United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

K.R., Appellant 

and 

U.S. POSTAL SERVICE, NETWORK 

DISTRIBUTION CENTER, Warrendale, PA, 

Employer 

__________________________________________ 

) 

) 

) 

) 

) 

) 

) 

) 

) 

Docket No. 16-0839 

Issued: July 7, 2016 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant 

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On March 17, 2016 appellant, through counsel, filed a timely appeal from a February 3, 

2016 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 a right hand or 

arm injury causally related to her federal employment. 

FACTUAL HISTORY 

On January 9, 2015 appellant, then a 23-year-old seasonal temporary mail handler, filed a 

traumatic injury claim (CA-1) alleging that she injured her right wrist and arm in the 

 1

 5 U.S.C. § 8101 et seq. 
2

performance of duty on December 31, 2014. On the claim form she indicated that she had 

injured her left hand two or three days earlier and had been assigned light duty.2

 Appellant 

reported that she felt right hand pain due to over compensation. The reverse of the claim form 

reported appellant stopped working on January 2, 2015. 

An employing establishment manager submitted a January 6, 2015 letter indicating that 

appellant had reported a left wrist injury on December 27, 2014. The manager reported appellant 

had been hired on December 13, 2014 and, that after December 31, 2014, she had been working 

light duty with a 10-pound restriction. She noted that appellant opened sacks, sorted parcels, and 

rewrapped containers. In a January 7, 2015 letter, a supervisor indicated that appellant also 

complained of right hand pain on December 27, 2014, and indicated the pain began on 

December 26, 2014 when she was tossing a parcel. An employing establishment human 

resources specialist submitted a January 7, 2015 letter asserting that appellant’s claim did not 

appear to be a traumatic injury claim, as it occurred over more than one workday. The 

employing establishment reported that appellant had been hired as a temporary employee for the 

holiday season, and that she had reported she was a sign language student, which could have 

contributed to a right hand injury. 

As to medical evidence, appellant submitted an emergency department form report from 

Dr. Anita Conway, Board-certified in emergency medicine, reflecting treatment on 

January 2, 2015. Dr. Conway wrote that appellant should be off work until January 6, 2015, with 

the need to wear a right wrist splint for at least a week. 

By letter dated February 2, 2015, OWCP requested that appellant submit additional 

evidence. It afforded appellant 30 days to submit additional medical evidence to support her 

claim for compensation. 

In a narrative report dated January 2, 2015, Dr. Conway provided a history of a right 

wrist injury on December 31, 2014, which appellant felt may have occurred because she was 

over using her right hand after a left arm injury. She opined that appellant “appears to have over 

used her right upper extremity and then sprained it and now has tendinitis.” 

Appellant submitted a January 12, 2015 report from Dr. Gwynne Bragdon, a Boardcertified orthopedic surgeon. Dr. Bragdon reported that appellant had left arm pain on 

December 26, 2014, and was diagnosed with tendinitis. According to Dr. Bragdon, appellant 

started using her right arm while working and felt overuse and had to stop. She provided results 

on examination, noting diffuse pain throughout the right hand and wrist that “cannot be defined.” 

Dr. Bragdon reported x-rays of the right wrist showed no acute fracture, but she diagnosed 

bilateral de Quervain’s and left lateral epicondylitis. Dr. Bragdon recommended a 10-pound 

lifting restriction. In reports dated February 16 and March 23, 2015, Dr. Bragdon indicated that 

appellant was seen for a follow up of her right de Quervain’s. 

By decision dated April 15, 2015, OWCP denied the claim for compensation. It found 

that the medical evidence was insufficient to establish causal relationship between a diagnosed 

condition and the accepted work events. 

 2

 Appellant’s claim for a left arm injury is not before the Board on this appeal (OWCP File No. xxxxxx227). 
3

In a letter dated and postmarked May 14, 2015, appellant, through counsel, requested a 

hearing before an OWCP hearing representative. A telephonic hearing was held on 

December 9, 2015. During the hearing, appellant contended that her claim was based on work 

duties such as loading, unloading, and opening parcels, casing mail, and pushing carts performed 

over a number of days. 

Appellant submitted a January 6, 2016 report from Dr. Bragdon. No physical 

examination results were provided. Dr. Bragdon opined that the reason appellant could have 

developed tendonitis in both arms was that she was using her hand in a repetitive lateral pinch 

and was twisting her arm which can lead to de Quervain’s. She opined, “The way she was lifting 

and maneuvering could lead to a de Quervain’s tendinitis which is why it may be related to the 

[employing establishment].” Dr. Bragdon reported that she could not opine that the condition 

had nothing to do with sign language, as she did not know how often appellant signs or the 

maneuvers used for sign language. 

By decision dated February 3, 2016, the hearing representative affirmed the April 15, 

2015 OWCP decision, finding the medical evidence speculative and insufficient to establish the 

claim for compensation. 

LEGAL PRECEDENT 

A claimant seeking benefits under FECA has the burden of proof to establish the essential 

elements of his or her claim by the weight of the reliable, probative, and substantial evidence, 

including that an injury was sustained in the performance of duty as alleged and that any specific 

condition or disability claimed is causally related to the employment injury.3

 

To establish that an injury was sustained in the performance of duty, a claimant must 

submit: (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 diagnosed condition is causally related to the 

employment factors identified by the claimant.4

 

Causal relationship is a medical question that can generally be resolved only by 

rationalized medical opinion evidence.5

 A physician’s opinion on the issue of whether there is a 

causal relationship between the claimant’s diagnosed condition and the implicated employment 

factors must be based on a complete factual and medical background of the claimant.6

 

Additionally, in order to be considered rationalized, the opinion must be expressed in terms of a 

reasonable degree of medical certainty, and must be supported by medical rationale, explaining 

 

 3 20 C.F.R. § 10.115(e), (f) (2005); see Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996). 

 4 Ruby I. Fish, 46 ECAB 276, 279 (1994). 

 5 See Robert G. Morris, 48 ECAB 238 (1996). 

 6 Victor J. Woodhams, 41 ECAB 345, 352 (1989). 
4

the nature of the relationship between the diagnosed condition and appellant’s specific 

employment factors.7

 

ANALYSIS 

In the present case, appellant filed a claim for injury to her right hand or wrist. The 

record indicates she had been hired on December 13, 2014 as a seasonal temporary mail handler 

and her duties involved casing mail, lifting, and opening parcels. Appellant stopped work on 

January 2, 2015. Although appellant filed a traumatic injury claim, her statements at the 

December 9, 2015 hearing indicate that she was claiming that her work duties during the period 

she worked contributed to a right hand/wrist injury.8

 As appellant has alleged injury over the 

course of more than one shift, her claim is for an occupational disease. 

OWCP has accepted that appellant performed the claimed work duties. The issue, 

therefore, is whether there is sufficient medical evidence on causal relationship between a 

diagnosed right hand or wrist condition and the accepted employment factors. In her January 2, 

2015 report, Dr. Conway does not provide a complete history of injury and only refers briefly to 

over use of the right hand, without further explanation. She reports that appellant sprained her 

hand and then developed tendinitis, without supporting an opinion with medical rationale. The 

Board finds that the report from Dr. Conway is insufficient to establish the present claim as she 

did not sufficiently address how appellant’s work duties contributed to a diagnosed medical 

condition.9

Dr. Bragdon has diagnosed bilateral de Quervain’s syndrome, but she does not provide a 

rationalized medical opinion relating a right hand condition to the identified employment factors. 

She mentions a repetitive lateral pinch and twisting, without providing a history that shows 

familiarity with appellant’s limited work history at the employing establishment and the extent of 

the specific job duties performed. As to causal relationship, the physician uses speculative terms 

such as “could” and “may be” related without supporting the opinion with sound medical 

rationale. Medical opinions that a condition “could be” causally related are speculative and 

therefore of diminished probative value.10 

It is appellant’s burden of proof to establish her claim. For the reasons discussed, the 

Board finds that appellant did not meet her burden of proof. The record does not contain a 

medical report with a complete and accurate history and a medical opinion on causal relationship 

with employment that is supported by sound medical rationale.11 

 7 Id. 

8

 A claim for injury over more than one work day or shift is properly considered an occupational disease or 

illness, rather than a traumatic injury. See 20 C.F.R. § 10.5(q) and (ee). 

9 See E.M., Docket No. 15-1120 (issued January 13, 2016). 

10 See Kathy A. Kelley, 55 ECAB 206, 211 (2004). 

11 Supra note 6. 
5

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 did not establish a right hand or arm injury causally 

related to her federal employment. 

ORDER 

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

Compensation Programs dated February 3, 2016 is affirmed. 

Issued: July 7, 2016 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board