United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.H., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Portland, OR, Employer 

__________________________________________ 

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Docket No. 15-0923 

Issued: September 15, 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 

COLLEEN DUFFY KIKO, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On March 23, 2015 appellant filed a timely appeal from a January 28, 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 the case.2

ISSUE 

The issue is whether appellant met his burden of proof to establish that his left knee 

condition is causally related to his federal employment. 

 1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that OWCP received additional evidence following its January 28, 2015 decision. The Board 

lacks jurisdiction to review evidence for the first time on appeal. 20 C.F.R. § 501.2(c)(1). 
2

FACTUAL HISTORY 

On October 24, 2014 appellant, then a 27-year-old letter carrier, filed an occupational 

disease claim (Form CA-2) alleging that he sustained knee strain due to repetitive stair climbing. 

He first became aware of his condition on October 8, 2014 and first realized that it resulted from 

his employment on October 9, 2014. Appellant did not stop work. 

Employing establishment accident reports from October 9 and 17, 2014 indicate that 

appellant reported having knee pain on October 8 and 16, 2014 while delivering mail. Appellant 

attributed the injury to being out of shape. 

In an October 21, 2014 statement, appellant reported that his left knee pain began on 

October 9, 2014 while climbing stairs at customers’ residences. He explained that he recently 

transitioned from a driving route to a walking route and that the change caused his injury. 

Appellant reported no history of knee problems. 

OWCP received an October 15, 2014 workers’ compensation form report. On his portion 

of the form, appellant stated that he suffered knee pain after walking up and down stairs. 

Dr. Jeffrey Olenick, Board-certified in family medicine, diagnosed leg pain. In an October 15, 

2014 report, he reported seeing appellant for knee pain. Dr. Olenick noted appellant’s assertion 

that his pain stemmed from excessive stair climbing. After a physical examination, he diagnosed 

hamstring tendinitis. In an October 15, 2014 work restrictions letter, Dr. Olenick advised that 

appellant should not climb stairs, but could return to normal duty after two weeks. 

In an October 21, 2014 duty status report (Form CA-17), James Cooke, a family nurse 

practitioner, diagnosed appellant with knee strain and provided work restrictions. In an 

October 21, 2014 form report, he authorized modified work from October 21 to 

November 18, 2014. 

In a November 10, 2014 letter, OWCP informed appellant that the evidence of record was 

insufficient to support his claim. It advised him to provide a medical report containing a 

diagnosis and a physician’s opinion supported by a medical explanation as to how work factors 

resulted in the claimed condition. 

Appellant provided physical therapy records noting an initial assessment of leg pain on 

October 30, 2014. Ann Scherner, a physical therapist, described appellant’s mechanism of injury 

as cumulative stair climbing during employment. In a November 3, 2014 plan of care report, 

Dr. Benjamin Taylor, Board-certified in family medicine, reported that appellant’s knee pain was 

due to prolonged stair climbing on his mail route. 

In October 21, 2014 progress notes, Mr. Cooke related that appellant complained of left 

knee pain, attributing his injury to his work duties. He diagnosed knee and hamstring strain and 

asserted that he would have Dr. Taylor cosign the report. 

In a November 14, 2014 workers’ compensation form report, Dr. Lori Gross, Boardcertified in occupational medicine, diagnosed appellant with knee and hamstring strain and 

authorized modified work from November 14 to December 1, 2014. In a November 14, 2014 

progress report, she related that he attributed his left knee injury to repetitive stair climbing. 
3

Based on chart notes, Dr. Gross diagnosed left knee and hamstring strain, but noted that 

appellant’s symptoms had resolved. She indicated that he could work full duty except for 

limiting stair climbing to six hours a day. 

December 1 and 15, 2014 reports reflect that Dr. Gross saw appellant for follow-up 

appointments and she again attributed his injury to repetitive stair climbing at work. She further 

reported that his symptoms had resolved. In the December 15, 2014 report, Dr. Gross advised 

that appellant could work full duty without restrictions and she released him from her care. 

In a January 28, 2015 decision, OWCP denied appellant’s claim, finding the medical 

evidence insufficient to demonstrate that his condition was causally related to the accepted work 

events. 

LEGAL PRECEDENT 

An employee seeking compensation under FECA has the burden of establishing the 

essential elements of his or her claim by the weight of the reliable, probative, and substantial 

evidence,3

 including that he or she is an employee within the meaning of FECA4 and that he or 

she filed his or her claim within the applicable time limitation.5

 The employee must also 

establish that he or she sustained an injury in the performance of duty as alleged and that his or 

her disability for work, if any, was causally related to the employment injury.6 

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 

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.7 

Causal relationship is a medical issue8 and the medical evidence generally required to 

establish causal relationship is rationalized medical evidence. 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 employee.9

 3 J.P., 59 ECAB 178 (2007); Joseph M. Whelan, 20 ECAB 55, 57 (1968). 

4 See M.H., 59 ECAB 461 (2008); see 5 U.S.C. § 8101(1). 

5 R.C., 59 ECAB 427 (2008); see id. at § 8122. 

6 G.T., 59 ECAB 447 (2008); Elaine Pendleton, 40 ECAB 1143, 1145 (1989). 

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

8 Mary J. Briggs, 37 ECAB 578 (1986). 

9 Victor J. Woodhams, 41 ECAB 345 (1989). 
4

ANALYSIS 

OWCP accepted that appellant’s duties included repetitive stair climbing. The issue, 

therefore, is whether appellant established that he sustained a knee injury as a result of his 

employment duties. The Board finds that the medical evidence of record is insufficient to 

establish a causal relationship between his claimed left knee condition and his employment 

duties. 

An October 30, 2014 report, signed by Dr. Taylor on November 3, 2014, diagnosed knee 

pain and stated that appellant’s injury was caused by prolonged stair climbing. While the report 

indicates that he believed appellant’s work contributed to his knee pain, it does not provide a 

definitive diagnosis10 or a detailed explanation of the reasons supporting Dr. Taylor’s opinion. 

Specifically, Dr. Taylor failed to explain the process whereby ascending and descending stairs 

would rationally cause the claimed condition. The Board has long held that a medical opinion 

not fortified by medical rationale is of little probative value.11 Thus, the report is insufficient to 

establish appellant’s claim. 

In an October 15, 2014 report, Dr. Olenick reported that appellant complained of left 

knee pain due to excessive stair use. He diagnosed hamstring tendinitis. Dr. Olenick did not, 

however, provide his own opinion regarding whether appellant’s work activities caused or 

contributed to the diagnosed condition. Instead, he merely related the history of injury as 

reported by appellant. To the extent that Dr. Olenick’s statements reflect his own opinion on 

causal relationship, he failed to provide any medical rationale explaining how the mechanisms of 

excessive stair use caused the diagnosed hamstring tendinitis.12 His October 15, 2014 form 

report did not provide any opinion as to the cause of appellant’s condition. 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.13

In reports dated November 14 through December 15, 2014, Dr. Gross related that 

appellant attributed his injury to repetitive work activity. While she provided a history of injury, 

she did not specifically furnish an opinion regarding the cause of his condition. Absent an 

opinion as to whether appellant’s condition was work related, Dr. Gross’ reports are of limited 

probative value.14 

The Board also notes that appellant submitted reports from a nurse practitioner and 

physical therapist that were not signed by a physician. These reports do not constitute probative 

 10 The Board notes that knee pain is a symptom, not a medical diagnosis, and subjective complaints of pain are 

not sufficient, in and of themselves, to support compensation benefits under FECA. 20 C.F.R. § 10.501(a)(3); G.M., 

Docket No. 15-279 (issued April 2, 2015). 

11 Brenda L. Dubuque, 55 ECAB 212, 217 (2004); Donald W. Long, 41 ECAB 142 (1989). 

12 See Brenda L. Dubuque, id. 

13 J.F., Docket No. 09-1061 (issued November 17, 2009). 

14 Id. 
5

medical opinion evidence as nurse practitioners and physical therapists are not physicians as 

defined under FECA.15 

On appeal, appellant contends that the transition from a driving mail route to a walking 

mail route caused his injury, as the walking route provided new physical stress. The Board has 

held that a belief that a disease was caused or aggravated by employment factors or incidents is 

insufficient to establish causal relationship.16 Causal relationship must be substantiated by 

reasoned medical opinion evidence. As established above, appellant failed to provide such 

evidence. 

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 his burden of proof to establish that his left 

knee condition is causally related to his federal employment. 

 15 L.B., Docket No. 13-1253 (issued September 18, 2013) (physician assistants, physical therapists, physical 

therapy assistants, and nurse practitioners do not qualify as physicians under FECA and, therefore, their medical 

reports do not qualify as probative medical evidence supportive of a claim for federal workers’ compensation, unless 

such medical reports are countersigned by a physician). See 5 U.S.C. § 8101(2) (defines the term “physician” as 

used in FECA); see also Charley V.B. Harley, 2 ECAB 208, 211 (1949) (where the Board held that medical opinion, in 

general, can only be given by a qualified physician). 

16 Joe T. Williams, 44 ECAB 518, 521 (1993). 
6

ORDER 

IT IS HEREBY ORDERED THAT the January 28, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: September 15, 2015 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board