United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.M., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

East Amherst, NY, Employer 

__________________________________________ 

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Docket No. 16-1837 

Issued: March 17, 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 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On September 15, 2016 appellant filed a timely appeal from an April 19, 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 an injury causally 

related to factors of her federal employment. 

On appeal appellant argues that OWCP erred in denying her claim. 

FACTUAL HISTORY 

On January 15, 2016 appellant, then a 54-year-old window distribution clerk, filed an 

occupational disease claim (Form CA-2) alleging that on July 21, 2015 she first became aware of 

 1

 5 U.S.C. § 8101 et seq. 
2

injury to her upper arm and shoulder and related it to factors of her federal employment on 

January 12, 2016. She believed that her duties of sorting letter and flat pieces of mail and lifting 

parcels with her right arm while scanning parcels with her left hand and arm were the direct 

cause of her medical condition. Appellant did not stop work. 

In a January 13, 2016 report, Dr. Kathryne L. Buege, an examining osteopath, noted that 

appellant had sought treatment for right shoulder pain. She provided a medical history, history 

of injury, and physical examination findings. Appellant related that the injury occurred at work, 

approximately one week prior, when she experienced right shoulder pain. A physical 

examination of the right shoulder revealed decreased range of motion and tenderness. Dr. Buege 

reviewed a right shoulder x-ray, which showed no pathology. She diagnosed right rotator cuff 

tendinitis and cervical radiculopathy. In an attached visit information form, Dr. Buege noted 

appellant was seen that day for complaints of right shoulder pain associated with employmentrelated repetitive work. 

In a January 15, 2016 report, Dr. Thomas E. Price, a treating internist specializing in 

occupational medicine, indicated that appellant was seen for an evaluation of her right shoulder 

pain. He reported that her pain began “over the summer in July [2015]” and worsened since 

then. Appellant stated that her work duties included repetitive lifting and pushing packages with 

her right shoulder. Dr. Price observed that this type of activity currently aggravated her pain. A 

review of x-ray interpretations showed mild right shoulder degenerative changes and mild C5-6 

degenerative changes with no bony pathology. Examination findings included decreased right 

shoulder range of motion and right trapezius pain/tenderness. Dr. Price noted that appellant’s 

complaints were consistent with her history of injury. He diagnosed right shoulder tendinitis and 

right shoulder pain in his report. Appellant was given work restrictions including no lifting more 

than 15 pounds and no overhead bilateral upper extremity use. 

A January 15, 2016 work status summary indicated that appellant was capable of working 

with restrictions of no overhead work and lifting up to 15 pounds. She was referred for physical 

therapy.2

 

By letter dated February 22, 2016, OWCP informed appellant that the evidence of record 

was insufficient to establish her claim. It informed her that the record of evidence failed to 

establish both the factual portion of her claim, i.e., that she actually experienced the employment 

factors alleged to have caused her injury, and the medical portion, i.e., that the alleged factors 

caused the diagnosed conditions. Appellant was advised as to the medical and factual evidence 

required to establish her claim and afforded her 30 days to provide this information. OWCP also 

requested that she respond to an attached development questionnaire. 

By letter dated February 22, 2016, OWCP requested that the employing establishment 

provide comments from a knowledgeable supervisor about the accuracy of appellant’s statement, 

a copy of her position description, precautions taken to minimize effects of the activities alleged, 

and the frequency and duration of the tasks requiring physical exertion. 

 2

 The signature on the form appears to be of Dr. Price and is on a Work Status Summary note similar to others he 

submitted in this claim. 
3

OWCP received medical and factual evidence including physical therapy notes, progress 

notes, and work status form reports dated January 15 and February 26, 2016. 

In a February 25, 2016 report, Jody B. Dauber, a physical therapist, noted that appellant 

had worked at the employing establishment for approximately 30 years and her job required 

daily repetitive motion of scanning parcels, grabbing the parcel, and then tossing the parcels 

aside. She opined that appellant’s right shoulder pain and injury had been caused by the daily 

repetitive work activities. 

In a February 26, 2016 progress note, Dr. Price noted appellant’s subjective complaints 

and medical and injury histories. He reported her job required repetitive movements of her right 

shoulder and hand due to lifting and pushing parcels. A physical examination revealed slightly 

limited right shoulder abduction, but full forward flexion, internal rotation, and external rotation. 

Dr. Price diagnosed right shoulder strain/tendinitis, which he attributed to appellant’s work. 

In progress notes dated March 7, 2016, Dr. Gordon Steinagle, a treating Board-certified 

internist and occupational medicine physician, attributed appellant’s right shoulder injury to her 

duties as a distribution clerk. He diagnosed a right shoulder repetitive impingement/injury due to 

daily lifting and scanning packages. Appellant related having right shoulder pain which 

disturbed her sleep at times. A physical examination revealed 100 degrees right shoulder 

abduction and some right biceps muscle tenderness. Diagnoses included anxiety, cervical spinal 

stenosis, C-3 herniated disc, low back pain, right biceps tendinitis, and right shoulder rotator 

labral cuff tear. Dr. Steinagle recommended a magnetic resonance imaging scan be performed 

on the right shoulder. 

In a statement dated March 9, 2016, R.M., postmaster, noted that she had reviewed and 

agreed with appellant’s statement. She noted that appellant’s job was as a distribution/window 

clerk and that her duties were more distribution than customer service window. R.M. attached a 

copy of a position description for sales distribution associate job, which included 13 distinct 

duties and responsibilities. 

By decision dated April 19, 2016, OWCP denied appellant’s claim, finding that she had 

failed to establish fact of injury. Specifically, it found that she failed to establish the factual 

portion of her claim as she had not responded to the questions contained in the provided 

development questionnaire. In addition, OWCP further found that appellant failed to submit 

rationalized medical evidence explaining how the diagnosed condition had been caused or 

aggravated by the identified employment factors. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA3

 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 and/or specific condition for which compensation is claimed are causally related to the 

 3 Supra note 1. 
4

employment injury.4

 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.5 

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.6

 

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

establish causal relationship is rationalized medical opinion evidence.7

 Rationalized medical 

opinion evidence is medical evidence which includes a physician’s rationalized opinion on 

whether there is a causal relationship between the employee’s diagnosed condition and the 

compensable employment factors.8

 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.9

 

ANALYSIS 

Appellant filed an occupational disease claim alleging upper arm and shoulder injuries 

due to her job duties of scanning mail, sorting letter and flat pieces of mail, and lifting parcels. 

OWCP denied her claim finding that the evidence of record was insufficient to establish that she 

performed the duties alleged and that the medical evidence was insufficient to establish a causal 

relationship between the diagnosed medical conditions and her employment duties. 

Appellant alleged in a Form CA-2 dated January 15, 2016, that her upper arm and 

shoulder pain was sustained while lifting and tossing parcels and sorting mail. There is no 

dispute that she performed such duties. The employing establishment confirmed on February 22, 

2016 that appellant performed such duties, and also provided a position description. Thus, the 

Board finds that she has established the factual component of her claim. However, the Board 

further finds that appellant has submitted insufficient medical evidence to establish that these 

duties caused injury.10

 4 C.S., Docket No. 08-1585 (issued March 3, 2009); Bonnie A. Contreras, 57 ECAB 364 (2006). 

5 S.P., 59 ECAB 184 (2007); Joe D. Cameron, 41 ECAB 153 (1989). 

6 D.U., Docket No. 10-0144 (issued July 27, 2010); R.H., 59 ECAB 382 (2008); Roy L. Humphrey, 57 ECAB 238 

(2005); Donald W. Wenzel, 56 ECAB 390 (2005). 

7 Y.J., Docket No. 08-1167 (issued October 7, 2008); A.D., 58 ECAB 149 (2006); D’Wayne Avila, 57 ECAB 

642 (2006). 

8 J.J., Docket No. 09-0027 (issued February 10, 2009); Michael S. Mina, 57 ECAB 379 (2006). 

9 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989). 

10 E.M., Docket No. 15-1120 (issued January 13, 2016). 
5

Dr. Buege in her January 13, 2016 report diagnosed right rotator cuff tendinitis and 

cervical radiculopathy. She noted that appellant’s right shoulder pain was associated with 

repetitive work activities. However, pain is a symptom, not a specific medical diagnosis.11 

Furthermore, Dr. Buege did not provide an explanation of how appellant’s repetitive work 

activities either caused or contributed to her current right shoulder and cervical conditions. The 

mere fact that a condition manifests itself during a period of employment is not sufficient to 

establish causal relationship.12

In his January 15, 2016 report, Dr. Price noted that appellant’s work duties included 

repetitive lifting and pushing packages with her right shoulder. He concluded that she had 

degenerative changes of the right shoulder and of C5-6 of the cervical spine. In his February 16, 

2016 progress note, Dr. Price diagnosed right shoulder strain/tendinitis which he attributed to 

appellant’s work. However, he did not provide a sufficient explanation, based on medical 

rationale, of how any of her duties would have physiologically caused or contributed to these 

diagnosed medical conditions.13

Likewise, Dr. Steinagle related in his March 7, 2016 report, that appellant had a right 

shoulder repetitive injury, which he attributed to daily lifting and scanning of packages. His 

opinion regarding causal relationship is vague and is therefore insufficient to establish causal 

relationship as he too fails to provide medical rationale explaining how her employment duties 

would have physiologically caused the diagnosed condition.14 

OWCP also received a report from a physical therapist who opined that appellant’s right 

shoulder pain and injury were caused by daily repetitive work activities. However, the Board 

has held that reports signed by physical therapists have no probative value as physical therapists 

are not considered physicians under FECA.15

The Board finds that, as appellant has not submitted rationalized medical evidence 

establishing that she sustained an injury causally related to factors of her federal employment, 

she has not met her burden of proof.16 

 11 C.P., Docket No. 17-0042 (issued December 27, 2016). 

12 See D.I., 59 ECAB 158, 162 (2007). 

13 See A.F., Docket No. 16-1342 (issued December 5, 2016). 

14 Id. 

15 5 U.S.C. § 8101(2) provides that the term physician includes surgeons, podiatrists, dentists, clinical 

psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined 

by State law. The term physician includes chiropractors only to the extent that their reimbursable services are 

limited to treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by 

x-ray to exist and subject to regulation by the Secretary. See Merton J. Sills, 39 ECAB 572, 575 (1988); 

P.R., Docket No 14-1007 (issued August 13, 2014). See David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006) (lay 

individuals such as physical therapists are not competent to render a medical opinion under FECA); 5 U.S.C. 

§ 8101(2). 

16 Supra note 6. 
6

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 met her burden of proof to establish an injury 

causally related to factors of her federal employment. 

ORDER 

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ 

Compensation Programs dated April 19, 2016 is affirmed as modified. 

Issued: March 17, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board