United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

C.H., Appellant

and

U.S. POSTAL SERVICE, ARCADIA STATION, 

Phoenix, AZ, Employer

__________________________________________

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Docket No. 19-0409

Issued: August 5, 2019

Appearances: Case Submitted on the Record

Alan J. Shapiro, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

JANICE B. ASKIN, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On December 18, 2018 appellant, through counsel, filed a timely appeal from a 

November 1, 2018 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 met his burden of proof to establish left thumb 

conditions causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On February 22, 2018 appellant, then a 32-year-old city carrier assistant, filed an 

occupational disease claim (Form CA-2) alleging that he developed left thumb ligament strain due 

to repeated usage while in the performance of duty. He indicated that he first became aware of his 

condition on January 30, 2018 and attributed it to his federal employment on February 20, 2018. 

In a narrative statement, appellant alleged that he struck his thumb during his first week of work. 

He sought medical treatment, received a brace, and continued to work. Appellant alleged that his 

left thumb pain continued after several weeks of work and on February 20, 2018 he experienced 

severe left thumb pain.

In a note dated February 22, 2018, Dr. Stephen A. Cohen, a family practitioner, reported 

appellant’s complaints of left hand pain since February 20, 2018 and diagnosed radial styloid 

tenosynovitis. He provided appellant with a thumb spica brace and released him to work with 

restrictions. 

Dr. Matthew Shores, Board-certified in sports medicine, examined appellant on 

February 23, 2018 and diagnosed left thumb sprain at the metacarpophalangeal (MCP) joint. He 

noted that appellant first sought treatment with him on February 22, 2018 due to a work-related 

gradual onset injury. Appellant attributed his left thumb condition to repetitive motion while 

carrying mail including holding mail in his left hand and grasping the mail repeatedly between his 

thumb and index finger. He also noted that he had tripped and fallen at home on January 31, 2018 

injuring his left hand.

In a February 28, 2018 narrative statement, appellant described his work duties from 

February 17 through 20, 2018 as lifting and moving parcels from the conveyor belt into cages. On 

February 20, 2018 the job became more demanding requiring him to move cages of mail, which 

resulted in pain and strain of his left thumb. Appellant also lifted boxes and parcels weighing over 

10 pounds.

On March 2, 2016 appellant underwent a left thumb magnetic resonance imaging (MRI) 

scan, which demonstrated full-thickness avulsion tear of the ulnar collateral ligament (UCL) at the 

MCP joint, moderate volar subluxation of the first proximal phalanx relative to the metacarpal 

head and thickening of the volar plate with joint effusion.

In a March 14, 2018 development letter, OWCP advised appellant of the deficiencies of 

his claim. It requested additional factual and medical evidence from him, and provided a 

questionnaire for his completion. OWCP afforded appellant 30 days to respond.

On March 3, 2018 Dr. Shores completed a narrative report and described appellant’s fall 

at home on January 31, 2018. Appellant noted further pain and aggravation or exacerbation of his 

thumb injury with his return to work. Dr. Shores listed the job duties that may have aggravated 
3

appellant’s thumb pain as repetitive gripping of letters, mail, magazines, and forceful gripping with 

thumb opposition including carrying parcels. He opined that the initial UCL tear occurred during 

the January 31, 2018 fall. Dr. Shores noted that, in the following three weeks, “further aggravation 

of the pain in the thumb may have resulted from the essential job duties as a mail carrier, such as 

repetitive forceful thumb opposition.” He deferred to an orthopedic hand specialist for any further 

determination of the cause of the tear and any further aggravation/exacerbation due to appellant’s 

employment duties.

On March 14, 2018 Dr. Joseph Haber, a Board-certified hand surgeon, related a history of 

appellant’s fall at home on January 30, 2018 and appellant’s belief that his left thumb became more 

painful after taking a job with the employing establishment. He indicated that appellant did not 

have a specific injury at work, but rather an injury when he fell at home on January 30, 2018. 

Dr. Haber noted that appellant felt that he had been markedly worse since working and trying to 

deliver mail and train as a postal worker. He described appellant’s work duties as pushing and 

pulling. Dr. Haber provided appellant with a thumb cast and opined that as it was a chronic injury 

it would likely require a tendon graft for repair of the ligament.

In a note dated March 15, 2018, Dr. Shores reported that appellant’s initial injury was his 

fall at home on January 31, 2018, but that this was likely further exacerbated at work with 

repetitive use. He deferred to Dr. Haber to determine any associated aggravation or worsening 

due to repetitive use between January 31 and February 22, 2018.

On March 28, 2018 appellant provided an additional narrative statement and asserted that 

his federal work duties were very physically demanding. He noted that he was required to inspect 

his vehicle, case his route, and gather parcels. Appellant then loaded his vehicle and drove to his 

route to deliver the mail. He asserted that most items weighed between 15 and 20 pounds, that he 

was required to lift up to 35 pounds frequently and 50 to 70 pounds rarely.

On April 4, 2018 Dr. Haber reported that appellant continued to experience severe left 

thumb pain. He diagnosed chronic left thumb collateral ligament injury and recommended 

surgery.

By decision dated April 17, 2018, OWCP denied appellant’s claim, finding that the medical 

evidence of record was insufficient to establish causal relationship between the diagnosed 

condition and the accepted work duties.

On April 24, 2018 appellant, through counsel, requested an oral hearing before an OWCP 

hearing representative. During the September 12, 2018 oral hearing, he testified that he began 

work at the employing establishment on January 20, 2018 and that he fell “at home around 

January 30[, 2018].” Appellant asserted that his left thumb condition worsened between 

February 17 and 20, 2018 despite wearing a brace as he was emptying conveyor belts and moving 

heavy cages of mail. He was separated from employment with the employing establishment on 

May 1, 2018 and underwent thumb surgery on June 2, 2018.

On October 9, 2018 appellant provided additional medical evidence including a 

January 29, 2018 note from Dr. James M. Kurbat, Board-certified in emergency medicine, who 
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indicated that appellant injured his left thumb on January 29, 2018 trying to catch himself while 

falling at home. Dr. Kurbat diagnosed finger sprain. 

On June 1, 2018 Dr. Paul S. Mahoney, a Board-certified hand surgeon, performed a repair 

of the left thumb MCP joint UCL using a graft.

By decision dated November 1, 2018, OWCP’s hearing representative affirmed the 

April 17, 2018 OWCP decision, finding that appellant had not provided medical evidence 

sufficient to establish causal relationship between his diagnosed condition and the accepted factors 

of his federal employment.

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 timely filed within the applicable 

time limitation period of FECA,3that an injury was sustained in the performance of duty as alleged, 

and that any disability or medical condition for which compensation is claimed is 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 upon a traumatic injury or an occupational disease.5

OWCP’s regulations define an occupational disease as “a condition produced by the work 

environment over a period longer than a single workday or shift.”

6

 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 diagnosed condition is causally related to the identified 

employment factors.7

Causal relationship is a medical question, which requires rationalized medical opinion 

evidence to resolve the issue.8 A physician’s opinion on whether there is causal relationship 

between the diagnosed condition and the implicated employment factors must be based upon a 

 

3 S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 ECAB 178 (2007); Joe D. Cameron, 41 ECAB 

153 (1989).

4

J.M., Docket No. 17-0284 (issued February 7, 2018); R.C., 59 ECAB 427 (2008); James E. Chadden, Sr., 40 

ECAB 312 (1988).

5 K.M., Docket No. 15-1660 (issued September 16, 2016); L.M., Docket No. 13-1402 (issued February 7, 2014); 

Delores C. Ellyett, 41 ECAB 992 (1990).

6 20 C.F.R. § 10.5(q).

7 L.E., Docket No. 18-1138 (issued February 1, 2019).

8 E.V., Docket No. 18-1617 (issued February 26, 2019).
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complete factual and medical background.9 Additionally, the physician’s opinion must be 

expressed in terms of a reasonable degree of medical certainly, and must be supported by medical 

rationale, explaining the nature of the relationship between the diagnosed condition and the 

claimant’s specific employment factors.10 The belief of a claimant that a condition was caused or 

aggravated by the employment is not sufficient to establish causal relation.11

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish left thumb 

conditions causally related to the accepted factors of his federal employment.

In support of his claim, appellant submitted several reports from Dr. Shores who listed 

appellant’s job duties and opined that they “may have” aggravated appellant’s thumb pain as 

repetitive gripping of letters, mail, and magazines as well as forceful gripping with thumb 

opposition including carrying parcels. On March 15, 2018 Dr. Shores noted that appellant’s 

initially injured his thumb in a fall at home, but he opined that this was “likely” further exacerbated 

at work with repetitive use. His opinions are couched in speculative terms, noting only the 

possibility that appellant’s job duties “may” and “likely” could have contributed to his left thumb 

condition. Entitlement to FECA benefits may not be based on surmise, conjecture, speculation, or 

on the employee’s own belief of a causal relationship.12 While the opinion supporting causal 

relationship does not have to reduce the cause or etiology of a disease or a condition to an absolute 

certainty, the opinion must be one of reasonable medical certainty and not speculative or equivocal 

in character.13 Because Dr. Shores’ opinions are speculative and equivocal in nature these 

opinions are not rationalized and do not carry appellant’s burden of proof as to causal relationship.

In addition appellant submitted medical reports of Dr. Haber, Dr. Kurbat, and Dr. Mahoney 

in support of his claim. However, none of these physicians offered an opinion on causal 

relationship between appellant’s diagnosed condition and the accepted employment factors. The 

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

employee’s condition is of no probative value on the issue of causal relationship.14 These reports, 

therefore, are insufficient to establish appellant’s claim.

 

9

Id.

10 Id.; Victor J. Woodhams, 41 ECAB 345, 352 (1989).

11 E.V., supra note 8; Lourdes Harris, 45 ECAB 545, 547 (1994).

12 M.S., Docket No. 19-0189 (issued May 14, 2019); L.T., Docket No. 18-1603 (issued February 21, 2019).

13 M.S., id.; C.L., Docket No. 18-1379 (issued February 5, 2019).

14 See L.B., Docket No. 18-0533 (issued August 27, 2018); D.K., Docket No. 17-1549 (issued July 6, 2018).
6

The Board finds that the record lacks rationalized medical evidence establishing causal 

relationship between appellant’s left thumb condition and the accepted factors of his federal 

employment.

15

 Thus, appellant has not met his burden of proof.

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 has not met his burden of proof to establish left thumb 

conditions causally related to the accepted factors of his federal employment.

ORDER

IT IS HEREBY ORDERED THAT the November 1, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: August 5, 2019

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board

 

15 L.E., supra note 7; J.S., Docket No. 17-0507 (issued August 11, 2017).