United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

P.D., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Medway, MA, Employer

__________________________________________

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Docket No. 19-1458

Issued: February 10, 2020

Appearances: Case Submitted on the Record

John DeGeneres, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 25, 2019 appellant, through counsel, filed a timely appeal from a January 3, 2019 

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.3

 

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.

3 Appellant timely requested oral argument before the Board. By order dated February 3, 2020, the Board exercised 

its discretion and denied the request as the matter could be adequately addressed based on a review of the case record. 

Order Denying Oral Argument, Docket No. 19-1458 (issued February 3, 2020).
2

ISSUE

The issue is whether appellant has met his burden of proof to establish a bilateral hip

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

FACTUAL HISTORY

On November 20, 2017 appellant, then a 50-year-old letter carrier, filed an occupational 

disease claim (Form CA-2) alleging that he developed bilateral hip osteoarthritis as a result of 

repetitive employment duties over the course of 18 years while in the performance of duty. He

first became aware of his condition and of its relationship to factors of his federal employment on 

July 20, 2017. Appellant did not stop work.

In a June 6, 2017 narrative statement, appellant described his employment duties for the 

employing establishment over the course of 18 years since his employment began in 1999. He 

described his work duties in various positions he held which included walking six to eight miles 

per day while carrying a satchel weighing up to 35 pounds and parcels weighing up to 70 pounds, 

standing, bending, squatting, reaching, stooping, twisting, pivoting, lifting, pushing, pulling, going 

up and down hundreds of stairs and curbs per day, and getting in and out of his postal vehicle about 

250 to 300 times per day. Appellant further estimated slipping, tripping, stumbling, or falling at 

least a dozen times each winter month. He reported that the rigorous physical activities from his 

employment duties caused his bilateral hip condition and arthritis.

A September 14, 2014 magnetic resonance imaging (MRI) scan of the lumbar spine was 

submitted which indicated mild degenerative changes.

Physical therapy notes dated September 29 through November 4, 2016 discussed plans to 

improve hip and lumbar flexibility and strength.

In a progress note dated February 21, 2017, Dr. David Blaustein, a Board-certified 

physiatrist, indicated that appellant’s job involved repetitive twisting, bending, and lifting, which 

could contribute to his low-grade back pain with some radiation into the right lower extremity that 

seemed more mechanical/myofascial in nature.

An x-ray report dated March 28, 2017 demonstrated mild degenerative changes of 

appellant’s right hip with associated joint space narrowing and similar features in the partially 

imaged left hip. X-ray reports dated April 19, 2017 indicated that appellant’s joint spaces 

remained relatively stable when compared to the nonweight-bearing images from March 28, 2017,

noting mild degenerative changes of both hips.

In a May 29, 2017 note, Dr. Justin W. Kung, a Board-certified radiologist, reviewed 

radiographs of appellant’s bilateral hips taken on April 19, 2017 and noted both femoroacetabular

joint space measuring 2.0 millimeters (mm) indicating moderate degenerative changes.

In a report dated July 20, 2017, Dr. George P. Whitelaw, a Board-certified orthopedic 

surgeon, described appellant’s employment duties over the course of 18 years while working for 

the employing establishment. He noted review of pertinent medical records and indicated that 

beginning in 2014, appellant was treated for right hip pain and in September 2016, he subsequently 
3

reported a similar left hip pain. Dr. Whitelaw diagnosed degenerative osteoarthritis of both hips 

with 2.0 mm of femoroacetabular compartment joint space. He opined that appellant’s bilateral 

hip osteoarthritis was likely permanently aggravated and accelerated by his work activities which 

included lifting, walking and climbing on a repeated basis as a letter carrier for 18 plus years.

Appellant further opined that appellant’s employment duties accelerated his arthritis because of 

his continuous walking, stooping, squatting, lifting, and bending. Dr. Whitelaw indicated that

appellant’s medical records objectively supported his conclusion that the high impact loading work 

activities engaged by appellant contributed to the development and progression of his arthritis. He 

explained that appellant’s work activities caused a permanent aggravation of his osteoarthritis as 

his loss of cartilage space was irreversible and would not regrow. Dr. Whitelaw explained that the 

cartilage of both hips was degraded by 2.0 mm to its prior condition and once the cartilage loss 

was aggravated in the biological and physical process described, the condition of the joint would 

never go back to any prior level of severity as it was forever and permanently deteriorated. He 

opined that the 18 years of physical activity from appellant’s employment duties accelerated his 

arthritis because of the continuous walking, stooping, squatting, lifting, and bending. 

Dr. Whitelaw further noted that the 18 years of carrying mail hastened his osteoarthritis, which 

would not have progressed as early and as fast as it did. He discussed the mechanism of injury by 

stating that arthritis is a loss of articular cartilage surface. Dr. Whitelaw reported that impact 

loading resulting from repeated local stresses causes and accelerates the progression of arthritis 

through a process of chronic inflammation. Appellant’s employment duties as a letter carrier 

required constant and repetitive walking, standing, squatting, stooping, climbing, bending, lifting,

carrying, stair climbing, and twisting activities. These impact loading activities exerted repeated 

local stresses to his lower extremities and the arthritis was caused by a well-described 

biological/chemical process where excessive impact loading and repeated local stresses on the 

cartilage surface result in chronic inflammation. Dr. Whitelaw noted that the inflammation 

resulted in chemical changes within the cartilage, most significantly the loss of proteoglycans 

which was significant because proteoglycans were responsible for cartilage resilience. With less 

resilience, the cartilage became more susceptible to the wear and tear of the impact loading 

activities, which in turn resulted in an accelerated loss of articular cartilage as a result of those 

activities. Dr. Whitelaw noted that this process was evident in appellant’s history and examination, 

and was evidenced by his medical records and radiology studies demonstrating the cartilage loss 

to which his work activities certainly contributed. He further explained that, while other factors 

such as age and obesity may also contribute to the arthritic process, these other factors tended to 

enhance, and did not detract, from the substantial contribution that repetitive impact loading 

activities had on the condition. 

Dr. Whitelaw concluded that there was no doubt that the high impact loading work 

activities engaged by appellant contributed to the development and progression of his arthritis

through the process described above. Appellant’s medical records objectively supported this 

conclusion as they showed that during the time period that he was engaged in high impact loading 

activities, his arthritis presented and progressed. He reported that causation was established, that

even if work factors were a nonexclusive, minor, and insubstantial contributor to his medical 

condition, the duration of and extent of his high impact loading activities definitively established

the causal relationship in this case. 

By development letter dated January 12, 2018, OWCP informed appellant that the evidence 

of record was insufficient to support his claim. It advised him of the medical and factual evidence 
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needed and provided him with a questionnaire for completion. OWCP afforded appellant 30 days 

to submit the necessary evidence. In another development letter of even date, it requested that the 

employing establishment provide comments pertaining to appellant’s alleged occupational disease 

claim.

In a January 26, 2018 statement from the employing establishment, the postmaster related

that appellant’s daily duties included: one to two hours of standing, twisting, and bending setting 

up the route; six to seven hours of driving; four to five hours of walking from a vehicle to a mail 

box; two hours of driving up to mailboxes without exiting the vehicle by delivering to the box on 

the post; six to seven hours of twisting to gather mail for delivery at each address; and four to five 

hours of walking up and down stairs (approximately 800 to 900 stairs). She did not believe that 

appellant walked six to eight miles a day as he only had to walk from the vehicle to the mailbox 

for four to five hours per day. The postmaster noted that appellant had in the past carried a satchel 

weighing up to 35 pounds, but the route he had been on since December 2016 did not have a park 

and loop area requiring him to carry a satchel. She also noted that carriers were required to lift up 

to 70 pounds, which was an occasional package from the truck to the front door of the residence. 

The postmaster reported that appellant was required to lift trays of mail from the back of the vehicle 

to the front for loading, but during the course of the day, he only carried the amount of mail for 

one delivery at a time. 

By letter dated January 31, 2018, counsel argued that Dr. Whitelaw’s July 20, 2017 

medical report established that appellant’s bilateral hip osteoarthritis was causally related to his 

federal employment duties. He further noted additional evidence submitted in support of 

appellant’s claim.

In a January 31, 2018 narrative statement, appellant responded to OWCP’s questionnaire 

and related that he did not engage in any sports or recreational activities outside of his federal 

employment. He further submitted additional medical reports in support of his claim including 

physical therapy notes dated July 9 through September 23, 2014, x-ray reports of the lumbosacral 

spine dated July 17 and 24, 2014, an undated lower limb questionnaire, and progress notes dated 

June 12, 2014 through June 15, 2017 documenting treatment for his condition. A position 

description for a city carrier was also submitted. 

By decision dated May 7, 2018, OWCP denied appellant’s claim, finding that the medical 

evidence of record was insufficient to establish that his diagnosed bilateral hip osteoarthritis 

condition was causally related to the accepted factors of his federal employment, which included 

lifting, walking, and climbing. It noted that Dr. Whitelaw’s opinion was speculative as he opined 

that appellant’s condition was likely caused or aggravated by his employment duties.

On May 16, 2018 appellant, through counsel, requested an oral hearing before an OWCP 

hearing representative. A hearing was held on October 25, 2018 during which appellant testified 

in support of his occupational disease claim.

In an October 31, 2018 narrative statement, appellant responded to the postmaster’s

statement. He reported that she failed to discuss the other routes that he had been assigned for 15 

years prior to changing routes in December 2016. Appellant reported that he was not solely 

attributing his current duties to his condition, but rather that the various employment duties he 
5

performed over the course of 18 years cumulatively contributed to his condition. He explained 

that, over the span of his entire career, his routes involved around 500 deliveries per day, walking 

six to eight miles per day, going up and down hundreds of stairs and curbs a day, and lifting, 

carrying, and delivering hundreds of pounds of mail and parcels per day on foot in all kinds of 

weather and over all kinds of terrain. Appellant also estimated getting in and out of his vehicle 

approximately 250 to 300 times per day over the span of his career. He further noted that the 

employing establishment omitted the fact that he cased mail for one to two hours per day which 

involved standing on his feet the entire time, bending at the hips, knees, and back, squatting,

reaching, walking, stooping, and a lot of twisting and pivoting on his feet to get the mail and 

parcels ready to deliver.

In a November 19, 2018 note, Dr. Whitehead responded to OWCP’s May 7, 2018 decision 

which found that his prior report was speculative. He reported that all of his opinions from his 

July 20, 2017 report were based on a reasonable degree of medical certainty. Dr. Whitehead

further asserted that appellant’s work activities as a letter carrier aggravated and hastened his 

arthritis and he reconfirmed his prior opinion with the highest degree of medical confidence that 

appellant’s employment duties caused his bilateral hip osteoarthritis.

In a statement dated November 14, 2018, the postmaster indicated that appellant had been 

employed at the Natick post office from 1999 until he came to the Medway post office in 2007. 

She noted that the Medway office was small with six routes and only one route required walking. 

The postmaster indicated that while employed from 2007 to 2016 in Medway, appellant was only 

required to deliver a route that required walking once a week, unless another carrier was on 

vacation or out sick. She noted that the other routes had no walking other than to dismount from 

the truck to the house.

By decision dated January 3, 2019, OWCP’s hearing representative affirmed the May 7, 

2018 decision finding that the medical evidence of record failed to establish that appellant’s 

bilateral hip osteoarthritis was 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 timely filed within the applicable 

time limitation period 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 

 

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

153 (1989).
6

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 a claim for 

occupational disease, 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.7

In an occupational disease claim, rationalized medical opinion evidence is required to 

establish causal relationship.8 The opinion of the physician must be based on a complete factual 

and medical background, 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 incident.9 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.10

ANALYSIS

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

In medical reports dated July 20, 2017 and November 19, 2018, Dr. Whitelaw opined that 

appellant’s employment duties as a letter carrier over the course of 18 years contributed to and 

accelerated his bilateral hip osteoarthritis. He discussed appellant’s medical history, reviewed 

diagnostic reports, provided findings on physical examination, and explained how appellant’s 

employment factors physiologically caused his bilateral hip osteoarthritis. 

 

5

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

ECAB 312 (1988).

6 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).

7 C.M., Docket No. 19-0264 (issued December 19, 2019); see Roy L. Humphrey, 57 ECAB 238, 241 (2005). Ruby I. 

Fish, 46 ECAB 276, 279 (1994). 

8 See 20 C.F.R. § 10.110(a); M.M., Docket No. 18-1366 (issued February 27, 2019); John M. Tornello, 35 ECAB 

234 (1983).

9 S.S., Docket No. 18-1488 (issued March 11, 2019). 

10 S.H., Docket No. 17-1660 (issued March 27, 2018); James Mack, 43 ECAB 321 (1991).
7

Dr. Whitelaw discussed the mechanism of injury for this occupational disease claim.11 He 

defined arthritis as a failure and loss of articular cartilage surface, explaining that the progression 

of arthritis was accelerated through a biological/chemical process that occurs by which excessive 

impact loading and repeated local stresses which caused mechanical stresses on the cartilage 

surface, resulting in chronic inflammation. This inflammation resulted in an accelerated loss of 

articular cartilage in the affected areas, in this case in the lower extremities. Inflammation resulted

in a chemical change within the cartilage as it activated degradative enzymes which caused the 

loss of the proteoglycans. Dr. Whitelaw noted that this loss of proteoglycans was significant 

because, among other reasons, proteoglycans are responsible for cartilage resilience. He explained 

that loading and local stresses arising from appellant’s repetitive motion activities such as knee 

bending, kneeling, lifting, climbing, stooping, twisting, squatting, and carrying contributed to the 

development and progression of appellant’s accelerated loss of articular cartilage and his bilateral 

hip osteoarthritis. Dr. Whitelaw indicated that appellant’s medical records contained objective 

support for causal relationship between his longstanding heavy labor work activities and his 

bilateral hip osteoarthritis. 

In the January 3, 2019 decision, OWCP’s hearing representative took issue with

Dr. Whitelaw’s reports noting that there was no objective evidence that the osteoarthritis had

accelerated. The Board notes that appellant has provided medical reports and studies dating back 

to 2014 which document the progression of his condition. The Board further notes that appellant 

has established the described repetitive employment duties over the course of his 18-year career 

as he is claiming an occupational disease as a result of his employment as a letter carrier. Thus,

Dr. Whitelaw had an accurate history based on a cumulative description of the various duties 

performed beginning in 1999 at the start of his employment.

The Board finds that the medical evidence of record is sufficient to require further 

development of the case record.12 It is well established that proceedings under FECA are not 

adversarial in nature and while the claimant has the burden of establishing entitlement to 

compensation, OWCP shares responsibility in the development of the evidence to see that justice 

is done.13

The Board notes that Dr. Whitelaw provided an opinion based on examination findings. 

Additionally, his opinion is not contradicted by any substantial medical or factual evidence of 

record.14 The Board finds that the opinion of Dr. Whitelaw is sufficient to require further 

development of the medical evidence.

15

 

 

11 See L.H., Docket No. 17-0947 (issued March 8, 2018).

12 C.T., Docket No. 16-1222 (issued March 9, 2017).

13 A.P., Docket No. 17-0813 (issued January 3, 2018); Phillip L. Barnes, 55 ECAB 426 (2004).

14 J.G., Docket No. 18-1484 (issued June 14, 2019); L.R., Docket No. 12-0239 (issued August 17, 2012).

15 J.W., Docket No. 19-1201 (issued November 8, 2019); L.D., Docket No. 09-1503 (issued April 15, 2010).
8

The Board will remand the case for further development of the medical evidence.16 On 

remand OWCP should prepare a statement of accepted facts and route the case file and appellant 

to an appropriate Board-certified physician to obtain a rationalized opinion as to whether 

appellant’s bilateral hip osteoarthritis is causally related to his federal employment duties, directly 

or through aggravation, precipitation, or acceleration.17 Following this and any other further 

development deemed necessary, OWCP shall issue a de novo decision on appellant’s occupational 

disease claim.18

CONCLUSION

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

ORDER

IT IS HEREBY ORDERED THAT the January 3, 2019 decision of the Office of 

Workers’ Compensation Programs is set aside and the case is remanded for further development 

consistent with this decision.

Issued: February 10, 2020

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

 

16 C.W., Docket No. 17-1293 (issued February 12, 2018).

17 X.V., Docket No. 18-1360 (issued April 12, 2019); P.A., Docket No. 09-0319 (issued November 23, 2009).

18 S.W., Docket No. 18-0119 (issued October 5, 2018).