United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

T.P., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE,

West Haven, CT, Employer

__________________________________________

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Docket No. 19-1568

Issued: October 30, 2020

Appearances: Case Submitted on the Record

John L. DeGeneres, Jr., Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

ALEC J. KOROMILAS, Chief Judge

JANICE B. ASKIN, Judge

PATRICIA H. FITZGERALD, Alternate Judge

JURISDICTION

On July 17, 2019 appellant, through counsel, filed a timely appeal from a January 25, 2019 

merit decision of the Office of Workers’ Compensation Programs (OWCP).2 Pursuant to the 

Federal Employees’ Compensation Act3(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 Appellant timely requested oral argument before the Board. By order dated May 18, 2020, the Board exercised 

its discretion and denied the request as the matter could be adequately addressed based on a review of the case record. 

Order Denying Oral Argument, Docket No. 19-1568 (issued May 18, 2020).

3 5 U.S.C. § 8101 et seq.
2

ISSUE

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

causally related to the accepted factors of her federal employment.

FACTUAL HISTORY

On April 25, 2016 appellant, then a 56-year-old letter carrier, filed an occupational disease 

claim (Form CA-2) alleging that she required a hip replacement causally related to factors of her 

federal employment. She indicated that she became aware of her condition on June 2, 2016 and 

attributed it to her federal employment on June 14, 2014. 

In a report dated April 21, 2016, Dr. Michael P. Leslie, an osteopath and Board-certified 

orthopedic surgeon, advised that he had evaluated appellant on February 2, 2016 and diagnosed 

end stage degenerative disease of the left hip. He discussed her history of working for the 

employing establishment and of an accident 10 years prior where she underwent a lumbar spine 

procedure. Dr. Leslie opined that appellant’s left hip pain and arthritis was “the result of the 

accident itself along with working as a letter carrier.” He recommended a total hip joint 

replacement.

In an April 25, 2016 statement, appellant described her employment duties as a letter 

carrier for 28 years. She related that she had experienced left hip pain beginning in April 2014 

that she initially believed had been caused by a back injury. Appellant underwent surgery for her 

back in July 2015, but the left hip pain continued. She attributed her left hip condition to walking, 

lifting, and bending. Appellant asserted that she had no history of a prior hip injury.

On June 1, 2016 Dr. Leslie advised that he was treating appellant for advanced 

degenerative joint disease of the left hip. He noted that she had not experienced hip pain prior to 

a 2004 accident at work. Dr. Leslie opined that appellant’s extensive walking as a letter carrier 

had aggravated an “underlying predisposition to arthritis of the hip” and necessitated a total hip 

replacement. He opined that her predisposition to a hip injury arose due to either her prior 

employment injury or from an aggravation of an underlying condition. Dr. Leslie related that 

“[e]ither way there is evidence that the relationship of this advanced degenerative disease is to her 

occupation.” 

In a development letter dated June 20, 2016, OWCP notified appellant of the type of 

evidence needed to establish her occupational disease claim, including a detailed description of 

any repetitive activities performed outside of her employment and medical evidence explaining 

how the identified work activities resulted in a diagnosed medical condition. It attached a 

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

information from the employing establishment. It afforded both parties 30 days to respond.

Appellant, in a June 27, 2016 response, advised that she engaged only in necessary home 

activities and did not walk or jog.
3

By decision dated August 1, 2016, OWCP denied appellant’s occupational disease claim. 

It found that the evidence of record was insufficient to establish a medical condition causally 

related to the accepted factors of her federal employment.

On July 18, 2017 appellant, through counsel, requested reconsideration. He contended that

Dr. Minotti’s July 13, 2017 report was sufficient to establish that her employment contributed to 

her left hip arthritis. 

In support of his request for reconsideration, appellant submitted additional evidence, 

including a report dated July 21, 2016 from Dr. Philip A. Minotti, a Board-certified orthopedic 

surgeon. Dr. Minotti evaluated her for left hip pain that had progressively worsened for the past 

three years. He diagnosed degenerative joint disease of the left hip, noting that x-rays revealed 

severe degeneration, joint space narrowing, osteophyte formation, and subchondral sclerosis. 

On August 22, 2016 Dr. Minotti performed a left total hip replacement.4 In reports dated 

September 2016 through August 2017, he described appellant’s progress subsequent to the 

surgery.

In a June 7, 2017 statement, appellant set forth her employment duties, which included 

repetitively casing mail, walking, carrying satchels and parcels, and climbing steps.

In a report dated July 13, 2017, Dr. Minotti discussed appellant’s history of a total hip 

replacement on August 22, 2016 due to degenerative joint disease of the left hip. He noted that 

she had worked for years as a letter carrier performing “physically demanding routes.” Dr. Minotti 

related that repetitive employment activities “can certainly contribute to development of severely 

symptomatic disease sooner than it might otherwise had occurred. Clearly, [appellant’s] work is 

not the sole cause of her left hip degenerative joint disease, but, in my opinion, it clearly 

contributed to her rapid development of symptoms and advanced disease.”

By decision dated November 24, 2017, OWCP denied modification of its August 1, 2016 

decision. It found that the medical evidence of record was insufficient to establish to explain how 

factors of appellant’s federal employment caused her hip condition as opposed to the natural 

progression of the condition.

In a report dated October 28, 2018, Dr. Byron V. Hartunian, an orthopedic surgeon, 

reviewed appellant’s work history and employment duties and discussed her current complaints of 

pain, stiffness, and loss of motion in the left hip, left knee, and left foot. He provided examination 

findings and diagnosed status post left total hip replacement for end-stage degenerative arthritis, 

left knee joint arthritis, and first metatarsophalangeal foot arthritis. Answering a series of specific 

questions, Dr. Hartunian opined that appellant’s employment duties, including climbing, lifting, 

and walking repetitively, had permanently aggravated her left hip, foot, and knee conditions. He

found that working as a letter carrier over a long period “can and does accelerate arthritis because 

of the continuous walking, stooping, squatting, stair climbing/descending and the like involved.”

Dr. Hartunian asserted that such impact-loading activities had stressed appellant’s lower 

extremities and aggravated her arthritis. He indicated that arthritis occurred due to chronic 

 

4 On August 28, 2016 appellant sought treatment at the emergency department for a rash at the surgical site.
4

inflammation caused by repeated local stress on cartilage surfaces. Dr. Hartunian related, “With 

less resilience, the cartilage becomes more susceptible to wear and tear of the impact-loading 

activities, which in turn results in an accelerated loss of articular cartilage as a result of those 

activities. This is what happened to [appellant] as documented in her medical records.”

Dr. Hartunian indicated that it was impossible to say what the natural progression of her 

osteoarthritis would have been as current research attributed the condition to environmental factors 

rather than aging. He advised that work factors had contributed to appellant’s progressive hip and 

knee arthritis as it had occurred while she was performing high impact-loading activities over an 

extended duration. Dr. Hartunian found that, at a minimum, her employment duties had 

contributed to the development of her right hip and knee arthritis.5

By decision dated January 25, 2019, OWCP denied modification of its November 24, 2017 

decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA6 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 filed within the applicable time limitation 

period of FECA,7that an injury was sustained while in the performance of duty, as alleged, and 

that any disability or specific condition for which compensation is claimed is causally related to 

the employment injury.8 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.9

In an occupational disease claim, appellant’s burden of proof requires submission of 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.10

 

5 Dr. Hartunian indicated that appellant had sustained right rather than left hip and knee arthritis; however, it appears 

that this is a typographical error.

6 Supra note 3.

7 S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989).

8

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

9 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).

10 S.C., Docket No. 18-1242 (issued March 13, 2019); R.H., 59 ECAB 382 (2008).
5

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

relationship is rationalized medical opinion evidence.11 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 claimant.12

ANALYSIS

The Board finds that the case is not in posture for decision.

In a report dated October 28, 2018, Dr. Hartunian discussed appellant’s employment injury 

and reviewed her work duties. He diagnosed end-stage degenerative left hip arthritis treated with 

a left hip replacement, left knee arthritis, and arthritis at the first metatarsophalangeal joint of the 

left foot. Dr. Hartunian opined that appellant’s repetitive employment duties, including climbing, 

lifting, squatting, bending, stair climbing, and walking, had permanently aggravated her left hip, 

foot, and knee arthritis. He found that impact-loading activities that she had performed working 

as a letter carrier over an extended period had aggravated her arthritis due to the stress on her lower 

extremities. Dr. Hartunian explained that repeated stress on cartilage surfaces had caused chronic 

inflammation, accelerating cartilage loss. 

The Board finds that this report from Dr. Hartunian is sufficient to require further 

development of the medical evidence. Dr. Hartunian provided a proper factual and medical history 

and evidenced an understanding of appellant’s employment duties. He explained physiologically 

how lifting, walking, stooping, squatting, and stair climbing at work had aggravated her left hip 

arthritis. The Board has held that it is unnecessary that the evidence of record in a case be so 

conclusive as to suggest causal connection beyond all possible doubt. Rather, the evidence 

required is only that necessary to convince the adjudicator that the conclusion drawn is rational, 

sound, and logical.13 Dr. Hartunian’s opinion, while insufficiently reasoned to meet appellant’s 

burden of proof, provides medical rationale explaining how the accepted employment factors 

aggravated the claimed diagnosed condition and, thus, raises an uncontroverted inference of causal 

relationship sufficient to require further development of appellant’s claim.14

It is well established that proceedings under FECA are not adversarial in nature and, while 

appellant has the burden of proof to establish entitlement to compensation, OWCP shares 

responsibility in the development of the evidence.15 OWCP has an obligation to see that justice is 

 

11 A.M., Docket No. 18-1748 (issued April 24, 2019); T.H., 59 ECAB 388 (2008).

12 M.V., Docket No. 18-0884 (issued December 28, 2018); I.J., 59 ECAB 408 (2008).

13 B.C., Docket No. 20-0498 (issued August 27, 2020); S.M., Docket No. 19-1634 (issued August 25, 2020); W.M., 

Docket No. 17-1244 (issued November 7, 2017).

14 See A.S., Docket No. 19-1432 (issued August 5, 2020); C.H., Docket No. 20-0440 (issued August 3, 2020).

15 A.P., Docket No. 17-0813 (issued January 3, 2018); Jimmy A. Hammons, 51 ECAB 219 (1999).
6

done.16 The nonadversarial policy of proceedings under FECA is reflected in OWCP’s regulations 

at section 10.121.17

The case will therefore be remanded to OWCP for further development of the medical 

evidence. On remand OWCP shall refer appellant to an appropriate medical specialist for an 

opinion regarding whether her claimed condition of left hip arthritis is causally related to the 

accepted factors of her federal employment. Following this and such other further development 

as deemed necessary, OWCP shall issue a de novo decision.

CONCLUSION

The Board finds that the case is not in posture for decision.

ORDER

IT IS HEREBY ORDERED THAT the January 25, 2019 decision of the Office of 

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

consistent with this opinion of the Board.

Issued: October 30, 2020

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Alternate Judge

Employees’ Compensation Appeals Board

 

16 See B.C., Docket No. 15-1853 (issued January 19, 2016); John J. Carlone, 41 ECAB 354 (1989).

17 20 C.F.R. § 10.121.