United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.B., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Charlotte, NC, Employer 

__________________________________________ 

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Docket No. 16-1531 

Issued: August 28, 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 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On July 26, 2016 appellant filed a timely appeal from a June 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 traumatic injury 

causally related to the accepted March 25, 2014 employment incident. 

FACTUAL HISTORY 

On October 9, 2015 appellant, then a 48-year-old rural carrier, filed a traumatic injury 

claim (Form CA-1) alleging that on March 25, 2014 she sustained a left shoulder injury when 

she was closing a long line vehicle (LLV) door on an inclined driveway. She reported that she 

                                                             1

 5 U.S.C. § 8101 et seq.
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pulled her arms which resulted in pain in both shoulders, more on the left. Appellant notified her 

supervisor on October 9, 2015. 

By letter dated October 14, 2015, the employing establishment controverted the claim 

contending that appellant failed to establish fact of injury. 

On October 20, 2015 OWCP informed appellant that the evidence of record was 

insufficient to support her claim. Appellant was advised as to the medical and factual evidence 

required to support her claim and was afforded 30 days to provide the requested evidence. No 

further evidence was received pursuant to this request. 

By decision dated November 27, 2015, OWCP denied appellant’s claim finding that the 

evidence of record failed to establish that she sustained an injury because she did not submit any 

medical evidence containing a medical diagnosis in connection with the accepted March 25, 

2014 employment incident. 

On December 28, 2015 appellant requested review of the written record before an OWCP 

hearing representative. 

In a December 29, 2015 witness statement, K.H., a customer service representative, 

reported that on March 25, 2014 appellant called the office to report an accident after she injured 

her left shoulder while trying to keep her LLV door from shutting/slamming. K.H. noted that the 

accident was reported immediately and appellant was experiencing shoulder pain, but declined to 

file a claim on that date. She further noted that all information and details were consistent with 

the injury claim. 

In an undated narrative statement, appellant explained that she notified her postmaster 

minutes after the alleged employment injury occurred, but did not seek medical treatment from 

her physician because she was hoping the pain would eventually subside. When the pain 

continued to worsen, she sought medical treatment on October 12, 2015. Appellant noted that 

her physician provided findings pertaining to both a left shoulder and left hand condition, but 

that the left hand condition was unrelated to her current injury. 

In an October 12, 2015 medical report, Dr. Scott Smith, a Board-certified orthopedic 

surgeon, reported that appellant sought treatment for complaints of left shoulder pain. Appellant 

reported a work injury having occurred at the employing establishment approximately two years 

prior when she was trying to pull open the door of a mail truck and injured her left shoulder. She 

did not seek treatment at the time of the injury and experienced intermittent pain since then. 

Dr. Smith provided findings on physical examination and reviewed x-rays of the left shoulder 

which revealed os acromiale with resulting type 3 morphology. He diagnosed impingement of 

the left shoulder with os acromiale. 

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

November 27, 2015 decision finding that the evidence of record failed to establish a firm medical 

diagnosis which could be reasonably attributed to the accepted March 25, 2014 employment 

incident. 
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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 are causally related to the 

employment injury.2

 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.3

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.4 The second 

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

established only by medical evidence. 

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.5

 The opinion of the physician must be based on 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.6

ANALYSIS 

OWCP has accepted that the March 25, 2014 incident occurred as alleged. The Board 

finds that appellant failed to establish a traumatic injury causally related to the accepted 

March 25, 2014 employment incident.7 

In an October 12, 2015 report, Dr. Smith provided findings on physical examination, 

reviewed diagnostic testing, and diagnosed left shoulder impingement with os acromiale. In its 

June 16, 2016 decision, OWCP found insufficient evidence to establish fact of injury. The issue 

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

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

4 Elaine Pendleton, 40 ECAB 1143 (1989). 

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

6 James Mack, 43 ECAB 321 (1991). 

7 See Robert Broome, 55 ECAB 339 (2004).
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on appeal is whether appellant has established a traumatic injury causally related to the 

March 25, 2014 incident. Thus, appellant must submit rationalized medical evidence to establish 

her claim. 

While Dr. Smith’s report established a sufficient diagnosis of left shoulder impingement 

with os acromiale, he failed to provide any opinion regarding the cause of appellant’s condition. 

He only generally repeated appellant’s allegations pertaining to the employment incident. Such 

generalized statements do not establish causal relationship because they merely repeat

appellant’s allegations and are unsupported by adequate medical rationale explaining how this 

physical activity actually caused the diagnosed conditions.8

 Moreover, Dr. Smith failed to 

provide a detailed medical history or discuss whether there was any prior treatment for the left 

shoulder.9

 The Board notes that appellant did not seek treatment for her injury until more than 

18 months after the March 25, 2014 employment incident. A well-rationalized opinion is 

particularly warranted given the delay in treatment as it remains unclear if appellant’s injury was 

caused by the March 25, 2014 work incident, was a preexisting condition, or was a 

nonoccupational injury.10 The Board has held that medical evidence that fails to offer a 

rationalized opinion regarding the cause of an employee’s condition is of limited probative value 

on the issue of causal relationship.11 Thus, Dr. Smith’s report is of limited probative value and 

insufficient to meet appellant’s burden of proof.12 

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.13 An award of compensation may not 

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

relation.14 In the instant case, appellant has not submitted sufficient medical evidence to 

establish a causal relationship between the March 25, 2014 employment incident and an injury. 

Any medical opinion evidence appellant may submit to support her claim should reflect a correct 

history and offer a medically sound explanation by the physician of how the specific 

employment incident caused a traumatic injury.15 As Dr. Smith’s report does not meet that 

standard, appellant has failed to meet her burden of proof.16

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

9 Supra note 6. 

10 See J.C., Docket No. 11-1980 (issued July 18, 2012). 

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

12 See L.M., Docket No. 14-973 (issued August 25, 2014); R.G., Docket No. 14-113 (issued April 25, 2014); 

K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-548 (issued November 16, 2012). 

13 Daniel O. Vasquez, 57 ECAB 559 (2006). 

14 D.D., 57 ECAB 734 (2006). 

15 T.G., Docket No. 14-751 (issued October 20, 2014). 

16 J.M., Docket No. 15-1174 (issued August 18, 2015). 
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Appellant may submit additional evidence, together with a written request for 

reconsideration, to OWCP within one year of the Board’s merit decision, pursuant to 5 U.S.C. 

§ 8128(a) and 20 C.F.R. §§ 10.605 and 10.607. 

CONCLUSION 

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

injury causally related to the March 25, 2014 employment incident. 

ORDER 

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

Workers’ Compensation Programs is affirmed. 

Issued: August 28, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board