United States Department of Labor

Employees’ Compensation Appeals Board

__________________________________________

S.H., Appellant

and

U.S. POSTAL SERVICE, POST OFFICE, 

Chicago, IL, Employer

__________________________________________

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Docket No. 18-1398

Issued: March 12, 2019

Appearances: Case Submitted on the Record

Alan J. Shapiro, 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

VALERIE D. EVANS-HARRELL, Alternate Judge

JURISDICTION

On July 10, 2018 appellant, through counsel, filed a timely appeal from a March 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.3

 

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.

3 The Board notes that appellant submitted additional evidence on appeal. However, the Board’s Rules of Procedure 

provides: “The Board’s review of a case is limited to the evidence in the case record that was before OWCP at the 

time of its final decision. Evidence not before OWCP will not be considered by the Board for the first time on appeal.” 

20 C.F.R. § 501.2(c)(1). Thus, the Board is precluded from reviewing this additional evidence for the first time on 

appeal. Id. 
2

ISSUE

The issue is whether appellant has met her burden of proof to establish a recurrence of total 

disability for the period July 27 through November 3, 2017, causally related to her accepted 

bilateral carpal tunnel syndrome condition. 

FACTUAL HISTORY

On November 17, 2016 appellant, then a 40-year-old maintenance operation support clerk, 

filed an occupational disease claim (Form CA-2) alleging that she developed bilateral carpal tunnel 

syndrome as a result of her repetitive employment duties. She noted that she had also worked as 

a labor custodian. Appellant related that both jobs required constant carrying, lifting, gripping, 

pushing, and pulling for eight hours a day, five to six days a weeks. She indicated that she first 

became aware of her claimed condition on May 12, 2014 and first realized it was related to her 

federal employment on October 4, 2016. Appellant did not stop work. 

By decision dated March 13, 2017, OWCP accepted appellant’s claim for bilateral carpal 

tunnel syndrome. 

Appellant received medical treatment from Dr. Ankur Chhadia, a Board-certified 

orthopedic surgeon. In reports dated March 24 and June 20, 2017, Dr. Chhadia related appellant’s 

complaints of worsening pain and numbness and tingling in her fingers. He noted that appellant 

performed repetitive work as a labor custodian and maintenance clerk, including sweeping, 

mopping, pulling trash, lifting, and pulling. Physical examination of appellant’s bilateral wrists 

revealed no tenderness upon palpation, normal alignment, and no effusion. Tinel’s, Phalen’s, and 

carpal tunnel compression tests were positive on both sides. Dr. Chhadia related that an 

electromyography (EMG) and nerve conduction velocity (NCV) study report showed moderate 

carpal tunnel syndrome. He diagnosed bilateral carpal tunnel syndrome and recommended that 

appellant work light duty with restrictions of no driving and no lifting more than five pounds. 

In a July 24, 2017 work duty status form and a duty status report (Form CA-17),

Dr. Chhadia marked a box indicating that appellant was “medically unable to work due to pain and 

inability to perform job duties.” He noted a date of injury of May 12, 2014 and a diagnosis of 

bilateral carpal tunnel syndrome. 

On August 3, 2017 appellant filed a claim for wage-loss compensation (Form CA-7) for 

the period July 24 to August 4, 2017. In an accompanying time analysis form, she claimed four

hours of leave without pay (LWOP) on July 24, 2017 and indicated the reason for leave was 

physical therapy. Appellant also claimed four hours of daily LWOP for the period July 27 through

31, 2017. She noted the reason for leave as “unable to work; drs orders.” Appellant filed 

additional Form CA-7 claims for compensation for wage-loss due to continuing total disability 

until November 13, 2017.4

On August 4, 2017 appellant called OWCP and informed them that she had been taken off 

work by her attending physician due to a worsening of her accepted condition. 

 

4 Appellant filed CA-7 forms on August 23 and25, September 14 and 28, October 27, and November 13, 2017. In

accompanying time analysis forms, she indicated that her reason to use leave was “unable to work; drs. orders.”
3

By development letter dated August 7 and September 13, 2017, OWCP advised appellant 

of the type of evidence needed to establish her wage-loss compensation claim for the period 

beginning July 24, 2017 and continuing. OWCP afforded appellant 30 days to submit the 

necessary evidence. 

OWCP received a July 24, 2017 report by Dr. Chhadia. Dr. Chhadia related that appellant 

complained of increasing and more frequent bilateral wrist pain and weakness in her bilateral 

hands. Upon physical examination of appellant’s bilateral wrists, he observed no tenderness upon 

palpation. Tinel’s, Phalen’s, and carpal tunnel compression tests were positive on both sides. 

Dr. Chhadia diagnosed bilateral carpal tunnel syndrome. Regarding appellant’s work status, he

noted “off work.”

In an August 16, 2017 letter, Dr. Chhadia responded to OWCP’s request for additional 

evidence. He related that he was treating appellant for bilateral carpal tunnel syndrome. 

Dr. Chhadia indicated that she was working with limited-duty restrictions on July 24, 2017. He 

explained that appellant had “significant deterioration of her condition,” including symptoms 

radiating up to her forearms and dropping things, dysfunction in gripping, and sensitivity about 

her wrists and hands. Dr. Chhadia reported: “based on the deterioration of subjective and 

objective physical exam[ination] findings, I recommend she be medically incapacitated from work 

for a period of time as part of her overall status and treatment regimen.”

Dr. Chhadia continued to treat appellant. In examination reports dated August 25 and 

September 19, 2017, he discussed her medical treatment for her bilateral carpal tunnel syndrome. 

Dr. Chhadia provided examination findings and diagnosed bilateral carpal tunnel syndrome. He

reiterated that appellant had experienced significant deterioration of her bilateral carpal tunnel 

syndrome, including symptoms radiating up to her forearms, beginning to drop things, dysfunction 

in gripping and sensitivity about her wrists and hands, and weakened grip. Dr. Chhadia opined 

that she was “medically incapacitated from work for a period of time effective [July 24, 2017]

including August 5 through September 1, 2017.” He completed form reports, which indicated that 

appellant was “medically unable to work due to pain and inability to perform job duties.”

A September 26, 2017 EMG/NCV study report showed evidence of mild-to-moderate left 

and moderate right median neuropathy in its wrist segment. 

In a September 30, 2017 letter, Dr. Chhadia indicated that appellant’s current symptoms 

were numbness, tingling, throbbing, pressure, and pain in her hand and wrist. He reported current 

examination findings of tenderness to palpation, and positive peripheral neuropathy, compression 

signs, Tinel’s, Phalen’s, and carpal compression tests. Dr. Chhadia diagnosed bilateral carpal 

tunnel syndrome, as confirmed by EMG/NCV study. Regarding appellant’s renewed disability 

from work, he indicated that initially appellant was working full duty and her condition began to 

“deteriorate subjectively and objectively in terms of her numbness, grip strength, and function.” 

Addressing causal relationship, Dr. Chhadia reported that appellant’s bilateral carpal tunnel 

condition was stable and controlled and began to “become progressively worse and deteriorate in 

nature. It is clearly related to her occupational diagnosed conditions and not a separate unrelated 

worsening.”

On October 6, 2017 OWCP received appellant’s completed questionnaire dated 

September 28, 2017. Appellant described that, on July 24, 2017, she was given an excessive 

amount of work that required excessive typing. She indicated that her hands began to cramp and 
4

she could not straighten her fingers. Appellant related that she was in a lot of pain and left work 

to obtain medical treatment. She explained that she believed her disability was due to her original 

injury because the injury occurred while she was working and the symptoms were similar. 

By decision dated October 18, 2017, OWCP denied appellant’s claim for wage-loss 

compensation due to total disability for the period July 27 2017 and continuing.5 It found that the 

medical evidence of record was insufficient to establish that she was disabled from work due to a 

material change or worsening of her accepted bilateral carpal tunnel condition. 

Following OWCP’s decision, appellant filed CA-7 forms on October 27 and November 13, 

2017 for wage-loss compensation due to total disability for the period October 13 to 

November 3, 2017. In the accompanying time analysis forms, she claimed eight hours of daily 

LWOP from October 14 through 16 and 19, through 23, 2017 and indicated the reason for leave 

use was “due to doctors restriction.” Appellant claimed eight hours of daily LWOP from 

October 26 through 30, 2017. She related that the reason for using leave was “no work available.” 

Appellant claimed eight hours of daily LWOP on November 2 and 3, 2017 due to “wounded 

warrior leave/physical therapy.”

In an October 25, 2017 examination report, Dr. Chhadia discussed appellant’s history of 

injury and conducted an examination. He diagnosed bilateral carpal tunnel syndrome and 

indicated that appellant could work light duty. Dr. Chhadia continued to opine that appellant was 

“medically incapacitated from work for a period of time effective [July 24, 2017] including 

August 5 through September 1, 2017.” He completed a duty status report (Form CA-17), which 

indicated that appellant could work full-time light duty with restrictions of no driving, no lifting 

more than five pounds, and no typing for more than one hour every two hours. 

OWCP received an October 27, 2017 request or notification of absence by the employing 

establishment, which noted that there was “no work available” from October 26 to 27, 2017. 

On an October 30, 2017 duty status report, Dr. Chhadia checked a box marked “Light 

Duty.” He noted a diagnosis of bilateral carpal tunnel syndrome. 

On November 1, 2017 the employing establishment offered appellant a job as a full-time 

modified maintenance support clerk, effective that date. Appellant accepted the modified job offer 

on November 3, 2017. 

On November 2, 2017 the employing establishment informed OWCP that appellant was 

scheduled to return to work full time with restrictions on November 12, 2017 in a new position 

based on the updated restrictions. 

The employing establishment called OWCP on November 9, 2017 and confirmed that no 

work was available for appellant for October 26 and 27, 2017. It further noted that she remained 

on leave using “wounded warrior” leave until November 9, 2017 when she was to return to work. 

In a November 8, 2017 letter, Dr. Chhadia related that his examination reports dated 

March 1, August 22, and September 30, 2017 provided a detailed description of the original 

 

5 The Board notes that OWCP noted an incorrect period of July 27, 2017 through July 4, 2017. The incorrect 

notation appears to be a typographical error. 
5

mechanism of appellant’s occupational exposure and symptoms, current objective findings and 

diagnostic study results, and a current diagnosis of bilateral carpal tunnel syndrome. Addressing 

appellant’s work stoppage, he noted that she was now off work given the deterioration in her 

clinical course and condition. Dr. Chhadia reported that she had significant weakness, sensitivity, 

numbness, tingling, and altered sensation in her hands. He explained: “This spontaneous change 

is a gradual deterioration of [appellant’s] condition in her clinical course such that her probability 

of requiring surgical carpal tunnel release is increasing and recommended.”

On November 28, 2017 appellant requested reconsideration and resubmitted various 

reports by Dr. Chhadia. 

By decision dated March 1, 2018, OWCP denied modification of its October 18, 2017 

denial decision. It found that the medical reports submitted did not sufficiently explain how 

appellant was disabled from work for the period July 27 to November 3, 2017 due to a material 

change or worsening of her accepted bilateral carpal tunnel condition.

LEGAL PRECEDENT

A recurrence of disability means an inability to work after an employee has returned to 

work, caused by a spontaneous change in a medical condition, which had resulted from a previous 

injury or illness without an intervening injury or new exposure to the work environment that caused 

the illness.6 This term also means an inability to work when a light-duty assignment made 

specifically to accommodate an employee’s physical limitations due to the work-related injury or 

illness is withdrawn (except when such withdrawal occurs for reasons of misconduct, 

nonperformance of job duties, or a reduction-in-force), or when the physical requirements of such 

an assignment are altered such that they exceed his or her established physical limitations.7 

When an employee, who is disabled from the job he or she held when injured on account 

of employment-related residuals, returns to a light-duty position, or the medical evidence of record 

establishes that light duty can be performed, the employee has the burden of proof to establish by

the weight of the reliable, probative, and substantial evidence a recurrence of total disability. As 

part of this burden, the employee must show either a change in the nature and extent of the injuryrelated condition, or a change in the nature and extent of the light-duty requirements.8

 

An employee who claims a recurrence of disability resulting from an accepted employment 

injury has the burden of proof to establish that the disability is causally related to the accepted 

injury. This burden requires furnishing medical evidence from a physician who, on the basis of a 

complete and accurate factual and medical history, concludes that the disabling condition is 

causally related to the employment injury and supports that conclusion with sound medical 

reasoning.9 

 

6 20 C.F.R. § 10.5(x); see Theresa L. Andrews, 55 ECAB 719 (2004).

7

Id. 

8 Albert C. Brown, 52 ECAB 152 (2000); Mary A. Howard, 45 ECAB 646 (1994); Terry R. Hedman, 38 ECAB 

222 (1986).

9 S.S., 59 ECAB 315 (2008); Ronald A. Eldridge, 53 ECAB 218 (2001).
6

ANALYSIS

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

total disability for the period July 27 through October 25, 2017, causally related to her accepted 

bilateral carpal tunnel condition. 

The medical evidence relevant to the claimed recurrence of disability includes medical 

reports by Dr. Chhadia. In a July 24, 2017 examination report, Dr. Chhadia noted physical 

examination findings of no tenderness upon palpation. Tinel’s, Phalen’s, and carpal tunnel 

compression tests were positive on both sides for carpal tunnel. Dr. Chhadia diagnosed bilateral 

carpal tunnel syndrome. He completed a work-duty status and Form CA-17 and related that 

appellant was “medically unable to work due to pain and inability to perform job duties.” The 

Board finds, however, that Dr. Chhadia did not provide a fully-rationalized explanation as to why 

appellant was suddenly unable to perform her light-duty position on July 24, 2017. Specifically,

Dr. Chhadia did not provide objective findings to demonstrate how appellant’s accepted injuries 

had worsened to the point of disability, but rather he merely attributed her inability to work to 

subjective complaints of pain. When a physician’s statements regarding an employee’s ability to 

work consist only of repetition of the employee’s complaints that he or she hurt too much to work, 

without objective findings of disability being shown, the physician has not presented a medical 

opinion on the issue of disability.10 This report, therefore, failed to establish appellant’s inability 

to work on July 24, 2017.

Dr. Chhadia further related in letters and work status reports dated August 16 to 

November 8, 2017 that appellant was working limited duty and had a “significant deterioration of 

her condition, including symptoms radiating up to her forearms, dysfunction in gripping and 

sensitivity about her wrists and hands, and weakened grip. He opined that appellant was 

“medically incapacitated from work for a period of time effective [July 24, 2017] including 

August 5 through September 1, 2017.” Although Dr. Chhadia related that appellant’s inability to 

work was a result of “significant deterioration” of appellant’s accepted bilateral carpal tunnel 

condition, he failed to provide any medical explanation, based on medical rationale, as to how her 

bilateral carpal tunnel condition had materially changed or worsened to the extent that she was 

unable to work.11 A mere conclusion without the necessary rationale is insufficient to meet a 

claimant’s burden of proof.12 Without rationale supporting disability, Dr. Chhadia’s reports are 

insufficient to meet appellant’s burden of proof.13 

For each period of disability claimed, an employee has the burden of proof to establish a 

causal relationship between his or her recurrence of disability and his or her accepted employment 

injury.14 Because appellant has not submitted sufficient medical evidence demonstrating that she 

was unable to work from July 27 to October 25, 2017 due to a spontaneous change or worsening 

 

10 P.D., Docket No. 14-744 (issued August 6, 2014); G.T., 59 ECAB 447 (2008).

11 See C.C., Docket No. 18-719 (issued November 9, 2018); S.E., Docket No. 17-1549 (issued July 6, 2018).

12 See E.L., Docket No. 17-1632 (issued January 3, 2018).

13 See K.A., Docket No. 16-0592 (issued October 26, 2016).

14 Amelia S. Jefferson, 57 ECAB 183 (2005); William A. Archer, 55 ECAB 674 (2004).
7

of her accepted bilateral carpal tunnel condition, the Board finds that she has not met her burden 

of proof in this case with regard to that claimed period.

The Board further finds that the evidence of record establishes that there was no work

available within appellant’s restrictions on October 26 and 27, 2017. OWCP received an 

October 27, 2017 request or notification of absence by the employing establishment, which noted 

that there was “no work available” from October 26 to 27, 2017. The employing establishment 

again confirmed during a telephone call with OWCP on November 9, 2017 that no work was 

available for appellant on October 26 and 27, 2017. Because the employing establishment has 

confirmed that it was unable to accommodate appellant’s work restrictions, the Board must remand 

the case for OWCP to issue appropriate wage-loss compensation for the period October 26 

to 27, 2017.15 

For the remaining period October 28 to November 3, 2017, the Board finds the case not in 

posture for decision as the record lacks sufficient information to determine whether there was work 

available within appellant’s restrictions. The evidence of record demonstrated that on 

November 3, 2017 appellant accepted an offer of employment to work as a full-time modified 

maintenance support clerk, effective November 1, 2017. In addition, on November 2, 2017 the 

employing establishment informed OWCP that appellant was scheduled to return to work full time 

with restrictions on November 12, 2017. The Board finds that it is unclear from the record whether 

the employing establishment was able to accommodate appellant’s work restrictions for the period 

October 28 to November 3, 2017.16 Accordingly, the Board will remand the case for OWCP to 

make factual findings regarding whether there was work available within appellant’s restrictions 

from October 28 through November 3, 2017. After this and other such further development as 

deemed necessary, OWCP shall issue a de novo decision. 

CONCLUSION

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

total disability for the period July 27 to October 25, 2017, due to her accepted bilateral carpal 

tunnel condition. The Board further finds, however, that appellant has established entitlement to 

wage-loss compensation for the period October 26 to 27, 2017 and that the case is not in posture 

for decision regarding her entitlement to wage-loss compensation for the period October 28 to 

November 3, 2017. 

 

15 See D.V., Docket No. 17-1344 (issued March 19, 2018).

16 See T.A., Docket No. 18-0431 (issued November 7, 2018); see also T.M., Docket No. 17-1552 (issued 

July 10, 2018).
8

ORDER

IT IS HEREBY ORDERED THAT the March 1, 2018 decision of the Office of Workers’

Compensation Programs is affirmed in part, as modified, and set aside in part. The case is 

remanded for further action consistent with this decision.

Issued: March 12, 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