United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.L., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Visalia, CA, Employer 

__________________________________________ 

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Docket No. 16-0272 

Issued: March 21, 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 

COLLEEN DUFFY KIKO, Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On November 30, 2015 appellant filed a timely appeal from a June 19, 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 his burden of proof to establish bilateral carpal 

tunnel syndrome causally related to factors of his federal employment. 

FACTUAL HISTORY 

On April 14, 2015 appellant, then a 59-year-old letter carrier, filed an occupational 

disease claim (Form CA-2) alleging bilateral carpal tunnel syndrome on or before January 6, 

2014 due to repetitive motion casing and carrying mail since November 5, 1988. He explained 

 1

 5 U.S.C. § 8101 et seq. 
2

that he first became aware of the condition on January 6, 2014 and first related it to his federal 

employment on August 7, 2014. Appellant described repetitive pinching and grasping with both 

hands throughout his workday, including holding six to eight inches of flats in his left arm while 

casing with his right hand, which he asserted put pressure on the tendons that moved his right 

thumb. He also noted pushing mail into the case with his left thumb and having to hold his 

fingers at unnatural angles while handling bundled mail. Appellant did not stop work. 

Dr. Jonathan C. Liu, an attending Board-certified orthopedic surgeon, submitted August 7 

and September 10, 2014 reports noting appellant’s federal employment as a letter carrier. On 

examination, he observed an acquired trigger finger, swelling in both wrists, and he related 

appellant’s complaints of bilateral hand pain and paresthesias. Dr. Liu diagnosed bilateral carpal 

tunnel syndrome and a right small trigger finger. He administered a tendon sheath injection to 

the trigger finger. Dr. Liu ordered electromyography (EMG) and nerve conduction velocity 

(NCV) studies performed on September 26, 2014, which demonstrated moderately severe-tosevere bilateral carpal tunnel syndrome. On December 11, 2014 he administered tendon sheath 

injections to both wrists and prescribed bilateral thumb spica splints. 

In an April 23, 2015 letter, OWCP advised appellant of the additional evidence needed to 

establish his claim, including a report from his attending physician explaining how and why the 

identified work factors would cause carpal tunnel syndrome. Appellant was afforded 30 days to 

submit such evidence. OWCP later granted him an extension, allowing him to submit additional 

evidence until June 19, 2015. 

In response, appellant submitted a report from Dr. Adolph J. Nava, an attending Boardcertified internist. Dr. Nava opined on June 17, 2015 that according to appellant’s “job 

description there is clear evidence that his newly revealed diagnosis of carpal tunnel syndrome 

appears work related.” 

By decision dated June 19, 2015, OWCP denied the claim, finding that the medical 

evidence failed to establish causal relationship between the repetitive upper extremity motions 

and the diagnosis of bilateral carpal tunnel syndrome. 

LEGAL PRECEDENT 

An employee seeking benefits under FECA has the burden 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 filed within the applicable time 

limitation; that an injury was sustained while in the performance of duty as alleged; and that any 

disability and/or specific condition for which compensation is claimed are causally related to the 

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

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

 2 Joe D. Cameron, 41 ECAB 153 (1989). 

3 See Irene St. John, 50 ECAB 521 (1999); Michael E. Smith, 50 ECAB 313 (1999). 
3

An occupational disease is defined 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) 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 is generally 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.5

ANALYSIS 

Appellant claimed that he sustained bilateral carpal tunnel syndrome in the performance 

of duty on or before January 16, 2015. He attributed the condition to repetitive pinching and 

grasping motions while casing and carrying mail. OWCP accepted that these work factors 

occurred as described. 

In support of his claim, appellant submitted reports from Dr. Liu, a Board-certified 

orthopedic surgeon, who diagnosed bilateral carpal tunnel syndrome, confirmed by 

September 26, 2014 electrodiagnostic studies. Although Dr. Liu noted that appellant worked as 

a letter carrier, he did not address any causal relationship between appellant’s federal 

employment and the development of bilateral carpal tunnel syndrome. Dr. Nava, an attending 

Board-certified internist, provided a June 17, 2015 report opining that appellant’s carpal tunnel 

syndrome appeared work related. However, he did not set forth his medical reasoning for 

supporting a causal relationship between appellant’s duties as a letter carrier and the diagnosed 

carpal tunnel syndrome. The Board has found that a medical report which fails to offer an 

opinion on causal relationship is of little probative value.6

OWCP advised appellant by April 23, 2015 letter of the information needed to establish 

his claim. Appellant has failed to meet his burden of proof. 

 4

 20 C.F.R. § 10.5(q). 

5 Solomon Polen, 51 ECAB 341 (2000). 

6 Donald T. Pippin, 54 ECAB 631, 634 (2003).
4

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 met his burden of proof to establish bilateral carpal 

tunnel syndrome causally related to factors of his federal employment. 

ORDER 

IT IS HEREBY ORDERED THAT the decision of the Office of Workers’ 

Compensation Programs dated June 19, 2015 is affirmed. 

Issued: March 21, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board