United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

G.Z., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Kingsfield, MI, Employer 

__________________________________________ 

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Docket No. 16-0195 

Issued: April 18, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On November 10, 2015 appellant filed a timely appeal of an October 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 to consider the merits of this case. 

ISSUE 

The issue is whether appellant has established that he sustained an injury causally related 

to factors of his federal employment. 

FACTUAL HISTORY 

On September 17, 2014, appellant a 53-year-old window clerk, filed an occupational 

disease claim (Form CA-2) alleging that he developed right arm and shoulder conditions causally 

related to employment factors, which required the repetitive use of his arms.2 He alleged that he 

 1

 5 U.S.C. § 8101 et seq. 

2

 The record reflects that appellant has filed prior claims with OWCP, alleging both traumatic and occupational 

injuries. 
2

first became aware of his condition and its relation to his employment on January 1, 1997. 

Appellant did not stop work. The employing establishment controverted appellant’s claim 

contending that it was untimely filed. 

In support of his claim, appellant submitted a February 21, 2012 report from 

Dr. James N. Grace, a Board-certified orthopedic surgeon. Dr. Grace reviewed the history of a 

February 2007 right shoulder injury, the effects of which he noted had not improved, and a 

January 2009 left shoulder repair, which he noted had healed satisfactorily. Based on the results 

of a January 26, 2012 magnetic resonance imaging (MRI) scan, he diagnosed a superior labral 

from anterior to posterior (SLAP) tear and recommended a shoulder arthroscopy with a labral 

repair, similar to what appellant had undergone with his left shoulder. Dr. Grace concluded, with 

“a reasonable degree of medical certainty that the repetitive work of his right shoulder led to the 

labral tearing in the right shoulder.” Further, he added that the “highly repetitive nature” of 

appellant’s work aggravated and accelerated his right shoulder condition, for which he 

recommended surgery. 

By letter dated November 19, 2014, OWCP advised appellant that it required factual and 

medical evidence to determine whether he was eligible for compensation benefits. It asked him 

to submit a comprehensive report from a treating physician describing his symptoms and the 

medical reasons for his condition, including an opinion as to whether his claimed condition was 

causally related to his federal employment. OWCP requested that appellant submit this evidence 

within 30 days. 

In an October 22, 2014 report, received by OWCP on December 16, 2014, Dr. Robert 

Blotter, Board-certified in orthopedic surgery, advised that appellant had been experiencing 

increasing right shoulder pain since he began working for the employing establishment 21 years 

ago. Appellant related that the pain became worse in 2007 when he lifted a heavy object too 

quickly. He underwent surgery on the right shoulder in December 2012 to repair a SLAP tear. 

Appellant reported that he underwent a similar procedure on his left shoulder in 2009. 

Dr. Blotter advised that appellant had been diagnosed with shoulder dyskinesia and had 

undergone multiple sessions of physical therapy, all without improvement of his symptoms. He 

obtained x-rays which showed a normal glenohumeral joint and some acromioclavicular joint 

arthrosis. Dr. Blotter advised that he would consider having appellant undergo an MRI scan to 

see if any change had occurred to his labrum or his rotator cuff since his last surgery. He noted 

that appellant believed that his job sorting mail on a machine was the activity which aggravated 

his right shoulder. 

In a January 7, 2015 report, Dr. Blotter noted that appellant was still experiencing pain in 

his right shoulder. Appellant was forced to discontinue work for the previous two weeks to help 

get his shoulder pain under control. He related that the pain intensified when he returned to work 

in December 2015 and increased his activities. Dr. Blotter noted that the SLAP injury appellant 

sustained in 2007 caused a right shoulder problem, but advised that the repetitive nature of his 

work contributed heavily to his condition. He reported that appellant continued to experience 

right shoulder pain and continued to have trouble performing his regular work activities of his 

regular duty. Dr. Blotter asserted that appellant was going to have trouble continuing to do his 

present job without significant light-duty restrictions that limited his right shoulder to sedentary 

activity, no repetitive activity with the right upper extremity, and no repetitive lifting. He 

advised that he would schedule appellant for an MRI scan arthrogram. 
3

By decision dated January 23, 2015, OWCP denied the claim, finding that while it was 

time filed and the evidence supports that the injury and/or events occurred as described, 

appellant failed to submit sufficient medical evidence establishing that he sustained a medical 

condition in the performance of duty. 

On January 30, 2015 appellant requested an oral hearing before an OWCP hearing 

representative, which was held on August 13, 2015. 

In a March 4, 2015 report, Dr. Blotter asserted that appellant continued to have 

limitations in his right shoulder, but was able to work light duty. He advised that appellant 

underwent an MRI scan arthrogram, which showed a recurrence of his SLAP tear, some early 

degenerative changes of his humeral head, and a paralabral cyst at the inferior anterior part of the 

glenoid which he attributed to his SLAP tear. Dr. Blotter noted that the rotator cuff was intact. 

He advised that appellant had right shoulder pain with recurrent SLAP tear and early 

degenerative arthritis of his inferior humeral head. Dr. Blotter recommended that appellant 

continue with modified activity within the bounds of his light-duty assignment. He opined that a 

repeat arthroscopy to repair of the SLAP injury was probably not advisable because it might 

accelerate any arthritic changes which had occurred there. Dr. Blotter concluded that appellant 

had a chronic condition from his years of repetitive activity at the employing establishment. He 

advised that appellant could probably work indefinitely within the limitations of his disability or 

attempt another surgical procedure, but noted that there was no guarantee he could return to full 

duty. 

By decision dated October 28, 2015, an OWCP hearing representative affirmed the 

January 23, 2015 decision. She found that there was no rationalized medical evidence of record 

establishing an injury causally related to factors of his federal employment. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA3 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.4 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.5

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 

 3 Supra note 1. 

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

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

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 and the specific employment factors 

identified by the claimant.6

Appellant has the burden of establishing by the weight of the substantial, reliable and 

probative evidence, a causal relationship between his claimed right shoulder condition and his 

federal employment. This burden includes providing medical evidence from a physician who 

concludes that the disabling condition is causally related to employment factors and supports that 

conclusion with sound medical reasoning.7

ANALYSIS 

The Board finds that appellant has failed to submit any medical opinion containing a 

rationalized, probative report which relates any claimed condition to factors of his federal 

employment. For these reasons, he has not discharged his burden of proof. 

Dr. Grace reported on February 21, 2012, with “a reasonable degree of medical certainty” 

that the repetitive nature of appellant’s work duties resulted in the SLAP tear. However, he did 

not provide a description of the employment factors and failed to explain the mechanism of 

injury by detailing how the established employment factors would cause the diagnosed 

condition.8 The Board has consistently held that a medical opinion not fortified by rationale is of 

limited probative value.9 As Dr. Grace’s report lacks the necessary medical rationale, it is 

insufficient to establish appellant’s claim. 

Appellant submitted a series of reports dated October 22, 2014 and January 7 and 

March 4, 2015 reports from Dr. Blotter. Dr. Blotter related appellant’s complaints of right 

shoulder pain and presented diagnoses of recurrence of his SLAP tear, some early degenerative 

changes of his humeral head, and a paralabral cyst, but did not provide a rationalized medical 

opinion that these findings were causally related to factors of his employment. In his 

October 22, 2014 report, he noted that appellant had been experiencing increasing right shoulder 

pain since he began working for the employing establishment. Dr. Blotter advised that the pain 

became worse in 2007 when appellant lifted a heavy object and underwent right shoulder surgery 

in December 2012 to repair a SLAP tear in his right shoulder. He reported that appellant had 

 6 Id.

7 See Nicolea Bruso, 33 ECAB 1138, 1140 (1982). 

8 See V.N., Docket No. 16-0238 (issued March 1, 2016). 

9 Id.; see also M.H., Docket No. 12-733 (issued September 5, 2012).
5

been diagnosed with shoulder dyskinesia and that extensive physical therapy had not improved 

his symptoms. Dr. Blotter noted in his January 7, 2015 report, that appellant was still 

experiencing right shoulder pain, which intensified when he returned to work in December 2014 

and increased his activities. He opined that the SLAP injury appellant sustained in 2007 caused 

a right shoulder problem and that the repetitive nature of his work contributed to his condition. 

Dr. Blotter reported that appellant continued to have right shoulder pain and continued to have 

trouble doing his regular work activities. He restricted appellant from repetitive lifting and 

engaging in repetitive activity with the right upper extremity. In his March 4, 2015 report, 

Dr. Blotter noted that appellant underwent an MRI scan arthrogram, which showed a recurrence 

of his SLAP tear, some early degenerative changes of his humeral head, and a paralabral cyst at 

the inferior anterior part of the glenoid. He reported that appellant had right shoulder pain with 

recurrent SLAP tear and early degenerative arthritis of his inferior humeral head. Dr. Blotter 

opined that appellant had a chronic condition due to his years of repetitive activity at the 

employing establishment. He asserted that appellant could probably continuing working light 

duty within his current limitations or attempt another surgical procedure; Dr. Blotter opined, 

however, that there was no guarantee that surgery would enable him to could return to full duty. 

Dr. Blotter’s reports do not provide a probative, rationalized medical opinion that 

appellant’s claimed condition or disability 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 right shoulder condition was currently affected by or 

related to factors of employment.10 Dr. Blotter’s opinions state conclusions, but offer no medical 

explanation as to how appellant’s alleged work duties physiologically caused the diagnosed 

conditions of recurrent SLAP tear and early degenerative arthritis of his inferior humeral head. 

Medical opinion evidence submitted to support the claim should reflect a correct history and 

offer a medically sound explanation by the physician of how the specific employment duties 

physiologically, caused or aggravated his shoulder condition.11

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

examination, the accuracy and completeness of 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.12 Dr. Blotter did not sufficiently describe appellant’s job duties 

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

the claimed condition.13 His reports thus did not constitute adequate medical evidence to 

establish that appellant’s claimed condition was causally related to his 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 his condition was caused, precipitated, or aggravated by his employment is 

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

11 See D.B., Docket No. 15-1506 (October 26, 2015). 

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

13 E.R., Docket No. 15-1815 (issued December 24, 2015). 
6

sufficient to establish causal relationship.14 Causal relationship must be established by 

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

OWCP advised appellant of the evidence required to establish his claim, however, he 

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

establishing that his claimed condition was causally related to his 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 his burden of proof to establish an 

injury condition was causally related to factors of his federal employment. 

ORDER 

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

Workers’ Compensation Programs is affirmed. 

Issued: April 18, 2016 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy 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 

 14 Supra note 11.