United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.K., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Lake Zurich, IL, Employer 

__________________________________________ 

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Docket No. 16-1772 

Issued: February 6, 2017 

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 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On September 2, 2016 appellant, through counsel, filed a timely appeal from an 

August 8, 2016 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 over the merits of this case. 

ISSUE 

The issue is whether appellant has met her burden of proof to establish a left shoulder 

injury causally related to a December 2, 2014 employment incident. 

 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

On appeal, counsel contends that OWCP’s decision is contrary to fact and law. 

FACTUAL HISTORY 

On December 5, 2014 appellant, then a 50-year-old mail carrier, filed an occupational 

disease claim (Form CA-2) alleging a left shoulder injury as a result of performing physical 

activities at work such as lifting. She first became aware of her condition on December 2, 2014 

and first realized that it was caused by her employment on December 3, 2014. Appellant stopped 

work on December 3, 2014. 

In a note dated December 4, 2014, Dr. Monica E. Gavran, an attending Board-certified 

internist, placed appellant off work. Appellant also submitted an illegible duty status form report 

(Form CA-17). 

By letter dated December 16, 2014, OWCP advised appellant of the deficiencies of her 

claim and afforded her 30 days to submit additional evidence. 

In a December 5, 2014 attending physician’s report (Form CA-20), Dr. Gavran provided 

a history that on December 2, 2014 appellant felt severe pain in her left shoulder while lifting a 

heavy package. She provided findings on examination and diagnosed shoulder 

impingement/rotator cuff injury. Dr. Gavran checked a box marked “yes” indicating that 

appellant’s condition was caused or aggravated by an employment activity. She indicated that 

appellant was totally disabled commencing on December 3, 2014. 

Work status reports dated December 12, 2014 and January 9, 2015 from Dr. Justin J. 

Gent, an attending Board-certified orthopedic surgeon, noted a date of injury as December 2, 

2014 and provided diagnoses of left shoulder pain, left shoulder partial thickness bursal-sided 

rotator cuff tear, and possible superior labrum anterior to posterior (SLAP) tear. He advised that 

appellant could not return to work. 

In a December 30, 2014 narrative statement, appellant described the claimed incident. 

On December 2, 2014 she was delivering mail and lots of packages on her regular route and 

when she moved packages for delivery forward in her truck, she felt a snap in her left shoulder. 

Appellant did not immediately feel pain, but knew something was not right. She continued to 

deliver all of her mail that day. Appellant did not know that she should have reported her injury 

because she had not realized the seriousness of her injury at that time. On the next day at 

4:00 a.m., she was awakened by excruciating pain in her shoulder and neck. Appellant called 

into work at 5:00 a.m. and requested unscheduled sick leave. 

In an undated narrative statement, J.A., an employee, controverted appellant’s claim on 

behalf of the employing establishment. She noted that on December 3, 2014 appellant called in 

sick for two days. Appellant went to her physician who told her she had an on-the-job injury. 

She notified the employing establishment about her condition. The employing establishment 

gave appellant a Form CA-2 because she could not point to any specific cause of her injury. J.A. 

noted the Form CA-20 (attending physician’s) report, which found that appellant’s injury was 

caused by lifting a heavy package and contended that this was never conveyed to anyone at 

work. 
3

By decision dated January 16, 2015, OWCP considered appellant’s claim as one for a 

traumatic injury and accepted that the December 2, 2014 work incident occurred as alleged. 

However, it denied her claim because the medical evidence of record did not contain a 

rationalized medical opinion to establish a causal relationship between her diagnosed condition 

and the accepted employment incident. 

Appellant continued to submit medical evidence. In a December 10, 2014 left shoulder 

magnetic resonance imaging (MRI) scan report, Dr. Scott S. White, a Board-certified radiologist, 

found evidence of a fairly significant deep bursal surface partial-thickness tear involving the 

posterior margin of the supraspinatus tendon near the myotendinous junction as it overlaid the 

humeral head. He also found associated edema of the posterior aspect of the supraspinatus 

muscle without significant appearing tendon retraction. There was tendinosis of the 

supraspinatus tendon more anteriorly and distally at its insertion, subscapularis tendinosis 

without evidence of a frank tear, and suspected low-grade SLAP lesion. 

In a January 9, 2015 report, Dr. Gent noted a history of the December 2, 2014 

employment incident and appellant’s continuing left shoulder symptoms and treatment. He 

reported findings on examination and assessed left shoulder pain after an injury that occurred at 

work on December 2, 2014, partial thickness rotator cuff tear, and possible SLAP tear. Dr. Gent 

was concerned that appellant’s condition was worsening and recommended additional diagnostic 

testing. He also kept her off work. In a January 13, 2015 report, Dr. Gent noted that physical 

examination was unchanged. He reviewed MRI scan results which showed a complete tear of 

the supraspinatus tendon that appeared significantly worse. Dr. Gent related that there was also 

muscle contusion in the rotator cuff and a large glenohumeral joint effusion. He reiterated his 

prior left shoulder diagnoses of left shoulder pain from an injury at work on December 2, 2014, 

partial thickness rotator cuff tear, and possible SLAP tear. Dr. Gent found that appellant could 

not return to work. He restated these diagnoses and his opinion regarding her disability in a 

January 13, 2015 work status report. 

In a January 12, 2015 left shoulder MRI scan report, Dr. Linda L. Dew, a Board-certified 

radiologist, found a complete supraspinatus tear at the distal insertion rotator cuff tendinosis. 

She also found a contusion supraspinatus muscle, downward sloping of the lateral aspect of the 

distal acromion, and Type 1 acromion. There was fluid in the subacromial/subdeltoid bursa, 

large glenoid humeral joint effusion with very severe tenosynovitis, and a bone contusion in the 

lateral two thirds of the humeral head. Dr. Dew reported that the remainder of the study was 

unremarkable. 

A February 4, 2015 operative report indicated that Dr. Gent performed left shoulder 

arthroscopy with an arthroscopic rotator cuff repair and extensive debridement of synovitis 

biceps tendon including, biceps tenotomy, and subacromial space adhesions. 

On February 19, 2015 appellant requested a review of the written record by an OWCP 

hearing representative. 

In a June 15, 2015 decision, an OWCP hearing representative affirmed the January 16, 

2015 decision, finding that appellant failed to submit rationalized medical evidence sufficient to 
4

establish that her left shoulder condition was causally related to the December 2, 2014 work 

incident. 

OWCP received an October 9, 2015 work status report in which Dr. Gent reiterated his 

prior left shoulder diagnoses and noted appellant’s February 9, 2015 left shoulder surgery. 

Dr. Gent diagnosed left shoulder adhesive capsulitis with subacromial and subdeltoid bursitis 

with loculation and a small anterior supraspinatus, recurrent SLAP tear on a May 13, 2015 MRI 

scan, and status post left shoulder incision and drainage for deep abscess and neurotoma on 

January 15, 2015. He advised that appellant could not return to work.3

 

On December 2, 2015 appellant appealed the January 15, 2016 OWCP decision to the 

Board. On January 11, 2016 she requested that the appeal be dismissed. By order dated May 4, 

2016, the Board granted appellant’s request for dismissal of her appeal. 

OWCP received a March 24, 2016 work status report from Dr. Gent who provided a 

diagnosis of status post left shoulder scope and debridement. He again found that appellant was 

unable to return to work. 

On May 12, 2016 appellant, through counsel, requested reconsideration of OWCP’s 

June 15, 2015 decision and submitted additional medical evidence. In progress notes dated 

December 14, 2014 and January 30, 2015 and a report dated July 15, 2015, Dr. Gavran noted 

appellant’s history and provided results on examination. She again assessed left shoulder 

impingement and left shoulder rotator cuff tear. Dr. Gavran also assessed left shoulder adhesion. 

In a December 16, 2015 letter, she restated appellant’s history. Dr. Gavran diagnosed left 

shoulder recurrent rotator cuff tear with left shoulder infection and glenohumeral 

chondromalacia with significant impairment in appellant’s movement. She related that recovery 

seemed to be minimal and appellant’s situation was worsening since her injury had occurred. 

Appellant was unable to lift with her left shoulder and return to her work at the employing 

establishment. 

In a December 21, 2015 report, Dr. Gent noted a history of injury of the December 2, 

2014 employment incident and appellant’s symptoms. He reported examination results and 

noted diagnostic tests performed. Dr. Gent diagnosed status post left shoulder arthroscopy, 

rotator cuff repair, and extensive debridement performed on February 4, 2015. He also 

diagnosed status post left shoulder incision and drainage for deep abscess and hematoma 

performed on July 15, 2015. Dr. Gent signed his name below a form statement and advised that 

“the facts of injury” were “the direct and proximate cause” of the above-noted diagnosis. 

In a June 3, 2016 work status report, Dr. Anthony A. Romeo, a Board-certified 

orthopedic surgeon, indicated that appellant was currently under his medical care and that she 

had undergone shoulder surgery on May 24, 2016. He related that she would remain off work 

for six weeks postoperative. 

By decision dated August 8, 2016, OWCP denied modification of its June 15, 2015 

decision. It found that the medical evidence of record was not sufficiently rationalized to 

 3

 Docket No. 16-0287 (issue May 4, 2016). 
5

establish that appellant’s left shoulder condition was caused by the accepted December 2, 2014 

employment incident. 

LEGAL PRECEDENT 

An employee 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 

evidence4

 including that he or she sustained an injury in the performance of duty and that any 

specific condition or disability for work for which he or she claims compensation is causally 

related to that employment injury.5

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, it first must be determined whether fact of injury has been established.6

 

There are two components involved in establishing the fact of injury. First, the employee must 

submit sufficient evidence to establish that she actually experienced the employment incident at 

the time, place, and in the manner alleged.7

 

The second component is whether the employment incident caused a personal injury and 

generally can be established only by medical evidence.8 The evidence required to establish 

causal relationship is rationalized medical opinion evidence, based upon complete factual and 

medical background, showing a causal relationship between the claimed condition and the 

identified factors.9 The belief of the claimant that a condition was caused or aggravated by the 

employment is insufficient to establish a causal relationship.10

ANALYSIS 

The Board finds that appellant has not met her burden of proof to establish that she 

sustained a traumatic injury caused or aggravated by the accepted December 2, 2014 

employment incident. Appellant failed to submit sufficient medical evidence to establish that 

she had a left shoulder injury causally related to the accepted employment incident. 

Dr. Gavran’s December 5, 2014 Form CA-20 report provided a history of the 

December 2, 2014 work incident and diagnosed shoulder impingement/rotator cuff injury. She 

checked a box marked “yes” indicating that the condition was caused or aggravated by an 

 4 J.P., 59 ECAB 178 (2007); Joseph M. Whelan, 20 ECAB 55, 58 (1968). 

5 G.T., 59 ECAB 447 (2008); Elaine Pendleton, 40 ECAB 1143, 1145 (1989). 

6 S.P., 59 ECAB 184 (2007); Alvin V. Gadd, 57 ECAB 172 (2005). 

7 Bonnie A. Contreras, 57 ECAB 364 (2006); Edward C. Lawrence, 19 ECAB 442 (1968). 

8 John J. Carlone, 41 ECAB 354 (1989); see supra note 2 at § 8101(5) (injury defined); 20 C.F.R. §§ 10.5(ee), 

10.5(q) (traumatic injury and occupational disease defined, respectively). 

9 Lourdes Harris, 45 ECAB 545 (1994); see Walter D. Morehead, 31 ECAB 188 (1979). 

10 Kathryn Haggerty, 45 ECAB 383, 389 (1994). 
6

employment activity and found that appellant was totally disabled commencing on 

December 3, 2014. However, the Board has held that a checkmark, without supporting rationale, 

is of limited probative value, and is insufficient to establish the claim.11 Dr. Gavran did not 

explain how appellant’s diagnosed condition and resultant disability were caused or contributed 

to by the accepted work incident. While her remaining prescription, progress notes, and reports 

dated December 4, 2014 to December 16, 2015 noted a history of the December 2, 2014 

employment incident and noted diagnoses, she did not opine whether appellant’s conditions and 

resultant disability were caused by the accepted employment incident.12 Thus, the Board finds 

that Dr. Gavran’s reports are insufficient to meet appellant’s burden of proof. 

The remaining medical evidence is also insufficient to establish causal relationship 

between appellant’s injury and the December 2, 2014 employment incident. Dr. Gent assessed 

left shoulder conditions including rotator cuff tear and possible SLAP tear, which he generally 

attributed to the accepted work incident and found that appellant could not work. In a 

December 21, 2015 report, he noted a history of injury of the December 2, 2014 employment 

incident and appellant’s symptoms. Dr. Gent signed his name below a form statement advised 

that “the facts of injury” were “the direct and proximate cause” of the above-noted diagnosis. He 

did not provide a probative, rationalized opinion regarding whether the December 2, 2014 

employment incident caused a personal injury.13 Dr. Gent did not sufficiently explain the 

reasons why, medically, appellant would have sustained a left shoulder injury that resulted in her 

disability and surgery because she lifted heavy packages at work on December 2, 2014. 

Therefore, his reports are of limited probative value. 

Similarly, the diagnostic test results from Dr. White and Dr. Dew are of limited probative 

value. These two physicians failed to offer an opinion on whether these conditions were caused 

or aggravated by the accepted December 2, 2014 employment incident.14 Likewise, 

Dr. Romeo’s report failed to provide an opinion as to whether appellant’s May 24, 2016 shoulder 

surgery and postoperative disability were causally related to the accepted work incident. 

The Board finds that appellant has failed to submit rationalized, probative medical 

evidence sufficient to establish that she sustained a left shoulder injury causally related to the 

December 2, 2014 employment incident. Appellant therefore did not meet her burden of proof. 

On appeal, counsel contends that OWCP’s decision is contrary to fact and law. For the 

reasons stated above, the Board finds that the weight of the medical evidence does not establish 

that appellant sustained a left shoulder condition causally related to the accepted December 2, 

2014 work incident. 

 11 See D.S., Docket No. 15-1930 (issued January 30, 2016). 

12 A.D., 58 ECAB 159 (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). 

13 See George Randolph Taylor, 6 ECAB 986, 988 (1954) (where the Board found that a medical opinion not 

fortified by medical rationale is of little probative value). 

14 See supra note 12. 
7

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 failed to meet her burden of proof to establish a left 

shoulder injury causally related to a December 2, 2014 employment incident. 

ORDER 

IT IS HEREBY ORDERED THAT the August 8, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: February 6, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board