United States Department of Labor

Employees’ Compensation Appeals Board

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E.H., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Elizabeth, CO, Employer

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Docket No. 17-1402

Issued: November 8, 2017

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

COLLEEN DUFFY KIKO, Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On June 12, 2017 appellant, filed a timely appeal of a May 15, 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 OWCP properly terminated compensation for wage loss effective 

May 14, 2017. 

FACTUAL HISTORY

On December 29, 2015 appellant, then a 69-year-old postmaster, filed an occupational 

disease claim (Form CA-2), asserting that she developed a strain as a result of repetitive motions 

 

1

5 U.S.C. § 8101 et seq.
2

of grasping and casing mail over the years. She first became aware of her illness and realized it 

was causally related to factors of her federal employment on July 1, 2010. 

Appellant was treated by Dr. Daniel R. Henley, a Board-certified family practitioner, on 

December 2, 2015, for chronic left thumb pain over several years. Dr. Henley diagnosed pain in 

the thumb and osteoarthritis of the knee and recommended a thumb brace.

Appellant came under the treatment of Dr. Karl M. Larsen, a Board-certified orthopedist, 

on December 14, 2015, for chronic left thumb-base pain. She related her condition to working 

for the employing establishment for 34 years. Appellant managed her condition with thumb 

spica braces. Dr. Larsen noted findings on examination of an obvious shoulder sign to the left

thumb, normal capillary refill in the digits, normal gross sensation to light touch in the pads of 

the digits, she could achieve full fist, full digital extension, abnormal tenderness over the thumb 

carpometacarpal (CMC) joint, positive CMC joint grind test, unstable metacarpophalangeal

(MCP) joint, and negative Tinel’s sign over the superficial radial nerve distribution. Dr. Larsen 

noted x-rays of the thumb, lateral wrist, and hyperpronated thumb revealed severe thumb CMC 

arthritis with subluxation and erosion of the radial margin and the trapezium. He diagnosed 

thumb CMC osteoarthritis and likely associated carpal tunnel syndrome. Dr. Larsen provided a 

corticosteroid injection. 

On February 22, 2016 OWCP denied the claim finding that appellant had submitted 

insufficient medical evidence to establish causal relationship.

Appellant requested reconsideration on March 13, 2016 and continued to submit medical 

evidence. In a March 2, 2016 report, Dr. Larsen indicated that the diagnosed thumb-base 

arthritis with associated MCP joint instability and carpal tunnel syndrome on the left side was 

causally related to her employment. He opined that appellant’s repeated gripping, grasping, and 

pinching activities at work, holding packets of mail, and boxing mail, aggravated her arthritic

condition to the point where she required treatment earlier than would otherwise be required 

absent these work activities. Dr. Larsen advised that she failed reasonable nonsurgical treatment 

including corticosteroid injections and bracing, and he recommended surgical intervention. In a 

March 2, 2016 return to work slip, he noted that appellant was undergoing left hand surgery on 

March 15, 2016 and would be incapacitated for 12 to 16 weeks. Appellant stopped work on 

March 2, 2016 to undergo surgery

In an operative report dated March 15, 2016, Dr. Larsen performed a left thumb CMC

arthroplasty, left thumb MCP joint arthrodesis, and left carpal tunnel release. He diagnosed left 

thumb carpometacarpal osteoarthritis with MCP joint instability and left carpal tunnel syndrome.

On April 25, 2016 Dr. Larsen treated appellant in follow-up postsurgery and noted findings of 

solid and nontender arthrodesis, stable thumb base, and normal sensation to light touch in the 

pads of the digits. He indicated that x-rays of the thumb revealed solidifying arthrodesis with no 

hardware issues. Dr. Larsen opined that appellant was doing well and he recommended physical 

therapy. On June 6, 2016 he treated appellant in follow-up and appellant reported burning 

discomfort over her dorsal thumb MCP joint. Dr. Larsen noted findings of stable MCP 

arthrodesis, stable CMC arthroplasty, tenderness over her fixation hardware with mild cutaneous 

hypersensitivity. He noted x-rays of the left hand revealed the arthrodesis was solidifying nicely 

with no changes in her hardware. Dr. Larsen advised that appellant developed some 
3

hypersensitivity over the digit and appears to be having irritation from her hardware. He noted 

that it was too early to consider hardware removal and recommended observation.

On May 5, 2016 OWCP accepted temporary aggravation of osteoarthritis of the first 

CMC joint of the left hand. It advised appellant as to how she could claim wage-loss 

compensation.2 OWCP noted that carpal tunnel syndrome was not accepted.

In a letter dated June 22, 2016, OWCP requested appellant provide a periodic medical 

report from her treating physician addressing whether the work-related condition was resolved.

On July 14, 2016 appellant indicated that she was using her own sick leave and personal 

insurance to cover her work injury and she received no compensation for her claim.3

In a report dated August 3, 2016, Dr. Larsen treated appellant in follow-up for left thumb 

CMC arthroplasty and MCP arthrodesis. He noted that appellant was doing very well and her 

thumb sensitivity improved. Dr. Larsen indicated that appellant’s motion improved and she was 

starting to use her hand more normally. He noted findings of nontender arthrodesis, some 

sensitivity in the dorsal skin flap, localized over the proximal fixation hardware, and stable

thumb base which was painless to stress. Dr. Larsen noted x-rays of the left thumb revealed a 

solid arthrodesis, no hardware issue and a well-preserved trapezial resection space. He noted 

that appellant’s sensitivity over the hardware improved and he released appellant from his care. 

In a return to work slip dated August 3, 2016, Dr. Larsen returned appellant to work without 

restrictions.4

In a statement dated August 18, 2016 and an e-mail dated August 22, 2016, appellant 

indicated that she submitted new medical treatment documentation and a request for leave under 

the Family Medical Leave Act (FMLA).

In an OWCP telephone log, the employing establishment indicated that appellant had 

taken sick leave since full-duty release on August 3, 2016. It indicated that appellant would be 

retiring effective September 30, 2016.

Appellant underwent physical therapy for her left thumb from April 26 to May 27, 2016. 

Appellant submitted an earlier report from Dr. Larsen dated March 2, 2016 who treated 

her for left thumb CMC arthritis with MCP instability and carpal tunnel syndrome. Dr. Larsen

noted that the corticosteroid injection provided only temporary relief. He noted findings of 

hyperextension and abduction instability of the thumb MCP joint, abnormal tenderness of the 

thumb CMC joint, with positive grind test. Dr. Larsen noted that appellant had persistent 

 

2 OWCP subsequently authorized the March 15, 2016 surgery. 

3 The record does not indicate that appellant has claimed wage-loss compensation for any period that may have 

been necessitated by the accepted condition or the authorized surgery. 

4 Appellant also submitted July 12 and August 16, 2016 reports from Dr. Kyle Schauf, a Board-certified family 

practitioner, who treated her for back pain, hypertension, hyperlipidemia, and left-sided thoracic pain and spasm. 

On August 4, 2016 Dr. Henley treated appellant for thoracic back pain and radiculopathy.
4

symptoms due to thumb-base arthritis, associated MCP instability, numbness, and tingling 

consistent with carpal tunnel syndrome. He recommended a CMC arthroplasty with MCP 

arthrodesis and carpal tunnel release. Dr. Larsen opined that appellant’s arthritis, while 

potentially preexisting or associated with normal aging process, had been aggravated during her 

work activities to the point where she was required treatment earlier than she might have 

otherwise required. On March 28, 2016 he treated appellant status post left thumb surgery and 

noted findings on examination of improved numbness and tingling, intact sensation, the incisions 

were clean and dry without evidence of infection, and a stable thumb base. Dr. Larsen diagnosed 

two weeks’ status post left thumb CMC arthroplasty, MCP arthrodesis, and carpal tunnel release. 

In a note dated April 25, 2016, he diagnosed left thumb CMC arthroplasty, MCP arthrodesis and 

referred appellant for physical therapy twice a week for six weeks and for hand and forearm 

splints. In a report dated May 20, 2016, Dr. Larsen opined that appellant had permanent 

aggravation of her thumb-base arthritis associated with her work activities. He noted that this 

was not a discrete event but spanned more than 30 years of gripping and pinching activities 

performed in the course of her work activities. Dr. Larsen further noted that the arthritis 

progressed and she had developed secondary instability of the MCP joint that required 

arthrodesis and associated carpal tunnel syndrome. He advised that the requirement for 

treatment in the form of surgery with CMC arthroplasty, MCP joint arthrodesis and carpal tunnel 

release was a direct result of the unrelenting pinching and gripping activities spent across a long 

career.

On March 2, 2017 OWCP proposed to terminate all benefits finding that the August 3, 

2016 report of appellant’s treating physician Dr. Larsen established no continuing residuals of 

her work-related conditions.

In a statement dated March 14, 2017, appellant indicated that her date of retirement from 

the employing establishment was September 30, 2016. She indicated that she never received any 

compensation from OWCP for her claim. Appellant submitted a report from Dr. Larsen dated 

August 3, 2016 and a return to work slip from Dr. Larsen dated August 3, 2016, both previously 

of record. 

In a decision dated May 15, 2017, OWCP terminated appellant’s eligibility for wage-loss

compensation benefits effective May 14, 2017. It based its decision on the August 3, 2016 report 

of Dr. Larsen, appellant’s treating physician, who opined that appellant’s accepted work-related 

conditions had resolved without residuals, and that she could return to work without restrictions. 

OWCP did not terminate medical benefits.

LEGAL PRECEDENT

Once OWCP accepts a claim it has the burden of justifying modification or termination 

of an employee’s benefits. After it has determined that an employee has disability causally 

related to his or her federal employment, it may not terminate compensation without establishing 

that the disability ceased or that it was no longer related to the employment.5

 

5 Kenneth R. Burrow, 55 ECAB 157 (2003). 
5

ANALYSIS

OWCP accepted appellant’s claim for temporary aggravation of osteoarthritis of the first 

CMC joint of the left hand and authorized left thumb CMC arthroplasty, left thumb MCP joint 

arthrodesis, and left carpal tunnel release which was performed on March 15, 2016. Appellant 

stopped work on March 2, 2016 to undergo surgery and was released to work without restrictions 

on August 3, 2016. She retired on September 30, 2016. 

Appellant submitted reports from Dr. Larsen in March 2016 supporting that she had an 

employment-related condition. On March 15, 2016 Dr. Larsen performed a left thumb CMC

arthroplasty, left thumb MCP joint arthrodesis, and left carpal tunnel release. He diagnosed left 

thumb CMC osteoarthritis with MCP joint instability and left carpal tunnel syndrome. Appellant 

underwent physical therapy from April 26 to May 27, 2016. In his report of August 3, 2016,

Dr. Larsen continued to treat appellant and noted that she was doing very well and her thumb 

sensitivity improved. He indicated that appellant had improved motion and was starting to use 

her hand more normally. Dr. Larsen noted findings of nontender arthrodesis, some sensitivity in 

the dorsal skin flap, localized over the proximal fixation hardware, and stable thumb base which 

was painless to stress. He noted x-rays of the left thumb revealed a solid arthrodesis, no 

hardware issue, and a well-preserved trapezial resection space. Dr. Larsen noted that appellant’s 

sensitivity over the hardware improved and he released appellant from his care. In a return to 

work slip dated August 3, 2016, he returned appellant to work without restrictions.

The Board finds that the opinion of Dr. Larsen, the treating physician, represents the 

weight of the evidence and establishes that any work-related disability had resolved by 

May 14, 2017. He indicated that appellant did not have residuals from the condition of

temporary aggravation of osteoarthritis of the first CMC joint of the left hand and that she could 

return to her regular duties. There is no contemporaneous or subsequent medical evidence 

supporting appellant’s claim for continuing disability or residuals of the accepted condition.

6

 

For these reasons, OWCP met its burden of proof to terminate appellant’s eligibility for 

wage-loss benefits for her accepted conditions.

On appeal appellant asserts that she never received any monetary compensation from 

OWCP for her accepted employment injury. The record before the Board does indicate that she 

never claimed wage-loss compensation for any disability attributable to her accepted condition

prior to the termination of wage-loss benefits. As explained, however, the Board finds that the

August 3, 2016 report from Dr. Larsen supports OWCP’s finding that appellant was not 

entitlement to wage-loss compensation causally related to her accepted condition after 

May 14, 2017. There is no other evidence to support continuing disability.

 

6 As indicated, supra note 4, appellant also submitted July 12 and August 16, 2016 reports from Drs. Schauf and 

Henley, who treated her for back conditions, radiculopathy, and hypertension. However, OWCP has not accepted

these other conditions. 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; see Alice J. Tysinger, 

51 ECAB 638 (2000).
6

CONCLUSION

The Board finds that OWCP has met its burden of proof to terminate wage-loss benefits 

effective May 14, 2017.

ORDER

IT IS HEREBY ORDERED THAT the May 15, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: November 8, 2017

Washington, DC

Colleen Duffy Kiko, Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board