had commenced about 7 days prior to admission; and though the Schedule awards, hearing, loss of Evidence did not establish that appellant had a permanent hearing loss related to his March 29, 1973 noise exposure incident which would entitle him to a schedule award, where the audiogram made the following day was read by the dispensary doctor and the Office assistant medical director as indicating that appellant did not have a significant hearing loss. Docket No. 74-152; Submitted on the Record; Before FLOYD G. ANSLEY, E. GERALD LAMBOLEY, FRED E. STRINE The issue is whether the noise to which appellant was subjected at work on March 29, 1973 caused his disability commencing March 30, 1973 or caused a permanent loss of hearing. On March 30, 1973, appellant, a 56 year old packer, went to the dispensary of the employing establishment because of ear pain and numbness in the right side of his face. He stated that on the previous day he had worked in an area where an air hammer had been used for about an hour and where pipe had been dropped on a concrete floor. He stated that this had affected his right ear and his mouth. His blood pressure was 200/100. Dr. O. M. Rhodes, the examining physician, was of the impression that appellant had sustained a cerebrovascular accident. An audiogram made at that time showed only a slight impairment in the middle frequencies for the right ear. Appellant was referred to Dr. Willian E. Bronson, who hospitalized him on March 31, 1973. Appellant gave a history that about 7 days prior to admission he had experienced a pulling of the left side of his face with weakness and inability to grimace, temporary retrograde amnesia, profound weakness, substernal distress and diaphoresis. He had been treated for the past two years for labile hypertension and recurrent kidney infections. The final diagnoses were left cerebrovascular accident of the anterior cerebral artery, labile hypertensive disease, chronic pancreatitis, and a prediabetic glucose tolerance curve. He was discharged from the hospital on April 20, 1973 On May 14, 1973 appellant returned to work but he was again absent from June 19 to August 20, 1973. On July 3, 1973, Dr. Thomas Hawk, a Board-certified neurosurgeon, performed a left carotid endarterectomy. Appellant was released from the hospital on July 9, 1973. However, he was rehospitalized from July 23 to July 29, 1973 because of arteriosclerotic heart disease and hypertension. Appellant filed a claim alleging that his disability was caused by his exposure to noise at work on March 29, 1973. He also alleged that this had affected his hearing. In a report dated May 29, 1973, Dr. Hawk noted that appellant had stated that he became aware of his facial weakness at the time a fellow worker had dropped a metal pipe causing a loud noise. Dr. Hawk commented, "The only way I could explain any relationship was that he could have had increased blood pressure at the time but there would be no way to prove this definitely." In a subsequent report dated December 7, 1973, Dr. Hawk stated that the loud noise on the day of appellant's attack antedated his symptoms. The doctor commented, "It would be unlikely to implicate a cause and effect. It is possible that if it had been a fearful situation it could have altered his blood pressure but I think this is making too much out of the situation. It seems more likely to have been simply coincidental." In a brief report dated November 1, 1973, Dr. Bronson answered "no" to the question as to whether appellant's disability commencing March 30, 1973 was related to a history of injury. In two previous brief reports, the doctor had given some support to appellant's claim. The Office of Workers' Compensation Programs, formerly the Office of Federal Employees' Compensation, prepared a statement of accepted facts which it submitted with the case record to Dr. John N. Meagher, a Board-certified neurosurgeon and an associate of Dr. Hawk. Dr. Meagher was requested to examine appellant and to render an opinion regarding the relationship between appellant's disability beginning March 30, 1973 and factors of his employment. In a report dated December 11, 1973, Dr. Meagher indicated that he had examined appellant and had access to his previous medical records. Appellant told the doctor that his hypertension was first noted in 1965. He stated that on March 29, 1973, six inch pipes fell from a fork lift onto a concrete floor causing a loud noise. Shortly thereafter a fellow worker noted that appellant's face was dis torted and he could not move the right side of his face. He also noted decreased hearing in the right ear but he continued working until the end of his shift four and a half hours later. The doctor noted that appellant had two periods of disability commencing the day after the incident. Appellant told the doctor that since returning to work on August 20, 1973 he had missed only two days because of illness. Based upon his examination of appellant, the history and the medical records, Dr. Meagher concluded that the cerebrovascular accident sustained in March 1973 was the result of appellant's hypertensive cardiovascular disease and his prediabetic state. The doctor stated that he could not establish any relationship between appellant's employment and the cerebrovascular accident or any of his other conditions. He added that appellant's neurologic deficit had resolved and that he did not have a functional deficit at the time of the examination. The assistant medical director of the Office after examining the case record stated that there were no medical grounds for concluding that there was a relationship between appellant's employment and his illness. The doctor added that the audiogram of March 30, 1973 showed no significant hearing loss. The Office issued a compensation order dated April 19, 1974 finding that appellant's disability for work commencing March 30, 1973 was not related to any factor of his employment and that he did not have an employment-related hearing loss ratable for schedule award purposes. The Board finds that the evidence fails to establish that there was any relationship between appellant's exposure to noise on March 29, 1973 at work and his disability beginning March 30, 1973 from a cerebrovascular accident. When hospitalized on March 31, he gave a history that his symptoms had commenced about seven days prior to admission. Dr. Hawk, the attending Board-certified neurosurgeon, was under the impression that appellant's symptoms began after his exposure to noise on March 29, and he speculated about a possible connection between the noise and an increase in blood pressure. However, he concluded that the appearance of appellant's symptoms shortly after the noise was merely coincidental. Dr. Meagher, the Board-certified neurosurgeon who examined appellant and the case record, concluded that appellant's cerebrovascular accident and resulting disability had no relation to the noise incident. Likewise, Dr. Bronson, the attending internist, negated causal relationship in his most recent report. The Board further finds that the evidence does not establish that appellant has a permanent hearing loss related to the March 29, 1973 incident which would entitle him to a schedule award. The audiogram made the following day was read by the dispensary doctor and by the assistant medical director of the Office as indicating that appellant did not have a significant hearing loss. There is no medical evidence in the record indicating that he has a ratable permanent hearing loss. The compensation order of the Office of Workers' Compensation Programs, dated April 19, 1974, is affirmed. In the Matter of WILLIAM E. HENDERSON and DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION, Hilliard, Fla. Burden of proof, inferences and presumptions-Causal relation, Appellant has the burden of establishing by the weight of the Back injuries, disability due to other causes-Causal relation, proof Appellant failed to establish that his back condition was related to conditions of his employment where, although the record contained reports from several attending physicians including those who performed both laminectomies, none of them expressed an opinion on causal relation, and an Office medical adviser negated it. Docket No. 74-155; Submitted on the Record; Before FLOYD G. ANSLEY, E. GERALD LAMBOLEY, FRED E. STRINE The issue is whether appellant's back condition and resulting disability were causally related to conditions of his employment. On October 25, 1972, appellant, a team supervisor of air traffic controllers, filed a claim for disability caused by a herniated lumbar disk which he alleged was the result of standing and bending in connection with his duties over a 15 year period. He stated that beginning March 24, 1957, he as assigned duties of a coordinator which required him to stand behind controllers and supervise their work. He further stated that the work subjected him to long periods of standing and bending at the waist. He performed those duties until July 1, 1972, when he was in a leavewithout-pay status and he retired under the disability provisions of the Civil Service Retirement Act because of his back condition effective September 18, 1972. On February 14, 1973, appellant submitted a statement in which he said the onset of the injury was gradual and that prior to March 9, 1971, the first date he consulted a doctor for his claimed injury, the pain in his back and right leg would stop after periods of rest. He was seen by Dr. Walter G. Jarrell, a general practitioner, on March 9, 1971. Dr. Jarrell submitted a report stating that appellant complained of back pain on April 26, 1971, and a diagnosis of sciatica as made. Appellant was treated for several months thereafter for back complaints by Dr. H. DeCosta, an associate of Dr. Jarrell. On March 15, 1972, appellant was examined by Dr. Louis J. Larmoyeux, Sr., an osteopath, who noted symptoms of "herniated nucleus pulposa, lumbar," and referred appellant to Dr. Howard C. Chandler, a Board-certified neurosurgeon, for neurological consultation and possible myelogram and surgery. Dr. Chandler initially examined appellant on March 20, 1972, and diagnosed a herniated disk of the fourth lumbar vertebra. The doctor reported that appellant underwent laminectomies on April 5 and June 8, 1972. A medical examiner of the Office of Workers' Compensation Programs, formerly the Office of Federal Employees' Compensation, examined the case record and stated, "There is no condition of employment that would have precipitated, aggravated, or caused a herniated disc and no medical reports indicate any causal relationship." The medical examiner concluded that appellant's back condition was not causally related to his employment. By compensation order dated March 1, 1974, the Office rejected appellant's claim for compensation for the reasons that, "The fact of an injury sustained in the performance of duty is not established and the disability for which compensation is claimed is not causally related to the employment." Appellant has the burden of establishing by the weight of the evidence that his back condition was causally related to conditions of his employment. As this Board has stated on many occasions, neither the fact that the condition became apparent during a period of employment, nor the belief of appellant that the condi |