United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

T.F., Appellant

and

U.S. POSTAL SERVICE, NATIONAL PRINT 

CENTER, Topeka, KS, Employer

__________________________________________

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Docket No. 19-1361

Issued: December 19, 2019

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

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 6, 2019 appellant filed a timely appeal from a May 22, 2019 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 binaural hearing

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

FACTUAL HISTORY

On February 25, 2017 appellant, then a 50-year-old print line operator, filed an 

occupational disease claim (Form CA-2) alleging that he sustained significant sensorineural 

binaural hearing loss due to factors of his federal employment. He noted that he had been directly 

 

1 5 U.S.C. § 8101 et seq.
2

exposed to “excessively loud noise” being produced from presses and machinery on a continuous

and constant basis throughout his eight-hour workday, 40 hours a week, and year after year for 30 

plus years. Appellant indicated that he first became aware of his condition on September 15, 2016

and its relationship to his federal employment on February 23, 2017. On the reverse side of the 

claim form, the employing establishment noted that he first reported his condition to his supervisor 

on February 28, 2017. 

Appellant submitted audiograms performed by the employing establishment as part of a 

hearing conservation program dated August 25, 1987 through July 27, 2016. 

Appellant also submitted a March 26, 2014 medical report from Kathleen Bogina, an 

audiologist. Ms. Bogina responded “yes” to the questions of whether he always wore hearing 

protection at work and that he had a normal bilateral appearing tympanic membrane evaluation 

with otoscopic screening. 

In a February 20, 2017 medical report, Dr. Justin Tourtillott, an audiologist, noted that 

appellant reported a history that he was exposed to noise while working for 30 years at the 

employing establishment. As a press operator appellant was exposed to high levels of noise on a 

daily basis. He indicated that noise level surveys showed several areas of the plant where noise 

levels were damaging to hearing, especially around the Didde line. Appellant also reported 

consistent use of hearing protection at work. Oftentimes he wore double protection (foam plugs 

and earmuffs), but he still developed a headache from the constant noise exposure. Appellant had

intermittent bilateral tinnitus and difficulty hearing family and friends. He denied any noise 

exposure outside the workplace and was not aware of any family history of hearing loss. Appellant

maintained that baseline hearing testing from 1987 showed good hearing in both ears.

Dr. Tourtillott reported an unremarkable otoscopic examination. On audiological examination, he 

reported that test results suggested moderate sloping to severe sensorineural hearing loss, 

bilaterally, slightly worse in the right ear. Type A tympanograms were noted bilaterally suggesting 

normal middle ear function. Reduced speech discrimination ability was also noted bilaterally. 

Dr. Tourtillott provided an impression of significant sensorineural hearing loss in both ears 

consistent with prolonged exposure to noise. He opined that appellant’s hearing loss was primarily 

due to work-related noise exposure at the employing establishment. Dr. Tourtillott recommended

hearing aids and indicated that he would benefit from custom hearing protection.

An unsigned statement dated March 1, 2017, indicated that appellant was a computer print 

line production operator which required him to spend approximately five hours daily working on 

a print line while wearing mandatory hearing protection. His work schedule was Monday through 

Friday from 7:30 a.m. to 4:00 p.m.

OWCP, in a development letter dated March 10, 2017, requested information from the 

employing establishment, including the locations of appellant’s job sites where the alleged

exposure occurred, sources of exposure to noise and machinery, the decibel and frequency level

(to include a noise survey report for each job site) and period of exposure, the types of ear 

protection and noise attenuation in decibels if known, and copies of all medical examinations 

pertaining to hearing or ear problems, including preemployment examination, and all audiograms. 

It also requested employment data and the date of last exposure to hazardous noise and the pay 

rate in effect on that date. OWCP afforded the employing establishment 30 days to respond. 
3

OWCP subsequently received statements dated March 8, 2017, wherein C.S., appellant’s 

former supervisor, and G.G., a computer maintenance supervisor, controverted appellant’s claim. 

They each noted that the employing establishment had a hearing conservation program since 1984. 

The hearing conservation program required mandatory hearing protection for Didde and mail 

handler operators for lines 3 and 2. Hearing protection became mandatory in other areas in 2012. 

It was also recommended, but not mandatory, that operators in the offset press and pressure 

sensitive areas wear hearing protection. Hearing testing was performed yearly for all mail handlers 

who were operators or rotated as operators. Based on consultation with an industrial hygienist 

there were no known issues with the hearing conservation program. C.S. and G.G. indicated that 

appellant rotated as an operator with three other employees in April 2010. 

OWCP subsequently received a noise survey report dated November 2016 and a copy of 

appellant’s official computer print line production operator position description.

In a May 2, 2017 e-mail, E.D., an employing establishment manager, responded to 

OWCP’s March 10, 2017 development letter. He noted that appellant was exposed to noise when 

he worked on Lines 1 and 3 as an operator and a packer/shipper and used a Heidelberg Didde 

press. E.D. related, however, that employees were responsible for wearing hearing protection in 

accordance with the employing establishment hearing conservation program and were not 

continuously exposed to such noise for eight hours a day. They were provided two 10-minute 

breaks and a 30-minute lunch break. 

OWCP received additional audiograms dated November 18, 2005 through March 26, 2014 

and an undated audiogram performed by the employing establishment as part of its hearing 

conservation program. 

In an April 25, 2017 report, Dr. Tourtillott reiterated his prior diagnosis of noise-induced 

binaural hearing loss. 

By letter dated June 30, 2017, QTC Medical Services, OWCP’s scheduling contractor, 

referred appellant, together with a statement of accepted facts (SOAF), the medical record, and an 

otologic evaluation questionnaire, for a second opinion evaluation with Dr. Jay A. Dunfield, a 

Board-certified otolaryngologist. 

In a June 14, 2017 report, Dr. Dunfield reviewed the SOAF, examined appellant, and 

completed the questionnaire. His report included an audiogram taken on June 15, 2017 in which 

it noted measurements at the frequencies of 500, 1,000, 2,000, and 3,000 Hertz (Hz). The right 

ear losses were recorded as 40, 45, 30, and 55 decibels (dBs), respectively; the left ear losses were 

recorded as 35, 35, 30, and 35 dBs, respectively. In response to the evaluation questionnaire,

Dr. Dunfield noted physical examination findings. He diagnosed sensorineural hearing loss due 

to noise exposure encountered in appellant’s federal civilian employment. Dr. Dunfield reasoned 

that his noise exposure was significant enough to cause his hearing loss. He indicated that there 

was no other history to suggest other potential causes. Dr. Dunfield recommended hearing aids 

and hearing conservation. 

On June 30, 2017 QTC Medical Services notified OWCP that appellant was only noise free 

for two hours prior to his examination by Dr. Dunfield although he wore earplugs. In a July 25, 
4

2017 letter, OWCP advised appellant that he was required to avoid exposure to hazardous noise 

16 hours prior to his second opinion examination. On July 26, 2017 QTC Medical Services again 

referred appellant to Dr. Dunfield for another second opinion evaluation regarding causal 

relationship between his hearing loss and federal employment. 

Dr. Dunfield, in an August 14, 2017 report, noted appellant’s history and complaints. He 

reviewed an audiogram performed on the same day which indicated that appellant was free from 

noise exposure for 16 hours prior to testing. Dr. Dunfield again diagnosed work-related 

sensorineural hearing loss. 

On October 29, 2017 Dr. Jeffrey M. Israel, a Board-certified otolaryngologist serving as 

an OWCP district medical adviser (DMA), reviewed the SOAF and appellant’s medical records, 

including Dr. Dunfield’s reports. He noted that the August 14, 2017 audiogram revealed moderate 

hearing loss bilaterally across the board. Dr. Israel related that this was not the typical pattern seen 

with a noise-induced work-related acoustic trauma. He found that, in accordance with the sixth 

edition of the American Medical Association, Guides to the Evaluation of Permanent Impairment2

(A.M.A., Guides), appellant had 35.625 percent monaural hearing loss in both ears, which he 

rounded to a “35.6” percent binaural hearing loss. Dr. Israel determined that he reached maximum 

medical improvement (MMI) on August 14, 2017. He recommended yearly audiograms, noise 

protection for the ears, and authorization for hearing aids.

On November 2, 2017 OWCP requested that Dr. Israel clarify his prior report. It requested 

that he review Dr. Dunfield’s June 14 and August 14, 2017 reports and state whether he agreed 

with his findings. OWCP also requested that he note that Dr. Dunfield’s reports provided valid 

results and consistent effort by appellant. 

In another report dated October 29, 2017, Dr. Israel reiterated that the August 14, 2017 

audiogram showed a moderate loss across the board bilaterally. He noted that it differed from 

appellant’s past audiograms. Dr. Israel indicated audiograms performed on March 7 and 23, 2006 

had significant differing results. He further indicated that a July 27, 2016 audiogram showed 

severe to profound loss across the board in the right ear. The left ear had moderate hearing loss 

from 500 Hz to 3 kilohertz (KHZ) followed by a drop to severe loss at 6 to 8 KHZ. Dr. Israel 

related that he was concerned with how this compared to the August 14, 2017 audiogram and, 

therefore, he was not sure about its validity. He related that perhaps a Stenger test might determine 

whether there was malingering. Dr. Israel suggested that at least two other audiograms be 

performed to see how consistent they were with the August 14, 2017 audiogram. He stood by his 

previous comment that this was not the typical pattern seen with a noise-induced work-related 

acoustic trauma.

On November 21, 2017 QTC Medical Services again referred appellant to Dr. Dunfield for 

an additional otologic evaluation. 

In a December 13, 2017 supplemental report, Dr. Dunfield noted no change in appellant’s 

job requirements or responsibilities, noise exposure, use of hearing protection, and symptom 

complaints. He discussed findings on physical examination. Dr. Dunfield reiterated his prior 

 

2 A.M.A., Guides (6th ed. 2009).
5

diagnosis of binaural sensorineural hearing loss. He reviewed prior auditory brainstem response

(ABR) test results and opined that these results were inadequate for hearing interpretation. 

Dr. Dunfield reasoned that first, the waveforms were too difficult to interpret correctly and the 

stimulus was a click, so no pure tone thresholds could be performed (the stimulus should be tone 

burst so hearing thresholds could be confirmed and determined whether they matched appellant’s 

previous audiograms). He advised that overall this limited ABR did not answer the question of 

where real thresholds lie. Dr. Dunfield recommended a threshold search with a tone burst ABR 

and otoacoustic emission (OAE) match. 

On February 2, 2018 QTC Medical Services referred appellant to Dr. Laina M. Burdiek, 

an audiologist. In a letter dated February 6, 2018, Dr. Burdiek noted that an otoscopic examination 

was unremarkable and that ABR testing was normal. 

On March 6, 2019 QTC Medical Services referred appellant to Dr. Mary Horsch, an 

audiologist, for additional ABR and OAE testing. On March 21, 2019 Dr. Horsch reported that 

ABR/OAE results suggested near normal hearing through 2,000 Hz bilaterally with a mild high 

frequency loss from 3,000 to 4,000 Hz. 

Dr. Dunfield, in addendum reports dated March 28 and April 19, 2019, discussed findings 

on physical examination. He noted that he reviewed Dr. Horsch’s ABR/OAE test findings and 

agreed with her interpretation that appellant had normal threshold responses through 2,000 Hz and 

a slight hearing loss at 4,000 Hz consistent with normal aging of hearing. Dr. Dunfield advised 

that he did not have any significant hearing loss and that the previous pure tone audiograms should 

be disregarded and considered inaccurate. He concluded that, appellant had no significant hearing 

loss directly caused by his work-related noise exposure. 

By decision dated May 22, 2019, OWCP denied the claim, finding that the medical 

evidence of record was insufficient to establish that appellant’s hearing loss was causally related 

to his accepted workplace noise exposure. It afforded the weight of the evidence to Dr. Dunfield. 

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 timely filed within the applicable

time limitation period of FECA,4and that an injury was sustained in the performance of duty as

alleged, and that any disability or medical condition for which compensation is claimed is causally

related to the employment injury.5 These are the essential elements of each and every

 

3

Id.

4 S.C., Docket No. 18-1242 (issued March 13, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 

ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

5 T.H., Docket No. 18-1736 (issued March 13, 2019); J.M., Docket No. 17-0284 (issued February 7, 2018); R.C.,

59 ECAB 427 (2008); James E. Chadden, Sr., 40 ECAB 312 (1988).
6

compensation claim, regardless of whether the claim is predicated upon a traumatic injury or an

occupational disease.6

To establish that, an injury was sustained in the performance of duty in an occupational

disease claim, a claimant must submit the following: (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

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.7

Neither the condition becoming apparent during a period of employment, nor the belief of

the employee that the hearing loss was causally related to noise exposure in federal employment,

is sufficient to establish causal relationship.8 The medical evidence required to establish causal

relationship is rationalized medical opinion evidence.9 Rationalized medical opinion evidence is

medical evidence which includes a physician’s rationalized opinion on the issue of whether there

is 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.10

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish binaural hearing 

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

In order to determine the causal relationship, if any, between appellant’s claimed hearing 

loss and the accepted factors of his federal employment, OWCP referred him, along with the case 

record, a SOAF, and a list of questions to Dr. Dunfield for a second opinion examination. On 

June 14, 2017 Dr. Dunfield examined appellant and reviewed the medical record, including the

audiogram performed on his behalf. He diagnosed binauralsensorineural hearing loss due to workrelated noise exposure and recommended binaural hearing aids and hearing conservation. OWCP 

subsequently determined that additional otologic and audiological evaluations were necessary 

because appellant was not free from noise exposure for at least 16 hours before his examination 

by Dr. Dunfield. On August 14, 2017 Dr. Dunfield reexamined appellant as directed by OWCP 

 

6 T.E., Docket No. 18-1595 (issued March 13, 2019); K.M., Docket No. 15-1660 (issued September 16, 2016); L.M.,

Docket No. 13-1402 (issued February 7, 2014); Delores C. Ellyett, 41 ECAB 992 (1990).

7 Supra note 4.

8 C.C., Docket No. 18-1229 (issued March 8, 2019).

9 M.B., Docket No. 17-1999 (issued November 13, 2018).

10 M.L., Docket No. 18-1605 (issued February 26, 2019).
7

and reviewed an audiogram performed on that same day. He reiterated his prior diagnosis of workrelated binaural sensorineural hearing loss. 

On October 29, 2017 Dr. Israel, OWCP’s DMA, reviewed the SOAF and appellant’s 

medical records, including Dr. Dunfield’s reports and the August 14, 2017 audiogram. He 

concluded that, in accordance with the sixth edition of the A.M.A., Guides, appellant had 35.6 

percent binaural hearing loss. While Dr. Israel noted that the August 14, 2017 audiogram revealed 

moderate hearing loss bilaterally across the board, he maintained that this was not the typical 

pattern seen with a noise-induced work-related acoustic trauma. He determined that appellant had 

reached MMI on August 14, 2017 recommended yearly audiograms, noise protection for the ears, 

and requested authorization for hearing aids. 

OWCP obtained a supplemental report from Dr. Israel, who recommended additional 

audiological testing because earlier audiograms were not consistent with the August 14, 2017 

audiogram findings. 

On December 13, 2017 Dr. Dunfield again examined appellant and continued to diagnose 

binaural sensorineural hearing loss. He reviewed prior ABR test results and explained why these 

results were inadequate for hearing interpretation. Dr. Dunfield recommended additional testing 

with ABR testing along with OAE testing. 

In addendum reports dated March 28 and April 19, 2019, Dr. Dunfield reviewed

Dr. Horsch’s March 21, 2019 ABR and OAE test results and agreed with her interpretation that 

the test results revealed near normal hearing through 2,000 Hz bilaterally and a slight hearing loss 

at 4,000 Hz consistent with normal aging of hearing. He opined that appellant had no significant 

hearing loss directly caused by his work-related noise exposure. 

The Board finds that Dr. Dunfield’s March 28 and April 19, 2019 reports represent the 

weight of the medical evidence and establish that appellant’s binaural hearing loss was not due to 

exposure to noise in the workplace.11 Dr. Dunfield’s opinion is based on a proper factual and 

medical history as he reviewed current and previous audiometric test results and related his 

findings on examination and testing in support of his opinion that appellant’s hearing loss was not 

due to the noise in his federal employment.12

Although audiologist Dr. Tourtillott offered an opinion on causal relationship, his opinion 

is of no probative value because audiologists are not considered qualified physicians within the 

meaning provided by FECA.13 Moreover, the employing establishment audiograms do not 

constitute probative medical evidence as they lack proper certification of calibration, speech 

 

11 R.M., Docket No. 18-1801 (issued March 25, 2019); R.B., Docket No. 18-0720 (issued November 13, 2018); 

R.J., Docket No. 11-1644 (issued February 14, 2012); J.L., Docket No. 07-1740 (issued December 20, 2007).

12 R.M., id.; R.B., id.; T.T., Docket No. 17-0471 (issued August 8, 2017).

13 See H.M., Docket No. 19-0188 (issued April 26, 2019); Thomas Lee Cox, 54 ECAB 509 (2003) (an audiologist 

is not defined as a physician under 5 U.S.C. § 8101(2) and an opinion of an audiologist cannot be considered a medical 

opinion by a qualified physician).
8

testing, and bone conduction scores and were not prepared or certified as accurate by a physician 

as defined under FECA.14

As the record in the instant case is devoid of rationalized medical opinion evidence 

attributing appellant’s hearing loss to his accepted employment exposure, the Board finds that he

has not established that his claimed binaural hearing loss is causally related to the accepted factors 

of his federal employment.15 Accordingly, appellant has not met his burden of proof to establish 

his claim.

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 his burden of proof to establish binaural hearing 

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

 

14 See R.M., supra note 11; R.B., Docket No. 18-0720 (issued November 13, 2018); M.I., Docket No. 16-0759 

(issued June 10, 2016).

15 Id.
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ORDER

IT IS HEREBY ORDERED THAT the May 22, 2019 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: December 19, 2019

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board