United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

O.T., Appellant

and

DEPARTMENT OF JUSTICE, FEDERAL 

BUREAU OF INVESTIGATION, 

Washington,DC, Employer

__________________________________________

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Docket No. 20-1444

Issued: October 12, 2021

Appearances: Case Submitted on the Record

Erik B. Blowers, 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 July 27, 2020 appellant, through counsel, filed a timely appeal from a June 30, 2020 

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 to consider 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 his burden of proof to establish a right hip condition 

causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

This case has previously been before the Board.3 The facts and circumstances as set forth 

in the Board’s prior decision are incorporated herein by reference. The relevant facts are as 

follows. 

On May 17, 2018 appellant, then a 56-year-old retired special agent, filed an occupational 

disease claim (Form CA-2) alleging that he sustained aggravation and/or acceleration of right hip 

osteoarthritis due to factors of his federal employment. He indicated that he had a right total hip 

replacement (THR) in 2011.

4

 Appellant noted that on March 19, 2018 his physician informed him 

that his right hip condition was caused by his work activities.

In a March 19, 2018 report, Dr. Stephen Candela, a Board-certified orthopedic surgeon,

noted that appellant was seen for evaluation of his right hip. He noted that appellant had a left 

THR that “was a work-related injury with repetitive stress on the left side” and that appellant was 

retired with a left hip disability. Dr. Candela advised that the question was whether appellant’s 

right hip condition also was caused by his job. He diagnosed degenerative joint disease (DJD) and 

osteoarthritis of the left and right hips, and explained that DJD was wear and tear and osteoarthritis

was an inflammatory process, which “cascades with all the different factors.” Dr. Candela noted 

that appellant had to participate in weightlifting, specifically regular squats with heavy weights,

along with his regular duties of repetitive walking, climbing, stooping, squatting, and 

stairclimbing, as part of his regular duties and fitness program. He opined that “the cause of DJD 

and osteoarthritis, which has caused him to have a THR on the right side, is definitely work related 

with the stress on the joint.” Dr. Candela explained that irritating the joint causes a progression of 

cascading effects, which lead to chondromalacia and further erosion of the joint, which leads to a 

joint replacement to relieve the pain, which becomes chronic. He opined: “I feel the right hip 

joint replacement was the same factors that caused the left hip joint to degenerate and, therefore,

were found to be work related.” Dr. Candela further advised that the left and right hips “both seem 

to have suffered from the same factors. [Diagnosis] has been confirmed by the patient’s detailed 

medical history, work activities, clinical presentation, and abnormal findings on films with his 

regular exam[ination].” He opined that, “within a reasonable degree of medical certainty, the right

THR was due to DJD and osteoarthritis caused by appellant’s work-related stress from exercising, 

weight lifting, and running and walking and continuous impacting.” Dr. Candela noted that 

appellant had no family history of osteoarthritis and, therefore, he had concluded that the right hip 

had the same problems with degeneration and osteoarthritis requiring joint replacement on the 

right side because of factors caused by his work activities.

3 Docket No. 19-1932 (issued May 21, 2020). 

4 Appellant provided a May 31, 2018 statement relating that he sustained an injury to his left hip at work on June 29, 

2017 and,thereafter, underwent a left hip replacement.
3

In a development letter dated May 18, 2018, OWCP informed appellant that the evidence 

of record was insufficient to establish his claim. It advised him of the type of factual and medical 

evidence necessary and provided a questionnaire for his completion. OWCP afforded appellant 

30 days to respond. In a separate development letter also dated May 18, 2018, it requested 

additional factual information from the employing establishment.

In a May 31, 2018 response to OWCP’s development questionnaire, appellant noted his

work history as a special agent, which included weightlifting, walking, running, climbing, 

squatting, and other physical activities, six days per week from 1988 to 2017. He noted that he

served on the Special Weapons and Tactics (SWAT) and rapid deployment teams, which had 

additional physical fitness requirements, that his workouts lasted from one to one and a half hours 

per day, that he participated in a weekly basketball league with other agents once every other week 

for approximately four years, and that he injured his left hip on June 29, 2017, while participating 

in a running event during the annual fitness test, and had a left THR in 2017. Appellant indicated 

that he previously had his right hip replaced in 2011 and that Dr. Candela informed him that his 

right hip condition also was caused by his work activities. He related that Dr. Candela explained 

that his work activities continually placed stress on the joint, causing degenerative disease and 

osteoarthritis, which led to the right THR.

By decision dated July 3, 2018, OWCP denied appellant’s occupational disease claim, 

finding that the medical evidence of record was insufficient to establish a diagnosed medical 

condition causally related to accepted factors of appellant’s employment. It concluded, therefore, 

that the requirements had not been met to establish an injury as defined by FECA.

On July 23, 2018 appellant, through counsel, requested reconsideration and submitted 

additional evidence.

A February 18, 2010 magnetic resonance imaging (MRI) scan of the right hip read by

Dr. Sanford Davis, a Board-certified diagnostic radiologist, revealed no acute fraction or 

dislocation, degenerative changes in the hip joint, and fluid in the hip joint.

OWCP received an October 17, 2011 operative report fromDr. Michael T. Reilly, a Boardcertified orthopedic surgeon, who performed a right total hip arthroplasty and autologous plasma 

tissue graft injection.

Appellant also resubmitted the March 19, 2018 report from Dr. Candela.

In an August 2, 2018 decision, OWCP modified the July 3, 2018 decision. It noted that a 

March 19, 2018 report from Dr. Candela diagnosed primary osteoarthritis of the right hip and 

degenerative joint disease of the right hip in connection with the claimed work factors. The claim 

remained denied, however, as the medical evidence of record was insufficient to establish causal 

relationship between the diagnosed right hip condition and the accepted factors of appellant’s 

federal employment.

On October 18, 2018 appellant, through counsel, requested reconsideration. He argued 

that the medical evidence supported that appellant’s right hip had the same medical issues as his 

left hip with degeneration and osteoarthritis caused by work activities.
4

OWCP received a November 15, 2017 report, wherein Dr. Candela provided an 

explanation regarding causal relationship of appellant’s left hip condition to work-related 

activities. He opined that the DJD and osteoarthritis were clearly caused by, precipitated, 

accelerated, and/or aggravated by the daily exercise routines appellant engaged in during his 29-

year career as a Federal Bureau of Investigation (FBI) special agent. Dr. Candela explained the 

differences between DJD and osteoarthritis, noting that DJD was wear and tear on a joint with 

thinning of articular cartilage and osteophyte formation and that osteoarthritis was where the joint 

became inflamed and painful. He opined that the DJD and trauma were clearly caused by and 

precipitated, accelerated, and/or aggravated by appellant’s continuous workout routine.

Dr. Candela noted that appellant’s June 29, 2017 aggressive run caused a sudden worsening of the 

hip inflammation, sharp pain,and throbbing. He concluded thatthere was no doubtthat appellant’s 

left hip osteoarthritis was caused by his work activities.

In a July 25, 2017 statement, appellant noted his work activities since September 6, 1988. 

They included participating in the FBI physical fitness program with regular running and 

weightlifting on a daily basis with one day off per week, being on the SWAT team and rapid 

deployment team, and being a crisis management coordinator with additional physical fitness 

requirements. Appellant denied any history of osteoarthritis in his family. He noted that on 

June 29, 2017, while participating in the mandatory FBI physical fitness routine, he sustained an 

acute pain in his left hip that continued and progressively worsened since that date.

OWCP continued to receive duplicative evidence. 

In a January 16, 2019 decision, OWCP denied modification of the August 2, 2018 decision.

On April 18, 2019 appellant, through counsel, requested reconsideration and submitted 

additional evidence.

In a July 18, 2017 report, Dr. Candela provided an opinion on causal relationship that 

appellant’s left THR and his previous right THR were more likely than not caused by, or 

accelerated by, the constant and repeated work activities of the past 29 years through his job as a 

special agent.

In an undated report received on April 18, 2019, Dr. Candela explained that he was 

providing an opinion related to appellant’s injury and subsequent surgery for the right hip and 

arthritis in both hips with replacements in both hips. He noted that he had reviewed all of 

appellant’s medical records from June 2011 through October 5, 2012. Dr. Candela opined that 

appellant “had degenerative arthritis and subsequent treatment with total hip replacement 

precipitated by his vigorous training and workloads on the hip. Therefore, the cause of his arthritis 

and degeneration was his work with no other reasonable cause being evident. This I believe should 

be evident to anyone who has any knowledge of the causes of arthritis and patients with this 

physical size and weight which do not contribute to osteoarthritis in his case.”

OWCP received a September 1, 2011 report wherein Dr. Reilly indicated appellant was 

scheduled for a total hip replacement on October 3, 2011. It received a copy of his October 17, 

2011 operative report. Dr. Reilly recommended a continued treatment plan on November 1, and 

November 22, 2011. In a December 9, 2011 report, he provided a gait analysis. Dr. Reilly
5

submitted a March 15, 2012 chart note advising that appellant was status post October 17, 2011 

right non cemented total hip arthroplasty. He saw appellant on July 26, 2012 and noted that he 

was doing well post operatively.

OWCP received chart notes dated September 28, November 1 and 22, 2011, and June 14, 

2012, from a physician assistant. 

By decision dated June 13, 2019, OWCP denied modification of the January 16, 2019 

decision.

On September 18, 2019 appellant, through counsel, filed a timely appeal to the Board from 

the June 13, 2019 decision. On May 21, 2020 the Board issued an Order Remanding Case.

5

 The 

Board found that the June 13, 2019 OWCP decision did not review all of the relevant evidence

received on reconsideration. The Board remanded the case to OWCP to enable it to properly 

consider all the evidence submitted at the time of the June 13, 2019 decision.

By decision dated June 30, 2020, OWCP denied modification of the January 16, 2019 

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 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,7that 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.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

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 o f the 

disease or condition; (2) medical evidence establishing the presence or existence of the disease or 

5 Docket No. 19-1932 (issued May 21, 2020).

6

Supra note 2.

7

See S.M., Docket No. 19-1634 (issued August25, 2020); E.W., Docket No. 19-1393 (issued January 29, 2020);

J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

8 L.C., Docket No. 19-1301 (issued January 29, 2020); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

9

20 C.F.R. § 10.115; E.S., Docket No. 18-1580 (issued January 23, 2020); L.M., Docket No. 13-1402 (issued 

February7, 2014); DeloresC. Ellyett, 41 ECAB 992 (1990).
6

condition for which compensation is claimed; and (3) medical evidence establishing that the 

diagnosed condition is causally related to the identified employment factors. 10

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.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 Neither the mere fact 

that a disease or condition manifests itself during a period of employment, nor the belief that the 

disease or condition was caused or aggravated by employment factors, is sufficient to establish 

causal relationship.13

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, 

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

of the work-related injury or disease and the preexisting condition.14

ANALYSIS

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

Appellant provided several reports from his treating physician, Dr. Candela, to support that 

his right hip conditions were causally related to the accepted factors of his federal employment.

In his March 19, 2018 report, Dr. Candela noted that appellant’s left hip condition was 

accepted as work related and opined that the right hip condition also was work related. He noted 

that appellant had DJD and osteoarthritis of both hips which required the THR on the right side. 

Dr. Candela also noted that as a special agent, appellant had to participate in weightlifting, 

specifically regular squats with heavy weights, along with his regular duties of repetitive walking, 

climbing, stooping, squatting, and stair climbing. He opined that “I feel the right hip joint 

replacement was the same factors that caused the left hip joint to degenerate and therefore were 

found to be work related.” Dr. Candela further opined that “the cause of DJD and osteoarthritis

which has caused him to have a THR on the right side, is definitely work related with the stress on 

the joint.” He explained that irritating the joint causes a progression of cascading effects which 

lead to chondromalacia, further erosion of the joint, and the THR.

10 See T.L., Docket No. 18-0778 (issued January 22, 2020); Roy L. Humphrey, 57 ECAB 238, 241 (2005); Victor J. 

Woodhams, 41 ECAB 345, 352 (1989).

11 J.F., Docket No. 18-0492 (issued January 16, 2020); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

12 A.M., Docket No. 18-0562 (issued January 23, 2020); LeslieC. Moore, 52 ECAB 132 (2000).

13 E.W., supra note 7; Gary L. Fowler, 45 ECAB 365 (1994).

14 Federal (FECA) Procedure Manual, Part 2 --Claims, Causal Relationship, Chapter 2.805.3e (January 2013). See 

R.D., Docket No. 18-1551 (issued March 1, 2019).
7

In a report dated April 18, 2019, Dr. Candela noted that he had reviewed all of appellant’s

medical records from June 2011 through October 5, 2012. He opined that appellant “had 

degenerative arthritis and subsequent treatment with total hip replacement precipitated by his 

vigorous training and workloads on the hip. Therefore, the cause of appellant’s arthritis and 

degeneration was his work with no other reasonable cause being evident. This I believe should be 

evident to anyone who has any knowledge of the causes of arthritis and patients with this physical 

size and weight which do not contribute to osteoarthritis in his case.”

Dr. Candela is a Board-certified physician who is qualified in his field of medicine to render 

rationalized opinions on the issue of causal relationship who reviewed appellant’s medical record 

and explained the mechanism of appellant’s injury. Although his opinion is insufficiently 

rationalized to establish causal relationship, it does raise an uncontroverted inference regarding 

causal relationship between the diagnosed condition and the accepted employment incident 

sufficient to require that OWCP further develop the medical evidence relating to the claim.15

Proceedings under FECA are not adversarial in nature and OWCP is not a disinterested 

arbiter. The claimant has the burden of proof to establish entitlement to compensation and OWCP 

shares responsibility in the development of the evidence to see that justice is done.16

The case shall, therefore, be remanded for OWCP to administratively combine appellant’s 

claims relevant to the right hip, and refer appellant to a specialist in the appropriate field of 

medicine, along with the case record and an updated statement of accepted facts (SOAF). The

referral physician shall provide a well-rationalized opinion as to whether appellant’s diagnosed 

conditions are causally related to the accepted employment factors. If the physician opines that 

the diagnosed conditions are not causally related to the employment incident, he or she must 

provide a rationalized explanation as to why their opinion differs from that of Dr. Candela. After 

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

CONCLUSION

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

15 See A.K., Docket No. 20-1426 (issued March 8, 2021); E.G., Docket No. 19-1296 (issued December 19, 2019); 

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

16 See A.J., Docket No. 18-0905 (issued December 10, 2018); WilliamJ. Cantrell, 34 ECAB 1233, 1237 (1983); 

Gertrude E. Evans, 26 ECAB 195 (1974).
8

ORDER

IT IS HEREBY ORDERED THAT the June 30, 2020 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: October 12, 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