United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

G.M., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Twin Falls, ID, Employer

__________________________________________

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Docket No. 23-0689

Issued: September 15, 2023

Appearances: Case Submitted on the Record

Michael John Watson, 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

JAMES D. McGINLEY, Alternate Judge

JURISDICTION

On April 17, 2023 appellant, through counsel, filed a timely appeal from a January 24, 

2023 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 met her burden of proof to establish a right knee condition 

causally related to the accepted factors of her federal employment.

FACTUAL HISTORY

On June 15, 2021 appellant, then a 72-year-old rural carrier, filed an occupational disease 

claim (Form CA-2) alleging that her right knee joint osteoarthritis was caused by the repetitive 

movements required by her job duties. She first became aware of her condition on September 17, 

2019, but did not realize that it had been caused or aggravated by her employment duties until 

March 16, 2021. Appellant stopped work on June 15, 2021.

In a development letter dated June 16, 2021, OWCP informed appellant of the deficiencies 

of her claim. It advised her of the type of evidence necessary to establish her claim and provided 

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

that the employing establishment provide comments from a knowledgeable supervisor regarding 

the accuracy of appellant’s allegations. It afforded both parties 30 days to respond. 

A supervisor statement dated June 16, 2021 stated that rural carriers are allowed to take 

breaks as needed, up to 60 minutes each day. The supervisor controverted appellant’s claim, noting 

that a rural carrier cased mail during the beginning of the day and drove delivering mail for the 

rest of the day. A rural mail carrier would only exit the vehicle to deliver items requiring a 

signature or oversized parcels.

By decision dated July 22, 2021, OWCP denied appellant’s claim, finding she failed to 

establish the factual portion of the claim. It noted that she had not responded to the factual 

questionnaire sent to her on June 16, 2021. 

OWCP subsequently received reports dated October 22, 2020, and February 25 and 

July 13, 2021 from Matt McKinlay, a certified physician assistant. Mr. McKinlay provided 

examination findings and noted that appellant wished to proceed with total joint arthroplasty. In 

the February 25 and July 13, 2021 reports, he provided status updates on appellant’s condition 

following her January 11, 2021 right knee arthroplasty. 

Mr. McKinlay, in an April 8, 2021 return-to-work note, advised that appellant was 

currently totally disabled. In a May 20, 2021return-to-work note, he released her to full duty with 

no restrictions on May 22, 2021. 

In a report dated May 2, 2022, Dr. John W. Ellis, a physician Board-certified in family 

medicine and environmental medicine, noted appellant’s history of injury, reviewed medical 

evidence and diagnostic tests, and providedphysical examination findings. He reported that under

OWCP File No. xxxxxx722, OWCP accepted left hip sprain, lower back fascia, tendon, and muscle 

strain, left knee lateral meniscus tear, and left knee contusion due to a June 20, 2017 traumatic 

injury. Dr. Ellis reported that appellant underwent total left knee replacement surgery in 2019. On 

physical examination, he reported well-healed bilateral surgical incisions consistent with prior 

total knee replacements. Dr. Ellis diagnosed right knee unilateral primary osteoarthritis and right 
3

knee patellar tendinitis, which he attributed to cumulative trauma. He opined that, based upon 

reasonable medical certainty, that it was more probable than not that the diagnosed conditions

arose out of the course of appellant’s employment. Dr. Ellis opined that her job duties which 

required constant mounting and dismounting from her vehicle, constant bending, twisting, 

stooping, and kneeling, placed an excessive amount of lower extremity stress and strain led to 

cumulative micro traumas. He explained that these micro traumas prevented appellant’s body

from having time to properly heal and led to overuse injury and cumulative trauma disorder.

On July 6, 2022 appellant requested reconsideration and submitted additional evidence.

In a January 11, 2021 hospital operative report, Dr. Aaron Altenburg, a Board-certified 

orthopedic surgeon, diagnosed degenerative osteoarthritis, and indicated that he had performed

right total knee arthroplasty surgery.

On August 25, 2022 OWCP referred appellant, along with a statement of accepted facts 

(SOAF), the medical record, and a series of questions to Dr. Qing-Min Chen, a Board-certified 

orthopedic surgeon, for a second opinion evaluation to determine whether appellant’s diagnosed 

conditions were causally related to the accepted factors of her employment. It provided a definition 

of aggravation of preexisting conditions. The SOAF noted appellant had filed an occupational 

disease claim for right knee condition with an injury date of September 17, 2019, noted her job 

duties, listed treating physicians, Dr. Altenberg and Dr. Ellis, that she was off work from 

December 4, 2020 through May 18, 2021, and had returned to full-time work. 

In a report dated October 17, 2022, Dr. Chen, based upon a review of medical and 

employment histories, SOAF, and medical records, diagnosed preexisting right knee osteoarthritis. 

He described appellant’s job duties, noted that she had worked for the employing establishment 

for 23 years, and noted that she had an accepted claim for torn left knee meniscus. Dr. Chen 

reported that she had undergone total left knee replacement surgery on January 6, 2019. He noted 

that appellant did not report any specific injury to the right knee and that she had undergone right 

total knee replacement surgery in January 2021. Dr. Chen noted her physical examination findings 

related to the right knee. He opined that appellant’s employment duties of walking, carrying, 

lifting, or dismounting did not cause her diagnosed right knee osteoarthritis. In support of his 

conclusion, Dr. Chen explained that the medical literature contains no evidence that the accepted 

employment factors would cause the diagnosed condition over nonwork factors such as genetics.

Thus, he concluded that appellant’s right knee osteoarthritis was preexisting and unrelated to any 

work exposure or injury.

By decision dated December 6, 2022, OWCP modified its prior decision, finding that 

appellant had established a valid medical diagnosis. However, the claim remained denied, as the 

medical evidence of record was insufficient to establish causal relationship between her diagnosed 

medical condition and the accepted employment factors.

On December 12, 2022 appellant, through counsel, requested reconsideration. Counsel 

asserted that Dr. Chen’s opinion should be disregarded due to his bias that arthritis cannot be 

aggravated by any factor except genetics. 

By decision dated January 24, 2023, OWCP denied modification.
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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 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.4 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.

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) rationalized medical evidence establishing that the diagnosed 

condition is causally related to the identified employment factors. 5

Causal relationship is a medical question that requires rationalized medical opinion 

evidence to resolve the issue.6 The opinion of the physician must be based on 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 factors.7

ANALYSIS

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

OWCP referred appellant to Dr. Chen for a second opinion on whether the diagnosed 

conditions were causally related to the accepted factors directly or by aggravation .

In his October 17, 2022 report, Dr. Chen opined that appellant’s right knee osteoarthritis 

was preexisting. He related that medical literature did not support that the accepted employment 

factors would have caused or contributed to the diagnosed conditions over nonwork factors such 

as genetics. However, he explain how the medical articles cited applied to appellant’s particular 

3

Id. 

4 T.F., Docket No. 22-0573 (issued March 31, 2023); A.A., Docket No. 21-0774 (issued January 11, 2022); C.K., 

Docket No. 19-1549 (issued June 30, 2020); R.G., Docket No. 19-0233 (issued July 16, 2019); Elaine Pendleton, 40 

ECAB 1143 (1989).

5 T.F., id.; A.A., id.; L.D., Docket No. 19-1301 (issued January29, 2020); S.C., Docket No. 18-1242 (issued 

March 13, 2019); Victor J. Woodhams, 41 ECAB 345, 352 (1989).

6 T.F., id.; A.A., id.; I.J., Docket No. 19-1343 (issued February 26, 2020); T.H., 59 ECAB 388 (2008); RobertG. 

Morris, 48 ECAB 238 (1996).

7 T.F., id.; A.A., id.; D.J., Docket No. 19-1301 (issued January 29, 2020).
5

situation.8 Rather, Dr. Chen only provided a generalized statement that appellant’s right knee 

conditions were preexisting and genetic in nature. Generalized statements are, however, of little 

probative value.9

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

arbiter.10 The claimant has the burden of proof to establish entitlement to compensation, but 

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

11

 

Accordingly, once OWCP undertakes to develop the medical evidence further, it has the 

responsibility to do so in the proper manner.

12

 Once it starts to procure a medical opinion, it must 

secure an opinion which adequately addresses the relevant issues.

13

 

The Board finds that the second opinion report of Dr. Chen is insufficient to resolve the 

issue of whether appellant’s right knee conditions are causally related to the accepted factors of 

her federal employment as his report is conclusory in nature. A conclusory opinion provided by a 

physician, without the necessary rationale explaining how and why an accepted employment injury 

was insufficient, either directly or by aggravation, to result in a diagnosed medical condition, is 

insufficient to resolve the issue.14 

Due to the deficiencies in Dr. Chen’s report, OWCP should have sought clarification or 

referred appellant for a new second opinion evaluation. On remand, OWCP shall obtain a 

supplemental report from Dr. Chen or refer appellant, together with a SOAF and a list of specific 

questions, to a new second opinion physician in the appropriate field of medicine to reso lve the 

issue.

15

 Following 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 a decision.

8 A.P., Docket No. 17-0813 (issued January 3, 2018); see J.H., Docket No. 17-0248 (issued May 10, 2017).

9 A.P., id.; see generally M.M., Docket No. 14-1488 (issued November 19, 2014).

10 D.L., Docket No. 21-0047 (issued February 22, 2023); D.S., Docket No. 18-0353 (issued February 18, 2020); I.J. 

59 ECAB 408 (2008); Victor J. Woodhams, supra note 5.

11 D.L., id.; D.T., Docket No. 20-0234 (issued January 8, 2021); F.K., Docket No. 19-1804 (issued April27, 2020);

B.W., Docket No. 19-0965 (issued December 3, 2019).

12 A.K., Docket No. 18-0462 (issued June 19, 2018); Robert F. Hart, 36 ECAB 186 (1984).

13 T.B., Docket No. 20-0182 (issued April23, 2021); L.V.,Docket No. 17-1260 (issued August 1, 2018); MaeZ. 

Hackett, 34 ECAB 1421, 1426 (1983).

14 J.O., Docket No. 19-0326 (issued July 16, 2019); J.D., Docket No. 14-2061 (issued February 27, 2015).

15 D.L., supra note 10; T.S., Docket No. 18-1702 (issued October 4, 2019).
6

ORDER

IT IS HEREBY ORDERED THAT the January 24, 2023 decision of the Office of 

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

consistent with this decision.

Issued: September 15, 2023

Washington, DC

Alec J. Koromilas, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

James D. McGinley, Alternate Judge

Employees’ Compensation Appeals Board