United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.H., Appellant

and

U.S. POSTAL SERVICE, SAINT JOSEPH POST 

OFFICE, St. Joseph, MO, Employer

__________________________________________

)

)

)

)

)

)

)

)

Docket No. 20-0649

Issued: November 10, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Deputy Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On January 30, 2020 appellant filed a timely appeal from a January 3, 2020 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.

ISSUE

The issue is whether appellant has met her burden of proof to establish a left knee condition 

causally related to the accepted factors of her federal employment.

FACTUAL HISTORY

On October 14, 2019 appellant, then a 41-year-old city carrier, filed an occupational 

disease claim (Form CA-2) alleging that she developed Hoffa’s syndrome in her left knee due to 

factors of her federal employment, including repetitive movement. She explained that she 

 

1 5 U.S.C. § 8101 et seq.
2

experienced severe pain in the left knee and that her knee gives out. Appellant noted that she first 

became aware of her condition and realized its relationship to her federal employment on 

October 8, 2019. She did not stop work. 

In a September 26, 2019 medical report, Dr. Corey Trease, a Board-certified orthopedic 

surgeon, noted that appellant complained of left knee pain and that cortisone shots were no longer 

helping her. He recommended a magnetic resonance imaging (MRI) scan of the left knee. 

An October 4, 2019 left knee MRI scan revealed trace edema at the superior lateral aspect 

of Hoffa’s fat pad and diffuse partial thickness cartilage thinning over the lateral patellar facet and 

lateral trochlear ridge without underlying subchondral marrow edema. It demonstrated no acute 

osseous injury. 

In an October 8, 2019 medical report, Dr. Trease reviewed the October 4, 2019 MRI scan 

and diagnosed Hoffa’s syndrome in the left knee. 

In an undated statement, appellant noted that she had been seen by an orthopedic specialist 

for severe pain in her left knee. She indicated that she walked 13 miles a day and that cortisone 

shots no longer worked. 

In a November 6, 2019 development letter, OWCP informed appellant that the evidence 

submitted was insufficient to establish her claim. It advised her of the type of factual and medical 

evidence necessary to establish her claim and attached a factual questionnaire for her completion. 

In a separate development letter of even date, OWCP requested that the employing establishment 

provide additional information, including comments from a knowledgeable supervisor and an 

explanation of appellant’s work activities. It afforded both parties 30 days to submit the necessary 

evidence.

In a November 12, 2019 general medical and surgical authorization request, Dr. Trease 

again noted a diagnosis of Hoffa’s syndrome.2 

A December 3, 2019 letter from the employing establishment controverted appellant’s 

claim, asserting that she also worked as a bartender and previously sustained multiple injuries 

while riding a motorcycle, a four-wheeler, and horses. It also provided a job description for a city 

carrier. 

By decision dated January 3, 2020, OWCP denied appellant’s occupational disease claim 

finding that the medical evidence of record was insufficient to establish that her diagnosed 

condition was causally related to the accepted factors of her federal employment. 

 

2 OWCP received physical therapy reports dated October 28 and 31, 2019, which the Board notes related to OWCP 

File No. xxxxxx176. 
3

LEGAL PRECEDENT

An employee seeking benefits under FECA3 has the burden of proof to establish the 

essential elements of his or her claim, including that the individual is an employee of the United 

States within the meaning of FECA, that the claim was timely filed within the applicable time 

limitation of FECA,4that an injury was sustained in the performance of duty as alleged, and that 

any disability or medical condition for which compensation is claimed is causally related to the 

employment injury.5 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.6

To establish that, an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant 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 claimant.7 

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

relationship is rationalized medical opinion evidence.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 specific employment factors identified by the employee.9

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a left knee 

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

In support of her claim, appellant submitted a series of medical reports from Dr. Trease 

who diagnosed Hoffa’s syndrome in the left knee. While he provided a firm medical diagnosis, 

he did not offer a specific opinion as to whether her employment caused or aggravated her 

 

3 Supra note 1.

4

J.W., Docket No. 18-0678 (issued March 3, 2020); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 

ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989). 

5

J.S., Docket No.18-0657 (issued February 26, 2020); J.M., Docket No. 17-0284 (issued February 7, 2018); 

James E. Chadden, Sr., 40 ECAB 312 (1988).

6 L.J., Docket No. 19-1343 (issued February 26, 2020); R.R., Docket No.18-0914 (issued February 24, 2020); 

Delores C. Ellyett, 41 ECAB 992 (1990).

7 S.C., Docket No. 18-1242 (issued March 13, 2019); R.H., 59 ECAB 382 (2008).

8 A.M., Docket No. 18-1748 (issued April 24, 2019); T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 

238 (1996).

9 R.G., Docket No. 18-0792 (issued March 11, 2020); D.J., Docket No. 19-1301 (issued January 29, 2020); I.J., 59 

ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989).
4

diagnosed condition. 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 on the issue of causal 

relationship.10 These reports, therefore, are insufficient to establish appellant’s claim. 

Finally, appellant submitted an October 4, 2019 left knee MRI scan. However, the Board 

has held that reports of diagnostic tests, standing alone, lack probative value on the issue of causal 

relationship as they do not provide an opinion as to whether the accepted employment factors were 

sufficient to have caused the diagnosed conditions.

11

 Therefore, this evidence is also insufficient 

to establish appellant’s claim.

As there is no rationalized medical evidence of record explaining how appellant’s accepted 

factors of her federal employment caused or aggravated her condition, the Board finds that she has 

not met her burden of proof to establish her claim.

On appeal appellant asserts that the left knee MRI scan and diagnosis of Hoffa’s disease 

demonstrates that her condition was caused by repetitive action at work. However, as explained 

above, the Board finds that she has not submitted sufficient medical evidence to have met her 

burden of proof to establish her claim. 

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 a left knee 

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

 

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

11 S.K., Docket No. 19-0272 (issued July 21, 2020); A.V., Docket No. 19-1575 (issued June 11, 2020).
5

ORDER

IT IS HEREBY ORDERED THAT the January 3, 2020 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: November 10, 2020

Washington, DC

Christopher J. Godfrey, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board