United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

R.H., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Coppell, TX, Employer 

__________________________________________ 

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Docket No. 15-213 

Issued: March 12, 2015 

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 

JAMES A. HAYNES, Alternate Judge 

JURISDICTION 

On October 28, 2014 appellant filed a timely appeal from the August 14, 2014 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 expand his accepted work 

conditions to include carpal tunnel syndrome, foot effusions of tarsal metatarsal joints, tendinosis 

of the supraspinatus, infraspinatus, and subscapularis tendons, mild subacromial subdeltoid 

bursitis, and mild effusions of the glenohumeral joint. 

 

 1 5 U.S.C. §§ 8101-8193. 
2

FACTUAL HISTORY 

In April 2014 OWCP accepted that appellant, then a 59-year-old mail handler, sustained 

bilateral shoulder and upper arm sprains and right synovitis and tenosynovitis due to performing 

his work duties over time. It has been accepted that appellant was required to lift and carry mail 

sacks weighing up to 70 pounds and to push and pull heavy equipment. 

On February 19, 2014 Dr. Mahe T. Nadeem, an attending Board-certified physical 

medicine and rehabilitation physician, obtained x-ray testing of appellant’s extremities. The 

x-ray testing of his left ankle/foot showed no evidence of fracture, but did show evidence of 

postsurgical hardware at the posterior medial aspect of tibia with moderate degenerative changes 

of the distal tibia, distal fibula, and proximal talus. There were moderate degenerative changes 

of the ankle mortise joint. 

The findings of April 28, 2014 magnetic resonance imaging (MRI) scan testing of 

appellant’s left shoulder showed findings suggestive of impingement, mild subacromial 

subdeltoid bursitis, mild effusion of the glenohumeral joint, tendinosis of the subscapularus 

tendon, tendinosis of the supraspinatus and infraspinatus tendons, partial intrasubstance tear of 

the supraspinatus tendon, and para-labral cyst which had a high correlation with the presence of 

occult labral tears. 

In an April 30, 2014 report, Dr. Nadeem discussed appellant’s work duties and noted that 

he currently complained of pain in both shoulders, tingling in both hands, and back pain. 

Appellant had knee pain with standing and right elbow pain with gripping and holding. 

Dr. Nadeem mentioned February 19, 2014 x-ray testing of appellant’s extremities, April 28, 

2014 MRI scan testing of his left shoulder, and February 24, 2014 electromyogram (EMG) and 

nerve conduction velocity (NCV) testing.2

 She stated, “In my professional medical opinion, the 

patient’s conditions should be upgraded to include the diagnoses listed below due to the recent 

diagnostic studies performed....” Dr. Nadeem recommended additional conditions be expanded 

to include rotator cuff tear of the supraspinatus tendon, carpal tunnel syndrome, foot effusions of 

tarsal metatarsal joints, tendinosis of the supraspinatus, infraspinatus, and subscapularis tendons, 

mild subacromial subdeltoid bursitis, and mild effusions of the glenohumeral joint. 

On May 14, 2014 OWCP medical adviser noted that appellant had mild generalized 

degenerative arthritis which was not uncommon to his age group. He believed the request for 

additional accepted conditions was based on multiple testing results, some of which were fraught 

with frequent false positive findings, and which were not uncommon findings with any such tests 

in appellant’s age group. OWCP medical adviser stated, “What is lacking here is a clear, 

rational, causal related diagnosis that is supported by reliable history, physical findings, and 

corroborating laboratory findings. With lack of these, it is my opinion that none of the diagnoses 

should be accepted as job related.” 

In a May 21, 2014 decision, OWCP denied appellant’s request to expand his accepted 

work conditions as he had failed to submit sufficient rationalized medical evidence. 

 2

 The record does not contain a copy of the February 24, 2014 EMG and NCV test findings. 
3

The findings of June 4, 2014 MRI scan testing of appellant’s left shoulder showed 

findings compatible with impingement and long segment of severe articular surface partial tear 

of the supraspinatus tendon which had within it multiple small complete perforations or tears 

without retraction. 

In a June 10, 2014 report, Dr. Nadeem reported findings of examination on that date and 

again recommended accepting the additional conditions of rotator cuff tear of the supraspinatus 

tendon, carpal tunnel syndrome, foot effusions of tarsal metatarsal joints, tendinosis of the 

supraspinatus, infraspinatus, and subscapularis tendons, mild subacromial subdeltoid bursitis, 

and mild effusions of the glenohumeral joint. She stated, “In my professional medical opinion, 

[appellant] has been a consistent patient at this office and by performing examinations, 

therapeutic procedures, and sending out to request specific diagnostic procedures. The findings 

of the diagnostic procedures specify unquestionable diagnosis. Therefore, I feel [appellant’s] 

conditions should be upgraded....” 

In a June 30, 2014 report, Dr. Gregg Podleski, an attending osteopath, described the 

symptoms of appellant’s left shoulder. On July 15, 2014 Dr. Podleski performed a rotator cuff 

repair of his left shoulder. 

On August 8, 2014 OWCP medical adviser reviewed the recent diagnostic testing of the 

left shoulder and Dr. Podleski’s July 15, 2014 operative report. He found left shoulder rotator 

cuff tear should be accepted as work related. 

In an August 14, 2014 decision, OWCP accepted a partial tear of the left rotator cuff, but 

denied the expansion of the claim to include carpal tunnel syndrome, foot effusions of tarsal 

metatarsal joints, tendinosis of the supraspinatus, infraspinatus, and subscapularis tendons, mild 

subacromial subdeltoid bursitis, and mild effusions of the glenohumeral joint. 

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 timely filed within the applicable 

time limitation period of FECA, that an injury was sustained in the performance of duty as 

alleged and that any specific condition and/or disability for which compensation is claimed are 

causally related to the employment injury.3

 The medical evidence required to establish a causal 

relationship between a claimed period of disability and an employment injury is rationalized 

medical opinion evidence. The opinion of the physician must be based on a complete factual and 

medical background of the claimant, 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.4

 3 J.F., Docket No. 09-1061 (issued November 17, 2009). 

4 See E.J., Docket No. 09-1481 (issued February 19, 2010). 
4

ANALYSIS 

In April 2014 OWCP accepted that appellant sustained bilateral shoulder and upper arm 

sprains and right synovitis and tenosynovitis due to performing his work duties over time. Based 

on the opinion of OWCP medical adviser, it expanded appellant’s accepted work conditions to 

include a partial tear of the left rotator cuff. 

Appellant also claimed that his accepted work conditions should be expanded to include 

carpal tunnel syndrome, foot effusions of tarsal metatarsal joints, tendinosis of the supraspinatus, 

infraspinatus, and subscapularis tendons, mild subacromial subdeltoid bursitis, and mild 

effusions of the glenohumeral joint. The Board finds that appellant has failed to establish that 

these conditions were caused by his employment. 

In reports dated April 30 and June 10, 2014, Dr. Nadeem, an attending Board-certified 

physical medicine and rehabilitation physician, recommended that carpal tunnel syndrome, foot 

effusions of tarsal metatarsal joints, tendinosis of the supraspinatus, infraspinatus, and 

subscapularis tendons, mild subacromial subdeltoid bursitis, and mild effusions of the 

glenohumeral joint be accepted as work related.5

The Board notes that Dr. Nadeem did not provide sufficient medical rationale to support 

the causal relationship of these conditions. Dr. Nadeem did not adequately explain how these 

conditions were work related or why they were not duplicative of other accepted conditions.6 In 

her June 10, 2014 report, she stated that her request was justified by diagnostic testing, but she 

did not explain the basis for this statement. 

Moreover, the record contains an opinion of OWCP medical adviser explaining why 

these additional medical conditions should not be accepted as work related. In his August 8, 

2014 report, OWCP medical adviser stated that the conditions of tendinosis of the supraspinatus, 

infraspinatus, and subscapularis tendons, mild subacromial subdeltoid bursitis, and mild 

effusions of the glenohumeral joint were duplicative of other accepted work conditions. He also 

explained how the medical evidence, including the diagnostic testing in the record, did not 

clearly show that the claimed conditions of carpal tunnel syndrome and foot effusions of tarsal 

metatarsal joints were work related. OWCP medical adviser found the reports of Dr. Podleski 

did not show carpal tunnel syndrome and that diagnostic testing suggested that appellant’s foot 

effusions were due to a nonwork-related condition. 

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. 

 5

 Dr. Nadeem also recommended that appellant’s claim include a left rotator cuff tear, but this condition was in 

fact accepted by OWCP. 

6 See supra note 4. 
5

CONCLUSION 

The Board finds that appellant did not meet his burden of proof to expand his accepted 

work conditions to include carpal tunnel syndrome, foot effusions of tarsal metatarsal joints, 

tendinosis of the supraspinatus, infraspinatus, and subscapularis tendons, mild subacromial 

subdeltoid bursitis, and mild effusions of the glenohumeral joint. 

ORDER 

IT IS HEREBY ORDERED THAT the August 14, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: March 12, 2015 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 James A. Haynes, Alternate Judge 

 Employees’ Compensation Appeals Board