United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

T.D., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Philadelphia, PA, Employer

__________________________________________

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Docket No. 17-1011

Issued: January 17, 2018

Appearances: Case Submitted on the Record

Thomas R. Uliase, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

ALEC J. KOROMILAS, Alternate Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On April 10, 2017 appellant, through counsel, filed a timely appeal from a December 6, 

2016 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 this case.

3

 

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.

3 The Board notes that, following the December 6, 2016 decision, OWCP received additional evidence. 

However, the Board may only review evidence that was in the record at the time OWCP issued its final decision. 

See 20 C.F.R. §§ 501.2(c)(1); M.B., Docket No. 09-0176 (issued September 23, 2009); J.T., 59 ECAB 293 (2008); 

G.G., 58 ECAB 389 (2007); Donald R. Gervasi, 57 ECAB 281 (2005); Rosemary A. Kayes, 54 ECAB 373 (2003). 
2

ISSUES

The issues are: (1) whether OWCP met is burden of proof to terminate appellant’s

compensation benefits, effective April 22, 2016; and (2) whether appellant met her burden of 

proof to establish any continuing disability or residuals on and after April 22, 2016.

FACTUAL HISTORY

On May 16, 2008 appellant, then a 39-year-old mail handler, filed an occupational 

disease claim (Form CA-2) alleging that, on that date, she first realized that her right wrist 

condition was caused by factors of her federal employment. She returned to work on 

May 17, 2008. OWCP accepted the claim for right de Quervain’s syndrome and bilateral carpal 

tunnel syndrome and paid appellant wage-loss compensation from September 13, 2008 through 

October 24, 2009 on the supplemental rolls.

4

 By letter dated November 12, 2009, it placed her

on the periodic rolls for temporary total disability as of October 25, 2009. 

Appellant filed a separate occupational disease claim, assigned OWCP File No. 

xxxxxx188, alleging injury as of June 26, 2008, which was accepted for left de Quervain’s

tenosynovitis/left radial styloid tenosynovitis.

5

 

Appellant was initially treated by Dr. Alphonse J. Digiovanni, a Board-certified general 

surgeon, Dr. Wayne Henstschel, an osteopath specializing in family medicine, and Dr. Chandra 

Reddy, a physician specializing in general surgery, for right de Quervain’s syndrome. On 

September 10, 2008 she came under the care of Dr. Scott Fried, a Board-certified orthopedic 

surgeon, for tendinitis, bilateral de Quervain’s tenosynovitis, bilateral upper extremities 

sympathetically mediated pain syndrome, bilateral radial neuropathy, bilateral radial neuritis, 

brachial plexitis, right wrist scapholunate ligament grade 2, left wrist grade 1 radioulnar joint 

injury, left overuse syndrome, bilateral posterior occipital neuralgia, and bilateral carpal tunnel 

median neuropathy. Appellant was also seen by Dr. Steven J. Valentino, a Board-certified 

orthopedic surgeon, for bilateral de Quervain’s syndrome. 

Appellant continued to treat with Dr. Fried, who continued to opine that appellant had 

residuals of her accepted work-related conditions. 

On March 14, 2014 OWCP referred appellant for a second opinion evaluation with

Dr. Stanley Askin, a Board-certified orthopedic surgeon.6 In a March 28, 2014 report, Dr. Askin 

 

4 OWCP assigned File No. xxxxxx271 to this claim. It also paid appellant for health benefits adjustment for the 

period January 17 to September 25, 2010 on the supplemental rolls. 

5 On April 3, 2009 OWCP combined OWCP File Nos. xxxxxx188 and xxxxxx271, with the latter as the master 

file. 

6 OWCP provided a statement of accepted facts (SOAF) noting the accepted conditions for OWCP File Nos. 

xxxxxx188 and xxxxxx271 noting that the two claims had been combined with the latter serving as the master file 

number. It also advised that it had accepted two traumatic injury claims filed by appellant. Under OWCP File No. 

xxxxxx595, OWCP had accepted a back contusion and sacroiliac ligament sprain and under OWCP File No. 

xxxxxx404 it had accepted a back sprain under OWCP File No. xxxxxx404. 
3

noted the history of injury and appellant’s treatment, detailed the medical evidence he reviewed, 

listed his findings on examination, and concluded that the accepted conditions were no longer 

active or causing any disability. He opined that she could work her date-of-injury position with 

no limitations. 

Dr. Fried continued to submit reports opining that appellant continued to have residuals 

from the diagnosed conditions, which prevented her from returning to her regular job. 

On August 21, 2014 OWCP referred appellant to Dr. Gregory S. Maslow, a Boardcertified orthopedic surgeon, to resolve the conflict in the medical opinion evidence between

Dr. Fried and Dr. Askin regarding the status of the accepted conditions and whether appellant

continued to have any residuals or disability due to her accepted work conditions. 

In a September 9, 2014 report, Dr. Maslow noted the history of injury, his review of the 

SOAF, and appellant’s medical record. He then detailed his physical examination findings. 

Dr. Maslow reported full bilateral elbow and wrist range of motion, no olecranon or epicondylar 

tenderness, no bilateral tenderness at de Quervain’s point, negative bilateral Finkelstein’s test, 

normal skin color and temperature, pain on palpation over bilateral elbow ulnar nerve, and 

complaints of bilateral wrist numbness, negative bilateral wrist compression test, and intact 

upper extremity reflexes. He diagnosed right de Quervain’s tenosynovitis due to appellant’s

work activities. However, Dr. Maslow concluded that the conditions had resolved based on the 

lack of any objective evidence of bilateral de Quervain’s tenosynovitis. He noted that appellant 

had a variety of upper extremity complaints which he observed were unrelated to the accepted 

de Quervain’s tenosynovitis and there was no definitive evidence supporting a diagnosis of 

brachial plexus abnormality. Next, Dr. Maslow explained that the clinical examination showed 

some evidence of radiculopathy or cervical radiculitis and possibly mild carpal tunnel syndrome, 

but that these conditions were unrelated to her work activities. He concluded that appellant was 

capable of working with restrictions and required no further medical treatment. 

Dr. Fried continued to submit disability notes and reports opining that appellant 

continued to be totally disabled. 

In an investigative report dated March 23, 2015, the employing establishment’s Office of 

Inspector General noted that appellant had been under surveillance from December 11, 2014 

through March 13, 2015 and noted its surveillance findings. It related that she was active, drove 

daily, and conducted errands. The report also noted that appellant was observed twisting in and 

out of vehicles, opening and closing vehicle doors, and lifting and carrying items. 

On August 27, 2015 OWCP proposed to terminate appellant’s wage-loss compensation 

and medical benefits as she no longer had any residuals or continuing disability from the 

accepted work-related medical conditions. Special weight was accorded to Dr. Maslow’s 

impartial medical opinion. Appellant was afforded 30 days to submit additional evidence or 

argument. 

In response OWCP’s proposal to terminate compensation benefits, counsel contended 

that Dr. Maslow’s report lacked sufficient detail to establish resolution of the accepted 

conditions. 
4

Subsequent to the notice of proposed termination, OWCP received additional reports 

from Dr. Fried in which he again opined that appellant was totally disabled due to her accepted 

work conditions. 

On November 2, 2015 OWCP requested that Dr. Maslow review an attached surveillance 

digital video disc and SOAF dated May 9, 2014.7 It also requested that he provide supporting 

medical rationale for his conclusions. 

In a November 2, 2015 report, Dr. Fried summarized appellant’s examination findings 

and objective tests since first treating her in 2008 through December 11, 2014. He reviewed

Dr. Maslow’s September 9, 2014 report, noted his disagreement with Dr. Maslow’s conclusion, 

and argued that the diagnostic and clinical evidence supported that appellant continued to suffer 

from the diagnosed conditions and was disabled from work. 

In a November 25, 2015 supplemental report, Dr. Maslow reviewed the SOAF provided 

by OWCP and noted that left de Quervain’s tenosynovitis was accepted under another claim. He 

reiterated that he found no objective evidence of bilateral de Quervain’s tenosynovitis during his 

examination of appellant and that appellant had recovered from her accepted work conditions.

Dr. Maslow indicated that his review of the video did not cause him to change his opinions. 

Dr. Fried continued to submit reports and disability notes supporting appellant’s 

continued disability and residuals from the appellant’s accepted conditions. 

By decision dated April 21, 2016, OWCP terminated appellant’s wage-loss compensation 

and medical benefits, effective April 22, 2016. It found that Dr. Maslow’s opinion was entitled 

to the special weight of the impartial medical examiner. 

Subsequent to the April 21, 2016 decision terminating appellant’s benefits, Dr. Fried 

resubmitted submitted disability notes, treatment notes, and reports, noting she continued 

disability due to her accepted work conditions. He also submitted new reports dated May 19 to 

September 1, 2016. 

In a letter dated April 29, 2016, counsel requested an oral hearing before an OWCP 

hearing representative, which was held on September 27, 2016. He presented arguments in his 

letter and at the hearing that Dr. Maslow’s opinion should not be considered the special weight 

of the evidence. 

Dr. Fried reported in a September 1, 2016 narrative report that appellant had right 

shoulder and bilateral hand complaints. He noted that she had experienced additional symptoms 

recently due to a little bit of extra driving she had been doing and due to the weather. Dr. Fried 

noted appellant’s examination findings and diagnosed a number of conditions. His diagnoses 

included: brachial plexopathy/cervical radiculopathy right, with long thoracic neuritis; brachial 

 

7 By letter dated November 2, 2015, OWCP informed counsel that a copy of the surveillance video had been 

forwarded to Dr. Maslow. It noted that a copy of the video would be provided to appellant upon request. Counsel 

requested a copy of the video on November 13, 2015 and OWCP provided a copy of the video to him on 

November 23, 2015. 
5

plexopathy/cervical radiculopathy left, with neurogenic tendinitis; bilateral de Quervain’s 

tenosynovitis; scapholunate ligament, right wrist; radioulnar joint injury, left wrist; bilateral

radial neuropathy of the wrists; bilateral radial neuritis of the wrists; bilateral carpal tunnel; and 

bilateral posterior occipital neuralgia. Dr. Fried concluded that appellant remained symptomatic 

and could not return to regular work activities. 

By decision dated December 6, 2016, an OWCP hearing representative affirmed 

OWCP’s April 29, 2106 decision, finding that appellant no longer had any disability or residuals 

due to the accepted work-related conditions. 

LEGAL PRECEDENT -- ISSUE 1

Once OWCP accepts a claim and pays compensation, it has the burden of proof to justify

modification or termination of an employee’s benefits.8 Once it has determined that, an 

employee has disability causally related to his or her federal employment, OWCP may not 

terminate compensation without establishing that the disability has ceased or that it is no longer 

related to the employment.9 OWCP’s burden of proof includes the necessity of furnishing 

rationalized medical opinion evidence based on a proper factual and medical background.10

The right to medical benefits for an accepted condition is not limited to the period of 

entitlement for disability.11 To terminate authorization for medical treatment, OWCP must 

establish that appellant no longer has residuals of an employment-related condition, which would 

require further medical treatment.12

Section 8123(a) of FECA provides that if there is a disagreement between the physician 

making the examination for the United States and the physician of an employee, the Secretary 

shall appoint a third physician (known as a referee physician or impartial medical specialist) who 

shall make an examination.13 This is called a referee examination and OWCP will select a 

physician who is qualified in the appropriate specialty and who has no prior connection with the 

case.14 When there exists opposing medical reports of virtually equal weight and rationale and 

the case is referred to an impartial medical specialist for the purpose of resolving the conflict, the 

opinion of such specialist, if sufficiently well rationalized and based upon a proper factual 

background, must be given special weight.15

 

8 S.F., 59 ECAB 642 (2008); Kelly Y. Simpson, 57 ECAB 197 (2005); Paul L. Stewart, 54 ECAB 824 (2003).

9

I.J., 59 ECAB 408 (2008); Elsie L. Price, 54 ECAB 734 (2003).

10 See J.M., 58 ECAB 478 (2007); Del K. Rykert, 40 ECAB 284 (1988).

11 T.P., 58 ECAB 524 (2007); Kathryn E. Demarsh, 56 ECAB 677 (2005).

12 Kathryn E. Demarsh, id.; James F. Weikel, 54 ECAB 660 (2003).

13 5 U.S.C. § 8123(a); see R.S., Docket No. 10-1704 (issued May 13, 2011); S.T., Docket No. 08-1675 (issued 

May 4, 2009); Darlene R. Kennedy, 57 ECAB 414 (2006).

14 20 C.F.R. § 10.321.

15 Gloria J. Godfrey, 52 ECAB 486 (2001).
6

ANALYSIS -- ISSUE 1

OWCP accepted that appellant sustained bilateral de Quervain’s syndrome and bilateral 

carpal tunnel syndrome as a result of her federal employment duties in 2008. Appellant stopped 

work in June 2008 and was eventually retained on OWCP’s periodic compensation rolls. OWCP 

terminated her wage-loss compensation and medical benefits, effective April 22, 2016, based on 

the reports of Dr. Maslow, the impartial medical specialist. By decision dated December 6, 

2016, an OWCP hearing representative affirmed OWCP’s April 22, 2016 termination decision. 

OWCP properly referred appellant to Dr. Maslow for an impartial medical examination 

to resolve the conflict in medical opinion evidence, between Drs. Askin and Fried as to whether 

appellant had any continuing employment-related residuals or disability, pursuant to 5 U.S.C. 

§ 8123(a). 

The Board finds that OWCP met its burden of proof to terminate appellant’s medical and 

wage-loss compensation benefits based on the September 9, 2014 and November 25, 2015

reports of Dr. Maslow, who accurately summarized her medical history, reviewed an updated 

SOAF, viewed surveillance video, and examined her finding no objective evidence to support 

ongoing employment-related residuals or disability due to the accepted conditions.

In his September 9, 2014 report, Dr. Maslow conducted a neurologic examination of the 

upper extremities, which was essentially normal with no findings of atrophy. He concurred with

Dr. Askin’s opinion that the bilateral carpal tunnel syndrome apparent on his examination was 

not work related. Dr. Maslow stated that appellant had not worked in many years and that there 

was no indication that the carpal tunnel syndrome would prohibit her return to her previous 

employment. He also related that there was also no evidence on examination that any of the 

other diagnoses were present or would interfere with return to the previous employment.

Dr. Maslow opined that appellant was capable of returning to work full duty, full-time work 

without restrictions imposed by the previously accepted work-related diagnoses. A review of the 

surveillance tapes confirmed his opinions.

In his November 25, 2015 supplemental report, Dr. Maslow reiterated his opinion that 

there was no objective evidence of bilateral de Quervain’s tenosynovitis and noted that he had

reviewed the SOAF OWCP provided, which stated that left de Quervain’s tenosynovitis had 

been accepted under another claim. He again concluded that the accepted work conditions had 

resolved without disability.

The Board finds that Dr. Maslow’s opinion is well rationalized and based on a complete 

and accurate history, a complete SOAF, and the entire case record, including surveillance videos. 

Dr. Maslow examined appellant thoroughly, reviewed the medical records, and reported accurate 

medical and employment histories and reviewed the surveillance video of appellant. Thus, his 

opinion that the accepted conditions have resolved without residuals is entitled to special 

weight.16

 

16 See Bryan O. Crane, 56 ECAB 713 (2005).
7

The additional medical evidence submitted in response to Dr. Maslow’s report is 

insufficient to overcome the special weight accorded to him as an impartial medical specialist 

regarding this issue. While Dr. Fried submitted a November 2, 2015 report arguing that 

appellant continued to suffer from the diagnosed conditions and was disabled from working and 

noting his disagreement with Dr. Maslow’s opinion, he had been on one side of the conflict in 

medical opinion regarding whether there were any residuals of the employment-related 

conditions and whether they were disabling. Reports from a physician who was on one side of a 

medical conflict that an impartial medical specialist resolved, are generally insufficient to 

overcome the special weight accorded to the opinion of the impartial medical specialist or to 

create a new conflict.17

LEGAL PRECEDENT -- ISSUE 2

As OWCP properly terminated appellant’s compensation benefits, the burden shifts to 

appellant to establish continuing disability after that date causally related to her accepted 

injury.18 To establish causal relationship between the accepted conditions as well as any 

attendant disability claimed and the employment injury, an employee must submit rationalized 

medical evidence based on a complete medical and factual background supporting such causal 

relationship.19 Causal relationship is a medical issue and the medical evidence required to 

establish causal relationship is rationalized medical evidence.20

ANALYSIS -- ISSUE 2

The Board finds that appellant has not established continuing disability or residuals after 

April 22, 2016 causally related to her accepted employment injuries. 

Following OWCP’s termination of appellant’s wage-loss compensation and medical 

benefits, effective April 22, 2016, the burden of proof shifted to appellant to demonstrate that she 

continued to be disabled from work on and after that date due to her accepted employment 

conditions.21

Subsequent to the termination of her wage-loss compensation, effective April 22, 2016, 

appellant submitted reports from Dr. Fried which were previously of record as well as new

progress notes dated May 19 to September 1, 2016. OWCP also received a narrative report from

Dr. Fried dated September 1, 2016. In these reports, Dr. Fried found that appellant continued to 

have residuals of her accepted employment injuries and that she was unable to perform her 

regular work duties. He offered a conclusion, but no medical rationale explaining why she had 

continuing disability due to the accepted conditions. A medical opinion that states a conclusion, 

 

17 I.J., 59 ECAB 408 (2008); Dorothy Sidwell, 41 ECAB 857, 874 (1990).

18 Manuel Gill, 52 ECAB 282 (2001).

19 R.D., Docket No. 16-0982 (issued December 20, 2016).

20 Paul Foster, 56 ECAB 208 (2004); Jacqueline M. Nixon-Steward, 52 ECAB 140 (2000).

21 Supra note 18.
8

but does not offer any rationalized medical explanation regarding the cause of an employee’s 

condition is of limited probative value on the issue of causal relationship.22

Moreover, the Board has long held that reports from a physician who was on one side of 

a medical conflict that an impartial medical specialist resolved, are generally insufficient to 

overcome the special weight accorded to the report of the impartial medical specialist, or to 

create a new conflict.23 The Board notes that as Dr. Fried was on one side of the conflict 

resolved by Dr. Maslow, Dr. Fried’s additional reports and disability notes are of insufficient 

weight to overcome the special weight accorded to Dr. Maslow’s pinion or to create a new 

medical conflict. The Board finds, therefore, that appellant has not established continuing 

disability or residuals after April 22, 2016 causally related to the accepted conditions.24

The Board also notes that Dr. Fried diagnosed a number of additional conditions in his 

September 1, 2016 report. Dr. Fried however offered no opinion regarding the cause of these 

additional conditions. The Board has held that medical evidence which does not offer a clear 

opinion regarding the cause of an employee’s condition is of limited probative value on the issue 

of causal relationship.25 Therefore, this report from Dr. Fried does not establish appellant’s 

claim for additional employment-related medical conditions.26

Thus, the Board finds that appellant has not met her burden of proof to establish 

continuing residuals or disability after April 22, 2016 due to her accepted conditions. 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 OWCP met its burden of proof to terminate appellant’s wage-loss 

compensation and medical benefits, effective April 22, 2016. The Board further finds that she

has not met her burden of proof to establish any continuing disability or residuals after 

April 22, 2016. 

 

22 See E.H., Docket No. 17-0986 (issued August 10, 2017). 

23 Id.

24 Virginia Davis-Banks, 44 ECAB 389 (1993); Dorothy Sidwell, supra note 17.

25 See Charles H. Tomaszewski, 39 ECAB 461 (1988).

26 See J.S., Docket No. 16-0472 (issued June 3, 2016). 
9

ORDER

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

Compensation Programs dated December 6, 2016 is affirmed. 

Issued: January 17, 2018

Washington, DC

Patricia H. Fitzgerald, Deputy 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