United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

T.M., Appellant

and

U.S. POSTAL SERVICE, PROCESSING & 

DISTRIBUTION CENTER, Knoxville, TN, 

Employer

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Docket No. 19-1360

Issued: December 12, 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

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 6, 2019 appellant filed a timely appeal from a May 9, 2019 merit decision of the 

Office of Workers’ Compensation Programs (OWCP).1 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.3

 

1 Appellant has also filed an appeal from a May 10, 2019 decision in Docket No. 19-1566 relating to a claimed left 

foot injury. Issues relating to a claimed left foot injury are not addressed in this decision and Docket No. 19-1566 will 

proceed to a separate decision. 

2 5 U.S.C. § 8101 et seq.

3 The Board notes that, following the May 9, 2019 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 her burden of proof to establish a right foot stress 

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

FACTUAL HISTORY

On February 14, 2019 appellant, then a 37-year-old mail handler, filed an occupational 

disease claim (Form CA-2) for a right foot stress fracture that she attributed to factors of her federal 

employment including excessive walking during her tour in her work area. She indicated that she 

first became aware of her condition and first realized it resulted from her federal employment on 

February 5, 2019.

In an accompanying statement, appellant related that the foot pain became intense in 

February 2019 so she went to the doctor and was informed that it was a stress fracture due to 

excessive walking. She reported that excessive walking was required to perform her job. 

Appellant indicated that she walked on concrete on the dock for eight hours per day up to seven

days per week. She recounted that she was also diagnosed with a left foot stress fracture in 

July 2017, and April and December 2018 and that she was advised to wear a walking boot for six 

to eight weeks.

In a February 5, 2019 report, Dr. James Engblom, a podiatrist and Board-certified foot and 

ankle surgeon, recounted appellant’s complaints of persistent right foot pain for the prior two 

weeks. He noted that appellant did not remember a specific injury. Upon examination of 

appellant’s right foot, Dr. Engblom observed inflammation and tenderness, primarily in the base 

of the fourth metatarsal. He diagnosed right foot stress fracture.

Appellant also submitted February 14, 2019 laboratory test results.

In a development letter dated March 18, 2019, OWCP informed appellant that the evidence 

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

evidence necessary to support her claim and provided a questionnaire for her completion. OWCP 

afforded appellant 30 days to submit the requested information.

Appellant responded to OWCP’s development letter in a completed questionnaire dated 

April 1, 2019. She described the employment-related activities that she believed contributed to 

her condition as walking 8 to 11 miles per shift on concrete and pushing or pulling heavy 

equipment. Appellant reported that she performed these activities for 5 days per week for 1 year 

and 10 months. She indicated that she did not have a right foot injury or medical condition prior 

to her federal employment. Appellant related that her activities outside of her federal employment 

included watching television and social media for two hours per day.

By decision dated May 9, 2019, OWCP denied appellant’s occupational disease claim. It 

accepted her employment duties as a mail handler and a diagnosis of right foot stress fracture, but 

it denied her claim finding insufficient medical evidence to establish causal relationship between 

her right foot condition and the accepted factors of her federal employment.
3

LEGAL PRECEDENT

An employee seeking benefits under FECA4 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,5that 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.6 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.7

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.8 

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

relationship is rationalized medical opinion evidence.9 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.

10

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a right foot 

stress fracture causally related to the accepted factors of her federal employment. 

In a February 5, 2019 report, Dr. Engblom recounted appellant’s complaints of right foot 

pain for the prior two weeks and noted examination findings of inflammation and tenderness, 

primarily in the base of the fourth metatarsal and right mild effusion at the base of the fourth 

 

4 Supra note 1.

5 S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989). 

6

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

7 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); 

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

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

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

238 (1996).

10 M.V., Docket No. 18-0884 (issued December 28, 2018); I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 

ECAB 345, 352 (1989).
4

metatarsal. He diagnosed right foot stress fracture. Dr. Engblom did not, however, offer an 

opinion regarding the cause of the diagnosed right foot condition. 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.11 Accordingly, Dr. Engblom’s report is insufficient to establish 

appellant’s claim for a right foot injury.

Likewise, the February 14, 2019 laboratory test results also lacks probative value to 

establish causal relationship as it did not provide an opinion on causal relationship between 

appellant’s employment duties and her claimed stress fracture.12 

On appeal appellant noted her disagreement with the decision. As explained above, the 

medical evidence of record is insufficient to establish that appellant’s mail handler employment 

duties caused or contributed to her right foot stress fracture. Causal relationship is a medical 

question that requires rationalized medical opinion evidence to resolve the issue.13 As appellant 

has not submitted such rationalized medical opinion evidence in this case, the Board finds that she 

has not met her burden of proof to establish her claim.14

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 right foot 

stress fracture causally related to the accepted factors of her federal employment.

 

11 M.W., Docket No. 18-1624 (issued April 3, 2019); S.B., Docket No. 18-1296 (issued January 24, 2019).

12 See A.B., Docket No. 17-0301 (issued May 19, 2017).

13 Supra note 8. 

14 See M.C., Docket No. 19-0673 (issued September 6, 2019).
5

ORDER

IT IS HEREBY ORDERED THAT the May 9, 2019 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: December 12, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board