United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

V.S., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

San Diego, CA, Employer

__________________________________________

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Docket No. 17-1926

Issued: February 20, 2018

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

PATRICIA H. FITZGERALD, Deputy Chief Judge

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On September 12, 2017 appellant, through counsel, filed a timely appeal from a May 15, 

2017 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 has met her burden of proof to establish bilateral hand and 

feet arthritic conditions causally related to the accepted 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

FACTUAL HISTORY

On February 9, 2017 appellant, then a 53-year-old rural mail carrier, filed an occupational 

disease claim (Form CA-2) alleging that the arthritis in her hands and feet had been aggravated 

by her federal employment duties. She stopped work on January 18, 2017. 

A December 13, 2016 x-ray interpretation of appellant’s feet revealed severe right foot 

first metatarsophalangeal joint (MTP) osteoarthritis, some second and third MTP osteoarthritic 

changes, right proximal interphalangeal joint erosive osteoarthritis, and some left foot first MTP 

space narrowing. 

In a Januuary 13, 2017 duty status report (Form CA-17), Dr. James Italiano, a treating 

Board-certified family practitioner, diagnosed severe pain due to erosive bilateral hand and foot 

osteoarthritis. He opined that appellant’s work duties of operating her mail vehicle and repetitive 

use of hands and wrists with handling mail aggravated her conditions. Work restrictions were 

provided.

In a January 16, 2017 report, Dr. Italiano diagnosed debilitating arthritis. He noted 

appellant’s condition has been present for over 10 years. Dr. Italiano explained that her arthritic 

condition was erosive in nature and aggravated by repetitive overuse. He recommended that 

appellant limit her work to an eight-hour shift with restrictions. The restrictions included no 

lifting over 20 pounds lifting, no running, jumping, jogging, kneeling, or squatting, and limited

grabbing and gripping.

In a February 8, 2017 report, Dr. Jeffrey Schiffman, a Board-certified orthopedic 

surgeon, detailed appellant’s employment and medical histories, and noted that appellant had 

experienced increasing complaints of hand and foot pain for the past five years. Appellant’s

physical examination revealed swollen finger joints with chronic soft tissue changes, severe right 

foot arthritis, and no significant left foot arthritis. Dr. Schiffman diagnosed erosive arthritis in 

the fingers, bilateral foot arthritis, and bilateral hand arthritis. 

Dr. Schiffman, in a February 8, 2017 Form CA-17, detailed appellant’s work restrictions. 

Diagnoses included bilateral hand and foot arthritis. Dr. Schiffman again opined that appellant 

sustained injury due to her work duties of entering and exiting the mail vehicle, frequent standing 

and walking long periods of time, and repetitive use of hands and wrists while handling mail. 

In a February 9, 2017 statement, appellant related that she first became aware of her right 

hand stiffness on May 1, 2011. She noted that her work entailed repetitive work which caused 

her hands and feet to hurt. The repetitive work included grasping large piles of mail at least 60 

times per day, jumping in and out of a postal vehicle, grasping slippery mail, and walking up 

long driveways. Appellant related her belief that her conditions had been aggravated by her 

repetitive work duties.

By development letter dated February 24, 2017, OWCP informed appellant that the 

evidence of record was insufficient to support her claim. It advised her regarding the medical 

and factual evidence needed to establish her claim. Appellant was afforded 30 days to provide 

the requested evidence. 
3

In reports dated February 22 and March 13, 2017, Dr. Schiffman noted appellant was 

evaluated that day for bilateral hand arthritis. Physical examination findings remained 

unchanged. In the March 13, 2017 narrative report, Dr. Schiffman detailed appellant’s 

employment and medical histories. He described the duties appellant performed as a mail carrier 

for the past five years. Dr. Schiffman reviewed x-ray interpretations which showed bilateral 

hand arthritis with finger erosions and bilateral first metatarsophalangeal. He opined that her

repetitive work with her hands aggravated her bilateral hand arthritis and that her constant 

walking aggravated her bilateral foot arthritis.

By decision dated May 15, 2017, OWCP denied appellant’s claim as it found the medical 

evidence of record insufficient to establish causal relationship between the diagnosed medical 

conditions and the accepted employment factors, which include repetitive grasping, jumping in 

and out of a mail vehicle, handling of mail, and frequent standing and walking long periods of 

time.

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 

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 causal relationship between the employee’s diagnosed condition and the 

 

3

Id.

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. 10-0144 (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).
4

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

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

accepted factors of her federal employment caused or aggravated her diagnosed medical 

conditions. Appellant identified the factors of employment that she believed caused her 

conditions, including repetitive grasping, operating her mail vehicle, handling of mail, and 

frequent standing and walking long periods of time. OWCP accepted these factors as factual. 

However, in order to establish a claim for an employment-related injury, she must also submit 

rationalized medical evidence which explains how or why her medical conditions were caused or 

aggravated by the accepted employment factors.10

Drs. Italiano and Schiffman both opined that appellant’s bilateral hand and foot arthritis 

had been aggravated by her repetitive job duties. In a January 16, 2017 report and Form CA-17,

Dr. Italiano diagnosed erosive arthritis, which he believed had been aggravated by her repetitive 

work duties or repetitive overuse. On February 8 and 22 and March 13, 2017 Dr. Schiffman 

diagnosed erosive finger arthritis, bilateral foot arthritis, and bilateral hand arthritis. He opined 

that the diagnosed conditions had been aggravated by appellant’s work duties of jumping in and 

out of a mail vehicle, repetitive handling of mail, and frequent standing and walking. However, 

both physicians offered only conclusory opinions. The Board has previously held that mere 

conclusory statements, not fortified by explanation, are insufficient to establish causal 

relationship between employment factors and diagnosed conditions.

11

 Without further 

explaining how physiologically the movements involved in appellant’s employment duties 

caused or contributed to the diagnosed conditions, these opinions on causal relationship are of 

limited probative value.12

Appellant also submitted a December 13, 2016 x-ray in support of her claim. The x-ray 

report is insufficient to establish her claim as it is merely a diagnostic report and contains no 

opinion as to the cause of the medical conditions identified on x-ray.13

As appellant has not submitted any rationalized medical evidence to support her 

allegation that her diagnosed arthritic conditions of the hands and feet were causally related to 

the accepted employment factors, she failed to meet her burden of proof.

 

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).

10 See V.U., Docket No. 17-0860 (issued July 26, 2017); A.C., Docket No. 08-1453 (issued November 18, 2008).

11 N.M., Docket No. 010-0283 (issued August 19, 2010).

12 See S.C., Docket No. 17-0103 (issued May 2, 2017).

13 T.D., Docket No. 17-0649 (filed June 16, 2017).
5

On appeal counsel blanketly 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 without substance and are not substantiated.

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

Appellant has not met her burden of proof to establish bilateral hand and feet arthritic 

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

ORDER

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

Compensation Programs dated May 15, 2017 is affirmed.

Issued: February 20, 2018

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board