United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

P.Y., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Attica, MI, Employer

__________________________________________

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Docket No. 18-1136

Issued: January 7, 2019

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On May 15, 2018 appellant, through counsel, filed a timely appeal from an April 26, 2018 

merit decision of the Office of Workers’ Compensation Programs (OWCP). 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.

 

1

In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for legal 

or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. § 501.9(e). 

No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An attorney or 

representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject to fine or 

imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation.

2 5 U.S.C. § 8101 et seq. 
2

ISSUE

The issue is whether appellant has met her burden of proof to establish that her right hip

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

FACTUAL HISTORY

On February 15, 2017 appellant, then a 51-year-old sales and service associate/distribution 

clerk, filed an occupational disease claim (Form CA-2) alleging that she developed pain in her 

right hip and lower back, and arthritis in her right hip while in the performance of duty.3 She

alleged that she first became aware of her claimed conditions and of their relationship to her federal 

employment on November 2, 2016. She did not stop work. 

In an accompanying narrative statement, appellant noted that she had previously filed 

claims for left knee and lower back injuries. She indicated that consistent with all of her prior 

arthritic issues, her right hip/side was overcompensating for these injuries as she walked and 

worked. Appellant’s right hip started to bother her in March 2016 while she was having left knee 

trouble. Her right hip became extremely sore on August 1, 2016. Appellant described her work 

duties as working six days a week and distributing mail from large equipment to several carrier 

divisions, about two hours a day. Appellant also lifted, twisted, and turned to sort approximately 

700 parcels in various locations within 15 feet of breaking them down on a daily basis. She lifted

bags of parcels that weighed up to 60 pounds and single parcels that weighed up to 70 pounds. 

Appellant moved heavy wheeled equipment full of mail weighing up to 250 pounds and lifted tubs 

of mail weighing up to 45 pounds. She continuously bent and walked between various hampers 

and from the front to the back of the office to retrieve hold mail and notified parcels. Appellant 

stood at a counter line processing mail and accepting parcels of various lengths, sizes, and weight 

for approximately six hours on a daily basis. On approximately August 1, 2016 her right hip 

became extremely sore and she had very limited mobility such that she could not stand for any 

length of time and her gait was off. She sought medical treatment and an x-ray revealed joint 

narrowing and sclerosis in her right hip. Subsequently, on January 3, 2017 she received an 

injection in the right hip performed by Dr. Norman E. Walter, an attending Board-certified 

orthopedic surgeon. 

In support of her claim, appellant submitted an August 15, 2016 pelvis and bilateral hip xray report from Dr. Leighton Lum, a radiologist. Dr. Lum provided an impression of mild 

degenerative osteoarthritis of both hips. 

OWCP, by development letter dated February 22, 2017, advised appellant of the 

deficiencies of her claim and afforded her 30 days to submit additional medical evidence, including 

a detailed narrative report from her physician which included a history of the injury and a medical 

explanation with objective evidence of how the reported work events caused or aggravated her

 

3 Appellant had filed prior claims before OWCP. These claims include OWCP File No. xxxxxx152, OWCP File 

No. xxxxxx575, and OWCP File No. xxxxxx095 for left knee injuries and OWCP File No. xxxxxx895 for a back 

injury. These claims have been combined with OWCP File No. xxxxxx152 serving as the master file. The current 

claim has not been combined with the prior claims. 
3

condition. It also requested that the employing establishment submit medical evidence, if appellant 

had been treated at its medical facility. 

In an undated narrative statement, appellant again related her history of injury. In 2005,

she sustained a left knee injury at work and since that time she struggled with arthritis in her knees, 

hips, and lower back. Appellant continued to work and was treated by Dr. Walter. In late 2015,

she again experienced left knee pain for which she scheduled surgery. During this same time, 

appellant’s right hip became immobile and she struggled to walk, bend, lift her leg in and out of a 

car or shower, and walk up and down stairs. She noted the proposed medical treatment for her

knees and right hip.

Appellant submitted reports dated December 22, 2016 and February 1, 2017 from

Dr. Walter. In these reports, Dr. Walter noted that he had reviewed appellant’s social, family, and 

surgical history. He also noted her complaints of pain in her hip and back, and difficulty externally 

rotating the hip. Dr. Walter reviewed outside films brought by appellant, which showed 50 percent 

narrowing in the hip. He maintained that this was the main source of her problem as documented 

on internal and external rotation. Dr. Walter prescribed pain medication to treat appellant’s hip 

condition.

In response to OWCP’s development letter, appellant requested a 30-day extension to

submit a report from Dr. Walter regarding the causal relationship between her right hip condition 

and current work activities. No additional evidence was received by OWCP.

By decision dated March 27, 2017, OWCP denied appellant’s occupational disease claim

for failure to establish that the event occurred as alleged.

Appellant requested reconsideration on May 18, 2017. She submitted an April 27, 2017 

report from Dr. Walter who related a history of his own treatment of appellant commencing on 

May 20, 2010 for a left knee injury she sustained after her prior work injury. Dr. Walter noted that 

he evaluated her on December 22, 2016, and February 1 and April 12, 2017 regarding her 

complaints of pain in her right hip and groin. On April 12, 2017 he reviewed x-rays which showed 

significant arthritis in the right hip. Appellant reported to him that her pain was due to problems 

she had with her opposite knee because she was limping badly and had an altered gait. Dr. Walter 

performed an injection and advised appellant that her right hip condition may be related to the 

altered gait she developed due to her left knee condition. He noted that the prolonged limping 

aggravated the preexisting arthritis in her right hip and necessitated injection therapy. 

By decision dated August 14, 2017, OWCP affirmed its March 27, 2017 decision, as 

modified. It found that appellant had established fact of injury as she had substantiated the 

implicated employment factors. However, the claim remained denied because the medical 

evidence of record was insufficient to establish that appellant’s diagnosed right hip condition was 

caused or contributed to by the accepted employment factors. OWCP noted that, based on

Dr. Walter’s April 27, 2017 report, appellant should pursue the argument that her right hip 

condition was a consequence of the accepted left knee condition under that claim. 

On April 11, 2018 appellant, through counsel, requested reconsideration and submitted 

additional medical evidence from Dr. Walter. In a March 7, 2018 letter, Dr. Walter reiterated the 
4

history of his own treatment of appellant. He further noted her continuing left knee symptoms 

since 2010 and severe back and right hip pain following her work-related knee injury. Dr. Walter 

maintained that the back pain and right hip joint space narrowing (osteoarthritis), which required 

appellant to undergo a right total hip arthroplasty, were directly correlated to her prior left knee 

injuries which resulted in her having many years of an altered gait. He concluded that it was his 

firm belief that appellant’s employment contributed to that and would continue to do so without 

appropriate restrictions.

By decision dated April 26, 2018, OWCP denied modification of its prior decision. It 

found that appellant failed to submit rationalized medical opinion evidence explaining how her 

diagnosed right hip condition was caused or aggravated by the established work factors. OWCP 

noted that, based on Dr. Walter’s March 7, 2018 report, she should seek expansion of the 

acceptance of her left knee claim to include a consequential right hip injury.

LEGAL PRECEDENT

An employee seeking benefits under FECA4 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 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.5 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.6

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 

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 employment 

factors identified by the claimant were the proximate cause of the condition for which 

compensation is claimed or, stated differently, 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 generally required to 

establish causal relationship is rationalized medical opinion evidence.8 Rationalized medical 

opinion evidence is medical evidence which includes a physician’s rationalized opinion on 

 

4 Supra note 2.

5 T.H., Docket No. 17-0747 (issued May 14, 2018); C.S., Docket No. 08-1585 (issued March 3, 2009); Elaine 

Pendleton, 40 ECAB 1143 (1989).

6 T.H., id.; S.P., 59 ECAB 184 (2007); Victor J. Woodhams, 41 ECAB 345 (1989); Joe D. Cameron, 41 ECAB 

153 (1989).

7 Victor J. Woodhams, id.

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

642 (2006).
5

whether there is causal relationship between the employee’s diagnosed condition and the 

compensable employment factors.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 the specific employment factors identified by the employee.10 

ANALYSIS

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

diagnosed right hip condition was causally related to the accepted factors of her federal 

employment.

Appellant submitted a series of reports from her physician, Dr. Walter. In reports dated

April 27, 2017 and March 7, 2018, Dr. Walter opined that appellant’s back pain and right hip 

osteoarthritis were caused by her prior work-related left knee injuries. As Dr. Walter related 

appellant’s diagnosed conditions to prior employment injuries, his opinion is insufficient to 

establish that she sustained back and right hip conditions due to the accepted employment factors.11 

His remaining reports dated December 22, 2016 and February 1, 2017 found that appellant’s right 

hip condition was caused by 50 percent narrowing in the hip as demonstrated by x-rays. However,

Dr. Walter failed to provide a firm diagnosis or specifically attribute a condition to the accepted 

employment factors. Without a firm diagnosis supported by medical rationale, his opinion is of 

little probative value.

12

 For the reasons set forth, the Board finds that Dr. Walter’s reports are of 

insufficient probative value to meet appellant’s burden of proof.

The diagnostic study report of record from Dr. Lum is of limited probative value. The 

Board has held that reports of diagnostic tests lack probative value as they do not provide an 

opinion on causal relationship between appellant’s employment duties and a diagnosed 

condition.13 The Board finds, therefore, that this evidence is insufficient to establish appellant’s 

claim. 

The Board finds that appellant has failed to submit rationalized, probative medical evidence 

sufficient to establish a right hip injury causally related to the accepted employment factors. 

Appellant therefore has not met her burden of proof.

On appeal counsel contends that OWCP’s April 26, 2018 decision is contrary to fact and 

law. For the reasons set forth above, the Board finds that the weight of the medical evidence of 

record does not establish that appellant’s right hip condition was caused or contributed to by the 

accepted employment factors. 

 

9

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

10 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, supra note 6.

11 J.M., Docket No. 07-0974 (issued December 12, 2007).

12 See Samuel Senkow, 50 ECAB 370 (1999).

13 See K.V., Docket No. 18-0723 (issued November 9, 2016). 
6

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 that her right 

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

ORDER

IT IS HEREBY ORDERED THAT the April 26, 2018 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: January 7, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board