United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

V.T., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE,

Bergenfield, NJ, Employer

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Docket No. 18-0881

Issued: November 19, 2018

Appearances: Case Submitted on the Record

James D. Muirhead, Esq., for the appellant1

Office of Solicitor, for the Director

DECISION AND ORDER

Before:

CHRISTOPHER J. GODFREY, Chief Judge

PATRICIA H. FITZGERALD, Deputy Chief Judge

ALEC J. KOROMILAS, Alternate Judge

JURISDICTION

On March 19, 2018 appellant, through counsel, filed a timely appeal from a February 13, 

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 to consider the merits of the 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 arthritis 

and de Quervain’s tenosynovitis causally related to the accepted factors of his federal employment.

FACTUAL HISTORY

On November 17, 2016 appellant, then a 57-year-old letter carrier, filed an occupational 

disease claim (Form CA-2) alleging that he had developed left thumb and hand arthritis and 

de Quervain’s syndrome due to carrying mail in his left hand for almost 30 years. He noted that 

he first became aware of his claimed conditions on June 1, 2014 and first realized their relation to 

his federal employment on September 12, 2016. Appellant did not stop work.

By development letter dated December 14, 2016, OWCP requested that appellant provide 

additional factual and medical evidence in support of his claim. More specifically, it requested a 

medical report from his physician which set forth an opinion, supported by a medical explanation 

as to how work activities in his federal employment caused, contributed to, or aggravated his 

medical conditions. OWCP afforded him 30 days for a response.

Appellant provided a narrative statement and explained that as a letter carrier, he needed 

to carry envelopes in his left hand while delivering the mail. He described gripping a pile of 

envelopes in his left hand throughout his workday. Appellant alleged that he developed pain and 

weakness in his left hand as a result of this work activity and that he was diagnosed with arthritis 

and de Quervain’s syndrome.

On March 20, 2015 Dr. Jen F. Lee, a Board-certified orthopedic surgeon, performed a left 

thumb carpometacarpal (CMC) joint arthroplasty, transfer of the flexor carpi radialis tendon, 

de Quervain tendon release, and tenosynovectomy of the extensor tendon.

By decision dated February 3, 2017, OWCP accepted that the claimed employment factors

occurred as alleged, but denied appellant’s occupational disease claim finding that he had not 

submitted medical evidence establishing causal relationship between his diagnosed conditions and 

the accepted factors of his federal employment.

Counsel requested an oral hearing before an OWCP hearing representative on 

February 10, 2017.

Appellant testified at the July 26, 2017 hearing and described his employment duties. He 

alleged that to case mail he was required to hold between four and six inches of mail in his left 

hand at all times. Appellant noted this stretched his hand and required him to use pressure to hold 

the mail while placing it in the appropriate case. He then sorted the mail held in his left hand with 

his right. Appellant performed this duty for three hours a day. He also noted that to deliver the 

mail, hand bundles were required to be between four and six inches and he was also required to 

hold between four and six inches of magazines with his left arm.

In a report dated March 22, 2017, Dr. David Weiss, an osteopath Board-certified in 

orthopedic surgery, noted appellant’s diagnosed conditions of left thumb CMC joint arthritis and 

de Quervain’s tendinitis in his left extensor tendon. On physical examination he found no thenar 
3

or hypothenar atrophy, normal fist presentation, and no carpal instability on the left. Dr. Weiss 

diagnosed cumulative and repetitive trauma disorder, aggravation of age-related CMC joint 

arthropathy to the left thumb, and de Quervain’s tenosynovitis of the left thumb with resulting 

surgeries. He opined that the cumulative and repetitive occupational trauma sustained by appellant 

was the competent producing factor for his diagnosed conditions.

By decision dated August 31, 2017, OWCP’s hearing representative affirmed the denial of 

appellant’s occupational disease claim, finding that Dr. Weiss’ report did not provide medical 

rationale supporting his opinion that appellant’s diagnosed conditions were the result of his 

employment duties. He noted that Dr. Weiss made general reference to work tasks, but did not 

explain how specific work factors caused or aggravated the diagnosed conditions.

On November 17, 2017 appellant, through counsel, requested reconsideration of the 

August 31, 2017 decision and submitted a report from Dr. Weiss dated November 6, 2017. 

Dr. Weiss diagnosed osteoarthritis and degenerative joint disease of the left thumb CMC joint. He 

reported that osteoarthritis was believed to be caused by a mechanical stress on a joint and low 

grade inflammatory process. Dr. Weiss noted that osteoarthritis was characterized by worn 

cartilage and was a degenerative “wear and tear” process. He opined that it was reasonable to 

assume the more wear and tear on a joint, the greater the risk of osteoarthritis. Dr. Weiss explained 

that trauma and overuse could cause rapid development of osteoarthritis and that activities and 

jobs that placed high stress on the thumb joint were a noted risk factor for osteoarthritis at the base 

of the thumb. He noted that repetitive activities such as pinching and grasping could wear out the 

joint and cause an increase in inflammation leading to osteoarthritis. Dr. Weiss concluded that 

appellant experienced work-related injuries to his left thumb due to his work duties of casing mail 

with repetitive pinching and grasping.

By decision dated February 13, 2018, OWCP denied modification of its prior decision, 

finding that appellant had not provided rationalized medical opinion evidence sufficient to 

establish that the accepted factors of his federal employment caused or aggravated his diagnosed 

medical conditions. It therefore denied his claim.

LEGAL PRECEDENT

An employee seeking benefits under FECA3 has the burden of proof to establish the 

essential elements of his or her claim by the weight of the reliable, probative, and substantial 

evidence, 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, that 

an injury was sustained 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 an occupational disease.5

 

3

Id.

4 Kathryn Haggerty, 45 ECAB 383, 388 (1994).

5 K.B., Docket No. 17-1997 (issued July 27, 2018).
4

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 employment factors identified by the claimant were the 

proximate cause of the condition for which compensation is claimed or, stated differently, medical 

evidence establishing that the diagnosed condition is causally related to the employment factors 

identified by the claimant.

The evidence required to establish causal relationship is rationalized medical opinion 

evidence, based upon a complete factual and medical background, showing a causal relationship 

between the claimed condition and identified factors. The belief of a claimant that a condition was

caused or aggravated by the employment is not sufficient to establish causal relation.7 A medical

report is of limited probative value on a given medical question if it is unsupported by medical 

rationale.8 Medical rationale includes a physician’s rationalized opinion on the issue of whether 

these is a causal relationship between the claimant’s diagnosed condition and the implicated 

employment activity. The opinion of the physician must be based on a complete factual and 

medical background of the claim, 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 specific employment activity or factors identified by the claimant.9

ANALYSIS

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

arthritis and de Quervain’s tenosynovitis are causally related to the accepted factors of his federal 

employment. 

In support of his claim, appellant provided reports from Dr. Weiss. In his March 22, 2017 

report, Dr. Weiss attributed appellant’s diagnosed left thumb conditions to the cumulative and 

repetitive occupational trauma sustained by appellant. In this report he failed to identify the 

specific employment activities that he felt caused or contributed to appellant’s diagnosed 

conditions. Dr. Weiss also failed to provide a medically sound explanation of how the specific 

employment factors, physiologically, caused appellant’s conditions.10 As such this report is 

insufficient to establish appellant’s claim.

 

6 20 C.F.R. § 10.5(q).

7 Lourdes Harris, 45 ECAB 545, 547 (1994).

8 T.F., 58 ECAB 128 (2006).

9 A.D., 58 ECAB 149 (2006).

10 W.S., Docket No. 17-1769 (issued July 26, 2018).
5

In his November 6, 2017 report, Dr. Weiss noted that repetitive activities such as pinching 

and grasping could wear out the joint and cause an increase in inflammation leading to 

osteoarthritis. He concluded that appellant experienced work-related injuries to his left thumb due 

to his work duties of casing mail with repetitive pinching and grasping. Dr. Weiss further noted 

that osteoarthritis was believed to be caused by a mechanical stress on a joint and low grade 

inflammatory process and opined that it was reasonable to assume the more wear and tear on a 

joint, the greater the risk of osteoarthritis. His opinions in this report are speculative as he generally 

noted that repetitive activities “could” cause inflammation and that it was reasonable to “assume”

that repetitive activities would result in a greater risk of osteoarthritis. The opinion of a physician 

supporting causal relationship must not be speculative or equivocal.11 Dr. Weiss’ statement on 

causation also failed to provide a sufficient explanation as to the mechanism of injury pertaining 

to this occupational disease claim as alleged by appellant, namely, how specific duties of a letter 

carrier would cause and or aggravate the osteoarthritis in appellant’s left thumb CMC joint as 

opposed to the natural progression of the preexisting conditions.12 As he failed to provide a 

medically-sound explanation of how the specific employment factors, in particular 

physiologically, caused or aggravated appellant’s left hand conditions, this report is also 

insufficient to establish appellant’s claim.13

Appellant also submitted a report from Dr. Lee, which related that he had undergone a left 

thumb carpometacarpal joint arthroplasty, transfer of the flexor carpi radialis tendon, de Quervain 

tendon release, and tenosynovectomy of the extensor tendon on March 20, 2015. However, this 

report from Dr. Lee lacks probative value. The Board has explained 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

As appellant has not submitted rationalized medical opinion evidence sufficient to establish 

causal relationship, he has not met his burden of proof.15

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.

 

11 K.R., Docket No. 18-0711 (issued September 6, 2018);see also D.D., 57 ECAB 734, 738 (2006); Kathy A. Kelley,

55 ECAB 206 (2004).

12 Id.

13 Id.

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

15 Id.
6

CONCLUSION

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

arthritis and de Quervain’s tenosynovitis causally related to the accepted factors of his federal 

employment.

ORDER

IT IS HEREBY ORDERED THAT the February 13, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: November 19, 2018

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Alec J. Koromilas, Alternate Judge

Employees’ Compensation Appeals Board