United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

J.E., Appellant 

and 

DEPARTMENT OF THE NAVY, FLEET 

FORCES COMMAND STATIONS, Norfolk, VA, 

Employer 

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Docket No. 16-0370 

Issued: June 27, 2016 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On December 22, 2015 appellant, through counsel, filed a timely appeal from an 

October 21, 2015 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 over the merits of this case. 

ISSUE 

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

syndrome and ulnar neuropathy causally related to factors of his federal employment. 

FACTUAL HISTORY 

On September 15, 2014 appellant, then a 64-year-old composite/plastic fabricator, filed 

an occupational disease claim (Form CA-2) alleging that he developed a bilateral wrist and hand 

 1

 5 U.S.C. § 8101 et seq.
2

injury as a result of his repetitive employment duties. He first notified his supervisor of his 

condition on June 10, 2010. Appellant did not stop work. 

In an accompanying narrative statement, appellant explained that he worked for the U.S. 

Navy on submarines for the last 19 years and his duties involved numerous tasks including 

repairs on fairings, fair water planes, and the dome. He explained that his repair work required 

extensive chipping using a large pneumatic chisel to remove void filling material from the fair 

water planes. Appellant noted that his duties entailed using a vibrating pneumatic dual action 

sander, 8-inch grinder, and body files for fiber glass repair. He reported that he had been 

experiencing sharp burning pain in his lower arms since March 2010. Appellant noted that he 

sought treatment with a King Bay Occupational Health physician who restricted appellant from 

using vibrating pneumatic tools for a few weeks. However, his condition did not improve. 

Appellant stated that recently he began to experience discomfort in the joints of both hands, a 

sharp burning pain above both wrists, and stiffness around the finger and knuckle joints. 

By letter dated September 30, 2014, OWCP informed appellant that the evidence of 

record was insufficient to support his claim. Appellant was advised of the medical and factual 

evidence needed and was afforded 30 days to submit the additional evidence. In another letter of 

even date, OWCP requested that the employing establishment provide further information 

pertaining to appellant’s occupational disease claim. 

In an undated narrative statement received on October 14, 2014, appellant described his 

employment duties and stated that, in June 2010, he experienced pain and burning in his hands 

and arms after several days of hard grinding and chipping during an extended refit period. He 

had provided his supervisor with a Form CA-2 which was never properly submitted. At that 

time, appellant sought treatment with an employing establishment physician, Dr. Aaron 

Patterson, Board-certified in occupational medicine. He stated that his injury had progressively 

worsened over the years. Appellant noted exposure to rigorous vibrations of chipping 

equipment, manufacturing, and repairing various types of cables which were large and heavy and 

using heavy-duty pneumatic tools. He explained that he most recently sought treatment on 

September 10, 2014. 

By letter dated October 16, 2014, Robert Nevers, appellant’s supervisor, reported that 

appellant was employed as a composite fabricator. Upon reviewing appellant’s statements, 

Mr. Nevers agreed with the description of appellant’s employment duties, the tools used, and the 

environments in which he worked. Notification of Personnel Action and an official job 

description for a composite/plastic fabricator were also submitted. 

In an August 4, 2010 medical report, which was submitted in support of his claim, 

Dr. Zhigao Huang, a Board-certified neurologist, reported that appellant sought an initial 

consultation due to complaints of intermittent burning pain of the forearms bilaterally over the 

last two to three years, as well as tightness and stiffness of the hands. He provided findings on 

physical examination, noted possible carpal tunnel syndrome (CTS), and referred appellant for 

electromyography (EMG) and nerve conduction velocity (NCV) testing of the upper extremities. 

In a September 23, 2010 medical report, Dr. Shachie V. Aranke, a Board-certified 

neurologist, reported that appellant presented for EMG testing the prior day. Appellant noted 
3

complaints of burning pain intermittently in the forearm for the last two to three years. 

Dr. Aranke reported that appellant performed a lot of repetitive duties using his hands and arms 

while working on a submarine ship for many years with repeated bending and twisting of the 

hands and wrists. She further explained that appellant’s EMG study revealed abnormal findings 

due to the presence of median nerve entrapments at the wrists which were mild to moderate in 

severity and relatively symmetric bilaterally. Dr. Aranke opined that this was likely due to 

repetitive hand activities over the years. She further found evidence of bilateral compressive 

ulnar mononeuropathies at the elbows, which she opined were likely due to repeated bending of 

the elbows over the years. 

In a September 29, 2010 medical report, Dr. Huang reviewed the EMG testing, provided 

findings on physical examination, and diagnosed bilateral CTS and ulnar neuropathy. 

By decision dated November 4, 2014, OWCP denied appellant’s claim finding that the 

medical evidence failed to establish that his diagnosed condition was causally related to his 

accepted federal employment duties. 

On October 15, 2015 appellant, through counsel, requested reconsideration of OWCP 

decision. Counsel resubmitted Dr. Huang and Dr. Aranke’s reports previously of record. 

A June 10, 2010 report of injury/accident from Naval Branch Health Clinic Kings Bay 

was submitted. Dr. Patterson diagnosed neuropathy, noting that use of grinding and chipping 

equipment over the past 19 years was causing appellant discomfort in both hands and wrists. 

Duty Status Reports (Form CA-17) dated June 18 through September 30, 2010 were also 

submitted which provided him with work restrictions. 

In progress notes dated June 11 to August 10, 2010, Dr. Patterson reported that appellant 

complained of hand and forearm pain, swelling, and discomfort from chipping, sanding, and 

grinding with body files, jack hammers, and chipping equipment. He provided findings on 

physical examination and diagnosed soft tissue pain in the fingers, neuropathic pain in the hands 

and wrists, joint stiffness in the fingers, joint pain in the fingers, and exposure to chronic 

vibration from tool operations. 

In a September 30, 2010 handwritten progress note, findings of an NCV study were 

noted. 

By decision dated October 21, 2015, OWCP affirmed the November 4, 2014 decision 

finding that the medical evidence failed to establish that appellant’s diagnosed condition was 

causally related to his accepted federal employment duties. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of proof to establish 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 filed within the applicable 

time limitation, that an injury was sustained while in the performance of duty as alleged, and that 

any disability or specific condition for which compensation is claimed is causally related to the 
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employment injury.2

 These are the essential elements of every compensation claim regardless of 

whether the claim is predicated on a traumatic injury or occupational disease.3

In order to determine whether an employee actually sustained an injury in the 

performance of duty, OWCP begins with an analysis of whether fact of injury has been 

established. Generally, fact of injury consists of two components which must be considered in 

conjunction with one another. The first component to be established is that the employee 

actually experienced the employment incident which is alleged to have occurred.4 The second 

component is whether the employment incident caused a personal injury and generally can be 

established only by medical evidence. 

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

occupational disease, an employee must submit: (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.5 

To establish a causal relationship between the condition, as well as any attendant 

disability claimed and the employment event or incident, the employee must submit rationalized 

medical opinion evidence based on a complete factual and medical background, supporting such 

a causal relationship.6 The opinion of the physician 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 claimant. This 

medical opinion must include an accurate history of the employee’s employment injury and must 

explain how the condition is related to the injury. The weight of medical evidence is determined 

by its reliability, its probative value, its convincing quality, the care of analysis manifested, and 

the medical rationale expressed in support of the physician’s opinion.7

ANALYSIS 

OWCP accepted that appellant was engaged in repetitive activities in his employment 

duties as a composite/plastic fabricator. It denied his claim, however, as the evidence of record 

failed to establish a causal relationship between those work activities and his bilateral upper 

extremity injuries. The Board finds that the medical evidence of record is insufficient to 

establish that appellant developed bilateral CTS and ulnar neuropathy causally related to factors 

of his federal employment as a composite/plastic fabricator. 

 2 Gary J. Watling, 52 ECAB 278 (2001); Elaine Pendleton, 40 ECAB 1143, 1154 (1989). 

3 Michael E. Smith, 50 ECAB 313 (1999). 

4 Elaine Pendleton, supra note 2 at 1143 (1989). 

5 See Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. Fish, 46 ECAB 276, 279 (1994). 

6 See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983). 

7 James Mack, 43 ECAB 321 (1991). 
5

In medical reports dated June 10 to August 10, 2010, Dr. Patterson reported that use of 

grinding and chipping equipment over the past 19 years was causing appellant discomfort in his 

hands and wrists. He diagnosed soft tissue pain in fingers, neuropathic pain in hands and wrists, 

joint stiffness in fingers, joint pain in fingers, and exposure to chronic vibration from tool 

operations. The Board notes that Dr. Patterson failed to provide a firm medical diagnosis as only 

joint stiffness and pain were diagnosed. The Board has consistently held that pain is a symptom, 

rather than a compensable medical diagnosis.8

 

OWCP received medical reports dated August 4 and September 29, 2010, in which 

Dr. Huang reviewed EMG testing, provided findings on physical examination, and diagnosed 

bilateral CTS and ulnar neuropathy. While Dr. Huang provided a firm medical diagnosis of 

bilateral CTS and ulnar neuropathy, he failed to provide any opinion regarding the cause of these 

conditions.9 He did not provide a detailed medical history or describe any of appellant’s federal 

employment duties as a composite/plastic fabricator which may have caused him injury. The 

Board has held that medical evidence that does not offer any opinion regarding the cause of an 

employee’s condition is of limited probative value.10 Thus, the reports of Dr. Huang are 

insufficient to establish appellant’s occupational exposure claim. 

In her September 23, 2010 report, Dr. Aranke reported that appellant performed many 

repetitive duties using his hands and arms while working on a submarine ship with repeated 

bending and twisting of the hands and wrists. She explained that the EMG study revealed 

abnormal findings due to the presence of bilateral median nerve entrapments at the wrists and 

bilateral compressive ulnar mononeuropathies at the elbows. The Board finds, however, that the 

opinion of Dr. Aranke is not well rationalized. While Dr. Aranke interpreted the EMG study, she 

failed to provide an adequate explanation regarding the cause of appellant’s conditions. She 

opined that appellant’s conditions were caused by repetitive use of the hands and bending of the 

elbows over the years, yet the report is unclear as to what duties and movements the physician is 

referring. Dr. Aranke failed to adequately describe appellant’s work duties and did not specify 

how long he worked as a composite/plastic fabricator, how many hours a day he worked, the 

types of tools he used or the frequency of other physical movements and tasks. She also did not 

provide a detailed medical history to determine whether appellant’s conditions could have been a 

result of a nonoccupational preexisting condition. Appellant’s opinion is vague and not 

sufficiently rationalized as to whether his injury was caused by the repetitive use of the hands 

and elbows from his employment duties, a result of a preexisting condition, or due to 

nonoccupational factors. 

Medical reports without adequate rationale on causal relationship are of diminished 

probative value and do not meet an employee’s burden of proof.11 The opinion of a physician 

supporting causal relationship must rest on a complete factual and medical background supported 

 8 See B.P., Docket No. 12-1345 (issued November 13, 2012) (regarding pain); C.F., Docket No. 08-1102 (issued 

October 10, 2008) (regarding pain); J.S., Docket No. 07-881 (issued August 1, 2007) (regarding spasm). 

9 D.H., Docket No. 11-1739 (issued April 18, 2012). 

10 C.B., Docket No. 09-2027 (issued May 12, 2010); S.E., Docket No. 08-2214 (issued May 6, 2009).

11 Id.
6

by affirmative evidence, address the specific factual and medical evidence of record, and provide 

medical rationale explaining the relationship between the diagnosed condition and the 

established incident or factor of employment.12 As Dr. Aranke failed to provide a fully 

rationalized opinion that appellant’s bilateral CTS and ulnar neuropathy were caused or 

aggravated by his federal employment duties, her medical report fails to establish that his injuries 

are a result of a work-related occupational exposure.13 

The September 30, 2010 illegible, handwritten progress note is also of no probative value 

as it cannot be discerned and it is unknown whether a physician signed or authored the 

document.14

There is no contemporaneous medical report of record containing current examination 

findings with an opinion on causal relationship from a qualified physician. To establish a firm 

medical diagnosis and causal relationship, appellant must submit a physician’s report in which 

the physician reviews those factors of employment alleged to have caused his condition and, 

taking these factors into consideration, as well as findings upon examination and his medical 

history, explain how these employment factors caused or aggravated any diagnosed condition, 

and present medical rationale in support of his opinion.15 Thus, the medical evidence of record 

fails to support that he developed bilateral CTS and ulnar neuropathy as a result of his federal 

employment duties.16 

Appellant may submit additional evidence, together with a written request for 

reconsideration, to OWCP within one year of the Board’s merit decision, pursuant to 5 U.S.C. 

§ 8128(a) and 20 C.F.R. §§ 10.606 and 10.607. 

CONCLUSION 

The Board finds that appellant did not meet his burden of proof to establish bilateral CTS 

and ulnar neuropathy causally related to factors of his federal employment. . 

 12 See Lee R. Haywood, 48 ECAB 145 (1996). 

13 S.R., Docket No. 12-1098 (issued September 19, 2012). 

14 See also Sheila A. Johnson, 46 ECAB 323, 327 (1994); see Merton J. Sills, 39 ECAB 572, 575 (1988). 

15 Supra note 6. 

16 R.M., Docket No. 11-1921 (issued April 10, 2012). 
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ORDER 

IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’ 

decisions dated October 21, 2015 is affirmed. 

Issued: June 27, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board