United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

D.A., Appellant 

and 

DEPARTMENT OF THE ARMY, MEDICAL 

COMMAND, Fort Collins, CO, Employer 

__________________________________________ 

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Docket No. 16-0399 

Issued: June 9, 2016 

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 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On December 29, 2015 appellant filed a timely appeal from a December 3, 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 OWCP met its burden of proof to rescind its acceptance of 

appellant’s claim for several right upper extremity conditions. 

 1

 5 U.S.C. § 8101 et seq. 
2

FACTUAL HISTORY 

On July 31, 2014 appellant, then a 59-year-old dental assistant,2 filed a traumatic injury 

claim (Form CA-1) alleging that on June 9, 2014 she experienced pain and numbness in her right 

palm and wrist when she was typing on that date. She did not stop work, but continued to 

perform modified-duty work. 

The record contains an authorization for examination and/or treatment form (Form 

CA-16) completed on June 9, 2014 by Dr. John Reasoner, an attending Board-certified family 

practitioner. Dr. Reasoner examined appellant on June 9, 2014 and reported right wrist pain and 

hand numbness while working on a computer. He noted that she had preexisting right carpal 

tunnel syndrome and he diagnosed de Quervain’s tenosynovitis and exacerbation of degenerative 

joint disease of the first metacarpophalangeal and carpometacarpal joints.3 Dr. Reasoner 

checked a “yes” box indicating that the conditions found were caused or aggravated by the 

employment activity described. 

In a report dated June 10, 2014, Dr. Kenneth A. Stone, an attending Board-certified 

family practitioner, examined appellant on that date. Appellant reported that, on the prior day, 

she experienced sudden onset of pain in the palm of her right hand and burning pain along the 

extensor tendon from her right thumb to her right forearm. She indicated that she was working 

on the computer each day and “not really performing” her dental assistant duties. Dr. Stone 

diagnosed “acute de Quervain’s tenosynovitis right thumb, wrist, and forearm that is work 

related, possibly associated with an aggravation of preexisting [carpal tunnel syndrome].” 

In a June 19, 2014 report, Dr. Reasoner noted that appellant came in for follow up of 

“injury/pain hand, injury/pain wrist, and work injury” and reported physical examination 

findings. He diagnosed exacerbation of preexisting right carpal tunnel syndrome, right 

de Quervain’s tenosynovitis, and exacerbation of osteoarthrosis the first metacarpophalangeal 

and carpometacarpal joints of her right hand. Dr. Reasoner noted that appellant continued to 

perform modified-duty work.4

 

On July 22, 2015 OWCP accepted that appellant sustained aggravation of preexisting 

right carpal tunnel syndrome, right de Quervain’s tenosynovitis, and aggravation of preexisting 

osteoarthritis of the first metacarpophalangeal and carpometacarpal joints of her right hand. 

In an August 15, 2014 report, Dr. Reasoner indicated in the history section of the report, 

“[Appellant] has had continued tingling of right hand due to increased typing at work despite 

 2

 Appellant identified herself as a dental assistant on the (Form CA-1). At the time she filed her claim, she was 

not performing her regular dental assistant duties, but rather was working in a sedentary, modified-duty position that 

involved typing on a computer. 

3

 Dr. Reasoner noted that appellant could perform light-duty work beginning June 9, 2014. The findings of 

June 9, 2014 right hand x-rays showed no acute bony abnormality, mild osteoarthritis of the first 

metacarpophalangeal joint, and minimal osteoarthritis of the first carpometacarpal and scaphotrapezium joints. 

4

 In a July 3, 2014 report, Dr. Reasoner reported physical examination findings and diagnosed the same right 

upper extremity conditions. 
3

wrist brace. [Appellant] has [degenerative joint disease of the first carpometacarpal] joint, which 

has been exacerbated by her work activities.” He diagnosed exacerbation of preexisting right 

carpal tunnel syndrome and exacerbation of osteoarthrosis the first metacarpophalangeal and 

carpometacarpal joints of appellant’s right hand, and recommended that she continue performing 

modified work. 

By letter dated October 8, 2015, OWCP advised appellant that it proposed to rescind its 

acceptance of her claim for aggravation of preexisting right carpal tunnel syndrome, right 

de Quervain’s tenosynovitis, and aggravation of preexisting osteoarthritis of the first 

metacarpophalangeal and carpometacarpal joints of her right hand. It explained that the record 

did not contain a medical report with a rationalized medical opinion relating these conditions to 

her described work duties on June 9, 2014. OWCP provided appellant 30 days to submit 

additional evidence challenging the proposed rescission action, including information about her 

work duties on June 9, 2014 and a medical report with sound reasoning regarding the causal 

relationship between the diagnosed conditions and work factors.5

 

Appellant submitted an October 22, 2015 statement in which she noted that, since 

October 2013, she had only been performing administrative duties. She described her duties of 

typing information for 50 to 250 patients each day, noting that she spent several minutes typing 

for each patient.6

 In a November 2, 2015 statement, appellant described the problems she 

encountered in obtaining additional medical reports from attending physicians. She noted that 

Dr. Reasoner had left his medical practice group. 

In an October 19, 2015 letter, an employing establishment official indicated that appellant 

had been performing “strictly administrative” work duties since 2013, which included typing 

information for 50 to 250 patients per day. Typing in the information for each patient took a 

maximum of two minutes. 

In a December 3, 2015 decision, OWCP rescinded its acceptance of appellant’s claim for 

aggravation of preexisting right carpal tunnel syndrome, right de Quervain’s tenosynovitis, and 

aggravation of preexisting osteoarthritis of the first metacarpophalangeal and carpometacarpal 

joints of her right hand. It discussed the reports of Dr. Reasoner and Dr. Stone and indicated that 

the rescission action was justified by the fact that the medical evidence of record did not contain 

a rationalized medical opinion relating the accepted employment conditions to specific work 

factors she experienced on June 9, 2014. OWCP noted that appellant was provided an 

opportunity to submit a rationalized medical report on the matter of causal relationship, but 

failed to do so. 

 5

 In an October 8, 2015 letter, OWCP also requested that the employing establishment submit additional 

information about appellant’s work duties. 

6

 Appellant also described the dental assistant duties she performed between December 2005 and October 2013, 

including sterilizing dental instruments and typing information for patients. 
4

LEGAL PRECEDENT 

Section 8128 of FECA provides that the Secretary of Labor may review an award for or 

against payment of compensation at any time on his or her own motion or on application.7

 The 

Board has upheld OWCP’s authority to reopen a claim at any time on its own motion under 

section 8128 of FECA and, where supported by the evidence, set aside or modify a prior decision 

and issue a new decision.8

 The Board has noted, however, that the power to annul an award is 

not an arbitrary one and that an award for compensation can only be set aside in the manner 

provided by the compensation statute.9

 

Workers’ compensation authorities generally recognize that compensation awards may be 

corrected, in the discretion of the compensation agency and in conformity with statutory 

provision, where there is good cause for so doing, such as mistake or fraud. It is well established 

that, once OWCP accepts a claim, it has the burden of justifying the termination or modification 

of compensation benefits. This holds true where, as here, OWCP later decides that it erroneously 

accepted a claim. In establishing that its prior acceptance was erroneous, OWCP is required to 

provide a clear explanation of the rationale for rescission.10

ANALYSIS 

On July 31, 2014 appellant filed a traumatic injury claim alleging that on June 9, 2014 

she sustained a right upper extremity condition. She indicated that she experienced pain and 

numbness in her right palm and wrist when she was typing on that date.11 OWCP accepted that 

appellant sustained aggravation of preexisting right carpal tunnel syndrome, right de Quervain’s 

tenosynovitis, and aggravation of preexisting osteoarthritis of the first metacarpophalangeal and 

carpometacarpal joints of her right hand. In a December 3, 2015 decision, it rescinded its 

acceptance of her claim for these right upper extremity conditions. OWCP indicated that the 

rescission action was justified by the fact that the medical evidence of record did not contain a 

rationalized medical opinion relating the accepted employment conditions to specific work 

factors appellant experienced on June 9, 2014. 

The Board finds that OWCP met its burden of proof to terminate its acceptance of 

appellant’s claim for aggravation of preexisting right carpal tunnel syndrome, right de 

Quervain’s tenosynovitis, and aggravation of preexisting osteoarthritis of the first 

metacarpophalangeal and carpometacarpal joints of her right hand. 

 7

 5 U.S.C. § 8128. 

8 John W. Graves, 52 ECAB 160, 161 (2000). 

9 See 20 C.F.R. § 10.610. 

10 Supra note 8. 

11 At the time she filed her claim, appellant was not performing her regular dental assistant duties, but rather was 

working in a sedentary, modified-duty position that involved typing on a computer. 
5

In a CA-16 form report completed on June 9, 2014 by Dr. Reasoner, an attending Boardcertified family practitioner, noted his examination of appellant on June 9, 2014 and that she 

reported developing right wrist pain and hand numbness while working on a computer. He noted 

that she had preexisting right carpal tunnel syndrome and diagnosed de Quervain’s tenosynovitis 

and exacerbation of degenerative joint disease of the first metacarpophalangeal and 

carpometacarpal joints. Dr. Reasoner checked a “yes” box indicating that the conditions found 

were caused or aggravated by the employment activity described. 

In rescinding its acceptance of appellant’s claim for several right upper extremity 

conditions, OWCP explained its December 3, 2015 decision that Dr. Reasoner had not provided a 

rationalized medical opinion relating the diagnosed conditions to the specific work duties she 

performed on June 9, 2014. The Board has held that when a physician’s opinion on causal 

relationship consists only of checking “yes” to a form question, without more by the way of 

medical rationale, that opinion has little probative value and is insufficient to establish causal 

relationship. Appellant’s burden includes the necessity of furnishing an affirmative opinion from a 

physician who supports his or her conclusion with sound medical reasoning.12 As Dr. Reasoner 

did no more than check “yes” to a form question, his opinion on causal relationship is of little 

probative value and is insufficient to show that she sustained employment-related right upper 

extremity conditions. He did not describe appellant’s June 9, 2014 duties in any detail or explain 

how they could have caused or aggravated the observed medical conditions. 

In a June 19, 2014 report, Dr. Reasoner noted that appellant returned for follow up of 

“injury/pain hand, injury/pain wrist, and work injury” and reported physical examination 

findings. He diagnosed exacerbation of preexisting right carpal tunnel syndrome, right 

de Quervain’s tenosynovitis, and exacerbation of osteoarthrosis the first metacarpophalangeal 

and carpometacarpal joints of her right hand. In an August 15, 2014 report, Dr. Reasoner 

indicated in the history section of the report, “[Appellant] has had continued tingling of right 

hand due to increased typing at work despite wrist brace. [Appellant] has [degenerative joint 

disease of the first carpometacarpal] joint which has been exacerbated by her work activities.” 

He diagnosed exacerbation of preexisting right carpal tunnel syndrome and exacerbation of 

osteoarthrosis the first metacarpophalangeal and carpometacarpal joints of appellant’s right hand. 

However, as noted by OWCP in its December 3, 2015 rescission decision, Dr. Reasoner did not 

describe her June 9, 2014 work duties in detail or provide a rationalized medical opinion 

explaining the medical process through which they could have been related to the diagnosed 

conditions. 

In a report dated June 10, 2014, Dr. Stone, an attending Board-certified family 

practitioner, reported that, on the prior day, appellant had experienced a sudden onset of pain in 

the palm of her right hand and burning pain along the extensor tendon from her right thumb to 

her right forearm while working on a computer. He diagnosed “acute de Quervain’s 

tenosynovitis right thumb, wrist, and forearm that is work related, possibly associated with an 

aggravation of preexisting [carpal tunnel syndrome].” OWCP noted in its December 3, 2015 

rescission decision that Dr. Stone did not provide a rationalized opinion explaining how the 

observed medical conditions could have been related to appellant’s June 9, 2014 work duties. 

 12 Lillian M. Jones, 34 ECAB 379, 381 (1982). 
6

Dr. Stone did not describe June 9, 2014 work duties and only generally indicated that the 

diagnosed conditions were “work related” without further elaborating on the reasons for his 

opinion. With respect to the carpal tunnel condition, his opinion on causal relationship was 

speculative in nature. The Board has held that an opinion which is speculative in nature is of 

limited probative value regarding the issue of causal relationship.13 

For these reasons, OWCP provided a clear explanation of the rationale for rescinding its 

acceptance of appellant’s claim for aggravation of preexisting right carpal tunnel syndrome, right 

de Quervain’s tenosynovitis, and aggravation of preexisting osteoarthritis of the first 

metacarpophalangeal and carpometacarpal joints of her right hand.14 Therefore, it justified the 

rescission of its acceptance of her claim for these right upper extremity conditions.15 

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. 

The Board notes that where an employing establishment properly executes a Form 

CA-16, which authorizes medical treatment as a result of an employee’s claim for an 

employment-related injury, the CA-16 form creates a contractual obligation, which does not 

involve the employee directly, to pay for the cost of the examination or treatment regardless of 

the action taken on the claim. See Tracy P. Spillane, 54 ECAB 608 (2003). The period for 

which treatment is authorized by a CA-16 form is limited to 60 days from the date of issuance, 

unless terminated earlier by OWCP. See 20 C.F.R. § 10.300(c). 

CONCLUSION 

The Board finds that OWCP met its burden of proof to rescind its acceptance of 

appellant’s claim for several right upper extremity conditions. 

 13 See Leonard J. O’Keefe, 14 ECAB 42, 48 (1962); James P. Reed, 9 ECAB 193, 195 (1956). 

14 OWCP noted in its December 3, 2015 rescission decision that appellant was provided an opportunity to submit 

a rationalized medical report on the matter of causal relationship but failed to do so. 

15 See supra note 8. 
7

ORDER 

IT IS HEREBY ORDERED THAT the December 3, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: June 9, 2016 

Washington, DC 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board