R.S. and U.S. Postal Service, Post Office (Board decision, February 18, 2026)

ECAB final decision. The Board affirmed OWCP’s October 16, 2025 denial of a left hip occupational disease claim. A party may petition the Board for reconsideration within 30 days of issuance unless this order specifies another period, under 20 C.F.R. § 501.7(a). FECA compensation decisions are generally not subject to court review under 5 U.S.C. § 8128(b).

Plain-English summary

A postal mail handler attributed left hip osteoarthritis to standing, walking, pushing, and lifting at work. Her doctor linked the condition to repetitive duties but did not explain medically how those duties caused it; an earlier statement that work might worsen pain was speculative. The Board upheld denial because the medical evidence did not establish causation.

Decision snapshot

• Authority: Federal Employees’ Compensation Act, 5 U.S.C. § 8101 et seq.; 20 C.F.R. §§ 501.2(c), 501.3.
• Outcome: Denial of the left hip occupational disease claim affirmed.
• Key point: A causal opinion needs a medical explanation of how work duties produced the condition.

Full text (ECAB public release)

United States Department of Labor
Employees’ Compensation Appeals Board

________
)
R.S., Appellant
)
)
and ) Docket No. 26-0053
) Issued: February 18, 2026
U.S. POSTAL SERVICE, POST OFFICE,
)
St. Louis, MO, Employer
)
__________ )

Appearances: Case Submitted on the Record
Alan J. Shapiro, 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 October 27, 2025 appellant, through counsel, filed a timely appeal from an October 16, 2025 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.3

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.
3
The Board notes that, following the October 16, 2025 decision, OWCP received additional evidence. The Board’s Rules of Procedure provides: “The Board’s review of a case is limited to the evidence in the case record that was before OWCP at the time of its final decision. Evidence not before OWCP will not be considered by the Board for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this additional evidence for the first time on appeal. Id.
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 August 12, 2024 appellant, then a 64-year-old mail handler, filed an occupational disease claim (Form CA-2) alleging that she developed a left hip condition due to factors of her federal employment, including pushing, standing on concrete, lifting, and prolonged periods of walking. She noted that she first became aware of her condition and realized its relationship to her federal employment on June 5, 2024. Appellant did not stop work.

In a letter dated July 2, 2024, Dr. Ilya Bendich, a Board-certified orthopedic surgeon, diagnosed appellant with left hip osteoarthritis and noted that she was scheduled for an intra- articular hip injection on June 19, 2024. He advised that she could continue with hip injections for pain relief or schedule a total hip replacement surgery in the future.

In a development letter dated August 23, 2024, OWCP informed appellant of the deficiencies of her claim. It advised her of the type of additional factual and medical evidence needed and provided a questionnaire for her completion. OWCP afforded appellant 60 days to respond.

OWCP thereafter received a letter dated August 28, 2024 by Dr. Laila Hanna, a Board- certified internist, who diagnosed left hip osteoarthritis. Dr. Hanna opined that “repetitive work might worsen the pain.” and that appellant had opted for hip surgery.

In a September 3, 2024 response to OWCP’s development questionnaire, appellant related that her job duties included standing all day on concrete and constant pulling, twisting, bending, and lifting for many years.

In a follow-up development letter dated September 20, 2024, OWCP advised appellant that it had conducted an interim review, and the evidence remained insufficient to establish her claim. It noted that she had 60 days from the August 23, 2024 letter to submit the requested necessary evidence. OWCP further advised that if the evidence was not received during this time, it would issue a decision based on the evidence contained in the record.

OWCP thereafter received a form report dated September 9, 2024, wherein Dr. Bendich indicated that appellant was scheduled for left total hip arthroplasty on September 24, 2024. He opined that she would be totally disabled from work for the period September 24 through December 17, 2024.

By decision dated October 24, 2024, OWCP denied appellant’s claim, finding that the evidence of record was insufficient to establish causal relationship between her diagnosed left hip condition and the accepted employment factors.

On October 31, 2024 appellant, through counsel, requested an oral hearing before a representative of OWCP’s Branch of Hearings and Review.

A hearing was held on February 6, 2025.

2
By decision dated March 17, 2025, OWCP’s hearing representative affirmed the October 24, 2024 decision.

On October 14, 2025 appellant, through counsel, requested reconsideration of OWCP’s March 17, 2025 decision. In support thereof, she submitted an October 10, 2025 narrative report by Dr. Hanna, who diagnosed left hip osteoarthritis. Dr. Hanna opined that the condition “was job related from the repetitive work that she does on a daily basis. From standing and bending, pulling crates, twisting, and lifting. All contributed to her injury.”

By decision dated October 16, 2025, OWCP denied modification of the March 17, 2025 decision.

LEGAL PRECEDENT

An employee seeking benefits under FECA4 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 timely filed within the applicable time limitation of FECA,5 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.6 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.7

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) medical evidence establishing that the diagnosed condition is causally related to the identified employment factors.8

The medical evidence required to establish causal relationship between a diagnosed condition and the accepted employment factors is rationalized medical opinion evidence.9 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

4
Supra note 2.
5
F.H., Docket No. 18-0869 (issued January 29, 2020); J.P., Docket No. 19-0129 (issued April 26, 2019); Joe D. Cameron, 41 ECAB 153 (1989). 6 L.C., Docket No. 19-1301 (issued January 29, 2020); J.H., Docket No. 18-1637 (issued January 29, 2020);
James E. Chadden, Sr., 40 ECAB 312 (1988).
7
P.A., Docket No. 18-0559 (issued January 29, 2020); K.M., Docket No. 15-1660 (issued September 16, 2016);
Delores C. Ellyett, 41 ECAB 992 (1990).
8
S.R., Docket No. 24-0839 (issued October 30, 2024); T.W., Docket No. 20-0767 (issued January 13, 2021); L.D., Docket No. 19-1301 (issued January 29, 2020); S.C., Docket No. 18-1242 (issued March 13, 2019). 9 S.S., Docket No. 19-0688 (issued January 24, 2020); A.M., Docket No. 18-1748 (issued April 24, 2019); Robert G. Morris, 48 ECAB 238 (1996).

3 rationale explaining the nature of the relationship between the diagnosed condition and specific employment factors identified by the employee.10

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.11

ANALYSIS

The Board finds that appellant has not met her burden of proof to establish a left hip condition causally related to the accepted employment factors.

In support of her claim, appellant submitted an October 10, 2025 narrative report by Dr. Hanna, who diagnosed left hip osteoarthritis. She opined that appellant’s injury resulted from repetitive job duties, including standing, bending, pulling crates, twisting, and lifting. While Dr. Hanna provided an affirmative opinion in support of causal relationship, she did not offer sufficient rationale to support her opinion.12 The Board has held that medical opinion evidence must offer a medically-sound explanation of how the employment factors physiologically caused an injury.13 This evidence is therefore insufficient to establish the claim.

In an August 28, 2024 letter, Dr. Hanna diagnosed left hip osteoarthritis pain and opined that “repetitive work might worsen the pain.” The Board has long held that an opinion which is equivocal or speculative in nature, is of limited probative value.14 Therefore, this evidence is insufficient to establish appellant’s claim.

In a July 2, 2024 letter and September 9, 2024 form report, Dr. Bendich diagnosed left hip osteoarthritis and indicated that appellant would be totally disabled for a period of time following a September 24, 2024 left total hip replacement surgery. He did not, however, provide an opinion on causal relationship. The Board has held that medical evidence that does not offer an opinion

10
T.L., Docket No. 18-0778 (issued January 22, 2020); Y.S., Docket No. 18-0366 (issued January 22, 2020);
Victor J. Woodhams, 41 ECAB 345, 352 (1989).
11
Federal (FECA) Procedure Manual, Part 2 -- Claims, Causal Relationship, Chapter 2.805.3e (May 2023); M.B., Docket No. 20-1275 (issued January 29, 2021); see R.D., Docket No. 18-1551 (issued March 1, 2019). 12 See J.S., Docket No. 25-0231 (issued March 7, 2025); A.C., Docket No. 24-0661 (issued September 11, 2024);
R.B., Docket No. 23-1027 (issued April 3, 2024); S.B., Docket No. 24-0064 (issued February 28, 2024); S.C., Docket No. 21-0929 (issued April 28, 2023); J.D., Docket No. 19-1953 (issued January 11, 2021); M.W., Docket No. 14-1664 (issued December 5, 2014). 13 C.L, Docket No. 25-0593 (issued July 15, 2025); K.J., Docket No. 21-0020 (issued October 22, 2021);
L.R., Docket No. 16-0736 (issued September 2, 2016); J.R., Docket No. 12-1099 (issued November 7, 2012); Douglas M. McQuaid, 52 ECAB 382 (2001). 14 S.L., Docket No. 23-0152 (issued May 16, 2023); see L.L., Docket No. 21-0981 (issued July 1, 2022);
C.A., Docket No. 21-0601 (issued November 15, 2021); J.P., Docket No. 19-0216 (issued December 13, 2019); T.M., Docket No. 08-0975 (issued February 6, 2009).

4 regarding the cause of an employee’s condition is of no probative value on the issue of causal relationship.15 Therefore, this evidence is insufficient to establish appellant’s claim.

As the medical evidence of record is insufficient to establish a left hip condition causally related to the accepted employment factors, the Board finds that appellant has not met her burden of proof.

Appellant may submit new evidence or argument with a written request for reconsideration to OWCP within one year of this merit decision, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R.
§§ 10.605 through 10.607.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish a left hip condition causally related to the accepted employment factors.

ORDER

IT IS HEREBY ORDERED THAT the October 16, 2025 decision of the Office of Workers’ Compensation Programs is affirmed.

Issued: February 18, 2026
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

15
See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).

5