United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

A.F., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Peabody, MA, Employer 

__________________________________________ 

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Docket No. 15-1687 

Issued: June 9, 2016 

Appearances: Case Submitted on the Record

Daniel Shapiro, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On August 3, 2015 appellant, through counsel, filed a timely appeal from a February 4, 

2015 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.2

ISSUE 

The issue is whether appellant met his burden of proof to establish an occupational 

disease in the performance of duty. 

 1

 5 U.S.C. § 8101 et seq. 

2

 Appellant requested oral argument. By order dated December 8, 2015, the Board, in its discretion, denied oral 

argument as it determined that the issues on appeal could be adequately addressed in a decision based on a review of 

the case record. Order Denying Request for Oral Argument, Docket No. 15-1687 (issued December 8, 2015). 
2

FACTUAL HISTORY 

On January 23, 2013 appellant, then a 64-year-old former letter carrier, filed an 

occupational disease claim (Form CA-2) alleging that factors of his employment caused a 

permanent acceleration of osteoarthritis of the bilateral knees and hips. He alleged that standing, 

bending, twisting, pivoting, stooping, walking, climbing stairs, lifting, and carrying contributed 

to his condition. Appellant contended that he first became aware of his condition and its relation 

to his federal employment on October 24, 2012. He retired on April 30, 2010. 

Multiple reports from Dr. William Murzic, a Board-certified orthopedic surgeon, and 

Dr. Maurice Greenbaum, Board-certified in internal medicine, were submitted assessing 

osteoarthritis of various areas of appellant’s body. On June 26, 2006 appellant underwent a right 

total hip arthroplasty. His preoperative diagnosis was osteoarthritis of the right hip. 

In September 22, 2011 diagnostic reports, Dr. Michael Geary, a Board-certified 

diagnostic radiologist, advised that x-rays revealed mild left hip osteoarthritis, right knee 

tri-compartmental degenerative spurring of the right knee, and prominent joint space narrowing 

in the medial compartment of the left knee. 

In a January 4, 2013 report, Dr. Byron Hartunian, an orthopedic surgeon, advised that 

appellant’s job duties included walking five to eight miles a day, carrying a satchel weighing up 

to 35 pounds, lifting and carrying up to 70 pounds, prolonged standing, repetitive bending, 

twisting, pivoting, stooping, squatting, climbing, and reaching. He noted that in 2000 appellant 

noticed right hip pain radiating towards the right knee and that currently he had significant 

arthritic changes of the left knee and increased stiffness of the left hip. Right hip examination 

revealed 25 percent limitation of squatting because of stiffness, 89 degrees of flexion, 6 degrees 

extension, 14 degrees internal rotation, 36 degrees external rotation, 34 degrees abduction, and 

18 degrees adduction. The left hip had 90 degrees flexion, 6 degrees extension, 12 degrees 

internal rotation, 34 degrees external rotation, 24 degrees abduction, and 16 degrees adduction. 

Examination of the knees revealed tenderness to palpation along the medial joint, 98 degrees 

right knee flexion, and 84 degrees left knee flexion. Dr. Hartunian noted the results of 

October 24, 2012 x-rays and assessed post right total hip replacement for end-stage degenerative 

arthritis, primary right knee joint arthritis, left hip arthritis, and left knee arthritis. He opined 

that, although the etiology of arthritis cannot be stated with certainty, repetitive forceful stress 

through the hips and knees is a known and recognized causative factor and such was likely the 

case with appellant. Dr. Hartunian noted that scientific evidence established that factors 

contributing to the progression of osteoarthritis in joints include heavy work, standing, walking, 

stooping, bending, kneeing, lifting, twisting, and pivoting, which was the type of work appellant 

performed. He asserted that, no matter the original cause of the arthritis, appellant’s activities 

permanently accelerated the preexistent degenerative process in his hips and knees. 

Dr. Hartunian noted that OWCP had accepted numerous claims where letter carrier duties 

affected lower extremity joints already afflicted with arthritis. He quoted a report from an 

OWCP medical adviser, in another claim where OWCP accepted that mail carrier duties 

aggravated osteoarthritis. 

By letter dated January 31, 2013, the employing establishment controverted appellant’s 

claim arguing that medical evidence showed that he was well aware of his condition prior to 
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October 2012. It contended that a more acceptable date of injury would be May 28, 2002, as a 

radiology report on that day showed bilateral degenerative arthritis of the hips. 

By letter dated March 1, 2013, OWCP informed appellant of the type of evidence needed 

to establish his claim. It advised him that he had 30 days from the date of the letter to submit 

responsive evidence. 

By decision dated May 2, 2013, OWCP denied the claim finding the medical evidence of 

record was insufficient to establish that the diagnosed conditions were causally related to the 

work duties. It noted that Dr. Hartunian’s opinion was based in part on diagnostic tests that were 

not made available to OWCP. 

On May 7, 2013 appellant, through counsel, requested an oral hearing. Later on July 27, 

2013, counsel requested a review of the written record as opposed to an oral hearing. 

In a July 25, 2013 report, Dr. Hartunian clarified that he mistakenly referenced an 

October 24, 2012 diagnostic report and that he actually reviewed September 22, 2011 x-rays. He 

reiterated his opinion that appellant’s job duties permanently hastened and accelerated the 

preexisting degenerative process in his hips and knees and that his work duties were a significant 

causative factor in that regard. 

By decision dated December 9, 2013, an OWCP hearing representative affirmed the 

denial of appellant’s claim. 

By letter dated December 5, 2014, appellant requested reconsideration. In support of his 

request, counsel submitted reports, from other claims not involving appellant, where OWCP 

medical advisers found that the duties of letter carriers aggravated and accelerated osteoarthritis. 

He asserted that this was precedent under OWCP procedures. 

In a February 4, 2015 decision, OWCP advised that before newly submitted evidence was 

insufficient to warrant modification of its prior decision. 

On appeal, appellant’s counsel disagreed with the hearing representative. He contended 

that she misconstrued causal relationship, inaccurately characterized evidence and testimony, and 

inaccurately quoted and applied applicable law. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden 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 timely filed within the applicable time 

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

disabilities and/or specific conditions for which compensation is claimed are causally related to 
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the employment injury.3

 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.4

Whether an employee actually sustained an injury in the performance of duty begins with 

an analysis of whether fact of injury has been established. To establish an occupational disease 

claim, 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.5 

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

causal relationship is rationalized medical opinion evidence. Rationalized medical opinion 

evidence is generally required to establish causal relationship. The opinion of the physician must 

be based on a complete factual and medical background, 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.6

 

The weight of medical evidence is determined by its reliability, its probative value, its 

convincing quality, the care of analysis manifested and the medical rationale expressed in 

support of the physician’s opinion.7 

ANALYSIS 

The Board finds that this case is not in posture for a decision. 

Appellant filed an occupational disease claim asserting that he sustained an acceleration 

of bilateral hip and knee osteoarthritis due to factors of his employment. OWCP denied the 

claim because he submitted insufficient medical evidence to establish that factors of his federal 

employment caused an aggravation of bilateral knee and hip osteoarthritis. The Board finds, 

however, that the case requires further development regarding whether appellant sustained an 

occupational disease causally related to employment factors. 

In his January 4, 2013 report, Dr. Hartunian noted appellant’s work duties and reviewed 

his duties and requirement as a letter carrier. He noted the weight of the mailbag and the amount 

of miles he walked daily. Dr. Hartunian indicated that the climbing of stair loads the lower body 

joints three times the body weight, and descending stairs loads six times the body weight. 

Further, he articulated that repetitive forceful stresses through the hip and knees are a known and 

causative factor of degenerative arthritis. Dr. Hartunian also outlined appellant’s detailed 

treatment history. He opined that, although the etiology of arthritis cannot be determined with 

 3 Elaine Pendleton, 40 ECAB 1143 (1989). 

4 Victor J. Woodhams, 41 ECAB 345 (1989). 

5 R.H., 59 ECAB 382 (2008); Ernest St. Pierre, 51 ECAB 623 (2000). 

6 I.J., 59 ECAB 408 (2008); supra note 4. 

7

 James Mack, 43 ECAB 321 (1991). 
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certainty, repetitive forceful stress through the hips and knees is a known and recognized 

causative factor and such was likely the case with appellant. Dr. Hartunian noted that scientific 

evidence established that factors contributing to the progression of osteoarthritis in joints include 

heavy work, standing, walking, stooping, bending, kneeing, lifting, twisting, and pivoting, which 

was the type of work appellant performed. He asserted that, no matter the original cause of the 

arthritis, appellant’s activities permanently accelerated the preexistent degenerative process in 

his hips and knees. Dr. Hartunian reiterated his opinion on causal relationship in his July 25, 

2013 report. He opined that appellant’s activities as a letter carrier permanently hastened and 

accelerated the preexisting degenerative process in his hips and knees. 

Dr. Hartunian’s reports, when read together, identified employment factors which 

appellant claimed caused his condition, identified findings upon examination, and explained how 

the identified employment factors caused or aggravated a diagnosed condition. The Board finds 

that Dr. Hartunian’s opinion, while not sufficiently rationalized to meet appellant’s burden of 

proof, is sufficient, given the absence of any opposing medical evidence, to require further 

development of the record.8

 It is well established that proceedings under FECA are not 

adversarial in nature9 and while appellant has the burden to establish entitlement to 

compensation, OWCP shares responsibility in the development of the evidence.10 OWCP has an 

obligation to see that justice is done.11

The case will be remanded to OWCP for further action consistent with this decision. On 

remand, after such further development of the case record as OWCP deems necessary, a de novo

decision shall be issued.12 

CONCLUSION 

The Board finds that the case is not in posture for a decision. 

 8 See Earnest J. Reece, Jr., 32 ECAB 1508, 1510 (1981). See also John J. Carlone, 41 ECAB 354 (1989); 

Horace Langhorne, 29 ECAB 820 (1978). 

9 See e.g., Walter A. Fundinger, Jr., 37 ECAB 200, 204 (1985); Michael Gallo, 29 ECAB 159, 161 (1978); 

William N. Saathoff, 8 ECAB 769, 770-71 (1956). 

10 Dorothy L. Sidwell, 36 ECAB 699, 707 (1985). 

11 William J. Cantrell, 34 ECAB 1233, 1237 (1983); Gertrude E. Evans, 26 ECAB 195 (1974). 

12 See John J. Carlone, 41 ECAB 354 (1989). 
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ORDER 

IT IS HEREBY ORDERED THAT the February 4, 2015 decision of the Office of 

Workers’ Compensation Programs is set aside and the case remanded for additional development 

consistent with this decision. 

Issued: June 9, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board