United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

R.W., Appellant 

and 

DEPARTMENT OF THE NAVY, MILITARY 

SEALIFT COMMAND, Norfolk, VA, Employer 

__________________________________________ 

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Docket No. 15-0345 

Issued: September 20, 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 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On November 24, 2014 appellant filed a timely appeal from a September 11, 2014 merit 

decision of the Office of Workers’ Compensation Programs (OWCP), which denied his 

consequential injury claim. 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 established a consequential injury of tinnitus causally 

related to his employment-related hearing loss. 

FACTUAL HISTORY 

On January 12, 2001 appellant, then a 47-year-old deck mechanic, filed an occupational 

disease claim alleging that he sustained hearing loss as a result of excessive noise in the 

workplace. He first became aware of his condition and realized it resulted from his employment 

on July 17, 2000. Appellant had been disabled from work since June 5, 1998 due to a previous 

 1

 5 U.S.C. § 8101 et seq.
2

traumatic injury.2

 OWCP accepted his claim for noise-induced hearing loss and paid wage-loss 

and medical benefits. Appellant was granted a schedule award of six percent permanent 

impairment for bilateral hearing loss. 

On November 30, 2012 appellant requested information via telephone regarding how to 

expand his case to include tinnitus. 

In an April 26, 2013 report, Dr. T. Oma Hester, a Board-certified otolaryngologist, 

examined appellant for complaints of increasing bilateral ringing tinnitus. Appellant stated that 

the tinnitus was constant and prevented him from sleep. Dr. Hester related that appellant had a 

history of loud noise exposure, which included working in the military and around heavy 

equipment and diesel engines for about 14 years. He also noted that appellant had hearing tests 

over the years which revealed a mild-to-moderate downsloping sensorineural loss into the higher 

frequencies with some recovery after a peak loss at 4,000 Hz. Upon examination, Dr. Hester 

observed clear bilateral ear canals and translucent and mobile tympanic membranes. He 

diagnosed bilateral sensorineural hearing loss and tinnitus. 

In a May 2, 2013 report, Dr. Hester stated that appellant had mild-to-moderate 

sensorineural hearing loss, with a peak loss at 4,000 Hz, consistent with a noise-induced pattern. 

He also noted that appellant had a significant amount of loud noise exposure in the workplace 

during his time in the military over 14 years. 

On July 17, 2013 appellant again requested via telephone that OWCP expand his claim to 

include tinnitus. 

By letter dated July 17, 2013, OWCP advised appellant that medical evidence was 

needed to expand the accepted conditions in his claim. It advised that appellant’s physician 

provide a medical statement showing that his new condition was part of the original July 17, 

2000 hearing loss injury, that the new condition was caused by the accepted work-related hearing 

loss, or that his new condition was caused by the treatment of the accepted injury. 

In a January 2, 2014 report, Dr. Hester related appellant’s complaints of constant bilateral 

ringing tinnitus. He noted that appellant had a history of loud noise exposure from working in 

the military and around heavy equipment and diesel engines for approximately 14 years. 

Dr. Hester related that appellant had hearing tests performed over the years which showed a 

mild-to-moderate downsloping sensorineural loss in the higher frequencies. He reported that a 

March 20, 2013 audiogram demonstrated mild to borderline flat sensorineural hearing loss up to 

2,000 Hz and a slight drop at 4,000 Hz with some recovery at 8,000 Hz. Dr. Hester stated that 

appellant’s hearing tests over a series of years showed evidence of primarily isolated highfrequency loss with some recovery after a peak drop at 4,000 Hz. He opined that appellant’s 

tinnitus complaints were most likely related to the hearing loss and a direct result of the hearing 

loss itself. 

In a decision dated April 11, 2014, OWCP denied appellant’s claim for tinnitus as a result 

of his employment-related hearing loss. It found that the medical evidence was insufficient to 

establish that tinnitus was causally related to his employment hearing loss. 

 2

 Appellant has a previously accepted traumatic injury case (File No. xxxxxx423) for an April 14, 1997 injury. 
3

On June 11, 2014 appellant requested reconsideration. He submitted an April 11, 2014 

audiology evaluation which revealed a mild-to-moderate hearing loss in each ear. The 

audiologist noted that appellant’s hearing thresholds had been stable since March 20, 2013. 

In a May 19, 2014 report, Dr. Hester related that appellant continued to have problems 

with bilateral ringing-type tinnitus. He noted that appellant had bilateral sensorineural hearing 

loss due to loud noise exposure while employed for the Department of Labor. Upon 

examination, Dr. Hester observed clear ear canals and translucent and mobile tympanic 

membranes. He related that an April 11, 2014 hearing test demonstrated a bilateral mild-tomoderate sensorineural hearing loss with a peak loss at 4,000 Hz and some recovery beyond. 

Dr. Hester explained that it was very difficult to determine the cause of tinnitus. He stated that it 

was an extremely common problem that was believed to be related to sensorineural hearing loss. 

Thus, Dr. Hester concluded that appellant’s tinnitus was related to his sensorineural hearing loss, 

which was related to the employment factors of loud noise exposure. 

By decision dated September 11, 2014, OWCP denied modification of the April 11, 2014 

decision. It found that the medical evidence was insufficient to establish that appellant’s tinnitus 

was a direct and natural result of his employment-related hearing loss. 

LEGAL PRECEDENT 

It is an accepted principle of workers’ compensation law that when the primary injury is 

shown to have arisen out of and in the course of employment, every natural consequence that 

flows from the injury is deemed to arise out of the employment, unless it is the result of an 

independent, intervening cause attributable to the employee’s own intentional conduct.3 The 

basic rule is that a subsequent injury, whether an aggravation of the original injury or a new and 

distinct injury, is compensable if it is the direct and natural result of a compensable primary 

injury.4 The Board has held that the subsequent progression of an employment-related condition 

“remains compensable so long as the worsening is not shown to have been produced by an 

independent nonindustrial cause.”5

 

A claimant bears the burden of proof to establish a claim for consequential injury. As 

part of this burden, he must present rationalized medical opinion evidence, based on a complete 

medical and factual background, establishing causal relationship.6

 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.7

 3

 Clement Jay After Buffalo, 45 ECAB 707, 715 (1994); John R. Knox, 42 ECAB 193, 196 (1990). 

4 See A. Larson, The Law of Workers’ Compensation § 10.01 (November 2000). 

5

 Raymond A. Nester, 50 ECAB 173, 175 (1998); Robert W. Meeson, 44 ECAB 834, 839 (1993). 

6 R.C., Docket No. 10-1789 (issued April 22, 2001); Jennifer Atkerson, 55 ECAB 317 (2004). 

7

 B.B., 59 ECAB 234 (2007); D.S., Docket No. 09-860 (issued November 2, 2009). 
4

ANALYSIS 

OWCP accepted appellant’s claim for employment-related bilateral hearing loss. 

Appellant alleges that he sustained tinnitus as a consequence of his accepted employment injury. 

The Board finds that appellant has failed to submit sufficient medical evidence to establish 

tinnitus as causally related to his employment-related hearing loss. 

In support of his consequential injury claim, appellant submitted various reports by 

Dr. Hester from April 26, 2013 to May 19, 2014. He stated that he treated appellant for 

complaints of increasing bilateral ringing tinnitus. Dr. Hester related that appellant had a history 

of loud noise exposure, working in the military and around heavy equipment and diesel engines 

for about 14 years. He also noted that appellant had hearing tests over the years which revealed 

a mild-to-moderate downsloping sensorineural loss into the higher frequencies with some 

recovery after a peak loss at 4,000 Hz. Upon examination, Dr. Hester observed clear bilateral ear 

canals and translucent and mobile tympanic membranes. He diagnosed bilateral sensorineural 

hearing loss and tinnitus. In his January 2, 2014 report, Dr. Hester opined that appellant’s 

tinnitus complaints were most likely related to the hearing loss and a direct result of the hearing 

loss itself. His opinion, however, that appellant’s tinnitus was “most likely related” to his 

hearing loss is speculative in nature. The Board has held that medical opinions that are 

speculative or equivocal in character are of diminished probative value.8 An award of 

compensation may not be based on surmise, conjecture, speculation or upon appellant’s own 

belief that there is causal relationship between his claimed condition and his employment.9 The 

Board finds that Dr. Hester’s opinion is insufficient to establish appellant’s claim. 

Furthermore, in a May 19, 2014 report, Dr. Hester related that appellant continued to 

have problems with bilateral ringing-type tinnitus. He noted that appellant had bilateral 

sensorineural hearing loss due to loud noise exposure while employed for the Department of 

Labor. Dr. Hester explained that it was very difficult to determine the cause of tinnitus and 

noted that it was an extremely common problem that was believed to be related to sensorineural 

hearing loss. He concluded that appellant’s tinnitus was related to his sensorineural hearing loss, 

which was related to his loud noise exposure. Although Dr. Hester provided an opinion on 

causal relationship, the Board notes that he failed to offer any medical explanation as to how 

appellant’s tinnitus resulted from his employment-related hearing loss.10 A medical opinion that 

states a conclusion but does not offer any rationalized medical explanation regarding the cause of 

an employee’s condition is of limited probative value on the issue of causal relationship.11 

The additional April 11, 2014 audiology evaluation is likewise insufficient to establish 

appellant’s consequential injury claim. The report does not contain any diagnosis of tinnitus nor 

provide any opinion on whether appellant sustained tinnitus as a consequence of his 

employment-related hearing loss. The Board has held that medical evidence that does not offer 

 8 D.D., 57 ECAB 734, 738 (2006); Kathy A. Kelley, 55 ECAB 206 (2004). 

9 Robert A. Boyle, 54 ECAB 381 (2003); Patricia J. Glenn, 53 ECAB 159 (2001). 

10 See D.M., Docket No. 13-1798 (issued November 12, 2013); see also R.K., Docket No. 10-415 (issued 

January 21, 2011). 

11 J.F., Docket No. 09-1061 (issued November 17, 2009); A.D., 58 ECAB 149 (2006). 
5

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

issue of causal relationship.12

The Board notes that the A.M.A., Guides at section 11.2b, page 24913 states that, if the 

tinnitus interferes with the activities of daily living such as sleep, reading, enjoyment of quiet 

recreation, and emotional well-being, up to five percent may be added to a measureable hearing 

impairment. Dr. Hester did not, in any of his reports, make a finding that tinnitus impacted 

appellant’s ability to perform activities of daily living. Thus his rating for an additional 

impairment for tinnitus is not substantiated in this case.14

On appeal, appellant stated that Dr. Hester provided letters explaining in depth about his 

tinnitus to support his case. As discussed above, however, Dr. Hester’s medical reports are 

insufficient to establish a consequential relationship between appellant’s employment-related 

hearing loss and his claimed tinnitus. 

The Board finds that appellant has failed to meet his burden of proof to establish tinnitus 

as a consequential injury as the medical evidence is insufficient. 

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 tinnitus as a 

consequence of his employment-related hearing loss. 

 12 C.B., Docket No. 09-2027 (issued May 12, 2010); J.F., supra note 11; A.D., supra note 11. 

13 A.M.A., Guides 249. 

14 K.G., Docket No. 14-1827 (issued January 5, 2015). 
6

ORDER 

IT IS HEREBY ORDERED THAT the September 11, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed.15

Issued: September 20, 2016 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 15 James A. Haynes, Alternate Judge, participated in the original decision but was no longer a member of the 

Board effective November 16, 2015.