United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

V.R., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Cleveland, OH, Employer

__________________________________________

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Docket No. 18-0118

Issued: April 19, 2018

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

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On October 20, 2017 appellant, through counsel, filed a timely appeal from a July 20, 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 over the merits of this case.

 

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

ISSUE

The issue is whether appellant has more than five percent permanent impairment of the left 

upper extremity and five percent permanent impairment of the right upper extremity, for which 

she has previously received schedule awards. 

FACTUAL HISTORY

On August 25, 2005 appellant, then a 42-year-old mail handler, filed an occupational 

disease claim (Form CA-2) alleging that she developed bilateral carpal tunnel syndrome (CTS) as 

a result of her repetitive employment duties of grasping, taping mail together, and placing mail in 

envelopes. By decision dated November 21, 2005, OWCP accepted the claim for bilateral CTS. 

It subsequently expanded acceptance of the claim to include acquired bilateral trigger finger. 

On May 24, 2006 appellant stopped work and underwent authorized right carpal tunnel 

surgery. On January 24, 2007 she underwent authorized left carpal tunnel surgery. Appellant 

received wage-loss compensation for total disability and she returned to work in a full-time 

limited-duty capacity on April 20, 2007. 

On January 24, 2008 appellant filed a claim for a schedule award (Form CA-7).

In an April 10, 2008 report, Dr. Robert Leb, a Board-certified orthopedic surgeon and 

appellant’s attending physician, reported that she had reached maximum medical improvement 

(MMI). He noted a May 16, 2008 electromyography (EMG) and nerve conduction velocity (NCV) 

study which revealed bilateral median neuropathies at or distal to the wrist CTS with the right 

being greater than the left. In accordance with the fifth edition of the American Medical 

Association, Guides to the Evaluation of Permanent Impairment (A.M.A., Guides) (5th ed. 2001),

Dr. Leb determined that appellant sustained five percent permanent impairment of the left upper 

extremity and five percent permanent impairment of the right upper extremity due to her bilateral 

CTS. 

In a July 25, 2008 medical report, Dr. Anthony Skalak, a Board-certified orthopedic 

surgeon serving as an OWCP district medical adviser (DMA), reviewed Dr. Leb’s April 10, 2008 

report and agreed with his impairment rating finding five percent permanent impairment of the left 

upper extremity and five percent permanent impairment of the right upper extremity due to 

bilateral CTS. Dr. Skalak noted that he did not find a ratable impairment based on physical 

examination as appellant did not demonstrate objective findings of sensory, motor, or range of 

motion deficit. However, as appellant was status post bilateral carpal tunnel release and the 

May 16, 2008 EMG/NCV study revealed persistent bilateral median neuropathies at or distal to 

the wrist, the left and the right upper extremity warranted five percent permanent impairment each. 

By decision dated December 15, 2008, OWCP granted a schedule award for five percent 

permanent impairment of the left upper extremity and five percent permanent impairment of the 

right upper extremity. The date of MMI was reported as April 10, 2008.

On February 23, 2016 appellant filed another Form CA-7 requesting an increased schedule 

award. 
3

In a March 24, 2015 medical report, Dr. Leb diagnosed left thumb trigger finger and left 

thumb stenosing tenosynovitis. In an October 19, 2015 medical note, he reported that appellant 

reached MMI for her left thumb trigger finger. 

By development letter dated March 11, 2016, OWCP requested that appellant submit an 

impairment evaluation from her attending physician in accordance with the A.M.A., Guides.

3

 

In support of her schedule award claim, appellant submitted a March 5, 2016 impairment 

rating from Dr. Catherine Watkins Campbell, Board-certified in occupational and family 

medicine. Dr. Watkins Campbell reported evaluating appellant on January 5, 2016 and noted the

accepted conditions of bilateral CTS and bilateral trigger finger. She identified a prior schedule 

award for five percent permanent impairment of the left upper extremity and five percent

permanent impairment of the right upper extremity which were calculated using the fifth edition 

of the A.M.A., Guides. Dr. Watkins Campbell reported that appellant reached MMI for her 

bilateral CTS on April 10, 2008 and MMI for the left trigger thumb on October 30, 2015. She 

discussed a May 16, 2008 EMG study which provided qualification for rating nerve entrapment 

with evidence of prolonged latency sensory and motor on the right. With respect to appellant’s 

right CTS, Dr. Watkins Campbell utilized Table 15-23, Entrapment/Compression Neuropathy 

Impairment, of the sixth edition of the A.M.A., Guides.

4

 She determined that test findings resulted 

in a grade 1 modifier, history resulted in a grade 1 modifier, and physical findings of decreased 

sensation resulting in a grade 2 modifier. The grade modifiers averaged 1.33 for a grade 1 

modifier. Appellant’s QuickDASH score of 54 was in the moderate range, resulting in a three 

percent permanent impairment of the right upper extremity. Dr. Watkins Campbell further 

determined that appellant sustained zero percent permanent impairment of the left upper extremity 

for CTS. She provided physical examination findings for the left wrist and explained that 

appellant’s EMG study did not show any sensory or motor latency loss on the left, therefore nerve 

entrapment was not established. Dr. Watkins Campbell also found no permanent impairment of 

the left trigger thumb based on Table 15-2 for digital stenosing tenosynovitis.5

On October 12, 2016 OWCP routed Dr. Watkins Campbell’s report, a statement of 

accepted facts (SOAF), and the case file to Dr. Arthur S. Harris, a Board-certified orthopedic 

surgeon serving as an OWCP DMA, for review and determination regarding whether appellant 

sustained a permanent partial impairment and date of MMI in accordance with the sixth edition of 

the A.M.A., Guides. 

In an October 13, 2016 medical report, Dr. Harris reported that he reviewed Dr. Watkins 

Campbell’s evaluation and determined that appellant reached MMI on January 5, 2016. He further 

agreed with her impairment rating for three percent right upper extremity impairment due to

residual problems with mild CTS. Dr. Harris also reported that appellant sustained zero percent 

impairment of the left upper extremity. 

 

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

4

Id. at 449, Table 15-23

5

Id. at 391.
4

On October 21, 2016 OWCP requested that the DMA provide an addendum report. It 

informed him that appellant had previously been awarded a schedule award for five percent right 

upper extremity impairment and five percent left upper extremity impairment. OWCP requested 

clarification regarding whether his impairment rating included the prior percentage awarded or if 

it should be considered an addition to the prior percentage awarded. 

In an October 24, 2016 report, Dr. Harris reported that there had been no increase in 

appellant’s right upper extremity or left upper extremity impairment other than that which was 

previously awarded. 

By decision dated November 2, 2016, OWCP found that appellant failed to establish that 

she had impairments of the right upper extremity and left upper extremity greater than the five

percent previously awarded. The date of MMI was noted as January 5, 2016. OWCP found that 

the current medical evidence established that appellant was entitled to three percent permanent 

impairment of the right upper extremity and zero percent permanent impairment of the left upper 

extremity. As appellant had previously received an award for five percent impairment of the each

upper extremity, the medical evidence of record did not support an increase in the impairment 

already compensated. OWCP further noted that there was no overpayment issue regarding her 

claim as her previous impairment was calculated based on the fifth edition of the A.M.A., Guides 

while her current impairment rating was based on the sixth edition. 

On November 10, 2016 appellant, through counsel, requested an oral hearing before an 

OWCP hearing representative. 

A hearing was held on June 1, 2017. Counsel for appellant argued that her schedule award 

should be calculated using the fifth edition of the A.M.A., Guides which would establish a 

worsening of her condition and a higher impairment rating. He further stated that she was entitled 

to an additional award for three percent permanent impairment of the right upper extremity. 

By decision dated July 20, 2017, an OWCP hearing representative affirmed the 

November 2, 2016 decision finding that the medical evidence of record failed to establish that 

appellant was entitled to more than the five percent permanent impairment of each upper extremity

previously awarded. 

LEGAL PRECEDENT

The schedule award provision of FECA and 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.6 However, FECA does not 

specify the manner in which the percentage of loss shall be determined. For consistent results and 

to ensure equal justice under the law to all claimants, good administrative practice necessitates the 

use of a single set of tables so that there may be uniform standards applicable to all claimants. 

 

6 5 U.S.C. § 8107; 20 C.F.R. § 10.404.
5

Through its implementing regulations, OWCP adopted the A.M.A., Guides as the appropriate 

standard for evaluating schedule losses.7 

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

of the A.M.A., Guides (2009).8 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.9

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).10 Under the sixth edition, the evaluator identifies the impairment Class of 

Diagnosis (CDX), which is then adjusted by grade modifiers based on Functional History 

(GMFH), Physical Examination (GMPE), and Clinical Studies (GMCS).

11

 The net adjustment 

formula is (GMFH - CDX) + (GMPE - CDX) + (GMCS - CDX).

It is the claimant’s burden of proof to establish that he or she has sustained a permanent 

impairment of the scheduled member or function as a result of any employment injury.

12

 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.

13

 

ANALYSIS

The Board finds that appellant has not established that she has more than five percent 

permanent impairment of either upper extremity, for which she previously received schedule 

awards.

14

 

On December 15, 2008 OWCP granted appellant schedule awards for five percent

permanent impairment of each upper extremity for her bilateral CTS. The date of MMI was noted 

 

7 20 C.F.R. § 10.404. See also Ronald R. Kraynak, 53 ECAB 130 (2001).

8 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 (March 2017). 

9

Isidoro Rivera, 12 ECAB 348 (1961).

10 A.M.A., Guides (6th ed. 2009), page 3, section 1.3, The International Classification of Functioning, Disability 

and Health (ICF): A Contemporary Model of Disablement.

11 Id. at 411. 

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

13 Supra note 8 at Chapter 2.808.5 (March 2017).

14 W.R., Docket No. 13-0492 (issued June 26, 2013).
6

as April 10, 2008 and the schedule awards were calculated in accordance with the fifth edition of 

the A.M.A., Guides.

On February 23, 2016 appellant filed another Form CA-7 requesting an increased schedule 

award and submitted Dr. Watkins Campbell’s March 5, 2016 impairment evaluation in support of 

her claim. The Board notes that Dr. Watkins Campbell properly utilized the sixth edition of the 

A.M.A., Guides in determining that appellant had no ratable impairment of the left upper extremity 

based on her left CTS and left thumb trigger finger. Dr. Watkins Campbell then calculated three 

percent permanent impairment of the right upper extremity due to residual problems with mild 

CTS and neuropathy impairment. Dr. Harris on October 16, 2013 reported that he agreed with her 

impairment rating for three percent right upper extremity impairment due to residual problems 

with mild CTS. He also reported that appellant sustained zero percent permanent impairment of 

the left upper extremity.

In this regard, Dr. Watkins Campbell and the DMA properly used appellant’s May 16, 

2008 upper extremity EMG/NCV for purposes of rating compression neuropathy under Table 

15-23.15 Dr. Watkins Campbell explained that, since appellant had no left upper extremity sensory 

or motor latency loss demonstrated by the EMG, appellant had zero percent permanent impairment 

of the left upper extremity. For the right upper extremity, she described her findings, explaining 

that appellant had an average grade modifier 1 based on test findings, history, and physical 

findings, which corresponded to a default upper extremity impairment of two percent under Table 

15-23.16 The final step in the rating process was to factor in functional scale based on appellant’s 

QuickDASH score of 54 (moderate), which represented a grade modifier 2 and adjusted her 

impairment upward to three percent.17 Dr. Harris, serving as the DMA, agreed with Dr. Watkins 

Campbell’s findings, establishing that appellant was entitled to no more than the five percent 

permanent impairment previously awarded. Thus, the Board finds that appellant was not entitled 

to an increased schedule award other than that which was previously awarded.

18

On appeal, counsel for appellant argues that her claim for an additional schedule award

should have been adjudicated under the fifth edition of the A.M.A., Guides and not the sixth edition 

which rendered a lesser impairment. He argued that her initial schedule award was calculated 

using the fifth edition which would render a greater award and impairment rating. As appellant’s

award for five percent permanent impairment of the left and right upper extremity predated the 

May 1, 2009 implementation of the sixth edition of the A.M.A., Guides, OWCP was required to

calculate her award utilizing the previous edition of the A.M.A., Guides. 

 

15 A.M.A., Guides 449, Table 15-23. 

16 Id. 

17 If the grade modifier assigned to the functional scale score is equal to the grade assigned for the condition -- in 

this case grade 1 -- the default value (two percent) within that grade is the appropriate final rating. However, if the 

functional scale score is 1 grade higher or lower than the grade assigned the condition, the lower or higher value, 

respectively, is the appropriate impairment rating. A.M.A., Guides 449, section 15.4f.

18 M.J., Docket No. 13-0598 (issued May 8, 2013).
7

In this case, appellant simply made a claim for an increased schedule award. She had no 

vested right to a schedule award under the fifth edition of the A.M.A., Guides for decisions issued 

after May 1, 2009. In Harry D. Butler,

19 the Board noted that Congress delegated authority to the 

Director regarding the specific methods by which permanent impairment is to be rated. Pursuant 

to this authority, the Director adopted the A.M.A., Guides as a uniform standard applicable to all 

claimants and the Board has concurred in the adoption.20 On March 15, 2009 the Director 

exercised authority to advise that as of May 1, 2009 all schedule award decisions of OWCP should 

reflect use of the sixth edition of the A.M.A., Guides.

21

 FECA Bulletin No. 09-03 notes that a 

claimant who has received a schedule award calculated under a previous edition and who claims 

an increased award, will receive a calculation according to the sixth edition for any decision issued 

on or after May 1, 2009.22 The applicable date of the sixth edition is as of the schedule award 

decision reached. It is not determined by either the date of MMI or when the claim for such award 

was filed. 

Ultimately, both Dr. Watkins Campbell and the DMA agreed that appellant had three 

percent permanent impairment of the right upper extremity and zero percent permanent 

impairment of the left upper extremity.23 The Board finds that Dr. Watkins Campbell and

Dr. Harris’ bilateral upper extremity impairment rating is consistent with the sixth edition of the 

A.M.A., Guides. Appellant has not demonstrated permanent impairment in excess of what she has 

already been awarded. Accordingly, OWCP’s July 20, 2017 schedule award shall be affirmed.

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 failed to establish more than five percent permanent 

impairment of the left upper extremity and five percent permanent impairment of the right upper 

extremity for which she previously received schedule awards. 

 

19 43 ECAB 859 (1992).

20 Id. at 866.

21 FECA Bulletin No. 09-03 (issued March 15, 2009). Supra note 8 at Chapter 2.808.5(a) (March 2017).

22 Supra note 21; see also 20 C.F.R. § 10.404, which provides for when and how compensation for a schedule 

impairment is paid.

23 E.G., Docket No. 15-1739 (issued January 28, 2016).
8

ORDER

IT IS HEREBY ORDERED THAT the Office of Workers’ Compensation Programs’

decision dated July 20, 2017 is affirmed.

Issued: April 19, 2018

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board