United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.I., Appellant 

and 

DEPARTMENT OF THE NAVY, PUGET 

SOUND NAVAL SHIPYARD, Bremerton, WA, 

Employer 

__________________________________________ 

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Docket No. 16-0759 

Issued: June 10, 2016 

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 March 7, 2016 appellant filed a timely appeal from a January 25, 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 has met her burden of proof to establish binaural (both 

ears) hearing loss causally related to her federal employment. 

On appeal appellant contends that she sustained a work-related hearing loss as an OWCP 

referral physician did not provide rationale to support her opinion that she did not sustain hearing 

loss related to her exposure to loud noise. 

 1

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

On October 28, 2015 appellant, then a 56-year-old retired woodworker, filed an 

occupational disease claim (Form CA-2) alleging that on June 1, 2015 she first became aware of 

her bilateral hearing loss and realized that her condition was caused or aggravated by her federal 

employment. 

By letter dated November 3, 2015, OWCP notified appellant of the deficiencies of her 

claim and afforded her 30 days to submit medical and factual evidence. It requested that the 

employing establishment respond to her allegations and provide a copy of all medical 

examinations pertaining to her hearing or ear problems, including any preemployment 

examinations and audiograms. 

OWCP received employment records from the employing establishment. Appellant 

worked in various positions with the employing establishment since September 3, 1985. She 

worked as a woodworker for several employing establishment agencies since July 23, 2006. A 

description of appellant’s woodworker position noted her duties, responsibilities, and exposure to 

high noise levels. A notification of personnel action (SF 50-B) dated October 30, 2015 indicated 

that she had retired effective that date. Audiograms performed by the employing establishment 

as part of a hearing conservation program dated October 27, 1989 to April 30, 2015 were 

submitted. 

By letter dated November 25, 2015, the employing establishment controverted the claim 

and noted that appellant worked five months as a woodworker at the employing establishment 

from June 14 to October 30, 2015. It noted that she was no longer an employee. The employing 

establishment stated that appellant was in a hearing conservation program from 1989 until her 

retirement. 

In an investigative memorandum dated November 10, 2015, the employing establishment 

stated that appellant had general exposure to noise from September 3, 1985 to October 30, 2015. 

On December 1, 2015 appellant provided her employment history, which indicated that 

she was exposed to noise from 1981 to 1984 during her non-federal employment and from 1987 

to 2015 while working at the employing establishment. 

By letter dated December 28, 2015, OWCP informed appellant that a second opinion 

evaluation was scheduled with Dr. Julie A. Gustafson, a Board-certified otolaryngologist, for 

January 14, 2016 at 12:00 a.m. 

In a January 14, 2016 medical report, Dr. Gustafson noted appellant’s complaint of 

hearing loss without tinnitus, examined her, reviewed her medical records, and analyzed the 

results of an audiogram performed on that date. She diagnosed appellant with sensorineural 

hearing loss that was probably genetic. Dr. Gustafson noted that her configuration of hearing 

loss was inconsistent with noise exposure. She found that it had “a cookie bite” type formation, 

which was most consistent with a genetic or hereditary loss. Dr. Gustafson advised that genetic 

and hereditary losses did not need to be associated with a clear family history of hearing loss. 

She found no acceleration of high frequency hearing loss that would be normally seen with a 
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noise-induced loss. Appellant had low and mid-frequency loss at the time she began work at the 

employing establishment and it advanced slowly over time irrespective of the level of noise 

exposure. Utilizing the sixth edition of the American Medical Association, Guides to the 

Evaluation of Permanent Impairment (A.M.A., Guides), Dr. Gustafson found that appellant had 

no ratable hearing loss. Appellant also had no impairment due to tinnitus as she did not 

complain about this condition. Dr. Gustafson recommended bilateral hearing aids for appellant’s 

sensorineural hearing loss which had an unknown etiology, but again noted that it was probably 

genetic. She opined that the workplace exposure as described in materials provided by appellant, 

was not of sufficient intensity and duration to have caused or contributed to the hearing loss in 

question. Dr. Gustafson noted that the workplace exposure did not add to her hearing loss from 

other conditions. She concluded that appellant’s sensorineural hearing loss was not due to noise 

exposure in her federal employment. Dr. Gustafson maintained that her opinion was supported 

by the occupational audiometric record and configuration of appellant’s hearing loss. 

In a January 25, 2016 decision, OWCP denied appellant’s hearing loss claim. It found 

that Dr. Gustafson’s opinion constituted the weight of the evidence and established that she did 

not have hearing loss due to her accepted employment-related noise exposure. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of establishing 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 the 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. 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.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 the disease or condition for which compensation is claimed; (2) 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 

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 a claimant. The 

medical evidence required to establish causal relationship is generally rationalized medical 

opinion 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 

 2 Gary J. Watling, 52 ECAB 357 (2001). 
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nature of the relationship between the diagnosed condition and the specific employment factors 

identified by the claimant.3

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

sufficient to establish a causal relationship.4

 The mere fact that a disease or condition manifests 

itself or worsens during a period of employment5

 or that work activities produce symptoms 

revelatory of an underlying condition6 does not raise an inference of causal relation between the 

condition and the employment factors. 

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.7

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

establish causal relationship is rationalized medical evidence. 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.8

ANALYSIS 

The Board finds that appellant has not established that she sustained binaural hearing loss 

causally related to her federal employment noise exposure. 

Appellant submitted results from audiometric testing performed October 27, 1989 to 

April 30, 2015 by audiologists were submitted as part of the hearing conservation program at 

work, but the audiograms alone are insufficient to establish her hearing loss as causally related to 

her federal employment as they do not comply with the requirements set forth by OWCP. These 

tests were not prepared or certified as accurate by a physician as defined by FECA. None of the 

audiograms were accompanied by a physician’s opinion addressing how appellant’s 

 3 Solomon Polen, 51 ECAB 341 (2000). 

4 Robert G. Morris, 48 ECAB 238-39 (1996); William Nimitz, Jr., 30 ECAB 567, 570 (1979). 

5 William Nimitz, Jr., id.

6 Richard B. Cissel, 32 ECAB 1910, 1917 (1981). 

7 G.T., 59 ECAB 447 (2008); Elaine Pendleton, 40 ECAB 1143, 1145 (1989). 

8 See I.J., 59 ECAB 408 (2008); see also Victor J. Woodhams, 41 ECAB 345 (1989). 
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employment-related noise exposure caused or aggravated any hearing loss.9

 OWCP is not 

required to rely on this evidence as it does not constitute probative medical opinion evidence and 

is insufficient to meet appellant’s burden of proof.10 

Following the submission of evidence from appellant, OWCP referred appellant for an 

audiological and otologic evaluation by Dr. Gustafson. In a January 14, 2016 report, 

Dr. Gustafson examined appellant, reviewed her medical records, and analyzed the results of an 

audiogram performed on that date. She diagnosed appellant with sensorineural hearing loss, but 

found that her hearing loss was not related to noise exposure in her federal employment. 

Dr. Gustafson explained that the workplace exposure, as described by appellant, was not of 

sufficient intensity and duration to have caused or contributed to her diagnosed hearing loss. She 

further explained that appellant’s hearing loss was genetic as she had “a cookie bite” type 

formation, which was most consistent with a genetic or hereditary loss. Dr. Gustafson 

maintained that her opinion on causal relationship was supported by the occupational 

audiometric record and configuration of appellant’s hearing loss. She provided a thorough 

examination and a reasoned opinion explaining how the findings on examination and testing 

were not due to the noise in appellant’s federal employment. 

There is no current medical evidence of record supporting that appellant’s hearing loss is 

employment related. The Board finds that Dr. Gustafson’s report represents the weight of the 

medical evidence.11 Appellant has failed to establish that her binaural hearing loss was due to 

her federal employment. 

On appeal appellant contends that she sustained a work-related hearing loss as 

Dr. Gustafson’s report did not provide rationale to support her opinion that she did not sustain 

hearing loss related to her exposure to loud noise. As noted above, it is appellant’s burden to 

submit medical evidence to support the issue of causal relationship.12 As she has not submitted 

any medical evidence definitively establishing that her hearing loss is due to factors of her 

employment, she has not established her claim. 

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 not met her burden of proof to establish binaural (both 

ears) hearing loss causally related to her federal employment. 

 9 See Leon Thomas, 52 ECAB 202 (2001) (an audiologist is not considered a “physician” under FECA). 

10 Joshua A. Holmes, 42 ECAB 231, 236 (1990). 

11 See John D. Jackson, 55 ECAB 465 (2004). 

12 See supra note 10. 
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ORDER 

IT IS HEREBY ORDERED THAT the January 25, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: June 10, 2016 

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