United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

K.R., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Fernley, NV, Employer

__________________________________________

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Docket No. 19-0730

Issued: June 5, 2020

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On February 20, 2019 appellant, through counsel, filed a timely appeal from a November 2, 

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 her burden of proof to establish bilateral shoulder

conditions causally related to the accepted factors of her federal employment. 

FACTUAL HISTORY

On March 30, 2018 appellant, then a 57-year-old rural mail carrier, filed an occupational 

disease claim (Form CA-2), alleging that she developed a right shoulder torn rotator cuff and an

inflamed left shoulder causally related to factors of her federal employment including lifting large 

heavy boxes and delivering mail out of the vehicle window. She indicated that she first became 

aware of the condition on March 1, 2015 and its relationship to her federal employment on 

December 1, 2017. Appellant explained that she did not file the claim within 30 days of realizing 

that her condition was caused or aggravated by her employment because she had filed a previous 

claim which was denied, but her shoulder continued to worsen. She noted that she received the 

results of magnetic resonance imaging (MRI) scans, which displayed damage to her shoulders.

3

 

On the reverse side of the claim form, the employing establishment indicated that appellant first 

received medical treatment on January 5, 2018 and stopped work on March 20, 2018.

In a March 30, 2018 statement, appellant related that she began experiencing shoulder pain 

in March 2015 and was treated by a chiropractor and orthopedic surgeon, but that her shoulder 

pain returned after a year, and she filed a claim. She indicated that in January 2018 she again saw 

an orthopedist and received a cortisone injection in her right shoulder, returned on February 26, 

2018 when her shoulders again started hurting, and the doctor scheduled the MRI scans. The 

orthopedist then told her that she had a torn rotator cuff in her right shoulder and that her left 

shoulder was inflamed. Appellant indicated that on March 21, 2018 she became unable to perform 

her job tasks.

On a March 30, 2018 work status form, Dr. Michael Edmunds, a Board-certified orthopedic 

surgeon, advised that appellant could return to light duty with upper extremity restrictions.

By development letter dated April 4, 2018, OWCP advised appellant that additional 

evidence was required to support her claim. It advised her of the type of factual and medical 

evidence necessary to establish her claim and attached a questionnaire for her completion. OWCP 

also requested a narrative medical report from appellant’s physician that provided a firm diagnosis 

of a condition and a rationalized opinion on how appellant’s employment duties caused or 

aggravated her condition. It afforded her 30 days to provide the necessary information. 

In an undated statement, A.P., the officer-in-charge at the employing establishment, noted 

that on March 20, 2018 appellant advised him that her condition was worsening, and that the doctor 

requested an MRI scan, which showed that appellant had a torn rotator cuff. He indicated that 

appellant then contacted him to file a claim. A.P. noted that she had filed a claim the previous 

year which was denied. He reported that appellant had submitted medical documentation and 

requested a CA-2 form. 

 

3 The MRI scan reports are not found in the case record.
3

In response to the April 5, 2018 development letter, appellant submitted a timeline from 

March 2015 to May 2018 concerning her shoulder problems. She indicated that in March 2015 

she first noticed problems in her arms and shoulder, noting that they were fine in the morning, but 

ached, burned, and were uncomfortable on her drive home from work. Appellant related that she 

had several months of treatment with a chiropractor, and the pain subsided. She indicated that she 

had purchased a lightweight hand truck to aid with heavy and awkward packages at work, but that 

in July 2016 severe pain returned and she again sought medical care with Dr. Edmunds who 

administered an injection her shoulder which relieved her pain until October/November 2017 when 

the pain returned. Appellant indicated that she again sought medical treatment and had another 

injection in her right shoulder, but returned to see Dr. Edmunds in February 2018 who scheduled 

an MRI scan of both shoulders. She noted the MRI scan results and stated that she could no longer 

tolerate the pain, so that on March 20, 2018 she stopped work and filed her claim. Appellant noted 

that, at the present time, her left shoulder had improved, but her right shoulder interrupted her 

sleep. She indicated that, even with the hand truck, she still had to get packages into and out of 

the back of the postal vehicle and that swinging heavy trays of mail into the front also contributed 

to her pain. Appellant maintained that the volume of packages had increased, and that even with 

packages that were not heavy, the repeated stretching and reaching needed for mail handling were 

contributing factors to her shoulder pain. She reiterated her belief that the pain was work related 

because it had lessened in the morning, but was worse after work. Appellant noted that right 

shoulder surgery was tentatively scheduled for May 16, 2018. 

Appellant indicated that she worked from 7:00 a.m. to 4:00 p.m. five days a week, plus or 

minus 30 minutes, and spent approximately 2.5 hours casing mail, 30 minutes sorting up to 200 

packages per day and loading them and trays of mail into her vehicle. She related that loading the 

mail trays, which could weight up to 45 pounds, required picking them up and swinging them into 

the front tray of her vehicle with the majority of the weight on her right side and shoulder height. 

Appellant reported that packages could weigh up to 75 pounds plus, and could be large and bulky. 

She indicated that she spent 4.5 to 6 hours daily delivering mail out of the vehicle, which required 

reaching out the window, pulling on mailboxes that could stick. Appellant maintained that thick 

mail put a strain on her right wrist, thumb, and arm when delivering out the window. She also 

indicated that she owned horses and livestock, but that since having shoulder issues, she had to 

hire someone to care for her livestock. 

An April 24, 2018 state workers’ compensation form report by Dr. Alan Taylor, an

osteopath Board-certified in occupational medicine, noted appellant’s complaint of bilateral 

shoulder pain and a history of injury while delivering mail due to repetitious heavy lifting, which 

caused a strain in both shoulders. In response to the question “from the information given by the 

employee, together with the medical evidence, can you directly connect this injury or occupational 

disease as job incurred,” he wrote “No.” Dr. Taylor advised that appellant could return to work 

with a 10-pound lifting restriction.

In additional reports dated April 24, 2018, Dr. Taylor reported appellant’s complaint of a 

chronic shoulder condition that started in September 2015 and was not precipitated by a particular 

incident. He noted appellant’s history of treatment including MRI scans that demonstrated a right 

shoulder rotator cuff tear and left shoulder rotator cuff tendinitis. Appellant described the pain in 

her right shoulder as sharp and moderate-to-severe and indicated that it limited her range of motion, 

but that the pain in her left shoulder was not as bad. Dr. Taylor noted examination findings of no 
4

gross deformities on the right, with diffuse tenderness to palpitation over the entire shoulder,

decreased abduction, and intact strength and sensation. The left shoulder demonstrated a gross 

deformity, with diffuse tenderness to palpation minimal over the anterior shoulder, full range of 

motion, and intact strength and sensation. Dr. Taylor advised that she could return to restricted 

duty from April 24, 2018 to May 29, 2018. He recommended over-the-counter medication. 

By decision dated May 11, 2018, OWCP accepted that appellant’s employment factors 

occurred as alleged, but denied the claim because the evidence of record was insufficient to 

establish that appellant’s bilateral shoulder conditions were causally related to the accepted factors 

of federal employment. It concluded, therefore, that the requirements had not been met to establish 

an injury as defined by FECA.4

In a June 1, 2018 work status form, Dr. Edmunds diagnosed right rotator cuff tendinitis 

and advised that appellant should remain off work until her next appointment in four weeks. On 

a treatment note signed by Dr. Edmunds on June 12, 2018, he indicated that appellant was seen for 

a follow-up appointment two weeks after a non-authorized right shoulder supraspinatus tendon 

repair, which took place on June 1, 2018. Dr. Edmunds indicated that the small incisions healed. 

He referred appellant for physical therapy, recommended that she continue to wear a sling until 

her next visit, and advised that she avoid active use of her shoulder. Dr. Edmunds noted that he 

had discussed the history of appellant’s rotator cuff injury with her, and that she reported that she 

did far more lifting at work than she did at home. He opined that it was more likely than not that 

the repetitious lifting that appellant had done at work for the last 11 years was the primary 

contributor to her injury.

On August 6, 2018 appellant requested reconsideration. 

By decision dated November 2, 2018, OWCP denied modification of the May 11, 2018 

OWCP decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA5 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 of FECA,6that 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 

 

4 The record includes a second May 11, 2018 decision that is incomplete. 

5 Supra note 2.

6

J.P., Docket No. 19-0129 (issued April 26, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); Joe D. 

Cameron, 41 ECAB 153 (1989). 
5

the employment 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

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit: (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 identified employment factors.9

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.10 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factors must be based on a 

complete factual and medical background.11 Additionally, the physician’s opinion must be 

expressed in terms of a reasonable degree of medical certainty, and must be supported by medical 

rationale explaining the nature of the relationship between the diagnosed condition and appellant’s 

specific employment factors.12

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish bilateral 

shoulder conditions causally related to her accepted federal employment factors. 

In form reports dated April 24, 2018, Dr. Taylor did not address whether appellant’s 

shoulder condition was employment related. In response to a question on an April 24, 2018 state 

workers’ compensation form report inquiring: “from the information given by the employee, 

together with the medical evidence, can you directly connect this injury or occupational disease as 

job incurred,” he responded “No.” The Board has held that medical evidence that negates causal 

relationship is of no probative value.13 As Dr. Taylor negated causal relationship between the 

 

7 N.M., Docket No. 19-0258 (issued May 8, 2020); J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 

ECAB 427 (2008); James E. Chadden, Sr., 40 ECAB 312 (1988). 

8 R.R., Docket No. 19-0048 (issued April 25, 2019); L.M., Docket No. 13-1402 (issued February 7, 2014); 

Delores C. Ellyett, 41 ECAB 992 (1990). 

9 R.G., Docket No. 19-0233 (issued July 16, 2019). See also Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. 

Fish, 46 ECAB 276, 279 (1994); Victor J. Woodhams, 41 ECAB 345 (1989).

10 N.M., supra note 7; T.H., 59 ECAB 388 (2008); Robert G. Morris, 48 ECAB 238 (1996).

11 L.M., Docket No. 19-1981 (issued May 11, 2020); M.V., Docket No. 18-0884 (issued December 28, 2018); T.H., 

id.

12 L.M., id.; Victor Woodhams, supra note 9.

13 B.W., Docket No. 18-1674 (issued May 7, 2020, T.W., Docket No. 19-0677 (issued August 16, 2019); Solomon 

Polen, 51 ECAB 341 (issued March 1, 2000).
6

accepted employment factors and appellant’s diagnosed shoulder conditions, his reports are 

insufficient to meet her burden of proof.14

On June 12, 2018 Dr. Edmund reported a history that appellant did far more lifting at work 

than she did at home. He opined that it was more likely than not that the repetitious lifting appellant 

had done at work for 11 years was the primary contributor to her injury. The Board has held that 

a medical opinion is of limited value if it is conclusory in nature.15 A medical opinion must provide 

an explanation of how the implicated employment factors physiologically caused, contributed to, 

or aggravated the specific diagnosed conditions.16 Dr. Edmunds did not provide an explanation of 

the physiological mechanism by which appellant’s accepted factors of federal employment caused 

her shoulder conditions. As noted, a physician’s opinion must be based on a complete factual and 

medical background, must be expressed in terms of a reasonable degree of medical certainty, and 

must be supported by medical rationale explaining the nature of the relationship between the 

diagnosed condition and appellant’s specific employment factors.17 For this reason, Dr. Edmund’s 

opinion is insufficient to establish causal relationship.

Appellant has not submitted any rationalized medical evidence establishing that her 

claimed bilateral shoulder conditions are causally related to the accepted factors of her federal 

employment. As such, she has not met her burden of proof.

On appeal counsel maintained that the November 2, 2018 decision was contrary to law and 

fact. As explained above, the medical evidence of record is insufficient to meet appellant’s burden 

of proof.18

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 her burden of proof to establish bilateral 

shoulder conditions casually related to her accepted federal employment factors. 

 

14 See J.L., Docket No. 17-0177 (issued April 24, 2017). 

15 M.S., Docket No. 19-0189 (issued May 14, 2019). 

16 Id. 

17 Supra notes 11 and 12.

18 L.J., Docket No. 19-1343 (issued February 26, 2020).
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ORDER

IT IS HEREBY ORDERED THAT the November 2, 2018 decision of the Office of the 

Workers’ Compensation Program is affirmed. 

Issued: June 5, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board