United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.H., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Wheeling, IL, Employer

__________________________________________

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Docket No. 19-0838

Issued: October 1, 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

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On March 13, 2019 appellant, through counsel, filed a timely appeal from a February 25, 

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.

 

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 a left ankle condition 

causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On December 18, 2017 appellant, then a 37-year-old city carrier assistant, filed an 

occupational disease claim (Form CA-2) for a left ankle condition due to factors of his federal 

employment including walking. He indicated that he first realized that he had a left ankle condition 

and that it was causally related to factors of his federal employment on December 4, 2017. On the 

back of the claim form a supervisor noted that appellant had not stopped work and had returned to 

work without restrictions. 

In a statement dated December 22, 2017, C.M., a supervisor of customer service, related

that appellant began working at the employing establishment in May 2017 and, when questioned 

about an absence in June 2017, advised that he had a preexisting foot condition. Appellant also 

mentioned injuring his foot in October 2017 while playing basketball. It was not until C.M. began 

removal proceedings due to appellant’s “foot problem and other continued absence” that appellant 

advised that his condition was employment related and filed an occupational disease claim. 

In a January 29, 2018 development letter, OWCP advised appellant that no medical 

evidence had been received in support of his claim. It informed him regarding the factual and 

medical evidence required to establish his claim and afforded him 30 days to provide the necessary 

evidence. Appellant submitted evidence in response to OWCP’s request. 

In a progress note dated August 23, 2017, Dr. Matthew D. Sorensen, a specialist in

podiatric surgery, provided examination findings and diagnosed left ankle calcaneofibular 

ligament sprain, left ankle joint instability, and ankle osteochondral defect. 

In progress notes dated from September 6 and October 18, 2017, Dr. Sorensen provided 

appellant’s physical examination findings and continued to note appellant’s left ankle diagnoses. 

Dr. Sorensen examined appellant again on December 4, 2017 and diagnosed left ankle joint 

instability and left ankle synovitis. In a December 18, 2017 report, he noted that appellant was 

initially evaluated for left foot pain. Dr. Sorensen reported that conservative medical treatment 

was unsuccessful due to employment-related aggravation of appellant’s left ankle instability. 

In an undated statement received on February 16, 2018, appellant related that he was 

assigned the longest route when he transferred to the employing establishment. His duties included 

lifting 5 to 35 pounds and walking between 8 to 10 hours daily. Appellant related that his pain 

worsened the more he worked his route. 

By decision dated March 19, 2018, OWCP denied the claim finding the evidence of record 

was insufficient to establish a causal relationship between the diagnosed medical condition and the 

accepted factors of employment. 
3

On March 26, 2018 appellant, through counsel, requested a telephonic hearing before an 

OWCP hearing representative, which was held on August 15, 2018. In physical therapy notes 

dated from April 13 through June 20, 2018, a physical therapist provided examination findings 

and related that appellant was status post ankle ligament repair and had left ankle pain, difficulty 

walking, and left ankle joint stiffness. 

By decision dated October 26, 2018, OWCP’s hearing representative affirmed the 

March 19, 2018 decision denying appellant’s claim. 

On November 28, 2018 appellant, through counsel, requested reconsideration and 

submitted a June 29, 2018 report from Dr. Sorensen. In the June 29, 2018 report, Dr. Sorensen

related that appellant was first seen on August 23, 2017 for left ankle pain complaints, which he 

related had been long standing, but had worsened. On December 4, 2017 appellant was seen for a 

worsening of his pain, which he attributed to his mail carrier position. He believed his left ankle 

condition had been aggravated and become more unstable due to his mail route, which consisted 

of even surfaces, cement, stairs, curbs, and other obstacles. Dr. Sorensen concluded that 

appellant’s long-standing left ankle instability had been aggravated by his work. 

By decision dated February 25, 2019, OWCP denied modification of the October 16, 2018 

decision. 

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,3that 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.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

OWCP’s regulations define an occupational disease as “a condition produced by the work 

environment over a period longer than a single workday or shift.”

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) 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 

 

3 T.H., Docket No. 18-1585 (issued March 22, 2019); S.B.,Docket No. 17-1779 (issued February 7, 2018); J.P., 59 

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

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

Sr., 40 ECAB 312 (1988).

5

J.P., Docket No. 19-0303 (issued August 13, 2019); K.M., Docket No. 15-1660 (issued September 16, 2016); 

L.M., Docket No. 13-1402 (issued February 7, 2014); DeloresC. Ellyett, 41 ECAB 992 (1990).

6

20 C.F.R. § 10.5(q).
4

establishing the presence or existence of the disease or condition for which compensation is 

claimed; 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 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 

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. 9

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish a left ankle 

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

In support of his claim, appellant submitted a series of reports from Dr. Sorensen. In 

reports dated December 18, 2017 and June 29, 2018, Dr. Sorensen opined that appellant’s left 

ankle instability had been aggravated by his employment duties. In the June 29, 2018 report, he 

related that appellant believed that his left ankle condition had become more unstable and been 

aggravated by his mail route. While Dr. Sorensen supported causal relationship, he did not identify 

specific work duties which allegedly caused or contributed to appellant’s left ankle condition nor 

did he offer medical rationale explaining how and why he opined that appellant’s work activities 

could result in the diagnosed conditions. The Board has frequently held that conclusory medical 

opinions are entitled to little probative weight and are insufficient to support causal relationship. 10 

A medical opinion must provide an explanation of how the specific employment factors 

physiologically caused or aggravated the diagnosed conditions.11 A rationalized medical opinion 

is especially necessary in light of appellant’s apparent preexisting left ankle condition.12 Without 

medical rationale explaining how the accepted employment factors caused or contributed to the 

diagnosed conditions, these reports are insufficient to establish appellant’s claim.13 

Dr. Sorensen’s remaining notes are of no probative value because they did not relate 

appellant’s diagnosis of left ankle calcaneofibular ligament sprain, left ankle joint instability, left 

 

7

J.P., supra note 5; BeverlyA. Spencer, 55ECAB 501 (2004).

8 T.H., supra note 3; I.R.,Docket No. 09-1229 (issued February 24, 2010); D.I., 59 ECAB 158 (2007).

9 M.S., Docket 19-0189 (issued May 14, 2019); L.T., Docket No. 18-1603 (issued February 21, 2019).

10 R.R., Docket No. 19-0714 (issued August8, 2019). 

11 A.H., Docket No. 19-0270 (issued June 25, 2019); M.W., Docket No. 18-1624 (issued April 3, 2019);

B.H., Docket No. 18-1219 (issued January 25, 2019).

12 D.M., Docket No. 19-0389 (issued July 16, 2019). 

13 A.H., supra note 11; M.W.,supra note 11; R.T.,Docket No. 17-2019 (issued August 24, 2018).
5

ankle pain, left ankle synovitis, and ankle osteochondral defect to the accepted employment 

factors. 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.14 For the reasons set forth 

above, the Board finds that Dr. Sorensen’s progress notes and reports are insufficient to establish 

appellant’s burden of proof.

OWCP also received reports from a physical therapist. However, physical therapy reports 

have no probative medical value in establishing appellant’s claim as a physical therapist is not 

considered a “physician” as defined under FECA.15 As such, this evidence is also insufficient to 

meet appellant’s burden of proof.

On appeal counsel contends that OWCP’s February 25, 2019 decision is contrary to fact 

and law. For the reasons set forth above, the Board finds that appellant has not met his burden of 

proof.

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 his burden of proof to establish a left ankle 

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

 

14 See S.G., Docket No. 19-0041 (issued May 2, 2019); L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., 

Docket No. 17-1549 (issued July 6, 2018).

15 5 U.S.C. § 8101(2) provides that a physician includes surgeons, podiatrists, dentists, clinical psychologists, 

optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by state law. 

See 5 U.S.C. § 8102(2); S.G., id.; S.A.,Docket No. 16-1128 (issued November 24, 2017); M.M., Docket No. 16-1617 

(issued January 24, 2017); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006) (lay individuals such as nurses, 

physician assistants and physical therapists are not competent to render a medical opinion under FECA). See also 

Gloria J. McPherson, 51 ECAB 441 (2000); Charley V.B. Harley, 2 ECAB 208, 211 (1949) (a medical issue such as 

causal relationship can only be resolved through the submission of probative medical evidence from a physician).
6

ORDER

IT IS HEREBY ORDERED THAT the February 25, 2019 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: October 1, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board