United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

T.F., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Verona, PA, Employer 

__________________________________________ 

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Docket No. 17-0429 

Issued: June 1, 2017 

Appearances: Case Submitted on the Record

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

ALEC J. KOROMILAS, Alternate Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On December 19, 2016 appellant filed a timely appeal from a December 5, 2016 merit 

decision of the Office of Workers’ Compensation Programs (OWCP).1

 Pursuant to the Federal 

Employees’ Compensation Act2

 (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 her burden of proof to establish an injury causally 

related to factors of her federal employment. 

 1

 Appellant has submitted additional evidence on appeal. The Board’s jurisdiction, however, is limited to 

evidence that was before OWCP at the time of the December 5, 2016 final decision on appeal. Thus, the Board is 

precluded from reviewing this evidence on appeal. See 20 C.F.R. § 501.2(c)(1). 

2

 5 U.S.C. § 8101 et seq. 
2

FACTUAL HISTORY 

On October 8, 2015 appellant, then a 47-year-old city carrier assistant, filed an 

occupational disease claim (Form CA-2) alleging that she sustained a leg condition causally 

related to walking in the performance of her federal employment. She stopped work on 

October 3, 2015. 

By letter dated October 15, 2015, the employing establishment indicated that appellant 

had been working for only five weeks as a city carrier assistant, and challenged the claim based 

on causal relationship. 

In a letter dated October 26, 2015, OWCP requested that appellant submit additional 

factual and medical evidence to support her claim for compensation. Appellant was afforded 30 

days to submit this additional evidence. 

Appellant submitted an October 26, 2015 note from Dr. Dane Wukich, a Board-certified 

orthopedic surgeon, who indicated that appellant was being treated for bilateral foot pain. In a 

note dated November 2, 2015, Dr. Wukich wrote that appellant was being treated for left 

posterior tibial tendinitis. He reported that she had been working with restrictions the prior four 

weeks, but could return to regular duty. Appellant also submitted a November 10, 2015 note 

from Dr. Wukich, which indicated that she was being treated for bilateral hallux rigidus and left 

posterior tibial tendon dysfunction. 

Appellant submitted a November 12, 2015 response to questions posed by OWCP as to 

her claim. According to her, she walked many hours delivering mail.3

 Appellant confirmed that 

her claim was based on continued incidents over more than one workday. 

By decision dated December 23, 2015, OWCP denied appellant’s claim for 

compensation. It found that the medical evidence of record was insufficient to establish a 

diagnosed condition casually related to factors of her federal employment. 

On February 8, 2016 appellant requested a hearing before an OWCP hearing 

representative. She submitted a November 10, 2015 report from Dr. Wukich, diagnosing 

bilateral hallux rigidus, posterior tibial tendon dysfunction, and bilateral foot pain. Dr. Wukich 

reported that appellant had pain in both feet, and x-rays confirmed that she has osteoarthritis of 

the hallux metatarsophalangeal (MTP) joint bilaterally. He opined that appellant’s “duties as a 

letter carrier aggravated her medical condition. Clearly appellant has an underlying arthritis.” 

According to Dr. Wukich, she reported that she had no problems with her left lower extremity 

prior to starting work at the employing establishment. 

A hearing was held on September 20, 2016. Appellant referred to an incident where she 

fell on uneven ground, but could not remember the date.4

 She also indicated that she intended to 

 3

 Appellant also described what appeared to a specific incident where she fell and twisted her foot, but she did not 

indicate when this occurred. 

4

 The hearing representative advised appellant that if she was claiming an injury from this incident, it would be a 

traumatic injury claim and a Form CA-1 could be submitted for that claim. 
3

submit additional medical evidence, and the hearing representative advised appellant that the 

case would be held open for 30 days. No further evidence was received. 

By decision dated December 5, 2016, the hearing representative affirmed the 

December 23, 2015 decision. She found that the medical evidence of record was insufficient to 

establish appellant’s claim for compensation. 

LEGAL PRECEDENT 

A claimant seeking benefits under FECA 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 that an injury was sustained in the performance of duty as alleged and that any specific 

condition or disability claimed is causally related to the employment injury.5

 

To establish that an injury was sustained in the performance of duty, a claimant must 

submit: (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 diagnosed condition is causally related to the 

employment factors identified by the claimant.6

 

Causal relationship is a medical question that can generally be resolved only by 

rationalized medical opinion evidence.7 A physician’s opinion on the issue of whether there is 

causal relationship between the claimant’s diagnosed condition and the implicated employment 

factors must be based on a complete factual and medical background of the claimant.8 

Additionally, the opinion must be expressed in terms of a reasonable degree of medical certainty, 

and must be supported by medical rationale, explaining the nature of the relationship between the 

diagnosed condition and appellant’s specific employment factors.9 

ANALYSIS 

In the present case, appellant filed a claim alleging that walking in the performance of her 

federal employment had contributed to foot and leg conditions. OWCP accepted that her 

employment as a city carrier assistant involved walking. 

Dr. Wukich diagnosed bilateral hallux rigidus, and posterior tibial tendon dysfunction. In 

the November 10, 2015 report, he opines that appellant’s employment aggravated her condition. 

Dr. Wukich did not provide a complete factual and medical history. A medical report is 

 5

 20 C.F.R. § 10.115(e), (f) (2005); see Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996). 

6 Ruby I. Fish, 46 ECAB 276, 279 (1994). 

7 See Robert G. Morris, 48 ECAB 238 (1996). 

8 Victor J. Woodhams, 41 ECAB 345, 352 (1989). 

9 Id. 
4

insufficient to establish appellant’s claim if the report is not based on a complete factual history. 

Dr. Wukich related in his November 2, 2015 report that appellant had worked with restrictions 

for the prior four weeks, but he never provided a history which related that appellant had only 

worked as a city carrier for five weeks prior to October 8, 2015.10 He did not demonstrate an 

understanding of appellant’s work duties, or discuss her employment history. Dr. Wukich’s 

opinion that work duties aggravated appellant’s condition is not accompanied by sound medical 

rationale.11 As such his opinion is of diminished probative value.

Furthermore, Dr. Wukich indicated that appellant had arthritis which was aggravated by 

her work duties. He did not however discuss in any detail the preexisting condition. The Board 

has long held that medical conclusions unsupported by rationale are of diminished probative 

value and are insufficient to establish causal relation.12 An opinion with respect to aggravation 

must differentiate between the effects of the work-related injury or disease and the preexisting 

condition.13 The Board has held that the physician must clearly explain the nature and extent of 

any aggravation, including whether temporary or permanent.14 The reference to appellant 

reporting she did not have problems with her left lower extremity prior to working at the 

employing establishment is not sufficient medical rationale. The Board has held that without 

supporting rationale, an opinion that a condition is causally related to an employment injury 

because the employee was asymptomatic before the injury, but symptomatic after it, is 

insufficient to establish causal relationship.15

It is appellant’s burden of proof to establish her claim. The Board finds appellant has not 

submitted sufficient evidence to meet her burden of proof in this case. 

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 has not met her burden of proof to establish an injury 

causally related to factors of her federal employment. 

 10 A.E., Docket No. 16-1803 (issued February 2, 2017). 

11 Id. 

12 See O.L., Docket No. 16-616 (issued October 24, 2016). 

13 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3(e) (January 2013). 

14 See R.H., Docket No. 15-1785 (issued January 29, 2016). 

15 See Cleopatra McDougal-Saddler, 47 ECAB 480 (1996) (because the employee is symptomatic after an injury 

is not sufficient to establish causal relationship without supporting rationale). 
5

ORDER 

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

Compensation Programs dated December 5, 2016 is affirmed. 

Issued: June 1, 2017 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy 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