United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.P., Appellant 

and 

U.S. POSTAL SERVICE, MAIN POST OFFICE, 

Grand Rapids, MI, Employer 

__________________________________________ 

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Docket No. 17-0148 

Issued: May 18, 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 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On October 31, 2016 appellant, through counsel, filed a timely appeal from a 

September 29, 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 this case. 

ISSUE 

The issue is whether appellant met her burden of proof to establish a right shoulder 

condition 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

On appeal counsel contends the decision is contrary to fact and law. 

FACTUAL HISTORY 

On March 1, 2016 appellant, then a 63-year-old rural carrier, filed an occupational 

disease claim (Form CA-2) alleging that on December 30, 2015 she first realized that her right 

shoulder condition was due to prolonged repetitive use in the course of her federal employment. 

She did not stop work. 

In a December 30, 2015 report, Dr. Joseph Yacisen, a treating Board-certified orthopedic 

surgeon, noted that appellant was seen for right shoulder pain complaints, which she related had 

been occurring for the past four to six years. Appellant attributed her condition to her 

employment as a rural carrier. A physical examination of appellant’s right shoulder revealed 

positive O’Brien’s test, 180 degrees forward flexion, and intact internal and external rotation. 

Dr. Yacisen reviewed an x-ray which showed a type 2 acromion with a 10-millimeter spur. He 

diagnosed right shoulder pain, suspected labral tear, shoulder impingement, and lipoma. 

A January 12, 2016 right shoulder magnetic resonance imaging (MRI) scan was 

interpreted as showing a large supraspinatus tendon tear and a superior labrum at the biceps 

insertion (SLAP) tear. 

Dr. Yacisen, in a February 18, 2016 report, noted appellant’s complaints and provided a 

history of appellant’s condition and examination findings. The physical examination of the right 

shoulder showed positive O’Brien’s test, 160 degrees forward flexion, 5+/5 internal and external 

rotation strength, and positive impingement signs. Dr. Yacisen related that review of appellant’s 

MRI scan showed subchondral cyst at the supraspinatus insertion, complete supraspinatus tendon 

tear, and SLAP tear. He diagnosed rotator cuff tear and SLAP tear of the right shoulder. 

In a March 23, 2016 report, Dr. Yacisen reiterated appellant’s history of injury and 

examination findings. A physical examination performed that day revealed 150 degrees right 

shoulder forward flexion, positive drop arm test, positive Obrien’s test, and 5+/5 internal and 

external rotation strength. Diagnoses included SLAP tear, shoulder pain, and rotator cuff tear of 

the right shoulder. 

In a letter dated April 15, 2016, OWCP informed appellant that the evidence of record 

was insufficient to establish her claim. It advised her regarding the medical and factual evidence 

required to establish her claim. Appellant was afforded 30 days to provide the requested 

information. 

On May 13, 2016 Dr. Yacisen reported the dates on which appellant was evaluated for 

complaints of right shoulder pain. He related that there was no known injury mechanism for the 

last four to five years. Dr. Yacisen related that appellant’s positive O’Brien’s test was indicative 

of a shoulder labral tear, x-ray interpretations revealed a 10-millimeter subacromial spur and two 

acromion, and her MRI scan showed a SLAP tear, supraspinatus tendon tear with retraction, and 

subchondral cyst at the supraspinatus insertion. He explained that the positive impingement sign 

was indicative of subacromial impingement and the drop arm test was indicative of a 

supraspinatus tear. Dr. Yacisen recommended surgery and released appellant to regular-duty 
3

work. He observed that work could have contributed to the diagnosed conditions if the work 

duties required carrying heavy loads with her hands, carrying or lifting heavy loads above or on 

the shoulders, working at intervals of more than 15 minutes at a time with arms raised above the 

shoulders, pulling or pushing heavy loads, and repetitive wrist or arm movements with force for 

long periods of time. 

By decision dated May 26, 2016, OWCP denied appellant’s claim. It found the medical 

evidence of record was insufficient to establish a causal relationship between the diagnosed right 

shoulder supraspinatus tear and SLAP tear. 

On July 6, 2016 OWCP received appellant’s request for reconsideration. In support of 

her request, appellant submitted a June 29, 2016 letter from Dr. Yacisen. Dr. Yacisen opined 

that in his expert opinion appellant’s right shoulder conditions were “likely directly related 

and/or caused” by the repetitive movements, overhead work, and repeated heavy lifting for over 

23 years. 

By letter dated August 18, 2016, OWCP informed appellant that additional evidence was 

required to establish a causal relationship between her work factors and the diagnosed right 

shoulder conditions. It noted that she had been copied on a letter it had sent to Dr. Yacisen 

regarding further development. OWCP advised appellant that it was her responsibility to ensure 

the additional evidence from Dr. Yacisen was received within the time frame allocated in the 

letter. 

In a letter to Dr. Yacisen, dated August 18, 2016, OWCP provided a statement of 

accepted facts and accepted definitions sheet for review. It requested Dr. Yacisen explain how 

appellant’s work exposure caused or aggravated the diagnosed conditions and requested a 

response be submitted within 30 days from the date of the letter. No response was received. 

By decision dated September 29, 2016, OWCP denied modification. It found that 

Dr. Yacisen had failed to provide a firm and rationalized opinion supported by objective findings 

to establish that the factors of appellant’s employment caused or contributed to her right shoulder 

condition. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA3

 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, that the claim was filed within the applicable time 

limitation, that an injury was sustained while 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 

 3

 5 U.S.C. § 8101 et seq. 
4

employment injury.4 These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated on a traumatic injury or an occupational disease.5

 

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.6 

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

establish causal relationship is rationalized medical opinion evidence.7 Rationalized medical 

opinion evidence is medical evidence which includes a physician’s rationalized opinion on 

whether there is a causal relationship between the employee’s diagnosed condition and the 

compensable employment factors.8 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.9 

ANALYSIS 

Appellant attributed her right shoulder condition to prolonged repetitive use. The Board 

finds that appellant failed to submit sufficient medical evidence to establish a right shoulder 

condition causally related to accepted factors of her employment as a rural carrier. For this 

reason, appellant did not discharge her burden of proof. 

In support of her claim, appellant submitted reports from Dr. Yacisen covering the period 

December 30, 2015 to June 29, 2016. Dr. Yacisen diagnosed right shoulder pain and suspected 

labral tear, lipoma, and shoulder impingement in a December 30, 2015 report. In reports dated 

February 18 and March 23, 2016, he diagnosed rotator cuff tear, shoulder pain and SLAP tear. 

None of these reports by Dr. Yacisen contain any opinion regarding the cause of the diagnosed 

conditions. The Board has held that medical evidence that does not offer any opinion regarding 

 4 C.S., Docket No. 08-1585 (issued March 3, 2009); Bonnie A. Contreras, 57 ECAB 364 (2006). 

5 S.P., 59 ECAB 184 (2007); Joe D. Cameron, 41 ECAB 153 (1989). 

6 D.U., Docket No. 10-144 (issued July 27, 2010); R.H., 59 ECAB 382 (2008); Roy L. Humphrey, 57 ECAB 238 

(2005); Donald W. Wenzel, 56 ECAB 390 (2005). 

7 Y.J., Docket No. 08-1167 (issued October 7, 2008); A.D., 58 ECAB 149 (2006); D'Wayne Avila, 57 ECAB 

642 (2006). 

8 J.J., Docket No. 09-27 (issued February 10, 2009); Michael S. Mina, 57 ECAB 379 (2006). 

9 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989). 
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the cause of an employee’s condition is of limited probative value on the issue of causal 

relationship.10 

In a May 13, 2016 report, Dr. Yacisen diagnosed labral tear, SLAP tear, supraspinatus 

tendon tear with retraction, chondral cyst at the supraspinatus insertion, 10-millimeter 

subacromial spur, and two acromion. He opined that the diagnosed conditions could be due to 

her work if it involved carrying heavy loads, lifting or carrying heavy loads above or on her 

shoulders, working at intervals of 15 minutes with her arms raised above her shoulder, repetitive 

wrist or arm movements with force for extended periods of time, and pulling or pushing heavy 

loads. Similarly, in a June 29, 2016 letter, Dr. Yacisen explained that appellant’s overhead work, 

repetitive movements, and repeated heavy lifting for the past 23 years were the likely cause of 

appellant’s right shoulder conditions. The Board has held that medical opinions which are 

speculative or equivocal are of diminished probative value.11 Furthermore, a mere conclusion 

without the necessary rationale explaining how work activities could result in the diagnosed 

condition is insufficient to meet appellant’s burden of proof.12 Dr. Yacisen’s opinion is of 

limited probative value as it does not contain any medical rationale explaining how appellant’s 

job duties physiologically caused the diagnosed shoulder conditions.13 

OWCP attempted to assist appellant in obtaining a rationalized medical opinion from 

Dr. Yacisen. On August 18, 2016 it provided a statement of accepted facts and accepted 

definitions for his use in explaining how appellant’s work duties caused or contributed to her 

diagnosed condition. However Dr. Yacisen did not respond. As such his existing reports are 

insufficient to discharge appellant’s burden of proof as they do not present a rationalized medical 

opinion regarding causal relationship. 

The remaining evidence submitted by appellant is insufficient to establish causal 

relationship. The diagnostic test results of record fail to provide an opinion addressing the causal 

relationship of appellant’s condition.14

On appeal, counsel contends that OWCP’s decision was contrary to fact and law. Based 

on the findings and reasons stated above, the Board finds the attorney’s arguments are not 

substantiated. 

 10 See C.B., Docket No. 09-2027 (issued May 12, 2010); S.E., Docket No. 08-2214 (issued May 6, 2009); Jaja K. 

Asaramo, 55 ECAB 200 (2004). 

11 See S.E., Docket No. 08-2214 (issued May 6, 2009) (finding that opinions such as the condition is probably 

related, most likely related, or could be related are speculative and diminish the probative value of the medical 

opinion); Cecilia M. Corley, 56 ECAB 662, 669 (2005) (finding that medical opinions which are speculative or 

equivocal are of diminished probative value). 

12 See Beverly A. Spencer, 55 ECAB 501 (2004).

13 S.H., Docket No. 16-1227 (issued February 9, 2017). 

14 See K.W., 59 ECAB 271 (2007); A.D., 58 ECAB 149 (2006); Linda I. Sprague, 48 ECAB 386 (1997) (medical 

evidence that does not offer any opinion regarding the cause of an employee’s condition is of limited probative 

value on the issue of causal relationship). 
6

CONCLUSION 

The Board finds appellant has not met her burden of proof to establish a right shoulder 

condition causally related to factors of her federal employment. 

ORDER 

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ 

Compensation Programs dated September 29, 2016 is affirmed. 

Issued: May 18, 2017 

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