United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

T.V., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Midlothian, VA, Employer 

__________________________________________ 

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Docket No. 16-0656 

Issued: July 27, 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 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On February 19, 2016 appellant filed a timely appeal of a December 15, 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 the case. 

ISSUE 

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

disease causally related to factors of her federal employment. 

FACTUAL HISTORY 

On September 8, 2015 appellant then a 53-year-old rural carrier, filed a Form CA-2, 

occupational disease claim, alleging that she developed a left rotator cuff tear as a result of 

repetitively lifting mail off the floor, repetitively lifting above her head and shoulders for 

 

 1 5 U.S.C. § 8101 et seq. 
2

delivery point sequence (DPS) trays, and pulling mail down from the case. She became aware of 

her condition on December 5, 2014 and realized it was causally related to her employment on 

August 30, 2015. Appellant stopped work on September 8, 2015. 

On January 7, 2015 appellant was treated by Dr. Steven Fiore, a Board-certified 

orthopedist, for lumbar pain. She reported persistent symptoms since August 1, 2014 which 

were not the result of an accident or injury. Dr. Fiore noted appellant’s pain was in the midline 

of the low back with aching in the right shoulder, pain and tenderness of the anterior 

acromioclavicular joint, normal bilateral straight leg testing, intact deep tendon reflexes in the 

bilateral lower extremities, and intact sensation in the legs. An x-ray of the lumbar spine showed 

mild degeneration of the lumbar spine. Dr. Fiore diagnosed left annular tear and rotator cuff 

tendinitis and performed a steroid injection into the bursa. He recommended physical therapy 

and returned appellant to work light duty on January 12, 2015. 

Appellant was treated by Dr. Marion Herring, a Board-certified orthopedist, on March 2, 

2015 for left shoulder pain. Appellant reported the pain had been present since December 2014, 

but she could not recall a specific injury causing her pain. Appellant noted significant relief in 

pain after the steroid injection into the left bursa. Dr. Herring noted examination of the left 

shoulder revealed positive Hawkins and Neer sign, scapulothoracic dyskinesia, no tenderness 

over the acromioclavicular joint, and no muscle atrophy or gross deformity. With regard to the 

right shoulder, he noted well-healed incisions from a right shoulder rotator cuff tear in 2008, 

normal passive and active range of motion, no anterior or posterior instability, no pain over the 

acromioclavicular joint, normal range of motion of the elbow and wrist, and intact sensation and 

motor testing. The left shoulder x-ray revealed no glenohumeral or acromioclavicular arthritis, 

no subluxation, fracture, or dislocation. Dr. Herring diagnosed left shoulder pain and shoulder 

impingement syndrome and returned appellant to work full duty. 

Appellant was treated by Dr. Marianne L. Siegrist, a Board-certified family practitioner. 

on May 29, 2015 for left arm, shoulder, and elbow pain. Dr. Siegrist diagnosed left bicipital 

tendinitis, severe musculoskeletal degenerative changes of the cervical and thoracic spine 

secondary to a work-related injury, and left acromioclavicular bursitis. She recommended a 

depomedrol injection. In an excuse slip dated May 29, 2015, Dr. Siegrist noted that appellant 

was disabled from May 2 to 4, 2015 and was released to work on June 5, 2015. In notes dated 

September 2 and 9, 2015, she diagnosed torn left supraspinatus tendon and recommended 

surgery. 

Appellant submitted a magnetic resonance imaging (MRI) scan of the left humerus dated 

August 30, 2015 which revealed a glenohumeral effusion and tear of the supraspinatus. A left 

shoulder MRI scan dated August 30, 2015 revealed subacromial spurring of the anterior 

acromion process, glenohumeral effusion, a large full-thickness tear of the supraspinatus, torn 

fibers retracted to the glenoid with atrophy, and tendinopathy of the superior subscapularis with 

edema. 

By letter dated October 6, 2015, OWCP advised appellant of the type of evidence needed 

to establish her claim. It particularly requested that appellant submit a reasoned physician’s 

opinion addressing the relationship of her claimed condition and specific employment factors. 
3

In a responsive statement completed on September 19, 2015, appellant described her rural 

letter carrier duties which she alleged to have performed eight hours per day for five days a 

week. She was required to stand and sort mail for three hours a day, mail delivery for five hours 

per day, bending and lifting mail tubs, and sorting flat mail and inserts. 

Appellant submitted an October 5, 2015 certification of health care provider from 

Dr. Herring who noted that appellant was totally disabled from performing her letter carrier 

duties after surgery for 12 weeks from October 23, 2015 to January 23, 2016. In a report dated 

September 22, 2015, he treated appellant for left shoulder pain. Appellant again reported pain 

present since December 2014, but she could not recall a specific injury causing her pain. She 

noted moderate relief in pain after two steroid injections into the bursa. Dr. Herring noted that 

left shoulder examination revealed subacromial crepitation and positive Hawkins and Neer 

impingement sign. With regard to the right shoulder, Dr. Herring noted no atrophy or scars, no 

tenderness over the sternoclavicular acromioclavicular or bicipital groove, normal passive and 

active range of motion, no anterior or posterior instability, no pain over the acromioclavicular 

joint, normal range of motion of the elbow and wrist, and intact sensation and motor testing. 

Dr. Herring diagnosed sprain of the left rotator cuff capsule and recommended surgery. 

In a decision dated December 15, 2015, OWCP denied the claim as appellant had failed 

to meet her burden of proof to establish an injury or medical condition causally related to the 

accepted work factors. 

LEGAL PRECEDENT 

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

essential elements of his her claim. When an employee claims that he or she sustained an injury 

in the performance of duty, he or she must submit sufficient evidence to establish that he or she 

experienced a specific event, incident, or exposure occurring at the time, place, and in the 

manner alleged. Appellant must also establish that such event, incident, or exposure caused an 

injury.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 claimant. 

The medical evidence required to establish causal relationship is generally rationalized 

medical opinion evidence. Rationalized medical opinion evidence is medical evidence which 

 

2 See Walter D. Morehead, 31 ECAB 188, 194 (1979) (occupational disease or illness); Max Haber, 19 ECAB 

243, 247 (1967) (traumatic injury). See generally John J. Carlone, 41 ECAB 354 (1989); Elaine Pendleton, 40 

ECAB 1143 (1989). 
4

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 nature of the relationship between the diagnosed condition and the 

specific employment factors identified by the claimant.3

ANALYSIS 

It is undisputed that appellant’s work duties as a rural letter carrier included repetitively 

lifting mail off the floor, lifting mail trays above her head and shoulders, and pulling mail down 

from the case. It is also undisputed that appellant was diagnosed with left shoulder annular tear, 

rotator cuff tendinitis, and impingement syndrome. However, appellant has not submitted 

sufficient medical evidence to establish that her diagnosed conditions are causally related to 

specific employment factors. 

Appellant was treated by Dr. Siegrist on May 29, 2015 for left arm pain extending from 

her shoulder to elbow. Dr. Siegrist diagnosed bicipital tendinitis, severe musculoskeletal 

degenerative changes of the cervical and thoracic spine secondary to a work-related injury, and 

acromioclavicular bursitis. The Board finds that, although Dr. Siegrist supported causal 

relationship noting that appellant’s condition was secondary to a work injury, she did not provide 

medical rationale explaining the basis of her conclusory opinion regarding the causal relationship 

between appellant’s bicipital tendinitis, acromioclavicular bursitis and a torn supraspinatus 

tendon, and the factors of employment.4 Dr. Siegrist did not explain the process by which 

repetitively lifting mail off the floor, and lifting above her head and shoulders for mail trays 

would cause the diagnosed condition and why such condition would not be due to any nonwork 

factors such as age-related degenerative changes. Other reports from Dr. Siegrist are of limited 

probative value as they did not specifically address whether employment factors caused or 

aggravated the diagnosed conditions.5 Therefore, these reports are insufficient to meet 

appellant’s burden of proof. 

On January 7, 2015 appellant was treated by Dr. Fiore for lumbar pain. She reported that 

her symptoms began on August 1, 2014 and were not the result of an accident or injury. 

Dr. Fiore diagnosed annular tear and rotator cuff tendinitis and returned appellant to light duty. 

Similarly, a March 2, 2015 report from Dr. Herring noted appellant’s complaints of left shoulder 

pain beginning in December 2014 and advised that appellant could not recall a specific injury. 

Dr. Herring noted findings and diagnoses. In reports dated September 22 and October 5, 2015, 

he treated appellant for left shoulder pain which began in December 2014. Dr. Herring 

diagnosed left rotator cuff sprain and recommended surgery. However, these reports are 

 3 Solomon Polen, 51 ECAB 341 (2000). 

4 See T.M., Docket No. 08-975 (issued February 6, 2009) (a medical report is of limited probative value on the 

issue of causal relationship if it contains a conclusion regarding causal relationship which is unsupported by medical 

rationale). 

5 A.D., 58 ECAB 149 (2006) (medical evidence which does not offer any opinion regarding the cause of an 

employee’s condition is of limited probative value on the issue of causal relationship). 
5

insufficient to establish the claim as the physicians did not provide a history of injury6

 or 

specifically address whether appellant’s employment activities had caused or aggravated a 

diagnosed medical condition.7

The remainder of the medical evidence, including reports of diagnostic testing, are of 

limited probative value as they fail to provide an opinion on the causal relationship between 

appellant’s job and her diagnosed left shoulder condition. For this reason, this evidence is not 

sufficient to meet appellant’s burden of proof.8

On appeal appellant asserts that OWCP improperly denied the claim and that the 

submitted medical evidence is sufficient evidence to establish that she developed left shoulder 

conditions as a result of performing repetitive duties at work. As noted above, the medical 

evidence does not establish that appellant’s diagnosed conditions are causally related to her 

employment. Appellant has not submitted a physician’s report, based on an accurate history, 

which explains how work activities caused or aggravated her left shoulder condition. 

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 did not meet her burden of proof to establish that her 

claimed conditions were causally related to her employment. 

 6 Frank Luis Rembisz, 52 ECAB 147 (2000) (medical opinions based on an incomplete history or which are 

speculative or equivocal in character have little probative value). 

7 See supra note 5. 

8 Supra note 5. 
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ORDER 

IT IS HEREBY ORDERED THAT the December 15, 2015 decision of OWCP is 

affirmed. 

Issued: July 27, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board