United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

M.E., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Millbrae, CA, Employer

__________________________________________

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Docket No. 18-0215

Issued: June 13, 2018

Appearances: Case Submitted on the Record

Appellant, pro se

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 November 7, 2017 appellant filed a timely appeal from an October 2, 2017 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. 

ISSUE

The issue is whether appellant has met his burden of proof to establish bilateral shoulder 

conditions causally related to the accepted factors of his federal employment. 

 

1 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY

On December 3, 2016 appellant, then a 53-year-old city carrier, filed an occupational 

disease claim (Form CA-2) alleging that he sustained a left shoulder tear and tendinitis due to the 

duties of his federal employment. He stopped work on November 1, 2016.

In a statement dated December 2, 2016, appellant related that his federal employment

duties included driving, carrying packages, and walking long hours at times while carrying a 

satchel on his shoulder weighing from 15 to 30 pounds. He contended that carrying this heavy 

weight caused pain in both shoulders. Appellant also noted that most of the houses he delivered

to had more than 25 steps to the mailbox and that he had tripped multiple times on slippery surfaces

and uneven sidewalks. 

In an x-ray report dated April 1, 2016, Dr. David S. Marcus, a radiologist, diagnosed 

bilateral acromioclavicular joint greater than glenohumeral joint degenerative arthritis.

Appellant was treated by Dr. Alberto Bolanos, a Board-certified orthopedic surgeon. In an 

April 21, 2016 initial report, Dr. Bolanos noted that appellant had bilateral shoulder pain. He also 

discussed appellant’s other medical conditions, including issues with his bilateral knees, left hip 

arthritis, and lumbar spondylosis.

In a May 7, 2016 magnetic resonance imaging (MRI) scan of appellant’s left shoulder,

Dr. Avanti Ambekar, a Board-certified radiologist found: (1) acromioclavicular joint arthritis and 

distal clavicle/acromion marrow edema with marked capsular hypertrophy; (2) moderate 

supraspinatus tendon thinning and partial articular-sided insertional tearing less than 50 percent 

thickness, small subacromial bursitis, greater tuberosity degenerative changes and subcortical 

edema; and (3) small tubular fluid extending into the subscapularis recess possibly through a 

sublabral sulcus, no definite tear.

In reports dated May 11 to November 9, 2016, Dr. Bolanos noted severe acromioclavicular 

joint arthrosis in appellant’s left shoulder with moderate supraspinatus tendon thinning and partial 

articular-sided insertional tearing less than 50 percent thickness. He further noted small bursitis, 

greater tuberosity degenerative changes. Regarding the right shoulder he noted severe 

acromioclavicular joint arthrosis and severe distal supraspinatus tendon thinning with sit like fullthickness tendon tearing. 

On November 14, 2016 Dr. Bolanos performed a left shoulder arthroscopic decompression 

and mini open rotator cuff repair, glenohumeral synovectomy, labral debridement, and distal 

clavicle resection. In a report following the surgery, he noted that a left shoulder arthroscopic 

subacromial decompression was performed, that intra-op findings showed a full-thickness rotator 

cuff tear, and that a mini open rotator cuff repair was performed. 

By development letter dated December 15, 2016, OWCP informed appellant that further 

evidence was necessary to establish his claim, including a physician’s opinion supported by a 

medical explanation as to how appellant’s work activities caused, contributed to, or aggravated his 

medical condition. Appellant was afforded 30 days to submit the requested evidence.
3

In a December 23, 2016 report, Dr. Bolanos related that appellant had provided a very clear 

temporal correlation between his symptoms and employment activities. He opined that the 

occupational requirements created repetitive stress on the shoulder in question and were clear and 

strong indicators of the causation of his pathology. 

By decision dated February 9, 2017, OWCP denied appellant’s claim. It determined that 

the medical evidence of record did not demonstrate that the claimed medical condition was related 

to the established employment events. 

On February 22, 2017 appellant requested an oral hearing before an OWCP hearing 

representative. 

In a March 1, 2017 report, Dr. Bolanos indicated that appellant’s symptoms were clearly 

related to his carrying a 25-pound satchel 10 to 12 hours a day, sometimes on stairs. He noted that 

appellant developed pain during that job activity, and that therefore causation had been established. 

At the hearing held on August 29, 2017, an OWCP hearing representative noted that 

appellant was wearing a sling. Appellant testified that he had surgery on November 14, 2016, that 

he had not worked since that date, and that he was going to undergo another surgery. He stated

that during his federal employment, he carried satchels weighing 30 to 35 pounds. Appellant noted

that he fell many times delivering mail. The hearing representative explained to appellant that his 

physician had to submit a rationalized medical opinion establishing causal relationship.

After the hearing appellant resubmitted the December 23, 2016 report from Dr. Bolanos. 

Attached to this report was an Internet article on arthritis of the shoulder and a note from

Dr. Bolanos’ physician assistant.

By decision dated October 2, 2017, OWCP’s hearing representative affirmed the 

February 9, 2017 decision denying appellant’s claim. She determined that the medical evidence 

of record was insufficient to establish that appellant’s employment duties caused or contributed to 

his bilateral shoulder arthritis and left rotator cuff tear.

LEGAL PRECEDENT

An employee seeking benefits under FECA2 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, 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.3

 

2

Id.

3 Kathryn Haggerty, 45 ECAB 383, 388 (1994). 
4

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.4 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.5

Whether an employee sustained an injury requires the submission of rationalized medical 

opinion evidence.6 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 evidence explaining the nature of the relationship between the diagnosed condition and 

the specific employment factors identified by the employee.7 The weight of the 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.8 

ANALYSIS

The Board finds that appellant failed to meet his burden of proof to establish his 

occupational disease claim as the medical evidence of record does not establish a causal 

relationship between the accepted employment factors and appellant’s diagnosed medical 

conditions. 

Appellant established the duties of his federal employment and also submitted evidence of 

medical diagnoses. However, he has failed to submit a rationalized medical opinion establishing 

that a medical diagnosis was causally related to the accepted duties of his federal employment.

9

The reports of appellant’s treating surgeon, Dr. Bolanos, do not meet appellant’s burden of 

proof. Dr. Bolanos did not discuss appellant’s employment factors or causal relationship until his 

December 23, 2016 report. In the December 23, 2016 report, he opined that there was a very clear 

temporal correlation between appellant’s symptoms and his work-related activities. Dr. Bolanos

noted that appellant’s occupational requirements caused repetitive stress on appellant’s shoulder. 

In a March 1, 2017 report, he noted that appellant’s symptoms were clearly related to appellant 

carrying satchels weighing 25 pounds a day, sometimes on stairs. Dr. Bolanos explained that 

 

4 20 C.F.R. § 10.5(q). 

5 T.C., Docket No. 17-0872 (issued October 5, 2017). 

6 See J.Z., 58 ECAB 388 (2008); see also M.H., Docket No. 15-0849 (issued July 22, 2016). 

7

I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 465 (2005). 

8

James Mack, 43 ECAB 321 (1991). 

9 See S.M., Docket No. 17-1756 (issued February 20, 2018). 
5

appellant’s pain developed during the job-related activity, and that therefore causation was 

established. The conclusions of Dr. Bolanos regarding causal relationship were primarily 

conclusions that appellant developed his shoulder pain during the course of his federal 

employment. However, pain and/or discomfort is only considered a symptom, not a medical 

diagnosis.10

Moreover, Dr. Bolanos did not provide adequate medical rationale on causal relationship. 

His statement on causation failed to provide a sufficient explanation as to the mechanism(s) of 

injury pertaining to this occupational disease claim as alleged by appellant. Namely, Dr. Bolanos 

did not medically explain that appellant’s city carrier duties caused or aggravated his bilateral 

shoulder conditions.11 Without explaining how physiologically the movements involved in 

appellant’s employment duties caused or contributed to his diagnosed condition, Dr. Bolanos’

opinion on causal relationship is equivocal in nature and of limited probative value.12 The fact 

that a condition manifests itself during a period of employment is insufficient to establish causal 

relationship.13 Thus, Dr. Bolanos’ report is insufficient to meet appellant’s burden of proof.

The remaining medical evidence of record is of limited probative value. The x-ray report 

of Dr. Marcus and the MRI scan report of Dr. Ambekar fail to offer a medical opinion with regard 

to how the factors of appellant’s federal employment caused a medical condition.14 Diagnostic 

reports which offer no opinion regarding causal relationship are of limited probative value.15

Finally, the Board notes that appellant submitted an Internet article with a handwritten note 

from a physician assistant for Dr. Bolanos. The Board has held that such articles lack evidentiary 

value as they are of general application and are not determinative of whether specific conditions 

are causally related to the particular employment factors of a claim.16 The Board has held that 

reports by a physician assistant are not considered medical evidence as physician assistants are not 

considered physicians under FECA.17

 

10 See B.W., Docket No. 17-0005 (issued April 25, 2018). 

11 S.W., Docket No. 08-2538 (issued May 21, 2009).

12 See L.M., Docket No. 14-0973 (issued August 25, 2014); R.G., Docket No. 14-0113 (issued April 25, 2014); 

K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-0548 (issued November 16, 2012). 

13 20 C.F.R. § 10.115(e). See also L.R.., Docket No. 16-1673 (issued February 20, 2018); S.D., Docket No. 17-

1873 (issued February 2, 2018). 

14 E.C., Docket No. 17-1640 (issued January 25, 2018). 

15 See G.H., Docket No. 17-1387 (issued October 24, 2017). 

16 S.G., Docket No. 13-1263 (issued September 20, 2013).

17 See David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006) (lay individuals such as physician assistants, nurses, and 

physical therapists are not competent to render a medical opinion under FECA); 5 U.S.C. § 8102(2) (this subsection 

defines a physician as surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and 

osteopathic practitioners within the scope of their practice a defined by state law). 
6

An award of compensation may not be based on surmise, conjecture, speculation, or on the 

employee’s own belief of causal relation.18 As appellant did not establish that his medical 

condition was causally related to the accepted factors of his federal employment, he did not meet 

his burden of proof.19 

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 failed to meet his burden of proof to establish bilateral 

shoulder conditions causally related to the accepted factors of his federal employment.

ORDER

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

Programs dated October 2, 2017 is affirmed.

Issued: June 13, 2018

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

 

18 D.D., 57 ECAB 734 (2006); see also R.H., Docket No. 17-1141 (issued September 21, 2017). 

19 F.P., Docket No. 15-1826 (issued December 16, 2015).