United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

L.B., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Philadelphia, PA, Employer 

__________________________________________ 

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Docket No. 15-1017 

Issued: September 19, 2016 

Appearances: Case Submitted on the Record

Thomas R. Uliase, Esq., for the appellant1

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On April 2, 2015 appellant, through counsel, filed a timely appeal from a 

December 5, 2014 merit decision of the Office of Workers’ Compensation Programs (OWCP). 

Pursuant to the Federal Employees’ Compensation Act2

 (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 her burden of proof to establish that she sustained a 

recurrence of disability on January 6, 2014. 

 1

 In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for 

legal or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. 

§ 501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An 

attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject 

to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation 

2

 5 U.S.C. §§ 8101-8193. 
2

On appeal counsel asserts that appellant sustained a recurrence of disability because the 

accepted conditions worsened and the employing establishment withdrew limited-duty work. 

FACTUAL HISTORY 

On September 5, 2013 appellant, then a 62-year-old mail handler, filed an occupational 

disease claim alleging that in July 2013 her duties aggravated bilateral arm and hand conditions. 

She did not stop work. OWCP adjudicated the claim under file number xxxxxx907.3 In an 

October 24, 2013 report, Dr. Scott M. Fried, a Board-certified osteopath specializing in 

orthopedic and hand surgery, referenced case number xxxxxx451. He stated that appellant’s left 

wrist and hands continued to hurt, especially at work, where she was working full duty. 

Dr. Fried advised that left wrist physical examination demonstrated tenderness and a positive 

Phalen’s test. Fisting was good. Dr. Fried diagnosed bilateral de Quervain’s tenosynovitis; 

bilateral osteoarthritis of the carpometacarpal joint of the thumb, bilateral wrist TFCC wrist 

tears; radioulnar joint injury of the left wrist; lunotriquetral ligament injury of the right wrist; 

scapholunate ligament injury of the left wrist; status post bilateral median nerve carpal tunnel 

decompression with tenosynovectomy; overuse syndrome; and bilateral median, radial and 

carpal tunnel neuropathy, all of which were secondary to work activities. He advised that 

appellant could not perform regular work duties. 

On December 2, 2013 OWCP accepted the present claim for bilateral radial styloid 

(de Quervain’s) tenosynovitis and bilateral localized, primary osteoarthritis of the hand. 

In a disability slip dated January 2, 2014, Dr. Fried advised that appellant was under his 

care for work-related injuries. He found that she could not perform repetitive grasping, gripping, 

keying, or machinery activities, and could not lift over four pounds. Dr. Fried referred her for a 

work capacity evaluation.4 On an appended handwritten note dated January 6, 2014, an 

employing establishment supervisor related that she met with appellant and a union 

representative. She informed appellant that there was no work available that met the physical 

limitations provided and that appellant could request light duty. 

On January 17, 2014 appellant filed a recurrence claim (Form CA-2a), stating that she 

sustained a recurrence of disability on January 6, 2014 when she was told that the employing 

establishment had no work available within her restrictions. 

In a report dated January 30, 2014, Dr. Fried noted appellant’s complaint that her left 

wrist was worsening. He provided physical examination findings of swelling in the left ulnar 

wrist and provided left wrist range of motion findings. Dr. Fried reiterated his diagnoses, 

concluded that all conditions were work related, and advised that appellant could not return to 

regular work duties. 

 3

 The record indicates that appellant has several other claims. Under file number xxxxxx600, OWCP accepted 

bilateral carpal tunnel syndrome and aggravation of a tear of the triangular fibrocartilage (TFCC) on the right. 

Under that claim, in a decision dated January 10, 2013, the Board found that a conflict in medical evidence existed 

regarding the degree of impairment of appellant’s upper extremities and remanded the case to OWCP for referral to 

an impartial specialist. Docket No. 12-1270 (issued January 10, 2013). File number xxxxxx451 was accepted for a 

left wrist sprain that occurred on April 21, 2001. These other claims are not presently before the Board. 

4

 A work capacity evaluation dated January 2, 2014 is not found in the case record. 
3

On March 19, 2014 OWCP informed appellant of the type of evidence needed to support 

her recurrence claim. 

In treatment notes dated February 10, March 27, May 8, and June 30, 2014, Dr. Fried 

noted that appellant was not working and continued to have symptoms in both thumbs and radial 

wrist. He provided physical examination findings of left wrist dysesthesias, limited bilateral 

wrist and carpometacarpal (CMC) joint range of motion. Dr. Fried reiterated his diagnoses and 

advised that she remained disabled due to “noted and documented” injuries. 

By decision dated June 4, 2014, OWCP denied appellant’s recurrence claim because the 

medical evidence of record was insufficient to establish how the accepted conditions had caused 

the claimed disability on January 6, 2014. 

Appellant, through counsel, timely requested a hearing. In a June 30, 2014 report, 

Dr. Fried stated that appellant had continued symptoms in bilateral wrists and hands, more 

significant on the left. He noted negative Phalen’s and Tinel’s tests and good wrist range of 

motion. Dr. Fried reiterated his diagnoses and advised that appellant was treated with therapy 

and medication. He recommended a carpal tunnel help book and indicated that appellant 

continued to be disabled from work due to “noted and documented injuries.” 

At the hearing, held on October 20, 2014, appellant testified that she had bilateral hand 

surgery in the past, but had returned to work. She described her job duties in 2013, stating that 

additional hand problems began that June. Appellant stated that she had to stop work in 

January 2014 because the employing establishment had no jobs available within the restrictions 

provided by Dr. Fried and had that she not returned to work. She stated that she had retired from 

the employing establishment and had a part-time job at Costco. Counsel noted that appellant had 

a separate claim, adjudicated under file number xxxxxx600, that was accepted for bilateral carpal 

tunnel syndrome and right TFCC tear.5

 He asserted that because the employing establishment 

did not have work within her medical restrictions, a recurrence had clearly been established. 

In an October 30, 2014 treatment note, Dr. Fried reported that appellant’s bilateral hand 

and wrist symptoms continued. He reiterated his diagnoses and indicated that appellant could 

not return to her usual job, noting that she had retired on October 1, 2014, and continued parttime work at Costco. 

In a November 10, 2014 statement, appellant maintained that she could not think straight 

and had poor short-term memory due to an employment-related concussion that she had in 2007. 

She stated that she continued to work full duty because she needed the money and would not 

have continued working if she had known that it would injure her hands. 

By decision dated December 5, 2014, an OWCP hearing representative affirmed the 

June 4, 2014 decision. He found the reports of Dr. Fried to be of insufficient rationale because 

the physician did not explain how the accepted conditions of thumb arthritis or radial styloid 

tenosynovitis worsened in January 2014 such that appellant could not perform regular duties. 

 5 Supra note 2. 
4

LEGAL PRECEDENT 

A recurrence of disability means “an inability to work after an employee has returned to 

work, caused by a spontaneous change in a medical condition which had resulted from a 

previous injury or illness without an intervening injury or new exposure to the work environment 

that caused the illness.”6 An individual person who claims a recurrence of disability due to an 

accepted employment-related injury has the burden of establishing by the weight of the substantial, 

reliable, and probative evidence that the disability for which she claims compensation is causally 

related to the accepted injury. This burden of proof requires that an employee furnish medical 

evidence from a physician who, on the basis of a complete and accurate factual and medical 

history, concludes that the disabling condition is causally related to the employment injury and 

supports that conclusion with sound medical reasoning.7 Where no such rationale is present, 

medical evidence is of diminished probative value.8

ANALYSIS 

The Board finds that appellant has not established a recurrence of disability on January 6, 

2014 under this claim, adjudicated by OWCP under file number xxxxxx907. Under this claim 

OWCP had accepted that appellant sustained bilateral radial styloid (de Quervain’s) 

tenosynovitis and bilateral localized, primary osteoarthritis of the hand. 

In support of her recurrence claim, appellant submitted reports dated January 2 and 6, 

February 10, March 27, May 8, June 30, and October 30, 2014 in which Dr. Fried noted her 

complaints and described physical examination findings, especially with regard to her left wrist 

and hand. Dr. Fried listed numerous diagnoses which he advised were work-related and 

indicated that she was off work due to “noted and documented injuries.” However, he did not 

specifically relate appellant’s claimed recurrence of disability to the conditions accepted in this 

case. 

A physician’s opinion on causal relationship between a claimant’s disability and an 

employment injury is not dispositive simply because it is rendered by a physician. To be of 

probative value, the physician must provide rationale for the opinion reached.9

 Without medical 

reasoning showing that the conclusion reached is sound, logical, and rational, a medical opinion 

is of diminished probative value.10 As Dr. Fried did not specifically discuss how the accepted 

conditions in this case caused appellant’s disability from work beginning January 6, 2014, his 

opinion is of insufficient probative value to meet her burden of proof. 

An individual who claims a recurrence of disability due to an accepted employment-related 

injury has the burden of establishing by the weight of the substantial, reliable, and probative 

evidence that the disability for which he or she claims compensation is causally related to the 

 6

 20 C.F.R. § 10.5(x); R.S., 58 ECAB 362 (2007). 

7

 S.S., 59 ECAB 315 (2008). 

8

 See Ronald C. Hand, 49 ECAB 113 (1997). 

9 Thaddeus J. Spevack, 53 ECAB 474 (2002). 

10 See E.A., 58 ECAB 677 (2007). 
5

accepted injury.11 In the case at hand, appellant did not submit sufficient evidence to show that 

the claimed recurrence and disability were causally related to the bilateral radial styloid 

tenosynovitis and bilateral localized primary osteoarthritis of the hand. 

Counsel asserts that wage-loss compensation should be paid because the employing 

establishment withdrew limited-duty work. The record indicates that appellant did not stop work 

due to the accepted condition which is the subject of this claim and that the duty restrictions 

placed on her by Dr. Fried were not due to the accepted injury in the present claim. 

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 failed to establish a recurrence of disability on 

January 6, 2014. 

ORDER 

IT IS HEREBY ORDERED THAT the December 5, 2014 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: September 19, 2016 

Washington, DC 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 11 Supra note 7.