United States Department of Labor

Employees’ Compensation Appeals Board

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R.R., Appellant

and

DEPARTMENT OF THE ARMY,TACOM FMX, 

Fort Leonard Wood, MO, Employer

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Docket No. 19-0714

Issued: August 8, 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

JANICE B. ASKIN, Judge

JURISDICTION

On February 19, 2019 appellant filed a timely appeal from a November 23, 2018 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 has met his burden of proof to establish bilateral carpal 

tunnel syndrome and left trigger thumb causally related to the accepted factors of his federal 

employment.

FACTUAL HISTORY

On May 11, 2018 appellant, then a 52-year-old small arms repairer, filed an occupational 

disease claim (Form CA-2) alleging that he sustained bilateral carpal tunnel syndrome due to 

 

1 5 U.S.C. § 8101 et seq.
2

factors of his federal employment including intense repetitive motions when servicing weapons. 

He noted that he first became aware of his claimed condition on August 15, 2016 and first realized 

that his condition was caused or aggravated by his federal employment on May 12, 2017. In a 

statement, appellant attributed his condition to repetitive motions, used approximately 40 to 60 

times per day, while performing services equaling five hours per day, five days a week, on 

approximately 150 weapons per week.

In a report dated May 12, 2017, Dr. Stephen Williamson, Board-certified in occupational 

medicine, diagnosed bilateral carpal tunnel syndrome and left trigger thumb and advised appellant

to wear a splint at night and gloves. Additionally, in an examination report dated October 16, 

2017, Dr. Mohammad Choudhary, a Board-certified neurologist, reviewed an electromyogram and 

nerve conduction velocity (EMG/NCV) study and concluded that appellant’s condition was 

consistent with bilateral carpal tunnel syndrome.

In a development letter dated May 17, 2018, OWCP advised appellant of the factual and 

medical deficiencies of his claim. It provided a questionnaire for his completion to establish the 

employment factors alleged to have caused or contributed to his medical condition and requested 

a medical report from his attending physician explaining how and why his federal work activities 

caused, contributed to, or aggravated his medical condition. In a separate development letter of 

even date, OWCP requested that the employing establishment provide additional information 

regarding appellant’s occupational disease claim, including comments from a knowledgeable 

supervisor regarding the accuracy of appellant’s statements, and a copy of appellant’s position 

description and physical requirements of his position. It afforded him and the employing 

establishment 30 days to submit the necessary evidence.

On May 23, 2018 C.S., appellant’s supervisor, submitted a letter providing a description 

of appellant’s work activities, work environment, and relevant precautions implemented in the 

performance of these tasks. He indicated that appellant’s work activities required him to turn the 

barrel of different rifles with moderate effort to ensure each barrel was secure. C.S. estimated that 

each repairman services approximately 40 rifles per day. He noted that each repairman is also 

provided mechanic gloves, hearing protection gear, eye protection goggles, steel toe boots, as well 

as two 15-minute breaks and a half-hour lunch break as precautionary measures.

By decision dated June 18, 2018, OWCP denied appellant’s claim finding that the evidence 

submitted was insufficient to establish that his diagnosed medical conditions were causally related 

to the accepted factors of his federal employment. It concluded, therefore, that he had not met the 

requirements to establish an employment-related injury or condition.

OWCP continued to receive medical evidence. In a progress note dated June 27, 2017,

Dr. Charles S. Harriman, a Board-certified family practitioner, noted that appellant presented with 

complaints of bilateral hand pain that was getting worse. He also noted that appellant had difficulty 

grasping at work and had developed a nodular mass along his distal second flexor tendon. In a 

progress note dated September 28, 2017, Dr. Victoria Kubik, a Board-certified orthopedic 

surgeon, noted that appellant presented with bilateral hand numbness and tingling consistent with 

carpal tunnel syndrome.
3

On August 16, 2018 appellant requested reconsideration and submitted new evidence in 

support of his claim.

In a July 12, 2017 report, Dr. Harriman opined that appellant’s condition was caused by 

the recurrent forceful hand and wrist manipulation experienced during the performance of his work 

duties and not related to any other discovered personal activities. Appellant also provided

Dr. Harriman’s June 13, 2018 progress notes, which detailed his job duties, as described to

Dr. Harriman. In a work restriction report dated July 12, 2018, Dr. Harriman limited appellant to 

no lifting over 15 pounds and no twisting or flexing of his wrists for 30 days.

By decision dated November 23, 2018, OWCP denied modification of its prior decision 

finding that appellant had not submitted rationalized medical evidence establishing causal 

relationship between his diagnosed conditions and the accepted factors of his federal employment.

LEGAL PRECEDENT

An employee seeking benefits under FECA2 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

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.6

 

2 Supra note 1.

3 S.C., Docket No. 18-1242 (issued March 13, 2019); S.B., Docket No. 17-1779 (issued February 7, 2018); J.P., 59 

ECAB 178 (2007); Joe D. Cameron, 41 ECAB 153 (1989).

4 S.C., id.; 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 S.C., id.; 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 C.D., Docket No. 17-2011 (issued November 6, 2018); Jacquelyn L. Oliver, 48 ECAB 232, 235-36 (1996).
4

Causal relationship is a medical issue and the medical evidence required to establish causal 

relationship is rationalized medical opinion evidence.7 Rationalized medical opinion evidence is 

medical evidence which includes a physician’s rationalized opinion on the issue of whether there 

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

factors. 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.8

ANALYSIS

The Board finds that appellant has not met his burden of proof to establish bilateral carpal 

tunnel syndrome and left trigger thumb causally related to the accepted factors of his federal

employment.

In his July 12, 2018 medical report, Dr. Harriman concluded that appellant’s condition was 

caused by his job tasks and was not related to any other discovered external activities. He 

specifically opined that appellant’s bilateral carpal tunnel syndrome is “without doubt and as a 

statement of medical fact caused by the recurrent forceful hand and wrist manipulation experienced 

during the performance of his assigned duties.” While Dr. Harriman supported causal relationship, 

he did not identify specific work duties which allegedly caused or contributed to appellant’s 

bilateral carpal tunnel syndrome nor did he offer medical rationale explaining how and why he 

opined that appellant’s work activities could result in the diagnosed conditions. The Board has 

frequently explained that conclusory medical opinions are entitled to little probative weight and 

are insufficient to support a causal relationship claim.9 Appellant also submitted reports of

Dr. Harriman dated July 12, 2017, and June 13 and 27, 2018 which do not contain and opinion on 

causal relationship. 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.10 For these reasons, Dr. Harriman’s reports are insufficient to establish a causal 

relationship.

In his May 12, 2017 report, Dr. Williamson made note of appellant’s bilateral hand pain 

and advised that he wear gloves and a splint at night. However, he did not opine as to the cause 

of appellant’s condition. As noted medical evidence that does not offer an opinion on causal 

relationship is of no probative value.11 Therefore, Dr. Williamson’s report is insufficient to 

establish appellant’s claim.

 

7 M.B., Docket No. 17-1999 (issued November 13, 2018).

8 M.L., Docket No. 18-1605 (issued February 26, 2019).

9 M.E., Docket No. 18-0330 (issued September 14, 2018); A.D., 58 ECAB 149 (2006).

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

11 Id. 
5

Similarly, Dr. Choudhary found in his October 16, 2017 examination report that the 

EMG/NCV study performed on that date demonstrated that appellant’s condition was consistent 

with bilateral carpal tunnel syndrome. He did not address causal relationship between appellant’s 

bilateral carpal tunnel syndrome and the factors of his federal employment. As such,

Dr. Choudhary’s report is also of no probative value on the issue of causal relationship.12

In her September 28, 2017 progress note, Dr. Kubik noted bilateral hand numbness and

tingling consistent with carpal tunnel syndrome. However, she did not opine as to the cause of 

appellant’s condition. As noted above, 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.13

As appellant has not submitted rationalized medical evidence establishing that his bilateral 

carpal tunnel syndrome and left trigger thumb is causally related to the accepted factors of his 

federal employment, the Board finds that he has not met his burden of proof to establish his claim.

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 bilateral carpel 

tunnel syndrome and left trigger thumb causally related to the accepted factors of his federal 

employment.

 

12 Id.

13 Id.
6

ORDER

IT IS HEREBY ORDERED THAT the November 23, 2018 decision of the Office of 

Workers’ Compensation Programs is affirmed.

Issued: August 8, 2019

Washington, DC

Christopher J. Godfrey, Chief Judge

Employees’ Compensation Appeals Board

Patricia H. Fitzgerald, Deputy Chief Judge

Employees’ Compensation Appeals Board

Janice B. Askin, Judge

Employees’ Compensation Appeals Board