United States Department of Labor

Employees’ Compensation Appeals Board

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M.L., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

HUDSON VALLEY HEALTH CARE SYSTEM, 

Wappinger Falls, NY, Employer

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Docket No. 18-1605

Issued: February 26, 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

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On August 20, 2018 appellant filed a timely appeal from a July 25, 2018 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 to 

consider the merits of this case.

ISSUE

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

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

FACTUAL HISTORY

On April 5, 2018 appellant, then a 61-year-old supervisory diagnostic radiologic 

technologist, filed a recurrence claim (Form CA-2a) alleging that on February 17, 2017 he 

 

1 5 U.S.C. § 8101 et seq.
2

sustained a recurrence of disability under OWCP File No. xxxxxx045.2 He reported that he 

experienced severe left shoulder pain and difficulty lifting his left arm, which he believed was 

related to his December 28, 2015 employment injury. Appellant also attributed his left shoulder 

condition to constantly changing coils, moving patients, and changing nonambulatory patients 

while in the performance of duty. 

In a note dated March 15, 2018, Dr. Monet A. France, an orthopedic surgeon, reported that 

appellant had experienced left shoulder pain for six months. She reported that he had an older 

work-related injury from 2015, but denied any new injury. On April 4, 2018 Dr. France diagnosed 

biceps tendinitis of the left, tendinitis of the left rotator cuff and noted that these were work-related 

injuries. She recommended a magnetic resonance imaging (MRI) scan.

By development letter dated May 10, 2018, OWCP informed appellant that his April 5, 

2018 claim for recurrence was administratively converted into a new occupational disease claim, 

assigned OWCP File No. xxxxxx224, based on his statement indicating that his medical condition 

occurred due to constantly changing coils, moving patients, and changing nonambulatory patients

and therefore constituted a new injury. It also informed him that the evidence of record was 

insufficient to establish his claim. OWCP advised appellant of the type of medical and factual 

evidence needed and provided a questionnaire for completion. By separate letter of even date, it 

requested that the employing establishment provide additional information pertaining to his

occupational disease claim. OWCP afforded appellant 30 days for submission of the additional 

evidence.

On May 18, 2018 appellant responded to OWCP’s development questionnaire. He 

described the employment activities he believed contributed to his condition, which included 

assisting to lift, move, and help patients for their MRI scan examinations. Appellant noted that,

for MRI scan examinations, he could not use standard commercially available wheelchairs or 

stretchers, and therefore was required to transfer all wheelchair, stretcher, walker, etc., patients 

onto the MRI scan safe equipment and then onto and off of the scanning table. He also attributed 

his condition to opening the large MRI equipment door with a special lever latching handle. 

Appellant noted that each patient required a radiofrequency coil which were up to 3 feet long, but 

weighed less than 30 pounds. He asserted that he performed these activities between 10 and 20 

times a day, 5 days a week. Appellant noted that among the MRI scanners, only he was also 

required to vacuum and mop the floors in the scanner room. On May 31, 2018 the employing 

establishment responded to OWCP and confirmed his description of his day-to-day duties. 

In a May 11, 2018 note, Dr. France reviewed appellant’s May 8, 2018 MRI scan report and 

found a partial-thickness intrasubstance tear of the infraspinatus tendon, supraspinatus 

tendinopathy, and tears of the proximal biceps tendon as well as the superior glenoid labrum. She 

diagnosed bicep tendinitis, impingement syndrome of the left shoulder, and tendinitis of the left 

rotator cuff. Dr. France opined that these conditions were work related. She recommended 

arthroscopic left shoulder subacromial decompression. 

 

2

In OWCP File No. xxxxxx045, appellant filed a traumatic injury claim (Form CA-1) on December 29, 2015 

alleging a work-related left elbow and shoulder injury on December 28, 2015 as a result of moving a heavy patient in 

the performance of duty. OWCP administratively accepted that claim for a limited amount of medical benefits.
3

In a statement dated June 25, 2018, Dr. France described appellant’s claimed 

December 28, 2015 employment injury and noted his MRI scan findings. She indicated that based 

on those findings, left shoulder surgery was medically necessary. 

By decision dated July 25, 2018, OWCP denied appellant’s claim, finding that he had not 

established causal relationship between his diagnosed left shoulder condition and the accepted 

factors of his federal employment. 

LEGAL PRECEDENT

A claimant seeking benefits under FECA3 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 

FECA, that the claim was timely filed within the applicable time limitation period of FECA, that 

an injury was sustained in the performance of duty as alleged, and that any specific condition or 

disability for which compensation is claimed is 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 upon a traumatic injury or an occupational disease.5

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 diagnosed 

condition is causally related to the identified employment factors.6 

Causal relationship is a medical question, which requires rationalized medical opinion 

evidence to resolve the issue.7 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factors must be based on a 

complete factual and medical background.8 Additionally, the physician’s 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

 

3 Supra note 1.

4 20 C.F.R. § 10.115(e), (f); see C.D., Docket No. 17-2011 (issued November 6, 2018); Jacquelyn L. Oliver, 48 

ECAB 232, 235-36 (1996).

5 M.B., Docket No. 17-1999 (issued November 13, 2018); Victor J. Woodhams, 41 ECAB 345 (1989).

6 C.D., supra note 4; Victor J. Woodhams, id.

7 M.B., supra note 5; Robert G. Morris, 48 ECAB 238 (1996).

8 Supra note 6.

9

Id.
4

In any case where a preexisting condition involving the same part of the body is present 

and the issue of causal relationship therefore involves aggravation, acceleration, or precipitation, 

the physician must provide a rationalized medical opinion that differentiates between the effects 

of the work-related injury or disease and the preexisting condition.10

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish a left shoulder 

condition causally related to the accepted factors of his federal employment.11

OWCP accepted that appellant engaged in work activities which included assisting to lift, 

move, and help patients for their MRI scan examinations. The issue therefore is whether appellant 

submitted sufficient medical evidence to establish that the employment activities caused a left 

shoulder condition.12 That is a medical issue which must be addressed by relevant medical 

evidence.13 

The medical evidence received consists of a series of reports from Dr. France. On April 4 

and May 11, 2018, Dr. France diagnosed biceps tendinitis of the left shoulder, impingement 

syndrome of the left shoulder, and tendinitis of the left rotator cuff. She concluded that these 

conditions were work related. The Board finds that Dr. France’s reports are of diminished 

probative value as she failed to offer any medical reasoning in support of her conclusions.14 While

Dr. France opined that appellant’s left shoulder conditions were work related, she did not explain 

how or why the accepted work activities resulted in his current left shoulder conditions.15 She did 

not accurately describe his work duties and medically explain the physiological process by which 

these duties would have caused or aggravation his condition.16 

Thus, the Board finds that, as appellant has not submitted a rationalized medical opinion 

supporting that his medical condition was causally related to the accepted factors of his federal 

employment, he has not met his burden of proof to establish his claim.

 

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

C.D., supra note 4.

11 J.S., Docket No. 18-0726 (issued November 5, 2018).

12 Id.; the Board notes that although appellant filed a notice of recurrence claiming disability, the evidence of record 

indicates an intervening incident negating causal relationship between his current left shoulder injury and his prior 

December 28, 2015 work-related injury. 

13 See supra note 11; Bobbie F. Cowart, 55 ECAB 746 (2004).

14 K.R., Docket No. 18-1388 (issued January 9, 2019).

15 R.T., Docket No. 17-1230 (issued May 3, 2018).

16 M.M., Docket No. 17-1641 (issued February 15, 2018).
5

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 a left shoulder

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

ORDER

IT IS HEREBY ORDERED THAT the July 25, 2018 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: February 26, 2019

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