United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

V.D., Appellant 

and 

U.S. POSTAL SERVICE, HOMEWOOD 

STATION, Pittsburgh, PA, Employer 

__________________________________________ 

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Docket No. 14-26 

Issued: March 21, 2014 

Appearances: Case Submitted on the Record

Jeffrey P. Zeelander, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

COLLEEN DUFFY KIKO, Judge 

PATRICIA HOWARD FITZGERALD, Judge 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On October 1, 2013 appellant, through his representative, filed a timely appeal from the 

September 19, 2013 merit decision of the Office of Workers’ Compensation Programs (OWCP). 

Pursuant to the Federal Employees’ Compensation Act1

 (FECA) and 20 C.F.R. §§ 501.2(c) and 

501.3, the Board has jurisdiction to review this decision. 

ISSUE 

The issue is whether appellant has more than a three percent impairment of his left upper 

extremity or has any impairment of his right upper extremity. 

FACTUAL HISTORY 

On December 26, 1999 appellant, a 45-year-old mail carrier, filed an occupational 

disease claim alleging that his carpal tunnel syndrome was causally related to casing and 

carrying mail. OWCP accepted his claim for bilateral carpal tunnel syndrome. 

 1

 5 U.S.C. § 8101 et seq.
2

In 2013 appellant filed a schedule award claim. Dr. Michael J. Platto, a Board-certified 

physiatrist, evaluated his impairment. He examined appellant on August 1, 2013. Dr. Platto 

related appellant’s complaints and described his findings on physical examination. He noted the 

results of nerve conduction studies and x-rays. 

Dr. Platto referred to Table 15-23, page 449 of the American Medical Association, 

Guides to the Evaluation of Permanent Impairment (6th ed. 2009). With respect to the left upper 

extremity, test findings showed evidence of a motor conduction block. Appellant’s history was 

one of mild intermittent symptoms. Physical examination showed decreased sensation. These 

criteria gave appellant a default rating of five percent, indicating a moderate impairment. Noting 

appellant’s QuickDASH score of 65, severe on the functional scale, Dr. Platto modified 

appellant’s rating to six percent. With respect to the right upper extremity, test findings showed 

a slight conduction delay. Appellant was essentially asymptomatic and he had no physical 

findings. These criteria indicated that appellant had no impairment. 

Dr. Platto noted that part of appellant’s degenerative joint disease in the left wrist was 

preexisting, going back to his teenage years, when he noted stiffness. Rather than determine 

impairment from a diagnosis of post-traumatic degenerative joint disease in Table 15-3, page 

397, he decided to use range of motion as an alternative stand-alone method. With 12 degrees of 

wrist extension, 2 degrees of radial deviation and 16 degrees of ulnar deviation, Dr. Platto found 

that appellant had a 14 percent impairment due to loss of motion. Combining this loss with the 6 

percent loss for carpal tunnel syndrome yielded a total left upper extremity impairment of 10 

percent. 

An OWCP medical adviser reviewed Dr. Platto’s calculations and agreed there was no 

basis for an impairment rating based on the right wrist. With respect to the left upper extremity, 

he explained that none of the testing met the A.M.A., Guides’ criteria for motor conduction 

block2

 but did show conduction delay. The medical adviser noted that Dr. Platto did not perform 

the required two-point discrimination testing for decreased sensation. As a result, appellant’s 

default impairment value was two percent, and the QuickDASH score increased this percentage 

to the next higher value. The medical adviser concluded that appellant had a three percent 

impairment of the left upper extremity. 

In a decision dated September 19, 2013, OWCP issued a schedule award for a three 

percent impairment of the left upper extremity and a zero percent impairment of the right. 

Appellant’s representative argues that preexisting conditions are to be included in 

impairment ratings, and OWCP’s medical adviser ignored the preexisting degenerative condition 

in appellant’s left wrist. 

 2

 Sensory and motor palm values were not provided, and the compound motor action potential was not below 

4mV (with a normal needle electromyogram). See A.M.A., Guides 487. 
3

LEGAL PRECEDENT 

The schedule award provision of FECA3 and the implementing regulations4 set forth the 

number of weeks of compensation payable to employees sustaining permanent impairment from 

loss or loss of use, of scheduled members or functions of the body. FECA, however, does not 

specify the manner in which the percentage of loss shall be determined. The method used in 

making such a determination is a matter that rests within the sound discretion of OWCP.5

For consistent results and to ensure equal justice under the law to all claimants, good 

administrative practice necessitates the use of a single set of tables so that there may be uniform 

standards applicable to all claimants. OWCP has adopted the A.M.A., Guides as the appropriate 

standard for evaluating schedule losses.6

 As of May 1, 2009, the sixth edition of the A.M.A., 

Guides is used to calculate schedule awards.7

The Board has held that preexisting conditions are to be included in determining the 

degree of impairment of the affected member of the body.8

ANALYSIS 

There is no dispute with respect to the right upper extremity. Dr. Platto, the evaluating 

physiatrist, found no impairment under the A.M.A., Guides. Test findings showed a slight 

conduction delay. Appellant was essentially asymptomatic and he had no physical findings. 

Under Table 15-23, page 449, these criteria indicate no impairment. OWCP’s medical adviser 

agreed. Accordingly, the Board will affirm OWCP’s September 19, 2013 decision on the issue 

of right upper extremity impairment. 

OWCP’s medical adviser found that Dr. Platto assigned the wrong default impairment 

rating for appellant’s left upper extremity. He explained that test findings did not show a motor 

conduction block under the criteria described on page 487 of the A.M.A., Guides. Conduction 

delays, on the other hand, were established. As a consequence, with an undisputed history of 

only mild intermittent symptoms, the default impairment value under Table 15-23, page 449, is 

two percent, which indicates a mild impairment.9

 3

 5 U.S.C. § 8107. 

4

 20 C.F.R. § 10.404. 

5 Linda R. Sherman, 56 ECAB 127 (2004); Danniel C. Goings, 37 ECAB 781 (1986). 

6

 20 C.F.R. § 10.404; Ronald R. Kraynak, 53 ECAB 130 (2001). 

7

 Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, 

Chapter 2.808.6.6a (January 2010). 

8 Richard Kirk, Docket No. 98-207 (1999) (remanding case for further development on whether any preexisting 

condition would increase the upper extremity impairment). 

9

 This is so even with physical findings of decreased sensation, which OWCP’s medical adviser noted was not 

supported with two-point discrimination. 
4

OWCP’s medical adviser modified this value to three percent based on appellant’s 

QuickDASH score of 65. A functional score greater than 60, however, is not consistent with 

mild impairment. The A.M.A., Guides states that such would suggest either the presenting 

diagnosis is incorrect or a second diagnosis, including symptom magnification, has been 

overlooked.10 Given the inconsistency, the Board will remand the case for clarification from 

OWCP’s medical adviser on whether a functional scale in the severe range should modify the 

default impairment value of a mild impairment. The A.M.A., Guides state that, if the functional 

scale is one grade higher than the grade assigned to the condition, the higher value is the 

appropriate impairment rating.11 Here, the functional scale is so much higher that Table 15-23 

does not even include it as a modifier for mild impairment. 

Clarification is also required on the issue of preexisting conditions. The Board has held 

that preexisting conditions are to be included in determining the degree of impairment of the 

affected member of the body. Dr. Platto noted a preexisting degenerative joint disease in the left 

wrist and included the impairment therefrom in his rating for the left upper extremity, but 

OWCP’s medical adviser did not address the issue. 

Under the sixth edition of the A.M.A., Guides, if there are multiple diagnoses, the 

examiner should determine if each should be considered or if the impairments are duplicative. If 

there are multiple diagnoses within a specific region, then the most impairing diagnosis is rated 

because it is probable this will incorporate the functional losses of the less impairing diagnosis. 

“In rare cases,” the examiner may combine multiple impairments within a single region if the 

most impairing diagnosis does not adequately reflect the losses. When uncertain about which 

method to choose or whether diagnoses are duplicative, the evaluator should calculate the 

impairment using different alternatives and choose the method or combination of methods that 

gives the most clinically accurate impairment rating.12

Dr. Platto used range of motion to evaluate the preexisting condition and combined that 

impairment with the impairment from carpal tunnel syndrome. The A.M.A., Guides states that 

peripheral nerve impairment may be combined with diagnosis-based impairments at the upper 

extremity level as long as the diagnosis-based impairment does not encompass the nerve 

impairment.13 That section, however, does not explicitly state that peripheral nerve impairment 

may be combined with range of motion. 

The Board will remand the case for a supplemental opinion from OWCP’s medical 

adviser clarifying the issues above. After such further development of the medical evidence as 

may be necessary, OWCP shall issue a de novo decision on appellant’s schedule award claim for 

the left upper extremity. 

 10 A.M.A., Guides 445. 

11 Id. at 449. 

12 Id. at 419. 

13 Id. 
5

CONCLUSION 

The Board finds that appellant has no impairment of his right upper extremity. The 

Board also finds that the case is not in posture for decision on the extent of his left upper 

extremity impairment. Further development of the medical evidence is warranted. 

ORDER 

IT IS HEREBY ORDERED THAT the September 19, 2013 decision of the Office of 

Workers’ Compensation Programs is affirmed on the issue of right upper extremity impairment 

and is set aside on the issue of left upper extremity impairment. The case is remanded for further 

action. 

Issued: March 21, 2014 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board