United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

I.L., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Wailuku, HI, Employer 

__________________________________________ 

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Docket No. 17-0684 

Issued: July 18, 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 

COLLEEN DUFFY KIKO, Judge 

ALEC J. KOROMILAS, Alternate Judge 

JURISDICTION 

On February 3, 2017 appellant filed a timely appeal from an October 14, 2016 merit 

decision and a January 13, 2017 nonmerit 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

ISSUES 

The issues are: (1) whether appellant has met her burden of proof to establish a bilateral 

hand condition causally related to factors of her federal employment; and (2) whether OWCP 

properly denied appellant’s request for further merit review of her claim pursuant to 5 U.S.C 

§ 8128(a). 

 1

 5 U.S.C. § 8101 et seq.

2

 Appellant submitted new evidence on appeal. However, the Board is precluded from reviewing evidence which 

was not before OWCP at the time of its final decision. See 20 C.F.R. § 501.2(c)(1). 
2

FACTUAL HISTORY 

On July 12, 2016 appellant, then a 57-year-old mail carrier, filed an occupational disease 

claim (Form CA-2) alleging that she developed pain in her hands and thumbs from her everyday 

work duties. She first became aware of her condition in March 2016 and of its relationship to 

her employment on April 12, 2016. 

The employing establishment provided an employee information form dated July 19, 

2016 which noted her job record, accident and injury history, and prior claims. 

By letter dated August 5, 2016, OWCP advised appellant of the deficiencies in her claim 

and provided her the opportunity to submit additional factual and medical evidence. This 

included a detailed narrative medical report from her treating physician which contained a 

history of the injury and a medical explanation with objective evidence of how the reported work 

exposure contributed to her claimed condition. 

In response, appellant submitted an August 20, 2016 narrative statement in which she 

described her work duties which mainly required the use of her thumbs and fingers. She held 

mail in bundles in one hand and fingered them individually with the other hand to case them into 

slots on shelves at work stations. Appellant pulled cased mail down and placed it into work trays 

or tubs to load into a mail truck for delivery. She related using a heavy and bulky hand-held 

scanner to scan multiple mail pieces, numerous parcels, and multiple managed service point 

labels throughout the workday. Appellant fingered through sequenced three-foot long mail trays. 

Her route usually had five trays that she worked through using her thumbs and index fingers to 

bring up a letter piece for delivery. Once appellant was in her vehicle, she used her hands to turn 

the ignition on and off, slide doors to open and close, set a hand brake, roll up the window, and 

lock her vehicle. Postal regulations required her to do this every time she exited and walked 

away from the vehicle. This was done numerous times as appellant’s route had about 1,000 

delivery points. Appellant opened and closed the back hatch of her truck to deliver parcels (she 

delivered two or three times more than other carriers). Her route consisted of more than half her 

deliveries to cluster box units (CBUs). Appellant constantly used her hands to open and close 

these metal units with a key. She noted that heavy latches must be lifted to fully open and close 

each unit. Appellant delivered mail to individual standing mailboxes which involved using her 

hands and thumbs to open and close the box doors. She used a pen to write notices and 

accountable mail, markers to label parcels when delivery could not be made, and rubber bands to 

bundle mail. Appellant sought medical treatment on April 12, 2016 after pain in both hands 

persisted for over a month. She was advised by two physicians that her pain was due to 

repetitive motions and overuse. Appellant asserted that she continued to have pain. 

Appellant submitted several reports from Dr. Rebecca A. Romack, a family practitioner. 

In progress notes and office visit reports dated August 8 and 23, 2016, Dr. Romack indicated that 

appellant was presented with a work-related injury. She noted appellant’s complaints which 

included pain due to trigger fingers and employment as a postal carrier. Regarding mechanism 

of injury, Dr. Romack noted that appellant informed her that on March 1, 2016 she repeatedly 

used her hands throughout the day at work. Appellant grabbed trays of mail with her fingers and 

lifted them out with her thumbs. She also opened a latch on CBUs and pulled things out of them. 

Appellant then held a bundle of mail in her left hand and lifted with her right hand. She opened 
3

and closed the hatch all day long when getting in and out of her truck. Appellant had an “old 

column shiftings” to turn the ignition on and off in her truck. Dr. Romack discussed examination 

findings and diagnosed bilateral first carpometacarpal (CMC) joint osteoarthritis. She opined 

that the underlying cause of appellant’s condition was overuse in the course of employment as a 

postal carrier. Dr. Romack related that there were no known preexisting conditions and/or 

nonoccupational factors contributing to the development of her injury. She maintained that 

medical maximum improvement was anticipated in one to two months and appellant’s prognosis 

was fair. 

In industrial work status reports dated August 8 and 23 and September 9, 2016, 

Dr. Romack restated her diagnosis of bilateral first CMC joint osteoarthritis. She placed 

appellant on modified activity at work and home from August 8 through October 7, 2016. 

Dr. Romack indicated that appellant could not work more than 8 hours a day or 40 hours a week. 

In a September 12, 2016 physician’s form report, she indicated by checking a box marked “yes” 

that appellant’s March 1, 2016 accident was the only cause of her condition. Dr. Romack noted 

that appellant had resumed light work on August 8, 2016. 

In an after-visit summary dated August 31, 2016, Nancy Zionkowski, an occupational 

therapist, provided instructions for an arthritis home program. 

By decision dated October 14, 2016, OWCP denied appellant’s occupational disease 

claim. It found that Dr. Romack had not provided a rationalized opinion, supported by a medical 

explanation, as to how the established employment factors caused, contributed to, or aggravated 

appellant’s bilateral hand condition. 

OWCP received a February 12, 2016 laboratory report which provided blood test results. 

In progress notes dated September 9 and October 7, 2016, Dr. Lisa K. Sodetani, a Board-certified 

internist, discussed examination findings and assessed appellant with bilateral first CMC joint 

osteoarthritis and de Quervain’s tenosynovitis. In an industrial work status report dated 

September 9, 2016, she restated her diagnosis and placed appellant off work through 

October 7, 2016. 

On December 31, 2016 appellant requested reconsideration. She noted that she would 

submit additional argument from her physician at a later time. Appellant related that her 

physician was on maternity leave. 

In a January 13, 2017 decision, OWCP denied appellant’s request for reconsideration. It 

found that the evidence of record was insufficient to warrant merit review of the prior decision. 

OWCP noted that “[n]o new evidence was presented for review.” 

LEGAL PRECEDENT -- ISSUE 1 

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 
4

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

To establish that an injury was sustained in the performance of duty in an occupational 

disease claim, a claimant must submit the following: (1) medical evidence establishing the 

presence or existence of the disease or condition for which compensation is claimed; (2) a factual 

statement identifying employment factors alleged to have caused or contributed to the presence 

or occurrence of the disease or condition; and (3) medical evidence establishing that the 

employment factors identified by the claimant were the proximate cause of the condition for 

which compensation is claimed or, stated differently, medical evidence establishing that the 

diagnosed condition is causally related to the employment factors identified by the claimant. 

The medical evidence required to establish a causal relationship is rationalized medical opinion 

evidence. The opinion of the physician must be based on a complete factual and medical 

background of the employee, must be one of reasonable certainty, and must be supported by 

medial rationale explaining the nature of the relationship between the diagnosed condition and 

the specific employment factors identified by the employee.5 

ANALYSIS -- ISSUE 1 

There is no dispute that appellant’s employment activities included fingering, pulling, 

lifting, turning, sliding, and rolling. The Board finds, however, that the medical evidence of 

record is insufficient to establish that these accepted factors of her federal employment caused or 

aggravated her bilateral hand conditions. 

Appellant submitted medical evidence primarily from her family physician, Dr. Romack. 

In progress notes and office visit reports dated August 8 and 23, 2016, Dr. Romack noted 

appellant’s history of injury, set forth examination findings, and diagnosed bilateral first CMC 

joint osteoarthritis. She opined that the diagnosed condition was caused by overuse at work. 

Although Dr. Romack found that appellant was injured at work, she did not provide medical 

rationale explaining the basis of her conclusory opinion regarding the causal relationship 

between her bilateral hand condition and the established employment factors.6

 This is especially 

important as she also indicated that appellant had preexisting conditions and/or nonoccupational 

factors that contributed to the development of her condition. The Board finds, therefore, that this 

evidence is insufficient to meet appellant’s burden of proof. 

In a September 12, 2016 physician’s form report, Dr. Romack indicated by checking a 

box marked “yes” that appellant’s March 1, 2016 accident was the only cause of her condition. 

 3 C.S., Docket No. 08-1585 (issued March 3, 2009); Elaine Pendleton, 40 ECAB 1143 (1989). 

4 S.P., 59 ECAB 184 (2007); Victor J. Woodhams, 41 ECAB 345 (1989); Joe D. Cameron, 41 ECAB 153 (1989). 

5 I.J., 59 ECAB 408 (2008); Victor J. Woodhams, id. 

6 See T.M., Docket No. 08-0975 (issued February 6, 2009) (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). 
5

However, she did not provide a firm diagnosis of a particular medical condition.7

 Moreover, the 

Board has held that when a physician’s opinion on causal relationship consists only of checking 

“yes” to a form question, without more by way of medical rationale, it is of little probative value 

and insufficient to establish appellant’s claim.8

 A mere conclusory opinion provided by a 

physician without the necessary rationale explaining how and why the incident or work factors 

were sufficient to result in the diagnosed medical condition is insufficient to meet a claimant’s 

burden of proof.9

 Dr. Romack has not offered sufficient explanation to address how the 

established work factors caused or aggravated a diagnosed medical condition. For the stated 

reasons, her report is insufficient to establish appellant’s claim. 

Other reports from Dr. Romack are of limited probative value as she did not offer a 

medical opinion on whether the diagnosed conditions were caused or aggravated by the 

established employment factors.10 Thus, her reports are insufficient to establish appellant’s 

burden of proof. 

The August 31, 2016 after-visit summary of Ms. Zionkowski, an occupational therapist, 

is insufficient to establish appellant’s claim. This evidence has no probative medical value as an 

occupational therapist is not considered a physician as defined under FECA.11 

Appellant’s belief that factors of employment caused or aggravated her condition is 

insufficient, by itself, to establish causal relationship.12 The issue of causal relationship is a 

medical one and must be resolved by probative medical opinion from a physician. The Board 

finds that there is insufficient medical evidence of record to establish that appellant’s bilateral 

hand condition was caused or aggravated by the established employment factors. Appellant, 

therefore, did not meet her burden of proof. 

On appeal appellant contends that her claim should not have been denied because her 

physician’s notes did not provide sufficient details. She noted that since her insurance provider 

did not have a physician specializing in occupational health and safety for federal employees, she 

was scheduled for an appointment with a regular physician, Dr. Romack. Appellant has the 

burden of proof, however, to establish her claim and OWCP notified her of the type of evidence 

 7 See Deborah L. Beatty, 54 ECAB 340 (2003) (where the Board found that, in the absence of a medical report 

providing a diagnosed condition and a reasoned opinion on causal relationship with the employment incident, 

appellant did not meet her burden of proof). 

8 See J.T., Docket No. 15-0196 (issued March 23, 2015); Lillian M. Jones, 34 ECAB 379 (1982). 

9 J.D., Docket No. 14-2061 (issued February 27, 2015). 

10 A.D., 58 ECAB 159 (2006) (medical evidence which does not offer any opinion regarding the cause of an 

employee’s condition is of limited probative value on the issue of causal relationship). 

11 5 U.S.C. § 8101(2); see R.S., Docket No. 16-1303 (issued December 2, 2016) (occupational therapists are not 

considered physicians as defined under FECA); J.J., Docket No. 15-0727 (issued July 16, 2015) (reports from an 

occupational therapist have no probative value as an occupational therapist is not a physician as defined under 

FECA). 

12 20 C.F.R. § 10.115(e); Phillip L. Barnes, 55 ECAB 426, 440 (2004). 
6

needed to establish her claim. Because she has not provided such medical opinion evidence in 

this case, she has failed to meet her burden of proof. 

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. 

LEGAL PRECEDENT -- ISSUE 2 

Section 8128 of FECA vests OWCP with a discretionary authority to determine whether 

it will review an award for or against compensation, either under its own authority or on 

application by a claimant.13 Section 10.608(b) of OWCP’s regulations provide that a timely 

request for reconsideration may be granted if OWCP determines that the claimant has presented 

evidence and/or argument that meet at least one of the standards described in section 

10.606(b)(3).14 This section provides that the application for reconsideration must be submitted 

in writing and set forth arguments and contain evidence that either: (1) shows that OWCP 

erroneously applied or interpreted a specific point of law; (2) advances a relevant legal argument 

not previously considered by OWCP; or (3) constitutes relevant and pertinent new evidence not 

previously considered by OWCP.15 Section 10.608(b) provides that when a request for 

reconsideration is timely, but fails to meet at least one of these three requirements, OWCP will 

deny the application for reconsideration without reopening the case for a review on the merits.16

ANALYSIS -- ISSUE 2 

OWCP issued a decision on October 14, 2016 denying appellant’s occupational disease 

claim, finding that the medical evidence did not contain a rationalized medical opinion 

explaining the causal relationship between the established employment factors and her diagnosed 

medical condition. On December 31, 2016 appellant requested reconsideration of this decision. 

Prior to her request for reconsideration on December 31, 2016 and after the issuance of OWCP’s 

decision on October 14, 2016, she submitted additional new medical evidence. Appellant 

submitted a February 12, 2016 laboratory report, which provided blood test results, 

Dr. Sodetani’s September 9 and October 7, 2016 progress notes, and an industrial work status 

report addressing appellant’s bilateral hand condition and disability from work. OWCP declined 

her request for reconsideration in a January 13, 2017 final nonmerit decision. It noted that no 

further evidence had been presented for review. 

The issue presented is whether appellant met any of the requirements of 20 C.F.R. 

§ 10.606(b)(3), requiring OWCP to reopen the case for review of the merits of the claim. 

 13 5 U.S.C. § 8128(a). 

14 20 C.F.R. § 10.608(a). 

15 Id. at § 10.606(b)(3). 

16 Id. at § 10.608(b). 
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The Board notes that the record is clear that OWCP received the February 12, 2016 

laboratory report and Dr. Sodetani’s September 9 and October 7, 2016 progress notes and 

industrial work status report prior to the issuance of its January 13, 2017 final nonmerit decision. 

OWCP, however, incorrectly determined in its January 13, 2017 decision denying appellant’s 

request for reconsideration of the merits of her claim that no new evidence was presented for 

review. 

FECA provides that OWCP shall determine and make findings of fact in making an 

award for or against payment of compensation after considering the claim presented by the 

employee and after completing such investigation as OWCP considers necessary with respect to 

the claim.17 Since the Board’s jurisdiction of a case is limited to reviewing that evidence which 

is before OWCP at the time of its final decision,18 it is necessary that OWCP review all evidence 

submitted by a claimant and received by OWCP prior to issuance of its final decision. As the 

Board’s decisions are final as to the subject matter appealed,19 it is crucial that all evidence 

relevant to that subject matter which was properly submitted to OWCP prior to the time of 

issuance of its final decision be addressed by OWCP.20 

The Board finds that OWCP improperly failed to consider all the relevant evidence 

submitted by appellant in denying her request for reconsideration of the merits of her claim 

pursuant to 5 U.S.C. § 8128(a). Therefore, the case is remanded to OWCP for consideration of 

the evidence she submitted in connection with her reconsideration request, to be followed by the 

issuance of an appropriate decision regarding her reconsideration request. 

CONCLUSION 

The Board finds that appellant has failed to meet her burden of proof to establish a 

bilateral hand condition causally related to factors of her federal employment. The Board further 

finds that OWCP did not consider all the evidence submitted by appellant before denying her 

request for reconsideration pursuant to 5 U.S.C. § 8128(a). The case is remanded to OWCP for 

consideration of the evidence appellant submitted in connection with her reconsideration request. 

 17 5 U.S.C. § 8124(a)(2). 

18 20 C.F.R. § 501.2(c). 

19 Id. at § 501.6(d). 

20 See E.P., Docket No. 14-0278 (issued February 26, 2014); see also William A. Couch, 41 ECAB 548, 

553 (1990). 
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ORDER 

IT IS HEREBY ORDERED THAT the October 14, 2016 decision of the Office of 

Workers’ Compensation Programs is affirmed. The January 13, 2017 decision of OWCP is set 

aside, and the case is remanded for further proceedings consistent with this decision of the 

Board. 

Issued: July 18, 2017 

Washington, DC 

 

 Christopher J. Godfrey, Chief Judge 

 Employees’ Compensation Appeals Board 

 

 Colleen Duffy Kiko, Judge 

 Employees’ Compensation Appeals Board 

 

 Alec J. Koromilas, Alternate Judge 

 Employees’ Compensation Appeals Board