United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

M.B., Appellant 

and 

DEPARTMENT OF VETERANS AFFAIRS, 

VETERANS ADMINISTRATION MEDICAL 

CENTER, Houston, TX, Employer 

__________________________________________ 

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Docket No. 15-1752 

Issued: December 8, 2015 

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 August 18, 2015 appellant filed a timely appeal from the August 7, 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 to review the merits of this case. 

ISSUE 

The issue is whether appellant has met his burden of proof to establish left carpal tunnel 

syndrome causally related to his federal employment. 

 1

 5 U.S.C. § 8101 et seq.
2

FACTUAL HISTORY 

This case has been before the Board previously. On the prior appeal,2 the Board found 

that appellant had not met his burden of proof to establish left carpal tunnel syndrome in the 

performance of duty. OWCP accepted that appellant did engage in the alleged duties of an 

information technology (IT) specialist (customer service) but that he had failed to submit 

medical evidence establishing a causal relationship between the employment factors and the 

diagnosed conditions. The facts of this case as set forth in the Board’s prior decision are 

incorporated herein by reference.3

On December 16, 2014 OWCP received a reconsideration request from appellant, who 

enclosed a signed copy of a January 16, 2014 treatment note, as well as treatment notes from 

February 27 and April 10, 2014. 

In the January 16, 2014 treatment note, Dr. Smith diagnosed left carpal tunnel syndrome 

and noted: “Clinically, most of his symptoms appear to be peripheral nerve compression and 

work related.” The February 17 and April 10, 2014 treatment notes provided essentially the 

same history of present illness, as related by appellant, and the same statement that most of his 

symptoms clinically appeared to be peripheral nerve compression and work related. 

In a decision dated August 7, 2015, OWCP reviewed the merits of appellant’s case and 

denied modification of its prior decision. It found that Dr. Smith’s use of the word “possible” 

and “probable” was speculative, that he had not fully described the factual history, and that he 

had not provided a well-reasoned opinion on how federal employment caused the diagnosed 

condition. 

On appeal, appellant notes that Dr. Smith specifically opined that the mechanism of 

injury was directly related to prolonged use of the hands and wrists while performing IT duties 

on the computer. 

LEGAL PRECEDENT 

FECA provides compensation for the disability of an employee resulting from personal 

injury sustained while in the performance of duty.4

 An employee seeking benefits under FECA 

has the burden of proof to establish the essential elements of his or her claim. When an 

employee claims that he or she sustained an injury in the performance of duty, he or she must 

submit sufficient evidence to establish that he or she experienced a specific event, incident or 

 2

 Docket No. 14-1286 (issued December 3, 2014). 

3

 On July 25, 2013 appellant, a 68-year-old IT specialist (customer support), filed an occupational disease claim 

alleging that his left carpal tunnel syndrome was causally related to his federal employment. He explained that his 

position required him to use his wrists and hands repetitively to install software and distribute work orders. 

4

 5 U.S.C. § 8102(a). 
3

exposure occurring at the time, place, and in the manner alleged. He or she must also establish 

that such event, incident, or exposure caused an injury.5

Causal relationship is a medical issue,6 and the medical evidence generally required to 

establish causal relationship is rationalized medical opinion evidence. The opinion of the 

physician must be based on a complete factual and medical background of the claimant,7 must be 

one of reasonable medical certainty,8 and must be supported by medical rationale explaining the 

nature of the relationship between the diagnosed condition and the established incident or factor 

of employment.9

ANALYSIS 

The Board finds that appellant has failed to establish his occupational disease claim. 

Each of the treatment notes submitted with appellant’s reconsideration request is very 

similar. Each provides the same general history of his present illness. Each diagnosed left carpal 

tunnel syndrome. Each notes that, clinically, most of appellant’s symptoms appear to be 

peripheral nerve compression and work related. 

Dr. Smith, the attending hand surgeon, noted appellant’s employment as an IT specialist. 

He acknowledged prolonged use of the hands and wrists and frequent typing. Dr. Smith noted 

that appellant’s symptoms were aggravated by use of the computer, at least according to the 

history appellant provided. It therefore appears that Dr. Smith had a fair understanding of the 

physical demands of appellant’s federal employment. 

The Board finds the treatment notes are insufficient because Dr. Smith did not fully 

explain the relationship between specific work factors and the diagnosed condition. Dr. Smith 

noted that most of appellant’s clinical symptoms appeared to be work related, but he did not 

provide an explanation. He did not discuss the nature of carpal tunnel syndrome or explain how 

specific work activities caused or aggravated the diagnosed left carpal tunnel syndrome. It is not 

necessary that the evidence be so conclusive as to suggest causal connection beyond all possible 

doubt, but it must have a rationalized explanation that connects the duties with the condition.10

Because Dr. Smith’s treatment notes do not provide sufficient medical reasoning to 

establish the element of causal relationship, the Board finds that appellant has not met his burden 

of proof. Accordingly, the Board will affirm OWCP’s August 7, 2015 decision. 

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

6 Mary J. Briggs, 37 ECAB 578 (1986). 

7 William Nimitz, Jr., 30 ECAB 567, 570 (1979). 

8 See Morris Scanlon, 11 ECAB 384, 385 (1960). 

9 See William E. Enright, 31 ECAB 426, 430 (1980). 

10 Kenneth J. Deerman, 34 ECAB 641, 645 (1983) and cases cited therein at note 1. 
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 to establish left carpal tunnel 

syndrome causally related to his federal employment. 

ORDER 

IT IS HEREBY ORDERED THAT the August 7, 2015 decision of the Office of 

Workers’ Compensation Programs is affirmed. 

Issued: December 8, 2015 

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