R.C. and U.S. Postal Service, Post Office, New Orleans, LA (Board decision, September 10, 2010)

ECAB final decision. The Board affirmed OWCP's November 28, 2009 denial of R.C.'s claim for a work-related hernia. The Board's decision binds OWCP and is generally not subject to court review under 5 U.S.C. § 8128(b). A party may petition the Board for reconsideration within 30 days of issuance unless this decision specifies another period, under 20 C.F.R. § 501.7(a).

Plain-English summary

R.C., a postal letter carrier, claimed that lifting mail trays and packages caused a right inguinal hernia. He submitted an operative report documenting repair of the hernia. The report did not address what caused the condition. OWCP requested a reasoned medical opinion connecting the diagnosis to his work duties, but R.C. did not provide one. The Board affirmed the claim denial because the required causal medical evidence was missing.

Decision snapshot

• Authority: FECA, 5 U.S.C. § 8101 et seq., governs compensation for work-related conditions.
• Outcome: November 28, 2009 hernia claim denial affirmed.
• Key point: An operative report established treatment but gave no opinion linking the hernia to work.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
R.C., Appellant
)
) Docket No. 10-545
and ) Issued: September 10, 2010
)
U.S. POSTAL SERVICE, POST OFFICE,
)
New Orleans, LA, Employer
)
__________ )

Appearances: Case Submitted on the Record
Appellant, pro se
Office of Solicitor, for the Director

DECISION AND ORDER

Before:
ALEC J. KOROMILAS, Chief Judge
COLLEEN DUFFY KIKO, Judge
JAMES A. HAYNES, Alternate Judge

JURISDICTION

On December 22, 2009 appellant filed a timely appeal of the November 28, 2009 decision of the Office of Workers’ Compensation Programs denying his claim for a hernia. Pursuant to 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over the merits of the claim.

ISSUE

The issue is whether appellant met his burden of proof to establish that he sustained a hernia causally related to factors of his employment.

FACTUAL HISTORY

On March 26, 2009 appellant, then a 60-year-old letter carrier, filed an occupational disease claim alleging that he sustained a hernia caused by lifting trays of flat mail and packages at his job.

In an October 23, 2009 letter, the Office asked appellant to provide a detailed description of the work duties that caused his condition and a comprehensive medical report from his treating physician containing a diagnosis, results of examinations and tests, treatment provided and a rationalized opinion on the causal relationship between the diagnosed condition and his employment duties.

In a March 24, 2009 operative report, Dr. Emad Kandil a Board-certified general surgeon, provided a preoperative diagnosis of a right inguinal hernia. He described the procedure performed on appellant, a laparoscopic right inguinal hernia repair.

In a November 28, 2009 decision, the Office denied appellant’s claim on the grounds that the medical evidence did not establish that his right inguinal hernia was causally related to work factors.

LEGAL PRECEDENT

To establish that an injury was sustained in the performance of duty in a claim for an occupational disease, 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.1 Causal relationship is a medical issue and the medical evidence generally required to establish causal relationship is rationalized medical evidence. Rationalized medical opinion evidence is medical evidence which includes a physician’s rationalized opinion on whether there is a causal relationship between the employee’s diagnosed condition and the compensable employment factors. The opinion of the physician must be based on a complete factual and medical background of the employee, 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 employee.2

An award of compensation may not be based on surmise, conjecture or speculation.
Neither the fact that an employee’s claimed condition became apparent during a period of employment, nor his belief that his condition was aggravated by his employment, is sufficient to establish causal relationship.3

ANALYSIS

The Board finds that appellant failed to meet his burden of proof to establish that his right inguinal hernia was causally related to factors of his employment.

The only medical evidence appellant submitted in support of his hernia claim was the March 24, 2009 operative report from Dr. Kandil. The cause of the hernia was not addressed in

1
See Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. Fish, 46 ECAB 276, 279 (1994).
2
I.J., 59 ECAB ___ (Docket No. 07-2362, issued March 11, 2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989).
3
D.I., 59 ECAB ___ (Docket No. 07-1534, issued November 6, 2007); Ruth R. Price, 16 ECAB 688, 691 (1965).

2 this report. The Office explained to appellant the type of medical evidence needed to establish his claim. It requested a comprehensive report from his treating physician with a diagnosis, results of examinations and tests, treatment provided and the doctor’s rationalized opinion on the causal relationship between the diagnosed condition and his employment duties. Appellant failed to provide such medical evidence. The Office properly denied his claim.

CONCLUSION

The Board finds that appellant failed to meet his burden of proof to establish that his right inguinal hernia was causally related to factors of his employment.

ORDER

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ Compensation Programs dated November 28, 2009 is affirmed.

Issued: September 10, 2010
Washington, DC

Alec J. Koromilas, Chief Judge
Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge
Employees’ Compensation Appeals Board

James A. Haynes, Alternate Judge
Employees’ Compensation Appeals Board

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