United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.S., Appellant 

and 

U.S. POSTAL SERVICE, TOWNSEND 

CARRIER ANNEX, San Francisco, CA, 

Employer 

__________________________________________ 

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Docket No. 17-0856 

Issued: July 26, 2017 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

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 March 8, 2017 appellant, through counsel, filed a timely appeal from a January 24, 

2017 merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to 

the Federal Employees’ Compensation Act2 (FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the 

Board has jurisdiction to consider the merits of the case. 

 1

 In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for 

legal or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. 

§ 501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An 

attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject 

to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation. 

2

 5 U.S.C. § 8101 et seq.
2

ISSUE 

The issue is whether appellant has met her burden of proof to establish that she developed 

an occupational disease causally related to factors of her federal employment. 

FACTUAL HISTORY 

On January 4, 2016 appellant, then a 61-year-old letter carrier, filed an occupational 

disease claim (Form CA-2) alleging that on January 4, 2016 she first became aware that her right 

arm and shoulder pain was due to factors of her federal employment duties.3

 In her 

accompanying statement, appellant noted that she performed repetitive movements with her right 

arm and shoulder while casing and pulling down mail on her route. She noted that she had 

worked at the employing establishment for 31 years. Appellant reported that she was currently 

performing limited duty, working only three hours a day, but continued to case and pull down 

her route. 

Appellant submitted a report dated June 15, 2004 from Dr. Kathryn Raphael, a Boardcertified internist. Dr. Raphael noted at the time of this report that appellant had worked as a 

letter carrier for more than 10 years. At that point, appellant attributed her right shoulder 

condition to an increased volume of mail on her new route. She asserted that she was carrying 

heavier buckets of mail weighing 10 to 25 pounds each. Dr. Raphael diagnosed right shoulder 

impingement resolved and mild chronic right shoulder pain of unclear etiology. She found that 

appellant was performing her full duties and had reached maximum medical improvement. 

In a letter dated January 14, 2016, OWCP requested that appellant provide additional 

factual and medical evidence in support of her claim for a work-related right shoulder condition. 

It afforded her 30 days for a response. 

Dr. Michael Hebrard, a Board-certified physiatrist, examined appellant on 

January 15, 2016. He diagnosed adhesive capsulitis of the right shoulder and incomplete rotator 

cuff tear of the left shoulder. Dr. Hebrard listed appellant’s job duties as repetitive pushing, 

pulling, reaching, and lifting at and above shoulder level, grasping, fingering, and pinching 

repetitively, squatting, bending, standing, sitting, climbing, and stooping. He noted that she 

attributed her right shoulder condition to casing mail requiring the physical activities of reaching 

above and below shoulder level, grasping, pinching, and extending her shoulder. Appellant 

performed these activities for three hours a day, five days a week. Dr. Hebrard reviewed a 

May 27, 2015 magnetic resonance imaging (MRI) scan which demonstrated a torn supraspinatus 

tendon, split tears in the subscapularis and infraspinatus tendons, mild glenohumeral capsulitis, 

and acromioclavicular joint arthropathy. He opined that appellant’s right shoulder was 

aggravated by the conditions of her employment. Dr. Hebrard explained that the physiologic 

 3

 Appellant has filed several prior occupational disease claims and one prior traumatic injury with OWCP. These 

claims include: No. xxxxxx232, OWCP accepted for bilateral wrist conditions; No. xxxxxx433, OWCP accepted 

for a right knee condition; No. xxxxxx854 OWCP accepted for bilateral hip degenerative joint disease; No. 

xxxxxx583 OWCP accepted a left knee condition; No. xxxxxx230 in which OWCP accepted right shoulder 

impingement in 1993; and No. xxxxxx871 in which OWCP accepted internal derangement of adhesive capsulitis of 

the left shoulder in 2015. These other claims are not part of the present appeal. 
3

mechanism of repetitive reaching at and above shoulder level led to repetitive exposure of 

impingement of the supraspinatus tendon which was located underneath the acromion. He 

further noted that repetitive reaching, pushing, and pulling at and above shoulder level led to 

chronic deterioration of the rotator cuff with microscopic tearing and a subsequent full tear of the 

supraspinatus tendon. 

Appellant responded to OWCP’s request for information on January 23, 2016 and 

described her job duties of repetitively sorting and casing letters and flats on both a straight case 

and a right wing case. She also noted that she was required to lift trays, buckets of letters, and 

flats. Appellant described pulling down her route as pulling, rubber banding, and placing items 

in the buckets for delivery. She asserted in 2015 her route was adjusted and increased resulting 

in increasing mail volume. Appellant noted that she had been working three hours a day since 

November 2012 and prior to November 2010 she was a full-time letter carrier. In regard to her 

previous right shoulder claim, she reported that she received no right shoulder treatment after 

June 15, 2004. 

On January 15, 2016 Dr. Hebrard provided additional work restrictions for appellant’s 

three-hour workday including no reaching overhead and no lifting or carrying more than 10 

pounds. He completed a note on March 22, 2016 and described her casing activities as including 

150 cases for three hours a day at 18 pieces of mail per minute. Dr. Hebrard calculated that 

appellant was repetitively reaching more than 500 times within her three-hour workday. He 

provided his findings on examination and diagnosed adhesive capsulitis of the right shoulder. 

Dr. Hebrard opined that appellant’s diagnosed condition was causally related to her job duties. 

By decision dated April 5, 2016, OWCP denied appellant’s occupational disease claim 

finding that she had not submitted the necessary medical opinion evidence to establish that her 

right shoulder condition was due to her employment activities. It found that Dr. Hebrard’s 

reports did not address her previous shoulder condition and had little probative value. 

Counsel requested an oral hearing with OWCP’s Branch of Hearings and Review on 

April 15, 2016. Appellant testified at the oral hearing, before an OWCP hearing representative, 

on November 30, 2016. She described her activities while casing mail as constantly placing 

pieces of mail in the appropriate slot. Appellant alleged that she cased between 800 and 1,000 

pieces of mail every work morning. She noted that she was restricted to sitting due to her 

previously accepted hip claim. Appellant continued to work three hours a day. She received 

compensation for the remaining five hours under an accepted right knee claim. 

Following the oral hearing, appellant submitted the May 27, 2015 right shoulder MRI 

scan. This scan demonstrated a torn supraspinatus tendon, splits in the subscapularis and 

infraspinatus tendons, mild glenohumeral capsulitis, and acromioclavicular joint arthropathy. In 

a July 23, 2015 report, Dr. Scott M. Taylor, an orthopedic surgeon, noted that appellant 

attributed her bilateral shoulder conditions to cumulative trauma from years of lifting and 

reaching at work. He reviewed appellant’s right shoulder MRI scan and diagnosed rotator cuff 

syndrome. 

Dr. Hebrard, in a June 27, 2016 report, addressed causal relationship between appellant’s 

employment activities and her hip, knee, and shoulder conditions. He opined that she had an 
4

underlying condition of osteoarthritis and that repetitive activities of her job aggravated these 

underlying conditions. Dr. Hebrard noted appellant’s reaching and lifting led to aggravation of 

her underlying osteoarthritis and joint disease. He opined that her conditions were due to her 

employment activities. 

By decision dated January 24, 2017, OWCP’s hearing representative found that appellant 

had not submitted the necessary rationalized medical opinion evidence to establish causal 

relationship between her diagnosed condition and her accepted employment factors. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA4 has the burden of proof to establish the 

essential elements of his or her claim by the weight of the reliable, probative, and substantial 

evidence, 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, that an injury was sustained in the performance of duty as alleged and that any 

disability or specific condition for which compensation is claimed is causally related to the 

employment injury.5

OWCP’s regulations define an occupational disease as “a condition produced by the work 

environment over a period longer than a single workday or shift.”6 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 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 the claimant. 

A medical report is of limited probative value on a given medical question if it is 

unsupported by medical rationale.7

 Medical rationale includes a physician’s detailed opinion on 

the issue of whether there is causal relationship between the claimant’s diagnosed condition and 

the implicated employment activity. The opinion of the physician must be based on a complete 

factual and medical background of the claim, 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 specific employment activity or factors identified by the claimant.8 The 

 4 Supra note 2. 

5 Kathryn Haggerty, 45 ECAB 383, 388 (1994). 

6

 20 C.F.R. § 10.5(q). 

7 T.F., 58 ECAB 128 (2006). 

8 A.D., 58 ECAB 149 (2006). 
5

belief of a claimant that a condition was caused or aggravated by the employment is insufficient 

to establish causal relationship.9

ANALYSIS 

The Board finds that appellant has not met her burden of proof to establish that she 

developed an occupational disease causally related to factors of her federal employment. 

OWCP accepted that appellant’s work duties included repetitive reaching and lifting in 

casing and pulling down mail. It denied her claim, however, because the medical evidence of 

record is insufficient to establish that appellant developed her claimed conditions causally related 

to factors of her federal employment as a modified mail handler. 

Appellant submitted a series of reports from Dr. Hebrard addressing her right shoulder 

condition. On January 15, 2016 Dr. Hebrard diagnosed adhesive capsulitis of the right shoulder 

and incomplete rotator cuff tear of the left shoulder. He described appellant’s accepted job 

duties and opined that appellant’s right shoulder was aggravated by the conditions of her 

employment. Dr. Hebrard failed, however, to provide a detailed medical history of her 

preexisting right shoulder condition or prior injuries related to the pain in her right shoulder.10 

Moreover, he failed to discuss whether her preexisting injury had progressed beyond what might 

be expected from the natural progression of that condition.11 While Dr. Hebrard explained how 

appellant’s current duties could contribute to her condition, without a clear understanding of her 

complicated history of injury, it is unclear whether appellant’s diagnosed conditions were caused 

or aggravated by her occupational employment duties, or were due to a preexisting condition, or 

to degenerative changes. A well-rationalized opinion is particularly warranted when there is a 

history of a preexisting condition.12

In his March 22 and June 27, 2016 report, Dr. Hebrard opined that appellant had an 

underlying condition of osteoarthritis and that repetitive job activities aggravated the underlying 

conditions. He noted that her reaching and lifting led to aggravation of her underlying 

osteoarthritis and joint disease. Dr. Hebrard opined that appellant’s conditions were due to her 

employment activities. His findings on causation, however, failed to provide a sufficient 

explanation as to the mechanism of injury pertaining to this occupational disease claim as alleged 

by appellant, namely, how repetitive reaching and lifting would cause or aggravate her right 

shoulder injury.13 Without explaining how physiologically the movements involved in 

 9 Lourdes Harris, 45 ECAB 545, 547 (1994). 

10 E.W., Docket No. 16-1729 (issued May 12, 2017). 

11 R.E., Docket No. 14-868 (issued September 24, 2014). 

12 E.W., supra note 10; T.M., Docket No. 08-975 (issued February 6, 2009); Michael S. Mina, 57 ECAB 

379 (2006). 

13 E.W., supra note 10; S.W., Docket 08-2538 (issued May 21, 2009). 
6

appellant’s employment duties caused or contributed to her diagnosed conditions, Dr. Hebrard’s 

opinion on causal relationship is equivocal in nature and of limited probative value.14 

The remaining medical evidence of record is also insufficient to establish appellant’s 

claim. The record contains a 2004 report from Dr. Raphael and a July 23, 2015 report from 

Dr. Taylor. Dr. Raphael’s 2004 report does not address the central issue of whether appellant’s 

right shoulder condition on or after January 4, 2016 is due to factors of her federal employment. 

Therefore, this report is insufficient to meet appellant’s burden of proof.15 Dr. Taylor noted that 

appellant attributed her bilateral shoulder conditions to cumulative trauma from years of lifting 

and reaching at work. 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 her 

employment is sufficient to establish causal relationship.16 As Dr. Taylor did not provide his 

own opinion on causal relationship between appellant’s condition and her employment, his 

report is insufficient to meet appellant’s 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 has not met her burden of proof to establish that she 

developed an occupational disease causally related to factors of her federal employment. 

 14 See E.W., supra note 10; L.M., Docket No. 14-973 (issued August 25, 2014); R.G., Docket No. 14-113 (issued 

April 25, 2014); K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-548 (issued 

November 16, 2012). 

15 J.C., Docket No. 14-1673 (issued November 14, 2014). 

16 D.L., Docket No. 16-1639 (issued May 8, 2017); Joe T. Williams, 44 ECAB 518, 521 (1993). 

17 Id. 
7

ORDER 

IT IS HEREBY ORDERED THAT the January 24, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: July 26, 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