United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

R.M., Appellant

and

DEPARTMENT OF HOMELAND SECURITY, 

CUSTOMS & BORDER PROTECTION, 

Atlanta, GA, Employer

__________________________________________

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Docket No. 18-1363

Issued: February 6, 2019

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 July 2, 2018 appellant filed a timely appeal from a March 2, 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 over 

the merits of this case.2

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following the March 2, 2018 decision, OWCP received additional evidence. However, the 

Board’s Rules of Procedure provides: “The Board’s review of a case is limited to the evidence in the case record that 

was before OWCP at the time of its final decision. Evidence not before OWCP will not be considered by the Board

for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this additional 

evidence for the first time on appeal. Id.
2

ISSUE

The issue is whether appellant has met his burden of proof to establish that his left foot 

conditions were causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On May 31, 2017 appellant, then a 49-year-old customs and border protection officer, filed 

an occupational disease claim (Form CA-2) alleging that he developed Haglund’s deformity, 

which is a bone spur, in his left heel and foot as a result of his federal employment duties. He

reported that his work duties entailed standing, lifting, sitting, and walking which aggravated his

heel/foot and caused a limp. Appellant noted that he first became aware of his claimed condition 

on August 1, 2016 and of its relationship to his federal employment on April 1, 2017. He notified 

his supervisor of his condition on May 22, 2017 and was assigned light-duty status performing 

administrative work.

By development letter dated August 22, 2017, OWCP informed appellant that the evidence 

of record was insufficient to establish his claim. It advised appellant of the type of medical and 

factual evidence needed and afforded him 30 days to submit the necessary evidence.

In a September 12, 2017 narrative statement, appellant reported that he sought medical 

treatment in August 2016 after he developed pain in his left heel. He discussed his airport 

passenger processing duties, noting that he was assigned to exit duties which entailed sitting and 

standing for prolonged periods of time to process passengers. Appellant further noted standing for 

prolonged periods of time while wearing a heavy ballistic vest and holding a rifle. He reported 

that his employment duties of standing, walking, and sometimes running caused his left foot pain 

to worsen. Appellant explained that standing for six to eight hours daily for his assignment 

continued to aggravate his injury. He sought medical treatment and was diagnosed with Haglund’s

deformity and Achilles tendinitis. On May 15, 2017 appellant’s physician provided him a boot to 

wear and placed him on light duty with restrictions of no standing. Appellant noted that on 

August 24, 2017 he underwent surgery for his condition and that he had not returned to work.

In support of his claim, appellant submitted medical reports dated August 22, 2016 through 

September 6, 2017 from Dr. Erroll Bailey, a Board-certified orthopedic surgeon. Dr. Bailey 

reported that appellant complained of left posterior heel pain. He noted that appellant used to work 

as a police officer and currently worked security at the Atlanta airport. Dr. Bailey reported that 

appellant did a lot of standing and walking which he had done all of his life. He provided physical 

examination findings and reviewed diagnostic testing. Dr. Bailey diagnosed left Haglund’s

deformity, insertional Achilles spur, and Achilles tendinosis. He reported that appellant underwent 

conservative treatment, but his condition had not improved. In August 2017, appellant underwent 

left Haglund’s deformity excision and Achilles tendon repair. In a September 14, 2017 report,

Dr. Bailey stated that appellant was status post excision surgery.

By decision dated November 7, 2017, OWCP denied appellant’s claim, finding that the 

medical evidence of record was insufficient to establish that his diagnosed conditions were

causally related to the accepted factors of his federal employment.
3

On December 4, 2017 appellant requested a review of the written record by an OWCP 

hearing representative.

In support of his request, appellant submitted a November 30, 2017 report from

Dr. Mitchell S. Nudelman, Board-certified in family medicine. Dr. Nudelman opined that 

appellant’s left Haglund’s deformity and Achilles tendinitis most likely developed due to 

prolonged standing at work while wearing a vest and carrying a rifle. He explained that while 

appellant may have had an anatomic propensity to develop such conditions, work aggravated and 

exacerbated the diagnosed conditions. Dr. Nudelman noted that surgery was performed following 

conservative treatment and appellant was expected to make a complete recovery. The report was 

cosigned by Dr. Bailey.

By decision dated March 2, 2018, an OWCP hearing representative affirmed the 

November 7, 2017 decision finding that the evidence of record failed to establish that appellant’s

diagnosed conditions of left Haglund’s deformity and Achilles tendinitis were causally related to 

the accepted factors of his federal employment.

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 

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

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.5 

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 supporting such causal relationship.6 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 claimant. 

 

3 Gary J. Watling, 52 ECAB 278 (2001).

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

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

6 See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983).
4

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.7

ANALYSIS

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

conditions were causally related to the accepted factors of his federal employment.8 

In support of his claim, appellant submitted medical reports dated August 22, 2016 through 

September 6, 2017 from Dr. Bailey, his treating physician. The Board finds that the reports of

Dr. Bailey are insufficient to establish appellant’s occupational disease claim.9 While Dr. Bailey 

noted a firm medical diagnosis of left Haglund’s deformity and Achilles tendinitis, he failed to 

provide an opinion on the cause of appellant’s injury.10 Rather, he only generally noted that 

appellant engaged in prolonged standing and walking. The Board has held that medical evidence 

that does not offer an opinion regarding the cause of an employee’s condition is of no probative 

value.11 As Dr. Bailey failed to provide an opinion that appellant’s left Haglund’s deformity and 

Achilles tendinitis were caused by his federal employment duties, his reports are insufficient to 

meet appellant’s burden of proof.12 

Dr. Nudelman’s November 30, 2017 report also fails to establish appellant’s alleged 

employment injury.

13

 He did not discuss appellant’s medical history, physical examination 

findings, or provide review of diagnostic testing. Dr. Nudelman’s report lacks the specificity and 

detail needed to establish that appellant’s injuries are a result of a work-related occupational 

exposure.14 

Dr. Nudelman opined that appellant’s left Haglund’s deformity and Achilles tendinitis 

most likely developed due to prolonged standing at work while wearing a vest and carrying a rifle. 

The Board notes that Dr. Nudelman’s opinion on causation is highly speculative and couched in 

equivocal terms as he failed to provide a definitive statement pertaining to the cause of appellant’s 

injury. To be of probative value, a physician’s opinion on causal relationship should be one of 

 

7

James Mack, 43 ECAB 321 (1991).

8 See Robert Broome, 55 ECAB 339 (2004).

9

J.I., Docket No. 18-0286 (issued September 17, 2018).

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

11 See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

12 K.W., Docket No. 10-0098 (issued September 10, 2010).

13 See L.M., Docket No. 14-0973 (issued August 25, 2014); R.G., Docket No. 14-0113 (issued April 25, 2014); 

K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-0548 (issued November 16, 2012).

14 P.O., Docket No. 14-1675 (issued December 3, 2015); S.R., Docket No. 12-1098 (issued September 19, 2012).
5

reasonable medical certainty.15 The physician noted that while appellant may have had an 

anatomic propensity to develop such conditions, work aggravated and exacerbated the diagnosed 

conditions. It remains unclear whether appellant’s left foot condition was the result of a preexisting 

condition or caused by his occupational employment duties. A well-rationalized opinion is 

particularly warranted when there is a history of a preexisting condition.16 Given these 

deficiencies, the Board finds Dr. Nudelman’s report lacks convincing quality and is of limited

probative value.17

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

employee’s own belief of causal relationship.18 The Board has held that the mere fact that a 

condition manifests itself during a period of employment does not raise an inference of causal 

relationship.19 

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

relationship between appellant’s federal employment duties as a customs and border protection 

officer and his diagnosed left foot Haglund’s deformity and Achilles tendinitis.

20

Appellant may submit additional evidence, together 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 that his left foot 

conditions are causally related to the accepted factors of his federal employment. 

 

15 See Beverly R. Jones, 55 ECAB 411 (2004).

16 T.M., Docket No. 08-0975 (issued February 6, 2009); Michael S. Mina, 57 ECAB 379 (2006).

17 Supra note 7. 

18 D.D., 57 ECAB 734 (2006).

19 Daniel O. Vasquez, 57 ECAB 559 (2006).

20 T.O., Docket No. 18-0139 (issued May 24, 2018).
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ORDER

IT IS HEREBY ORDERED THAT the March 2, 2018 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: February 6, 2019

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