United States Department of Labor 

Employees’ Compensation Appeals Board 

J.J., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS HEALTH ADMINISTRATION, 

Orlando, FL, Employer 

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Docket No. 15-1621 

Issued: January 8, 2016 

Appearances: Case Submitted on the Record 

Appellant, pro se 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

COLLEEN DUFFY KIKO, Judge 

JURISDICTION 

On July 21, 2015 appellant filed a timely appeal of a February 9, 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 has met her burden of proof to establish an injury causally 

related to factors of her federal employment. 

FACTUAL HISTORY 

On December 17, 2014 appellant, then a 31-year-old administrative support assistant, 

filed an occupational disease claim (Form CA-2) alleging that her carpal tunnel condition was 

due to her employment. She noted that, in her position, she used the computer for extended 

periods of time typing and responding to e-mails. Appellant alleged that her claimed conditions 

began on June 16, 2014. She did not stop work. 

 1

 5 U.S.C. § 8101 et seq.
2

By letter dated December 29, 2014, OWCP advised appellant that additional evidence 

was needed to establish her claim. Appellant was requested to provide a physician’s opinion 

supported by a medical explanation as to how the work factors caused the claimed conditions. 

In a January 5, 2015 e-mail, Michael Ostrow, a chief logistics officer, confirmed that 

appellant was engaged in an administrative position and that she was required to spend the 

majority of her time on the computer typing almost “exclusively each day.” He noted that 

appellant spent between two and six hours typing daily. OWCP also received a January 5, 2015 

ergonomic assessment worksheet, a position description, and a report. 

In a January 7, 2015 statement, appellant explained that during an eight-hour day she 

spent six to seven hours on the computer responding to e-mails and other data entry. She noted 

that she had a 30-minute lunch and two 15-minute breaks. Appellant had worked in the position 

since October 14, 2008 and contended that she did not engage in any physical activities or 

hobbies outside her federal duties. 

In a January 7, 2015 report, Dr. Lawrence S. Halperin, a Board-certified orthopedic hand 

surgeon, noted appellant’s history of injury and treatment. He explained that appellant had 

significant dorsal right wrist pain, which had been present for years and was slowly worsening, 

with minimal symptoms on the left. Dr. Halperin related that appellant denied trauma, 

constitutional symptoms, or a history of rheumatoid arthritis. He also related that appellant 

believed she had carpal tunnel syndrome and questioned whether it was work related, as her 

position involved heavy typing. Dr. Halperin examined appellant and determined that 

radiographs of both wrists, including carpal tunnel views, were unremarkable. He diagnosed 

bilateral wrist pain, worse on the right than the left. Dr. Halperin advised that appellant had wrist 

pain for years that was slowly worsening and was central on the carpus. He requested a 

magnetic resonance imaging (MRI) scan of the right wrist to rule out Kienbock’s disease. 

Appellant also provided a January 8, 2015 MRI scan of the right wrist without contrast, 

read by Dr. James Y. Wu, a Board-certified diagnostic radiologist. Dr. Wu reported findings to 

include multiloculated ganglion-like cystic change along the palmar margin of the distal radial 

metaphysics. 

By decision dated February 9, 2015, OWCP denied appellant’s claim. It found that the 

medical evidence of record failed to establish that the diagnosed medical conditions were related 

to the claimed work factors or events. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden of establishing the essential 

elements of his or her claim including the fact that the individual is an “employee of the United 

States” within the meaning 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 disability and/or specific condition for which compensation is claimed are causally related 
3

to the employment injury.2 These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated upon a traumatic injury or an occupational disease.3

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 medical 

evidence required to establish causal relationship, generally, is rationalized medical opinion 

evidence. Rationalized medical opinion evidence is medical evidence which includes a physician’s 

rationalized opinion on the issue of whether there is a causal relationship between the claimant’s 

diagnosed condition and the implicated employment factors. 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

ANALYSIS 

The evidence supports that appellant engaged in repetitive activities at work such as 

typing on the computer. However, appellant submitted insufficient medical evidence to establish 

that she has a wrist or hand condition caused or aggravated by these activities or any other 

specific factors of her federal employment. 

Appellant submitted a January 7, 2015 report from Dr. Halperin, who determined that she 

had significant dorsal right wrist pain, which was present for years and slowly worsening, with 

minimal symptoms on the left. Dr. Halperin related that appellant believed she had carpal tunnel 

and questioned if it was work related as her position involved heavy typing. Upon examination 

and review of x-rays of both wrists, including carpal tunnel views, he diagnosed only bilateral 

wrist pain, worse on the right than the left. Although appellant suggested her wrist condition was 

work related, Dr. Halperin did not diagnose a physical condition. He merely noted appellant’s 

suggestion of carpal tunnel syndrome but diagnosed only bilateral wrist pain. The Board has 

held that pain is a symptom not a compensable diagnosis.5

Similarly, reports of diagnostic testing are insufficient to establish the claim as these 

reports do not address how employment factors contributed to a diagnosed medical condition. 

 2 Joe D. Cameron, 41 ECAB 153 (1989); Elaine Pendleton, 40 ECAB 1143, 1145 (1989). 

3 Victor J. Woodhams, 41 ECAB 345 (1989). 

4 Id. 

5 Robert Broome, 55 ECAB 339, 342 (2004). 
4

The Board has held that the mere fact that a condition manifests itself during a period of 

employment does not raise an inference that there is a causal relationship between the two.6 

Neither the fact that the condition became apparent during a period of employment nor the belief 

that the condition was caused or aggravated by employment factors or incidents is sufficient to 

establish causal relationship.7 Causal relationship must be substantiated by reasoned medical 

opinion evidence, which is appellant’s responsibility to submit. 

As there is no reasoned medical evidence explaining how appellant’s employment duties 

caused or aggravated a diagnosed medical condition, appellant has not met her burden of proof to 

establish a medical condition causally related to factors of her employment. 

Appellant may submit evidence or argument with a written request for reconsideration 

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 did not meet her burden of proof to establish an injury 

causally related to factors of her federal employment. 

ORDER 

IT IS HEREBY ORDERED THAT the February 9, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: January 8, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 6 See Joe T. Williams, 44 ECAB 518, 521 (1993). 

7 Id.