United States Department of Labor

Employees’ Compensation Appeals Board

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D.K., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE,

Union, ME, Employer

__________________________________________

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Docket No. 17-1829

Issued: February 7, 2018

Appearances: Case Submitted on the Record

Appellant, pro se

Daniel Colbert, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On August 29, 2017 appellant filed a timely appeal from a July 28, 2017 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 consider the merits of the case.

ISSUE

The issue is whether appellant established a recurrence of her medical condition on or 

after November 1, 2016 causally related to the accepted employment injury.

On appeal a November 17, 2017 memorandum was received from the Solicitor of Labor, 

on behalf of the Director of OWCP. The Director argues that pursuant to the Federal (FECA) 

Procedure Manual, Chapter 2.1500.4(b) appellant has not met her burden of proof to establish a 

recurrence of a medical condition, noting that, as more than 90 days elapsed after appellant’s 

release from medical care to the alleged recurrence, appellant was responsible for submitting a 

 

1 5 U.S.C. § 8101 et seq.
2

rationalized medical report supporting causal relationship between her current condition and the 

original injury. He asserts that appellant did not submit a well-rationalized medical opinion 

supporting causation. 

FACTUAL HISTORY

On March 7, 2002 appellant, then a 43-year-old rural carrier associate, filed an 

occupational disease claim (Form CA-2) alleging that she developed tendinitis in her left elbow 

while driving her postal vehicle and lifting mail. By decision dated April 4, 2002, OWCP 

accepted her claim for left lateral epicondylitis. Appellant did not stop work.

In a note dated March 26, 2002, Peter C. Scherb, a physician assistant, diagnosed 

bilateral lateral epicondylitis more severe on the left, left distal bicipital tendinitis, and early mild

carpal tunnel syndrome. Appellant submitted a series of notes from Mr. Scherb. On 

September 4, 2002 Dr. W. Kevin Olehnik, a Board-certified orthopedic surgeon, diagnosed right 

lateral epicondylitis. He treated appellant for bilateral lateral epicondylitis on 

November 26, 2002.

Appellant filed a recurrence claim (Form CA-2a) on May 31, 2017. She listed her date of 

original injury as November 2, 2007 and her date of recurrence as November 1, 2016. Appellant 

noted that her claim was for medical treatment only and that she had not stopped work. She 

explained that she performed her regular duties after her original injury, but received 

occupational therapy. Appellant noted that her job was extremely repetitive and that her arms, 

elbows, and hands seemed less painful after therapy. 

On May 8, 2017 Dr. Michael D. Pleacher, a Board-certified pediatrician specializing in 

sports medicine, examined appellant for bilateral carpal tunnel syndrome worse on the left. He 

reported that appellant had been diagnosed with bilateral carpal tunnel syndrome in 2002 with a 

recurrence in 2007. At the end of 2016 appellant developed increasingly severe paresthesias in 

both hands in the median nerve distribution. Dr. Pleacher examined appellant on January 6, 

2017 for this condition and recommended therapy. Appellant was unable to attend therapy as 

she sustained a radial head fracture of the right elbow which required splinting and focused 

therapy. On physical examination on May 8, 2017 appellant had positive Phalen’s test, and 

Tinel’s sign with diminished sensation to light touch in a median nerve distribution on the left. 

Dr. Pleacher diagnosed bilateral, left greater than right, carpal tunnel syndrome, “likely a 

recurrence of her prior episodes of carpal tunnel related to her work in the post office.” He 

opined that appellant’s condition was a recurrence of a prior work-related condition and 

recommended electrodiagnostic testing. 

In a letter dated June 20, 2017, OWCP informed appellant that her claim had been 

accepted for left lateral epicondylitis and noted that Dr. Pleacher’s report did not establish that 

her current condition was related to her original injury. It requested additional medical evidence 

and afforded appellant 30 days to respond.

By decision dated July 28, 2017, OWCP denied appellant’s claim for a recurrence of 

medical treatment as the evidence of record was insufficient to establish that she required 

additional medical treatment due to a worsening of her accepted work-related conditions.
3

LEGAL PRECEDENT

FECA provides that the United States shall furnish to an employee who is injured while 

in the performance of duty the services, appliances, and supplies prescribed or recommended by 

a qualified physician that the Secretary of Labor considers likely to cure, give relief, reduce the 

degree or the period of any disability, or aid in lessening the amount of any monthly 

compensation.2

Recurrence of a medical condition means a documented need for further medical 

treatment after release from treatment for the accepted condition or injury when there is no 

accompanying work stoppage. Continuous treatment for the original condition or injury is not 

considered a need for further medical treatment after release from treatment, nor is an 

examination without treatment.

3

If a claim for recurrence of medical condition is made more than 90 days after release 

from medical care, a claimant is responsible for submitting a medical report supporting causal 

relationship between the employee’s current condition and the original injury in order to meet his 

or her burden of proof.4

An employee has the burden of proof to establish a recurrence of a medical condition that 

is causally related to an accepted employment injury. To meet this burden, the employee must 

submit medical evidence from a physician who, on the basis of a complete and accurate factual 

and medical history, supports that the condition is causally related and supports the conclusion 

with sound medical rationale.5

ANALYSIS

The Board finds appellant has not established a recurrence of her accepted medical

condition on or after November 1, 2016 causally related to her accepted employment injury.

OWCP accepted appellant’s occupational disease claim for left lateral epicondylitis on 

April 4, 2002. Appellant did not stop work due to her accepted condition and has continued to 

perform the duties of a rural carrier. On May 31, 2017 appellant claimed a recurrence of medical 

condition. She listed her date of recurrence as November 1, 2016. OWCP denied her recurrence 

claim on July 28, 2017.

In support of her claimed recurrence, appellant submitted the May 8, 2017 report from

Dr. Pleacher which diagnosed bilateral carpal tunnel syndrome. However, OWCP has not 

 

2 5 U.S.C. § 8103(a).

3 20 C.F.R. § 10.5(y).

4 Federal (FECA) Procedure Manual, Part 2 -- Claims, Recurrences, Chapter 2.1500.4(b) (June 2013); see also

J.H., Docket No. 17-1456 (issued December 11, 2017); J.M., Docket No. 09-2041 (issued May 6, 2010).

5 See J.H., supra note 4; K.T., Docket No. 15-1758 (issued May 24, 2016).
4

accepted appellant’s claim for bilateral carpal tunnel syndrome.

6

 For conditions not accepted by 

OWCP as being employment related, it is the employee’s burden of proof to provide rationalized 

medical evidence sufficient to establish causal relation, not OWCP’s burden to disprove such 

relationship.7 Dr. Pleacher did not offer an opinion or provide medical rationale casually relating

the diagnosis of bilateral carpal tunnel syndrome to appellant’s accepted condition of left lateral 

epicondylitis. His report is, therefore, insufficient to establish appellant’s claim for recurrence of 

a medical condition.8 The Board finds that appellant failed to establish her recurrence claim due 

to deficits in the medical evidence as noted above. Appellant is not precluded, however, from 

filing a new occupational disease claim (Form CA-2).

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 established a recurrence of her medical condition 

on or after November 1, 2016 causally related to her accepted employment injury.

 

6 The diagnosis of carpal tunnel syndrome was originally made on March 26, 2002 by Mr. Scherb, a physician 

assistant. Certain healthcare providers such as physician assistants, nurse practitioners, physical therapists, and 

social workers are not considered physicians as defined under FECA.6 Consequently, their medical findings and/or 

opinions will not suffice for purposes of establishing entitlement to FECA benefits. K.W., 59 ECAB 271, 279 

(2007); David P. Sawchuk, 57 ECAB 316, 320 n.11 (2006).

7 See J.H., supra note 4; T.M., Docket No. 16-1456 (issued January 10, 2017); E.C., Docket No. 10-1554 (issued 

April 1, 2011); Alice J. Tysinger, 51 ECAB 638 (2000).

8 See J.H., supra note 4.
5

ORDER

IT IS HEREBY ORDERED THAT the July 28, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: February 7, 2018

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board