United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.N., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Hendersonville, NC, Employer 

__________________________________________ 

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Docket No. 13-2163 

Issued: March 19, 2014 

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

RICHARD J. DASCHBACH, Chief Judge 

COLLEEN DUFFY KIKO, Judge 

PATRICIA HOWARD FITZGERALD, Judge 

JURISDICTION 

On September 23, 2013 appellant filed a timely appeal from the May 9, 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 sustained an occupational disease in the performance of 

duty. 

FACTUAL HISTORY 

On December 13, 2012 appellant, a 54-year-old rural carrier, filed an occupational 

disease claim alleging that the bone-to-bone condition of her left thumb was a result of her 

federal employment: “The more I hold mail, left hand, the more it hurt and would swell. Very 

 1

 5 U.S.C. § 8101 et seq.
2

sharp, stinging pains, weakness, dropping mail at times. Couldn’t get relief, so I went to doctor.” 

She indicated that she first became aware of this condition on July 27, 2012. 

On July 27, 2012 Dr. James S. Thompson, a Board-certified orthopedic surgeon, saw 

appellant for a left thumb problem that started one and a half years earlier while putting new 

z-chains on in snow. Appellant’s left hand slipped and rammed into the tire. She had pain and 

weakness in the thumb and using it at work was painful. Dr. Thompson diagnosed osteoarthritis, 

primary, any joint of the hand including the carpometacarpal joint of the thumb. He also found a 

probably healing fracture at the base of the first metacarpal, superimposed on trapeziometacarpal 

arthrosis. 

Dr. Christopher T. Lechner, a Board-certified orthopedic hand surgeon and associate of 

Dr. Thompson, saw appellant on October 25, 2012. He noted that she was a mail carrier who 

complained that constant pinching with the left thumb and index finger over time had caused 

pain and swelling. Dr. Lechner diagnosed carpometacarpal arthritis, left thumb, chronic “and 

related to her work as a mail carrier.” 

Dr. Lechner completed an attending physician’s form report on November 5, 2012. He 

indicated with an affirmative mark that appellant’s diagnosis was caused or aggravated by 

employment activity. 

The employing establishment confirmed that appellant did use her hands and thumbs as a 

letter carrier, “as in other activities in her daily life that are not work related.” It provided a 

position description describing the duties and responsibilities of a rural carrier. 

In a decision dated May 9, 2013, OWCP denied appellant’s claim for compensation. It 

found that she failed to establish the element of fact of injury. The evidence did not support that 

the injury or events occurred as alleged, and even if it did, appellant did not submit any medical 

evidence to establish that her diagnosed medical condition was causally related to the work 

injury or events. 

On appeal, appellant explains that the incident with the z-chains happened in 2003 and 

involved her right thumb, not her left. There was never an injury to her left thumb from an 

accident, only constant use from being a mail carrier 6 days a week for over 20 years. 

LEGAL PRECEDENT 

FECA provides compensation for the disability of an employee resulting from personal 

injury sustained while in the performance of duty.2

 An employee seeking benefits under FECA 

has the burden of proof to establish the essential elements of his or her claim. When an 

employee claims that he or she sustained an injury in the performance of duty, he or she must 

submit sufficient evidence to establish that he or she experienced a specific event, incident or 

 2

 5 U.S.C. § 8102(a). 
3

exposure occurring at the time, place and in the manner alleged. He or she must also establish 

that such event, incident or exposure caused an injury.3

Causal relationship is a medical issue,4 and the medical evidence generally required to 

establish causal relationship is rationalized medical opinion evidence. The opinion of the 

physician must be based on a complete factual and medical background of the claimant,5 must be 

one of reasonable medical certainty,6 and must be supported by medical rationale explaining the 

nature of the relationship between the diagnosed condition and the established incident or factor 

of employment.7

ANALYSIS 

Appellant attributes her left thumb condition to the duties she performed as a rural 

carrier, in particular, using her left hand to hold mail. There is no dispute that she performed 

such activities at work. The employing establishment confirmed that she did use her hands and 

thumbs as a letter carrier. The activities appellant described were consistent with the position 

description the employing establishment presented. Accordingly, the Board finds that appellant 

has met her burden to establish that she experienced a specific event, incident or exposure 

occurring at the time, place and in the manner alleged. 

The issue is whether such work activities as holding mail with her left hand caused or 

aggravated any diagnosed medical condition. The medical opinion evidence submitted in this 

case offers some support. Dr. Thompson, the orthopedic surgeon, related appellant’s history that 

using her left thumb at work was painful, but he offered no opinion on the element of causal 

relationship. His associate, Dr. Lechner, the orthopedic hand surgeon, found that appellant’s 

chronic left thumb carpometacarpal arthritis was “related to her work as a mail carrier.” In his 

attending physician’s form report, he indicated with an affirmative mark that appellant’s 

diagnosis was caused or aggravated by employment activity. 

However, Dr. Lechner offered no medical rationale to support his opinion. As the Board 

noted earlier, any opinion on causal relationship must be supported by medical rationale 

explaining the nature of the relationship between the diagnosed condition and the established 

incident or factor of employment. Dr. Lechner did not discuss from an orthopedic perspective 

how holding mail in the left hand, or any other employment activity, caused or aggravated to the 

diagnosed arthritis, or on what basis he could make such a determination. 

 3 John J. Carlone, 41 ECAB 354 (1989). 

4 Mary J. Briggs, 37 ECAB 578 (1986). 

5 William Nimitz, Jr., 30 ECAB 567, 570 (1979). 

6 See Morris Scanlon, 11 ECAB 384, 385 (1960). 

7 See William E. Enright, 31 ECAB 426, 430 (1980). 
4

Medical conclusions unsupported by rationale are of little probative value.8 As 

Dr. Lechner did not support his opinion with sound medical reasoning, the Board finds that 

appellant has not met her burden to establish the critical element of causal relationship. The 

Board will therefore affirm the May 9, 2013 decision denying her claim for compensation. 

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 to establish that she sustained an 

occupational disease in the performance of duty. The medical opinion evidence, although 

supportive, is insufficiently rationalized to establish the element of causal relationship. 

ORDER 

IT IS HEREBY ORDERED THAT the May 9, 2013 decision of the Office of Workers’ 

Compensation Programs is affirmed. 

Issued: March 19, 2014 

Washington, DC 

 

 Richard J. Daschbach, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia Howard Fitzgerald, Judge 

 Employees’ Compensation Appeals Board 

 8 Ceferino L. Gonzales, 32 ECAB 1591 (1981); George Randolph Taylor, 6 ECAB 968 (1954).