United States Department of Labor

Employees’ Compensation Appeals Board

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M.C., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

San Antonio, TX, Employer

__________________________________________

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Docket No. 17-1579

Issued: November 28, 2017

Appearances: Case Submitted on the Record

Appellant, pro se

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

PATRICIA H. FITZGERALD, Deputy Chief Judge

COLLEEN DUFFY KIKO, Judge

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On July 14, 2017 appellant filed a timely appeal from a May 5, 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 appellant met his burden of proof to establish right carpal tunnel 

syndrome causally related to factors of his federal employment.

FACTUAL HISTORY

On February 14, 2017 appellant, then a 62-year-old retired letter carrier, filed an 

occupational disease claim (Form CA-2) alleging that he developed a right wrist/hand injury as a 

result of factors of his federal employment. On the reverse side of the claim form, appellant’s 

 

1

5 U.S.C. § 8101 et seq.
2

supervisor controverted the claim stating that appellant was last exposed to conditions alleged to 

have caused his injury on March 31, 2014, the date he retired. 

In an accompanying narrative statement dated December 20, 2016, appellant reported 

that he was a retired letter carrier who worked for the employing establishment for 27 years. He 

stated that he was last exposed to the work factors that caused his right hand/wrist injury on 

March 31, 2014. Appellant described his employment duties which entailed preparing and 

casing mail for delivery. This entailed grabbing mail with his left hand and using his right thumb 

and index finger to grasp the outer edges of the letters to insert mail by street and number,

repetitively performing this task for three to four hours per day. Appellant further described his 

street duties which required delivering mail and grasping letters using his right hand, thumb, and 

index finger repetitively for six to eight hours per day over the last 27 years. He reported that 

this repetitive motion placed a lot of stress to his right hand causing him to self-medicate before 

and after work to alleviate his pain. Appellant explained that after he retired the pain did not 

subside, which caused him to seek medical treatment with Dr. Everett Lee Campbell, a Boardcertified orthopedic surgeon, on December 20, 2016. He concluded that he had no hobbies other 

than watching movies. 

In a May 10, 2016 medical report, Dr. Angelo Romagosa, Board-certified in physical 

medicine and rehabilitation, reported that appellant had sustained a work-related injury to the 

right upper extremity while working for the employing establishment on July 15, 2014.2 

Appellant was diagnosed with a rotator cuff tear and subsequently underwent surgical repair. He

eventually developed progressive numbness and tingling in the right upper extremity associated 

with weakness in the hand and discomfort/pain in the wrist and hand. Dr. Romagosa reported 

that an electromyography (EMG) and nerve conduction velocity (NCV) study revealed abnormal 

findings consistent with a median neuropathy on the right, with a lesion located at or near the 

wrist moderate in electrical degree with evidence of demyelination, but no evidence of axonal 

degeneration. He diagnosed right carpal tunnel syndrome. 

In a December 20, 2016 medical report, Dr. Campbell reported that appellant was retired,

but had worked for the employing establishment for 27 years which involved a great deal of 

repetitive tasks using the right hand. He noted that appellant often had symptoms of carpal 

tunnel syndrome which went untreated until recently when EMG/NCV testing revealed right 

carpal tunnel. Dr. Campbell reviewed appellant’s December 20, 2016 narrative statement 

detailing his employment duties, provided findings on physical examination, and diagnosed right 

carpal tunnel syndrome. He opined that the repetitive motion of having to grasp mail with his 

right thumb and index finger over a period of 27 years, for 8 to 10 hours per day, was the direct 

cause for appellant’s carpal tunnel syndrome. Dr. Campbell concluded that appellant’s narrative 

explanation of his condition and the repetitive tasks he performed with the right hand had a 

clinical presentation consistent with chronic right carpal tunnel syndrome. 

By letter dated February 22, 2017, OWCP informed appellant that the evidence of record 

was insufficient to support his claim. It advised of the medical and factual evidence needed and 

 

2 The record reflects that appellant filed a workers’ compensation occupational disease claim with a July 15, 2014 

date of injury under OWCP File No. xxxxxx246. The record before the Board contains no other information 

pertaining to this claim. 
3

directed him to submit the necessary evidence within 30 days. In another letter of that same 

date, OWCP requested additional information from the employing establishment pertaining to 

appellant’s occupational disease claim. 

A position description detailing appellant’s employment duties was received.

By letter dated April 24, 2017, the employing establishment controverted the claim 

arguing that appellant failed to establish that his carpal tunnel syndrome was work related. It

noted that he retired on March 31, 2014 and had not been exposed to the employment duties 

alleged to have caused his injury for over two years. 

By decision dated May 5, 2017, OWCP denied appellant’s claim finding that the 

evidence of record failed to establish that his diagnosed right carpal tunnel syndrome was

causally related to the accepted federal employment factors. 

LEGAL PRECEDENT

An employee seeking benefits under FECA3has 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 filed within the applicable 

time limitation, that an injury was sustained while in the performance of duty as alleged, and that 

any disability or specific condition for which compensation is claimed is causally related to the 

employment injury.4 These are the essential elements of every compensation claim regardless of 

whether the claim is predicated on a traumatic injury or occupational disease.5

To establish that an injury was sustained in the performance of duty in a claim for 

occupational disease, an employee must submit: (1) a factual statement identifying employment 

factors alleged to have caused or contributed to the presence or occurrence of the disease or 

condition; (2) medical evidence establishing the presence or existence of the disease or condition 

for which compensation is claimed; and (3) medical evidence establishing that the diagnosed 

condition is causally related to the employment factors identified by the employee.6

To establish causal relationship between the condition, as well as any attendant disability 

claimed and the employment event or incident, the employee must submit rationalized medical 

opinion evidence supporting such causal relationship.7 The opinion of the physician must be 

based on a complete factual and medical background of the claimant, must be one of reasonable 

medical certainty, and must be supported by medical rationale explaining the nature of the 

relationship between the diagnosed condition and the specific employment factors identified by 

the claimant. This medical opinion must include an accurate history of the employee’s 

 

3

Supra note 1.

4 Gary J. Watling, 52 ECAB 278 (2001); Elaine Pendleton, 40 ECAB 1143, 1154 (1989).

5 Michael E. Smith, 50 ECAB 313 (1999).

6

See Roy L. Humphrey, 57 ECAB 238, 241 (2005); Ruby I. Fish, 46 ECAB 276, 279 (1994). 

7

See 20 C.F.R. § 10.110(a); John M. Tornello, 35 ECAB 234 (1983).
4

employment injury and must explain how the condition is related to the injury. The weight of 

medical evidence is determined by its reliability, its probative value, its convincing quality, the 

care of analysis manifested, and the medical rationale expressed in support of the physician’s 

opinion.8

ANALYSIS

OWCP accepted that appellant engaged in repetitive activities using his hands in his

employment duties as a letter carrier. It denied his claim, however, finding that the evidence of 

record failed to establish causal relationship between those factors and his right carpal tunnel 

syndrome. The Board finds that the medical evidence of record was insufficient to establish that 

appellant developed right carpal tunnel syndrome causally related to factors of his federal 

employment as a letter carrier.

In support of his claim, appellant submitted a May 10, 2016 medical report from

Dr. Romagosa. The Board finds that Dr. Romagosa’s report does not provide support for a 

work-related occupational injury. Dr. Romagosa provided a history of injury, noting that 

appellant sustained a right rotator cuff tear on July 15, 2014 while working for the employing 

establishment. He reported that appellant subsequently underwent surgical repair and eventually 

developed progressive numbness and tingling in the right upper extremity, associated with 

weakness in the hand and discomfort/pain in the wrist and hand. The Board notes that

Dr. Romagosa attributed appellant’s right carpal tunnel symptoms to his rotator cuff injury rather 

than his repetitive employment factors as alleged in this claim. While he provided a diagnosis of 

right carpal tunnel, Dr. Romagosa failed to provide any opinion causally relating the condition to 

appellant’s alleged factors of employment. He did not discuss appellant’s work as a letter carrier 

and did not report an understanding of his federal employment factors to establish causation.9 

Dr. Romagosa’s conclusions are insufficient to establish the requisite causal relationship because 

he failed to explain how performing repetitive duties of a letter carrier caused or aggravated the 

diagnosed conditions.10

The Board has held that medical evidence that does not offer any rationalized opinion 

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

causal relationship.11 As such, Dr. Romagosa’s report is of limited probative value and 

insufficient to meet appellant’s burden of proof.12 

In a December 20, 2016 medical report, Dr. Campbell diagnosed right carpal tunnel 

syndrome and opined that appellant’s repetitive employment factors were the direct cause of his 

injury. The Board finds that the report of Dr. Campbell is not well rationalized and insufficient 

 

8

James Mack, 43 ECAB 321 (1991).

9

S.Y., Docket No. 11-1816 (issued March 16, 2012).

10 See Ralph Pasqua, Docket No. 01-1302 (issued January 25, 2002). 

11 C.B., Docket No. 09-2027 (issued May 12, 2010); S.E., Docket No. 08-2214 (issued May 6, 2009).

12 See L.M., Docket No. 14-0973 (issued August 25, 2014); R.G., Docket No. 14-113 (issued April 25, 2014); 

K.M., Docket No. 13-1459 (issued December 5, 2013); A.J., Docket No. 12-0548 (issued November 16, 2012).
5

to establish appellant’s occupational disease claim. Dr. Campbell had some understanding of 

appellant’s employment factors, noting the repetitive motion of having to grasp mail with his 

right thumb and index finger for 8 to 10 hours per day over 27 years. However, he only 

generally repeated appellant’s allegations pertaining to the employment factors. Such 

generalized statements do not establish causal relationship because they merely repeat

appellant’s allegations and are unsupported by adequate medical rationale explaining how this 

physical activity actually caused the diagnosed conditions.13 While Dr. Campbell provided a 

firm medical diagnosis, his statement on causation failed to explain the mechanism of injury 

pertaining to this occupational disease claim, namely, how repetitive grasping of mail for 8 to 10 

hours per day, would cause or aggravate appellant’s right carpal tunnel syndrome.

14

 Without 

explaining how physiologically the movements involved in his employment factors caused or 

contributed to his diagnosed condition, Dr. Campbell’s opinion on causal relationship is not 

sufficiently rationalized and is of limited probative value.15 

An award of compensation may not be based on surmise, conjecture, speculation, or on 

the employee’s own belief of causal relation.16 Appellant’s honest belief that his occupational 

employment duties caused his medical injury, however, sincerely held, does not constitute 

medical evidence sufficient to establish causal relationship.17 In the instant case, the record lacks 

rationalized medical evidence establishing causal relationship between his federal employment 

duties as a letter carrier and his diagnosed right carpal tunnel syndrome. Thus, appellant has 

failed to meet his burden of proof. 

Appellant may submit additional evidence, together with a written request for 

reconsideration, to OWCP within one year of the Board’s 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 right carpal 

tunnel syndrome causally related to factors of his federal employment. 

 

13 K.W., Docket No. 10-0098 (issued September 10, 2010). 

14 S.W., Docket 08-2538 (issued May 21, 2009).

15 See V.G., Docket No. 17-0067 (issued April 15, 2017). P.O., Docket No. 14-1675 (issued December 3, 2015); 

S.R., Docket No. 12-1098 (issued September 19, 2012). 

16 D.D., 57 ECAB 734 (2006).

17 See J.S., Docket No. 17-0967 (issued August 23, 2017). 
6

ORDER

IT IS HEREBY ORDERED THAT the May 5, 2017 decision of the Office of Workers’

Compensation Programs is affirmed.

Issued: November 28, 2017

Washington, DC

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Colleen Duffy Kiko, Judge

Employees’ Compensation Appeals Board

Valerie D. Evans-Harrell, Alternate Judge

Employees’ Compensation Appeals Board