United States Department of Labor

Employees’ Compensation Appeals Board

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S.R., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Woburn, MA, Employer

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Docket No. 20-0313

Issued: April 11, 2022

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

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

JURISDICTION

On November 22, 2019 appellant, through counsel, filed a timely appeal from a July 2, 

2019 merit decision of the Office of Workers’ Compensation Programs (OWCP).2 Pursuant to the 

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. 20 C.F.R. § 501.5(b). Pursuant to the Board’s Rules 

of Procedure, oral argument may be held in the discretion of the Board. 20 C.F.R. § 501.5(a). In support of appellant’s 

oral argument request, he asserted that oral argument should be granted to present argument on the issue of whether 

OWCP improperly required an opinion on the undefined term “natural progression” of degenerative osteoarthritis.

The Board, in exercising its discretion, denies appellant’s request for oral argument because this matter requires an 

evaluation of the medical evidence presented. As such, the arguments on appeal can adequately be addressed in a 

decision based on a review of the case record. Oral argument in this appeal would further delay issuance of a Board 

decision and not serve a useful purpose. As such, the oral argument request is denied and this decision is based on 

the case record as submitted to the Board.
2

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.

ISSUE

The issue is whether appellant has met his burden of proof to establish a bilateral knee 

condition causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On June 6, 2017 appellant, then a 61-year-old letter carrier, filed an occupational disease 

claim (Form CA-2) alleging that he developed bilateral knee osteoarthritis due to factors of his 

federal employment, including standing, walking, bending, lifting, and carrying performed over 

many years. He noted that he first became aware of his condition and realized its relation to his 

federal employment on April 28, 2017. On the reverse side of the claim form, the employing 

establishment indicated that appellant was last exposed to the conditions alleged on December 16, 

2014 and that he subsequently retired on August 1, 2015.

In a narrative statement dated April 13, 2017, appellant noted that he had worked at the 

employing establishment for 31 years. He asserted that he walked five to seven miles a day 

carrying a satchel weighing up to 35 pounds in order to deliver several hundreds of pounds of mail 

a day, including packages weighing up to 70 pounds. Appellant also stood for two hours a day

casing mail, walked up and down stairs, and entered and exited his vehicle 400 times a day.

On March 5, 2015 appellant underwent bilateral knee x-rays which revealed moderated 

osteoarthritis in the left medial knee joint and mild osteoarthritis in the right medial knee joint.

In a report dated April 28, 2017, Dr. John J. Walsh, a Board-certified orthopedic surgeon,

described appellant’s employment duties and noted that he began to experience pain, swelling, and 

giving way in both knees. He noted that appellant sought medical treatment for his knee condition 

in 1989 and underwent knee arthroscopy. Dr. Walsh found that during the years that he worked 

as a letter carrier, he experienced increasing problems with pain and swelling in his knees. He 

reviewed knee x-rays dated March 5, 2015 and April 23, 2017 and diagnosed bilateral knee 

osteoarthritis. Dr. Walsh opined that osteoarthritis was the result of repetitive impact loading

which caused damage to joint cartilage and resulted in a secondary inflammatory process which 

further accelerated the deterioration of the joint. He further explained that in the presence of 

damage to the articular cartilage, chemicals called proteoglycans were released which caused 

inflammation of the synovial lining of the joint which then led to further breakdown of the articular 

cartilage, which was characteristic of osteoarthritis. Dr. Walsh opined that appellant’s bilateral 

osteoarthritis was “most likely aggravated” by his work activities including lifting, walking, and 

climbing. He further found that his work activities “most likely” caused a permanent aggravation 

of his bilateral knee osteoarthritis. Dr. Walsh concluded that there was no doubt that appellant’s 

high impact loading work activities contributed to the development and progression of his bilateral 

knee arthritis. He also found that he had permanent impairment as a result of the diagnosed 

condition.

3

5 U.S.C. § 8101 et seq.
3

In an August 10, 2017 development letter, OWCP informed appellant of the deficiencies 

of his claim. It advised him of the type of factual and medical evidence needed, and provided a 

questionnaire for his completion. In a separate development letter of even date, OWCP requested 

that the employing establishment provide additional information, including comments from a 

knowledgeable supervisor, regarding appellant’s occupational disease claim. It afforded both 

parties 30 days to respond.

On September 11, 2017 appellant responded to OWCP’s development questionnaire. He 

indicated that he experienced chronic bilateral knee pain and had enjoyed playing baseball, hockey,

and skiing, but could no longer participate in those activities due to knee pain. 

In a note dated February 23, 2017, Dr. Richard Joseph, an internist, examined appellant 

due to his bilateral knee conditions. A left knee x-ray of even date revealed mild osteoarthritic 

changes in all compartments.

On March 17, 2015 Dr. Taylor diagnosed bilateral knee osteoarthritis, including moderate 

osteoarthritis of the left medial knee joint and mild osteoarthritis of right medial knee joint.

By decision dated November 16, 2017, OWCP denied appellant’s occupational disease 

claim,finding that he had not submitted medical evidence establishing causal relationship between 

his diagnosed bilateral knee osteoarthritis and the accepted factors of his federal employment.

On November 21, 2017 appellant, through counsel, requested an oral hearing before a 

representative of OWCP’s Branch of Hearings and Review. In a letter dated May 14, 2018, 

appellant, through counsel, modified his request for a review of the written record. He submitted 

additional medical records.

In a May 14, 2018 report, Dr. Walsh noted that appellant was exposed to more than 30 

years of impact loading activities at the employing establishment. He opined that there was “no 

doubt that the high impact loading work activities contributed to the development and progression 

of his bilateral knee arthritis.”

By decision dated July 30, 2018, the hearing representative affirmed the November 16, 

2017 decision. 

On January 22, 2019 appellant, through counsel, requested reconsideration.

By decision dated March 26, 2019, OWCP denied appellant’s request for reconsideration 

of the merits in accordance with 5 U.S.C. § 8128(a).

On April 10, 2019 appellant again requested reconsideration of the July 30, 2018 decision 

and submitted a January 18, 2019 report, wherein, Dr. Walsh opined that appellant’s work 

activities contributed to his bilateral knee osteoarthritis which was present prior to his retirement. 

He noted that he reviewed appellant’s x-rays from prior to his retirement which he found showed 

significantly degraded articular cartilage in both knees. Dr. Walsh opined that the deterioration 

process had been ongoing for quite some time including the time period during which appellant 

was performing heavy impact loading duties of his federal job. He further explained that his prior 

opinions were not speculative as he had opined that there was no doubt that the high impact loading 

work activities contributed to the development and progression of his bilateral knee arthritis. 

Finally, Dr. Walsh determined that appellant’s prior knee injuries were not the sole cause of the 
4

development and progression of his diagnosed osteoarthritis which he attributed in part to the high 

impact loading work activities in which appellant engaged in while performing his federal job 

duties.

By decision dated July 2, 2019, OWCP denied modification of the July 30, 2018 merit 

decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA4 has the burden of proof to establish the 

essential elements of his or her claim by the weight of the reliable, probative, and substantial 

evidence, 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, that 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 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 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 identified employment factors. 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 factor(s) 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 factor(s).10

4

Supra note 3.

5 K.V., Docket No. 18-0947 (issued March 4, 2019); M.E., Docket No. 18-1135 (issued January 4, 2019); Kathryn 

Haggerty, 45 ECAB 383, 388 (1994).

6 K.V., id., and M.E., id.; Elaine Pendleton, 40 ECAB 1143 (1989).

7 R.G., Docket No. 19-0233 (issued July 16, 2019);Roy L. Humphrey, 57 ECAB 238, 241 (2005); RubyI. Fish, 46 

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

8 T.H., 59 ECAB 388, 393 (2008); Robert G. Morris, 48 ECAB 238 (1996).

9 M.V., Docket No. 18-0884 (issued December 28, 2018).

10 Victor J. Woodhams, supra note 7.
5

ANALYSIS

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

In his reports dated May 14, 2018 and January 18, 2019, Dr. Walsh opined that appellant’s 

bilateral knee osteoarthritis was permanently aggravated by his employment duties including high 

impact loading activities. He explained how these activities caused damage to joint cartilage and 

resulted in a secondary inflammatory process which further accelerated the deterioration of the 

joint. In his April 28, 2017 report, Dr. Walsh opined that osteoarthritis was the result of repetitive 

impact loading which caused damage to joint cartilage and resulted in a secondary inflammatory 

process which further accelerated the deterioration of the joint. He further explained that in the 

presence of damage to the articular cartilage, chemicals called proteoglycans were released which 

caused inflammation of the synovial lining of the joint which then led to further breakdown of the 

articular cartilage, which was characteristic of osteoarthritis. Dr. Walsh acknowledged appellant’s 

prior knee injuries, but opined that his accepted work activities also contributed to his bilateral 

knee conditions.

Dr. Walsh’s reports suggest a pathophysiological explanation as to how appellant’s high 

impact loading activities resulted in a permanent aggravation of his bilateral knee osteoarthritis. 

Accordingly, while these reports from Dr. Walsh are not fully rationalized, they are sufficient to 

require further development of appellant’s claim.11

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.12 OWCP has an obligation to see that justice is 

done.13

On remand OWCP shall prepare a statement of accepted facts and obtain a rationalized 

opinion from a physician in the appropriate field of medicine as to whether the accepted 

employment incident caused, contributed to, or aggravated the diagnosed bilateral knee 

condition.14 If the physician opines that the diagnosed conditions are not causally related, he or 

she must explain with rationale how or why their opinion differs from that of Dr. Walsh. After 

this and other such further development as deemed necessary, OWCP shall issue a de novo

decision.

CONCLUSION

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

11 J.H., Docket No. 18-1637 (issued January 29, 2020); D.S., Docket No. 17-1359 (issued May 3, 2019); X.V., 

Docket No. 18-1360 (issued April12, 2019); C.M., Docket No. 17-1977 (issued January 29, 2019); WilliamJ. 

Cantrell, 34 ECAB 1223 (1983).

12 Id.; A.P., Docket No. 17-0813 (issued January 3, 2018); Jimmy A. Hammons, 51 ECAB 219, 223 (1999).

13 B.C., Docket No. 15-1853 (issued January 19, 2016); E.J., Docket No. 09-1481 (issued February 19, 2010); 

John J. Carlone, 41 ECAB 354 (1989).

14 M.S., Docket No. 20-1095 (issued March 29, 2022); C.G., Docket No. 20-1121 (issued February 11, 2021); A.G., 

Docket No. 20-0454 (issued October 29, 2020).
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ORDER

IT IS HEREBY ORDERED THAT the July 2, 2019 decision of the Office of Workers’

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

with this decision of the Board.

Issued: April 11, 2022

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board