United States Department of Labor

Employees’ Compensation Appeals Board

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Z.D., Appellant

and

DEPARTMENT OF JUSTICE, BUREAU OF 

ALCOHOL, TOBACCO, FIREARMS, & 

EXPLOSIVES, Sioux City, IA, Employer

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Docket No. 17-1830

Issued: February 5, 2018

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On August 29, 2017 appellant filed a timely appeal from an August 9, 2017 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 his burden of proof to establish that his cancer 

diagnoses were causally related to factors of his federal employment.

On appeal appellant asserts that the medical evidence, including scholarly publications 

submitted, establishes that his cancers are causally related to his job duties. 

 

1 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On February 13, 2017 appellant, then a 42-year-old special agent, filed an occupational 

disease claim (Form CA-2) alleging that job duties caused malignant melanoma and papillary 

thyroid cancer. He indicated that he first realized the illness was caused or aggravated by his 

federal employment on February 13, 2017. Appellant did not stop work.2 In an attached 

statement, he described his federal employment history and noted that he had been exposed to 

high radon levels while working in a basement office. Appellant indicated that in February 2013 

he was diagnosed with metastatic malignant melanoma and in March 2015 was diagnosed with 

papillary thyroid cancer. He referenced medical publications that he alleged supported a causal 

link between radon and cancer. Appellant noted that he also had employment-related sun 

exposure and was exposed to explosives and firearms while at work. He also forwarded a 

position description, a five-page document in which he referenced additional publications 

regarding radon, melanoma, and thyroid cancer, and a November 7, 2006 radon report of testing 

done at the Federal Courthouse at 320-6

th Street, in Sioux City, Iowa from April 20 to 

August 24, 2006. 

In a March 10, 2017 development letter, OWCP informed appellant of the evidence 

needed to support his claim. Appellant was asked to forward the medical reports regarding his 

cancer diagnoses and a report from his physician explaining how any specific exposure

contributed to his diagnoses. In a separate letter, OWCP asked the employing establishment to 

furnish comments from a knowledgeable supervisor regarding appellant’s claim, details of radon 

exposure, and whether he was exposed to other carcinogens while performing his job duties. 

In an undated response, appellant described his job duties and referenced radon test 

results. He indicated that, during melanoma surgery in February 2013, one positive lymph node 

was found and that he did not have follow-up radiation or chemotherapy. Appellant related that 

he was diagnosed with thyroid cancer in March 2015 and underwent alcohol ablation. He noted 

that he was treated for his cancer diagnoses at the Mayo Clinic in Rochester, MN. 

Medical evidence submitted in support of his claim included reports from physicians and 

results from tests conducted at the Mayo Clinic dated from February 2013, when appellant was 

diagnosed with malignant melanoma of the right forearm and had surgical excision with one 

positive lymph node. He had follow-up care regarding this diagnosis through January 4, 2017. 

Multiple positron emission tomography (PET) scans were performed, and no melanoma 

recurrences were found. In March 2015 appellant was diagnosed with papillary thyroid 

carcinoma. An ablation procedure was done on May 13, 2015. Follow-up visits found no 

recurrent thyroid cancer. In late 2015, an area of inflammation near the appendix was noted on a 

PET scan. This too was followed. On January 3, 2017 Dr. Robert R. McWilliams, Boardcertified in internal medicine and medical oncology, recommended a magnetic resonance 

imaging to analyze this area of inflammation. After the physician’s review of the study, he

 

2 The record also contains a Form CA-2 filed by appellant on January 18, 2007 in which he indicated that he was 

exposed to radon in his Federal Government office where he had worked for approximately four years. He indicated 

that he had not been diagnosed with cancer, but recognized that radon could cause cancer in later life. The record 

does not indicate that this claim has been developed by OWCP.
3

advised that the findings were not consistent with melanoma, but recommended follow-up in six 

months. 

On February 7, 2017 appellant contacted Dr. McWilliams and inquired about the causal 

relationship between his employment and his cancer diagnoses. Dr. McWilliams responded that 

he did not “see much in the literature associating skin melanoma with radon,” but noted that 

“outside sunlight exposure is associated with risk.” In a February 8, 2017 letter, he described 

appellant’s report that appellant had worked at the employing establishment since he was 23 and 

had been exposed to extensive outside work with sun exposure and that he worked in a basement 

office with high levels of radon. Dr. McWilliams noted appellant’s diagnoses of melanoma and 

papillary thyroid cancer. He opined that, sunlight exposure was associated with a risk for 

melanoma and indicated that, while radon had not been reported as associated with melanoma, it 

could be associated with an overall cancer risk. Dr. McWilliams concluded that, based on the 

information given by appellant, it was at least possible that his malignancy diagnoses were work 

related. 

Appellant again contacted Dr. McWilliams on February 21, 2017. He noted that he had 

done research and found scholarly articles listed on the National Institutes of Health website that 

he thought were supportive. In correspondence dated March 24, 2017, Dr. McWilliams noted 

that he had read specific articles regarding outdoor exposure of police personnel, the increased

incidence of thyroid cancer among police officers, and residential radon exposure and skin 

cancer. He concluded that, as appellant had notable exposures during his work at the employing 

establishment and had two malignancies at a young age, it was “certainly plausible that the 

work-related exposures contributed significantly to the incident of these cancers.” 

Appellant was last seen at the Mayo Clinic on July 11, 2017 by Dr. Svetomir N. 

Markovic, a Board-certified hematologist. He noted no evidence of melanoma recurrence and 

recommended a colonoscopy in six months to evaluate the low-level inflammatory-like uptake in 

the area of the appendix. 

By decision dated August 9, 2017, OWCP found that appellant was exposed to increased 

radon levels while working in a basement office from April 27 to August 24, 2006, that he was 

exposed to sunlight during his federal employment, and that he was exposed to fire during his 

federal employment. It, however, denied the claim because the medical evidence submitted was 

insufficient to establish a causal relationship between these accepted employment factors and his

cancer diagnoses. OWCP found Dr. McWilliams’ opinion too speculative to establish that the 

claimed conditions were employment related. 

LEGAL PRECEDENT

An employee seeking benefits under FECA 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, and that the claim was timely filed within the 

applicable time limitation period of FECA.3 When an employee claims that he or she sustained 

 

3 5 U.S.C. § 8101(1); L.M., Docket No. 16-0143 (issued February 19, 2016); B.B., 59 ECAB 234 (2007).
4

an injury in the performance of duty,4 he or she must submit sufficient evidence to establish a 

specific event, incident, or exposure occurring at the time, place, and in the manner alleged.5 

The employee must also establish that such event, incident, or exposure caused an injury.6 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.7

OWCP regulations define the term “occupational disease or illness” as “a condition 

produced by the work environment over a period longer than a single workday or shift.”

8

 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 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.9

Causal relationship is a medical issue, and the medical evidence required to establish a 

causal relationship is rationalized medical evidence.10 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.11 Neither the mere fact that a disease or condition manifests itself during a period 

of employment nor the belief that the disease or condition was caused or aggravated by 

employment factors or incidents is sufficient to establish causal relationship.12

ANALYSIS

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

diagnosed metastatic malignant melanoma and papillary thyroid carcinoma were causally related 

to the accepted federal work factors of radon, sunlight, and fire exposure.

 

4

Id. at § 8102(a).

5

J.C., Docket No. 16-0057 (issued February 10, 2016); E.A., 58 ECAB 677 (2007). 

6

Id.

7 R.H., 59 ECAB 382 (2008).

8 20 C.F.R. § 10.5(ee).

9 Roy L. Humphrey, 57 ECAB 238 (2005).

10 Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

11 Leslie C. Moore, 52 ECAB 132 (2000); Gary L. Fowler, 45 ECAB 365 (1994).

12 Dennis M. Mascarenas, 49 ECAB 215 (1997).
5

The record includes reports from a number of physicians and diagnostic studies that 

confirm the diagnoses of metastatic skin melanoma and papillary thyroid carcinoma. However, 

none of these reports contain sufficient medical rationale to establish that the diagnosed 

conditions were caused or aggravated by the accepted federal work factors.

The only reports that contain an opinion on causal relationship are the February 8 and 

March 24, 2017 letters from Dr. McWilliams. The Board finds that these reports are insufficient 

to establish causal relationship because they are couched in speculative terms. On February 8, 

2017 Dr. McWilliams noted that sun exposure was associated with a risk for melanoma and that 

radon could be associated with an overall cancer risk. In that report he opined that it was at least 

possible that appellant’s cancer diagnoses were employment related. On March 24, 2017

Dr. McWilliams noted that he had read specific articles regarding outdoor exposure of police 

personnel, the increased incidence of thyroid cancer among police officers, and residential radon 

exposure and skin cancer. He concluded that, as appellant had notable exposures during his 

work at the employing establishment and had two malignancies at a young age, it was “certainly 

plausible that the work-related exposures contributed significantly to the incident of these 

cancers.” 

The Board has long held that excerpts from publications have little probative value in 

resolving medical questions unless a physician shows the applicability of the general medical 

principles discussed in the articles to the specific factual situation at issue in the case.13 While

Dr. McWilliams generally related appellant’s diagnoses to publications that, found relationships 

between specific exposures and melanoma and thyroid cancer diagnoses, he merely mentioned 

the findings of the articles and made an assumption of plausibility without explaining in detail 

how these exposures caused or contributed to appellant’s diagnoses.

To establish causal relationship under FECA, a claimant must submit a medical opinion 

report in which a physician reviews the employment factors identified as causing the claimed 

condition (herein radon, sunlight, and fire exposure) and, taking these factors into consideration 

along with findings upon examination, opines whether the employment injury caused or 

aggravated the diagnosed conditions and presents medical rationale in support of his or her 

opinion.14 While the opinion of a physician supporting causal relationship need not be one of 

absolute medical certainty, the opinion must not be speculative or equivocal. The opinion should 

be expressed in terms of a reasonable degree of medical certainty.15 The Board finds

Dr. McWilliams’ medical opinions speculative and insufficient to meet appellant’s burden of 

proof.16

Thus, the evidence presently of record provides insufficient explanation from a physician

regarding whether appellant’s diagnosed malignant melanoma and thyroid carcinoma were 

 

13 Roger G. Payne, 55 ECAB 535 (2004).

14 J.M., 58 ECAB 303 (2007).

15 Ricky S. Storms, 52 ECAB 349 (2001).

16 Id.
6

caused or aggravated by his accepted factors of his federal employment. Appellant, therefore, 

did not meet his burden of proof.17

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 

cancer diagnoses were causally related to factors of his federal employment.

ORDER

IT IS HEREBY ORDERED THAT the August 9, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: February 5, 2018

Washington, DC

Christopher J. Godfrey, 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

 

17 See J.H., Docket No. 17-0248 (issued May 10, 2017).