United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.M., Appellant

and

U.S. POSTAL SERVICE, MORGAN 

PROCESSING & DISTRIBUTION CENTER, 

New York, NY, Employer

__________________________________________

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Docket No. 21-0937

Issued: December 21, 2021

Appearances: Case Submitted on the Record

Thomas S. Harkins, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 7, 2021 appellant, through counsel, filed a timely appeal from a January 5, 2021 

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 a medical condition 

causally related to accepted factors of her federal employment.

FACTUAL HISTORY

On June 25, 2019 appellant, then a 54-year-old supervisor of distribution operations, filed 

an occupational disease claim (Form CA-2) alleging that she developed back, bilateral knee, and 

bilateral foot conditions as a result of factors of her federal employment. She noted that she first 

became aware of her condition on November 27, 2017 and realized its relationship to her federal 

employment on November 27, 2018. Appellant stopped work on November 12, 2018.

In an August 8, 2019 development letter, OWCP informed appellant of the deficiencies of 

her claim. It advised her of the type of factual and medical evidence needed and provided a 

questionnaire for her completion. By separate development letter of even date, OWCP requested 

additional information from the employing establishment, including comments from a 

knowledgeable supervisor on the accuracy of appellant’s statements. It afforded appellant 30 days 

to provide the requested information.

In response, appellant submitted a completed questionnaire signed on August 21, 2019. 

She attributed the claimed conditions to repetitive walking, pushing, pulling, and bending while 

transporting mail back and forth over the distance of a long city block for nine hours a shift.

In a November 27, 2017 report, Dr. Ronald M. Chase, an orthopedic surgeon, diagnosed 

degenerative arthritis of both knees, lumbar herniated discs, lumbosacral radiculitis, and calcaneal 

spurs. He noted that these conditions had been confirmed by x-rays and magnetic resonance 

imaging (MRI) scans.

November 27, 2017 x-rays of the lumbar spine and left heel interpreted by Dr. Parashuram 

Pinnapureddy, a Board-certified radiologist, demonstrated mild degenerative spondylosis with 

levoscoliosis of the thoracolumbar spine, and calcaneal spurs.

In a July 24, 2018 report, Dr. Chase noted appellant’s symptoms of lumbar pain radiating 

into the lower extremities with bilateral paresthesias and weakness. On examination, he noted 

lumbar spasm, restricted lumbar motion, bilaterally positive straight leg raising tests, and bilateral 

lower extremity strength at 4-5/5. Dr. Chase noted that a lumbar MRI scan demonstrated multiple 

herniated discs with spinal cord and nerve root impingement.

In a report dated September 18, 2018, Dr. Chase noted complaints of pain and swelling in 

the dorsum of the right foot and bilateral heel pain, which appellant attributed to “extensive 

standing and walking at work.” On examination, he found swelling and bony deformity in the 

dorsum of the right midfoot. Dr. Chase diagnosed arthritis of the right ankle and right foot, and 

bilateral calcaneal spurs. He recommended heel cups, orthotics, and range of motion exercises.
3

OWCP received periodic reports by Dr. Chase dated from October 9, 2018 through 

February 12, 2019 noting continued lumbar, bilateral knee, right ankle, and right foot symptoms.

An x-ray of the right knee dated January 29, 2019 revealed mild degenerative changes and 

inferior patellar enthesophyte.

In a May 14, 2019 report, Dr. Chase diagnosed a left knee contusion with a flare-up of left 

knee arthritis following a fall while at work.

By decision dated November 4, 2019, OWCP accepted that the identified work factors had 

occurred as alleged and that the medical record contained definite diagnoses. It denied the claim, 

however, finding that the medical evidence of record was insufficient to establish causal 

relationship between appellant’s diagnosed lumbar and bilateral lower extremity conditions and 

the accepted employment factors.

On October 29, 2020 appellant, through counsel, requested reconsideration of OWCP’s 

November 4, 2019 decision, arguing that new medical evidence was sufficient to meet appellant’s 

burden of proof to establish causal relationship. He submitted an October 29, 2019 attending 

physician’s report (Form CA-20) by Dr. Chase, who noted that appellant had developed chronic

“pain from work.” Dr. Chase listed concurrent or preexisting conditions of degenerative arthritis 

of the left knee and chronic low back pain. On examination, he observed lumbar paraspinal muscle 

tenderness, radiculopathy into both lower extremities, and left knee swelling. Dr. Chase diagnosed 

a left knee contusion and a lumbosacral myofascial strain. He checked a box marked “Yes”

indicating his support for causal relationship, noting that appellant had developed chronic pain in 

her left knee and lower back related to employment activities. Dr. Chase found appellant totally 

disabled from work commencing November 27, 2018 and returned her to sedentary work.

In a November 10, 2020 report, Dr. Chase noted that appellant’s knees and lumbar spine 

had been symptomatic for several years. On examination, he observed an antalgic gait favoring 

the left lower extremity, bilateral patellar crepitus on range of motion, bilateral knee stiffness, mild 

instability of the left knee, paraspinal muscle tenderness with mild spasms, bilaterally positive 

straight leg raising tests, and lower extremity motor strength of 4-5/5 bilaterally. Dr. Chase

reviewed November 4, 2020 bilateral knee x-ray reports, which demonstrated bilateral inferior 

patellar enthesopathy and effusions. He also reviewed reports of lumbar x-rays and a lumbar MRI 

scan obtained on November 4, 2020, which demonstrated a grade 1 degenerative anterolisthesis at 

L4-5 contributing to mild spinal canal stenosis, a central L4-5 disc protrusion with left lateral 

herniation, a left central L5-S1 disc herniation, and levoscoliosis. Dr. Chase diagnosed bilateral 

degenerative knee arthritis, L4-5 and L5-S1 disc herniations, and lumbosacral radiculitis. He 

prescribed medication and noted work restrictions.

By decision dated January 5, 2021, OWCP denied modification of the November 4, 2019 

decision.
4

LEGAL PRECEDENT

An employee seeking benefits under FECA3 has the burden of proof to establish the 

essential elements of his or her claim, including 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,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

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 

casually related to the identified employment factors.7

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.8 The opinion of the physician must be based upon 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

In any case where a preexisting condition involving the same part of the body is present 

and the issue of causal relationship, therefore, involves aggravation, acceleration, or precipitation, 

3

Supra note 2.

4 F.H., Docket No.18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April26, 2019); JoeD. 

Cameron, 41 ECAB 153 (1989).

5 L.C., Docket No. 19-1301 (issued January29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020);

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

6 P.A., Docket No. 18-0559 (issued January 29, 2020);K.M., Docket No. 15-1660 (issued September 16, 2016);

DeloresC. Ellyett, 41 ECAB 992 (1990).

7 T.W., Docket No. 20-0767 (issued January 13, 2021); L.D., Docket No. 19-1301 (issued January 29, 2020);S.C., 

Docket No. 18-1242 (issued March 13, 2019).

8

I.J., Docket No. 19-1343 (issued February 26, 2020);T.H., 59 ECAB 388 (2008); Robert G. Morris, 48 ECAB 

238 (1996).

9 D.C., Docket No. 19-1093 (issued June 25, 2020);see L.B., Docket No. 18-0533 (issued August 27, 2018).
5

the physician must provide a rationalized medical opinion that differentiates between the effects 

of the work-related injury or disease and the preexisting condition.10

ANALYSIS

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

condition causally related to accepted factors of her federal employment.

In reports dated from November 27, 2017 through November 10, 2020, Dr. Chase 

diagnosed herniated L4-5 and L5-S1 discs with spinal cord and nerve root impingement, 

lumbosacral radiculitis, levoscoliosis, degenerative arthritis of both knees, arthritis of the right 

ankle and foot, and calcaneal spurs. He noted in a September 18, 2018 report that appellant 

attributed right foot and bilateral heel pain to extensive standing and walking at work. On May 14, 

2019 Dr. Chase diagnosed a left knee contusion and flare-up of left knee arthritis after a fall at 

work on an unspecified date. However, he did not provide an opinion on causal relationship in 

any of these reports. The Board has held that 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.11 Therefore, these reports are insufficient to establish appellant’s claim.

In an October 29, 2019 Form CA-20 report, Dr. Chase opined, with a checkmark “Yes”

that her diagnoses of left knee contusion and a lumbosacral myofascial strain were due to the 

chronic pain that she experienced from work. He listed concurrent or preexisting conditions of 

degenerative arthritis of the left knee and chronic low back strain. The Board has held, however, 

that when a physician’s opinion as to the cause of a condition or period of disability consists only 

of a checkmark on a form, without further explanation or rationale, that opinion is of diminished 

probative value and is insufficient to establish a claim.12 Therefore, Dr. Chase’s report is 

insufficient to establish appellant’s claim.

Appellant also submitted imaging studies. The Board, however, has explained that 

diagnostic studies, standing alone, lack probative value as they do not address whether the 

employment injury caused any of the diagnosed conditions.13

As appellant has not submitted rationalized medical evidence establishing a medical 

condition causally related to the accepted employment factors, the Board finds that she has not met 

her burden of proof to establish her claim.

10 Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (January 2013);

G.T., Docket No. 21-0170 (issued September 29, 2021); D.W., Docket No. 20-0674 (issued September 29, 2020);

V.W., Docket No. 19-1537 (issued May 13, 2020); N.C., Docket No. 19-1191 (issued December 19, 2019); R.D., 

Docket No. 18-1551 (issued March 1, 2019).

11 D.K., Docket No. 21-0214 (issued September 29, 2021); S.W., Docket No. 19-1579 (issued October 9, 2020); see 

L.B., Docket No. 18-0533 (issued August27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

12 See A.C., Docket No. 21-0087 (issued November 9, 2021); O.M., Docket No. 18-1055 (issued April15, 2020); 

Gary J. Watling, 52 ECAB 278 (2001).
6

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 a medical 

condition causally related to accepted factors of her federal employment.

ORDER

IT IS HEREBY ORDERED THAT the January 5, 2021 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: December 21, 2021

Washington, DC

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board