United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

J.W., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Dallas, TX, Employer

__________________________________________

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Docket No. 18-0670

Issued: September 11, 2018

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On February 8, 2018 appellant filed a timely appeal from a December 29, 2017 merit 

decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the Federal 

Employees’ Compensation Act1(FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has 

jurisdiction over the merits of this case.

ISSUE

The issue is whether appellant has met her burden of proof to establish a left lower 

extremity injury due to factors of her federal employment.

FACTUAL HISTORY

On October 14, 2016 appellant, then a 52-year-old supervisor of distribution, filed an 

occupational disease claim (Form CA-2) alleging that she sustained an injury to her left lower 

extremity due to factors of her federal employment. She advised that she had been a mail handler 

 

1 5 U.S.C. § 8101 et seq.
2

working on the north dock where she loaded, pushed, and pulled equipment, loaded trucks, and 

staged equipment on the dock for six hours per day. Appellant asserted that the continuous walking 

she engaged in at work had caused burning, swelling, tingling, and cramps in her left ankle/heel 

which moved up the back side of her left leg and calf muscle. She reported that she first became 

aware of her claimed condition on December 30, 2015 and first realized on October 4, 2016 that 

it was caused or aggravated by her federal employment. Appellant did not stop work.

In an October 19, 2016 letter, appellant’s immediate supervisor indicated that appellant 

was hired by the employing establishment on January 1, 1998 as a mail handler. The physical 

requirements of the mail handler job included lifting 70 pounds, walking, standing, bending, 

stooping, pushing, pulling, twisting, fine manipulation, and simple grasping for at least eight hours 

per day, five days per week. The supervisor noted that appellant was on the overtime list, so she 

might have worked up to 10 to 12 hours per day for five days per week. She indicated that appellant 

was promoted to a supervisor of distribution position in the spring of 2016, a position which 

involved supervising the operation of three automated flat sorter machines. The supervisor of 

distribution position required appellant to walk continuously.

The findings of an October 24, 2016 magnetic resonance imaging (MRI) scan of 

appellant’s left foot contained an impression of navicular bone edema with no evidence of fracture, 

mild osteoarthritis of the first metatarsophalangeal joint, and inferior calcaneal spur suggesting the 

patient suffered from plantar fasciitis in the past. An October 25, 2016 MRI scan of appellant’s 

left ankle contained an impression of grade 1 strain and mild intrasubstance partial tearing within 

the distal Achilles tendon, tibialis posterior and flexor hallucis longus tenosynovitis, grade 1 strain 

of the peroneal tendons near the level of the calcaneocuboid articulation, small tibiotalar and 

subtalar ankle effusions, bone edema within the navicular bone (without displaced fracture) -- most 

likely related to contusion “from the patient’s injury,” and edematous inferior calcaneal spur with 

minimal plantar fascial edema reflecting chronic plantar fasciitis and a mild superimposed acute 

component.2

In a November 4, 2016 development letter, OWCP requested that appellant submit 

additional evidence in support of her claim, including a physician’s opinion supported by a medical 

explanation as to how the reported employment activities caused or aggravated a diagnosed 

medical condition. In an attached questionnaire, it requested that she provide a detailed description 

of the work duties that she believed caused or aggravated her claimed condition, including a 

description of how often and for how long she performed such duties. OWCP afforded appellant 

30 days to respond. Appellant did not respond within the period afforded by OWCP.

In a November 4, 2016 letter, OWCP also requested additional information from the 

employing establishment regarding appellant’s physical requirements and the frequency and 

duration of her various work duties. In response, appellant’s immediate supervisor submitted a 

November 16, 2016 letter which contained the same text as her October 19, 2016 letter.

By decision dated January 23, 2017, OWCP accepted the employment factors as alleged, 

including the fact that appellant engaged in loading, pushing, and pulling equipment, loading 

 

2 The clinical history portion of the October 25, 2016 report indicates that appellant reported having a “work-related 

injury with ankle pain.” 
3

trucks, and staging equipment. However, it denied appellant’s claim because she failed to submit 

medical evidence containing a history of her injury and a medical diagnosis made in connection 

with the accepted employment factors.3

On April 25, 2017 appellant requested reconsideration of OWCP’s January 23, 2017 

decision.

In an October 4, 2016 report, Dr. Christopher R. Mann, an attending Board-certified family 

practitioner, indicated that appellant reported that she had worked for the employing establishment 

for the past 18 years. Appellant advised that she worked as a supervisor for the past year, but prior 

to that she worked as a mail handler up until November 2015. Dr. Mann noted that she reported

that she was working as a mail handler when she sustained an insidious injury to her left foot and 

ankle on November 30, 2015. Appellant reported that she was performing her usual work duties 

when she experienced a burning sensation shooting from her left ankle up to her left knee and her 

left leg started to swell and ache. She advised that these symptoms increased with the activities of 

standing and walking and she described her work duties as including pushing/pulling objects such 

as mail containers all day long, as well as engaging in lots of standing and walking. Dr. Mann 

indicated that appellant denied any prior injury to her left leg/foot or any history of hobbies, sports, 

or other personal activities that would contribute to her reported condition. He detailed the findings 

of the physical examination he conducted on October 4, 2016, noting that she had 5/5 left leg 

strength and negative results upon radiculopathy and straight leg testing of her left leg. Dr. Mann 

discussed appellant’s October 24 and 25, 2016 MRI scans and diagnosed left Achilles tendinitis, 

left ankle sprain, left plantar fasciitis, and left peroneal tendinitis. He noted, “The employment 

factors of doing above[-]mentioned activities at work have with reasonable medical certainty 

caused the injuries to her left ankle and foot.”

4

By decision dated July 19, 2017, OWCP denied appellant’s claim for an employmentrelated occupational injury. It modified its January 23, 2017 decision to reflect that she had 

established the medical component of the fact of injury, but that her claim remained denied because 

she failed to establish causal relationship between the claimed conditions and the accepted 

employment factors. OWCP indicated that, in his October 4, 2016 report, Dr. Mann diagnosed 

conditions which he felt were related to appellant’s work duties, but that he failed to provide 

sufficient medical rationale to establish causal relationship between those conditions and 

appellant’s work duties.

On October 3, 2017 appellant requested reconsideration of OWCP’s July 19, 2017 

decision.

In a September 5, 2017 report, Dr. Mann indicated that he was providing further 

explanation of the mechanics of the employment injury “claimed for the left foot and ankle on 

 

3 OWCP indicated that the diagnostic testing submitted by appellant was insufficient to establish the medical 

component of the fact of injury.

4 Dr. Mann indicated that, after full review of the available records, additional diagnostic testing might be required. 

He noted that appellant could perform regular-duty work with restrictions per a written duty status report (Form CA17), but the record does not contain a completed Form CA-17.
4

November 30, 2015.” He noted that appellant reported that her mail handler duties required a lot

of pushing and pulling of heavy containers and wire cages, as well as lots of walking and standing 

for long hours on uneven surfaces. Dr. Mann noted that appellant reported that, when she was 

pushing the various large containers of mail, her left leg was her dominant push-off leg and lots of 

force was repeatedly exerted into her left foot and ankle on a daily basis. He noted that the 

repetitive strain pattern was consistent with the physical findings of tender left ankle collateral 

ligaments and inflamed left peroneal tendon and indicated that this same repetitive push-off strain 

would cause inflammation in the left Achilles tendon as well. Dr. Mann posited that the lateral 

strain placed on appellant’s foot and ankle on a daily basis was the cause of the soft tissue edema 

and injury which was seen on the October 2017 MRI scans of her left foot and ankle. He noted 

that the MRI scan of her left ankle reflected this straining pattern with intrasubstance partial tearing 

within the distal Achilles tendon, mild tenosynovitis and grade 1 strain of the peroneal tendons, 

and proximal plantar fascia of a mildly edematous nature. Dr. Mann opined that appellant 

presented with a historical description that was consistent with her positive objective physical 

findings. He indicated that appellant’s diagnostic study results “confirmed injuries to her left

Achilles tendon, plantar fascia, peroneal tendon, and lateral stability of the ankle within reasonable 

medical certainty caused by the repeated strain the patient exerts into her left ankle and foot with 

each heavy push at her station.”

By decision dated December 29, 2017, OWCP denied modification of its July 19, 2017 

decision. It determined that Dr. Mann’s September 5, 2017 report was not sufficiently wellrationalized to establish causal relationship between the diagnosed conditions and the accepted 

employment factors.

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, that the injury was sustained while 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.5 To establish fact of injury, an employee must submit 

evidence sufficient to establish that he or she experienced a specific event, incident, or exposure 

occurring at the time, place, and in the manner alleged.6 An employee must also establish that 

such event, incident, or exposure caused an injury.7 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.8

 

 

5 5 U.S.C. § 8101(1); B.B., 59 ECAB 234 (2007); Elaine Pendleton, 40 ECAB 1143 (1989).

6

J.C., Docket No. 16-0057 (issued February 10, 2016); E.A., 58 ECAB 677 (2007). 

7

Id.

8 R.H., 59 ECAB 382 (2008); Ellen L. Noble, 55 ECAB 530 (2004).
5

OWCP regulations define the term “[o]ccupational disease or illness” as a condition 

produced by the work environment over a period longer than a single workday or shift.9 To 

establish that an injury was sustained in the performance of duty in an occupational disease claim, 

an employee 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 diagnosed condition is 

causally related to the employment factors identified by the employee.10

The medical evidence required to establish causal relationship generally is rationalized 

medical opinion evidence.11 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 established employment factors.12

ANALYSIS

The Board finds that the case is not in posture for decision regarding whether appellant met 

her burden of proof to establish a left lower extremity injury due to factors of her federal 

employment.

Appellant submitted an October 4, 2016 report from Dr. Mann, an attending physician,

who indicated that appellant reported that she had worked for the employing establishment for the 

past 18 years. She reported to Dr. Mann that she worked as a supervisor for the past year, but prior 

to that she worked as a mail handler up until November 2015. Dr. Mann noted that she reported 

that she was working as a mail handler when she sustained an insidious injury to her left foot and 

ankle on November 30, 2015. Appellant reported that she was performing her usual work duties 

when she experienced a burning sensation shooting from her left ankle up to her left knee and her 

left leg started to swell and ache. She described her work duties as including pushing/pulling 

objects such as mail containers all day long, as well as engaging in lots of standing and walking. 

Dr. Mann diagnosed left Achilles tendinitis, left ankle sprain, left plantar fasciitis, and left peroneal 

tendinitis and noted, “The employment factors of doing above[-]mentioned activities at work have 

with reasonable medical certainty caused the injuries to her left ankle and foot.”

Appellant also submitted a September 5, 2017 report from Dr. Mann who advised that he 

was providing further explanation of the mechanics of the employment injury claimed for 

appellant’s left foot and ankle. Dr. Mann noted that appellant reported that her mail handler duties 

required a lot of pushing and pulling of heavy containers and wire cages, as well as a lot of walking 

and standing for long hours on uneven surfaces. He indicated that she reported that, when she was 

 

9 20 C.F.R. § 10.5(q); see also Federal (FECA) Procedure Manual, Part 2 -- Claims, Initial Development of Claims, 

Chapter 2.800.2b (June 2011).

 

10 D.H., Docket No. 15-1876 (issued January 29, 2016); D.I., 59 ECAB 158 (2007); Victor J. Woodhams, 41 ECAB 

345 (1989).

 

11 F.S., Docket No. 15-1052 (issued July 17, 2015); Tomas Martinez, 54 ECAB 623 (2003).

 

12 P.K., Docket No. 08-2551 (issued June 2, 2009); John W. Montoya, 54 ECAB 306 (2003).
6

pushing the various large containers of mail, her left leg was her dominant push-off leg and lots of 

force was repeatedly exerted into her left foot and ankle on a daily basis. Dr. Mann opined that 

the lateral strain placed on appellant’s foot and ankle on a daily basis was the cause of the soft 

tissue edema and injury which was seen on the October 2017 MRI scans of her left foot and ankle. 

He noted that the repetitive strain pattern was consistent with the physical findings of tender left 

ankle collateral ligaments and inflamed left peroneal tendon and indicated that this same repetitive 

push-off strain would cause inflammation in the left Achilles tendon as well. He also indicated

that appellant’s diagnostic study results confirmed injuries, including those to her left Achilles 

tendon, plantar fascia, and peroneal tendon, which were caused by the repeated strain she “exerts 

into [appellant’s] left ankle and foot with each heavy push at her station.”

These reports contain a history of injury, diagnoses, and an opinion that appellant sustained 

a left lower extremity injury due to factors of her federal employment. While Dr. Mann’s reports 

are insufficient to meet appellant’s burden of proof, they do raise an uncontroverted inference of 

causal relation between the accepted employment factors and her diagnosed left lower extremity 

conditions, and are sufficient to require OWCP to undertake further development of appellant’s 

claim.13

Thus, the Board finds that further development is required to determine whether appellant 

sustained a left lower extremity injury due to factors of her federal employment.14 On remand 

OWCP should prepare a statement of accepted facts and refer appellant to an appropriate Boardcertified specialist for a second opinion examination and an evaluation regarding whether she has 

sustained injury causally related to the accepted employment factors. Following any necessary 

further development, OWCP shall issue a de novo decision. 

CONCLUSION

The Board finds that the case is not in posture for decision regarding whether appellant met

her burden of proof to establish a left lower extremity injury due to factors of her federal 

employment. The case is remanded to OWCP for further development.

 

13 See John J. Carlone, 41 ECAB 354 (1989).

14 D.C., Docket No. 14-1312 (issued May 6, 2015); K.M., Docket No. 12-0726 (issued January 22, 2013); D.N.,

Docket No. 09-0651 (issued April 20, 2010).
7

ORDER

IT IS HEREBY ORDERED THAT the December 29, 2017 decision of the Office of 

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

action consistent with this decision.

Issued: September 11, 2018

Washington, DC

Patricia H. Fitzgerald, Deputy 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