United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.S., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Dallas, TX, Employer 

__________________________________________ 

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Docket No. 16-0926 

Issued: July 26, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On April 1, 2016 appellant filed a timely appeal of a December 31, 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 merit decision in the case. 

ISSUE 

The issue is whether appellant has met her burden of proof to establish a left hip and knee 

injury causally related to factors of her federal employment. 

FACTUAL HISTORY 

On January 2, 2015 appellant then a 59-year-old sales and service associate, filed an 

occupational disease claim (Form CA-2) alleging that she developed pain in the left hip and left 

 1

 5 U.S.C. § 8101 et seq. 
2

knee as a result of repetitively standing, stooping, twisting, and overcompensating that was 

required in her job. She became aware of her condition on October 2, 2013 and realized it was 

causally related to her employment on September 15, 2014. Appellant did not stop work. 

Appellant submitted a statement dated December 5, 2014 noting that in October 2013 she 

began having pain in her left hip and cracking in the left knee. She noted that she was a clerk 

and her job required her to repeatedly stand and twist. Appellant reported having a right hip and 

knee condition which required her to overcompensate on the left side. 

Appellant submitted a report from Dr. Michael M. Taba, a Board-certified orthopedist, 

dated December 1, 2014, who treated appellant on October 3, 2013 for left hip pain and left knee 

locking, catching, and instability. Dr. Taba noted that as months passed appellant’s symptoms 

worsened. He indicated that appellant was being treated for a right knee and hip condition at the 

time and was overcompensating on the left side. Dr. Taba noted findings on examination of left 

hip of tenderness to palpation over the trochanteric bursa, pain with range of motion, no 

deformity, and intact strength. With regard to the left knee he noted there was no incision, scars 

or deformity, tenderness to palpation over the patellofemoral joint, no effusion, intact motor and 

sensory examination, some crepitation of the patellofemoral joint, and intact reflexes. Dr. Taba 

indicated that diagnostic testing and x-rays revealed no obvious pathology. He diagnosed left 

hip trochanteric bursitis, left hip strain, and left knee patellofemoral joint chondromalacia 

tendinitis. Dr. Taba opined that appellant’s left hip bursitis and tendinitis and left knee 

chondromalacia patella were aggravated and exacerbated by work-related injuries. 

By letter dated January 22, 2015, OWCP advised appellant of the type of evidence 

needed to establish her claim, particularly requesting that she submit a physician’s reasoned 

opinion addressing the relationship of her claimed condition and specific employment factors. 

Appellant did not respond within the time allotted. 

In a decision dated February 25, 2015, OWCP denied appellant’s claim for compensation 

because she failed to submit sufficient medical evidence to establish a diagnosed medical 

condition causally related to the claimed event or work factors. 

In a statement dated July 30, 2015, appellant requested reconsideration and noted all 

documents had been submitted, including a doctor’s narrative and a magnetic resonance imaging 

(MRI) scan. She submitted a July 15, 2015 report from Dr. Taba who noted treating appellant 

for left knee and left hip pain in October 2013. Dr. Taba indicated that appellant performed 

repetitive lifting, pushing, pulling, and standing multiple hours a day and as a result injured her 

left knee and hip. He noted that she had problems with weight bearing, standing, and stair 

climbing. On examination appellant had tenderness to palpation of the knee joint, pain with 

range of motion and crepitation with range of motion. A left hip MRI scan revealed tendinitis 

and bursitis of the hip joint while a left knee MRI scan showed grade three to four 

chondromalacia of the patella femoral joint as well as an abnormal signal of the lateral meniscus. 

Dr. Taba diagnosed post-traumatic arthrosis of the left knee and left hip bursitis. He opined that 

appellant’s left knee and left hip findings were directly a result of her work-related repetitive 

lifting, twisting, pushing, and pulling activities over the years. Dr. Taba noted that appellant was 

treated conservatively but remained symptomatic. 
3

In a decision dated December 31, 2015, OWCP denied modification, finding that the 

medical evidence did not provide sufficient medical rationale to support that the conditions 

identified were causally related to specific work factors. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of his or her claim. When an employee claims that he or she sustained an 

injury in the performance of duty, he or she must submit sufficient evidence to establish that he 

or she experienced a specific event, incident or exposure occurring at the time, place, and in the 

manner alleged. Appellant must also establish that such event, incident or exposure caused an 

injury.2 

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) 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 generally rationalized medical 

opinion 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 and the specific employment factors 

identified by the claimant.3

ANALYSIS 

It is not disputed that appellant’s work duties as a sales and service associate included 

repetitively lifting, pulling, pushing, and standing multiple hours each day. It is also not disputed 

that she was diagnosed with left hip trochanteric bursitis, left hip strain, and left knee 

patellofemoral joint chondromalacia tendinitis. The Board finds, however, appellant has not 

submitted sufficient rationalized medical evidence to establish that her diagnosed conditions are 

causally related to specific employment factors. 

Appellant submitted a December 1, 2014 report from Dr. Taba, who treated her on 

October 3, 2013 for worsening left hip pain and left knee locking, catching and instability. 

 2 See Walter D. Morehead, 31 ECAB 188, 194 (1979) (occupational disease or illness); Max Haber, 19 ECAB 

243, 247 (1967) (traumatic injury). See generally John J. Carlone, 41 ECAB 354 (1989); Elaine Pendleton, 40 

ECAB 1143 (1989). 

3 Solomon Polen, 51 ECAB 341 (2000). 
4

Dr. Taba indicated that appellant was being treated for a right knee and hip condition at the time 

and was overcompensating on the left side. Diagnostic testing and x-rays revealed no obvious 

pathology. Dr. Taba opined that appellant’s left hip bursitis, tendinitis, and left knee 

chondromalacia patella were aggravated and exacerbated by her work-related injuries. Similarly, 

in a July 15, 2015 report, he indicated that appellant’s job required repetitive lifting, pushing, 

pulling, and standing multiple hours a day causing left knee and hip conditions. Dr. Taba noted 

MRI scan findings and offered diagnoses. He opined that appellant’s left knee and left hip 

findings were directly a result of her work-related repetitive lifting, twisting, pushing, and 

pulling activities over the years. The Board finds that although Dr. Taba supported causal 

relationship, noting that her left knee and left hip conditions resulted from her repetitive work 

duties, he did not provide medical rationale explaining the basis of his conclusory opinion 

regarding the causal relationship.4

 Dr. Taba did not explain the process by which repetitive 

lifting, twisting, pushing, and pulling activities over the years would cause the diagnosed 

condition. Therefore, these reports are insufficient to meet appellant’s burden of proof. 

The remainder of the medical evidence fails to provide an opinion on the causal 

relationship between appellant’s job and her diagnosed left hip trochanteric bursitis, left hip 

strain, and left knee patellofemoral joint chondromalacia tendinitis. For this reason, this 

evidence is insufficient to meet appellant’s burden of proof.5 

On appeal appellant asserts that the medical evidence submitted in support of her claim 

was sufficient to establish her claim. As found above, the medical evidence fails to establish that 

her diagnosed conditions are causally related to her employment. Appellant has not submitted a 

physician’s report, which explains how particular work activities caused or aggravated her left 

hip trochanteric bursitis, left hip strain, and left knee patellofemoral joint chondromalacia 

tendinitis. 

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 an injury 

causally related to factors of her employment. 

 4 See T.M., Docket No. 08-975 (issued February 6, 2009) (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). 

5 A.D., 58 ECAB 149 (2006) (medical evidence which does not offer any opinion regarding the cause of an 

employee’s condition is of limited probative value on the issue of causal relationship). 
5

ORDER 

IT IS HEREBY ORDERED THAT the December 31, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: July 26, 2016 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board