United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

S.W., Appellant 

and 

DEPARTMENT OF JUSTICE, BUREAU OF 

PRISONS, FEDERAL CORRECTIONAL 

COMPLEX, Beaumont, TX, Employer 

__________________________________________ 

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Docket No. 17-0801 

Issued: July 14, 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 

COLLEEN DUFFY KIKO, Judge 

JURISDICTION 

On February 28, 2017 appellant filed a timely appeal from a January 24, 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 over the merits of this case. 

ISSUE 

The issue is whether appellant met her burden of proof to establish more than six percent 

permanent impairment of the right upper extremity, for which she previously received a schedule 

award. 

On appeal appellant disagrees with the number of weeks paid and the degree and nature 

of her permanent impairment. 

 1

 5 U.S.C. § 8101 et seq. 
2

FACTUAL HISTORY 

On August 28, 2012 appellant, then a 35-year-old correctional officer, filed a traumatic 

injury claim (Form CA-1) alleging that she injured her right hand that day when it was caught in 

a closing van door. She did not stop work and began treatment with Dr. Oscar J. Currie, a 

Board-certified orthopedic surgeon. OWCP accepted closed fracture of other metacarpal bones, 

right, on October 12, 2012. In reports dated October 12, 2012, Dr. Currie noted examination 

findings of no tenderness about the index finger with full range of motion of fist and fingers with 

minor decreased strength. He diagnosed healed index finger metacarpal base fracture. 

Dr. Currie advised that appellant was at maximum medical improvement (MMI) and could return 

to full duty. 

Dr. Juan E. Davila, an attending Board-certified physiatrist and associate of Dr. Currie, 

performed upper extremity electrodiagnostic studies on April 11, 2013. He advised that the 

studies were within normal limits. A second set of electrodiagnostic studies done by Dr. Davila 

on November 7, 2014 were also normal. On December 18, 2014 Dr. Currie acknowledged the 

two negative sets of studies, noted appellant’s complaint of right hand pain and numbness, and 

advised that carpal tunnel steroid injections gave her significant pain relief. He diagnosed right 

carpal tunnel syndrome. In an April 13, 2015 report, Dr. Michael A. Monmouth, a Boardcertified orthopedic surgeon, also diagnosed right carpal tunnel syndrome. 

On May 7, 2015 OWCP accepted right carpal tunnel syndrome. Dr. Currie performed 

right carpal tunnel release on July 15, 2015. He followed appellant postoperatively. On May 24, 

2016 Dr. Currie released appellant to full duty and advised that she was at MMI. He indicated 

that he would see her on an as-needed basis. 

On November 14, 2016 appellant filed a claim for a schedule award (Form CA-7). She 

submitted a September 1, 2016 report in which Dr. Frank L. Barnes, Board-certified in 

orthopedic surgery, noted the history of injury and appellant’s medical and surgical history. 

Dr. Barnes advised that examination of the right wrist demonstrated a well-healed scar, 

moderately limited range of motion, 4/5 strength, and no swelling, discoloration, instability, 

crepitation, or deformity. Sensory testing to light touch caused an aching feeling throughout the 

entire hand and fingers. Motion of the right fingers showed marked limitation. 

Dr. Barnes diagnosed fracture of right second metacarpal bone. He advised that appellant 

reached MMI on April 24, 2016 when she was released to full duty by Dr. Currie.2

 Dr. Barnes 

reported a QuickDASH score of 81.7 for symptoms, and a QuickDASH score of 62.5 under the 

work module. He advised that, in accordance with Table 15-2, Digit Regional Grid, of the sixth 

edition of the American Medical Association, Guides to the Evaluation of Permanent 

Impairment (hereinafter A.M.A., Guides),3

 appellant had a class 1 impairment with six percent 

 2

 There is no report from Dr. Currie dated April 24, 2016. As noted, by report dated October 12, 2012, Dr. Currie 

advised that appellant was at MMI for the metacarpal fracture and released her to full duty. By report dated May 24, 

2016, he noted that appellant was at MMI with regard to her carpal tunnel syndrome. Dr. Currie released appellant 

to full duty. 

3

 A.M.A., Guides (6th ed. 2009). 
3

default value. Dr. Barnes found no adjustments for clinical studies and functional history, and an 

adjustment of one for physical examination, finding two percent permanent impairment of the 

right arm due to metacarpal fracture. 

For the diagnosis of contusion of right hand, Dr. Barnes found that under Table 15-3, 

Wrist Regional Grid, this diagnosis yielded a class 1 impairment with no modifiers for clinical 

studies and functional history. Dr. Barnes found a modifier of two for physical examination, 

based on severe loss of wrist motion, which yielded two percent permanent impairment of the 

right arm due to wrist contusion. 

For the diagnosed carpal tunnel syndrome, he found that under Table 15-23, 

Entrapment/Compression Neuropathy Impairment, with functional history and physical 

examination severe with definable sensory loss, mild weakness, and no atrophy, she had eight 

percent right upper extremity permanent impairment due to carpal tunnel syndrome. Dr. Barnes 

added the three impairment values and concluded that appellant had a total 12 percent right 

upper extremity permanent impairment. 

In a December 27, 2016 report, Dr. Arthur S. Harris, a Board-certified orthopedic 

surgeon and OWCP medical adviser, noted his review of the record, including Dr. Barnes’ 

report. He advised that, in accordance with Table 15-2, appellant had one percent upper 

extremity permanent impairment for the metacarpal fracture. For the diagnosed right carpal 

tunnel syndrome, under Table 15-23, appellant had two percent upper extremity permanent 

impairment for residual problems of mild carpal tunnel syndrome. OWCP’s medical adviser 

utilized the Combined Values Chart and concluded that appellant had a total three percent right 

upper extremity permanent impairment. 

Appellant’s file was also referred to Dr. Todd Fellars, a Board-certified orthopedic 

surgeon and OWCP medical adviser. In a January 9, 2017 report, Dr. Fellars noted his review of 

the medical record and the accepted conditions of closed fracture of base of right metacarpal 

bone and right carpal tunnel syndrome. He indicated that appellant had a normal examination 

and reached MMI for the finger fracture on October 25, 2012 and, therefore, had no permanent 

impairment due to this injury. Dr. Fellars indicated that, for carpal tunnel syndrome, under 

Table 15-23, she had atrophy and a poor functional history, with 4/5 grip strength. He found a 

class 2 impairment with a modifier of one for functional history which yielded six percent right 

arm permanent impairment. Dr. Fellars indicated that he disagreed with Dr. Barnes’ impairment 

rating because appellant’s current loss of motion was not associated with her index finger 

fracture or work injury. He further indicated that he did not feel there was evidence of severe 

carpal tunnel syndrome, finding that based on the information provided appellant had a class 2 

impairment. Dr. Fellars concluded that appellant was at MMI for right carpal tunnel syndrome 

on September 1, 2016. 

By decision dated January 24, 2017, appellant was granted a schedule award for six 

percent right upper extremity permanent impairment, for 14.64 weeks of compensation, to run 

from September 1 to December 12, 2016. 
4

LEGAL PRECEDENT 

Section 8149 of FECA delegates to the Secretary of Labor the authority to prescribe rules 

and regulations for the administration and enforcement of FECA. The Secretary of Labor has 

vested the authority to implement the FECA program with the Director of OWCP.4 Section 8107 

of FECA sets forth the number of weeks of compensation to be paid for the permanent loss of 

use of specified members, functions, and organs of the body.5

 FECA, however, does not specify 

the manner by which the percentage loss of a member, function, or organ shall be determined. 

To ensure consistent results and equal justice under the law, good administrative practice 

requires the use of uniform standards applicable to all claimants. Through its implementing 

regulations, OWCP adopted the A.M.A., Guides as the appropriate standard for evaluating 

schedule losses.6

The sixth edition of the A.M.A., Guides was first printed in 2008. Within months of the 

initial printing, the A.M.A. issued a 52-page document entitled Clarifications and Corrections, 

Sixth Edition, Guides to the Evaluation of Permanent Impairment.” The document included 

various changes to the original text, intended to serve as an erratum/supplement to the first 

printing of the A.M.A., Guides. In April 2009, these changes were formally incorporated into 

the second printing of the sixth edition. 

As of May 1, 2009, schedule awards are determined in accordance with the sixth edition 

of the A.M.A., Guides (2009).7

 The Board has approved the use by OWCP of the A.M.A., 

Guides for the purpose of determining the percentage loss of use of a member of the body for 

schedule award purposes.8

Under the sixth edition of the A.M.A., Guides, entrapment neuropathy, such as carpal 

tunnel syndrome, is addressed at section 15-4f.9 Having established the diagnosis of carpal 

tunnel syndrome, the next step in the rating process is to consult Table 15-23, entitled 

Entrapment/Compression Neuropathy Impairment.

10 The table provides a series of grade 

modifiers from zero to four and a range of corresponding upper extremity impairments from zero 

 4 See 20 C.F.R. §§ 1.1-1.4. 

5

 For a complete loss of use of an arm, an employee shall receive 312 weeks’ compensation. 5 U.S.C. 

§ 8107(c)(1). 

6

 20 C.F.R. § 10.404; see also Ronald R. Kraynak, 53 ECAB 130 (2001). 

7 See Federal (FECA) Procedure Manual, Part 3 -- Medical, Schedule Awards, Chapter 3.700, Exhibit 1 

(January 2010); Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability 

Claims, Chapter 2.808.5a (February 2013). 

8 Isidoro Rivera, 12 ECAB 348 (1961). 

9 Supra note 3 at 432. 

10 Id. at 448-49. 
5

to nine percent. Grade modifiers are assigned based on a combination of factors including test 

findings, history, and physical findings.11 

ANALYSIS 

The issue on appeal is whether appellant established more than six percent permanent 

impairment of the right upper extremity. The accepted conditions in this case are closed fracture 

of base of other metacarpal bones, right, and carpal tunnel syndrome, right. On January 24, 2017 

appellant was granted a schedule award for six percent right arm permanent impairment, based 

on the opinion of Dr. Fellars, an OWCP medical adviser. 

With regard to the diagnosis of carpal tunnel syndrome, the Board finds a conflict in 

medical evidence has been created. In a September 1, 2016 report, Dr. Barnes, an attending 

Board-certified orthopedic surgeon, found that under Table 15-23, Entrapment/Compression 

Neuropathy Impairment, with functional history and physical examination severe, with definable 

sensory loss, mild weakness, and no atrophy, appellant had eight percent right upper extremity 

permanent impairment due to carpal tunnel syndrome. 

In contrast, Dr. Fellars, OWCP’s medical adviser, also a Board-certified orthopedic 

surgeon, reported on January 9, 2017 that he did not feel appellant had severe carpal tunnel 

syndrome. He noted atrophy and a poor functional history and 4/5 grip strength. Dr. Fellars 

advised that, under Table 15-23, appellant had a class 2 impairment with a modifier of one for 

functional history which yielded six percent right upper extremity impairment. He noted his 

disagreement with Dr. Barnes’ impairment rating because appellant’s current loss of motion was 

not associated with her index finger fracture or work injury. 

Table 15-23 provides a series of grade modifiers from zero to four and a range of 

corresponding upper extremity impairments from zero to nine percent. Grade modifiers are 

assigned based on a combination of factors including test findings, history, and physical findings. 

Dr. Barnes and Dr. Fellars disagreed regarding modifiers and the class of impairment. 

Thus, this case is not in posture for decision regarding the diagnosed carpal tunnel 

syndrome because there is a conflict in the medical opinion evidence between Dr. Barnes and 

Dr. Fellars regarding the degree of appellant’s right upper extremity impairment due to carpal 

tunnel syndrome.12 

In order to resolve the conflict in the medical opinion evidence regarding appellant’s 

right upper extremity impairment for the diagnosed carpal tunnel syndrome, the case shall be 

remanded to OWCP for referral of appellant to an impartial medical specialist for an examination 

and impairment evaluation for this right upper extremity diagnosis.13 After this and other 

 11 Additional grade modifications are permitted using the QuickDASH (Disabilities of the Arm, Shoulder, and 

Hand) functional assessment tool. 

12 Melvina Jackson, 38 ECAB 443 (1987). 

13 See S.C., Docket No. 15-1630 (issued October 23, 2015); 5 U.S.C. § 8123(a) (if there is disagreement between 

the physician making the examination for the United States and the physician of the employee, the Secretary of 

Labor shall appoint a third physician who shall make an examination). 
6

development deemed necessary, OWCP shall issue a de novo decision regarding appellant’s 

entitlement to schedule award compensation due to the accepted right carpal tunnel syndrome. 

As to the diagnosed metacarpal fracture of the right index finger, the Board also finds that 

the case is not in posture for decision. 

The Board has found that OWCP has inconsistently applied Chapter 15 of the sixth 

edition of the A.M.A., Guides when granting schedule awards for upper extremity claims. No 

consistent interpretation had been followed regarding the proper use of the diagnosis-based 

impairment (DBI) or range of motion (ROM) methodology when assessing the extent of 

permanent impairment for schedule award purposes.14 The purpose of the use of uniform 

standards is to ensure consistent results and to ensure equal justice under the law to all 

claimants.15 In T.H., the Board concluded that OWCP physicians were at odds over the proper 

methodology for rating upper extremity impairment, having observed attending physicians, 

evaluating physicians, second opinion physicians, impartial medical examiners, and district 

medical advisers use both DBI and ROM methodologies interchangeably without any consistent 

basis. Furthermore, the Board observed that physicians interchangeably cited to language in the 

first printing or the second printing when justifying use of either ROM or DBI methodology. 

Because OWCP’s own physicians have been found to be inconsistent in the application of the 

A.M.A., Guides, the Board finds that OWCP could no longer ensure consistent results and equal 

justice under the law for all claimants.16

In order to ensure consistent results and equal justice under the law for cases involving 

upper extremity impairment, the Board will set aside the January 24, 2017 decision. Following 

OWCP’s use of a consistent method for calculating permanent impairment for upper extremities 

to be applied uniformly, and such other development as may be deemed necessary, OWCP shall 

issue a de novo decision on appellant’s claim for an additional right upper extremity schedule 

award. 

CONCLUSION 

The Board finds this case not in posture for decision. 

 14 T.H., Docket No. 14-0943 (issued November 25, 2016). 

15 Ausbon N. Johnson, 50 ECAB 304, 311 (1999). 

16 Supra note 14. 
7

ORDER 

IT IS HEREBY ORDERED THAT the January 24, 2017 decision of the Office of 

Workers’ Compensation Programs is set aside, and the case is remanded for further action 

consistent with this decision. 

Issued: July 14, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Patricia H. Fitzgerald, Deputy Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board