United States Department of Labor

Employees’ Compensation Appeals Board

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M.C., Appellant

and

DEPARTMENT OF DEFENSE, DEFENSE 

COMMISSARY AGENCY, Parris Island, SC, 

Employer

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Docket No. 18-1199

Issued: April 5, 2019

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 May 24, 2018 appellant filed a timely appeal from a November 30, 2017 merit decision 

of the Office of Workers’ Compensation Programs (OWCP).1 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.

ISSUES

The issues are: (1) whether appellant has met her burden of proof to establish that the 

acceptance of her claim should be expanded to include additional conditions; and (2) whether 

OWCP met its burden of proof to terminate appellant’s wage-loss compensation and medical 

 

1 Appellant filed a timely request for oral argument before the Board. By order dated March 6, 2019, the Board, 

after exercising its discretion, denied her request finding that her arguments on appeal could be adequately addressed 

in a decision based on a review of the case record. Order Denying Request for Oral Argument, Docket No. 18-1199 

(issued March 6, 2019). 

2 5 U.S.C. § 8101 et seq.
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benefits, effective April 30, 2017, as she no longer had residuals or disability due to her accepted 

employment injuries.

FACTUAL HISTORY

On March 2, 2000 appellant, then a 47-year-old sales store checker, filed an occupational 

disease claim (Form CA-2) alleging that she experienced left arm pain from her shoulder to her 

fingers causally related to factors of her federal employment. She did not stop work, but began 

performing modified employment. OWCP accepted the claim for left lateral epicondylitis and 

bilateral carpal tunnel syndrome. It assigned File No. xxxxxx898. On March 21, 2001 appellant 

underwent a left carpal tunnel release.

OWCP subsequently accepted appellant’s April 2, 2002 occupational disease claim for 

cervical spondylosis at C5-6 beginning April 1998. It assigned File No. xxxxxx944. OWCP

administratively combined the two claims, with File No. xxxxxx898 designated as the master file.

Appellant retired on disability, effective February 18, 2006. She elected to receive 

compensation benefits under FECA, effective October 22, 2007. OWCP paid appellant wage-loss 

compensation for total disability on the periodic rolls beginning March 14, 2010.

In a report dated November 19, 2015, Dr. Leland C. Stoddard, Jr., a Board-certified 

orthopedic surgeon, noted that recent electrodiagnostic testing of appellant’s left upper extremity 

had yielded normal findings. He diagnosed left elbow transient synovitis.

OWCP on December 13, 2016 referred appellant to Dr. Henry Clark Deriso, a Boardcertified orthopedic surgeon, for a second opinion examination. It requested that he address 

whether she had continuing residuals from either her April 1998 or January 2000 employment 

injuries. OWCP provided Dr. Deriso with a statement of accepted facts (SOAF) that indicated that 

it had accepted as employment related left lateral epicondylitis, bilateral carpal tunnel syndrome, 

and cervical spondylosis at C5-6. 

In a report dated December 28, 2016, Dr. Deriso discussed appellant’s history of an upper 

extremity condition and cervical sprain due to factors of her federal employment. On examination,

he found mild tenderness at the medial and lateral epicondyle with full range of motion and no 

atrophy. Dr. Deriso found a positive Tinel’s sign on the left and an equivocal left Phalen’s test 

with no loss of thenar strength or muscle weakness. He further found a normal neurological 

examination of the upper extremities with no loss of muscle strength of the cervical spine or 

“evidence of a cervical disc clinically.” Dr. Deriso noted that he did not believe that repetitive 

stress was a cause of carpal tunnel syndrome and questioned OWCP’s acceptance of the condition. 

He diagnosed post left carpal tunnel syndrome, post left radial nerve release, a history of lateral 

and medial epicondylitis, a history of a cervical degenerative disc, and mild right carpal tunnel 

syndrome by prior electromyogram (EMG). Dr. Deriso found that appellant had no current left 

upper extremity diagnosis, noting that recent EMG studies had yielded normal findings. He related

that, “[Appellant] also has a history of degenerative discs of the cervical spine, but if she had a 

sprain of this [this] usually resolves within a matter of weeks therefore I do not think she has any 

diagnosis in regards to her cervical spine at the present time.” Dr. Deriso noted that the findings 
3

on MRI scan study of the cervical disc were normal and that appellant had no abnormal findings 

of the right upper extremity. He opined that she could return to work in her usual employment.

On February 15, 2017 OWCP notified appellant that it proposed to terminate her wageloss compensation and medical benefits, as the evidence of record established that she no longer 

had any employment-related residuals or due to her accepted bilateral carpal tunnel syndrome, left 

epicondylitis, or cervical spondylosis at C5-6. 

In a response received by OWCP on February 24, 2017, appellant asserted that Dr. Deriso 

referred to an incorrect physician as her attending physician. She also submitted a November 18, 

2016 decision from the Social Security Administration, finding that she was totally disabled. 

By decision dated April 13, 2017, OWCP terminated appellant’s wage-loss compensation 

and medical benefits, effective that date. It found that the opinion of Dr. Deriso represented the 

weight of the evidence and established that she had no further residuals or disability due to her 

accepted employment injuries.

On April 24, 2017 appellant requested an oral hearing before an OWCP hearing 

representative. 

Thereafter, OWCP received an August 15, 2016 report from Dr. Stoddard. Dr. Stoddard 

discussed appellant’s complaints of left arm pain and numbness and increasing neck pain. He

opined that she had “degenerative disc changes and possibly some spinal stenosis and left[-]sided 

radiculitis that could certainly explain [appellant’s] shoulder and arm symptoms.”

On October 21, 2016 appellant received treatment from Dr. Luke Baxley, who specializes 

in emergency medicine, for injuries sustained on that date in a motor vehicle accident.3 Dr. Baxley 

diagnosed an exacerbation of chronic pain with no apparent injury after a motor vehicle accident.

A December 23, 2016 cervical MRI scan study showed degenerative disc disease with 

bilateral foramina encroachment at C4-5, C5-6, and C6-7. 

On October 20, 2017 Dr. Stoddard diagnosed cervical disc disorder with radiculopathy, 

bilateral carpal tunnel syndrome, and left radial tunnel syndrome. He advised that he had treated 

appellant for years for her carpal and radial tunnel syndrome and found that it limited her ability 

to perform heavy or repetitive labor. Dr. Stoddard also related that, “[Appellant] also has cervical 

disc pathology causing radiculitis in the upper extremities. I believe [that] this disables her from 

most heavy and medium occupations confining her to light duty only involving limited use of the 

upper extremities.”

4

In a September 28, 2017 statement, appellant noted that Dr. Deriso appeared unaware that 

she had a cervical condition causing radiculopathy. 

 

3

In a report dated April 24, 2017, Dr. Stoddard diagnosed degenerative cervical spinal stenosis and the sequela of 

a motor vehicle accident. 

4 A nurse practitioner evaluated appellant for neck, thoracic, and low back pain following a motor vehicle accident. 
4

By decision dated November 30, 2017, OWCP’s hearing representative affirmed the 

April 13, 2017 decision. She found that the opinion of Dr. Deriso represented the weight of the 

evidence and established that appellant had no further disability or residuals of her accepted 

employment injury. The hearing representative further determined that appellant had not 

established that the acceptance of her claim should be expanded to include additional conditions.

LEGAL PRECEDENT -- ISSUE 1

An employee seeking benefits under FECA5 has the burden of proof to establish the 

essential elements of his or her claim, including the fact that he or she 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.6 

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.7

When an employee claims that, a condition not accepted or approved by OWCP was due 

to an employment injury, he or she bears the burden of proof to establish that the condition is 

causally related to the employment injury.8 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 based on a complete factual and medical 

background, supporting such a causal relationship.9 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.10 

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.

ANALYSIS -- ISSUE 1

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

acceptance of her claim should be expanded to include additional conditions.

 

5 Supra note 2.

6 See C.W., Docket No. 17-1636 (issued April 25, 2018).

7 R.H., 59 ECAB 382 (2008).

8 See T.F., Docket No. 17-0645 (issued August 15, 2018).

9 See S.A., Docket No. 18-0399 (issued October 16, 2018).

10 See P.M., Docket No. 18-0287 (issued October 11, 2018).
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OWCP accepted that appellant sustained left lateral epicondylitis and bilateral carpal tunnel 

syndrome under OWCP File No. xxxxxx898, and cervical spondylosis at C5-6 under OWCP File 

No. xxxxxx898. 

In an August 15, 2016 report, Dr. Stoddard noted that appellant had numbness and pain in 

her left arm and worsening neck pain. He diagnosed possible spinal stenosis and left radiculopathy 

with degenerative changes. On October 20, 2017 Dr. Stoddard advised that appellant had work 

limitations from carpal and radial tunnel syndrome and cervical disc disorder with radiculopathy. 

He opined that she was totally disabled. Dr. Stoddard did not address whether the diagnosed 

conditions were causally related to the accepted employment incident. 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.11 Dr. Stoddard’s reports are thus 

insufficient to support that appellant’s accepted conditions should be expanded.12 The Board thus 

finds that she has not met her burden of proof.

On appeal appellant asserts that the acceptance of her claim should be expanded to include 

additional conditions. As set forth above, she has not submitted reasoned evidence from a 

physician, who, based on an accurate factual history, found that she had additional conditions 

causally related to her employment injuries, and thus has not met her burden of proof.13

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 and 20 C.F.R. 

§§ 10.605 through 10.607.

LEGAL PRECEDENT -- ISSUE 2

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

modification or termination of an employee’s benefits.14 After 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.15 Its burden of proof includes the necessity of furnishing rationalized medical 

opinion evidence based on a proper factual and medical background.16

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

entitlement for disability.17 To terminate authorization for medical treatment, OWCP must 

 

11 See L.B., Docket No. 18-0533 (issued August 27, 2018).

12 See L.G., Docket No. 18-0321 (issued October 25, 2018).

13 See H.R., Docket No. 18-0640 (issued December 6, 2018). 

14 M.M., Docket No. 17-1264 (issued December 3, 2018).

15 E.B., Docket No. 18-1060 (issued November 1, 2018).

16 G.H., Docket No. 18-0414 (issued November 14, 2018).

17 L.W., Docket No. 18-1372 (issued February 27, 2019).
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establish that appellant no longer has residuals of an employment-related condition, which would 

require further medical treatment.18

OWCP’s procedures provide as follows:

“The [claims examiner] is responsible for ensuring that the SOAF is correct, 

complete, unequivocal, and specific. When the [district medical adviser], second 

opinion specialist, or referee physician renders a medical opinion based on an 

SOAF which is incomplete or inaccurate or does not use the SOAF as the 

framework in forming his or her opinion, the probative value of the opinion is 

seriously diminished or negated altogether.”

19

ANALYSIS -- ISSUE 2

The Board finds that OWCP has not met its burden of proof to terminate appellant’s wageloss compensation and medical benefits, effective April 30, 2017.

OWCP referred appellant to Dr. Deriso for a second opinion examination to determine 

whether she had continued residuals or disability due to either of her accepted employment 

injuries. 

Initially, the Board notes that, in securing the opinion of a medical specialist, OWCP’s 

procedures provide that a SOAF and development questions are to be prepared by the claims 

examiner for use of the physician.20 The claims examiner is required to set forth the relevant facts 

of the case, including the employee’s date of injury, age, job held when injured, the mechanism of 

injury, and any conditions claimed or accepted by OWCP.21 OWCP provided Dr. Deriso with a 

SOAF that listed the accepted conditions as left lateral epicondylitis, bilateral carpal tunnel 

syndrome, and cervical spondylosis at C5-6.

In a report dated December 28, 2016, Dr. Deriso indicated that appellant had sustained a 

cervical sprain and an upper extremity condition causally related to factors of her federal 

employment. He diagnosed post left carpal tunnel syndrome, post left radial nerve release, a 

history of lateral and medial epicondylitis, a history of a cervical degenerative disc, and mild right 

carpal tunnel syndrome. Dr. Deriso advised that appellant had no current evidence of a right or 

left upper extremity condition or cervical condition. He discussed her history of degenerative 

changes in the cervical spine, but noted that if she had only experienced a sprain that would have 

resolved within weeks, and thus concluded that she had no cervical spine diagnosis. Dr. Deriso 

indicated that repetitive stress did not usually cause carpal or radial tunnel syndrome. As noted, 

however, OWCP had previously accepted as employment related the conditions of left lateral 

 

18 R.P., Docket No. 18-0900 (issued February 5, 2019).

19 Federal (FECA) Procedure Manual, Part 3 -- Medical, Requirements for Medical Reports, Chapter 3.600.3 

(October 1990).

20 Id. at Part 2 -- Claims, Statement of Accepted Facts, Chapter 2.809.3 (September 2009).

21 Id.
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epicondylitis, bilateral carpal tunnel syndrome, and cervical spondylosis at C5-6. Dr. Deriso found

that appellant had sustained only a cervical sprain and questioned OWCP’s acceptance of carpal 

tunnel syndrome. OWCP provided him with a SOAF to ensure that his report was based on a 

proper factual background.22 As Dr. Deriso’s opinion is outside the framework of the SOAF, it is 

based on an inaccurate history and, thus, of diminished probative value.23 Consequently, OWCP 

has not met its burden of proof to terminate appellant’s wage-loss compensation and medical 

benefits effective April 30, 2017.

CONCLUSION

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

acceptance of her claim should be expanded to include additional conditions. The Board further 

finds that OWCP has not met its burden of proof to terminate her wage-loss compensation and 

medical benefits, effective April 30, 2017.

ORDER

IT IS HEREBY ORDERED THAT the November 30, 2017 decision of the Office of 

Workers’ Compensation Programs is affirmed in part and reversed in part.

Issued: April 5, 2019

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

 

22 Supra note 18.

23 Supra note 17; E.W., Docket No. 17-0707 (issued September 18, 2017).