United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

T.S., Appellant 

and 

DEPARTMENT OF THE ARMY, SURFACE 

DEPLOYMENT & DISTRIBUTION 

COMMAND, Fort Eustis, VA, Employer 

__________________________________________ 

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Docket No. 14-180 

Issued: May 20, 2014 

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

MICHAEL E. GROOM, Alternate Judge 

JURISDICTION 

On November 1, 2013 appellant filed a timely appeal from a May 8, 2013 merit decision 

of the Office of Workers’ Compensation Programs (OWCP) denying her claim for an 

employment-related injury. Pursuant to the Federal Employees’ Compensation Act1 (FECA) and 

20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over the merits of this case.2

 

ISSUE 

The issue is whether appellant met her burden of proof to establish carpal tunnel 

syndrome due to factors of her federal employment. 

 1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that, following the issuance of the May 8, 2013 OWCP decision, appellant submitted new 

evidence. The Board is precluded from reviewing evidence which was not before OWCP at the time it issued its 

final decision. See 20 C.F.R. § 501.2(c)(1). 
2

On appeal, appellant noted that she worked for the Federal Government for 35 years, of 

which 25 years required repetitive use of her fingers on a daily basis. She worked at a 

workstation that was not ergonomically designed for her body. Appellant’s carpal tunnel 

syndrome required surgical treatment. 

FACTUAL HISTORY 

On March 9, 2012 appellant, then a 68-year-old safety and occupational health specialist, 

filed an occupational disease claim (Form CA-2) alleging that she sustained carpal tunnel 

syndrome due to factors of her federal employment, including computer keyboarding and typing. 

On February 24, 2012 Dr. Nidal Shawahin, a Board-certified internist, found a positive 

Phalen’s test on appellant’s left hand and diagnosed possible carpal tunnel syndrome. He noted 

that appellant used her hands for typing at work and had similar symptoms in 2004 but was not 

under his care at that time. 

In an April 3, 2012 letter, OWCP notified appellant of the deficiencies of her claim. It 

afforded her 30 days to submit additional evidence and respond to its inquiries. 

Appellant submitted an April 27, 2012 statement, noting that her federal duties required 

frequent use of typing with a computer keyboard. She also submitted a position description and 

physical therapy notes dated December 30, 2004. 

In a May 13, 2003 record of occupational injury or illness, appellant reported that she 

noticed her hands were swollen from typing. The employing establishment restricted her from 

typing for two weeks due to carpal tunnel syndrome. 

On December 7, 2004 Hilda Williamson, a family nurse practitioner, diagnosed mid-back 

pain. She indicated that appellant’s neck and back pain were aggravated by factors of her federal 

employment, including the postural position in the chair to perform selected job tasking. 

In an August 16, 2007 report, Dr. Elizabeth Hughes, a family practitioner, diagnosed an 

occupational problem. She noted that appellant received an ergonomic chair following a prior 

assessment which had helped to somewhat relieve her lower back pain. Appellant continued to 

have bilateral shoulder pain and was provided with educational material on carpal tunnel 

syndrome. 

On February 27, 2012 Dr. Shawahin prescribed a wrist splint for her keyboard disability. 

Electromyography and nerve conduction studies (EMG/NCS) dated March 13, 2013 

revealed advanced bilateral carpal tunnel syndrome. 

By decision dated June 12, 2012, OWCP denied appellant’s claim. It accepted her work 

duties but found that the medical evidence was not sufficient to establish a causal relationship 

between her wrist conditions to the employment factors. 
3

On March 22, 2013 appellant requested reconsideration and submitted a March 20, 2013 

report from Dr. Shawahin who stated that appellant had “carpal tunnel possibly caused by her 

typing/keyboard at work.” 

By decision dated May 8, 2013, OWCP denied modification of the June 12, 2012 

decision. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA3 has the burden of establishing the essential 

elements of his or her claim, including the fact 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 period of FECA, and that an injury4

 was sustained in the performance of duty. These 

are the essential elements of each compensation claim, regardless of whether the claim is 

predicated upon a traumatic injury or an occupational disease.5

 

To establish that an injury was sustained in the performance of duty in a claim for an 

occupational disease claim, 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.6

 

Causal relationship is a medical issue and the medical evidence generally required to 

establish causal relationship is rationalized medical evidence. 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.7

 

ANALYSIS 

The Board finds that appellant did not meet her burden of proof to establish that her 

federal employment caused or aggravated her carpal tunnel syndrome. Appellant submitted a 

statement in which she identified the factors of employment that she believed caused the 

condition, including computer keyboarding and typing. In order to establish a claim, she must 

 3

 5 U.S.C. § 8101 et seq. 

4

 OWCP regulations define an occupational disease or illness as a condition produced by the work environment 

over a period longer than a single workday or shift. 20 C.F.R. § 10.5(q). 

5 See O.W., Docket No. 09-2110 (issued April 22, 2010); Ellen L. Noble, 55 ECAB 530 (2004). 

6 See D.R., Docket No. 09-1723 (issued May 20, 2010). See also Roy L. Humphrey, 57 ECAB 238, 241 (2005); 

Ruby I. Fish, 46 ECAB 276, 279 (1994); Victor J. Woodhams, 41 ECAB 345 (1989). 

7 See O.W., supra note 5. 
4

also submit rationalized medical evidence which explains how her medical conditions were 

caused or aggravated by her work factors.8

On February 24, 2012 Dr. Shawahin found a positive Phalen’s test on appellant’s left 

hand and diagnosed possible carpal tunnel syndrome. He noted generally that she used her hands 

for typing at work and had similar symptoms in 2004, but was not under his care at that time. On 

February 27, 2012 Dr. Shawahin prescribed a wrist splint. On March 20, 2013 he stated that she 

had “carpal tunnel possibly caused by her typing/keyboard at work.” Dr. Shawahin failed to 

provide a rationalized opinion explaining how factors of appellant’s federal employment, such as 

computer keyboarding and typing, caused or aggravated her carpal tunnel syndrome. He noted 

that her condition possibly occurred while she was at work, but such generalized statements are 

speculative and do not establish causal relationship. Dr. Shawahin’s opinion is unsupported by 

adequate medical rationale explaining how her physical activity at work actually caused or 

aggravated the diagnosed conditions.9 

In her August 16, 2007 report, Dr. Hughes diagnosed an “occupational problem” and 

noted that appellant received an ergonomic chair following a prior assessment. Appellant 

continued to have bilateral shoulder pain and was provided with educational material on carpal 

tunnel syndrome. Dr. Hughes failed to provide an opinion addressing how computer 

keyboarding or typing were competent to cause or aggravate appellant’s carpal tunnel syndrome. 

The March 13, 2013 EMG/NCS report is diagnostic in nature and does not address causal 

relationship. 

Appellant also submitted a position description, a May 13, 2003 record of occupational 

injury or illness, a December 7, 2004 report from Ms. Williamson, a nurse practitioner, and the 

physical therapy notes dated December 30, 2004. These documents do not constitute competent 

medical evidence as they do not contain rationale by a physician relating appellant’s disability to 

her employment.10 

On appeal, appellant stated that she worked for the Federal Government for 35 years, 25 

of which required repetitive use of her fingers on a daily basis. As noted she bears the burden of 

proof to establish her claim.11 As the medical evidence of record lacks a sufficient opinion on 

causal relationship, appellant failed to meet her burden of proof. The Board finds that her 

arguments are not substantiated. 

 8 See A.C., Docket No. 08-1453 (issued November 18, 2008); Donald W. Wenzel, 56 ECAB 390 (2005); Leslie C. 

Moore, 52 ECAB 132 (2000). 

9 See K.W., Docket No. 10-98 (issued September 10, 2010). 

10 See 5 U.S.C. § 8101(2). Section 8101(2) of FECA provides as follows: “(2) ‘physician’ includes surgeons, 

podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and osteopathic practitioners within the 

scope of their practice as defined by State law.” See also Paul Foster, 56 ECAB 208, 212 n.12 (2004); Joseph N. 

Fassi, 42 ECAB 677 (1991); Barbara J. Williams, 40 ECAB 649 (1989). 

11 See supra notes 3 to 7. 
5

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 that she 

sustained carpal tunnel syndrome in the performance of duty causally related to factors of her 

federal employment. 

ORDER 

IT IS HEREBY ORDERED THAT the May 8, 2013 decision of the Office of Workers’ 

Compensation Programs is affirmed. 

Issued: May 20, 2014 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Michael E. Groom, Alternate Judge 

 Employees’ Compensation Appeals Board