United States Department of Labor 

Employees’ Compensation Appeals Board 

__________________________________________ 

R.H., Appellant 

and 

U.S. POSTAL SERVICE, POST OFFICE, 

Cleveland, OH, Employer 

__________________________________________ 

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Docket No. 17-1141 

Issued: September 21, 2017 

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

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 May 2, 2017 appellant, through counsel, filed a timely appeal from a March 1, 2017 

merit decision of the Office of Workers’ Compensation Programs (OWCP). Pursuant to the 

Federal Employees’ Compensation Act2

 (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 an occupational disease causally related to the 

accepted factors of his federal employment. 

 1

 In all cases in which a representative has been authorized in a matter before the Board, no claim for a fee for 

legal or other service performed on appeal before the Board is valid unless approved by the Board. 20 C.F.R. 

§ 501.9(e). No contract for a stipulated fee or on a contingent fee basis will be approved by the Board. Id. An 

attorney or representative’s collection of a fee without the Board’s approval may constitute a misdemeanor, subject 

to fine or imprisonment for up to one year or both. Id.; see also 18 U.S.C. § 292. Demands for payment of fees to a 

representative, prior to approval by the Board, may be reported to appropriate authorities for investigation. 

2

 5 U.S.C. § 8101 et seq. 
2

On appeal counsel contends that appellant has submitted probative evidence such that his 

claim should be allowed. He also contends that appellant was “getting whipsawed between 

[appellant’s] two claims.” 

FACTUAL HISTORY 

On June 3, 2016 appellant, then a 53-year-old electronic technician, filed an occupational 

disease claim (Form CA-2) alleging that he suffered pain in his right wrist, forearm, and elbow 

as a result of the duties of his federal employment. He noted that he first became aware of the 

disease on July 17, 2000 and first became aware of its relationship to his employment on 

July 30, 2014. On the claim form, appellant explained his delay in filing the claim as “I thought 

the original claim was still in effect.”3 

In an October 12, 2015 progress note, Dr. Harry A. Hoyen, a Board-certified orthopedic 

surgeon specializing in hand surgery, diagnosed pseudofolliculitis, open fracture of proximal 

radius, ulnar nerve lesion, carpal tunnel syndrome, scar and fibrosis of skin, alopecia areata, and 

pain in limb. On the same date, he reviewed an x-ray of the right forearm and wrist and found 

mild residual deformity of the distal radial and ulnar shaft-metadiaphysis due to remote, 

well-healed fractures. Dr. Hoyen also noted mild osteopenia. 

In an October 12, 2015 progress note, Dr. Michael W. Keith, a Board-certified orthopedic 

surgeon specializing in hand surgery, noted that appellant had been his patient for 15 years. He 

noted that he reconstructed appellant’s forearm many years ago. Dr. Keith noted that appellant 

made it through at work despite some deformity and issues with his wrist, but that it was now 

becoming a bit excessive and that he was considering a change in position due to the level of 

function and the repetitive nature of his job. 

In an October 16, 2015 note, Dr. David R. Crowe, a Board-certified dermatologist, noted 

that he saw and evaluated appellant on that day. 

In a December 28, 2015 progress report, Dr. Hoyen noted a follow-up and listed 

numerous problems, including pain in limb, ulnar nerve lesion, carpal tunnel syndrome, 

pseudofolliculitis, and resolved open fracture of the proximal radius. He noted that the majority 

of appellant’s symptoms were over the dorsal aspect of the wrist, and were worse with activity, 

especially the repetitive nature of his work. Dr. Hoyen recommended a functional capacity 

evaluation to help guide him in reaching a conclusion concerning appellant’s restrictions. 

In a March 1, 2016 statement, appellant indicated that he had experienced soreness in his 

right forearm, wrist, and elbow, as a well as a popping sensation since the middle to latter part of 

2014. He noted that the pain in his elbow had been present since the latter part of January 2016, 

 3

 Appellant had previously filed a claim wherein he alleged that on July 17, 2000 he got his right arm caught 

between the roller and conveyer frame of a belt. This claim was assigned File No. xxxxxx543. OWCP accepted his 

traumatic injury claim for open fracture of the right radius, open reduction right radius/ulna, fasiotomy of the right 

volar compartment, and keloid scarring right forearm. Appellant stopped work on the date of injury and returned to 

limited-duty work on June 22, 2001. He was off work again on July 15 and 16, 2002. OWCP found that appellant 

had 23 percent permanent impairment of the right arm and paid a schedule award for the period November 5, 2003 

to April 27, 2004. 
3

and the itching had been present for over five years. Appellant contended that the present 

symptoms coincided with the exact area that was involved in the accepted employment injury 

and the same area where multiple surgeries had been performed, and that he therefore believed 

that the accepted employment injury was directly related to his present symptoms. He contended 

that, as a result of his arm being pulled into a conveyer belt up to his elbow, the tendons 

and ligaments in that area were weakened and this was responsible for his present symptoms. 

Appellant contended that he had a loss of strength in his right arm which made performing his 

job difficult. He described the duties of his work, which included the frequent use of hand tools 

in order to loosen screws, bolts, and nuts, and using extreme force to pull new belts over rollers. 

Appellant contended that he was not totally disabled from all work, but that there were certain 

tasks that should be eliminated from his job duties. 

By letter dated June 13, 2016, OWCP informed appellant that further information was 

necessary to support his claim. Appellant was afforded 30 days to submit the necessary 

evidence. 

By letter dated July 5, 2016, the employing establishment controverted the claim based 

on causal relationship and timeliness. In a separate letter of the same date, the human resources 

specialist for the employing establishment noted that the medical documentation provided a 

diagnosis of pseudofollicultiis, but did not provide medical rationale explaining how this illness 

was causally related to appellant’s employment. She argued that findings of pain absent 

explanatory medical evidence supporting how and why the underlying medical conditions were 

caused by or affected by work activities is insufficient to establish fact of injury. 

In a February 6, 2016 note, Dr. Peter J. Greco, an internist, indicated that he treated 

appellant and had provided stretching exercises for him. 

In an April 8, 2016 letter to appellant, in File No. xxxxxx543, OWCP noted that he was 

now claiming a need for additional medical care due to the July 17, 2000 work-related injury, but 

that, according to the evidence received, he was claiming a new injury and should therefore file a 

new claim for an occupational disease. 

By decision dated August 31, 2016, OWCP denied appellant’s claim. It determined that 

he had timely filed his claim, but found that he had not submitted information sufficient to 

establish that the employment events occurred as alleged. OWCP also noted that appellant had 

not established a diagnosed medical condition causally related to an alleged employment event. 

By letter received by OWCP on December 2, 2016, appellant, through counsel, requested 

reconsideration. Counsel resubmitted the October 12, 2015 report from Dr. Keith. 

In a January 27, 2017 internal memorandum, OWCP recommended doubling this case 

with File No. xxxxxx543 for case management purposes. It noted that there was pertinent 

evidence in File No. xxxxxx543 that had not been considered. 

By decision dated March 1, 2017, OWCP determined that the evidence was sufficient to 

modify the August 31, 2016 decision. It determined that the evidence supporting the factual 

component of the fact of injury for appellant’s occupational disease claim was submitted under 

File No. xxxxxx543. After reviewing this evidence, OWCP determined that, although the 
4

evidence was sufficient to support the factual component of fact of injury, the claim remained 

denied because the evidence of record failed to establish a causal relationship between 

appellant’s work exposure and a diagnosed medical condition. 

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 the 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.4 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.5

 

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 must include 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.6

 

ANALYSIS 

In File No. xxxxxx543, OWCP accepted that on July 17, 2000 appellant sustained an 

employment-related fracture of the right radius, open reduction right radius/ulna, fasiotomy of 

the right volar compartment, and keloid scarring of the right forearm. It issued a schedule award 

for 23 percent impairment of the right arm. That case remains open for medical benefits. In the 

instant case, appellant filed a claim for pain in his right wrist, forearm, and elbow as a result of 

the duties of his employment. OWCP accepted that he filed a timely occupational disease claim 

and that he experienced the employment factors alleged, but denied his case as he failed to 

establish a causal relationship between his work exposure and a diagnosed medical condition. 

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

5 See Irene St. John, 50 ECAB 521 (1999). 

6 Id. 
5

The Board finds that appellant failed to establish his occupational disease claim as the 

medical evidence of record does not establish a causal relationship between the accepted 

employment factors and a medical diagnosis. 

Dr. Hoyen noted diagnoses of mild osteopenia and pseudofolliculitis, ulnar nerve lesion, 

carpal tunnel syndrome, as well as appellant’s prior fracture of the proximal radius. Although he 

noted that appellant’s symptoms were made worse with the repetitive nature of his employment, 

he did not provide a well-rationalized explanation on causal relationship. A mere conclusion 

without the necessary rationale explaining how and why the physician believes that a claimant’s 

accepted exposure resulted in a diagnosed condition is insufficient to meet appellant’s burden of 

proof.7 

Dr. Keith discussed his treatment and noted that he had reconstructed appellant’s forearm 

many years ago. He noted that appellant was considering a change in position, and he did note 

the repetitive nature of appellant’s job, but he never provided a clear conclusion with regard to 

causal relationship supported by rationalized medical opinion. Dr. Keith’s report is therefore of 

limited probative value as it failed to provide a sufficient explanation as to the mechanism of 

injury pertaining to this occupational disease claim.8

 

Dr. Crowe merely indicated in his report that he agreed with an undated, unspecified 

medical report, while Dr. Greco indicated that he gave appellant stretching exercises. Neither 

provided any explanation with regard to a medical diagnosis caused by appellant’s employment. 

The Board has held that medical evidence that does not offer any opinion regarding the cause of 

an employee’s condition is of limited probative value.9

An award of compensation may not be based on surmise, conjecture, speculation, or on 

the employee’s own belief of causal relation.10 Appellant’s belief that the duties of his federal 

employment caused his injury is not in question, but that belief, however, sincerely held, does 

not constitute medical evidence sufficient to establish causal relationship.11 

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 did not establish an occupational disease causally related 

to the accepted factors of his federal employment. 

 7 G.M., Docket No. 14-2057 (issued May 12, 2015). 

8 See P.P., Docket No. 17-0483 (issued June 13, 2017). 

9 C.B., Docket No. 09-2027 (issued May 12, 2010); S.E., Docket No. 08-2214 (issued May 6, 2009). 

10 D.D., 57 ECAB 734 (2006). 

11 P.S., Docket No. 17-0598 (issued June 23, 2017). 
6

ORDER 

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

Compensation Programs dated March 1, 2017 is affirmed. 

Issued: September 21, 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