United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.F., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Pittsburgh, PA, Employer 

__________________________________________ 

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Docket No. 17-0135 

Issued: June 5, 2017 

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 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On October 27, 2016 appellant filed a timely appeal from an October 7, 2016 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 over the merits of this case.2

 

ISSUE 

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

condition causally related to factors of his federal employment. 

 1

 5 U.S.C. § 8101 et seq.

2

 The Board notes that appellant submitted additional evidence after OWCP rendered its October 7, 2016 

decision. The Board’s jurisdiction is limited to reviewing the evidence that was before OWCP at the time of its final 

decision and therefore, this additional evidence cannot be considered on appeal. 20 C.F.R. § 501.2(c)(1); Dennis E. 

Maddy, 47 ECAB 259 (1995); James C. Campbell, 5 ECAB 35, 36 n.2 (1952). 
2

FACTUAL HISTORY 

On January 19, 2016 appellant, then a 59-year-old tractor trailer operator, filed an 

occupational disease claim (Form CA-2) alleging that he developed right shoulder tendinitis as a 

result of his occupational employment duties. He reported that he mainly used his right arm to 

perform his employment duties for 8 to 12 hours per day, 7 days per week. Appellant stopped 

work on January 17, 2016 and returned to work on January 19, 2016. On the reverse side of the 

form, the employing establishment controverted the claim. 

In an accompanying narrative statement, appellant described his repetitive employment 

duties which required the use of his arms and shoulders to drive his tractor trailer, hook lines, 

release doors, raise trailers, and load mail. He reported that he had severe pain in his right 

shoulder and arm and was diagnosed with calcific tendinitis and shoulder sprain. Appellant 

reported that the tendinitis was not a sudden injury and had been occurring for a while. 

In a January 17, 2016 report, Dr. Olusola A. Akindele, Board-certified in occupational 

medicine, reported that appellant was a right-handed male who complained of right shoulder pain 

which had progressively worsened over time, resulting in his inability to raise his right arm. He 

noted that appellant’s symptoms worsened after an increased workload due to the Christmas 

holiday season. Dr. Akindele ordered an x-ray of appellant’s right shoulder. He diagnosed 

calcific tendinitis of the right shoulder and right shoulder sprain and provided appellant modified 

work duties. 

In work activity status reports dated January 17 through February 16, 2016, Dr. Akindele 

related appellant’s work restrictions. 

On January 19, 2016 appellant accepted an offer of modified assignment pursuant to his 

physician’s restrictions. 

By letter dated January 21, 2016, the employing establishment controverted the claim. 

In a January 28, 2016 diagnostic report, Dr. Ubaid A. Akhtar, a Board-certified 

radiologist, reported that a magnetic resonance imaging (MRI) scan of appellant’s right shoulder 

revealed calcific tendinopathy and subacromial subdeltoid bursitis. He further noted a small 

partial-thickness undersurface entheseal tear of the supraspinatus, no full-thickness rotator cuff 

tear, and moderate hypertrophic degenerative arthrosis of the acromioclavicular joint. 

In a February 9, 2016 medical report form, Dr. Robert L. Waltrip, a Board-certified 

orthopedic surgeon, diagnosed right shoulder calcific bursitis and restricted appellant to lightduty work. 

By letter dated February 29, 2016, OWCP informed appellant that the evidence of record 

was insufficient to support his claim. Appellant was advised of the medical and factual evidence 

needed and he was afforded 30 days to submit the requested evidence. In another letter of that 

same date, OWCP requested that the employing establishment provide further information 

pertaining to appellant’s occupational disease claim. 
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In a March 9, 2016 e-mail correspondence, the employing establishment reported that 

appellant was back to work full duty effective March 8, 2016. 

In a March 17, 2016 narrative statement, appellant reported that both his supervisor and 

the building safety manager concurred that his injury was work related, explaining that they were 

not contesting his claim. 

In support of his claim, appellant submitted additional medical reports. 

In a January 17, 2016 diagnostic report, Dr. Edmond V. Russ, a Board-certified 

diagnostic radiologist, reported that an x-ray of appellant’s right shoulder revealed calcific 

tendinosis and no acute bony abnormality. 

In treatment notes dated January 18 through March 1, 2016, Dr. Akindele provided 

findings on physical examination and review of diagnostic testing. He diagnosed sprain of right 

shoulder and calcific tendinitis of the right shoulder. Dr. Akindele provided appellant with 

continued work restrictions and referred him for an orthopedic evaluation. 

In a February 9, 2016 medical report, Dr. Waltrip reported that appellant presented for 

evaluation of his right shoulder with complaints of mild intermittent symptoms over the last six 

to eight months which worsened around the Christmas holiday with his increasing work 

activities. He noted that appellant worked as a spotter/driver for the employing establishment 

which entailed moving trailers around the yard and a lot of heavy pushing and pulling at 

approximately chest level. Appellant was evaluated on January 17, 2016 when his pain 

worsened and he was placed on light duty. Dr. Waltrip provided findings on physical 

examination and review of diagnostic testing. He diagnosed very prominent calcific bursitis of 

appellant’s right shoulder. Dr. Waltrip performed a subacromial corticosteroid injection and 

recommended physical therapy. 

In a March 8, 2016 note, Dr. Waltrip released appellant to full-duty work. 

By decision dated April 22, 2016, OWCP denied appellant’s claim, finding that the 

evidence of record failed to establish that his diagnosed conditions were causally related to his 

accepted federal employment duties. 

On June 6, 2016 appellant requested reconsideration of OWCP’s decision. He 

resubmitted his prior narrative statement describing his employment duties and reported that his 

orthopedic surgeon would be submitting a statement addressing causal relationship. 

In an accompanying narrative statement, appellant detailed his employment duties by 

listing his daily repetitive activities which he reported performing approximately 50 times per 

day. He noted that the majority of his work involved movement with his arms and shoulders 

which had been bothering him on and off for approximately one year. Appellant reported that he 

typically worked a 40-hour week, but due to a shortage of manpower and increasing volume 

during the holiday season, he was working up to 12 hours per day, sometimes 7 days per week, 

causing his shoulder condition to worsen. He further stated that the pain and numbness he was 

experiencing on his right side required surgery which was scheduled for July 22, 2016. 
4

In treatment reports dated March 8 and May 16, 2016, Dr. Waltrip provided findings on 

physical examination and noted continued symptoms from calcific tendinitis/bursitis. He 

reported that appellant could continue with full-duty work. 

In a May 11, 2016 medical report, Dr. Waltrip reported that he first evaluated appellant 

on February 9, 2016 for right shoulder pain. Appellant attributed his symptoms of increased pain 

to moving trailers around the yard as well as heavy pushing and pulling at approximately chest 

level. His radiographs showed very prominent calcific bursitis and he was noted to have 

increased signal throughout the subacromial space on MRI scan. Dr. Waltrip reported that the 

job duties appellant described may increase pain for a patient with such prominent calcific 

bursitis on radiological studies. Accordingly, appellant’s job-related activities may have 

aggravated his symptoms and contributed to the pain for which he sought treatment. Dr. Waltrip 

reported that he did not believe that appellant sustained a specific isolated vocational injury to 

cause his calcific bursitis, but opined that his job-related activities likely contributed to his pain 

as a result of the inflammatory condition. 

In progress notes dated June 13 through August 8, 2016, Natalie Llewellyn, a physician 

assistant, documented treatment provided for appellant’s right shoulder injury. Ms. Llewellyn 

reported that appellant elected to undergo surgery in the form of a right shoulder arthroscopy 

with subacromial decompression, debridement calcific tendinitis, and possible rotator cuff repair. 

In a June 22, 2016 medical report, Dr. Benedict C. Woo, Board-certified in physical 

medicine and rehabilitation, reported that appellant presented for consultation regarding 

numbness, tingling, and pain from chronic right shoulder pain which traveled to the neck at 

times. He noted that appellant was scheduled for right shoulder surgery on July 22, 2016. 

Dr. Woo diagnosed cervical strain, trapezius strain, and right arm numbness. He recommended 

an electromyography test of the upper right extremity to evaluate for radiculopathy and 

plexopathy prior to surgery. 

In diagnostic reports dated July 11, 2016, preoperative testing revealed normal prior to 

the scheduled July 22, 2016 surgery. 

In a September 12, 2016 medical report, Dr. Waltrip reported that appellant was doing 

well after his right shoulder arthroscopy and released him to light-duty work. 

By decision dated October 7, 2016, OWCP affirmed the April 22, 2016 decision finding 

that the evidence of record failed to establish that appellant’s diagnosed conditions were causally 

related to his accepted federal employment duties. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA 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 
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employment injury.3

 These are the essential elements of every compensation claim regardless of 

whether the claim is predicated on a traumatic injury or an occupational disease.4

In order to determine whether an employee actually sustained an injury in the 

performance of duty, OWCP begins with an analysis of whether fact of injury has been 

established. Generally, fact of injury consists of two components which must be considered in 

conjunction with one another. The first component to be established is that the employee 

actually experienced the employment incident which is alleged to have occurred.5 The second 

component is whether the employment incident caused a personal injury and generally can be 

established only by medical evidence. 

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 

To establish causal relationship between the condition, as well as any attendant disability 

claimed and the employment event or incident, the employee must submit rationalized medical 

opinion evidence based on a complete factual and medical background, supporting such causal 

relationship.7 The opinion of the physician 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 claimant. This 

medical opinion must include an accurate history of the employee’s employment injury and must 

explain how the condition is related to the injury. The weight of medical evidence is determined 

by its reliability, its probative value, its convincing quality, the care of analysis manifested, and 

the medical rationale expressed in support of the physician’s opinion.8

ANALYSIS 

OWCP accepted that appellant engaged in repetitive upper extremity activities as a 

tractor trailer operator. It denied his claim, however, finding the evidence of record failed to 

establish a causal relationship between those activities and his right shoulder diagnosis. The 

Board finds that the medical evidence of record is insufficient to establish that appellant 

developed right shoulder calcific bursitis and a right shoulder sprain causally related to factors of 

his federal employment as a tractor trailer operator. 

 3 Gary J. Watling, 52 ECAB 278 (2001); Elaine Pendleton, 40 ECAB 1143, 1154 (1989). 

4 Michael E. Smith, 50 ECAB 313 (1999). 

5 Elaine Pendleton, supra note 3. 

6 See Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. Fish, 46 ECAB 276, 279 (1994). 

7 See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983). 

8 James Mack, 43 ECAB 321 (1991). 
6

In medical reports dated January 17 through March 1, 2016, Dr. Akindele provided 

findings on physical examination and diagnosed sprain of the right shoulder and right shoulder 

calcific tendinitis. He failed to describe appellant’s employment duties or provide any opinion 

regarding the cause of his condition. The Board has found that a physician must provide a 

narrative description of the identified employment factors and a reasoned opinion on whether the 

employment factors described caused or contributed to the diagnosed medical condition.9

 As 

such, his reports are insufficient to meet appellant’s burden of proof. 

In medical reports dated February 9 through September 12, 2012, Dr. Waltrip provided 

findings on physical examination and review of diagnostic testing. He diagnosed right shoulder 

calcific bursitis. The Board finds that the opinion of Dr. Waltrip is insufficiently rationalized to 

establish appellant’s occupational disease claim. 

In his May 11, 2016 report, Dr. Waltrip opined that appellant’s job-related activities may 

have aggravated his symptoms and contributed to the pain for which he sought treatment. The 

Board notes that Dr. Waltrip’s opinion on causation is highly speculative as he notes that 

appellant’s employment duties “may have” aggravated his symptoms without a firm conclusion 

that they did in fact cause or aggravate his injury.10 While the opinion of a physician supporting 

causal relationship need not be one of absolute medical certainty, the opinion must not be 

speculative or equivocal. To be of probative value, a physician’s opinion on causal relationship 

should be expressed in terms of reasonable medical certainty.11 Dr. Waltrip further reported that 

he did not believe that appellant sustained a specific isolated vocational injury to cause his 

calcific bursitis, but opined that his job-related activities likely contributed to his pain as a result 

of the inflammatory condition. The Board notes that Dr. Waltrip associated appellant’s pain to 

his employment duties rather than the diagnosed medical condition. The Board has consistently 

held that pain is a symptom, rather than a compensable medical diagnosis.12 As Dr. Waltrip is 

attributing appellant’s symptoms to his employment duties rather than the right shoulder calcific 

bursitis, his opinion on causal relationship is of limited probative value.13 

Dr. Waltrip did not identify the cause of appellant’s underlying condition. He reported 

that appellant had prominent calcific bursitis on radiological studies. The Board notes that it is 

unclear if appellant’s calcific bursitis was caused or aggravated by his occupational employment 

duties, a result of a preexisting condition, or due to degenerative changes. A well-rationalized 

opinion is particularly warranted when there is history of a preexisting condition.14

Dr. Waltrip did not provide a sufficiently rationalized medical opinion explaining the 

mechanism of injury pertaining to this occupational disease claim. He did not explain how or 

 9 John W. Montoya, 54 ECAB 306 (2003). 

10 See Michael R. Shaffer, 55 ECAB 339 (2004). 

11 Rickey S. Storms, 52 ECAB 349 (2001); Beverly R. Jones, 55 ECAB 411 (2004). 

12 C.F., Docket No. 08-1102 (issued October 10, 2008). 

13 M.R., Docket No. 14-11 (issued August 27, 2014). 

14 T.M., Docket No. 08-975 (issued February 6, 2009); Michael S. Mina, 57 ECAB 379 (2006). 
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why the repetitive pushing and pulling activities described by appellant would have caused or 

aggravated his right shoulder calcific bursitis or shoulder sprain.15 As such, Dr. Waltrip’s report 

lacks the specificity and detail needed to establish that appellant’s right shoulder conditions were 

a result of a work-related occupational exposure.16 

The remaining medical evidence of record is also insufficient to establish appellant’s 

claim. Dr. Russ and Dr. Akhtar’s diagnostic reports only interpreted imaging studies and 

provided no opinion on the cause of appellant’s injury.17 Without any mention of the repetitive 

employment duties, any findings made could not be related to his claim to establish causal 

relationship.18

While Dr. Woo’s June 22, 2016 medical report provided additional diagnoses of cervical 

and trapezius strain, he failed to discuss appellant’s federal employment duties or give any 

opinion on the cause of his diagnosed conditions. The Board has held that medical evidence that 

does not offer any opinion regarding the cause of an employee’s conditions is of limited 

probative value.19 

Ms. Llewellyn’s progress notes dated June 13 through August 8, 2016 are also 

insufficient to establish appellant’s claim. Physician assistants are not considered physicians as 

defined under FECA; therefore, their opinions are not medical evidence and are of no probative 

value.20 

An award of compensation may not be based on surmise, conjecture, speculation, or on 

the employee’s own belief of causal relation.21 Appellant’s honest belief that his occupational 

employment duties caused his medical injury is not in question, but that belief, however 

sincerely held, does not constitute the medical evidence necessary to establish causal 

relationship. 

In the instant case, the record lacks rationalized medical evidence establishing a causal 

relationship between appellant’s federal employment duties as a tractor trailer operator and his 

diagnosed right shoulder calcific bursitis and sprain. Thus, appellant has failed to meet his 

burden of proof. 

 15 S.W., Docket 08-2538 (issued May 21, 2009). 

16 P.O., Docket No. 14-1675 (issued December 3, 2015); S.R., Docket No. 12-1098 (issued September 19, 2012). 

17 D.H., Docket No. 11-1739 (issued April 18, 2012). 

18 S.Y., Docket No. 11-1816 (issued March 16, 2012). 

19 S.E., Docket No. 08-2214 (issued May 6, 2009); C.B., Docket No. 09-2027 (issued May 12, 2010).

20 5 U.S.C. § 8102(2) of FECA provides as follows: (2) “physician” includes surgeons, podiatrists, dentists, 

clinical psychologists, optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as 

defined by State law. M.S., Docket No. 16-1497 (issued December 20, 2016); see Roy L. Humphrey, 57 ECAB 

238 (2005). See also W.M., Docket No. 16-1658 (issued May 3, 2017); A.F., Docket No. 15-1555 (issued 

December 16, 2015). 

21 D.D., 57 ECAB 734 (2006). 
8

Appellant may submit additional evidence, together with a written request for 

reconsideration, to OWCP within one year of the Board’s merit decision, pursuant to 5 U.S.C. 

§ 8128(a) and 20 C.F.R. §§ 10.606 and 10.607. 

CONCLUSION 

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

conditions causally related to factors of his federal employment as a tractor trailer operator. 

ORDER 

IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’ 

decision dated October 7, 2016 is affirmed. 

Issued: June 5, 2017 

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