United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

E.G., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Raleigh, NC, Employer

__________________________________________

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Docket No. 19-1296

Issued: December 18, 2019

Appearances: Case Submitted on the Record

Daniel F. Read, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On May 21, 2019 appellant, through counsel, filed a timely appeal from December 4, 2018 

and May 9, 2019 merit decisions 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 his burden of proof to establish knee conditions 

causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On February 7, 2018 appellant, then a 48-year-old letter carrier, filed an occupational 

disease claim (Form CA-2) alleging that he sustained right knee injuries in the performance of 

duty. He noted that he first became aware of his condition on November 23, 2017, and first 

realized it was caused or aggravated by factors of his federal employment on December 6, 2017. 

Appellant explained that he had a prior claim which had been accepted for a sprain of the right 

shoulder and upper arm, sprain of the right foot, bilateral knee contusions, and lumbar back strain

under OWCP File No. xxxxxx710 and that he had filed a claim for recurrence of disability under 

that claim number, but his recurrence claim was denied. On the reverse side of the claim form the 

employing establishment indicated that appellant was last exposed to the employment factors 

alleged to have caused his conditions on December 26, 2017, stopped work on December 27, 2017, 

and returned to work on February 7, 2018.

In a development letter dated February 15, 2018, OWCP advised appellant that additional 

factual and medical evidence was necessary to establish his claim. It requested that he submit a 

comprehensive narrative medical report from his attending physician which included a diagnosis 

of a medical condition and a rationalized medical opinion supporting causal relationship between 

the diagnosed condition and factors of his federal employment. Appellant was also provided a 

questionnaire for his completion. OWCP afforded him 30 days to submit the necessary evidence. 

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

of appellant’s claim. It requested comments from a knowledgeable supervisor on the accuracy of 

appellant’s statements, a list of tasks appellant performed which required physical exertion, a list 

of precautions taken to minimize effects of these activities, and a copy of appellant’s position 

description. OWCP afforded the employing establishment 30 days to respond.

In a report dated January 19, 2018, Dr. David Dellaero, a Board-certified orthopedic 

surgeon, indicated that appellant reported persistent popping in his right knee with diffuse and 

lateral pain. Based on an x-ray and magnetic resonance imaging (MRI) scan, he diagnosed right 

knee medial and lateral meniscus tears. Dr. Dellaero recommended partial medial and lateral 

meniscectomies. 

In a supplemental statement received on February 7, 2018 appellant related that he was 

seen on December 27, 2017 by Dr. Dellaero for right knee swelling, popping, and buckling. 

Appellant related that his workload usually increased each November, and in 2017 the parcel 

volume was extraordinarily heavy. As a result he worked 90- to 100-hour workweeks, 7 days a 

week. He related that the stress of being on his feet all day, stepping in and out of a mail truck, 

turning and twisting to load packages from a hamper into his truck, and retrieving packages from 

his truck caused stress on his right knee, which started swelling in late November or early 

December. 
3

An employing establishment supervisor’s statement dated February 7, 2018 confirmed that 

the workload increased tremendously at the employing establishment during the month of 

December 2017. Most carriers worked 14 to 15 hours a day, 7 days a week during December 2017. 

By decision dated March 22, 2018, OWCP denied appellant’s claim finding that he had not 

submitted medical evidence containing a medical diagnosis in connection with factors of his 

federal employment. 

In a report dated June 8, 2018, Dr. Dellaero diagnosed tear of the right knee medial 

meniscus and related that he had discussed right knee arthroscopy with appellant. 

In a supplemental statement dated August 21, 2018, appellant explained that a traumatic 

injury claim for a March 2013 injury had been accepted for bilateral knee contusions. He further 

related that the stress of being on his feet each day for 17 to 19 hours and carrying packages and 

other mail items up and down stairs, in and out of businesses, and residences had caused swelling, 

popping, and buckling of his right knee. 

On September 5, 2018 appellant, through counsel, requested reconsideration of OWCP’s 

March 22, 2018 decision. He submitted additional evidence with his request.

In reports dated January 29, February 11 and 25, June 16, September 28, and 

November 22, 2016, Dr. Dina Eisinger, Board-certified in pain medicine and physical medicine 

and rehabilitation, noted that she had examined appellant for a follow-up regarding his chronic 

back and knee pain. She diagnosed lumbosacral intervertebral disc degeneration and knee pain. 

In reports dated February 15, March 2 and 27, June 28, and August 7 and 24, 2017,

Dr. Eisinger noted that she examined appellant for a follow-up regarding his chronic back and 

knee pain. She diagnosed lumbar radiculopathy, lumbar intervertebral disc degeneration, and 

displacement of lumbar intervertebral disc without myelopathy.

In a letter dated August 29, 2018, Dr. Dellaero indicated that appellant had been a patient 

of his for over eight years. He noted that his first major clinical issue was a microfracture and 

meniscal tear of his left knee in 2010, which was treated with arthroscopic surgery. Dr. Dellaero 

related that appellant was then in a car accident in 2013 which resulted in bilateral knee contusions, 

lumbar sprain, right shoulder strain, and foot strain. He diagnosed right knee medial and lateral

meniscus tears, left hip femoral acetabular impingement syndrome, left knee post-traumatic 

osteoarthritis, lumbar radiculopathy, and right shoulder sprain. Dr. Dellaero opined that 

appellant’s knee conditions were a result of his workplace duties. He explained that osteoarthritis 

occurs when the lubricating protective cartilage that covers the ends of bones, known as articular 

cartilage, degenerates and wears down progressively. Dr. Dellaero explained that appellant was 

not yet 50 years of age, but that repetitive mechanical pressure on the knee, as well as prolonged 

standing which was superimposed on a knee already weakened by surgery and an automobile 

accident had accelerated that normal wearing down. He concluded that appellant’s workplace 

duties were therefore a significant contributing factor in advancing and accelerating the loss of 

cartilage in his left knee to the point that his osteoarthritis became a serious clinical problem. 

By decision dated December 4, 2018, OWCP affirmed, as modified, its March 22, 2018 

decision finding that appellant had established the factual component of his claim. It also found,
4

however, that the evidence of record was insufficient to establish that his diagnosed right knee 

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

On February 19, 2019 appellant, through counsel, requested reconsideration of OWCP’s 

December 4, 2018 decision. 

By decision dated May 9, 2019, OWCP denied modification of its December 4, 2018 

decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA3 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 timely filed within the applicable 

time limitation period of FECA, that an injury was sustained in the performance of duty as alleged, 

and that any disability and/or specific condition for which compensation is claimed are causally 

related to the employment injury.4 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.5

In an occupational disease claim, appellant’s burden of proof requires submission of the 

following: (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

The medical evidence required to establish causal relationship is rationalized medical 

opinion evidence. Rationalized medical opinion evidence is medical evidence which includes a 

physician’s rationalized opinion on the issue of whether there is a causal relationship between the 

claimant’s diagnosed condition and the implicated employment factors. 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.7

 

3 Supra note 2.

4 S.M., Docket No. 19-0556 (issued September 6, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018);

Joe D. Cameron, 41 ECAB 153 (1989); Elaine Pendleton, 40 ECAB 1143, 1145 (1989).

5 S.M., id.; J.M., Docket No. 17-0284 (issued February 7, 2018); Victor J. Woodhams, 41 ECAB 345 (1989).

6 S.M., supra note 4; C.D., Docket No. 17-2011 (issued November 6, 2018); Jacquelyn L. Oliver, 48 ECAB 232, 

235-36 (1996).

7 A.P., Docket No. 19-1158 (issued October 29, 2019); see J.R., Docket No. 17-1781 (issued January 16, 2018);

I.J., 59 ECAB 408 (2008).
5

ANALYSIS

The Board finds that this case is not in posture for decision.

In support of his claim appellant submitted a letter dated August 29, 2018, from his 

attending physician, Dr. Dellaero, who indicated that appellant had been a patient of his for over 

eight years. Dr. Dellaero noted his history of prior left knee conditions which included both a prior 

microfracture and a subsequent meniscal tear of his left knee in 2010. He explained that appellant 

had a prior arthroscopic surgery for the meniscal tear. Dr. Dellaero also noted that he had been in 

a car accident in 2013 which resulted in bilateral knee contusions, a lumbar sprain, a right shoulder 

strain, and a foot strain -- conditions accepted by OWCP in File No. xxxxxx710. He diagnosed 

current conditions including right knee medial and lateral meniscus tear, left hip femoral acetabular 

impingement syndrome, left knee post-traumatic osteoarthritis, lumbar radiculopathy, and right 

shoulder sprain. Dr. Dellaero opined that his knee conditions were a result of his workplace duties. 

In support of his opinion on causation the doctor explained that osteoarthritis occurs when the 

lubricating protective cartilage that covers the ends of bones (articular cartilage) degenerates and 

wears down progressively. Dr. Dellaero explained that appellant was not yet 50 years of age, but 

that repetitive mechanical pressure on the knee, as well as prolonged standing which was 

superimposed on a knee already weakened by surgery and an automobile accident had accelerated 

that normal wearing down. He discussed the accepted workplace duties performed by appellant 

and opined that, for the reasons he had explained, they were a significant contributing factor in 

advancing and accelerating the loss of cartilage in his left knee to the point that his osteoarthritis 

became a serious clinical problem. 

The Board finds that while Dr. Dellaero’s August 19, 2018 letter is not fully rationalized, 

it is relevant evidence in support of appellant’s claim as it explains the physiological process by 

which appellant’s accepted factors of his federal employment could have resulted in the claimed 

knee conditions. Although the opinion letter by Dr. Dellaero is alone insufficient to meet 

appellant’s burden of proof to establish his claim, it does raise an uncontroverted inference 

between the diagnosed knee conditions and the accepted employment factors sufficient to require 

OWCP to further develop the claim.8 

Proceedings under FECA are not adversarial in nature, nor is OWCP a disinterested arbiter. 

While it is appellant’s burden of proof to establish the claim, OWCP shares responsibility in the 

development of the evidence.9 It has the obligation to see that justice is done.10 The Board will, 

therefore, remand the case to OWCP for further development of the medical evidence. 

On remand OWCP shall refer appellant, a statement of accepted facts, and the medical evidence 

of record to an appropriate Board-certified physician. The chosen physician shall provide a 

rationalized opinion finding that the diagnosed conditions are causally related to the accepted 

 

8 See J.G., Docket No. 18-1484 (issued June 14, 2019); D.V., Docket No. 17-1590 (issued December 12, 2018); 

E.J., Docket No. 09-1481 (issued February 19, 2010); John J. Carlone, 41 ECAB 354 (1989); Horace Langhorne, 29 

ECAB 820 (1978).

9 C.W., Docket No. 19-0231 (issued July 15, 2019); D.G., Docket No. 15-0702 (issued August 27, 2015); Donald R. 

Gervasi, 57 ECAB 281, 286 (2005); William J. Cantrell, 34 ECAB 1233, 1237 (1983).

10 Id.
6

factors of appellant’s federal employment. If the physician opines that the diagnosed conditions 

are not causally related, they must explain with rationale how or why their findings differ from 

that of Dr. Dellaero’s.11 Following this and any other further development as deemed necessary, 

OWCP shall issue a de novo decision on appellant’s claim.

CONCLUSION

The Board finds that this case is not in posture for decision. 

ORDER

IT IS HEREBY ORDERED THAT the May 9, 2019 and December 4, 2018 decisions of 

the Office of Workers’ Compensation Programs are set aside and the case is remanded for further 

proceedings consistent with this decision of the Board.

Issued: December 18, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

 

11 OWCP’s procedures provide that cases should be administratively combined when correct adjudication of the 

issues depends on frequent cross-referencing between files. For example, if a new injury claim is reported for an 

employee who previously filed an injury claim for a similar condition or the same part of the body, doubling is 

required. See Federal (FECA) Procedure Manual, Part 2 -- Claims, File Maintenance & Management, Chapter 

2.400.8(c) (February 2000). On remand OWCP shall administratively combine all necessary claims with the present 

file for a full and fair adjudication of appellant’s pending right knee injury claim prior to the referral to an appropriate 

specialist.