United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.H., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Derry, NH, Employer

__________________________________________

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Docket No. 18-0108

Issued: July 19, 2018

Appearances: Case Submitted on the Record

Appellant, pro se

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 October 13, 2017 appellant filed a timely appeal from an April 27, 2017 merit decision 

and an August 29, 2017 nonmerit 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.

ISSUES

The issues are: (1) whether appellant has met his burden of proof to establish a bilateral 

hip injury causally related to factors of his federal employment; and (2) whether OWCP properly 

denied appellant’s request for reconsideration of the merits of his claim pursuant to 5 U.S.C 

§ 8128(a).

 

1 5 U.S.C. § 8101 et seq. 
2

FACTUAL HISTORY

This case has previously been before the Board.

2

 The facts of the case as presented in the 

prior Board decision are incorporated herein by reference. The relevant facts are set forth below.

On August 31, 2015 appellant, then a 62-year-old rural letter carrier, filed an occupational 

disease claim (Form CA-2) for right and left hip injuries. He claimed that he first became aware 

of his injuries on October 3, 2011 and realized their relationship to factors of his federal 

employment on April 14, 2015. Appellant did not stop work. 

In an accompanying narrative statement dated August 27, 2015, appellant provided a 

detailed description of his rural letter carrier work duties and listed sports activities he had 

participated in during his formative years and as an adult. He noted that in October 2011 he 

developed pain in his left knee area, which he associated with his 2007 medial meniscus surgery. 

Appellant also noted that it was not until December 15, 2014 diagnostic testing results and 

appointments and consultations with his physicians, including Dr. Akhilesh Sastry, a Boardcertified orthopedic surgeon, that he became aware of the need for hip replacements. He asserted 

that he and Dr. Sastry believed that his work duties contributed to the development of his bilateral 

hip osteoarthritis and need for hip replacements.

In a June 24, 2015 medical report, Dr. Sastry noted that appellant was referred to him for 

treatment of bilateral hip pain. He examined appellant and diagnosed advanced osteoarthritis. 

Dr. Sastry recommended hip replacements since nonoperative treatments had been ineffective in 

controlling appellant’s pain. Appellant related to him that he worked 37 years as a rural postal 

carrier for the employing establishment. His work duties included repeated heavy lifting, twisting, 

turning, stretching, bending, squatting, repetitive motions, high-impact activities, sedentary 

positions for long periods of time, and ascending and descending movements of the hips. 

Dr. Sastry opined that these activities contributed to the development of appellant’s bilateral hip 

osteoarthritis and need for hip replacement surgery.

By development letter dated September 22, 2015, OWCP advised appellant of the 

deficiencies in his claim and afforded him 30 days to submit additional medical evidence and 

respond to its inquiries.

In response to OWCP’s development letter, appellant submitted additional medical reports 

dated October 3, 2011 to December 15, 2014 from various physicians who reported that appellant 

had bilateral hip degenerative joint disease and osteoarthritis, performed an intra-articular steroid 

injection in the left hip, and recommended hip arthroplasty.

By decision dated December 1, 2015, OWCP denied appellant’s occupational disease 

claim, finding that he failed to submit a rationalized medical opinion explaining how his bilateral 

hip condition was caused or aggravated by the established work factors and not by his sports 

activities.

 

2 Docket No. 17-0074 (issued March 17, 2017).
3

On February 17, 2016 appellant, through his representative, requested reconsideration of 

the December 1, 2015 decision. In a February 11, 2016 statement, he related that he had not 

participated in sports activities in over 40 years. Appellant also related that he had not run at any 

level in 10 years. He contended that he never had any injuries to his hips or sought medical 

treatment for them due to his outside activities.

Appellant submitted a copy of a previously received report. In addition, he submitted 

additional reports that included reports dated April 14 and August 25, 2015 and February 9, 2016 

from Dr. Sastry. In these reports, Dr. Sastry examined appellant and reiterated his diagnosis of 

bilateral hip osteoarthritis and appellant’s work duties. He also restated his opinion that these 

activities caused or contributed to the diagnosed condition and need for surgery.

By decision dated May 11, 2016, OWCP denied appellant’s request for reconsideration. It 

found that the evidence submitted in support of the reconsideration request was cumulative or 

irrelevant and did not advance a relevant legal argument not previously considered or demonstrate 

legal error by OWCP. 

On July 13 and 25, 2016 appellant, through her representative, again requested 

reconsideration of the December 1, 2015 decision. He submitted a June 28, 2016 report from

Dr. Sastry who indicated that osteoarthritis, often called “wear and tear arthritis,” had occurred in 

this case in both hips after years of use. He maintained that it resulted in deterioration of the 

cartilage that normally acted as a cushion between the bones that came together within hip joints 

where the top of the femur (ball) came together with the acetabulum (socket). Dr. Sastry related 

that, when the cartilage became worn at this juncture, the bones came into direct contact which 

caused pain due to the deterioration that had occurred. He reiterated that appellant had advanced 

osteoarthritis of the hips. Dr. Sastry also reiterated that appellant’s work duties as a rural mail 

carrier included heavy lifting, twisting, turning, stretching, bending, squatting, repetitive motions, 

high impact activities, and ascending and descending movements of the hips. He maintained that 

there was no question these activities, which appellant had performed for 37 years, contributed to 

the diagnosis and need for hip replacement surgery. As Dr. Sastry indicated in his previous reports, 

he was aware of appellant’s outside activities and still opined unequivocally that the noted physical 

requirements of appellant’s job contributed to his diagnosis and need for surgery.

By decision dated September 16, 2016, OWCP denied appellant’s request for 

reconsideration of the merits of the claim, finding that Dr. Sastry’s June 28, 2016 report was 

cumulative in nature and substantially similar to evidence previously reviewed.

On October 17, 2016 appellant timely appealed OWCP’s May 11 and September 16, 2016 

decisions to the Board. 

By decision dated March 17, 2017, the Board affirmed OWCP’s May 11, 2016 decision,

finding that it properly denied appellant’s February 17, 2016 request for reconsideration of the 

merits of his claim under 5 U.S.C. § 8128(a). The Board found that appellant’s request did not 

satisfy the criteria for obtaining a merit review of his claim. The Board, however, set aside 

OWCP’s September 16, 2016 decision, finding that OWCP improperly denied appellant’s July 13 

and 25, 2016 requests for reconsideration. The Board found that, while Dr. Sastry’s June 28, 2016 

report reiterated his June 24, 2015 opinion on causal relationship, it provided greater medical 
4

rationale or reasoning, lacking in his previous reports, in support of his conclusion on causal 

relationship and, thus, was relevant to the issue of whether OWCP properly denied appellant’s 

claim for compensation. The Board explained that this rationale directly addressed OWCP’s 

previous finding that the medical evidence submitted did not explain how the established work 

factors caused or aggravated appellant’s current condition. Accordingly, the Board remanded the 

case for OWCP to conduct a merit review of the claim.

On remand OWCP reviewed the merits of appellant’s claim. By decision dated April 27, 

2017, it denied modification of its December 1, 2015 decision denying appellant’s occupational 

disease claim. OWCP found that Dr. Sastry’s June 28, 2016 report failed to sufficiently explain 

how the established work factors caused or contributed to appellant’s bilateral hip condition.

On July 19, 2017 appellant requested reconsideration and submitted a June 19, 2017 letter 

from Dr. Sastry. In this letter, Dr. Sastry referenced his June 28, 2016 statement and claimed that 

it clearly addressed how appellant’s work activities caused or contributed to the development of

his condition. He maintained that his opinion was unequivocal. Dr. Sastry further maintained that 

he clearly addressed how appellant’s federal employment had accelerated, aggravated, and altered 

the progression of his degenerative condition. He reviewed appellant’s August 27, 2015 statement 

and related that it provided an extremely detailed description of his work activities. Dr. Sastry 

noted that he was well aware of this information. He was also well aware of appellant’s outside 

activities detailed in appellant’s February 11, 2016 statement. Dr. Sastry reviewed OWCP’s 

March 17 and April 27, 2017 decisions and again contended that his opinion on causal relationship 

remained unequivocal.

By decision dated August 29, 2017, OWCP denied appellant’s request for reconsideration 

of the merits of his claim. It found that Dr. Sastry’s June 28, 2016 letter was cumulative and 

substantially similar to his previously submitted reports.

LEGAL PRECEDENT -- ISSUE 1

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 or specific condition 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 on 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 

 

3 Supra note 1.

4 C.S., Docket No. 08-1585 (issued March 3, 2009); Elaine Pendleton, 40 ECAB 1143 (1989).

5 S.P., 59 ECAB 184 (2007); Victor J. Woodhams, 41 ECAB 345 (1989); Joe D. Cameron, 41 ECAB 153 (1989).
5

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. The medical 

evidence required to establish causal relationship is rationalized medical opinion evidence. The 

opinion of the physician must be based on a complete factual and medical background of the 

employee, must be one of reasonable 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.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 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 -- ISSUE 1

The Board finds that this case is not in posture for decision as to whether appellant’s 

bilateral hip injury was causally related to factors of his federal employment.

In the prior appeal, the Board remanded appellant’s case for OWCP to conduct a merit 

review based on Dr. Sastry’s June 28, 2016 report. On remand OWCP denied modification of its 

prior decision denying appellant’s occupational disease claim. It found that Dr. Sastry’s June 28, 

2016 report was not sufficiently rationalized to establish causal relationship between appellant’s 

bilateral hip condition and the established employment factors. 

In his June 28, 2016 report, Dr. Sastry noted that appellant worked as a rural mail carrier 

for 37 years and described appellant’s duties to include heavy lifting, twisting, turning, stretching, 

bending, squatting, repetitive motions, high impact activities, and ascending and descending 

movements of the hips. He opined that there was no question the established work duties, which 

appellant had performed for 37 years, contributed to his advanced bilateral hip osteoarthritis and 

need for hip replacements. Dr. Sastry reasoned that years of use of appellant’s hips while 

performing his rural mail carrier duties resulted in deterioration of the cartilage that normally acted 

as a cushion between the bones that came together within hip joints where the top of the femur ball 

came together with the acetabulum socket. He further reasoned that, when the cartilage became 

worn at this juncture, the bones came into direct contact, which caused pain due to the deterioration 

that had occurred. Dr. Sastry noted that, while he was aware of appellant’s outside activities, his 

 

6

I.J., 59 ECAB 408 (2008); Victor J. Woodhams, id.

7 Y.J., Docket No. 08-1167 (issued October 7, 2008); A.D. 58 ECAB 149 (2006); D’Wayne Avila, 57 ECAB 

642 (2006).

8

J.J., Docket No. 09-0027 (issued February 10, 2009); Michael S. Mina, 57 ECAB 379 (2006).

9

I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345 (1989).
6

opinion on the causal relationship between the noted physical requirements of appellant’s job and 

need for surgery was unequivocal.

In a subsequent report dated June 19, 2017, Dr. Sastry reiterated that his June 28, 2016 

opinion on causal relationship remained unequivocal. In addition, he maintained that he had 

sufficiently explained how appellant’s federal employment had accelerated, aggravated, and 

altered the progression of his degenerative condition. 

Accordingly, the Board finds that Dr. Sastry provided an affirmative opinion on causal 

relationship. Further, the Board finds that Dr. Sastry’s reports, when read together, identified 

employment factors which appellant claimed caused his condition and explained how the 

identified employment factors caused or aggravated appellant’s diagnosed bilateral hip 

osteoarthritis. The Board finds that Dr. Sastry’s opinion, while not sufficiently rationalized to 

meet appellant’s burden of proof, is sufficient given the absence of any opposing medical evidence, 

to require further development of the record.10 It is well established that proceedings under FECA 

are not adversarial in nature, and while appellant has the burden of proof to establish entitlement 

to compensation, OWCP shares responsibility in the development of the evidence.11 OWCP has 

an obligation to see that justice is done.12

The case will be remanded to OWCP for further action consistent with this decision. On 

remand after such further development of the case record as OWCP deems necessary, it shall issue 

a de novo decision.

In light of the Board’s disposition regarding Issue 1, Issue 2 is rendered moot.

CONCLUSION

The Board finds that this case is not in posture for decision.

 

10 See J.G., Docket No. 17-1062 (issued February13, 2018); A.F., Docket No. 15-1687 (issued June 9, 2016). See 

also John J. Carlone, 41 ECAB 354 (1989); Horace Langhorne, 29 ECAB 820 (1978).

11 See, e.g., Walter A. Fundinger, Jr., 37 ECAB 200, 204 (1985); Dorothy L. Sidwell, 36 ECAB 699, 707 (1985); 

Michael Gallo, 29 ECAB 159, 161 (1978); William N. Saathoff, 8 ECAB 769, 770-71 (1956).

12 William J. Cantrell, 34 ECAB 1233, 1237 (1983); Gertrude E. Evans, 26 ECAB 195 (1974).
7

ORDER

IT IS HEREBY ORDERED THAT the August 29 and April 27, 2017 decisions of the 

Office of Workers’ Compensation Programs are set aside and the case is remanded to OWCP for 

further proceedings consistent with this decision of the Board.

Issued: July 19, 2018

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