Printing - FECA-PT2 - National Association of Letter Carriers

situation where ten days earlier the claimant had developed knee pain after playing basketball off
the job. In this situation, the physician's opinion relating the cartilage tear to the work injury,
even with explanation or rationale, will not have much value or weight since it is not based on all
pertinent facts.
When two physicians give reasoned but differing opinions concerning causal relationship and one
physician's opinion is based on inaccurate or incomplete factual or medical background, the opinion
based on accurate factual or medical history has more probative value.
e. Consistency with Physical Findings. A well-reasoned medical opinion must be consistent
with the findings upon examination. For example, a physician might state that a claimant has a
back sprain causally related to a work injury 10 years ago without citing physical findings to
support this conclusion. The physician explains that the claimant's injury is causally related to the
past injury because prior to the incident the claimant had no complaints of back pain, whereas
since the injury he or she has continued to complain of back pain. An "explanation" such as this,
not supported by physical findings, will not constitute well-rationalized medical opinion. The ECAB
has affirmed cases where benefits have been denied because there is no objective medical
evidence of disability (Thomas D. Petrylak, 39 ECAB 276.)
f. Comprehensiveness. A comprehensive report is one which reflects that all testing and
analysis necessary to support the physician's final conclusions were performed. An opinion based
on a cursory or incomplete examination will have less value compared to an opinion based on a
more complete evaluation. The ECAB has remanded cases where a physician has indicated that
further testing or evaluation is necessary to resolve an issue and the OWCP has not arranged for
the required testing or evaluation.
g. Equivocalness. Opinions which can be characterized as equivocal, speculative or conjectural
are those which contain language which is unclear or vague. Terms such as "could," "may," or
"might be" indicate that the report is equivocal, speculative or conjectural and has less probative
value compared to positively expressed medical opinions. The term "probably" is less speculative,
and should be viewed in the context of the rest of the medical report and the factual evidence.
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