United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.L., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS ADMINISTRATION MEDICAL 

CENTER, Tomah, WI, Employer 

__________________________________________ 

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Docket No. 16-1639 

Issued: May 8, 2017 

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 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On August 9, 2016 appellant filed a timely appeal from a July 15, 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 the case. 

ISSUE 

The issue is whether appellant met his burden of proof to establish hearing loss, tinnitus, 

and a consequential insomnia condition causally related to factors of his federal employment job 

duties. 

 1

 5 U.S.C. § 8101 et seq. 
2

FACTUAL HISTORY 

On May 10, 2016 appellant, a 38-year-old pharmacist, filed a claim for occupational 

disease (Form CA-2), alleging that he developed an insomnia condition which was partly 

attributable to work-related tinnitus and hearing loss. 

OWCP received on May 11, 2016 a report dated January 13, 2016 from Dr. Christine 

Jacobsen, a specialist in family practice. Dr. Christine advised that appellant believed that sitting 

near a running air conditioner at work had caused ringing in his ears and hearing loss. She 

reported that, because of this situation, appellant had experienced added pressure in his job and 

in his home life, causing anxiety and insomnia. 

In an October 6, 2015 report, received by OWCP on May 11, 2016, Dr. Jacobsen advised 

that appellant was experiencing insomnia. She reported that this condition had been worsening, 

and that he recently had panic-type symptoms while driving next to a truck and also had 

experienced depression. Dr. Jacobsen asserted that, in light of the fact that his insomnia seemed to 

be increasing with his stress load, she would recommend prescribing medication which could also 

help depression. 

In a November 8, 2015 report, received by OWCP on May 11, 2016, Dr. Jacobsen advised 

that appellant had been experiencing insomnia and anxiety problems, but advised that the 

medication she prescribed had been helping him sleep; he slept through the night most of the time 

and only had occasional awakenings. Dr. Jacobsen noted that appellant believed he was better able 

to handle his stressors when he was well rested, but he continued to be anxious and more irritable 

then he would prefer. 

In a December 11, 2015 report, Dr. Jacobsen advised that appellant was having problems 

with his hearing. He reported that he had been seen by an audiologist five months previously and 

was informed that he had borderline hearing, although he believed that his hearing had worsened 

since then. 

On May 16, 2016 OWCP advised appellant that it required additional factual and medical 

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

a comprehensive medical report from his treating physician describing his symptoms and the 

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

causally related to his federal employment, and a diagnosis of his claimed condition. OWCP 

afforded appellant 30 days to submit the additional evidence. 

On May 20, 2016 the employing establishment controverted the claim. It rebutted 

appellant’s assertion that he had developed insomnia due to hearing loss brought on by working in 

an office near a window air conditioner. Management noted that the window air conditioner was 

recently evaluated by environmental health technicians, and the readings were normal. In addition, 

the employing establishment noted that appellant was a pharmacist working in an office setting and 

was not exposed to loud noises. 

In a written statement dated June 13, 2016, appellant asserted that he had advised 

Dr. Jacobsen that he experienced insomnia on October 6, 2015, which Dr. Jacobsen believed was 
3

caused or worsened by anxiety or depression. He advised that he did not realize that his insomnia 

was primarily worsened by tinnitus until January 2016. Appellant asserted that a running air 

conditioner at work caused tinnitus from the middle of May until the end of June 2015. He 

therefore believed that the air conditioner was an employment-related factor which contributed to 

insomnia through tinnitus. 

By decision dated July 15, 2016, OWCP denied appellant’s claim, finding that he failed to 

submit medical evidence sufficient to establish an insomnia condition in the performance of 

duty. 

LEGAL PRECEDENT 

An occupational disease or illness means a condition produced by the work environment 

over a period longer than a single workday or shift.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 a disease or condition for which 

compensation is claimed; (2) a factual statement identifying the 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 diagnosed condition is causally related to the 

employment factors identified by the claimant. The medical opinion 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

 

The Board has held that the mere fact that a condition manifests itself during a period of 

employment does not raise an inference that there is a causal relationship between the two.4

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 her condition was caused, precipitated or aggravated by his employment is 

sufficient to establish causal relationship.5

 Causal relationship must be established by 

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

ANALYSIS 

Appellant has alleged that he was exposed to loud noise from a window air conditioner in 

the building where he worked, which caused the tinnitus/hearing loss condition he believed was the 

primary cause of his tinnitus. This assertion, was rebutted by management’s May 20, 2016 letter 

indicating that the air conditioner was recently tested by environmental health technicians, which 

 2

 20 C.F.R. § 10.5(q). 

3 Solomon Polen, 51 ECAB 341, 343-44 (2000). 

4 See Joe T. Williams, 44 ECAB 518, 521 (1993). 

5 Id.
4

recorded normal readings.6

 In addition, appellant failed to submit a probative, rationalized 

medical opinion containing a diagnosis causally related to this alleged exposure. The Board 

finds that appellant has not submitted medical opinion evidence sufficient to establish a causal 

relationship between a diagnosed condition and an accepted employment factor. 

Dr. Jacobsen advised in reports dated October 6 and November 8, 2015 that appellant was 

experiencing insomnia, which was worsening, in addition to anxiety and depression. She 

prescribed medication to help him deal with these problems. In her December 11, 2015 report, 

Dr. Jacobsen related that appellant was having problems with his hearing. She noted that he was 

seen by an audiologist who told him that, five months previously, he had borderline hearing loss, 

but it had become worse since then. Dr. Jacobsen advised in her January 13, 2016 report that 

appellant believed that sitting near a running air conditioner at work had caused ringing in his 

ears and hearing loss. She advised that, because of this situation, appellant had experienced 

added pressure in his job and in his home life, causing anxiety and insomnia. 

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

examination, the accuracy and completeness of the 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.7

 The reports from Dr. Jacobsen are not sufficient to 

meet appellant’s burden of proof as she did not present a rationalized opinion on the causal 

relationship between appellant diagnosed condition and an accepted employment exposure. She 

did not provide any medical reasoning to explain how and why she believed that appellant’s 

exposure to loud noise could have caused or contributed to tinnitus or hearing loss, resulting in 

insomnia. The January 13, 2016 report merely asserts that appellant believed that sitting near a 

running air conditioner at work had caused ringing in his ears and hearing loss, and that his 

conditions were caused by this exposure. Dr. Jacobsen’s opinion on causal relationship is of 

limited probative value in that she did not provide adequate medical rationale in support of her 

conclusions.8

 Thus, the Board finds that appellant failed to meet his burden of proof as he failed 

to provide a rationalized, probative medical opinion relating his current condition to factors of 

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. 

 6

 The evidence submitted by an employing establishment on the basis of their records will prevail over the 

assertions from the claimant unless such assertions are supported by documentary evidence. See generally Sue A. 

Sedgwick, 45 ECAB 211, 218 n.4 (1993); Federal (FECA) Procedure Manual, Part 2 -- Claims, Computation of 

Compensation, Chapter 2.900(b)(3) (September 1990). 

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

8 William C. Thomas, 45 ECAB 591 (1994). 
5

CONCLUSION 

The Board finds that appellant has not met his burden of proof to establish that he 

developed hearing loss, tinnitus, or a consequential insomnia condition causally related to factors 

of his federal employment. 

ORDER 

IT IS HEREBY ORDERED THAT the July 15, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: May 8, 2017 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board