosed condition and the 

compensable employment factors.10 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.11 

ANALYSIS 

Appellant alleged that he sustained a right shoulder injury as the result of performing 

pull-ups on March 26, 2008. OWCP accepted that the incident occurred as alleged, but denied 

the claim as it found the medical evidence insufficient to establish a causal relationship between 

the accepted March 26, 2008 employment incident and the diagnosed right shoulder conditions. 

The Board finds that appellant failed to meet his burden of proof. 

The record contains an April 7, 2008 narrative report and Form CA-17 duty status report 

from Dr. Lika diagnosing right shoulder bicipital tendinitis. In his report, Dr. Lika noted 

physical examination findings and that appellant heard a pop in his right shoulder while 

performing pull-ups for his fitness examination. On the CA-17 form he noted March 26, 2008 as 

the date of injury and that appellant could return to work with no restrictions. The Board finds, 

however, that Dr. Lika failed to adequately address the issue of causal relationship in either his 

report or Form CA-17 duty status report dated April 7, 2008. Dr. Lika did not explain, with 

medical rationale, the mechanism by which performing pull-ups on March 26, 2008 could have 

caused or aggravated appellant’s diagnosed right shoulder bicipital tendinitis. Medical reports 

 6 B.F., Docket No. 09-0060 (issued March 17, 2009); Bonnie A. Contreras, supra note 4. 

7 D.B., 58 ECAB 464 (2007); David Apgar, 57 ECAB 137 (2005). 

8 C.B., Docket No. 08-1583 (issued December 9, 2008); D.G., 59 ECAB 734 (2008); Bonnie A. Contreras, supra

note 4. 

9 Y.J., Docket No. 08-1167 (issued October 7, 2008); A.D., 58 ECAB 149 (2006); D’Wayne Avila, 57 ECAB 

642 (2006). 

10 J.J., Docket No. 09-0027 (issued February 10, 2009); Michael S. Mina, 57 ECAB 379 (2006). 

11 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345 (1989). 
5

without any rationale on causal relationship are of diminished probative value and do not meet 

an employee’s burden of proof.12 

The record contains an April 7, 2008 attending physician’s report from Dr. Lika 

diagnosing bicipital tendinitis which occurred while appellant was performing pull-ups. He 

checked a box marked “yes” to the question of whether the diagnosed condition had been caused 

or aggravated by the identified employment activity. The Board has held that when a physician’s 

opinion on causal relationship which consists only of checking “yes” to a form question, without 

explanation or rationale, it is of diminished probative value and is insufficient to establish a 

claim.13

Appellant also submitted reports from Dr. Davis dated February 13, March 13, and 

April 10, 2015 diagnosing right shoulder impingement, rotator cuff tear, and acromioclavicular 

impingement. However, Dr. Davis offered no opinion as to the cause of the diagnosed 

conditions. In this case, the accepted employment incident occurred on March 26, 2008, but the 

record lacks any bridging evidence of a right shoulder condition until 2015.14 Thus, the reports 

from Dr. Davis are of limited probative value as they failed to provide rationalized medical 

opinion, based upon a complete medical history, explaining the causal relationship between 

appellant’s accepted March 28, 2008 work incident and his 2015 diagnosed right shoulder 

conditions.15 

The record contains a February 21, 2016 report from Dr. Deveau diagnosing right 

shoulder partial supraspinatus and infraspinatus tears, degenerative changes, and 

acromioclavicular tendon impingements. He attributed appellant’s right shoulder tendon tears 

and limitations to the pull-ups which were performed on March 26, 2008. The Board has held 

that a medical report is of limited probative value on the issue of causal relationship if it contains 

a conclusion regarding causal relationship which is unsupported by medical rationale.16 

Dr. Deveau provided no rationale explaining how the accepted March 26, 2008 work incident 

caused or aggravated appellant’s 2015 diagnosed right shoulder condition. A rationalized 

explanation is especially important in this case as Dr. Deveau’s diagnoses occurred some eight 

years following the accepted employment incident and there is a lack of bridging evidence from 

the accepted incident to the current diagnoses.17 

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

Neidert, 57 ECAB 474 (2006). 

13 D.D., 57 ECAB 734 (2006); Sedi L. Graham, 57 ECAB 494 (2006); Cecelia M. Corley, 56 ECAB 662 (2005). 

14 See Ernest C. Martinez, Docket No. 97-2855 (issued August 24, 1999). 

15 See S.E., Docket No. 08-2214 (issued May 6, 2009); Ellen L. Noble, 55 ECAB 530 (2004) (medical evidence 

that does not offer any opinion regarding the cause of an employee’s condition is of limited probative value on the 

issue of causal relationship). 

16 C.M., Docket No. 14-0088 (issued April 18, 2014); Roma A. Mortenson-Kindschi, 57 ECAB 418 (2006). 

17 B.G., Docket No. 07-0620 (issued May 23, 2007). 
6

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

employment does not raise an inference of causal relation.18 An award of compensation may not 

be based on surmise, conjecture, speculation, or on the employee’s own belief of causal 

relationship.19 Causal relationship must be established by rationalized medical opinion 

evidence.20 Appellant failed to submit such evidence and therefore he has not met his burden of 

proof. 

The Board notes, however, that the record does not verify that the issue of appellant’s 

incurred medical expenses has been addressed. The record contains an undated Form CA-16 

from the employing establishment noting a March 26, 2008 injury date and signed by J.H. 

ATSAC authorizing medical treatment. Ordinarily, where the employing establishment 

authorizes treatment of a job-related injury by providing the employee a properly executed 

CA-16 form,21 OWCP is under contractual obligation to pay for the medical.22 The Board finds 

that, upon return of the case record, this matter should be addressed. 

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 established a right shoulder injury causally related 

to the accepted March 26, 2008 employment incident. 

 18 L.D., Docket No. 09-1503 (issued April 15, 2010); D.I., 59 ECAB 158 (2007); Daniel O. Vasquez, 57 ECAB 

559 (2006). 

19 S.S., 59 ECAB 315 (2008); J.M., 58 ECAB 303 (2007); Donald W. Long, 41 ECAB 142 (1989). 

20 See Dennis M. Mascarenas, 49 ECAB 215 (1997). 

21 See Val D. Wynn, 40 ECAB 666 (1989); see also Federal (FECA) Procedure Manual, Part 3 -- Medical, 

Authorizing Examination and Treatment, Chapter 3.300.3(a)(3) (February 2012). 

22 5 U.S.C. § 8103; 20 C.F.R. § 10.304. See L.B., Docket No. 10-0469 (issued June 2, 2010); see also Federal 

(FECA) Procedure Manual, id. 
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ORDER 

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

Compensation Programs dated January 6, 2017 is affirmed. 

Issued: August 1, 2017 

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