United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

A.J., Appellant 

and 

DEPARTMENT OF THE NAVY, CUSTOMER 

SERVICE DESK, Monterey, CA, Employer 

__________________________________________ 

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Docket No. 16-0678 

Issued: October 4, 2016 

Appearances: Case Submitted on the Record

Appellant, pro se 

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 February 22, 2016 appellant filed a timely appeal of a September 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 to consider the merits of the case.2

ISSUE 

The issue is whether appellant has met her burden of proof to establish a right hand 

condition causally related to factors of her federal employment. 

 1

 5 U.S.C. § 8101 et seq.

2

 The Board notes that appellant submitted additional evidence after OWCP rendered its September 21, 2015 

decision. The Board’s jurisdiction is limited to reviewing the evidence that was before OWCP at the time of its final 

decision. Therefore the Board lacks jurisdiction to review this additional evidence on appeal. 20 C.F.R. 

§ 501.2(c)(1). Appellant may submit this or any evidence to OWCP, together with a formal request for 

reconsideration, pursuant to 5 U.S.C. § 8128(a) and 20 C.F.R. § 10.606(b)(2). 
2

FACTUAL HISTORY 

On August 4, 2015 appellant, then a 71-year-old transportation assistant, filed an 

occupational disease claim (Form CA-2) alleging that she developed a right hand condition 

including sharp pain and tenderness in the thumb and joint while grasping and holding objects. 

She indicated that her job required her to pull junk file jackets each month out of the file cabinets 

and rearrange them back into the cabinets based on the monthly roster. Appellant indicated that 

she first became aware of her condition and first attributed the condition to her employment on 

January 1, 2013. On the reverse side of the claim form, appellant’s supervisor provided the 

information that appellant had resigned, effective October 17, 2014. 

In a letter dated August 13, 2015, OWCP requested that appellant provided additional 

factual and medical evidence in support of her occupational disease claim. It noted that she 

resigned from her position effective October 17, 2014. OWCP requested medical evidence of a 

diagnosed condition and allowed appellant 30 days to submit the requested information. 

Appellant submitted a series of notes Access Family Healthcare, signed by a physician 

assistant whose signature is illegible. Dr. Warren D. Turner, a physician Board-certified in 

emergency medicine, completed treatment notes beginning November 23, 2009 through 

December 20, 2011 addressing appellant’s ongoing knee conditions. He described appellant’s 

chronic back pain beginning on January 24, 2012. On May 20, 2013 Dr. Turner noted that 

appellant underwent knee surgery in November 2010 but continued to experience bilateral knee 

and back pain. 

Dr. Stephen Saglio, a Board-certified family practitioner, first examined appellant on 

November 26, 2012 due to essential hypertension. He listed her problems at that time to include 

low back pain, thumb pain, and wrist pain. Appellant continued to seek treatment from 

Dr. Saglio from December 27, 2012 through January 7, 2014 for conditions not related to her 

occupational disease claim. 

On February 14, 2014 Dr. Saglio examined appellant due to thumb and wrist pain. He 

noted that appellant had pain with resisted thumb flexion and diagnosed thumb pain and thumb 

flexor tendinitis. In a note dated August 22, 2014, Dr. Saglio described appellant’s complaints of 

right hand pain near the base of the thumb. He noted that her pain was worse when she gripped 

and had been bothering appellant for one year. Dr. Saglio examined appellant on September 17, 

2014 and reported that appellant attended hand therapy and also noted findings of thumb pain. 

He diagnosed thumb pain. On September 29, 2014 Dr. Saglio found right wrist pain located 

laterally on the radial side. He noted that appellant had an orthotic crafted and requested x-rays. 

Dr. Saglio diagnosed wrist pain. Appellant underwent hand and wrist x-rays on 

September 30, 2014. On October 8, 2014 Dr. Saglio noted appellant’s complaints of thumb and 

wrist pain. A note dated June 10, 2015 includes a list of current problems including thumb pain. 

Appellant submitted a referral from Duluth Family Medicine dated September 11, 2015 

diagnosing right hand pain and carpal tunnel syndrome.3

On September 15, 2014 Susan Trinity, an occupational therapist, treated appellant for 

right thumb flexor tendinitis. 

 3

 The signature on this note is illegible. 
3

By decision dated September 21, 2015, OWCP denied appellant’s claim for an 

occupational disease as she failed to submit medical evidence of a diagnosed condition and also 

failed to submit medical evidence attributing her condition to her employment. 

LEGAL PRECEDENT 

OWCP regulations define an occupational disease as “a condition produced by the work 

environment over a period longer than a single workday or shift.”4

 To establish that an injury 

was sustained in the performance of duty in an occupational disease claim, a claimant must 

submit the following: (1) medical evidence establishing the presence or existence of the disease 

or condition for which compensation is claimed; (2) a factual statement identifying employment 

factors alleged to have caused or contributed to the presence or occurrence of the disease or 

condition; and (3) medical evidence establishing that the employment factors identified by the 

claimant were the proximate cause of the condition for which compensation is claimed or, stated 

differently, medical evidence establishing that the diagnosed condition is causally related to the 

employment factors identified by the claimant. The evidence required to establish causal 

relationship is rationalized medical opinion evidence, based upon a complete factual and medical 

background, showing a causal relationship between the claimed condition and identified factors. 

The belief of a claimant that a condition was caused or aggravated by the employment is not 

sufficient to establish causal relation.5

ANALYSIS 

The Board finds that appellant has not submitted sufficient medical evidence to establish 

her occupational disease claim. 

Dr. Saglio diagnosed, among other maladies, thumb flexor tendinitis on 

February 14, 2014.6 Appellant has submitted medical evidence of a diagnosed condition. She 

also provided factual evidence in support of her claim as she attributed her right hand and thumb 

condition to pulling junk jackets out of filing cabinets and on a monthly basis since 2012. 

Appellant resigned from the employing establishment effective October 17, 2014. The Board 

finds, however, that the medical evidence submitted fails to establish a causal relationship 

between appellant’s diagnosed condition and her accepted employment activities. 

Dr. Turner did not provide a diagnosis of a right hand or thumb condition. His reports, 

therefore, cannot meet appellant’s burden of proof to establish an occupational disease resulting 

in a right hand condition. Dr. Saglio indicated on August 22, 2014 that appellant’s right thumb 

pain due to her diagnosed condition of thumb flexor tendinitis was worse when she gripped and 

had been bothering appellant for one year. While this note implicates appellant’s employment 

activity, he did not offer any opinion regarding the relationship between appellant’s employment 

and her condition. 

 4

 20 C.F.R. § 10.5(q). 

5 Lourdes Harris, 45 ECAB 545, 547 (1994). 

6

 The Board notes that the majority of the medical records address appellant’s hand and thumb pain. The Board 

has held that the mere diagnosis of “pain” does not constitute the basis for payment of compensation. Robert 

Broome, 55 ECAB 339 (2004). 
4

Appellant also provided treatment notes from an occupational therapist and a physician 

assistant. Certain healthcare providers such as physician assistants, nurse practitioners, physical 

therapists, and social workers are not considered physicians as defined under FECA.7

 

Consequently, their medical findings will not suffice for purposes of establishing entitlement to 

FECA benefits.8

 There is no other medical evidence of record addressing appellant’s diagnosed 

right hand or thumb condition and her employment, appellant has failed to meet her burden of 

proof to establish her occupational disease 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 has not submitted the necessary medical opinion evidence 

to establish a causal relationship between her diagnosed right thumb flexor tendinitis and her 

implicated employment duties. Due to this deficiency, appellant has failed to meet her burden of 

proof in establishing her occupational disease claim. 

ORDER 

IT IS HEREBY ORDERED THAT the September 21, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: October 4, 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 

 7

 5 U.S.C. § 8101(2); 20 C.F.R. § 10.5(t). 

8 K.W., 59 ECAB 271, 279 (2007); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006).