United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

D.H., Appellant

and

DEPARTMENT OF THE ARMY, ANNISTON 

ARMY DEPOT, Anniston, AL, Employer

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Docket No. 17-0520

Issued: April 23, 2018

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On January 9, 2017 appellant filed a timely appeal from a November 22, 2016 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 the claim.

ISSUE

The issue is whether appellant met her burden of proof to establish an injury causally 

related to the accepted March 17, 2016 employment incident.

FACTUAL HISTORY

On March 21, 2016 appellant, then a 39-year-old painter, filed a traumatic injury claim 

(Form CA-1) alleging that on March 17, 2016 she injured her right wrist while in the performance 

 

1 5 U.S.C. § 8101 et seq.
2

of duty. She noted that she was painting inside a tank and felt a pop in her right wrist. Appellant 

did not stop work.

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

employing establishment on March 21, 2016.

On March 21, 2016 a physician assistant indicated that appellant was seen in June 2015 

and diagnosed with tenosynovitis, but never followed up with orthopedics. He noted the history 

of the March 17, 2016 employment incident and diagnosed radial styloid tenosynovitis 

(de Quervain’s) injury. Appellant was released to work with restrictions. The report was later 

cosigned by Dr. Aatif M. Hayat, Board-certified in occupational medicine, on March 24, 2016.

In a March 29, 2016 report, Dr. Michael R. Wiedmer, a Board-certified orthopedic 

surgeon, indicated that appellant felt a pop at the base of the thumb while working about two weeks 

ago. Prior to that, her hand had been going numb and waking her up at night. An assessment of 

right de Quervain’s tendinitis and right carpal tunnel syndrome was provided. Dr. Wiedmer 

released appellant to light duty for three days. He opined, in a March 29, 2016 attending 

physician’s report, by checking a box marked “yes” that the diagnosed right de Quervain’s 

tendinitis and right carpal tunnel syndrome conditions were caused or aggravated by her 

employment activity. Dr. Wiedmer released appellant to work with no restrictions on 

May 20, 2016.

On May 10, 2016 Dr. Anthony J. Esposito, a Board-certified neurologist, indicated that the 

nerve conduction studies revealed evidence of a moderate right carpal tunnel syndrome. He 

released appellant to work without restrictions on May 11, 2016.

Forms CA-7 (claim for compensation) and CA-7a (time analysis form) for the intermittent 

period May 10 to 20, 2016 were also submitted.

By development letter dated May 26, 2016, OWCP advised appellant that the evidence of 

record was insufficient to support her claim. It indicated that a physician’s opinion supported by 

a medical explanation as to how the reported work incident caused or aggravated the claimed injury

was needed. OWCP afforded appellant 30 days to submit the requested information. 

In response, OWCP received: a duplicative copy of the May 10, 2016 electrodiagnostic 

report; a June 9, 2016 Form CA-3 (report of work status); and clinic passes dated June 16 and 

August 24, 2016 from the employing establishment which noted Dr. Wiedmer had released 

appellant to light duty with no use of right hand. The provider who signed the June 16, 2016 clinic 

pass is unknown, while the August 24, 2016 clinic pass was signed by a registered nurse.

In a May 20, 2016 note, Dr. Wiedmer noted that appellant had elbow pain and the 

electromyogram (EMG) revealed significant carpal tunnel at the wrist. An assessment of right 

carpal tunnel syndrome and lateral epicondylitis was provided. Dr. Wiedmer recommended right 

carpal tunnel release and injection of the elbow. A May 31, 2016 request for authorization was 

attached. Dr. Wiedmer released appellant to light duty in a note dated June 8, 2016. 

By decision dated July 6, 2016, OWCP denied appellant’s claim for compensation. It 

found that the incident occurred as alleged, but that appellant had not submitted medical evidence 
3

establishing that the accepted employment incident of March 17, 2016 caused or aggravated her 

diagnosed conditions of right carpal tunnel and right de Quervain’s tendinitis.

On July 12, 2016 OWCP received appellant’s July 11, 2016 request for an oral hearing 

before an OWCP hearing representative.2 On August 29, 2016 it received appellant’s July 11, 

2016 request for reconsideration. 

In letters dated August 9 and 10, 2016, appellant advised that she was requesting 

reconsideration. Multiple copies of her July 28, 2016 statement discussing her work injury were 

submitted, along with copies her July 11, 2016 request for reconsideration. 

By letter dated September 12, 2016, OWCP informed the employing establishment of 

appellant’s reconsideration request. In response, a representative from the employing 

establishment submitted a September 20, 2016 letter indicating that appellant’s physician had 

indicated in an August 22, 2016 report that she was capable of working light duty with no use of 

the right hand. A copy of Dr. Wiedmer’s August 22, 2016 note was attached, which indicated that 

appellant was released to light duty with no use of the right hand. 

By decision dated November 22, 2016, OWCP denied modification of its July 6, 2016 

decision. 

LEGAL PRECEDENT

An employee seeking benefits under FECA has the burden of proof to establish the 

essential elements of his or her claim, including the fact that the individual is an employee of the 

United States within the meaning of FECA, that the claim was filed within the applicable time 

limitation, that an injury was sustained while in the performance of duty as alleged, and that any 

disability and/or specific condition for which compensation is claimed are causally related to the 

employment injury.3 These are the essential elements of each and every compensation claim 

regardless of whether the claim is predicated on a traumatic injury or an occupational disease.4

In order to determine whether an employee actually sustained an injury in the performance 

of duty, OWCP begins with an analysis of whether fact of injury has been established. Generally, 

fact of injury consists of two components which must be considered in conjunction with one 

another. The first component to be established is that the employee actually experienced the 

employment incident which is alleged to have occurred.5 The second component is whether the 

 

2 On July 21, 2016 appellant requested authorization to see a Dr. Sauer. In an August 19, 2016 letter, OWCP 

advised appellant that it was unable to authorize any treatment at this time and that she could follow her appeal rights 

attached to the July 6, 2016 decision. 

3

Joe D. Cameron, 41 ECAB 153 (1989).

4 See Irene St. John, 50 ECAB 521 (1999); Michael E. Smith, 50 ECAB 313 (1999).

5 Elaine Pendleton, 40 ECAB 1143, 1154 (1989).
4

employment incident caused a personal injury and generally can be established only by medical 

evidence.6

The medical evidence required to establish causal relationship is generally rationalized 

medical opinion evidence. Rationalized medical opinion evidence is medical evidence which 

includes a physician’s rationalized opinion on the issue of whether there is a causal relationship 

between the claimant’s diagnosed condition and the implicated employment factors. The opinion 

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

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 claimant.7

ANALYSIS

The Board finds that appellant has not submitted sufficient medical evidence to establish 

that the March 17, 2016 accepted employment incident caused or aggravated her diagnosed 

conditions.

In a March 21, 2016 report, later cosigned by Dr. Hayat, a physician assistant noted the 

history of the March 17, 2016 employment incident and diagnosed radial styloid tenosynovitis 

(de Quervain’s) injury. He released appellant to work with restrictions. However, Dr. Hayat 

offered no opinion regarding the cause of appellant’s diagnosed condition and resultant disability. 

Medical evidence that does not offer any opinion regarding the cause of an employee’s condition 

is of limited probative value.8

In a March 29, 2016 report, Dr. Wiedmer noted the history of the March 17, 2016 

employment incident and that her hand had been going numb and waking her up at night before 

the reported incident. He provided an assessment of right de Quervain’s tendinitis and right carpal 

tunnel syndrome and released her to light duty for three days. Dr. Wiedmer opined, in a March 29, 

2016 attending physician’s report, by checking a box marked “yes” that the diagnosed right 

de Quervain’s tendinitis and right carpal tunnel syndrome conditions were caused or aggravated 

by her employment activity. A report that addresses causal relationship with a check mark, without 

medical rationale explaining how the employment incident caused or aggravated the alleged injury, 

is of diminished probative value and insufficient to establish causal relationship.9 Dr. Wiedmer 

failed to provide a rationalized opinion explaining the causal relationship between the diagnosed 

conditions and the accepted employment incident.10

 

6 See Roy L. Humphrey, 57 ECAB 238, 241 (2005); see also P.W., Docket No. 10-2402 (issued August 5, 2011).

7 Solomon Polen, 51 ECAB 341 (2000).

8 M.M., Docket No. 16-1180 (issued October 26, 2016).

9 See R.U., Docket No. 17-0168 (issued January 9, 2018). 

10 I.J., 59 ECAB 408, 415 (2008); Victor J. Woodhams, 41 ECAB 345, 352 (1989).
5

In a May 20, 2016 note, Dr. Wiedmer provided an assessment of right carpal tunnel 

syndrome and lateral epicondylitis and recommended right carpal tunnel release and injection of 

the elbow. In numerous notes, he also released appellant to light duty either with or without 

restrictions. However, Dr. Wiedmer did not offer any medical opinion addressing whether the 

diagnosed conditions or her disability were caused or aggravated by the accepted March 17, 2016 

employment incident.11 Therefore, his reports are insufficient to meet appellant’s burden of proof. 

On May 10, 2016 Dr. Esposito indicated that the nerve conduction studies revealed 

evidence of a moderate right carpal tunnel syndrome. He released appellant to work with no 

restrictions on May 11, 2016. However, Dr. Esposito offered no opinion regarding the cause of 

appellant’s diagnosed condition and resultant disability. Medical evidence that does not offer any 

opinion regarding the cause of an employee’s condition is of limited probative value.12

The August 24, 2016 report from a registered nurse is of no probative medical value. 

Registered nurses are not considered physicians as defined under FECA.13

The diagnostic testing of record is of diminished probative value and is insufficient to 

establish appellant’s claim as it does not provide a physician’s explanation regarding the causal 

relationship between appellant’s diagnosed conditions and the March 17, 2016 employment 

incident.14

The Board notes that a Form CA-16, authorization for examination and/or treatment, was 

issued by the employing establishment on March 21, 2016. When the employing establishment 

properly executes a Form CA-16 which authorizes medical treatment as a result of an employee’s 

claim for an employment-related injury, the Form CA-16 creates a contractual obligation, which 

does not involve the employee directly, to pay for the cost of the examination or treatment 

regardless of the action taken on the claim. The period for which treatment is authorized by a 

Form CA-16 is limited to 60 days from the date of issuance, unless terminated earlier by OWCP.15 

Therefore, the Board finds that the medical evidence of record is insufficient to establish 

that appellant’s diagnosed conditions are causally related to the accepted March 17, 2016 

employment incident.

 

11 C.B., Docket No. 09-2027 (issued May 12, 2010); J.F., Docket No. 09-1061 (issued November 17, 2009); Jaja K. 

Asaramo, 55 ECAB 200 (2004). 

12 M.M., Docket No. 16-1180 (issued October 26, 2016).

13 5 U.S.C. § 8101(2) provides that a physician includes surgeons, podiatrists, dentists, clinical psychologists, 

optometrists, chiropractors, and osteopathic practitioners within the scope of their practice as defined by state law. 

E.B., Docket No. 17-1862 (issued January 12, 2018) (a nurse is not considered a physician under FECA); see also 

G.A., Docket No. 09-2153 (issued June 10, 2010) (evidence from a registered nurse has no probative medical value 

as a nurse is not a physician as defined under FECA).

14 See K.E., Docket No. 17-1216 (issued February 22, 2018); see also C.P., Docket No. 15-0600 (issued 

June 2, 2015).

15 See 20 C.F.R. § 10.300(c); Tracy P. Spillane, 54 ECAB 608, 610 (2003).
6

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 her burden of proof to establish an injury 

causally related to the accepted March 17, 2016 employment incident. 

ORDER

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

Programs dated November 22, 2016 is affirmed.

Issued: April 23, 2018

Washington, DC

Christopher J. Godfrey, 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