United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

B.F., Appellant 

and 

DEPARTMENT OF THE TREASURY, 

INTERNAL REVENUE SERVICE, 

Kansas City, MO, Employer 

__________________________________________ 

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Docket No. 17-0347 

Issued: May 1, 2017 

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director 

DECISION AND ORDER 

Before: 

CHRISTOPHER J. GODFREY, Chief Judge 

PATRICIA H. FITZGERALD, Deputy Chief Judge 

VALERIE D. EVANS-HARRELL, Alternate Judge 

JURISDICTION 

On December 5, 2016 appellant filed a timely appeal from a June 20, 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.2

ISSUE 

The issue is whether appellant has established greater than two percent permanent 

impairment of each upper extremity, for which she previously received a schedule award. 

 1

 5 U.S.C. § 8101 et seq. 

2

 The Board notes that appellant submitted additional evidence to the Board on appeal. The Board s jurisdiction 

is limited to reviewing the evidence that was before OWCP at the time of its final decision. Therefore, this 

additional evidence cannot be considered by the Board for the first time on appeal. 20 C.F.R. § 501.2(c)(1). 
2

FACTUAL HISTORY 

OWCP accepted that on or before February 1, 2013 appellant, then a 48-year-old tax 

examining clerk, sustained bilateral carpal tunnel syndrome and bilateral trigger thumb due to 

repetitive keyboarding, folding documents, and pulling or pushing carts of documents. 

Dr. Valerie Deardoff, an attending Board-certified orthopedic surgeon, noted in a 

December 5, 2014 report that November 21, 2014 nerve conduction velocity (NCV) and 

electromyogram (EMG) studies showed severe bilateral carpal tunnel syndrome and mild right 

ulnar nerve compression at the elbow. Appellant underwent a series of steroid injections for 

bilateral trigger thumb. 

On March 2, 2015 Dr. Deardoff performed a right endoscopic carpal tunnel release and 

right trigger thumb release, approved by OWCP. Appellant returned to full-time restricted duty 

on March 26, 2015. She participated in occupational therapy in June and July 2015. 

On July 30, 2015 Dr. Deardoff performed a left carpal tunnel release and left trigger 

thumb release, approved by OWCP. She provided periodic progress reports through October 29, 

2015 noting scar thickening in the left hand and wrist. Appellant continued to participate in 

occupational therapy through January 2016. 

On February 22, 2016 appellant filed a claim for a schedule award (Form CA-7). In a 

March 8, 2016 letter, OWCP notified appellant of the evidence needed to establish her schedule 

award claim, including a report from her attending physician supporting that she had attained 

maximum medical improvement (MMI), the impairing diagnosis, a detailed description of the 

permanent impairment, and an impairment rating calculated according to the sixth edition of the 

American Medical Association, Guides to the Evaluation of Permanent Impairment (hereinafter, 

A.M.A., Guides). Appellant was afforded 30 days to submit such evidence. 

In response, appellant submitted a March 31, 2016 report from Dr. Deardoff, finding that 

appellant had attained MMI. On a March 23, 2016 examination, appellant complained of scar 

tenderness and difficulty with pinching and gripping. Monofilament testing in both hands 

showed normal sensation. Dr. Deardoff diagnosed bilateral carpal tunnel syndrome and bilateral 

stenosing synovitis of the thumbs. She opined that, according to Table 15-233

 of the A.M.A.,

Guides, appellant had three percent permanent impairment of each upper extremity due to carpal 

tunnel syndrome. Dr. Deardoff explained that as appellant had no objective clinical findings of 

stenosing synovitis, she had no permanent impairment rating for the accepted trigger thumbs 

according to Table 15-2.4

An OWCP medical adviser reviewed Dr. Deardoff’s report on April 16, 2016, noting that 

she did not provide an impairment calculation to support the percentages of permanent 

impairment offered. He found that appellant reached MMI by March 31, 2016. The medical 

adviser performed an impairment rating using Table 15-23. For both upper extremities, he rated 

 3

 Table 15-23, page 449 of the sixth edition of the A.M.A., Guides is titled “Entrapment/Compression Neuropathy 

Impairment.” 

4

 Table 15-2, page 392 of the sixth edition of the A.M.A., Guides is titled “Digit Regional Grid: Digit 

Impairments.” 
3

carpal tunnel syndrome. The medical adviser found a history grade modifier of 1 due to 

postoperative scar tissue without median nerve deficit, a grade modifier for physical findings of 

zero due to a normal sensory examination, and a grade modifier for test findings of 3 due to 

conduction delay on preoperative EMG and NCV testing. Averaging these modifiers, he 

calculated a grade modifier of 1.33, rounded downward to a grade modifier of 1.0. The medical 

adviser noted that, although Dr. Deardoff did not perform or score a QuickDASH or other 

functional questionnaire, she described mild functional deficits from carpal tunnel syndrome that 

did not require an adjustment of the default grade of two. He therefore found two percent 

permanent impairment of each upper extremity. 

By decision dated June 20, 2016, OWCP granted appellant a schedule award for two 

percent permanent impairment of each upper extremity due to carpal tunnel syndrome, based on 

Dr. Deardoff’s opinion as reviewed by OWCP’s medical adviser. 

LEGAL PRECEDENT 

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

essential elements of his or her claim.5

 With respect to a schedule award, it is appellant’s burden 

of proof to establish permanent impairment.6 A claimant may seek an increased schedule award 

if the evidence establishes that he or she sustained an increased impairment causally related to an 

employment injury.7 The medical evidence must include a detailed description of the permanent 

impairment.8 

The schedule award provision of FECA9

 and its implementing regulations10 set forth the 

number of weeks of compensation payable to employees sustaining permanent impairment from 

loss or loss of use, of scheduled members or functions of the body. However, FECA does not 

specify the manner in which the percentage of loss shall be determined. For consistent results 

and to ensure equal justice under the law to all claimants, good administrative practice 

necessitates the use of a single set of tables so that there may be uniform standards applicable to 

all claimants. The A.M.A., Guides has been adopted by the implementing regulations as the 

appropriate standard for evaluating schedule losses.11 For schedule awards after May 1, 2009, 

the impairment is evaluated under the sixth edition of the A.M.A., Guides.12 

 5 John W. Montoya, 54 ECAB 306 (2003). 

6 Edward W. Spohr, 54 ECAB 806, 810 (2003). 

7 See Rose V. Ford, 55 ECAB 449 (2004). 

8 See Vanessa Young, 55 ECAB 575 (2004). 

9

 5 U.S.C. § 8107. 

10 20 C.F.R. § 10.404 (1999). 

11 K.H., Docket No. 09-341 (issued December 30, 2009). For OWCP decisions issued after May 1, 2009, the 

sixth edition of the A.M.A., Guides is used. B.M., Docket No. 09-2231 (issued May 14, 2010). 

12 See Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, 

Chapter 2.808.5a (February 2013); Federal (FECA) Procedure Manual, Part 3 -- Medical, Schedule Awards, Chapter 

3.700.2 and Exhibit 1 (January 2010). 
4

Impairment due to carpal tunnel syndrome is evaluated under the scheme found in Table 

15-23 (Entrapment/Compression Neuropathy Impairment) and accompanying relevant text.13 In 

Table 15-23, grade modifier levels (ranging from zero to four) are described for the categories 

test findings, history, and physical findings. The grade modifier levels are averaged to arrive at 

the appropriate overall grade modifier level and to identify a default rating value. The default 

rating value may be modified up or down by one percent based on functional scale, an 

assessment of impact on daily living activities.14 

ANALYSIS 

OWCP accepted that appellant sustained bilateral carpal tunnel syndrome and bilateral 

trigger thumbs. Dr. Deardoff, an attending Board-certified orthopedic surgeon, performed right 

endoscopic tunnel release and trigger thumb release on March 2, 2015, and left carpal tunnel 

release and trigger thumb release on July 30, 2015. 

On February 22, 2016 appellant claimed a schedule award. Dr. Deardoff provided a 

March 31, 2016 report, finding that appellant had attained MMI. She found three percent 

permanent impairment of each arm due to carpal tunnel syndrome according to Table 15-23 of 

the A.M.A., Guides.

15 However, Dr. Deardoff’s impairment rating is of limited probative value 

as she did not explain how she applied the rating process for Table 15-23 to arrive at her 

impairment rating.16

An OWCP medical adviser (OMA) reviewed Dr. Deardoff’s report on April 16, 2016. 

Based on Dr. Deardoff’s findings, the OMA rated appellant’s diagnosed carpal tunnel syndrome 

using Table 15-23. He noted that appellant had a clinical history modifier of 1 for postoperative 

scar tissue, a modifier of zero for physical findings due to a normal sensory examination, and a 

modifier of 3 for test findings based on preoperative electrodiagnostic testing. The OMA 

averaged these to calculate a grade modifier of 1.33, rounded downward to a grade modifier of 

1.0. He explained that as Dr. Deardoff did not describe a functional deficit sufficient to warrant 

adjusting the default grade of two, appellant had two percent permanent impairment of each 

upper extremity due to carpal tunnel syndrome. 

The Board finds that the OMA properly applied the A.M.A., Guides, to Dr. Deardoff’s 

findings to determine that appellant had two percent permanent impairment of each arm. The 

OMA accurately applied the appropriate portions of the A.M.A., Guides to Dr. Deardoff’s 

clinical findings and provided detailed rationale explaining his application of the A.M.A., 

 13 A.M.A., Guides 449, Table 15-3 (6th ed 2009). 

14 A survey completed by a given claimant, known by the name QuickDASH, may be used to determine the 

Functional Scale score. Id. at 448-49. 

15 Supra note 13. The rating process for Table 15-23 is set forth at pages 448-50. 

16 See Richard A. Neidert, 57 ECAB 474 (2006) (an attending physician’s report is of little probative value where 

the A.M.A., Guides are not properly followed). 
5

Guides.

17 The Board finds that appellant has not met her burden of proof to establish more than 

two percent permanent impairment of each upper extremity. 

On appeal, appellant contends that new medical evidence established more than two 

percent permanent impairment of each upper extremity. However, the Board may not review 

evidence that was not before OWCP at the time it issued the last decision in the case.18 

Appellant may request a schedule award or an increased schedule award at any time 

based on evidence of a new exposure or medical evidence showing progression of an 

employment-related condition resulting in permanent impairment or increased impairment. 

CONCLUSION 

The Board finds that appellant has not established greater than two percent permanent 

impairment of each upper extremity, for which she previously received a schedule award. 

ORDER 

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

Compensation Programs dated June 20, 2016 is affirmed. 

Issued: May 1, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Valerie D. Evans-Harrell, Alternate Judge 

 Employees’ Compensation Appeals Board 

 17 See Linda Beale, 57 ECAB 429 (2006) (it is well established that, when the attending physician fails to provide 

an estimate of impairment conforming to the A.M.A., Guides, her opinion is of diminished probative value in 

establishing the degree of permanent impairment and OWCP may rely on the opinion of its medical adviser to apply 

the A.M.A., Guides, to the findings reported by the attending physician). 

18 Supra note 2.