United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

V.P., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Rockford, IL, Employer

__________________________________________

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Docket No. 20-0288

Issued: October 21, 2020

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

CHRISTOPHER J. GODFREY, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On November 21, 2019 appellant filed a timely appeal from an October 30, 2019 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.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.

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following the October 30, 2019 decision, OWCP received additional evidence. However, 

the Board’s Rules of Procedure provides: “The Board’s review of a case is limited to the evidence in the case record 

that was before OWCP at the time of its final decision. Evidence not before OWCP will not be considered by the 

Board for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this

additional evidence for the first time on appeal. Id.
2

FACTUAL HISTORY

On June 28, 2019 appellant, then a 48-year-old rural carrier, filed an occupational disease 

claim (Form CA-2) alleging bilateral shoulder conditions due to factors of her federal employment 

including repetitive pushing, pulling, and lifting of her arms while casing and delivering mail. She

indicated that she first became aware of her condition and its relationship to her employment on 

June 19, 2019. Appellant did not stop work.

In a development letter dated August 19, 2019, OWCP noted no evidence had been 

submitted with appellant’s claim. It advised her of the type of factual and medical evidence 

necessary to establish her claim and provided a questionnaire for her completion. OWCP afforded 

appellant 30 days to submit the requested evidence.

On September 9, 2019 OWCP received the May 30, 2019 computerized tomography (CT) 

scans of appellant’s bilateral shoulders. The right shoulder CT scan was unremarkable with no 

clear etiology for right shoulder pain. The left shoulder CT scan revealed no evidence of acute 

osseous shoulder abnormality and mild-to-moderate coronary artery atherosclerotic calcifications.

OWCP also received June 19, 2019 magnetic resonance imaging (MRI) scans. Appellant’s left 

shoulder MRI scan revealed mild supraspinatus tendinopathy, mild degenerative arthritis, and 

possible small SLAP tear within the labrum. The right shoulder MRI scan revealed no cuff tear, 

right cuff tendinosis/tendinopathy, a suggested small superior labrum tear, and biceps tendon 

superior labrum expansive signal changes, and tendinosis versus partial thickness tear.

In an August 6, 2019 report, Dr. Howard Freedburg, a Board-certified orthopedic surgeon, 

provided a history of appellant’s bilateral shoulder problems and summarized her medical history.

Appellant attributed her bilateral shoulder pain to 18 years of repetitive work at the employing 

establishment including lifting heavy boxes. Physical examination findings were set forth and 

diagnostic testing was noted to have been reviewed. Dr. Freedburg diagnosed bilateral shoulder 

bicipital tenosynovitis and partial shoulder rotator cuff tear. He opined that appellant’s constant 

pushing, pulling, carrying, and lifting up to 70 pounds, and constant overhead work while casing 

mail caused her bilateral shoulder conditions. Dr. Freedburg explained that the constant repetitive 

use mechanism of her work was the cause of her bilateral shoulder conditions.

OWCP also received work status reports dated August 6 and September 3, 2019 from

Dr. Freedburg indicating that appellant was capable of working without restrictions. 

Dr. Freedburg diagnosed bilateral shoulder bicipital tenosynovitis and partial shoulder rotator cuff 

tear and indicated by check mark that the conditions were employment related.

In a September 3, 2019 narrative statement, appellant noted that her work duties consisted 

of casing mail, carrying two foot long trays of mail, sorting packages, loading mail onto her 

vehicle, repetitive reaching, pulling, and lifting, and leaving large packages at customer doors.

By decision dated October 30, 2019, OWCP denied appellant’s occupational disease claim 

finding that the medical evidence of record failed to establish that her bilateral shoulder conditions 

were causally related to the accepted factors of her federal employment.
3

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

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

disease claim, an employee 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 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 employment factors identified by the employee.7

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.8 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.9 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.10

ANALYSIS

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

shoulder conditions causally related to the accepted factors of his federal employment.

 

3 Supra note 1.

4 D.C., Docket No. 19-0354 (issued May 27, 2020); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 

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

5 C.G., Docket No. 20-0139 (issued June 26, 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).

6 D.C., 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).

7 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).

8 D.C., supra note 4; T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 238 (1996).

9 C.G., supra note 5; M.V., Docket No. 18-0884 (issued December 28, 2018).

10 Id.; Victor J. Woodhams, supra note 7.
4

In support of her claim, appellant submitted an August 6, 2019 report from Dr. Freedburg 

diagnosing bilateral shoulder bicipital tenosynovitis and partial shoulder rotator cuff tear. 

Dr. Freedburg opined that the diagnosed shoulder conditions were causally related to the 18 years 

of constant repetitive activity required by appellant’s casing mail. The Board finds that, although

Dr. Freedburg noted that appellant’s injury was work related, his report is of limited probative 

value because it does not include medical rationale explaining the basis of his conclusory opinion 

regarding causal relationship between appellant’s bilateral shoulder conditions and the accepted 

factors of employment.11 Dr. Freedburg concluded that appellant’s bilateral shoulder conditions 

were due to the constant pushing, pulling, carrying, lifting up to 70 pounds, and constant overhead 

work while casing mail caused her bilateral shoulder conditions. While he described her work 

activities, he did not explain how the accepted employment factors physiologically caused, 

contributed to, or aggravated appellant’s diagnosed conditions.12 While Dr. Freeburg’s report 

offered an opinion on causal relationship, it merely stated a conclusion, without supporting medical 

rationale, and therefore this report is insufficient to establish her claim.

13

The record also contains work status reports dated August 6 and September 3, 2019 from

Dr. Freedburg diagnosing bilateral shoulder bicipital tenosynovitis and partial shoulder rotator cuff 

tear and indicating by checkmark that the diagnosed conditions were employment related. The 

Board has held however that when a physician’s opinion on causal relationship 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.14

Appellant also submitted bilateral shoulder CT scans dated May 30, 2019 and MRI scans 

dated June 19, 2019. The Board has held, however, that diagnostic studies standing alone lack 

probative value on the issue of causal relationship as they do not address whether the accepted 

employment factors caused any of the diagnosed conditions.15 These reports are therefore also 

insufficient to establish appellant’s claim.

As appellant has not submitted rationalized medical evidence establishing that her bilateral 

shoulder conditions are causally related to the accepted factors of her federal employment, the 

Board finds that she has not met her 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.

 

11 N.M., Docket No. 19-0258 (issued May 8, 2020); L.G., Docket No. 19-0142 (issued August 8, 2019).

12 A.M., Docket No. 19-1138 (issued February 18, 2020); S.H., Docket No. 19-0631 (issued September 5, 2019);

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

13 Id.

14 O.M., Docket No. 18-1055 (issued April 15, 2020); Gary J. Watling, 52 ECAB 278 (2001).

15 A.M., Docket No. 19-1138 (issued February 18, 2020); R.Z., Docket No. 19-0408 (issued June 26, 2019); J.S., 

Docket No. 17-1039 (issued October 6, 2017).
5

CONCLUSION

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

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

ORDER

IT IS HEREBY ORDERED THAT the October 30, 2019 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: October 21, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Christopher J. Godfrey, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board