United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.T., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Portland, OR, Employer

__________________________________________

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Docket No. 17-0593

Issued: December 15, 2017

Appearances: Case Submitted on the Record

Scott P. Monfils, Esq., for the appellant1

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 January 23, 2017 appellant, through counsel, filed a timely appeal from an 

October 14, 2016 merit decision and a December 15, 2016 nonmerit decision of the Office of 

Workers’ Compensation Programs (OWCP). Pursuant to the Federal Employees’ Compensation 

Act2(FECA) and 20 C.F.R. §§ 501.2(c) and 501.3, the Board has jurisdiction over the merits of 

this case.

 

1

In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for 

legal or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. 

§ 501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An 

attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject 

to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation.

2

5 U.S.C. § 8101 et seq.
2

ISSUES

The issues are: (1) whether appellant met her burden of proof to establish an injury 

causally related to an accepted July 24, 2014 employment incident; and (2) whether OWCP 

properly denied appellant’s request for reconsideration of the merits of her claim pursuant to 5 

U.S.C. § 8128(a).

FACTUAL HISTORY

On July 24, 2014 appellant, then a 47-year-old postal support employee (PSE)

distribution clerk, filed a traumatic injury claim (Form CA-1) alleging that on that same day she 

hit her left hand between a metal bar and a delivery point sequence (DPS) tray causing her thumb 

to become swollen from the lower knuckle to the wrist and for a large knot to form on top of her 

left hand. She stopped work on July 24, 2014 and returned on July 25, 2014. 

In a July 24, 2014 duty status report (Form CA-17), Suzanne Goodnight, a certified 

physician assistant, diagnosed of left thumb tenosynovitis. She authorized appellant to return to 

work on July 25, 2014 with restrictions of no use of the left hand and only four hours of sitting, 

standing, walking, kneeling, bending, stooping, twisting, and pushing and pulling. 

Appellant provided an employing establishment accident report dated July 31, 2014. 

A Form CA-16, authorization for examination and/or treatment, was issued by the 

employing establishment on August 4, 2014. On the form appellant noted a date of injury of 

July 24, 2014 and indicated that her left thumb and wrist were swelling. 

By letter dated August 4, 2014, the employing establishment controverted appellant’s 

claim because it contended that the injury may have occurred outside the performance of duty. It

also noted that the only medical report submitted was by a physician assistant who was not 

considered a “physician” within the meaning of FECA. 

On August 14, 2014 OWCP received a July 24, 2014 emergency room report from

Ms. Goodnight, who indicated that appellant complained of left-hand pain and swelling. 

Ms. Goodnight reported that appellant worked at the employing establishment and performed

repetitive activities throughout the day. Appellant related having bilateral hand numbness and 

tingling for the last nine months. Upon physical examination, Ms. Goodnight observed 

tenderness through the thumb extensor tendon and positive Phalen’s test for neuritis of the left 

hand. She related that an x-ray scan of appellant’s left hand showed mild-to-moderate 

degenerative changes of the first metatarsal phalangeal joint and no evidence of acute fracture or 

dislocation. Ms. Goodnight diagnosed left thumb extensor tenosynovitis, left wrist carpal tunnel, 

and left wrist pain. She indicated that appellant could return to modified duty. 

By letter dated August 5, 2014, OWCP advised appellant that the evidence of record was 

insufficient to establish her claim. It requested that she respond to the attached questionnaire in 

order to substantiate the factual element of her claim and provide a narrative medical report to

establish a medical condition causally related to the alleged employment incident. Appellant was 

afforded 30 days to submit the additional evidence. 
3

In an August 8, 2014 attending physician’s report, Ms. Goodnight again noted a history 

of acute onset of left hand pain and swelling at work when appellant hit her hand while moving 

objects. She also reported that appellant had a history of bilateral hand numbness and tingling 

for the past nine months and of mild-to-moderate degenerative changes in the first metacarpal 

phalangeal joint. Ms. Goodnight checked a box marked “yes” indicating that appellant’s 

condition was caused or aggravated by her employment. She authorized appellant to return to 

light duty with restrictions of limited-to-no use of the left hand. 

Appellant also submitted a July 24, 2014 left hand x-ray diagnostic examination by

Dr. Philip Baker, a Board-certified diagnostic radiologist, who noted no evidence of fracture or 

dislocation, but reported mild-to-moderate degenerative changes of the first metatarsal 

phalangeal joint. 

OWCP denied appellant’s claim in a decision dated September 18, 2014. It found that 

the evidence of record was insufficient to establish that the July 24, 2014 incident occurred as 

alleged. OWCP also determined that the medical evidence of record failed to establish a 

diagnosed condition causally related to the alleged employment incident. 

On September 19, 2014 OWCP received an August 28, 2014 report by Dr. Kim-Chi Vu, 

a Board-certified plastic surgeon, in which he related that appellant had sustained a traumatic 

injury on July 24, 2014 while at work. She described that appellant took off her gloves at the 

end of the day and noticed the area was swollen. Dr. Vu noted that, during the day, appellant 

had been working with some DPS tray when her hand got caught and was hit between a metal 

bar and the DPS tray. Appellant experienced immediate increased pain and swelling to her hand. 

She tried to continue her work, but the pain and swelling worsened so she went to the emergency 

room for treatment. Dr. Vu reviewed appellant’s history and conducted an examination. She 

observed a gross visibility of a probable bump on the dorsal surface of her first carpometacarpal 

(CMC) joint region and unstable CMC joint. Sensation was intact. Dr. Vu reported that 

appellant was able to flex and extend all the joints, but with the pain reproducible with thumb 

opposition. She related that x-ray scans showed some degenerative changes with regards to the 

joint surface. Dr. Vu diagnosed sprain of the CMC, mild-to-moderate degenerative changes of 

the first metatarsal phalangeal joint, and no evidence of fracture or dislocation of the left hand. 

She recommended that appellant continue restricted duty and obtain a magnetic resonance 

imaging (MRI) scan. 

A physical therapy note dated September 16, 2014 indicated that appellant had been

diagnosed with sprain of the first CMC joint. 

On September 30, 2014 appellant requested a review of the written record before an 

OWCP hearing representative. She resubmitted Dr. Baker’s July 24, 2014 x-ray examination 

report. 

Dr. Kevin G. Semonsen, a Board-certified diagnostic radiologist, provided a left hand 

MRI scan report dated September 12, 2014. He indicated that findings were consistent with 

advanced degenerative joint disease at the first CMC joint space and a small joint effusion. 

Dr. Semonsen also noted a small joint effusion and multiple surrounding small fluid ganglion 

cysts. 
4

In a September 16, 2014 report, Dr. Vu indicated that appellant had been off work for a 

few days and her hand and thumb symptoms had improved. She related that, when she returned 

to work, the pain and swelling had returned even though she wore a splint and had work 

restrictions. Upon physical examination, Dr. Vu observed tenderness to palpation over the base 

of the CMC joint of appellant’s thumb. She reported that appellant was able to flex and extend 

the thumb, but had pain on manipulation. Dr. Vu indicated that she reviewed the MRI scan, 

which was consistent with advanced degenerative joint disease of the first CMC joint. She 

diagnosed left thumb CMC joint sprain and degenerative joint disease. Dr. Vu explained that 

appellant “on a more probable basis or not already has some degenerative joint diseases going on 

and then her injury that she sustained was what caused aggravate or initiate the pain.” She 

indicated that the July 24, 2014 injury aggravated the pain at this present time. Dr. Vu restricted 

appellant from any use of her left hand. 

Appellant provided various witness statements. In a September 25, 2014 statement, an 

employee with an illegible signature indicated that he was in the breakroom with appellant when 

she removed her gloves and he saw that her left thumb and palm were swollen and bruised. 

Appellant informed him that she thought she hit her hand between a metal bar on the JP and the 

DPS tray. In a September 25, 2014 statement cosigned by appellant and Sharma Dalgat, 

appellant explained that she normally worked by DPS by herself, but occasionally another clerk 

helped out. She indicated that on July 24, 2014 Mr. Dalgat came to help out on the side and he 

saw that she had hit her thumb between a metal bar on the JP and the DPS tray. 

In September 25, 2014 statements, appellant explained that as a PSE distribution clerk 

she hashed out parcels, magazine bundles, tubs, and DPS. She indicated that on July 24, 2014 

she injured her left thumb area between the knuckle and the wrist. Appellant noted that she was 

hashing DPS trays when she hit a top of her thumb area on a metal bar of the JP. She reported 

that she was able to finish her work, but when she took her last break and removed her gloves 

she saw that her thumb and palm were swollen and bruised and she had a large knot on top of her 

hand between her thumb and wrist. Appellant requested that OWCP review the new medical 

reports because she had not been able to be examined by a physician until August 28, 2014. 

Dr. Vu continued to treat appellant. In reports dated October 9, 2014 to January 8, 2015, 

She related appellant’s continued complaints of left hand pain with any kind of repetitive use of 

activity. Upon physical examination, Dr. Vu observed tenderness to palpation over the base of 

the CMC joint of appellant’s thumb and well-maintained flexion and extension. She diagnosed 

sprain of the CMC joint, osteoarthritis, and tendinitis. Dr. Vu recommended that appellant 

continue modified light duty. 

By decision dated February 23, 2015, an OWCP hearing representative affirmed the 

September 18, 2014 decision with modification. He determined that appellant had established 

that the incident occurred as alleged and had established a diagnosed thumb condition, but 

denied her claim because the medical evidence of record was insufficient to establish that the left 

thumb condition was causally related to the accepted July 24, 2014 employment incident. 

Appellant submitted a February 5, 2015 report by Dr. Vu, who related appellant’s 

complaints of generalized pain and achiness with regards to her thumb. Upon physical 

examination, Dr. Vu observed palpability of the subluxations of the metacarpal CMC joint 
5

region and found tenderness could be reproduced in the CMC joint. She diagnosed sprain of the 

CMC. Dr. Vu reported that appellant had a “severe complex injury associated with [appellant’s]

left hand first CMC joint.” Appellant also resubmitted Dr. Vu’s reports dated August 28, 2014 

to January 8, 2015. 

A March 16, 2015 left hand x-ray examination report by Dr. Andrew Cox showed 

degenerative changes involving the CMC joint of the thumb similar to the hand radiographs 

performed on July 24, 2014. 

In an April 7, 2015 report, Dr. Vu indicated that appellant’s hand began to flare up again 

and was starting to bother her. Upon examination, she observed pain along the base of 

appellant’s CMC joint as well as some subluxation. Dr. Vu related that she reviewed appellant’s 

pathology of her initial July 24, 2014 initial injury and how it happened, as well as appellant’s 

employment history at the employing establishment. She noted that, based on appellant’s 

mechanism of injury and clinical condition, appellant had a work-related injury associated with 

her left hand from the trauma on July 24, 2014 and CMC arthritis. Dr. Vu further reported that,

on more probable than not basis, appellant’s occupational exposure while working at the 

employing establishment was the origin of her progressively developing arthritis to the CMC 

joint, but she remained asymptomatic up until the July 24, 2014 injury. Dr. Vu concluded that 

appellant’s July 24, 2014 injury was what aggravated and caused the progression of worsening of 

the conditions and symptoms associated with the osteoarthritis, which ultimately led her to have 

severe degenerative osteoarthritic changes involving the CMC joint. 

Dr. Vu diagnosed sprain of the carpometacarpal. She requested that appellant’s

osteoarthritis condition be accepted. 

On May 22, 2015 appellant requested reconsideration. 

In a decision dated July 25, 2016, OWCP denied modification of the February 23, 2015 

decision. It found that the medical evidence of record was insufficient to establish a causal 

relationship between appellant’s left thumb condition and the accepted July 24, 2014 

employment incident. OWCP determined that Dr. Vu had not supported appellant’s opinion on 

causal relationship with medical rationale. 

On October 3, 2016 appellant, through counsel, requested reconsideration. Counsel

alleged that on July 24, 2014 appellant had sustained a left thumb injury when it was struck 

between a metal bar and a DPS tray. He noted that diagnostic testing showed that appellant had 

mild-to-moderate changes in the first metacarpal phalangeal joint. Counsel noted that Dr. Vu 

had concluded that appellant’s alleged July 24, 2014 work injury caused a permanent worsening 

of appellant’s preexisting degenerative condition in the CMC thumb joint by increasing the 

inflammation and hastening the degenerative process. 

Counsel provided a letter dated September 14, 2016 where he had provided a series of 

leading questions to Dr. Vu and allowed her the option of replying “yes” or “no” to the 

questions. Dr. Vu signed and checked lines marked “yes” to the series of questions.
6

By decision dated October 14, 2016, OWCP denied modification of the July 25, 2016 

decision. It found that the medical evidence of record failed to establish a causal relationship 

between appellant’s thumb condition and the accepted July 24, 2014 employment incident. 

On November 4, 2016 appellant again requested reconsideration. Counsel asserted that 

OWCP should have found that Dr. Vu’s report was sufficient to constitute a reasoned medical 

report to establish causal relationship. He alleged that each statement to which Dr. Vu agreed by 

checking a box marked “yes” should be considered a competent medical opinion. Counsel noted 

that he was attaching a new October 25, 2016 report by Dr. Vu as evidence not previously 

submitted to support appellant’s reconsideration request. He contended that Dr. Vu’s opinion 

clearly established that the alleged July 24, 2014 work injury caused a permanent worsening of 

appellant’s preexisting degenerative thumb condition. 

In the October 25, 2016 report, Dr. Vu described that on July 24, 2014 appellant hit her 

left hand between a metal bar and a tray while at work. She explained that x-rays of appellant’s 

left hand showed mild narrowing of the first carpal metacarpal joint of the left thumb with 

moderate osteophyte, which suggested that appellant had mild-to-moderate degenerative changes 

in the first metacarpal phalangeal joint. Dr. Vu reported that the degenerative changes, reflected

in the diagnostic testing, had developed over time and were likely caused by the repetitive and 

hand-intensive work she did at the employing establishment. She explained: 

“[T]he repetitive use of her left hand from occupational exposure likely caused 

damage or injury to the ligaments, tendons, and muscles in the carpal metacarpal 

joint in the left thumb. The repetitive use would cause overstretching and tearing 

of ligaments with resultant inflammation in the thumb joint that was never given 

an opportunity to heal, and would wear down the ligaments and muscles in the 

joint, causing the narrowing revealed in the x-rays.” 

Dr. Vu further reported that when appellant injured her left thumb in July 2014, “that 

added trauma caused the previously asymptomatic degenerative condition to worsen and become 

symptomatic, and likely worsened the inflammation by causing further tearing and straining of 

the ligaments and muscles in the carpal metacarpal joint of the thumb.” She indicated that 

appellant had a degree of degenerative joint disease in the carpal metacarpal joint in the left 

thumb that had developed over time from her work at the employing establishment, but noted 

that appellant’s degenerative condition was asymptomatic before her July 2014 work injury. 

Dr. Vu opined that “the injury in July 2014 caused more tearing and wrenching to the ligaments 

in the thumb joint, thereby causing inflammation and resulting pain and discomfort that did not 

exist before the July 2014 injury.” She reported that following the July 2014 injury the increased 

tearing of the ligaments and resultant inflammation caused appellant’s disability and need for 

medical treatment. 

By decision dated December 15, 2016, OWCP denied appellant’s request for 

reconsideration, finding that she failed to submit any evidence sufficient to warrant further merit 

review under 5 U.S.C. § 8128(a). It found that Dr. Vu’s October 25, 2016 report was duplicative

of her previous reports. 
7

LEGAL PRECEDENT -- ISSUE 1

An employee seeking benefits under FECA3has the burden of proof to establish the 

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

evidence4including that he or she sustained an injury in the performance of duty and that any 

specific condition or disability for work for which he or she claims compensation is causally 

related to that employment injury.5

To determine whether a federal employee has sustained a traumatic injury in the 

performance of duty, it first must be determined whether “fact of injury” has been established.6 

There are two components involved in establishing the fact of injury. First, the employee must 

submit sufficient evidence to establish that she actually experienced the employment incident at 

the time, place, and in the manner alleged.7 Second, the employee must submit evidence, 

generally only in the form of probative medical evidence, to establish that the employment 

incident caused a personal injury.8 An employee may establish that the employment incident 

occurred as alleged, but fail to show that his or her disability or condition relates to the 

employment incident.9

Whether an employee sustained an injury in the performance of duty requires the 

submission of rationalized medical opinion evidence.10 The opinion of the physician must be 

based on a complete factual and medical background of the employee, 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 employee.11 The weight of the medical evidence is determined by its reliability, its probative 

value, its convincing quality, the care of analysis manifested, and the medical rationale expressed 

in support of the physician’s opinion.12

 

3

Id. 

4

J.P., 59 ECAB 178 (2007); Joseph M. Whelan, 20 ECAB 55, 58 (1968). 

5 G.T., 59 ECAB 447 (2008); Elaine Pendleton, 40 ECAB 1143, 1145 (1989).

6

S.P., 59 ECAB 184 (2007); Alvin V. Gadd, 57 ECAB 172 (2005). 

7 Bonnie A. Contreras, 57 ECAB 364 (2006); Edward C. Lawrence, 19 ECAB 442 (1968). 

8 David Apgar, 57 ECAB 137 (2005); John J. Carlone, 41 ECAB 354 (1989). 

9

T.H., 59 ECAB 388 (2008); see also Roma A. Mortenson-Kindschi, 57 ECAB 418 (2006).

10 See J.Z., 58 ECAB 529 (2007); Paul E. Thams, 56 ECAB 503 (2005).

11 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, 41 ECAB 465 (2005).

12 James Mack, 43 ECAB 321 (1991).
8

While the claimant has the burden of proof to establish entitlement to compensation, 

OWCP shares responsibility in the development of the evidence and to see that justice is done.13 

ANALYSIS -- ISSUE 1

Appellant filed a traumatic injury claim alleging a left thumb injury on July 24, 2014 in 

the performance of duty. OWCP accepted that on July 24, 2014 she hit her hand between a 

metal bar and a DPS tray at work and that she was diagnosed with left thumb CMC joint sprain 

and degenerative joint disease. It denied appellant’s claim, however, because the medical 

evidence of record failed to establish how the accepted July 24, 2014 employment incident 

caused the diagnosed conditions. 

The Board finds that this case is not in posture for decision.

Appellant submitted various reports by Dr. Vu dated from August 28, 2014. The Board 

finds that the September 16, 2014 and April 7, 2015 reverse order reports of Dr. Vu provide 

medical rationale explaining how the accepted employment incident caused or contributed to an 

aggravation of appellant’s degenerative joint disease condition and they strongly suggest and 

support a relationship between the accepted July 24, 2014 incident and her left thumb 

condition.14 While the reports from Dr. Vu are not completely rationalized, they are consistent in 

indicating that appellant sustained an exacerbation of her degenerative joint condition and are not 

contradicted by any substantial medical or factual evidence of record.15 

It is well-established that proceedings under FECA are not adversarial in nature and 

OWCP is not a disinterested arbiter.16 While the claimant has the burden of proof to establish 

entitlement to compensation, OWCP shares responsibility in the development of the evidence 

and to see that justice is done.17 Thus, the Board will remand the case to OWCP for further 

development to obtain a rationalized medical opinion as to whether appellant’s condition is 

causally related to the employment incident and issue a de novo decision on whether she 

sustained an injury causally related to the July 24, 2014 employment incident, as alleged.18

 

13 Donald R. Gervasi, 57 ECAB 281, 286 (2005); Jimmy A. Hammons, 51 ECAB 219 (1999); William J. Cantrell, 

34 ECAB 1233, 1237 (1983).

14 See L.F., Docket No. 14-1906 (issued August 13, 2015) (the Board determined that while reports by a 

claimant’s treating physician were not completely rationalized to establish a work-related injury they strongly 

supported a relationship between the employment incident and diagnosed condition and remanded the case for 

OWCP to further develop the medical evidence).

15 See E.J., Docket No. 09-1481 (issued February 19, 2010). Richard E. Simpson, 55 ECAB 490, 500 (2004);

John J. Carlone, 41 ECAB 354, 360 (1989). 

16 See Vanessa Young, 56 ECAB 575 (2004).

17 Supra note 13.

18 Because of the disposition of the first issue, the second nonmerit issue is moot.
9

CONCLUSION

The Board finds that this case is not in posture for decision.

ORDER

IT IS HEREBY ORDERED THAT the October 14, 2016 decision of the Office of 

Workers’ Compensation Programs is set aside and the case remanded to OWCP for further 

action consistent with this decision of the Board.19

Issued: December 15, 2017

Washington, DC

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

 

19 Colleen Duffy Kiko, Judge, participated in the original decision, but was no longer a member of the Board 

effective December 11, 2017.