United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

K.L., Appellant

and

DEPARTMENT OF THE AIR FORCE, 

WRIGHT-PATTERSON AIR FORCE 

BASE, OH, Employer

__________________________________________

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Docket No. 18-0937

Issued: December 28, 2018

Appearances: Case Submitted on the Record

Daniel M. Goodkin, Esq., for the appellant1

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 March 30, 2018 appellant, through counsel, filed a timely appeal from a March 7, 2018 

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.

 

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

ISSUE

The issue is whether appellant has met her burden of proof to establish an occupational 

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

FACTUAL HISTORY

On October 29, 2014 appellant, then a 64-year-old retired senior aerospace engineer, filed 

an occupational disease claim (Form CA-2) alleging that workplace exposure to mercury, lead, 

cadmium, arsenic, and aluminum caused multiple medical conditions including diabetes, multiple 

sclerosis, and Parkinson’s disease. The employing establishment indicated that appellant had been 

on leave for long periods of time from the summer of 2012 and had retired on June 3, 2013. 

By development letter dated December 8, 2014, OWCP advised appellant that the evidence 

of record was insufficient to establish her claim. It requested that she provide additional factual

and medical evidence. OWCP provided appellant a questionnaire for her completion and afforded 

her 30 days to submit additional evidence. 

After initial development, OWCP denied the claim on March 12, 2015. On April 9, 2015 

appellant, through counsel, requested a hearing before a representative of OWCP’s Branch of 

Hearings and Review. 

Results of March 2, 2015 laboratory testing ordered by Dr. L. Terry Chappell, an attending 

Board-certified family physician, found that appellant had positive results to aluminum, antimony, 

cadmium, cesium, gadolinium, lead, nickel, and uranium. In an October 7, 2015 report,

Dr. Chappell advised that he first saw appellant on March 2, 2015 and had reviewed her medical 

records since 1983. He noted that she had multiple gynecological problems, infections, 

pneumonias, respiratory problems, frequent fractures and falls, digestive problems, and profound 

fatigue. Dr. Chappell opined that appellant’s immune system had been compromised. He noted 

that appellant was exposed to toxic materials at work and advised that her health problems 

stemmed from this exposure. 

OWCP continued to receive a series of medical reports pertaining to diverse medical 

conditions which did not explain the cause of any diagnosed conditions. 

During the hearing, held on November 3, 2015, appellant testified regarding her 

employment exposure to toxic materials. The hearing representative explained the type of medical 

evidence needed if exposure were accepted.

By decision dated January 27, 2016, an OWCP hearing representative found that the case 

was not in posture for decision and remanded the case for OWCP to obtain additional evidence 

from the employing establishment regarding appellant’s chemical exposures. 

In letters dated February 9 and April 5, 2016, OWCP asked the employing establishment 

to furnish information regarding appellant’s exposure to specific toxic elements. The employing 

establishment did not respond.
3

By decision dated May 23, 2016, OWCP found that, based on medical testing on March 2, 

2015 and the absence of a response from the employing establishment, appellant had experienced 

exposure to aluminum, antimony, arsenic, barium, beryllium, bismuth, cadmium, cesium 133, 

gadolinium, lead, mercury, nickel, thallium, tin, tungsten, and uranium at the employing 

establishment. It found she had not established exposure to palladium, platinum, tellurium, and 

thorium. Following review of the medical evidence submitted, OWCP found that appellant had 

not established a diagnosed medical condition causally related to the accepted work exposures to 

toxic heavy metals.

On December 28, 2016 appellant, through counsel, requested reconsideration and 

submitted a December 21, 2016 report from Dr. Ernest P. Chiodo, Board-certified in internal and 

occupational medicine. 

In the December 21, 2016 report, Dr. Chiodo described appellant’s employment and 

exposure history and advised that she gradually developed a significant neurological disease 

during the course of her employment. He noted his review of some medical records and advised 

that appellant’s symptoms included difficulty with balance and walking, difficulty with 

concentration and impaired short-term memory, which continued to the present and rendered her 

unable to work. Dr. Chiodo indicated that appellant had been evaluated medically for Parkinson’s 

disease, thyroid and Lyme disease, diabetes, and multiple sclerosis, but was found not to suffer 

from any of these ailments. He noted his review of a medical publication, Neuropathology of 

Heavy Metal Intoxication,

3

regarding exposure to heavy metal causing neuropathy. Dr. Chiodo 

indicated that appellant had a long-term exposure to rocket propellants and the combustion 

products of rocket propellants that included hydrazine and heavy metals, opining that these were 

well known to cause the neurological manifestations from which she is suffering. He noted that, 

despite extensive medical evaluations, no alternative explanation for her neurological disease had

been found and, therefore, a differential diagnosis of etiology pointed only to her federal 

employment as the cause for her neurological impairment. Dr. Chiodo diagnosed neuropathy and 

encephalopathy. He concluded, within a reasonable degree of medical and scientific certainty, that 

appellant’s neurological disease was caused by her long-term exposure to rocket propellants and 

the combustion products of rocket propellants including hydrazine and heavy metals during the 

course of her federal employment, which caused her to be permanently disabled. 

By merit decision dated March 24, 2017, OWCP denied modification of its May 23, 2016 

decision. It noted that, as it did not appear that Dr. Chiodo examined appellant and because he did 

not specifically reference any of her prior medical records, his opinion that she suffered from 

employment-related neuropathy and encephalopathy was of diminished probative value. 

Appellant, through counsel, requested reconsideration on August 3, 2017. In a report dated 

April 11, 2017, Dr. Chiodo opined that appellant’s occupational exposure caused neuropathy and 

encephalopathy, noting that despite extensive work-up, no alternative explanation had been found. 

He indicated that he had physically examined appellant, and related that he observed that she had 

difficulty with ambulation, required a cane to walk, and had difficulty processing and answering 

 

3 Neuropathology of Heavy Metal Intoxication, 26 Environmental Health Perspectives, 117-120 (1978). 
4

questions. Dr. Chiodo reiterated that, upon his review of records and his observation of appellant, 

she had neuropathy and encephalopathy caused by occupational exposure. 

By merit decision dated March 7, 2018, OWCP found that appellant had not submitted 

medical evidence substantiating that her exposure to heavy metals in the course of her federal 

employment caused her diagnosed medical conditions. It noted that, although Dr. Chiodo 

indicated that he observed appellant ambulate and respond to questions, he did not provide 

complete physical examination findings. OWCP further noted that, although Dr. Chiodo again 

indicated that he reviewed medical records, he did not reference any specific report. It concluded 

that the evidence present was not of sufficient probative value to modify its prior decisions. 

LEGAL PRECEDENT

An employee seeking benefits under FECA4 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 he or she sustained an injury in the performance of duty, and that any 

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

related to that employment injury.5

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 employment factors identified 

by the claimant.6

Causal relationship is a medical issue, and the medical evidence required to establish causal 

relationship is rationalized medical evidence.7 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 employee.8 

Neither the mere fact that a disease or condition manifests itself during a period of employment 

nor the belief that the disease or condition was caused or aggravated by employment factors or 

incidents is sufficient to establish causal relationship.9

 

4 Supra note 2.

5 M.S., Docket No. 17-0980 (issued June 19, 2018).

6 E.M., Docket No. 18-0275 (issued June 8, 2018).

7 A.M., Docket No. 18-0685 (issued October 26, 2018).

8 E.V., Docket No. 18-0106 (issued April 5, 2018).

9 A.M., supra note 7; Dennis M. Mascarenas, 49 ECAB 215 (1997).
5

ANALYSIS

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

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

In his October 7, 2015 report, Dr. Chappell maintained that toxic exposure at work caused 

appellant’s health problems. However, he merely indicated that she had a history of multiple 

gynecological problems, multiple infections, pneumonias, respiratory problems, frequent fractures 

and falls, digestive problems, and profound fatigue, and generally opined that her immune system 

had obviously been compromised. Medical evidence must be 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 A medical

report is of limited probative value on the issue of causal relationship if it contains a conclusion 

regarding causal relationship which is unsupported by medical rationale.11 Dr. Chappell’s report 

is of insufficient rationale to establish causal relationship.12 

Dr. Chiodo diagnosed neuropathy and encephalopathy. The Board, however, finds that he 

did not provide sufficient explanation regarding whether the conditions he diagnosed were caused 

or aggravated by appellant’s work exposure. The Board has held that, in assessing medical 

evidence, the weight of a physician’s opinion is determined by the opportunity for and 

thoroughness of the examination, the accuracy and completeness of the physician’s knowledge of 

the facts and medical history, the care of analysis manifested, and the medical rationale used to 

explain the conclusions reached.13

Dr. Chiodo indicated that appellant was exposed to rocket propellants and the combustion 

products of rocket propellants at work on a long-term basis. He opined that a differential diagnosis 

of etiology pointed only to her federal employment as the cause for her neurological impairment

and concluded that these caused her to be permanently disabled from work. Although he reported 

that appellant had an extensive work-up which ruled out other causes of her condition, Dr. Chiodo

did not reference specific examinations, tests, or studies that led to the formation of his opinion. 

Moreover, his only description of examination findings was that he observed that she had difficulty 

with ambulation and required a cane to walk and had difficulty processing and answering 

questions. Dr. Chiodo did not provide specific neurological or neuropsychological test findings. 

Thus, contrary to counsel’s assertion on appeal, Dr. Chiodo’s reports are insufficient to meet 

appellant’s burden of proof.14 To establish causal relationship, a claimant must submit a 

physician’s report in which the physician reviews the employment factors identified as causing the 

claimed condition and, taking these factors into consideration as well as findings upon 

examination, explains how the employment factors caused or aggravated the diagnosed conditions 

 

10 See D.R., Docket No. 09-1723 (issued May 20, 2010).

11 See W.S., Docket No. 17-1769 (issued July 26, 2018); Roma A. Mortenson-Kindschi, 57 ECAB 148 (2006).

12 A.M., supra note 7.

13 T.P., Docket No. 17-1468 (issued August 6, 2018)

14 E.M., supra note 6.
6

and presents medical rationale in support of his or her opinion.15 Dr. Chiodo did not provide the 

necessary medical rationale to establish causal relationship between the accepted employment 

factors and the diagnosed medical conditions. 

As appellant has not submitted rationalized medical evidence to establish an occupational 

disease causally related to the accepted factors of her federal employment, she has failed to meet 

her burden of proof.

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 occupational 

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

ORDER

IT IS HEREBY ORDERED THAT the March 7, 2018 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: December 28, 2018

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

 

15 J.M., 58 ECAB 303 (2007).