United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

I.T., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

San Antonio, TX, Employer

__________________________________________

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Docket No. 18-1049

Issued: December 31, 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

PATRICIA H. FITZGERALD, Deputy Chief Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On April 26, 2018 appellant filed a timely appeal from February 15 and April 2, 2018 merit 

decisions 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

 

1 5 U.S.C. § 8101 et seq.

2 The Board notes that following OWCP’s decisions at issue, OWCP received additional evidence. However, the 

Board’s Rules of Procedure provides: “The Board’s review of a case is limited to the evidence in the case record that 

was before OWCP at the time of its final decision. Evidence not before OWCP will not be considered by the Board 

for the first time on appeal.” 20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this evidence for 

the first time on appeal. Id.
2

ISSUE

The issue is whether appellant has met her burden of proof to establish permanent 

impairment of a scheduled member, due to her accepted bilateral carpal tunnel syndrome, 

warranting a schedule award.

FACTUAL HISTORY

On March 7, 2013 appellant, then a 42-year-old rural carrier, filed an occupational disease 

claim (Form CA-2) alleging that she suffered from carpal tunnel syndrome and other tenosynovitis 

of the hand and wrist as a result of sorting, casing, loading, and delivering mail at work. She noted 

that she first became aware of her condition on February 21, 2013 and realized that it resulted from 

factors of her federal employment on October 29, 2012. Appellant stopped work on 

March 7, 2013. OWCP accepted her claim for bilateral carpal tunnel syndrome. It paid wage-loss 

compensation beginning March 7, 2013. 

On August 11, 2014 appellant returned to modified-duty work for four hours per day. She 

returned to full-time modified-duty work on March 13, 2015. 

On August 10, 2017 appellant filed a claim for a schedule award (Form CA-7).

3

By development letter dated August 24, 2017, OWCP advised appellant of the type of 

evidence needed to establish her schedule award claim. It requested that she provide an 

impairment rating in accordance with the sixth edition of the American Medical Association, 

Guides to the Evaluation of Permanent Impairment (A.M.A., Guides).4 It afforded appellant 30 

days to submit the requested information. 

In a September 22, 2017 report, Dr. Paul Chubb, an osteopathic physician who specializes 

in orthopedic hand surgery, discussed appellant’s history of injury and related that she still 

complained of pain and occasional numbness going down the left elbow into her hand. Upon 

physical examination of appellant’s left arm, he observed tenderness over the lateral condyle and 

proximal forearm over the radial tunnel. Range of motion was slow. Neurological and sensory 

examinations were intact. Dr. Chubb diagnosed bilateral elbow ulnar nerve entrapment and 

bilateral carpal tunnel syndrome. He completed duty status reports (CA-17 forms) dated 

August 25 and September 22, 2017 which indicated that appellant could work light duty. 

Appellant continued to seek treatment from Dr. Chubb. In reports dated October 31, 2017

to January 19, 2018, he related appellant’s complaints of continued numbness and tingling on the 

dorsum of her forearms and hands. Upon physical examination of appellant’s bilateral hands,

Dr. Chubb observed full range of motion of the digits and elbows. Neurological and sensory 

examinations were intact. Dr. Chubb diagnosed bilateral elbow ulnar nerve entrapment and 

bilateral carpal tunnel syndrome. In a November 28, 2017 report, he explained that he believed 

 

3 Appellant filed additional claims for a schedule award on November 6 and December 1, 2017. 

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

appellant’s carpal and cubital tunnel symptoms were resolved. Dr. Chubb opined that appellant’s 

forearm pain and tingling may be related to her spinal stenosis.

Dr. Chubb also completed an October 31, 2017 Form CA-17, which indicated that 

appellant could work light duty. In CA-17 forms dated November 28 and December 22, 2017, he 

related that appellant could work with no restrictions. 

OWCP received hospital records and operative reports dated March 20, 2017, which 

indicated that appellant underwent a right carpal tunnel release repair and cubital tunnel 

decompression surgery. 

A January 9, 2018 electromyography (EMG) and nerve conduction velocity (NCV) study 

report showed an essentially normal electrodiagnostic study of the left upper extremity. 

By decision dated February 15, 2018, OWCP denied appellant’s schedule award claim. It 

found that the medical evidence of record was insufficient to establish permanent impairment of a 

scheduled member as a result of her accepted bilateral carpal tunnel syndrome. OWCP noted that 

appellant did not submit evidence showing a measurable permanent impairment due to her 

accepted condition.

On March 5, 2018 appellant requested reconsideration. She related that she had a total of 

eight surgeries on her hands and noted that she was submitting a new EMG study. 

In a March 20, 2018 report, Dr. Chubb related that appellant still had symptoms of her 

fingertips and numbness throughout the left cubital tunnel. He reviewed appellant’s history and 

conducted an examination of appellant’s bilateral upper extremities. Dr. Chubb noted full range 

of motion and intact neurological examination. He diagnosed left arm numbness and tingling, 

bilateral ulnar nerve entrapment, and bilateral carpal tunnel syndrome. Dr. Chubb reported that 

appellant had recovered from her bilateral carpal tunnel syndrome, but still had work restrictions 

with regard to her back condition. 

OWCP also received several reports previously of record.

In a December 17, 2014 report, Dr. Hung Q. Vu, an orthopedic surgeon, indicated that 

appellant sustained a work-related injury of bilateral carpal tunnel syndrome and reviewed her 

history. Dr. Vu reported physical examination findings of decreased weakness in appellant’s right 

wrist. Neurological examination demonstrated decreased sensation and grip strength of both 

hands. Dr. Vu related that appellant could work with restrictions and completed a work capacity 

evaluation form (Form OWCP-5c). 

Appellant submitted health records and an operative report dated June 26, 2017, which 

indicated that appellant underwent left carpal tunnel release repair and left cubital tunnel 

decompression surgery. 

By decision dated April 2, 2018, OWCP denied modification of is February 15, 2018 

schedule award decision. It found that appellant had not submitted sufficient medical evidence to 

establish permanent impairment due to her accepted bilateral carpal tunnel condition. 
4

LEGAL PRECEDENT

The schedule award provisions of FECA5and its implementing regulations set forth the 

number of weeks of compensation payable to employees sustaining permanent impairment from 

loss or loss of use, of scheduled members or functions of the body. FECA, however, does not 

specify the manner in which the percentage of loss of a member shall be determined. The method 

used in making such determination is a matter which rests in the sound discretion of OWCP. For 

consistent results and to ensure equal justice, the Board has authorized the use of a single set of 

tables so that there may be uniform standards applicable to all claimants. The A.M.A., Guides has 

been adopted by OWCP as a standard for evaluation of schedule losses and the Board has 

concurred in such adoption.6 For schedule awards after May 1, 2009, the impairment is evaluated 

under the sixth edition of the A.M.A., Guides, published in 2009.7

The sixth edition of the A.M.A., Guides provides a diagnosis-based method of evaluation 

utilizing the World Health Organization’s International Classification of Functioning, Disability 

and Health (ICF).8 In addressing impairment for the upper extremities, the sixth edition of the 

A.M.A., Guides requires identifying the impairment class of diagnosis (CDX) condition, which is 

then adjusted by grade modifiers based on functional history (GMFH), physical examination

(GMPE), and clinical studies (GMCS).

9

 The net adjustment formula is (GMFH-CDX) + (GMPECDX) + (GMCS-CDX).10

Impairment due to carpal tunnel syndrome is evaluated under the scheme found in 

Table 15-23 (Entrapment/Compression Neuropathy Impairment) and accompanying relevant 

text.11 In Table 15-23, grade modifier levels (ranging from zero to four) are described for the 

categories of test findings, history, and physical findings. The grade modifier levels are averaged 

to arrive at the appropriate overall grade modifier level and to identify a default rating value. The 

default rating value may be modified up or down based on functional scale, an assessment of 

impact on daily living activities.12

 

5 5 U.S.C. § 8107.

6 20 C.F.R. § 10.404 (1999); see also Jacqueline S. Harris, 54 ECAB 139 (2002). 

7 Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, Chapter 

2.806.6.6a (March 2017); Federal (FECA) Procedure Manual, Part 3 -- Medical, Schedule Awards, Chapter 3.700.2 

and Exhibit 1 (January 2010).

8 A.M.A., Guides 3, section 1.3, The International Classification of Functioning, Disability and Health (ICF): A 

Contemporary Model of Disablement (6th ed. 2009).

9 A.M.A., Guides 385-419; see M.P., Docket No. 13-2087 (issued April 8, 2014).

10 Id. at 411.

11 Id. at 449.

12 Id. at 448-449.
5

It is the claimant’s burden of proof to establish permanent impairment of the scheduled 

member or function of the body as a result of an employment injury.13 OWCP procedures provide 

that, to support a schedule award, the file must contain competent medical evidence which shows 

that the impairment has reached a permanent and fixed state and indicates the date on which this 

occurred (date of MMI), describes the impairment in sufficient detail so that it can be visualized 

on review, and computes the percentage of impairment in accordance with the A.M.A., Guides.14

ANALYSIS 

The Board finds that appellant has not met her burden of proof to establish permanent 

impairment of a scheduled member, due to her accepted bilateral carpal tunnel syndrome, 

warranting a schedule award. 

In support of her claim, appellant submitted several reports by Dr. Chubb dated 

September 22, 2017 to March 20, 2018. Dr. Chubb reviewed appellant’s history of injury and 

provided physical examination findings. He diagnosed left arm numbness and tingling, bilateral 

ulnar nerve entrapment, and bilateral carpal tunnel syndrome. In a November 28, 2017 report,

Dr. Chubb opined that appellant’s carpal and cubital tunnel symptoms had resolved and indicated 

that appellant could work full duty. He, however, did not provide a date of maximum medical 

improvement nor address permanent impairment pursuant to the A.M.A., Guides. Dr. Chubb did 

not reach a conclusion with regard to appellant’s permanent impairment due to her accepted 

bilateral carpal tunnel condition. These reports, therefore, do not establish permanent impairment 

of a scheduled member or function of the body causally related to her accepted bilateral carpal 

tunnel syndrome.15 Likewise, the January 9, 2018 EMG/NCV study report and hospital records 

and operative reports dated March 20 and June 26, 2017 also do not contain a conclusion or an 

opinion with regard to appellant’s permanent impairment. As none of these physicians provided 

an estimate of impairment to appellant’s upper extremities, their reports are insufficient to establish 

appellant’s schedule award claim.16

As noted above, OWCP procedures provide that to support a schedule award, the file must 

contain medical evidence which shows that the impairment has reached a permanent and fixed 

state, indicates the date on which this occurred, describes the impairment in sufficient detail so 

that it can be visualized on review, and computes the percentage of permanent impairment in 

accordance with the A.M.A., Guides.

17

 The Board finds that in this case there is no current medical 

report of record that provides an impairment rating. Accordingly, there is no medical evidence 

warranting a schedule award.

 

13 Tammy L. Meehan, 53 ECAB 229 (2001).

14 Federal (FECA) Procedure Manual, Part 2 -- Claims, Schedule Awards and Permanent Disability Claims, Chapter 

2.808.5 (March 2017).

15 See M.M., Docket No. 18-0292 (issued July 9, 2018).

16 20 C.F.R. § 10.404 (1999); see also Jacqueline S. Harris, 54 ECAB 139 (2002).

17 Supra note 14.
6

Appellant may request a schedule award or increased schedule award at any time based on 

evidence of a new exposure or medical evidence showing progression of an employment-related 

condition resulting in permanent impairment or increased impairment.

CONCLUSION

The Board finds that appellant has not met her burden of proof to establish permanent 

impairment of a scheduled member, due to her accepted bilateral carpal tunnel syndrome, 

warranting a schedule award. 

ORDER

IT IS HEREBY ORDERED THAT the April 2 and February 15, 2018 merit decisions of 

the Office of Workers’ Compensation Programs are affirmed.

Issued: December 31, 2018

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board