United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

V.G., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Philadelphia, PA, Employer

__________________________________________

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Docket No. 17-1425

Issued: February 16, 2018

Appearances: Case Submitted on the Record

Russell T. Uliase, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 16, 2017 appellant, through counsel, filed a timely appeal from a March 31, 

2017 merit 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 to consider the merits of this case.

ISSUE

The issue is whether appellant met her burden of proof to establish total disability for the 

period June 7 to September 2, 2016 causally related to her accepted employment conditions.

 

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

FACTUAL HISTORY

On February 19, 2016 appellant, then a 55-year-old vehicle maintenance clerk, filed an 

occupational disease claim (Form CA-2), alleging that she developed right and left trigger 

fingers as a result of performing repetitive data entry and writing in the performance of duty. 

She stated that she first became aware of her condition on December 10, 2015 and realized that it 

was causally related to factors of her federal employment on the same date. Appellant stopped 

work on February 17, 2016. 

OWCP received reports from Dr. David J. Bozentka, a Board-certified orthopedist, 

beginning December 10, 2015, who noted referring appellant for therapy following right trigger 

thumb release. Dr. Bozentka also diagnosed acquired trigger finger and right carpal tunnel 

syndrome. On February 4, 2016 he treated appellant for bilateral finger complaints. 

Dr. Bozentka diagnosed acquired trigger finger. On April 8, 2016 he diagnosed bilateral long 

trigger fingers and bilateral trigger thumbs. Dr. Bozentka noted previously performing a left 

trigger thumb release on February 17, 2014 and right trigger thumb and carpal tunnel release on 

July 29, 2015. He opined that the bilateral trigger thumbs and bilateral long trigger fingers were 

directly caused by repetitive activities required by appellant’s position as a senior clerk over the 

past 14 years. Dr. Bozentka indicated that the trigger fingers and thumbs were related to 

tendinitis which causes pain and locking with flexion-extension of the digits. He opined that the 

repetitive activities required in appellant’s position led to the development of the nodule and 

symptoms of pain, locking, and triggering. Dr. Bozentka indicated that she had been off work 

due to the bilateral long trigger fingers since January 25, 2016, noting that the pain associated 

with the digits led her to be unable to perform her activities required in her job. He advised that 

appellant had reached maximum medical improvement with regard to nonoperative treatment. 

Dr. Bozentka recommended surgical release of the trigger digits. 

Appellant also provided treatment records for anxiety from Dr. Shormeh Yeboah, a 

Board-certified family practitioner, dated January 25 to April 11, 2016. Dr. Yeboah reported 

treating appellant since November 27, 2013 for work-related injuries and stress. 

On May 17, 2016 OWCP accepted appellant’s claim for right and left trigger thumb and 

right and left middle finger trigger finger. It informed her of the steps to take if she wished to 

claim wage-loss compensation. 

In an attending physician’s report (Form CA-20) dated June 16, 2016, Dr. Bozentka 

noted appellant’s history was significant for overuse since October 2015 and diagnosed bilateral 

thumb and middle finger trigger. He checked a box marked “yes” that her condition was caused 

or diagnosed by an employment activity and advised that she was totally disabled from 

February 4 to September 16, 2016. In a duty status report (Form CA-17) dated June 16, 2016,

Dr. Bozentka diagnosed trigger finger and noted that appellant could not resume work. 

Appellant filed Form CA-7 claims for compensation, for leave without pay (LWOP) due 

to total disability from work from June 7 to 24, 2016; June 25 to July 8, 2016; July 9 to 22, 2016; 

and July 23 to August 5, 2016. 
3

In an August 4, 2016 letter, OWCP requested that appellant submit additional medical 

evidence to support her claim for compensation beginning June 7, 2016. 

Appellant submitted additional treatment records from Dr. Bozentka. On February 4, 

2016 Dr. Bozentka noted findings on examination of tenderness about the volar 

metacarpophalangeal (MCP) region and bilateral long fingers and limitation in full flexion of the 

thumb. He diagnosed bilateral trigger fingers and limitation of the right thumb flexion. 

Dr. Bozentka performed an injection and indicated that appellant was disabled from work. On 

March 18, 2016 he treated appellant for persistent triggering of the right thumb and bilateral long 

fingers with locking with flexion. Dr. Bozentka noted findings on examination of palpable 

nodules at the flexor tendon at the volar MCP region with catching of the right thumb and 

bilateral long fingers. He diagnosed right trigger thumb and bilateral long trigger fingers. 

Dr. Bozentka recommended surgery. He returned appellant to work subject to the restriction of 

no repetitive activities. In July 14 and 28, 2016 reports, Dr. Bozentka who diagnosed bilateral 

long trigger fingers. He noted triggering of the fingers with flexion, and tenderness about the 

volar MCP joint of the bilateral long fingers. Dr. Bozentka recommended surgical release of the 

bilateral long trigger fingers to relieve the pain, locking and triggering of the bilateral long 

fingers. He opined that the development of the trigger fingers was related to the activities 

appellant performed at work. Dr. Bozentka advised that she was partially disabled since 

January 25, 2016 related to the bilateral trigger fingers.

In a July 25, 2016 narrative statement, appellant noted that her injuries were caused by 

performing repetitive duties as a clerk for 15 years including repetitive handwriting and data 

entry. Her left thumb condition began on July 19, 2013 and her right thumb and carpal tunnel 

syndrome on October 10, 2014. Appellant returned to work in November 2015 and performed 

repetitive handwriting and data entry for parts, bills for fuel, oil, and emissions. She noted not

working due to wrist, hand, and thumb symptoms. Appellant sought authorization for surgery. 

She indicated that she did not have any other injuries and did not participated in any hobbies, 

activities or another job since developing carpal tunnel and trigger thumbs.

Appellant was treated by Dr. Yeboah on July 29, 2016. Dr. Yeboah noted that 

appellant’s hand injuries caused significant impairment and disability including an anxiety 

disorder. She noted that the primary trigger for appellant’s anxiety was her hand injuries which 

were caused and accelerated by the requirements of her job. 

In a letter dated August 1, 2016, appellant, through counsel, indicated that she used sick 

and annual leave after she stopped work and began using LWOP on June 7, 2016. Counsel

indicated that she was not claiming lost wages or leave buy back for any time prior to 

February 4, 2016 when her orthopedist gave her cortisone injections and advised that she could 

no longer work due to her bilateral hand conditions.

On August 10, 2016 appellant indicated that her annual and sick leave was exhausted 

effective June 6, 2016 and she was claiming compensation beginning June 7, 2016. She sought 

medical attention for anxiety from the physical pain she had in both hands, but was not seeking a 

claim for compensation for anxiety. Appellant sought treatment for both hands. On August 8

and September 13, 2016, she filed claims for compensation (Form CA-7), for LWOP for total 

disability for the period August 6 to 19, 2016. 
4

Appellant submitted an operative report from Dr. Bozentka dated September 7, 2016 who 

performed release of the bilateral long trigger finger and diagnosed bilateral long trigger fingers.3 

In an attending physician’s report (Form CA-20) dated September 15, 2016, Dr. Bozentka 

diagnosed bilateral long trigger fingers by checking a box marked “yes” that her condition was 

aggravated by placing pressure on her bilateral palms and volar MCP joint. He that noted 

appellant was disabled from work February 4 to October 19, 2016. 

In a decision dated September 28, 2016, OWCP denied appellant’s claim for 

compensation for total disability for the period June 7 to September 2, 2016. It advised that the 

evidence of record failed to establish work-related disability during the period claimed.

On October 4, 2016 counsel requested an oral hearing before an OWCP hearing 

representative which was held on January 19, 2017. 

Appellant submitted additional records from Dr. Bozentka. In a different July 28, 2016 

report, Dr. Bozentka treated her for right carpal tunnel syndrome. He noted reviewing the job 

description provided by appellant for a position she performed from 2001 to the present time 

which noted extensive repetitive activities required. Dr. Bozentka noted that she had left trigger 

thumb release on February 17, 2014 and right trigger thumb and carpal tunnel release on 

July 29, 2015. He diagnosed right carpal tunnel syndrome by electromyogram. Dr. Bozentka 

opined that the right carpal tunnel syndrome was caused and accelerated by the employment 

conditions described by appellant including extensive repetitive activities with her hands as a 

senior clerk for 14 years. He advised that she was taken out of work on February 4, 2016 related 

to persistent symptoms about her hands. Dr. Bozentka recommended limiting appellant’s 

repetitive activities. 

On August 23, 2016 Dr. Bozentka treated appellant for triggering of the bilateral long 

fingers. He diagnosed trigger finger and recommended surgery. On October 25, 2016

Dr. Bozentka advised that appellant was totally disabled since February 4, 2016. He noted that

she had bilateral trigger finger release on September 7, 2016 which was due to a work injury. 

Dr. Bozentka advised that appellant required therapy after surgery and would reach maximum 

medical improvement three months after surgery. In an October 25, 2016 attending physician’s 

report (Form CA-20), he diagnosed bilateral thumbs and middle finger trigger. Dr. Bozentka

noted by checking a box marked “yes” that appellant’s condition was caused or aggravated by an 

employment activity and advised that she was totally disabled from February 4 to 

December 6, 2016. In an October 25, 2016 duty status report (Form CA-17), he diagnosed 

trigger finger and noted that she could not work. 

On November 7, 2016 the employing establishment forwarded to OWCP a notice of 

recurrence (Form CA-2a), of disability alleging that appellant had a recurrence of disability on 

September 7, 2016 causally related to her accepted employment conditions. Appellant stopped 

work on September 7, 2016 to undergo bilateral hand surgery. 

In a November 8, 2016 report, Dr. Bozentka noted that appellant was status post-release 

of the bilateral long trigger fingers on September 7, 2016. He reported treating her on 

 

3 On November 17, 2016 OWCP authorized the September 7, 2016 surgery. 
5

October 25, 2016 and noted discomfort about the scars and difficulty fully extending the right 

long finger. Dr. Bozentka recommended bilateral hand therapy and advised that appellant was 

unable to work due to scar discomfort, lack of extension, and strength. In a December 6, 2016 

attending physician’s report (Form CA-20), he noted a history of injury of overuse since 

October 2015. Dr. Bozentka diagnosed bilateral thumbs and middle finger trigger and indicated 

that appellant’s condition was caused or aggravated by work activity. He noted that she was 

totally disabled beginning February 4, 2016. Appellant also submitted physical therapy records. 

On January 12, 2017 OWCP accepted appellant’s claim for recurrence of disability. It 

noted that disability beginning September 7, 2017 was payable once it received appropriate pay 

rate information from the employing establishment.

In a January 17, 2017 report, Dr. Bozentka treated appellant for pain and swelling in her 

hands. He noted an essentially normal examination and returned her to work with restrictions of 

no repetitive activities. In a letter dated January 17, 2017, Dr. Bozentka noted that it was his 

medical opinion and definitive diagnosis that the bilateral trigger thumbs and bilateral trigger 

fingers were directly caused by repetitive activities appellant was required to perform over the 

past 14 years. He advised that the bilateral trigger thumbs and bilateral trigger fingers left her

totally disabled from June 7 to September 2, 2016. In an attending physician’s report (Form 

CA-20) dated January 17, 2017, Dr. Bozentka noted that appellant’s history was significant for 

overuse since October 2015. He diagnosed bilateral thumbs and middle finger trigger and

indicated that her condition was caused or aggravated by work activity. Dr. Bozentka noted that 

appellant was totally disabled from February 4, 2016 to January 17, 2017. In a work capacity 

evaluation (OWCP-5c) dated January 17, 2017, he noted that she could return to her usual job for 

eight hours a day with restrictions. Dr. Bozentka advised that appellant had reached maximum 

medical improvement and could work in a sedentary position.

By decision dated March 31, 2017, an OWCP hearing representative affirmed the 

decision dated September 28, 2016. 

LEGAL PRECEDENT

Section 8102(a) of FECA4sets forth the basis upon which an employee is eligible for 

compensation benefits. That section provides: “The United States shall pay compensation as 

specified by this subchapter for the disability or death of an employee resulting from personal 

injury sustained while in the performance of his duty....” In general, the term “disability” under 

FECA means “incapacity, because of an employment injury, to earn the wages the employee was 

receiving at the time of injury.”

5

 This meaning, for brevity, is expressed as disability from

work.6

 

4 5 U.S.C. § 8102(a). 

5 20 C.F.R. § 10.5(f). See also William H. Kong, 53 ECAB 394 (2002); Donald Johnson, 44 ECAB 540, 548 

(1993); John W. Normand, 39 ECAB 1378 (1988); Gene Collins, 35 ECAB 544 (1984). 

6 See Roberta L. Kaaumoana, 54 ECAB 150 (2002). 
6

For each period of disability claimed, the employee has the burden of proving that he or 

she was disabled from work as a result of the accepted employment injury.7 Whether a particular 

injury caused an employee to be disabled from employment and the duration of that disability are 

medical issues which must be proved by the preponderance of the reliable, probative, and 

substantial medical evidence.8

ANALYSIS

OWCP accepted appellant’s claim for right and left trigger thumb and right and left 

middle finger trigger finger. Appellant filed claims for compensation for LWOP for total 

disability for the period June 7 to September 2, 2016. The Board finds that the medical evidence 

of record is insufficient to establish total disability during the claimed period causally related to

her accepted employment condition.

Appellant submitted multiple reports from Dr. Bozentka. In July 14 and 28, 2016 reports,

Dr. Bozentka diagnosed bilateral long trigger fingers, opined that this condition was related to 

work activities, and advised that she was partially disabled since January 25, 2016.9 On

January 17, 2017 he opined that appellant’s bilateral trigger thumbs and bilateral trigger fingers 

were employment related and left appellant totally disabled from June 7 to September 2, 2016. 

Although Dr. Bozentka supported causal relationship, he did not provide medical rationale 

explaining the basis of his conclusory opinion regarding the causal relationship between the 

accepted conditions and the claimed period of disability.10 He did not explain how the accepted 

conditions would have caused appellant to be disabled from work during the claimed period. 

This report is, therefore, insufficient to establish appellant’s claim. 

Similarly, in reports dated October 25 and November 8, 2016, Dr. Bozentka noted 

appellant’s treatment and advised that she was totally disabled since February 4, 2016. 

Appellant also provided several attending physician’s reports from June 16 to January 17, 2017 

which supported that she had an employment-related condition and that she was disabled. While

Dr. Bozentka indicated in these that she was totally disabled from work he did not specifically 

explain how any accepted condition caused or contributed to the period of disability beginning 

June 7, 2016. Part of appellant’s burden of proof includes submitting rationalized medical 

 

7 See William A. Archer, 55 ECAB 674 (2004). 

8 See Fereidoon Kharabi, 52 ECAB 291, 292 (2001). 

9

In a different July 28, 2016 report, Dr. Bozentka attributed appellant’s diagnosed right carpal tunnel syndrome 

and associated disability to appellant’s employment. The Board notes that OWCP has not accepted carpal tunnel 

syndrome as employment related. See T.M., Docket No. 08-0975 (issued February 6, 2009) (where a claimant 

claims that a condition not accepted or approved by OWCP was due to an employment injury, the claimant bears the 

burden of proof to establish that the condition is causally related to the employment injury through the submission of 

rationalized medical evidence). 

10 See T.M., id., (a medical report is of limited probative value on the issue of causal relationship if it contains a 

conclusion regarding causal relationship which is unsupported by medical rationale).
7

evidence which supports a causal relationship between the period of disability and the accepted 

injury.11 Therefore, these reports are insufficient to meet her burden of proof. 

On April 8, 2016 Dr. Bozentka diagnosed bilateral long trigger fingers and bilateral 

trigger thumbs, noted appellant’s treatment, and supported that her diagnosed conditions were 

employment related. He indicated that she had been out of work due to the bilateral long trigger 

fingers since January 25, 2016 noting that the pain associated with the digits led her to be unable 

to perform her activities. However, this report predates the period of wage loss at issue. 

Dr. Bozentka did not otherwise explain the reasons why appellant’s wage loss beginning June 7, 

2016 was attributable to her accepted employment conditions.12 Similarly, other reports from

him are of limited probative value as they either predate the period of claimed disability or they 

do not specifically attribute the period of claimed disability to the accepted conditions.13

Appellant was also treated by Dr. Yeboah, who provided evidence including a July 29, 

2016 report noting that appellant’s hand injuries caused significant impairment and disability 

including triggering an anxiety disorder. Dr. Yeboah noted that the primary trigger for 

appellant’s anxiety was her hand injuries which were caused and accelerated by the requirements 

of her job. This report is insufficient to meet appellant’s burden of proof as Dr. Yeboah 

attributed appellant’s disability in part due to anxiety disorder. However, OWCP has not 

accepted that appellant developed an anxiety disorder as a result of her clerk duties14 and

Dr. Yeboah has not otherwise explained how the accepted hand conditions caused the claimed 

disability.

The record also contains physical therapy reports. However, the Board has held that 

treatment notes signed by physical therapists

15 have no probative value as these providers are not 

considered physicians under FECA16 and are not competent to render a medical opinion under 

FECA.

On appeal appellant asserts that she submitted sufficient medical evidence supporting 

disability for the period claimed. The Board finds that she failed to submit rationalized medical 

 

11 Franklin D. Haislah, 52 ECAB 457 (2001) (medical reports not containing rationale on causal relationship are 

entitled to little probative value) Jimmie H. Duckett, 52 ECAB 332 (2001). 

12 See George Randolph Taylor, 6 ECAB 986, 988 (1954) (where the Board found that a medical opinion not 

fortified by medical rationale is of little probative value).

13 See M.C., Docket No. 15-1762 (issued August 26, 2016) (medical reports are of limited probative value where 

they either predate the claimed period of disability or do not specifically address whether the claimed disability is 

causally related to the accepted condition).

14 Alice J. Tysinger, 51 ECAB 638 (2000).

15 V.W., Docket No. 16-1444 (issued March 14, 2017) (where the Board found that physical therapy reports do 

not constitute competent medical evidence because a physical therapist is not a “physician” as defined under FECA).

16 See David P. Sawchuk, 57 ECAB 316 (2006) (lay individuals such as physician assistants, nurses and physical 

therapists are not competent to render a medical opinion under FECA); 5 U.S.C. § 8101(2) (this subsection defines a 

“physician” as surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors, and osteopathic 

practitioners within the scope of their practice as defined by State law).
8

evidence establishing a causal relationship between the specific period of claimed disability and 

the accepted conditions. 

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 failed to establish total disability for the period June 7 

to September 2, 2016 causally related to the accepted employment conditions. 

ORDER

IT IS HEREBY ORDERED THAT the March 31, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: February 16, 2018

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board