United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

D.B., Appellant

and

DEPARTMENT OF VETERANS AFFAIRS, 

EDWARD HINES, JR. VETERANS 

ADMINISTRATION MEDICAL CENTER, 

Hines, IL, Employer

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Docket No. 19-0514

Issued: January 27, 2020

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

JANICE B. ASKIN, Judge

JURISDICTION

On January 8, 2019 appellant, through counsel, filed a timely appeal from an August 30, 

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 his burden of proof to establish lung conditions 

causally related to the accepted factors of his federal employment. 

FACTUAL HISTORY

On July 25, 2017 appellant, then a 60-year-old reproduction equipment operator, filed an 

occupational disease claim (Form CA-2) alleging multiple medical conditions as a result of being 

exposed to chemical fumes due to factors of his federal employment. He indicated that he first 

became aware of his conditions, and their relationship to factors of his federal employment, on 

October 21, 2014.

In a narrative statement dated July 25, 2017, appellant indicated that on September 3 

and 11, 2014 he was exposed to hazardous roofing material chemicals, which came through the 

air conditioning system and into his employment duty station. He noted that he left work on 

September 11, 2014 for medical examination. Appellant subsequently felt ill in the days after 

exposure and sought medical treatment from his primary physician on September 30, 2014. He 

related that a scan of his lungs revealed a number of noncalcified growths sprouting in both lungs. 

Appellant indicated that he began experiencing severe pain in his lower intestines on March 5, 

2015 and was diagnosed with infectious colitis. He noted that he was hospitalized and then placed 

on a steroid medication for his lung disease, which had been diagnosed as sarcoidosis. Appellant 

noted that the steroid medication caused side effects including a collapsed left lung and 

dangerously low levels of oxygen. He also noted that, subsequent to filing the Form CA-2, he also 

suffered from blood poisoning, bronchitis, a fractured back from repetitive coughing, a left-sided 

hernia, and had major corrective spinal surgery all of which he attributed to the chemical exposure 

in March 2014.

In a development letter dated August 9, 2017, OWCP advised appellant of the deficiencies 

of his claim. It provided a questionnaire for his completion and informed him of the medical 

evidence needed to establish his claim. OWCP afforded appellant 30 days to submit the necessary 

evidence.

In response to OWCP’s development letter, on August 14, 2017 OWCP received 

approximately 100 separate diagnostic examination reports ranging from December 17, 2008 to 

July 1, 2016 regarding appellant’s lung conditions.

In addition, OWCP received approximately 40 separate medical reports with dates ranging 

from March 30, 2014 to October 28, 2016 from various physicians at the Veterans Administration 

(VA) Hospital in Hines, IL including: a report dated March 30, 2014 from Dr. Hameeda Shaikh, 

a Board-certified pulmonologist; a report dated February 24, 2015 from Dr. Michael Eng, a Boardcertified cardiothoracic surgeon; reports dated April 7, 2015 from Dr. John Santaniello, a Boardcertified general surgeon, and Dr. Michael Sprang, a Board-certified gastroenterologist; a report 

dated April 21, 2015 from Dr. Jennifer Plitcha, a Board-certified general surgeon; a report dated 

May 19, 2015 from Dr. Usman Khan, a Board-certified pulmonologist; a report dated August 26, 

2015 from Dr. Ambrose Panico, an osteopath; a report dated September 15, 2015 from

Dr. William W. Ashley, a Board-certified neurosurgeon; a report dated December 8, 2015 from
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Dr. Linda Chan, a Board-certified pulmonologist; a report from Dr. Raj Uppal, an anesthesiology 

specialist; multiple reports dated February 1 through 16, 2016 from Dr. Teng Moua, a Boardcertified pulmonologist; reports dated February 2 and 17, 2016 from Dr. Robert A. Werners, a 

Board-certified endocrinologist; reports dated February 4, 2015 and June 9, 2016 from

Dr. Brian E. Grogg, Board-certified in physical medicine and rehabilitation; a report dated 

February 4, 2016 from Dr. Amy E. Rabatin, Board-certified in physical medicine and 

rehabilitation; multiple reports dated February 19 through April 15, 2016 from Dr. Michael Frett, 

a pain management specialist; a report dated May 15, 2016 from Dr. W. Richard Marsh, a Boardcertified neurosurgeon; a report dated May 18, 2016 from Dr. Jeremy L. Fogelson, a Boardcertified neurosurgeon; a report dated June 17, 2016 from Dr. Stephen J. Johans, a Board-certified 

neurosurgeon; a report dated June 29, 2016 from Dr. Jerry Bauer, a Board-certified neurosurgeon; 

and a report dated October 28, 2016 from Dr. Frank Laghi, a Board-certified pulmonologist. These 

physicians collectively diagnosed the following conditions: lung nodules, chronic back pain, 

degenerative disc disease, steroid-induced osteoporosis with fracture, steroid-induced testicular 

hypofunction, infectious colitis, enteritis, gastritis, blood poisoning, sleep apnea, and rheumatic 

disorders of both mitral and tricuspid valves. Each physician reviewed appellant’s history of injury 

and diagnostic reports, performed a physical examination, and diagnosed a variety of conditions.

In a report dated February 16, 2016, Dr. Moua indicated that he could not provide a 

definitive diagnosis as to whether the lung nodules were sarcoidic in nature, and noted that, even 

if the nodules were sarcoidic, the brief exposures on September 9 and 11, 2014 could not have 

caused them.

OWCP reviewed the medical records submitted and undertook further development of the 

claim. In a new development letter dated September 21, 2017, it advised appellant of the 

deficiencies of his claim, notified him of the type of additional evidence needed to establish his 

claim, and provided a questionnaire for his completion. Appellant was informed of the medical 

evidence necessary to establish his claim. OWCP afforded him 30 days to respond.

On October 17, 2017 OWCP received 83 separate medical reports, dated August 26, 2015 

to October 12, 2017, from a number of physicians at the VA Hospital in Hines, IL, including: a 

report dated August 26, 2015 from Dr. Keith Burgard, an internal medicine specialist; multiple 

reports dated September 14, 2015 through September 26, 2017 from Dr. Farah A. Meah, a Boardcertified endocrinologist; a report dated February 19, 2016 from Dr. Kaya Shah, a pain 

management specialist; multiple reports dated March 7, 2016 through June 2, 2017 from

Dr. Laghi; a report dated March 25, 2016 from Dr. Arslan Zaidi, a pain management specialist; a 

report dated April 15, 2016 from Dr. Sara Strowd, a pain management specialist; a report dated 

June 21, 2016 from Dr. Yvonne Lucero, a physical medicine and rehabilitation specialist; multiple 

reports dated August 25, 2016 through March 16, 2017 from Dr. Michael Wernhoff, a Boardcertified neurosurgeon; a report dated August 28, 2016 from Dr. Edward C. Villa, an emergency 

medicine specialist; a report dated September 23, 2016 from Dr. Bruce E. Lewis, a Board-certified 

neurosurgeon; a report dated November 26, 2016 from Dr. Stephen Roberts, a Board-certified 

neurosurgeon; a report dated December 3, 2016 from Dr. Swathi Chidambaram, a Board-certified 

neurosurgeon; a report dated December 13, 2016 from Dr. John S. Wheeler, a Board-certified 

neurosurgeon; two reports dated September 20, 2017 from Dr. Kevin Swong, a Board-certified 

neurosurgeon, and Dr. Matthew Kominsky, a pain management specialist; two reports dated 

October 11 and 12, 2017 from Dr. Wermers; a report dated October 12, 2017 from Dr. Grogg; and 
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two reports dated October 12 and 30, 2017 from Dr. Moua. These physicians provided 

examination findings including the previously listed diagnoses. 

In his October 12 and 30, 2017 reports, Dr. Moua indicated that he was provided with the 

material safety data sheet for the chemical exposure and that it was not likely that one exposure 

could be the cause of appellant’s pulmonary condition. In addition, he diagnosed nodules with 

unknown etiology and could not definitively choose between the possible causes of granulomatous 

infection or inflammation, sarcoidosis, or inhalation injury.

By decision dated January 11, 2018, OWCP denied appellant’s occupational disease claim 

finding that the evidence of record failed to establish that his diagnosed conditions were causally 

related to the accepted factors of his federal employment.

On January 22, 2018 appellant, through counsel, requested a telephonic hearing before an 

OWCP hearing representative. He submitted two diagnostic reports dated October 21, 2014 and

December 18, 2015 along with his request.

On June 26, 2018 a hearing was held before an OWCP hearing representative.

By decision dated August 30, 2018, OWCP’s hearing representative affirmed OWCP’s 

January 11, 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,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 

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 

In an occupational disease claim, to establish that an injury was sustained in the 

performance of duty, 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 

 

3 Supra note 2.

4 A.M., Docket No. 18-1748 (issued April 24, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 

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

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 A.M., supra note 4; 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).
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disease or condition;7(2) medical evidence establishing the presence or existence of the disease or 

condition for which compensation is claimed;8and (3) medical evidence establishing that the 

diagnosed condition is causally related to the employment factors identified by the claimant.9

Causal relationship is a medical issue, and the medical evidence required to establish causal 

relationship is rationalized medical evidence.10 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 employee.11 

Neither the mere fact that a disease or condition manifests itself during a period of employment 

nor the belief that the disease or condition was caused or aggravated by employment factors or 

incidents is sufficient to establish causal relationship.12

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish lung conditions 

causally related to the accepted factors of his federal employment.

In support of his occupational disease claim, appellant submitted a total of 288 medical 

reports dated February 13, 2014 to October 12, 2017. These reports indicated appellant’s 

diagnosed conditions, which included: lung nodules, chronic back pain, degenerative disc disease, 

steroid induced osteoporosis with fracture, steroid-induced testicular hypofunction, infectious 

colitis, enteritis, gastritis, blood poisoning, sleep apnea, and rheumatic disorders of both mitral and 

tricuspid valves. However, none of these reports included a narrative medical opinion regarding 

the cause of appellant’s diagnosed conditions. The Board has held that medical evidence which 

does not offer an opinion on causal relationship is of no probative value to the issue of causal 

relationship.13 Therefore, these reports are insufficient to establish appellant’s claim.

The only physician of record who addressed causal relationship was Dr. Moua. In his 

reports dated October 12 and 30, 2017, Dr. Moua opined that he could not definitely identify the 

 

7 C.C., Docket No. 18-1229 (issued March 8, 2019); Marlon Vera, 54 ECAB 834 (2003); Roger Williams, 52 ECAB 

468 (2001).

8 K.C., Docket No. 19-1185 (issued November 12, 2019); R.A., Docket No. 16-1218 (issued November 10, 2016);

Michael R. Shaffer, 55 ECAB 386 (2004).

9

Id.

10 A.M., Docket No. 18-0685 (issued October 26, 2018).

11 E.V., Docket No. 18-0106 (issued April 5, 2018).

12 A.M., supra note 10; Dennis M. Mascarenas, 49 ECAB 215 (1997).

13 See L.T., Docket No. 18-1603 (issued February 21, 2019); L.B., Docket No. 18-0533 (issued August 27, 2018); 

D.K., Docket No. 17-1549 (issued July 6, 2018).
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etiology or cause of appellant’s conditions. As Dr. Moua’s opinion is equivocal and speculative 

in nature, it is insufficient to establish appellant’s claim.14

On appeal counsel asserts that appellant has met his burden of proof to establish that his 

diagnosed lung conditions are causally related to the accepted factors of his federal employment. 

He does not, however, cite to a rationalized medical report on the issue of causation. As explained 

above, the Board finds that the record lacks rationalized medical evidence establishing causal 

relationship between appellant’s federal employment duties and his diagnosed conditions. For 

this reason, the Board finds that appellant has not met his burden of proof to establish his claim.

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 lung conditions 

causally related to the accepted factors of his federal employment.

ORDER

IT IS HEREBY ORDERED THAT the August 30, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: January 27, 2020

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

 

14 M.M., Docket No. 19-0061 (November 21, 2019); D.R., Docket No. 17-0971 (issued October 5, 2017).