United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

F.G., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Lakeview, MA, Employer 

__________________________________________ 

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Docket No. 17-0033 

Issued: March 8, 2017 

Appearances: Case Submitted on the Record

Brett Elliot Blumstein, Esq., for the appellant1

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 October 11, 2016 appellant, through counsel, filed a timely appeal from a 

September 2, 2016 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. 

ISSUE 

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

disease causally related to factors of her federal employment. 

 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

Counsel contends on appeal that appellant has submitted sufficient medical evidence to 

warrant acceptance or further development of her claim. 

FACTUAL HISTORY 

On May 26, 2015 appellant, then a 59-year-old letter carrier, filed an occupational disease 

claim (Form CA-2) alleging that she developed spondylolysis and spondylolisthesis due to her 

federal job duties. She first realized that her condition was due to her employment on 

May 12, 2015. Appellant reported that her condition caused difficulties with walking, sitting, 

and standing for long periods of time. She noted that casing mail, with lifting and twisting, 

increased her back pain. Appellant also reported that loading her mail truck was difficult due to 

severe pain from bending and lifting trays of mail. She noted that sitting in her truck increased 

her back pain. 

In a report dated May 26, 2015, Dr. David E. Adelberg, a Board-certified orthopedic 

surgeon, indicated that appellant’s symptom of back pain began about three months earlier. He 

diagnosed lumbar spondylolisthesis at L5-S1. 

In a letter dated June 25, 2015, OWCP requested that appellant provide additional factual 

and medical evidence in support of appellant’s occupational disease claim. It indicated that she 

should respond to this request within 30 days. 

On July 7, 2015 the employing establishment noted that appellant had a mounted route 

driving for seven hours a day. Appellant was required to walk the remaining hour while casing 

her mail. 

Appellant responded to OWCP on July 23, 2015 and described her job duties of twisting 

and turning while casing mail. She noted that she was required to bend to place the mail in her 

hamper. Appellant next lifted flats of mail from racks which ranged from overhead to floor level 

and bent to place these in her hamper. She was then required to load her truck from her hamper 

and to proceed to start her truck and deliver her route. Appellant noted that delivering packages 

caused additional strain on her back because she was required to pull up the emergency brake. 

Once her deliveries were completed, in approximately six hours, she then unloaded her truck. 

Appellant alleged that she was frequently required to work more than eight hours a day and on 

her days off, as the employing establishment was short staffed. 

On July 21, 2015 Dr. Priscilla Shube, a Board-certified family practitioner, diagnosed 

spondylolisthesis, spinal stenosis, and left L5-S1 radiculopathy. She opined that appellant’s 

symptoms were aggravated by activities at work including walking, prolonged sitting, bending, 

and lifting. 

In a decision dated August 27, 2015, OWCP denied appellant’s claim finding that the 

medical evidence did not establish that her diagnosed condition was caused or aggravated by her 

employment duties. 

Counsel requested reconsideration on June 10, 2016 and submitted additional medical 

evidence. 
3

In a report dated May 17, 2016, Dr. Byron V. Hartunian, an orthopedic surgeon, noted 

that appellant had worked at the employing establishment for 30 years and described her duties 

as a letter carrier including lifting, carrying, and moving up to 70 pounds. Appellant was 

required to perform repetitive climbing, squatting, bending, twisting, stooping, lifting, and 

reaching. Dr. Hartunian noted examination findings and reviewed her x-rays and magnetic 

resonance imaging scan. He diagnosed degenerative spondylolisthesis at L5-S1, herniated L4-

5 and L5-S1 discs, lumbar degenerative facet and disc disease, and bilateral L4 and L5 

radiculopathy. Dr. Hartunian opined that appellant’s diagnosed conditions were permanently 

aggravated, accelerated, contributed to, and precipitated by her repetitive work as a letter carrier. 

He described the process by which degenerative arthritis and disc disease occurs including 

impact loading resulting from repeated local stresses and causing chronic inflammation. 

Dr. Hartunian noted that appellant’s job required impact loading activities such as 

constant and repetitive walking, standing, squatting, stooping, climbing, bending, lifting, 

carrying, and twisting activities. He opined that excessive impact loading and repeated local 

stresses caused mechanical stress on cartilage and disc surfaces resulting in chronic inflammation 

and then accelerated loss of articular cartilage and disc structure. Dr. Hartunian provided 

citations to medical publications in support of his opinions. He opined that appellant’s spinal 

arthritis and disc degeneration would not have reached the point it had, but for her work 

activities. Dr. Hartunian concluded that her degenerative spine disease, herniated discs, and 

spondylolisthesis were hastened and accelerated by her work. He further noted that lower 

extremity loading activities such as repeated walking, standing, bending, kneeling, lifting, 

climbing, stooping, pushing, pulling, twisting, squatting, and carrying as required by appellant’s 

position contributed to the development and progression of spinal arthritis and disc degeneration. 

By decision dated September 2, 2016, OWCP denied modification of the August 27, 

2015 decision. It found that Dr. Hartunian’s report did not explain how appellant’s conditions 

were permanently aggravated, contributed to, or precipitated by her work activities. 

LEGAL PRECEDENT 

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.”3

 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. 

The evidence required to establish causal relationship is rationalized medical opinion 

evidence, based upon a complete factual and medical background, showing causal relationship 

 3

 20 C.F.R. § 10.5(q). 
4

between the claimed condition and identified factors. The belief of a claimant that a condition 

was caused or aggravated by the employment is not sufficient to establish causal relation.4

ANALYSIS 

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

In support of her claim for an occupational disease resulting in the diagnosed conditions 

of degenerative spondylolisthesis at L5-S1, herniated L4-5 and L5-S1 discs, lumbar degenerative 

facet and disc disease, and bilateral L4 and L5 radiculopathy, appellant submitted reports from 

Drs. Adelberg and Shube. These report, however, provided no opinion on causal relationship. 

Thus, the Board finds that they are of no probative value and are insufficient to establish the 

claim.5

On reconsideration, appellant submitted a detailed report from Dr. Hartunian dated 

May 17, 2016. Dr. Hartunian described her job duties of lifting, carrying, climbing, squatting, 

bending, twisting, stooping, and reaching. He provided an opinion that appellant’s employment 

duties contributed to her diagnosed conditions as her spinal arthritis and disc degeneration would 

not have reached the point it had, but for her work activities. Dr. Hartunian concluded that her 

degenerative spine disease, herniated discs, and spondylolisthesis were hastened and accelerated 

by her work. He also provided a detailed explanation of how and why appellant’s repetitive 

employment duties resulted in excessive impact loading and repeated local stresses, which in 

turn caused mechanical stress on cartilage and disc surfaces resulting in chronic inflammation 

and then accelerated loss of articular cartilage and disc structure. 

Dr. Hartunian’s report contains a history of injury, diagnosis and an opinion that 

appellant’s preexisting condition was exacerbated and accelerated by the accepted employment 

duties. While this report is not sufficient to meet her burden of proof, it does raise an 

uncontroverted inference of causal relation between her accepted employment factors and an 

exacerbation of her diagnosed condition sufficient to require further development of her claim.6

On remand OWCP should refer appellant, a statement of accepted facts, and a list of 

specific questions to an appropriate physician for a second opinion evaluation to determine if her 

diagnosed conditions of degenerative spondylolisthesis at L5-S1, herniated L4-5 and L5-S1 

discs, lumbar degenerative facet and disc disease, and bilateral L4 and L5 radiculopathy were 

exacerbated and accelerated by the accepted employment duties. After this and such other 

development as OWCP deems necessary, OWCP should issue a de novo decision. 

CONCLUSION 

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

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

5 Willie M. Miller, 53 ECAB 697 (2002). 

6 John J. Carlone, 41 ECAB 354, 358-60 (1989). 
5

ORDER 

IT IS HEREBY ORDERED THAT the September 2, 2016 decision of the Office of 

Workers’ Compensation Programs is set aside and remanded for further development consistent 

with this decision of the Board. 

Issued: March 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